|
HC IR PULMONARY
|
Facility
|
OP
|
$2,010.44
|
|
|
Service Code
|
CPT 75741
|
| Hospital Charge Code |
32000195
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$120.80 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$1,306.79
|
| Rate for Payer: Aetna Commercial |
$1,708.87
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,306.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$145.04
|
| Rate for Payer: BCN Commercial |
$145.04
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$1,608.35
|
| Rate for Payer: Cash Price |
$1,608.35
|
| Rate for Payer: Cofinity Commercial |
$1,728.98
|
| Rate for Payer: Cofinity Commercial |
$1,407.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,407.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,608.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$1,809.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,407.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,507.83
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,708.87
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$1,708.87
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,306.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$1,266.58
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.88
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$120.80
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$743.86
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,507.83
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
IP
|
$3,499.53
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,539.79 |
| Max. Negotiated Rate |
$3,149.58 |
| Rate for Payer: Aetna American Axle |
$2,274.69
|
| Rate for Payer: Aetna Commercial |
$2,974.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,274.69
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cofinity Commercial |
$2,449.67
|
| Rate for Payer: Cofinity Commercial |
$3,009.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,449.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.62
|
| Rate for Payer: Healthscope Commercial |
$3,149.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,449.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,624.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: PHP Commercial |
$2,974.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,274.69
|
| Rate for Payer: Priority Health SBD |
$2,204.70
|
| Rate for Payer: UMR Bronson Commercial |
$1,539.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,624.65
|
|
|
HC IR PULMONARY BILATERAL
|
Facility
|
OP
|
$3,499.53
|
|
|
Service Code
|
CPT 75743
|
| Hospital Charge Code |
32000196
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$137.89 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,274.69
|
| Rate for Payer: Aetna Commercial |
$2,974.60
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,274.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$147.78
|
| Rate for Payer: BCN Commercial |
$147.78
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cash Price |
$2,799.62
|
| Rate for Payer: Cofinity Commercial |
$3,009.60
|
| Rate for Payer: Cofinity Commercial |
$2,449.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,449.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,799.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,149.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,449.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,624.65
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,974.60
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,974.60
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,274.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,204.70
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.68
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$137.89
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,294.83
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,624.65
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
IP
|
$123.73
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$54.44 |
| Max. Negotiated Rate |
$111.36 |
| Rate for Payer: Aetna American Axle |
$80.42
|
| Rate for Payer: Aetna Commercial |
$105.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.42
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cofinity Commercial |
$106.41
|
| Rate for Payer: Cofinity Commercial |
$86.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.98
|
| Rate for Payer: Healthscope Commercial |
$111.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.17
|
| Rate for Payer: PHP Commercial |
$105.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.42
|
| Rate for Payer: Priority Health SBD |
$77.95
|
| Rate for Payer: UMR Bronson Commercial |
$54.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.80
|
|
|
HC IRRADIATION BLOOD PROD-EA UNIT
|
Facility
|
OP
|
$123.73
|
|
|
Service Code
|
CPT 86945
|
| Hospital Charge Code |
39000026
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.94 |
| Max. Negotiated Rate |
$120.87 |
| Rate for Payer: Aetna American Axle |
$80.42
|
| Rate for Payer: Aetna Commercial |
$105.17
|
| Rate for Payer: Aetna Medicare |
$40.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.08
|
| Rate for Payer: BCBS Complete |
$21.65
|
| Rate for Payer: BCBS MAPPO |
$38.46
|
| Rate for Payer: BCBS Trust/PPO |
$8.94
|
| Rate for Payer: BCN Commercial |
$8.94
|
| Rate for Payer: BCN Medicare Advantage |
$38.46
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cash Price |
$98.98
|
| Rate for Payer: Cofinity Commercial |
$86.61
|
| Rate for Payer: Cofinity Commercial |
$106.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.46
|
| Rate for Payer: Healthscope Commercial |
$111.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.80
|
| Rate for Payer: Mclaren Medicaid |
$20.61
|
| Rate for Payer: Mclaren Medicare |
$38.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.38
|
| Rate for Payer: Meridian Medicaid |
$21.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.17
|
| Rate for Payer: Nomi Health Commercial |
$115.38
|
| Rate for Payer: PACE Medicare |
$36.54
|
| Rate for Payer: PACE SWMI |
$38.46
|
| Rate for Payer: PHP Commercial |
$105.17
|
| Rate for Payer: PHP Medicare Advantage |
$38.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.87
|
| Rate for Payer: Priority Health Medicare |
$38.46
|
| Rate for Payer: Priority Health Narrow Network |
$96.70
|
| Rate for Payer: Priority Health SBD |
$77.95
|
| Rate for Payer: Railroad Medicare Medicare |
$38.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.46
|
| Rate for Payer: UHC Exchange |
$73.50
|
| Rate for Payer: UHC Medicare Advantage |
$38.46
|
| Rate for Payer: UHCCP Medicaid |
$20.61
|
| Rate for Payer: UMR Bronson Commercial |
$45.78
|
| Rate for Payer: VA VA |
$38.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.80
|
|
|
HC IR RENIN
|
Facility
|
OP
|
$3,485.46
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$96.14 |
| Max. Negotiated Rate |
$16,646.50 |
| Rate for Payer: Aetna American Axle |
$2,265.55
|
| Rate for Payer: Aetna Commercial |
$2,962.64
|
| Rate for Payer: Aetna Medicare |
$5,508.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,265.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$164.20
|
| Rate for Payer: BCN Commercial |
$164.20
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$2,788.37
|
| Rate for Payer: Cash Price |
$2,788.37
|
| Rate for Payer: Cofinity Commercial |
$2,997.50
|
| Rate for Payer: Cofinity Commercial |
$2,439.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,439.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,788.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$3,136.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,439.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,614.10
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,962.64
|
| Rate for Payer: Nomi Health Commercial |
$15,889.20
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$2,962.64
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,265.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,646.50
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$13,317.20
|
| Rate for Payer: Priority Health SBD |
$2,195.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.75
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$96.14
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,289.62
|
| Rate for Payer: VA VA |
$5,296.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,614.10
|
|
|
HC IR RENIN
|
Facility
|
IP
|
$3,485.46
|
|
|
Service Code
|
CPT 75893
|
| Hospital Charge Code |
32000209
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,533.60 |
| Max. Negotiated Rate |
$3,136.91 |
| Rate for Payer: Aetna American Axle |
$2,265.55
|
| Rate for Payer: Aetna Commercial |
$2,962.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,265.55
|
| Rate for Payer: Cash Price |
$2,788.37
|
| Rate for Payer: Cofinity Commercial |
$2,439.82
|
| Rate for Payer: Cofinity Commercial |
$2,997.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,439.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,788.37
|
| Rate for Payer: Healthscope Commercial |
$3,136.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,439.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,614.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,962.64
|
| Rate for Payer: PHP Commercial |
$2,962.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,265.55
|
| Rate for Payer: Priority Health SBD |
$2,195.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,533.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,614.10
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
OP
|
$11,023.53
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$428.57 |
| Max. Negotiated Rate |
$17,557.45 |
| Rate for Payer: Aetna American Axle |
$7,165.29
|
| Rate for Payer: Aetna Commercial |
$9,370.00
|
| Rate for Payer: Aetna Medicare |
$5,809.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,165.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,982.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,982.80
|
| Rate for Payer: BCBS Complete |
$3,143.94
|
| Rate for Payer: BCBS MAPPO |
$5,586.24
|
| Rate for Payer: BCBS Trust/PPO |
$6,640.63
|
| Rate for Payer: BCN Commercial |
$6,640.63
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.24
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cofinity Commercial |
$9,480.24
|
| Rate for Payer: Cofinity Commercial |
$7,716.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,716.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,818.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.24
|
| Rate for Payer: Healthscope Commercial |
$9,921.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,716.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,267.65
|
| Rate for Payer: Mclaren Medicaid |
$2,994.22
|
| Rate for Payer: Mclaren Medicare |
$5,586.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.55
|
| Rate for Payer: Meridian Medicaid |
$3,143.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,424.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,370.00
|
| Rate for Payer: Nomi Health Commercial |
$11,731.10
|
| Rate for Payer: PACE Medicare |
$5,306.93
|
| Rate for Payer: PACE SWMI |
$5,586.24
|
| Rate for Payer: PHP Commercial |
$9,370.00
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,165.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,557.45
|
| Rate for Payer: Priority Health Medicare |
$5,586.24
|
| Rate for Payer: Priority Health Narrow Network |
$14,045.96
|
| Rate for Payer: Priority Health SBD |
$6,944.82
|
| Rate for Payer: Railroad Medicare Medicare |
$5,586.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.43
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.24
|
| Rate for Payer: UHC Exchange |
$428.57
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.24
|
| Rate for Payer: UHCCP Medicaid |
$2,994.22
|
| Rate for Payer: UMR Bronson Commercial |
$4,078.71
|
| Rate for Payer: VA VA |
$5,586.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,267.65
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY FEMPOP UNI
|
Facility
|
IP
|
$11,023.53
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
36100168
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,850.35 |
| Max. Negotiated Rate |
$9,921.18 |
| Rate for Payer: Aetna American Axle |
$7,165.29
|
| Rate for Payer: Aetna Commercial |
$9,370.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,165.29
|
| Rate for Payer: Cash Price |
$8,818.82
|
| Rate for Payer: Cofinity Commercial |
$7,716.47
|
| Rate for Payer: Cofinity Commercial |
$9,480.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,716.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,818.82
|
| Rate for Payer: Healthscope Commercial |
$9,921.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,716.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,267.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,370.00
|
| Rate for Payer: PHP Commercial |
$9,370.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,165.29
|
| Rate for Payer: Priority Health SBD |
$6,944.82
|
| Rate for Payer: UMR Bronson Commercial |
$4,850.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,267.65
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
OP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$385.17 |
| Max. Negotiated Rate |
$17,557.45 |
| Rate for Payer: Aetna American Axle |
$7,224.50
|
| Rate for Payer: Aetna Commercial |
$9,447.42
|
| Rate for Payer: Aetna Medicare |
$5,809.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,224.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,982.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,982.80
|
| Rate for Payer: BCBS Complete |
$3,143.94
|
| Rate for Payer: BCBS MAPPO |
$5,586.24
|
| Rate for Payer: BCBS Trust/PPO |
$3,560.93
|
| Rate for Payer: BCN Commercial |
$3,560.93
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.24
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cofinity Commercial |
$9,558.56
|
| Rate for Payer: Cofinity Commercial |
$7,780.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,780.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,891.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.24
|
| Rate for Payer: Healthscope Commercial |
$10,003.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,780.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,335.96
|
| Rate for Payer: Mclaren Medicaid |
$2,994.22
|
| Rate for Payer: Mclaren Medicare |
$5,586.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.55
|
| Rate for Payer: Meridian Medicaid |
$3,143.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,424.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,447.42
|
| Rate for Payer: Nomi Health Commercial |
$11,731.10
|
| Rate for Payer: PACE Medicare |
$5,306.93
|
| Rate for Payer: PACE SWMI |
$5,586.24
|
| Rate for Payer: PHP Commercial |
$9,447.42
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,224.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,557.45
|
| Rate for Payer: Priority Health Medicare |
$5,586.24
|
| Rate for Payer: Priority Health Narrow Network |
$14,045.96
|
| Rate for Payer: Priority Health SBD |
$7,002.20
|
| Rate for Payer: Railroad Medicare Medicare |
$5,586.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.69
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.24
|
| Rate for Payer: UHC Exchange |
$385.17
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.24
|
| Rate for Payer: UHCCP Medicaid |
$2,994.22
|
| Rate for Payer: UMR Bronson Commercial |
$4,112.41
|
| Rate for Payer: VA VA |
$5,586.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,335.96
|
|
|
HC IR REVASCULARIZATION ANGIOPLASTY ILIAC UNILATERAL
|
Facility
|
IP
|
$11,114.61
|
|
|
Service Code
|
CPT 37220
|
| Hospital Charge Code |
36100164
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,890.43 |
| Max. Negotiated Rate |
$10,003.15 |
| Rate for Payer: Aetna American Axle |
$7,224.50
|
| Rate for Payer: Aetna Commercial |
$9,447.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,224.50
|
| Rate for Payer: Cash Price |
$8,891.69
|
| Rate for Payer: Cofinity Commercial |
$7,780.23
|
| Rate for Payer: Cofinity Commercial |
$9,558.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,780.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,891.69
|
| Rate for Payer: Healthscope Commercial |
$10,003.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,780.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,335.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,447.42
|
| Rate for Payer: PHP Commercial |
$9,447.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,224.50
|
| Rate for Payer: Priority Health SBD |
$7,002.20
|
| Rate for Payer: UMR Bronson Commercial |
$4,890.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,335.96
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
IP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,178.08 |
| Max. Negotiated Rate |
$6,500.61 |
| Rate for Payer: Aetna American Axle |
$4,694.88
|
| Rate for Payer: Aetna Commercial |
$6,139.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.88
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Commercial |
$5,056.03
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,056.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,056.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,417.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.46
|
| Rate for Payer: PHP Commercial |
$6,139.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.88
|
| Rate for Payer: Priority Health SBD |
$4,550.43
|
| Rate for Payer: UMR Bronson Commercial |
$3,178.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,417.18
|
|
|
HC IR REVASCULARIZATION ILIAC EACH ADDITIONAL
|
Facility
|
OP
|
$7,222.90
|
|
|
Service Code
|
CPT 37222
|
| Hospital Charge Code |
36100166
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$178.30 |
| Max. Negotiated Rate |
$8,596.00 |
| Rate for Payer: Aetna American Axle |
$4,694.88
|
| Rate for Payer: Aetna Commercial |
$6,139.46
|
| Rate for Payer: Aetna Medicare |
$3,611.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,694.88
|
| Rate for Payer: BCBS Complete |
$2,889.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,076.56
|
| Rate for Payer: BCN Commercial |
$3,076.56
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cash Price |
$5,778.32
|
| Rate for Payer: Cofinity Commercial |
$6,211.69
|
| Rate for Payer: Cofinity Commercial |
$5,056.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,056.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,778.32
|
| Rate for Payer: Healthscope Commercial |
$6,500.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,056.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,417.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,139.46
|
| Rate for Payer: PHP Commercial |
$6,139.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,694.88
|
| Rate for Payer: Priority Health SBD |
$4,550.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.13
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Exchange |
$178.30
|
| Rate for Payer: UMR Bronson Commercial |
$2,672.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,417.18
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
IP
|
$12,417.99
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,463.92 |
| Max. Negotiated Rate |
$11,176.19 |
| Rate for Payer: Aetna American Axle |
$8,071.69
|
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,071.69
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Cofinity Commercial |
$8,692.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,692.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,692.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,071.69
|
| Rate for Payer: Priority Health SBD |
$7,823.33
|
| Rate for Payer: UMR Bronson Commercial |
$5,463.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR REVASCULARIZATION ILIAC WITH STENT UNILATERAL
|
Facility
|
OP
|
$12,417.99
|
|
|
Service Code
|
CPT 37221
|
| Hospital Charge Code |
36100165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$475.14 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna American Axle |
$8,071.69
|
| Rate for Payer: Aetna Commercial |
$10,555.29
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,071.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$8,554.36
|
| Rate for Payer: BCN Commercial |
$8,554.36
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cash Price |
$9,934.39
|
| Rate for Payer: Cofinity Commercial |
$8,692.59
|
| Rate for Payer: Cofinity Commercial |
$10,679.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,692.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,934.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$11,176.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,692.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,313.49
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,555.29
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$10,555.29
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,071.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$7,823.33
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$522.65
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$475.14
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: UMR Bronson Commercial |
$4,594.66
|
| Rate for Payer: VA VA |
$11,111.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,313.49
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
OP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$520.97 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna American Axle |
$8,909.20
|
| Rate for Payer: Aetna Commercial |
$11,650.49
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,909.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,898.98
|
| Rate for Payer: BCN Commercial |
$6,898.98
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cofinity Commercial |
$9,594.52
|
| Rate for Payer: Cofinity Commercial |
$11,787.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,594.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,965.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$12,335.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,594.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,279.84
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,650.49
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$11,650.49
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,909.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$8,635.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$573.07
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$520.97
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: UMR Bronson Commercial |
$5,071.39
|
| Rate for Payer: VA VA |
$11,111.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,279.84
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERONL UNI
|
Facility
|
IP
|
$13,706.46
|
|
|
Service Code
|
CPT 37228
|
| Hospital Charge Code |
36100172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,030.84 |
| Max. Negotiated Rate |
$12,335.81 |
| Rate for Payer: Aetna American Axle |
$8,909.20
|
| Rate for Payer: Aetna Commercial |
$11,650.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,909.20
|
| Rate for Payer: Cash Price |
$10,965.17
|
| Rate for Payer: Cofinity Commercial |
$11,787.56
|
| Rate for Payer: Cofinity Commercial |
$9,594.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,594.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,965.17
|
| Rate for Payer: Healthscope Commercial |
$12,335.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,594.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,279.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,650.49
|
| Rate for Payer: PHP Commercial |
$11,650.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,909.20
|
| Rate for Payer: Priority Health SBD |
$8,635.07
|
| Rate for Payer: UMR Bronson Commercial |
$6,030.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,279.84
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
IP
|
$7,584.04
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,336.98 |
| Max. Negotiated Rate |
$6,825.64 |
| Rate for Payer: Aetna American Axle |
$4,929.63
|
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,929.63
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Commercial |
$5,308.83
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,308.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,308.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,688.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,929.63
|
| Rate for Payer: Priority Health SBD |
$4,777.95
|
| Rate for Payer: UMR Bronson Commercial |
$3,336.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,688.03
|
|
|
HC IR REVASCULARIZATION PLASTY TIB PERO UNI E
|
Facility
|
OP
|
$7,584.04
|
|
|
Service Code
|
CPT 37232
|
| Hospital Charge Code |
36100176
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$191.41 |
| Max. Negotiated Rate |
$8,596.00 |
| Rate for Payer: Aetna American Axle |
$4,929.63
|
| Rate for Payer: Aetna Commercial |
$6,446.43
|
| Rate for Payer: Aetna Medicare |
$3,792.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,929.63
|
| Rate for Payer: BCBS Complete |
$3,033.62
|
| Rate for Payer: BCBS Trust/PPO |
$4,249.06
|
| Rate for Payer: BCN Commercial |
$4,249.06
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cash Price |
$6,067.23
|
| Rate for Payer: Cofinity Commercial |
$6,522.27
|
| Rate for Payer: Cofinity Commercial |
$5,308.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,308.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,067.23
|
| Rate for Payer: Healthscope Commercial |
$6,825.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,308.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,688.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,446.43
|
| Rate for Payer: PHP Commercial |
$6,446.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,929.63
|
| Rate for Payer: Priority Health SBD |
$4,777.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$210.55
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Exchange |
$191.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,806.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,688.03
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
IP
|
$12,376.21
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,445.53 |
| Max. Negotiated Rate |
$11,138.59 |
| Rate for Payer: Aetna American Axle |
$8,044.54
|
| Rate for Payer: Aetna Commercial |
$10,519.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,044.54
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cofinity Commercial |
$10,643.54
|
| Rate for Payer: Cofinity Commercial |
$8,663.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,663.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,900.97
|
| Rate for Payer: Healthscope Commercial |
$11,138.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,663.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,282.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,519.78
|
| Rate for Payer: PHP Commercial |
$10,519.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,044.54
|
| Rate for Payer: Priority Health SBD |
$7,797.01
|
| Rate for Payer: UMR Bronson Commercial |
$5,445.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,282.16
|
|
|
HC IR REVASCULARIZATION STENT ILIAC UNI EACH ADDL
|
Facility
|
OP
|
$12,376.21
|
|
|
Service Code
|
CPT 37223
|
| Hospital Charge Code |
36100167
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$204.55 |
| Max. Negotiated Rate |
$11,138.59 |
| Rate for Payer: Aetna American Axle |
$8,044.54
|
| Rate for Payer: Aetna Commercial |
$10,519.78
|
| Rate for Payer: Aetna Medicare |
$6,188.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,044.54
|
| Rate for Payer: BCBS Complete |
$4,950.48
|
| Rate for Payer: BCBS Trust/PPO |
$9,119.76
|
| Rate for Payer: BCN Commercial |
$9,119.76
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cash Price |
$9,900.97
|
| Rate for Payer: Cofinity Commercial |
$8,663.35
|
| Rate for Payer: Cofinity Commercial |
$10,643.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,663.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,900.97
|
| Rate for Payer: Healthscope Commercial |
$11,138.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,663.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,282.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,519.78
|
| Rate for Payer: PHP Commercial |
$10,519.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,044.54
|
| Rate for Payer: Priority Health SBD |
$7,797.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$225.00
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Exchange |
$204.55
|
| Rate for Payer: UMR Bronson Commercial |
$4,579.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,282.16
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
IP
|
$10,518.95
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,628.34 |
| Max. Negotiated Rate |
$9,467.06 |
| Rate for Payer: Aetna American Axle |
$6,837.32
|
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Commercial |
$7,363.26
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,363.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,363.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,837.32
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
| Rate for Payer: UMR Bronson Commercial |
$4,628.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IR REVASCULARIZATION STENT TIB PERONL UNI EACH ADDL
|
Facility
|
OP
|
$10,518.95
|
|
|
Service Code
|
CPT 37234
|
| Hospital Charge Code |
36100178
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$270.16 |
| Max. Negotiated Rate |
$13,900.74 |
| Rate for Payer: Aetna American Axle |
$6,837.32
|
| Rate for Payer: Aetna Commercial |
$8,941.11
|
| Rate for Payer: Aetna Medicare |
$5,259.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,837.32
|
| Rate for Payer: BCBS Complete |
$4,207.58
|
| Rate for Payer: BCBS Trust/PPO |
$13,900.74
|
| Rate for Payer: BCN Commercial |
$13,900.74
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cash Price |
$8,415.16
|
| Rate for Payer: Cofinity Commercial |
$9,046.30
|
| Rate for Payer: Cofinity Commercial |
$7,363.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,363.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,415.16
|
| Rate for Payer: Healthscope Commercial |
$9,467.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,363.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,889.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,941.11
|
| Rate for Payer: PHP Commercial |
$8,941.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,837.32
|
| Rate for Payer: Priority Health SBD |
$6,626.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.18
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Exchange |
$270.16
|
| Rate for Payer: UMR Bronson Commercial |
$3,892.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,889.21
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
IP
|
$11,383.98
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,008.95 |
| Max. Negotiated Rate |
$10,245.58 |
| Rate for Payer: Aetna American Axle |
$7,399.59
|
| Rate for Payer: Aetna Commercial |
$9,676.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,399.59
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cofinity Commercial |
$7,968.79
|
| Rate for Payer: Cofinity Commercial |
$9,790.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,968.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,107.18
|
| Rate for Payer: Healthscope Commercial |
$10,245.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,968.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,537.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,676.38
|
| Rate for Payer: PHP Commercial |
$9,676.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,399.59
|
| Rate for Payer: Priority Health SBD |
$7,171.91
|
| Rate for Payer: UMR Bronson Commercial |
$5,008.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,537.98
|
|
|
HC IR REVISION TIPS WITH FLUORO
|
Facility
|
OP
|
$11,383.98
|
|
|
Service Code
|
CPT 37183
|
| Hospital Charge Code |
36100148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$353.07 |
| Max. Negotiated Rate |
$17,557.45 |
| Rate for Payer: Aetna American Axle |
$7,399.59
|
| Rate for Payer: Aetna Commercial |
$9,676.38
|
| Rate for Payer: Aetna Medicare |
$5,809.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,399.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,982.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,982.80
|
| Rate for Payer: BCBS Complete |
$3,143.94
|
| Rate for Payer: BCBS MAPPO |
$5,586.24
|
| Rate for Payer: BCBS Trust/PPO |
$4,506.67
|
| Rate for Payer: BCN Commercial |
$4,506.67
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.24
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cash Price |
$9,107.18
|
| Rate for Payer: Cofinity Commercial |
$9,790.22
|
| Rate for Payer: Cofinity Commercial |
$7,968.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,968.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,107.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,586.24
|
| Rate for Payer: Healthscope Commercial |
$10,245.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,968.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,537.98
|
| Rate for Payer: Mclaren Medicaid |
$2,994.22
|
| Rate for Payer: Mclaren Medicare |
$5,586.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.55
|
| Rate for Payer: Meridian Medicaid |
$3,143.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,424.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,676.38
|
| Rate for Payer: Nomi Health Commercial |
$11,731.10
|
| Rate for Payer: PACE Medicare |
$5,306.93
|
| Rate for Payer: PACE SWMI |
$5,586.24
|
| Rate for Payer: PHP Commercial |
$9,676.38
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,399.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,557.45
|
| Rate for Payer: Priority Health Medicare |
$5,586.24
|
| Rate for Payer: Priority Health Narrow Network |
$14,045.96
|
| Rate for Payer: Priority Health SBD |
$7,171.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5,586.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$388.38
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.24
|
| Rate for Payer: UHC Exchange |
$353.07
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.24
|
| Rate for Payer: UHCCP Medicaid |
$2,994.22
|
| Rate for Payer: UMR Bronson Commercial |
$4,212.07
|
| Rate for Payer: VA VA |
$5,586.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,537.98
|
|
