|
HC IR THROMBECTOMY 2ND ARTERIAL GRAFT W FLUOROSCPY
|
Facility
|
OP
|
$2,403.79
|
|
|
Service Code
|
CPT 37186
|
| Hospital Charge Code |
36100151
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$889.40 |
| 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 Medicare |
$1,201.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,562.46
|
| Rate for Payer: BCBS Complete |
$961.52
|
| 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 |
$889.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,802.84
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
IP
|
$5,718.04
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,515.94 |
| Max. Negotiated Rate |
$5,146.24 |
| Rate for Payer: Aetna American Axle |
$3,716.73
|
| Rate for Payer: Aetna Commercial |
$4,860.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,716.73
|
| Rate for Payer: Cash Price |
$4,574.43
|
| Rate for Payer: Cofinity Commercial |
$4,002.63
|
| Rate for Payer: Cofinity Commercial |
$4,917.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,002.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,574.43
|
| Rate for Payer: Healthscope Commercial |
$5,146.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,002.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,288.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,860.33
|
| Rate for Payer: PHP Commercial |
$4,860.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,716.73
|
| Rate for Payer: Priority Health SBD |
$3,602.37
|
| Rate for Payer: UMR Bronson Commercial |
$2,515.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,288.53
|
|
|
HC IR THROMBECTOMY ARTERIAL GRAFT 2ND AND SUBSEQUENT VESSELS
|
Facility
|
OP
|
$5,718.04
|
|
|
Service Code
|
CPT 37185
|
| Hospital Charge Code |
36100150
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,115.67 |
| Max. Negotiated Rate |
$5,146.24 |
| Rate for Payer: Aetna American Axle |
$3,716.73
|
| Rate for Payer: Aetna Commercial |
$4,860.33
|
| Rate for Payer: Aetna Medicare |
$2,859.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,716.73
|
| Rate for Payer: BCBS Complete |
$2,287.22
|
| Rate for Payer: Cash Price |
$4,574.43
|
| Rate for Payer: Cofinity Commercial |
$4,002.63
|
| Rate for Payer: Cofinity Commercial |
$4,917.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,002.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,574.43
|
| Rate for Payer: Healthscope Commercial |
$5,146.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,002.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,288.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,860.33
|
| Rate for Payer: PHP Commercial |
$4,860.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,716.73
|
| Rate for Payer: Priority Health SBD |
$3,602.37
|
| Rate for Payer: UMR Bronson Commercial |
$2,115.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,288.53
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
OP
|
$7,442.25
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,753.63 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$4,837.46
|
| Rate for Payer: Aetna Commercial |
$6,325.91
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,837.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cofinity Commercial |
$6,400.34
|
| Rate for Payer: Cofinity Commercial |
$5,209.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,209.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,953.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$6,698.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,209.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,581.69
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,325.91
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$6,325.91
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,837.46
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$4,688.62
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$2,753.63
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,581.69
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY
|
Facility
|
IP
|
$7,442.25
|
|
|
Service Code
|
CPT 37187
|
| Hospital Charge Code |
36100152
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,274.59 |
| Max. Negotiated Rate |
$6,698.02 |
| Rate for Payer: Aetna American Axle |
$4,837.46
|
| Rate for Payer: Aetna Commercial |
$6,325.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,837.46
|
| Rate for Payer: Cash Price |
$5,953.80
|
| Rate for Payer: Cofinity Commercial |
$5,209.57
|
| Rate for Payer: Cofinity Commercial |
$6,400.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,209.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,953.80
|
| Rate for Payer: Healthscope Commercial |
$6,698.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,209.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,581.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,325.91
|
| Rate for Payer: PHP Commercial |
$6,325.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,837.46
|
| Rate for Payer: Priority Health SBD |
$4,688.62
|
| Rate for Payer: UMR Bronson Commercial |
$3,274.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,581.69
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
OP
|
$5,369.59
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$3,490.23
|
| Rate for Payer: Aetna Commercial |
$4,564.15
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,490.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cofinity Commercial |
$4,617.85
|
| Rate for Payer: Cofinity Commercial |
$3,758.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,758.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,295.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,832.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,758.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,027.19
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,564.15
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$4,564.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,490.23
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$3,382.84
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,986.75
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,027.19
|
|
|
HC IR THROMBECTOMY VENOUS WITH FLUOROSCOPY SUBSEQUENT DAY
|
Facility
|
IP
|
$5,369.59
|
|
|
Service Code
|
CPT 37188
|
| Hospital Charge Code |
36100153
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,362.62 |
| Max. Negotiated Rate |
$4,832.63 |
| Rate for Payer: Aetna American Axle |
$3,490.23
|
| Rate for Payer: Aetna Commercial |
$4,564.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,490.23
|
| Rate for Payer: Cash Price |
$4,295.67
|
| Rate for Payer: Cofinity Commercial |
$3,758.71
|
| Rate for Payer: Cofinity Commercial |
$4,617.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,758.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,295.67
|
| Rate for Payer: Healthscope Commercial |
$4,832.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,758.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,027.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,564.15
|
| Rate for Payer: PHP Commercial |
$4,564.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,490.23
|
| Rate for Payer: Priority Health SBD |
$3,382.84
|
| Rate for Payer: UMR Bronson Commercial |
$2,362.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,027.19
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
OP
|
$1,798.46
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$1,618.61 |
| Rate for Payer: Aetna American Axle |
$1,169.00
|
| Rate for Payer: Aetna Commercial |
$1,528.69
|
| Rate for Payer: Aetna Medicare |
$899.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.00
|
| Rate for Payer: BCBS Complete |
$719.38
|
| Rate for Payer: Cash Price |
$1,438.77
|
| Rate for Payer: Cash Price |
$1,438.77
|
| Rate for Payer: Cofinity Commercial |
$1,546.68
|
| Rate for Payer: Cofinity Commercial |
$1,258.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,258.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,438.77
|
| Rate for Payer: Healthscope Commercial |
$1,618.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,258.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,348.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,528.69
|
| Rate for Payer: PHP Commercial |
$1,528.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.00
|
| Rate for Payer: Priority Health SBD |
$1,133.03
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$665.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,348.85
|
|
|
HC IR TRANSCATHETER BIOPSY
|
Facility
|
IP
|
$1,798.46
|
|
|
Service Code
|
CPT 75970
|
| Hospital Charge Code |
32000224
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$791.32 |
| Max. Negotiated Rate |
$1,618.61 |
| Rate for Payer: Aetna American Axle |
$1,169.00
|
| Rate for Payer: Aetna Commercial |
$1,528.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.00
|
| Rate for Payer: Cash Price |
$1,438.77
|
| Rate for Payer: Cofinity Commercial |
$1,258.92
|
| Rate for Payer: Cofinity Commercial |
$1,546.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,258.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,438.77
|
| Rate for Payer: Healthscope Commercial |
$1,618.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,258.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,348.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,528.69
|
| Rate for Payer: PHP Commercial |
$1,528.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.00
|
| Rate for Payer: Priority Health SBD |
$1,133.03
|
| Rate for Payer: UMR Bronson Commercial |
$791.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,348.85
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
OP
|
$2,172.48
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$1,955.23 |
| Rate for Payer: Aetna American Axle |
$1,412.11
|
| Rate for Payer: Aetna Commercial |
$1,846.61
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.11
|
| 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 |
$1,737.98
|
| Rate for Payer: Cash Price |
$1,737.98
|
| Rate for Payer: Cofinity Commercial |
$1,868.33
|
| Rate for Payer: Cofinity Commercial |
$1,520.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,520.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,737.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$1,955.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,520.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,629.36
|
| 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 |
$1,846.61
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$1,846.61
|
| 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 |
$1,412.11
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$1,368.66
|
| 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 |
$803.82
|
| Rate for Payer: VA VA |
$237.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,629.36
|
|
|
HC IR UNLISTED URINARY SYSTEM
|
Facility
|
IP
|
$2,172.48
|
|
|
Service Code
|
CPT 53899
|
| Hospital Charge Code |
36100254
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$955.89 |
| Max. Negotiated Rate |
$1,955.23 |
| Rate for Payer: Aetna American Axle |
$1,412.11
|
| Rate for Payer: Aetna Commercial |
$1,846.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,412.11
|
| Rate for Payer: Cash Price |
$1,737.98
|
| Rate for Payer: Cofinity Commercial |
$1,520.74
|
| Rate for Payer: Cofinity Commercial |
$1,868.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,520.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,737.98
|
| Rate for Payer: Healthscope Commercial |
$1,955.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,520.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,629.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,846.61
|
| Rate for Payer: PHP Commercial |
$1,846.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,412.11
|
| Rate for Payer: Priority Health SBD |
$1,368.66
|
| Rate for Payer: UMR Bronson Commercial |
$955.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,629.36
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
IP
|
$463.43
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$203.91 |
| Max. Negotiated Rate |
$417.09 |
| Rate for Payer: Aetna American Axle |
$301.23
|
| Rate for Payer: Aetna Commercial |
$393.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.23
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cofinity Commercial |
$324.40
|
| Rate for Payer: Cofinity Commercial |
$398.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.74
|
| Rate for Payer: Healthscope Commercial |
$417.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.92
|
| Rate for Payer: PHP Commercial |
$393.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.23
|
| Rate for Payer: Priority Health SBD |
$291.96
|
| Rate for Payer: UMR Bronson Commercial |
$203.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.57
|
|
|
HC IR UROGRAPHY ANTEGRADE
|
Facility
|
OP
|
$463.43
|
|
|
Service Code
|
CPT 74425
|
| Hospital Charge Code |
32000161
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$171.47 |
| Max. Negotiated Rate |
$980.43 |
| Rate for Payer: Aetna American Axle |
$301.23
|
| Rate for Payer: Aetna Commercial |
$393.92
|
| Rate for Payer: Aetna Medicare |
$362.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$435.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$435.38
|
| Rate for Payer: BCBS Complete |
$196.02
|
| Rate for Payer: BCBS MAPPO |
$348.30
|
| Rate for Payer: BCN Medicare Advantage |
$348.30
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cash Price |
$370.74
|
| Rate for Payer: Cofinity Commercial |
$398.55
|
| Rate for Payer: Cofinity Commercial |
$324.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$348.30
|
| Rate for Payer: Healthscope Commercial |
$417.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.57
|
| Rate for Payer: Mclaren Medicaid |
$186.69
|
| Rate for Payer: Mclaren Medicare |
$348.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$365.71
|
| Rate for Payer: Meridian Medicaid |
$196.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.92
|
| Rate for Payer: PACE Medicare |
$330.88
|
| Rate for Payer: PACE SWMI |
$348.30
|
| Rate for Payer: PHP Commercial |
$393.92
|
| Rate for Payer: PHP Medicare Advantage |
$348.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.23
|
| Rate for Payer: Priority Health Medicare |
$348.30
|
| Rate for Payer: Priority Health SBD |
$291.96
|
| Rate for Payer: Railroad Medicare Medicare |
$348.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$980.43
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$348.30
|
| Rate for Payer: UHC Exchange |
$665.64
|
| Rate for Payer: UHC Medicare Advantage |
$348.30
|
| Rate for Payer: UHCCP Medicaid |
$186.69
|
| Rate for Payer: UMR Bronson Commercial |
$171.47
|
| Rate for Payer: VA VA |
$348.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.57
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
IP
|
$357.38
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$157.25 |
| Max. Negotiated Rate |
$321.64 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: UMR Bronson Commercial |
$157.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC IR US GUIDED VASC ACCESS
|
Facility
|
OP
|
$357.38
|
|
|
Service Code
|
CPT 76937
|
| Hospital Charge Code |
40200043
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$132.23 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$232.30
|
| Rate for Payer: Aetna Commercial |
$303.77
|
| Rate for Payer: Aetna Medicare |
$178.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.30
|
| Rate for Payer: BCBS Complete |
$142.95
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cash Price |
$285.90
|
| Rate for Payer: Cofinity Commercial |
$307.35
|
| Rate for Payer: Cofinity Commercial |
$250.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$250.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$285.90
|
| Rate for Payer: Healthscope Commercial |
$321.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$303.77
|
| Rate for Payer: PHP Commercial |
$303.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$232.30
|
| Rate for Payer: Priority Health SBD |
$225.15
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UMR Bronson Commercial |
$132.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.04
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
OP
|
$490.40
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.45 |
| Max. Negotiated Rate |
$441.36 |
| Rate for Payer: Aetna American Axle |
$318.76
|
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna Medicare |
$245.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.76
|
| Rate for Payer: BCBS Complete |
$196.16
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$343.28
|
| Rate for Payer: Cofinity Commercial |
$421.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$343.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$441.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: PHP Commercial |
$416.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health SBD |
$308.95
|
| Rate for Payer: UMR Bronson Commercial |
$181.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.80
|
|
|
HC IR VASCULAR UNLISTED PROCEDURE
|
Facility
|
IP
|
$490.40
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
36100114
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.78 |
| Max. Negotiated Rate |
$441.36 |
| Rate for Payer: Aetna American Axle |
$318.76
|
| Rate for Payer: Aetna Commercial |
$416.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.76
|
| Rate for Payer: Cash Price |
$392.32
|
| Rate for Payer: Cofinity Commercial |
$343.28
|
| Rate for Payer: Cofinity Commercial |
$421.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$343.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.32
|
| Rate for Payer: Healthscope Commercial |
$441.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.84
|
| Rate for Payer: PHP Commercial |
$416.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.76
|
| Rate for Payer: Priority Health SBD |
$308.95
|
| Rate for Payer: UMR Bronson Commercial |
$215.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.80
|
|
|
HC IR VENOGRAM
|
Facility
|
IP
|
$1,122.69
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$493.98 |
| Max. Negotiated Rate |
$1,010.42 |
| Rate for Payer: Aetna American Axle |
$729.75
|
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.75
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$785.88
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.29
|
| Rate for Payer: PHP Commercial |
$954.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.75
|
| Rate for Payer: Priority Health SBD |
$707.29
|
| Rate for Payer: UMR Bronson Commercial |
$493.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.02
|
|
|
HC IR VENOGRAM
|
Facility
|
OP
|
$1,122.69
|
|
|
Service Code
|
CPT 75820
|
| Hospital Charge Code |
32000203
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna American Axle |
$729.75
|
| Rate for Payer: Aetna Commercial |
$954.29
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.75
|
| 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 |
$898.15
|
| Rate for Payer: Cash Price |
$898.15
|
| Rate for Payer: Cofinity Commercial |
$965.51
|
| Rate for Payer: Cofinity Commercial |
$785.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$785.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,010.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$785.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.02
|
| 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 |
$954.29
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$954.29
|
| 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 |
$729.75
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$707.29
|
| 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 |
$415.40
|
| Rate for Payer: VA VA |
$1,515.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.02
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
IP
|
$1,428.85
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$628.69 |
| Max. Negotiated Rate |
$1,285.96 |
| Rate for Payer: Aetna American Axle |
$928.75
|
| Rate for Payer: Aetna Commercial |
$1,214.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.75
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cofinity Commercial |
$1,000.20
|
| Rate for Payer: Cofinity Commercial |
$1,228.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,000.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.08
|
| Rate for Payer: Healthscope Commercial |
$1,285.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,000.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,071.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,214.52
|
| Rate for Payer: PHP Commercial |
$1,214.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$928.75
|
| Rate for Payer: Priority Health SBD |
$900.18
|
| Rate for Payer: UMR Bronson Commercial |
$628.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,071.64
|
|
|
HC IR VENOGRAM BIL
|
Facility
|
OP
|
$1,428.85
|
|
|
Service Code
|
CPT 75822
|
| Hospital Charge Code |
32000204
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna American Axle |
$928.75
|
| Rate for Payer: Aetna Commercial |
$1,214.52
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$928.75
|
| 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 |
$1,143.08
|
| Rate for Payer: Cash Price |
$1,143.08
|
| Rate for Payer: Cofinity Commercial |
$1,228.81
|
| Rate for Payer: Cofinity Commercial |
$1,000.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,000.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,143.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,285.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,000.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,071.64
|
| 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 |
$1,214.52
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,214.52
|
| 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 |
$928.75
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$900.18
|
| 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 |
$528.67
|
| Rate for Payer: VA VA |
$1,515.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,071.64
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
OP
|
$3,801.67
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,471.09
|
| Rate for Payer: Aetna Commercial |
$3,231.42
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,471.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| 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 |
$3,069.69
|
| 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 |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,231.42
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,231.42
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,471.09
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,395.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,406.62
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,851.25
|
|
|
HC IR VENOGRAM RENAL BILAT SELECT
|
Facility
|
IP
|
$3,801.67
|
|
|
Service Code
|
CPT 75833
|
| Hospital Charge Code |
32000207
|
|
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 VENOGRAM RENAL UNI SELECT
|
Facility
|
OP
|
$3,570.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,320.61
|
| Rate for Payer: Aetna Commercial |
$3,034.64
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cofinity Commercial |
$3,070.35
|
| Rate for Payer: Cofinity Commercial |
$2,499.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,213.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.63
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.64
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,034.64
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.61
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,249.21
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.96
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.63
|
|
|
HC IR VENOGRAM RENAL UNI SELECT
|
Facility
|
IP
|
$3,570.17
|
|
|
Service Code
|
CPT 75831
|
| Hospital Charge Code |
32000322
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,570.87 |
| Max. Negotiated Rate |
$3,213.15 |
| Rate for Payer: Aetna American Axle |
$2,320.61
|
| Rate for Payer: Aetna Commercial |
$3,034.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.61
|
| Rate for Payer: Cash Price |
$2,856.14
|
| Rate for Payer: Cofinity Commercial |
$2,499.12
|
| Rate for Payer: Cofinity Commercial |
$3,070.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.14
|
| Rate for Payer: Healthscope Commercial |
$3,213.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.64
|
| Rate for Payer: PHP Commercial |
$3,034.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.61
|
| Rate for Payer: Priority Health SBD |
$2,249.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.63
|
|
