|
HC IRRIGATION OF BLADDER
|
Facility
|
IP
|
$361.15
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.91 |
| Max. Negotiated Rate |
$325.04 |
| Rate for Payer: Aetna American Axle |
$234.75
|
| Rate for Payer: Aetna Commercial |
$306.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.75
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$252.81
|
| Rate for Payer: Cofinity Commercial |
$310.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$252.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: PHP Commercial |
$306.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health SBD |
$227.52
|
| Rate for Payer: UMR Bronson Commercial |
$158.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.86
|
|
|
HC IRRIGATION OF BLADDER
|
Facility
|
OP
|
$361.15
|
|
|
Service Code
|
CPT 51700
|
| Hospital Charge Code |
76100188
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$667.69 |
| Rate for Payer: Aetna American Axle |
$234.75
|
| Rate for Payer: Aetna Commercial |
$306.98
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$234.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cash Price |
$288.92
|
| Rate for Payer: Cofinity Commercial |
$310.59
|
| Rate for Payer: Cofinity Commercial |
$252.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$252.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$288.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$325.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.86
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$306.98
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$306.98
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$234.75
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$227.52
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$453.31
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: UMR Bronson Commercial |
$133.63
|
| Rate for Payer: VA VA |
$237.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.86
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
OP
|
$18.07
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.69 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna American Axle |
$11.75
|
| Rate for Payer: Aetna Commercial |
$15.36
|
| Rate for Payer: Aetna Medicare |
$9.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.75
|
| Rate for Payer: BCBS Complete |
$7.23
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$12.65
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: PHP Commercial |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: Priority Health SBD |
$11.38
|
| Rate for Payer: UMR Bronson Commercial |
$6.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.55
|
|
|
HC IRRIGATION SLEEVE
|
Facility
|
IP
|
$18.07
|
|
| Hospital Charge Code |
27000119
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$16.26 |
| Rate for Payer: Aetna American Axle |
$11.75
|
| Rate for Payer: Aetna Commercial |
$15.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.75
|
| Rate for Payer: Cash Price |
$14.46
|
| Rate for Payer: Cofinity Commercial |
$12.65
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.46
|
| Rate for Payer: Healthscope Commercial |
$16.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.36
|
| Rate for Payer: PHP Commercial |
$15.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.75
|
| Rate for Payer: Priority Health SBD |
$11.38
|
| Rate for Payer: UMR Bronson Commercial |
$7.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.55
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
IP
|
$1,959.74
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$862.29 |
| Max. Negotiated Rate |
$1,763.77 |
| Rate for Payer: Aetna American Axle |
$1,273.83
|
| Rate for Payer: Aetna Commercial |
$1,665.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.83
|
| Rate for Payer: Cash Price |
$1,567.79
|
| Rate for Payer: Cofinity Commercial |
$1,371.82
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,371.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.79
|
| Rate for Payer: Healthscope Commercial |
$1,763.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,371.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.78
|
| Rate for Payer: PHP Commercial |
$1,665.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.83
|
| Rate for Payer: Priority Health SBD |
$1,234.64
|
| Rate for Payer: UMR Bronson Commercial |
$862.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.81
|
|
|
HC IR SELECTIVE EACH ADDITION VESSEL
|
Facility
|
OP
|
$1,959.74
|
|
|
Service Code
|
CPT 75774
|
| Hospital Charge Code |
32000200
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$1,763.77 |
| Rate for Payer: Aetna American Axle |
$1,273.83
|
| Rate for Payer: Aetna Commercial |
$1,665.78
|
| Rate for Payer: Aetna Medicare |
$979.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,273.83
|
| Rate for Payer: BCBS Complete |
$783.90
|
| Rate for Payer: Cash Price |
$1,567.79
|
| Rate for Payer: Cash Price |
$1,567.79
|
| Rate for Payer: Cofinity Commercial |
$1,685.38
|
| Rate for Payer: Cofinity Commercial |
$1,371.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,371.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,567.79
|
| Rate for Payer: Healthscope Commercial |
$1,763.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,371.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,469.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,665.78
|
| Rate for Payer: PHP Commercial |
$1,665.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,273.83
|
| Rate for Payer: Priority Health SBD |
$1,234.64
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$725.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,469.81
|
|
|
HC IR SHEATH
|
Facility
|
OP
|
$234.09
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.61 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna American Axle |
$152.16
|
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna Medicare |
$117.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.16
|
| Rate for Payer: BCBS Complete |
$93.64
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$163.86
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: Priority Health SBD |
$147.48
|
| Rate for Payer: UMR Bronson Commercial |
$86.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC IR SHEATH
|
Facility
|
IP
|
$234.09
|
|
| Hospital Charge Code |
27200314
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$103.00 |
| Max. Negotiated Rate |
$210.68 |
| Rate for Payer: Aetna American Axle |
$152.16
|
| Rate for Payer: Aetna Commercial |
$198.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.16
|
| Rate for Payer: Cash Price |
$187.27
|
| Rate for Payer: Cofinity Commercial |
$163.86
|
| Rate for Payer: Cofinity Commercial |
$201.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.27
|
| Rate for Payer: Healthscope Commercial |
$210.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.98
|
| Rate for Payer: PHP Commercial |
$198.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.16
|
| Rate for Payer: Priority Health SBD |
$147.48
|
| Rate for Payer: UMR Bronson Commercial |
$103.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.57
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
IP
|
$729.07
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$320.79 |
| Max. Negotiated Rate |
$656.16 |
| Rate for Payer: Aetna American Axle |
$473.90
|
| Rate for Payer: Aetna Commercial |
$619.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.90
|
| Rate for Payer: Cash Price |
$583.26
|
| Rate for Payer: Cofinity Commercial |
$510.35
|
| Rate for Payer: Cofinity Commercial |
$627.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$510.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.26
|
| Rate for Payer: Healthscope Commercial |
$656.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$510.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.71
|
| Rate for Payer: PHP Commercial |
$619.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.90
|
| Rate for Payer: Priority Health SBD |
$459.31
|
| Rate for Payer: UMR Bronson Commercial |
$320.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.80
|
|
|
HC IR SHUNTOGRAM PREVIOUS SHUNT
|
Facility
|
OP
|
$729.07
|
|
|
Service Code
|
CPT 75809
|
| Hospital Charge Code |
32000202
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$656.16 |
| Rate for Payer: Aetna American Axle |
$473.90
|
| Rate for Payer: Aetna Commercial |
$619.71
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$583.26
|
| Rate for Payer: Cash Price |
$583.26
|
| Rate for Payer: Cofinity Commercial |
$627.00
|
| Rate for Payer: Cofinity Commercial |
$510.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$510.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$583.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$656.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$510.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.80
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.71
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$619.71
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.90
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$459.31
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$269.76
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.80
|
|
|
HC IR SIALOGRAM
|
Facility
|
IP
|
$583.28
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$256.64 |
| Max. Negotiated Rate |
$524.95 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: UMR Bronson Commercial |
$256.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC IR SIALOGRAM
|
Facility
|
OP
|
$583.28
|
|
|
Service Code
|
CPT 70390
|
| Hospital Charge Code |
32000025
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$663.58 |
| Rate for Payer: Aetna American Axle |
$379.13
|
| Rate for Payer: Aetna Commercial |
$495.79
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cash Price |
$466.62
|
| Rate for Payer: Cofinity Commercial |
$501.62
|
| Rate for Payer: Cofinity Commercial |
$408.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$524.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.46
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.79
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$495.79
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.13
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$367.47
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$215.81
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.46
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
OP
|
$975.38
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$360.89 |
| Max. Negotiated Rate |
$1,901.18 |
| Rate for Payer: Aetna American Axle |
$634.00
|
| Rate for Payer: Aetna Commercial |
$829.07
|
| Rate for Payer: Aetna Medicare |
$702.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$844.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$844.25
|
| Rate for Payer: BCBS Complete |
$380.12
|
| Rate for Payer: BCBS MAPPO |
$675.40
|
| Rate for Payer: BCN Medicare Advantage |
$675.40
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cofinity Commercial |
$838.83
|
| Rate for Payer: Cofinity Commercial |
$682.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$682.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$675.40
|
| Rate for Payer: Healthscope Commercial |
$877.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$682.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$731.53
|
| Rate for Payer: Mclaren Medicaid |
$362.01
|
| Rate for Payer: Mclaren Medicare |
$675.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$709.17
|
| Rate for Payer: Meridian Medicaid |
$380.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$776.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.07
|
| Rate for Payer: PACE Medicare |
$641.63
|
| Rate for Payer: PACE SWMI |
$675.40
|
| Rate for Payer: PHP Commercial |
$829.07
|
| Rate for Payer: PHP Medicare Advantage |
$675.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$362.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.00
|
| Rate for Payer: Priority Health Medicare |
$675.40
|
| Rate for Payer: Priority Health SBD |
$614.49
|
| Rate for Payer: Railroad Medicare Medicare |
$675.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,901.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$675.40
|
| Rate for Payer: UHC Exchange |
$1,290.76
|
| Rate for Payer: UHC Medicare Advantage |
$675.40
|
| Rate for Payer: UHCCP Medicaid |
$362.01
|
| Rate for Payer: UMR Bronson Commercial |
$360.89
|
| Rate for Payer: VA VA |
$675.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.53
|
|
|
HC IR SI JOINT NERVES ANESTHETIC/STEROID INJ
|
Facility
|
IP
|
$975.38
|
|
|
Service Code
|
HCPCS 64451
|
| Hospital Charge Code |
36100580
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$429.17 |
| Max. Negotiated Rate |
$877.84 |
| Rate for Payer: Aetna American Axle |
$634.00
|
| Rate for Payer: Aetna Commercial |
$829.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$634.00
|
| Rate for Payer: Cash Price |
$780.30
|
| Rate for Payer: Cofinity Commercial |
$682.77
|
| Rate for Payer: Cofinity Commercial |
$838.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$682.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$780.30
|
| Rate for Payer: Healthscope Commercial |
$877.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$682.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$731.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$829.07
|
| Rate for Payer: PHP Commercial |
$829.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$634.00
|
| Rate for Payer: Priority Health SBD |
$614.49
|
| Rate for Payer: UMR Bronson Commercial |
$429.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$731.53
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
IP
|
$408.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$179.61 |
| Max. Negotiated Rate |
$367.38 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: UMR Bronson Commercial |
$179.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC IR SINAGRAM FISTULAGRAM
|
Facility
|
OP
|
$408.20
|
|
|
Service Code
|
CPT 76080
|
| Hospital Charge Code |
32000235
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$151.03 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna American Axle |
$265.33
|
| Rate for Payer: Aetna Commercial |
$346.97
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cash Price |
$326.56
|
| Rate for Payer: Cofinity Commercial |
$351.05
|
| Rate for Payer: Cofinity Commercial |
$285.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$367.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.15
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.97
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$346.97
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.33
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$257.17
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$1,021.96
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: UMR Bronson Commercial |
$151.03
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.15
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
IP
|
$1,568.04
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$689.94 |
| Max. Negotiated Rate |
$1,411.24 |
| Rate for Payer: Aetna American Axle |
$1,019.23
|
| Rate for Payer: Aetna Commercial |
$1,332.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.23
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,097.63
|
| Rate for Payer: Cofinity Commercial |
$1,348.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,097.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Healthscope Commercial |
$1,411.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,097.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: PHP Commercial |
$1,332.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: Priority Health SBD |
$987.87
|
| Rate for Payer: UMR Bronson Commercial |
$689.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.03
|
|
|
HC IR SPHENOID ELECTRODE PLACEMENT
|
Facility
|
OP
|
$1,568.04
|
|
|
Service Code
|
CPT 95830
|
| Hospital Charge Code |
74000009
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$580.17 |
| Max. Negotiated Rate |
$1,633.00 |
| Rate for Payer: Aetna American Axle |
$1,019.23
|
| Rate for Payer: Aetna Commercial |
$1,332.83
|
| Rate for Payer: Aetna Medicare |
$784.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,019.23
|
| Rate for Payer: BCBS Complete |
$627.22
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cash Price |
$1,254.43
|
| Rate for Payer: Cofinity Commercial |
$1,348.51
|
| Rate for Payer: Cofinity Commercial |
$1,097.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,097.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,254.43
|
| Rate for Payer: Healthscope Commercial |
$1,411.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,097.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,176.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,332.83
|
| Rate for Payer: PHP Commercial |
$1,332.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,019.23
|
| Rate for Payer: Priority Health SBD |
$987.87
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UMR Bronson Commercial |
$580.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,176.03
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
OP
|
$3,801.67
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna American Axle |
$2,471.09
|
| Rate for Payer: Aetna Commercial |
$3,231.42
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,471.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cofinity Commercial |
$3,269.44
|
| Rate for Payer: Cofinity Commercial |
$2,661.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,661.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,041.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$3,421.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,661.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,851.25
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,231.42
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$3,231.42
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,471.09
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,395.05
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$10,075.45
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,406.62
|
| Rate for Payer: VA VA |
$5,272.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,851.25
|
|
|
HC IR SPINAL ANGIOGRAPHY
|
Facility
|
IP
|
$3,801.67
|
|
|
Service Code
|
CPT 75705
|
| Hospital Charge Code |
32000188
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,672.73 |
| Max. Negotiated Rate |
$3,421.50 |
| Rate for Payer: Aetna American Axle |
$2,471.09
|
| Rate for Payer: Aetna Commercial |
$3,231.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,471.09
|
| Rate for Payer: Cash Price |
$3,041.34
|
| Rate for Payer: Cofinity Commercial |
$2,661.17
|
| Rate for Payer: Cofinity Commercial |
$3,269.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,661.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,041.34
|
| Rate for Payer: Healthscope Commercial |
$3,421.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,661.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,851.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,231.42
|
| Rate for Payer: PHP Commercial |
$3,231.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,471.09
|
| Rate for Payer: Priority Health SBD |
$2,395.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,672.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,851.25
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
IP
|
$2,654.21
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,167.85 |
| Max. Negotiated Rate |
$2,388.79 |
| Rate for Payer: Aetna American Axle |
$1,725.24
|
| Rate for Payer: Aetna Commercial |
$2,256.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,725.24
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cofinity Commercial |
$1,857.95
|
| Rate for Payer: Cofinity Commercial |
$2,282.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,857.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,123.37
|
| Rate for Payer: Healthscope Commercial |
$2,388.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,857.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,990.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,256.08
|
| Rate for Payer: PHP Commercial |
$2,256.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,725.24
|
| Rate for Payer: Priority Health SBD |
$1,672.15
|
| Rate for Payer: UMR Bronson Commercial |
$1,167.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,990.66
|
|
|
HC IR SUPERIOR VENACAVAGRAM
|
Facility
|
OP
|
$2,654.21
|
|
|
Service Code
|
CPT 75827
|
| Hospital Charge Code |
32000206
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna American Axle |
$1,725.24
|
| Rate for Payer: Aetna Commercial |
$2,256.08
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,725.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cash Price |
$2,123.37
|
| Rate for Payer: Cofinity Commercial |
$2,282.62
|
| Rate for Payer: Cofinity Commercial |
$1,857.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,857.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,123.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$2,388.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,857.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,990.66
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,256.08
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$2,256.08
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,725.24
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$1,672.15
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,895.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: UMR Bronson Commercial |
$982.06
|
| Rate for Payer: VA VA |
$1,515.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,990.66
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$8,462.96
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,131.30 |
| Max. Negotiated Rate |
$49,296.87 |
| Rate for Payer: Aetna American Axle |
$5,500.92
|
| Rate for Payer: Aetna Commercial |
$7,193.52
|
| Rate for Payer: Aetna Medicare |
$18,213.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,500.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cofinity Commercial |
$7,278.15
|
| Rate for Payer: Cofinity Commercial |
$5,924.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,924.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,770.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$7,616.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,924.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,347.22
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,193.52
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$7,193.52
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,500.92
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health SBD |
$5,331.66
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,296.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Exchange |
$33,468.77
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,386.88
|
| Rate for Payer: UMR Bronson Commercial |
$3,131.30
|
| Rate for Payer: VA VA |
$17,512.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,347.22
|
|
|
HC IR THROMBECTOMY 1ST ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$8,462.96
|
|
|
Service Code
|
CPT 37184
|
| Hospital Charge Code |
36100149
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,723.70 |
| Max. Negotiated Rate |
$7,616.66 |
| Rate for Payer: Aetna American Axle |
$5,500.92
|
| Rate for Payer: Aetna Commercial |
$7,193.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,500.92
|
| Rate for Payer: Cash Price |
$6,770.37
|
| Rate for Payer: Cofinity Commercial |
$5,924.07
|
| Rate for Payer: Cofinity Commercial |
$7,278.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,924.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,770.37
|
| Rate for Payer: Healthscope Commercial |
$7,616.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,924.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,347.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,193.52
|
| Rate for Payer: PHP Commercial |
$7,193.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,500.92
|
| Rate for Payer: Priority Health SBD |
$5,331.66
|
| Rate for Payer: UMR Bronson Commercial |
$3,723.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,347.22
|
|
|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
IP
|
$2,403.79
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,057.67 |
| Max. Negotiated Rate |
$2,163.41 |
| Rate for Payer: Aetna American Axle |
$1,562.46
|
| Rate for Payer: Aetna Commercial |
$2,043.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,562.46
|
| Rate for Payer: Cash Price |
$1,923.03
|
| Rate for Payer: Cofinity Commercial |
$1,682.65
|
| Rate for Payer: Cofinity Commercial |
$2,067.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,682.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,923.03
|
| Rate for Payer: Healthscope Commercial |
$2,163.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,682.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,802.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,043.22
|
| Rate for Payer: PHP Commercial |
$2,043.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,562.46
|
| Rate for Payer: Priority Health SBD |
$1,514.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,057.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,802.84
|
|
