|
HC VENOGRAM ADRENAL
|
Facility
|
IP
|
$8,645.04
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,803.82 |
| Max. Negotiated Rate |
$7,780.54 |
| Rate for Payer: Aetna American Axle |
$5,619.28
|
| Rate for Payer: Aetna Commercial |
$7,348.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,619.28
|
| Rate for Payer: Cash Price |
$6,916.03
|
| Rate for Payer: Cofinity Commercial |
$6,051.53
|
| Rate for Payer: Cofinity Commercial |
$7,434.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,916.03
|
| Rate for Payer: Healthscope Commercial |
$7,780.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,051.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,483.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,348.28
|
| Rate for Payer: PHP Commercial |
$7,348.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,051.53
|
| Rate for Payer: Priority Health SBD |
$5,446.38
|
| Rate for Payer: UMR Bronson Commercial |
$3,803.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,483.78
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
OP
|
$4,919.81
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$123.12 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$3,197.88
|
| Rate for Payer: Aetna Commercial |
$4,181.84
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,197.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$138.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,935.85
|
| Rate for Payer: Cash Price |
$3,935.85
|
| Rate for Payer: Cofinity Commercial |
$3,443.87
|
| Rate for Payer: Cofinity Commercial |
$4,231.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,935.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,427.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,443.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,689.86
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,181.84
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$4,181.84
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,443.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$3,099.48
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.43
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$123.12
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,820.33
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,689.86
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
IP
|
$4,919.81
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,164.72 |
| Max. Negotiated Rate |
$4,427.83 |
| Rate for Payer: Aetna American Axle |
$3,197.88
|
| Rate for Payer: Aetna Commercial |
$4,181.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,197.88
|
| Rate for Payer: Cash Price |
$3,935.85
|
| Rate for Payer: Cofinity Commercial |
$3,443.87
|
| Rate for Payer: Cofinity Commercial |
$4,231.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,935.85
|
| Rate for Payer: Healthscope Commercial |
$4,427.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,443.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,689.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,181.84
|
| Rate for Payer: PHP Commercial |
$4,181.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,443.87
|
| Rate for Payer: Priority Health SBD |
$3,099.48
|
| Rate for Payer: UMR Bronson Commercial |
$2,164.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,689.86
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
OP
|
$2,394.47
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$152.59 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,556.41
|
| Rate for Payer: Aetna Commercial |
$2,035.30
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,556.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$186.88
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$1,915.58
|
| Rate for Payer: Cash Price |
$1,915.58
|
| Rate for Payer: Cofinity Commercial |
$2,059.24
|
| Rate for Payer: Cofinity Commercial |
$1,676.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,915.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,155.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,676.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,795.85
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,035.30
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,035.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,676.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,508.52
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.85
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$152.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$885.95
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,795.85
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
IP
|
$2,394.47
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,053.57 |
| Max. Negotiated Rate |
$2,155.02 |
| Rate for Payer: Aetna American Axle |
$1,556.41
|
| Rate for Payer: Aetna Commercial |
$2,035.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,556.41
|
| Rate for Payer: Cash Price |
$1,915.58
|
| Rate for Payer: Cofinity Commercial |
$1,676.13
|
| Rate for Payer: Cofinity Commercial |
$2,059.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,915.58
|
| Rate for Payer: Healthscope Commercial |
$2,155.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,676.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,795.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,035.30
|
| Rate for Payer: PHP Commercial |
$2,035.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,676.13
|
| Rate for Payer: Priority Health SBD |
$1,508.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,053.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,795.85
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
OP
|
$1,760.88
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,584.79 |
| Rate for Payer: Aetna American Axle |
$1,144.57
|
| Rate for Payer: Aetna Commercial |
$1,496.75
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,144.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$782.52
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,408.70
|
| Rate for Payer: Cash Price |
$1,408.70
|
| Rate for Payer: Cash Price |
$1,408.70
|
| Rate for Payer: Cofinity Commercial |
$1,514.36
|
| Rate for Payer: Cofinity Commercial |
$1,232.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,584.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,232.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,320.66
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,496.75
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,496.75
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,109.35
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.06
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$183.69
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$651.53
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,320.66
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
IP
|
$1,760.88
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$774.79 |
| Max. Negotiated Rate |
$1,584.79 |
| Rate for Payer: Aetna American Axle |
$1,144.57
|
| Rate for Payer: Aetna Commercial |
$1,496.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,144.57
|
| Rate for Payer: Cash Price |
$1,408.70
|
| Rate for Payer: Cofinity Commercial |
$1,232.62
|
| Rate for Payer: Cofinity Commercial |
$1,514.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,408.70
|
| Rate for Payer: Healthscope Commercial |
$1,584.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,232.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,320.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,496.75
|
| Rate for Payer: PHP Commercial |
$1,496.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,232.62
|
| Rate for Payer: Priority Health SBD |
$1,109.35
|
| Rate for Payer: UMR Bronson Commercial |
$774.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,320.66
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,553.46
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,003.52 |
| Max. Negotiated Rate |
$4,098.11 |
| Rate for Payer: Aetna American Axle |
$2,959.75
|
| Rate for Payer: Aetna Commercial |
$3,870.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,959.75
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$3,187.42
|
| Rate for Payer: Cofinity Commercial |
$3,915.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Healthscope Commercial |
$4,098.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,187.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,415.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PHP Commercial |
$3,870.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health SBD |
$2,868.68
|
| Rate for Payer: UMR Bronson Commercial |
$2,003.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,415.10
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,553.46
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$321.88 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,959.75
|
| Rate for Payer: Aetna Commercial |
$3,870.44
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,959.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,894.36
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$3,915.98
|
| Rate for Payer: Cofinity Commercial |
$3,187.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,098.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,187.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,415.10
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,870.44
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,868.68
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.07
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$321.88
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,684.78
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,415.10
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,381.07
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$607.67 |
| Max. Negotiated Rate |
$1,242.96 |
| Rate for Payer: Aetna American Axle |
$897.70
|
| Rate for Payer: Aetna Commercial |
$1,173.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.70
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cofinity Commercial |
$1,187.72
|
| Rate for Payer: Cofinity Commercial |
$966.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.86
|
| Rate for Payer: Healthscope Commercial |
$1,242.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$966.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,173.91
|
| Rate for Payer: PHP Commercial |
$1,173.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.75
|
| Rate for Payer: Priority Health SBD |
$870.07
|
| Rate for Payer: UMR Bronson Commercial |
$607.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.80
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,381.07
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,242.96 |
| Rate for Payer: Aetna American Axle |
$897.70
|
| Rate for Payer: Aetna Commercial |
$1,173.91
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$782.52
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cofinity Commercial |
$966.75
|
| Rate for Payer: Cofinity Commercial |
$1,187.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,242.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$966.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.80
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,173.91
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,173.91
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$870.07
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.06
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$183.69
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$511.00
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.80
|
|
|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,381.07
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$1,242.96 |
| Rate for Payer: Aetna American Axle |
$897.70
|
| Rate for Payer: Aetna Commercial |
$1,173.91
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$782.52
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cofinity Commercial |
$966.75
|
| Rate for Payer: Cofinity Commercial |
$1,187.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$1,242.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$966.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.80
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,173.91
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$1,173.91
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$870.07
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.06
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$183.69
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$511.00
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.80
|
|
|
HC VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,381.07
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$607.67 |
| Max. Negotiated Rate |
$1,242.96 |
| Rate for Payer: Aetna American Axle |
$897.70
|
| Rate for Payer: Aetna Commercial |
$1,173.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$897.70
|
| Rate for Payer: Cash Price |
$1,104.86
|
| Rate for Payer: Cofinity Commercial |
$1,187.72
|
| Rate for Payer: Cofinity Commercial |
$966.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,104.86
|
| Rate for Payer: Healthscope Commercial |
$1,242.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$966.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,035.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,173.91
|
| Rate for Payer: PHP Commercial |
$1,173.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$966.75
|
| Rate for Payer: Priority Health SBD |
$870.07
|
| Rate for Payer: UMR Bronson Commercial |
$607.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,035.80
|
|
|
HC VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
IP
|
$850.62
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$374.27 |
| Max. Negotiated Rate |
$765.56 |
| Rate for Payer: Aetna American Axle |
$552.90
|
| Rate for Payer: Aetna Commercial |
$723.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.90
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cofinity Commercial |
$595.43
|
| Rate for Payer: Cofinity Commercial |
$731.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.50
|
| Rate for Payer: Healthscope Commercial |
$765.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$595.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.03
|
| Rate for Payer: PHP Commercial |
$723.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.43
|
| Rate for Payer: Priority Health SBD |
$535.89
|
| Rate for Payer: UMR Bronson Commercial |
$374.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.96
|
|
|
HC VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
OP
|
$850.62
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$765.56 |
| Rate for Payer: Aetna American Axle |
$552.90
|
| Rate for Payer: Aetna Commercial |
$723.03
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$552.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$494.31
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cash Price |
$680.50
|
| Rate for Payer: Cofinity Commercial |
$731.53
|
| Rate for Payer: Cofinity Commercial |
$595.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$680.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$765.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$595.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$637.96
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$723.03
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$723.03
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$595.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$535.89
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.59
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$116.90
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$314.73
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$637.96
|
|
|
HC VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
OP
|
$1,000.73
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$900.66 |
| Rate for Payer: Aetna American Axle |
$650.47
|
| Rate for Payer: Aetna Commercial |
$850.62
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$494.31
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$800.58
|
| Rate for Payer: Cash Price |
$800.58
|
| Rate for Payer: Cash Price |
$800.58
|
| Rate for Payer: Cofinity Commercial |
$860.63
|
| Rate for Payer: Cofinity Commercial |
$700.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$900.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$700.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.55
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.62
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$850.62
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$630.46
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.59
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$116.90
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$370.27
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.55
|
|
|
HC VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
IP
|
$1,000.73
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$440.32 |
| Max. Negotiated Rate |
$900.66 |
| Rate for Payer: Aetna American Axle |
$650.47
|
| Rate for Payer: Aetna Commercial |
$850.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$650.47
|
| Rate for Payer: Cash Price |
$800.58
|
| Rate for Payer: Cofinity Commercial |
$860.63
|
| Rate for Payer: Cofinity Commercial |
$700.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$800.58
|
| Rate for Payer: Healthscope Commercial |
$900.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$700.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$750.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$850.62
|
| Rate for Payer: PHP Commercial |
$850.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$700.51
|
| Rate for Payer: Priority Health SBD |
$630.46
|
| Rate for Payer: UMR Bronson Commercial |
$440.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$750.55
|
|
|
HC VENT CPS Y
|
Facility
|
IP
|
$30.00
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna American Axle |
$19.50
|
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health SBD |
$18.90
|
| Rate for Payer: UMR Bronson Commercial |
$13.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC VENT CPS Y
|
Facility
|
OP
|
$30.00
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna American Axle |
$19.50
|
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health SBD |
$18.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
IP
|
$7,963.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,503.72 |
| Max. Negotiated Rate |
$7,166.70 |
| Rate for Payer: Aetna American Axle |
$5,175.95
|
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,175.95
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$5,574.10
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,574.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,972.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health SBD |
$5,016.69
|
| Rate for Payer: UMR Bronson Commercial |
$3,503.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,972.25
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
OP
|
$7,963.00
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.59 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna American Axle |
$5,175.95
|
| Rate for Payer: Aetna Commercial |
$6,768.55
|
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,175.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$3,042.48
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cash Price |
$6,370.40
|
| Rate for Payer: Cofinity Commercial |
$5,574.10
|
| Rate for Payer: Cofinity Commercial |
$6,848.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,370.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,166.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,574.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,972.25
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,768.55
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$6,768.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,574.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Priority Health SBD |
$5,016.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$59.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: UMR Bronson Commercial |
$2,946.31
|
| Rate for Payer: VA VA |
$2,861.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,972.25
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
IP
|
$841.51
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$370.26 |
| Max. Negotiated Rate |
$757.36 |
| Rate for Payer: Aetna American Axle |
$546.98
|
| Rate for Payer: Aetna Commercial |
$715.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.98
|
| Rate for Payer: Cash Price |
$673.21
|
| Rate for Payer: Cofinity Commercial |
$589.06
|
| Rate for Payer: Cofinity Commercial |
$723.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.21
|
| Rate for Payer: Healthscope Commercial |
$757.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$589.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$715.28
|
| Rate for Payer: PHP Commercial |
$715.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.06
|
| Rate for Payer: Priority Health SBD |
$530.15
|
| Rate for Payer: UMR Bronson Commercial |
$370.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.13
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
OP
|
$841.51
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$311.36 |
| Max. Negotiated Rate |
$757.36 |
| Rate for Payer: Aetna American Axle |
$546.98
|
| Rate for Payer: Aetna Commercial |
$715.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.98
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: Cash Price |
$673.21
|
| Rate for Payer: Cofinity Commercial |
$589.06
|
| Rate for Payer: Cofinity Commercial |
$723.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.21
|
| Rate for Payer: Healthscope Commercial |
$757.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$589.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$715.28
|
| Rate for Payer: PHP Commercial |
$715.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$589.06
|
| Rate for Payer: Priority Health SBD |
$530.15
|
| Rate for Payer: UMR Bronson Commercial |
$311.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.13
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
OP
|
$5,002.91
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$420.11 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$3,251.89
|
| Rate for Payer: Aetna Commercial |
$4,252.47
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,251.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$2,621.53
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$4,002.33
|
| Rate for Payer: Cash Price |
$4,002.33
|
| Rate for Payer: Cofinity Commercial |
$4,302.50
|
| Rate for Payer: Cofinity Commercial |
$3,502.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,002.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$4,502.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,502.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,752.18
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,252.47
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$4,252.47
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,502.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$3,151.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.12
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$420.11
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,851.08
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,752.18
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
IP
|
$5,002.91
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,201.28 |
| Max. Negotiated Rate |
$4,502.62 |
| Rate for Payer: Aetna American Axle |
$3,251.89
|
| Rate for Payer: Aetna Commercial |
$4,252.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,251.89
|
| Rate for Payer: Cash Price |
$4,002.33
|
| Rate for Payer: Cofinity Commercial |
$3,502.04
|
| Rate for Payer: Cofinity Commercial |
$4,302.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,002.33
|
| Rate for Payer: Healthscope Commercial |
$4,502.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,502.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,752.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,252.47
|
| Rate for Payer: PHP Commercial |
$4,252.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,502.04
|
| Rate for Payer: Priority Health SBD |
$3,151.83
|
| Rate for Payer: UMR Bronson Commercial |
$2,201.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,752.18
|
|
