|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
OP
|
$5,349.22
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.72 |
| Max. Negotiated Rate |
$4,814.30 |
| Rate for Payer: Aetna American Axle |
$3,476.99
|
| Rate for Payer: Aetna Commercial |
$4,546.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,476.99
|
| Rate for Payer: BCBS Complete |
$2,139.69
|
| Rate for Payer: BCBS Trust/PPO |
$3,671.40
|
| Rate for Payer: Cash Price |
$4,279.38
|
| Rate for Payer: Cash Price |
$4,279.38
|
| Rate for Payer: Cofinity Commercial |
$3,744.45
|
| Rate for Payer: Cofinity Commercial |
$4,600.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,279.38
|
| Rate for Payer: Healthscope Commercial |
$4,814.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,744.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,011.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,546.84
|
| Rate for Payer: PHP Commercial |
$4,546.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,744.45
|
| Rate for Payer: Priority Health SBD |
$3,370.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.79
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$200.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,979.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,011.92
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
IP
|
$5,349.22
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,353.66 |
| Max. Negotiated Rate |
$4,814.30 |
| Rate for Payer: Aetna American Axle |
$3,476.99
|
| Rate for Payer: Aetna Commercial |
$4,546.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,476.99
|
| Rate for Payer: Cash Price |
$4,279.38
|
| Rate for Payer: Cofinity Commercial |
$3,744.45
|
| Rate for Payer: Cofinity Commercial |
$4,600.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,279.38
|
| Rate for Payer: Healthscope Commercial |
$4,814.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,744.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,011.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,546.84
|
| Rate for Payer: PHP Commercial |
$4,546.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,744.45
|
| Rate for Payer: Priority Health SBD |
$3,370.01
|
| Rate for Payer: UMR Bronson Commercial |
$2,353.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,011.92
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
OP
|
$4,321.70
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$395.55 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$2,809.10
|
| Rate for Payer: Aetna Commercial |
$3,673.44
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,809.10
|
| 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 |
$3,457.36
|
| Rate for Payer: Cash Price |
$3,457.36
|
| Rate for Payer: Cofinity Commercial |
$3,025.19
|
| Rate for Payer: Cofinity Commercial |
$3,716.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,457.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$3,889.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,025.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,241.28
|
| 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 |
$3,673.44
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$3,673.44
|
| 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 |
$3,025.19
|
| 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 |
$2,722.67
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$435.10
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$395.55
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$1,599.03
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,241.28
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
IP
|
$4,321.70
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,901.55 |
| Max. Negotiated Rate |
$3,889.53 |
| Rate for Payer: Aetna American Axle |
$2,809.10
|
| Rate for Payer: Aetna Commercial |
$3,673.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,809.10
|
| Rate for Payer: Cash Price |
$3,457.36
|
| Rate for Payer: Cofinity Commercial |
$3,025.19
|
| Rate for Payer: Cofinity Commercial |
$3,716.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,457.36
|
| Rate for Payer: Healthscope Commercial |
$3,889.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,025.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,241.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,673.44
|
| Rate for Payer: PHP Commercial |
$3,673.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,025.19
|
| Rate for Payer: Priority Health SBD |
$2,722.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,901.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,241.28
|
|
|
HC VERSACROSS KIT
|
Facility
|
OP
|
$3,570.00
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,320.90 |
| Max. Negotiated Rate |
$3,213.00 |
| Rate for Payer: Aetna American Axle |
$2,320.50
|
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.50
|
| Rate for Payer: BCBS Complete |
$1,428.00
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$2,499.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Healthscope Commercial |
$3,213.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,034.50
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,499.00
|
| Rate for Payer: Priority Health SBD |
$2,249.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
HC VERSACROSS KIT
|
Facility
|
IP
|
$3,570.00
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,570.80 |
| Max. Negotiated Rate |
$3,213.00 |
| Rate for Payer: Aetna American Axle |
$2,320.50
|
| Rate for Payer: Aetna Commercial |
$3,034.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.50
|
| Rate for Payer: Cash Price |
$2,856.00
|
| Rate for Payer: Cofinity Commercial |
$2,499.00
|
| Rate for Payer: Cofinity Commercial |
$3,070.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.00
|
| Rate for Payer: Healthscope Commercial |
$3,213.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,034.50
|
| Rate for Payer: PHP Commercial |
$3,034.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,499.00
|
| Rate for Payer: Priority Health SBD |
$2,249.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.50
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
OP
|
$11,379.21
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$211.20 |
| Max. Negotiated Rate |
$12,699.49 |
| Rate for Payer: Aetna American Axle |
$7,396.49
|
| Rate for Payer: Aetna Commercial |
$9,672.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,396.49
|
| Rate for Payer: BCBS Complete |
$4,551.68
|
| Rate for Payer: BCBS Trust/PPO |
$12,699.49
|
| Rate for Payer: Cash Price |
$9,103.37
|
| Rate for Payer: Cash Price |
$9,103.37
|
| Rate for Payer: Cofinity Commercial |
$9,786.12
|
| Rate for Payer: Cofinity Commercial |
$7,965.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,103.37
|
| Rate for Payer: Healthscope Commercial |
$10,241.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,965.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,534.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,672.33
|
| Rate for Payer: PHP Commercial |
$9,672.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,965.45
|
| Rate for Payer: Priority Health SBD |
$7,168.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.32
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$211.20
|
| Rate for Payer: UMR Bronson Commercial |
$4,210.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,534.41
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
IP
|
$11,379.21
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,006.85 |
| Max. Negotiated Rate |
$10,241.29 |
| Rate for Payer: Aetna American Axle |
$7,396.49
|
| Rate for Payer: Aetna Commercial |
$9,672.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,396.49
|
| Rate for Payer: Cash Price |
$9,103.37
|
| Rate for Payer: Cofinity Commercial |
$7,965.45
|
| Rate for Payer: Cofinity Commercial |
$9,786.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,103.37
|
| Rate for Payer: Healthscope Commercial |
$10,241.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,965.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,534.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,672.33
|
| Rate for Payer: PHP Commercial |
$9,672.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,965.45
|
| Rate for Payer: Priority Health SBD |
$7,168.90
|
| Rate for Payer: UMR Bronson Commercial |
$5,006.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,534.41
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
IP
|
$10,344.74
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,551.69 |
| Max. Negotiated Rate |
$9,310.27 |
| Rate for Payer: Aetna American Axle |
$6,724.08
|
| Rate for Payer: Aetna Commercial |
$8,793.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,724.08
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cofinity Commercial |
$7,241.32
|
| Rate for Payer: Cofinity Commercial |
$8,896.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,275.79
|
| Rate for Payer: Healthscope Commercial |
$9,310.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,241.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,758.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,793.03
|
| Rate for Payer: PHP Commercial |
$8,793.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,241.32
|
| Rate for Payer: Priority Health SBD |
$6,517.19
|
| Rate for Payer: UMR Bronson Commercial |
$4,551.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,758.56
|
|
|
HC VERT AUG W MECH DEV LUMB 1ST
|
Facility
|
OP
|
$10,344.74
|
|
|
Service Code
|
CPT 22514
|
| Hospital Charge Code |
36100468
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$464.31 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna American Axle |
$6,724.08
|
| Rate for Payer: Aetna Commercial |
$8,793.03
|
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,724.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$6,194.45
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cofinity Commercial |
$7,241.32
|
| Rate for Payer: Cofinity Commercial |
$8,896.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,275.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$9,310.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,241.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,758.56
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,793.03
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Commercial |
$8,793.03
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,241.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Priority Health SBD |
$6,517.19
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$510.74
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$464.31
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: UMR Bronson Commercial |
$3,827.55
|
| Rate for Payer: VA VA |
$6,359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,758.56
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
IP
|
$10,344.74
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,551.69 |
| Max. Negotiated Rate |
$9,310.27 |
| Rate for Payer: Aetna American Axle |
$6,724.08
|
| Rate for Payer: Aetna Commercial |
$8,793.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,724.08
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cofinity Commercial |
$7,241.32
|
| Rate for Payer: Cofinity Commercial |
$8,896.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,275.79
|
| Rate for Payer: Healthscope Commercial |
$9,310.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,241.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,758.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,793.03
|
| Rate for Payer: PHP Commercial |
$8,793.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,241.32
|
| Rate for Payer: Priority Health SBD |
$6,517.19
|
| Rate for Payer: UMR Bronson Commercial |
$4,551.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,758.56
|
|
|
HC VERT AUG W MECH DEV THOR 1ST
|
Facility
|
OP
|
$10,344.74
|
|
|
Service Code
|
CPT 22513
|
| Hospital Charge Code |
36100467
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$498.04 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna American Axle |
$6,724.08
|
| Rate for Payer: Aetna Commercial |
$8,793.03
|
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,724.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCBS Trust/PPO |
$6,115.77
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cash Price |
$8,275.79
|
| Rate for Payer: Cofinity Commercial |
$7,241.32
|
| Rate for Payer: Cofinity Commercial |
$8,896.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,275.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$9,310.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,241.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,758.56
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,793.03
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Commercial |
$8,793.03
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,241.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Priority Health SBD |
$6,517.19
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.84
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Exchange |
$498.04
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: UMR Bronson Commercial |
$3,827.55
|
| Rate for Payer: VA VA |
$6,359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,758.56
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
OP
|
$1,226.49
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$453.80 |
| Max. Negotiated Rate |
$1,103.84 |
| Rate for Payer: Aetna American Axle |
$797.22
|
| Rate for Payer: Aetna Commercial |
$1,042.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.22
|
| Rate for Payer: BCBS Complete |
$490.60
|
| Rate for Payer: Cash Price |
$981.19
|
| Rate for Payer: Cofinity Commercial |
$1,054.78
|
| Rate for Payer: Cofinity Commercial |
$858.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.19
|
| Rate for Payer: Healthscope Commercial |
$1,103.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$858.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,042.52
|
| Rate for Payer: PHP Commercial |
$1,042.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.54
|
| Rate for Payer: Priority Health SBD |
$772.69
|
| Rate for Payer: UMR Bronson Commercial |
$453.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.87
|
|
|
HC VERTEBROPLASTY CEMENT
|
Facility
|
IP
|
$1,226.49
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800112
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$539.66 |
| Max. Negotiated Rate |
$1,103.84 |
| Rate for Payer: Aetna American Axle |
$797.22
|
| Rate for Payer: Aetna Commercial |
$1,042.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$797.22
|
| Rate for Payer: Cash Price |
$981.19
|
| Rate for Payer: Cofinity Commercial |
$1,054.78
|
| Rate for Payer: Cofinity Commercial |
$858.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$981.19
|
| Rate for Payer: Healthscope Commercial |
$1,103.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$858.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,042.52
|
| Rate for Payer: PHP Commercial |
$1,042.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$858.54
|
| Rate for Payer: Priority Health SBD |
$772.69
|
| Rate for Payer: UMR Bronson Commercial |
$539.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.87
|
|
|
HC VERTEBROPLASTY SACRUM BIL W WO BONE BX AND IMAGING
|
Facility
|
OP
|
$6,140.04
|
|
|
Service Code
|
CPT 0201T
|
| Hospital Charge Code |
36100298
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,271.81 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna American Axle |
$3,991.03
|
| Rate for Payer: Aetna Commercial |
$5,219.03
|
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,991.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$4,912.03
|
| Rate for Payer: Cash Price |
$4,912.03
|
| Rate for Payer: Cofinity Commercial |
$5,280.43
|
| Rate for Payer: Cofinity Commercial |
$4,298.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,912.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$5,526.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,298.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,605.03
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,219.03
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Commercial |
$5,219.03
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,298.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Priority Health SBD |
$3,868.23
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,271.81
|
| Rate for Payer: VA VA |
$6,359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,605.03
|
|
|
HC VERTEBROPLASTY SACRUM BIL W WO BONE BX AND IMAGING
|
Facility
|
IP
|
$6,140.04
|
|
|
Service Code
|
CPT 0201T
|
| Hospital Charge Code |
36100298
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,701.62 |
| Max. Negotiated Rate |
$5,526.04 |
| Rate for Payer: Aetna American Axle |
$3,991.03
|
| Rate for Payer: Aetna Commercial |
$5,219.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,991.03
|
| Rate for Payer: Cash Price |
$4,912.03
|
| Rate for Payer: Cofinity Commercial |
$5,280.43
|
| Rate for Payer: Cofinity Commercial |
$4,298.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,912.03
|
| Rate for Payer: Healthscope Commercial |
$5,526.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,298.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,605.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,219.03
|
| Rate for Payer: PHP Commercial |
$5,219.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,298.03
|
| Rate for Payer: Priority Health SBD |
$3,868.23
|
| Rate for Payer: UMR Bronson Commercial |
$2,701.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,605.03
|
|
|
HC VERTEBROPLASTY SACRUM UNI W WO BONE BX AND IMAGING
|
Facility
|
OP
|
$4,912.03
|
|
|
Service Code
|
CPT 0200T
|
| Hospital Charge Code |
36100299
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,817.45 |
| Max. Negotiated Rate |
$20,018.71 |
| Rate for Payer: Aetna American Axle |
$3,192.82
|
| Rate for Payer: Aetna Commercial |
$4,175.23
|
| Rate for Payer: Aetna Medicare |
$6,613.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,192.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,948.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,948.86
|
| Rate for Payer: BCBS Complete |
$3,652.66
|
| Rate for Payer: BCBS MAPPO |
$6,359.09
|
| Rate for Payer: BCN Medicare Advantage |
$6,359.09
|
| Rate for Payer: Cash Price |
$3,929.62
|
| Rate for Payer: Cash Price |
$3,929.62
|
| Rate for Payer: Cofinity Commercial |
$4,224.35
|
| Rate for Payer: Cofinity Commercial |
$3,438.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,929.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,359.09
|
| Rate for Payer: Healthscope Commercial |
$4,420.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,438.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,684.02
|
| Rate for Payer: Mclaren Medicaid |
$3,478.42
|
| Rate for Payer: Mclaren Medicare |
$6,359.09
|
| Rate for Payer: Meridian Medicaid |
$3,652.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6,677.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,312.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,175.23
|
| Rate for Payer: PACE Medicare |
$6,041.14
|
| Rate for Payer: PACE SWMI |
$6,359.09
|
| Rate for Payer: PHP Commercial |
$4,175.23
|
| Rate for Payer: PHP Medicare Advantage |
$6,359.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,478.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,438.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,018.71
|
| Rate for Payer: Priority Health Medicare |
$6,359.09
|
| Rate for Payer: Priority Health Narrow Network |
$16,014.97
|
| Rate for Payer: Priority Health SBD |
$3,094.58
|
| Rate for Payer: Railroad Medicare Medicare |
$6,359.09
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,359.09
|
| Rate for Payer: UHC Medicare Advantage |
$6,549.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,817.45
|
| Rate for Payer: VA VA |
$6,359.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,684.02
|
|
|
HC VERTEBROPLASTY SACRUM UNI W WO BONE BX AND IMAGING
|
Facility
|
IP
|
$4,912.03
|
|
|
Service Code
|
CPT 0200T
|
| Hospital Charge Code |
36100299
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,161.29 |
| Max. Negotiated Rate |
$4,420.83 |
| Rate for Payer: Aetna American Axle |
$3,192.82
|
| Rate for Payer: Aetna Commercial |
$4,175.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,192.82
|
| Rate for Payer: Cash Price |
$3,929.62
|
| Rate for Payer: Cofinity Commercial |
$3,438.42
|
| Rate for Payer: Cofinity Commercial |
$4,224.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,929.62
|
| Rate for Payer: Healthscope Commercial |
$4,420.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,438.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,684.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,175.23
|
| Rate for Payer: PHP Commercial |
$4,175.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,438.42
|
| Rate for Payer: Priority Health SBD |
$3,094.58
|
| Rate for Payer: UMR Bronson Commercial |
$2,161.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,684.02
|
|
|
HC VEST SUPPLY
|
Facility
|
IP
|
$455.60
|
|
| Hospital Charge Code |
27000169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$200.46 |
| Max. Negotiated Rate |
$410.04 |
| Rate for Payer: Aetna American Axle |
$296.14
|
| Rate for Payer: Aetna Commercial |
$387.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.14
|
| Rate for Payer: Cash Price |
$364.48
|
| Rate for Payer: Cofinity Commercial |
$318.92
|
| Rate for Payer: Cofinity Commercial |
$391.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$364.48
|
| Rate for Payer: Healthscope Commercial |
$410.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$318.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$341.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$387.26
|
| Rate for Payer: PHP Commercial |
$387.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.92
|
| Rate for Payer: Priority Health SBD |
$287.03
|
| Rate for Payer: UMR Bronson Commercial |
$200.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$341.70
|
|
|
HC VEST SUPPLY
|
Facility
|
OP
|
$455.60
|
|
| Hospital Charge Code |
27000169
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$168.57 |
| Max. Negotiated Rate |
$410.04 |
| Rate for Payer: Aetna American Axle |
$296.14
|
| Rate for Payer: Aetna Commercial |
$387.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$296.14
|
| Rate for Payer: BCBS Complete |
$182.24
|
| Rate for Payer: Cash Price |
$364.48
|
| Rate for Payer: Cofinity Commercial |
$318.92
|
| Rate for Payer: Cofinity Commercial |
$391.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$364.48
|
| Rate for Payer: Healthscope Commercial |
$410.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$318.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$341.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$387.26
|
| Rate for Payer: PHP Commercial |
$387.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$318.92
|
| Rate for Payer: Priority Health SBD |
$287.03
|
| Rate for Payer: UMR Bronson Commercial |
$168.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$341.70
|
|
|
HC VIABAHN 2
|
Facility
|
IP
|
$7,954.90
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,500.16 |
| Max. Negotiated Rate |
$7,159.41 |
| Rate for Payer: Aetna American Axle |
$5,170.68
|
| Rate for Payer: Aetna Commercial |
$6,761.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,170.68
|
| Rate for Payer: Cash Price |
$6,363.92
|
| Rate for Payer: Cofinity Commercial |
$5,568.43
|
| Rate for Payer: Cofinity Commercial |
$6,841.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,363.92
|
| Rate for Payer: Healthscope Commercial |
$7,159.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,568.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,966.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,761.66
|
| Rate for Payer: PHP Commercial |
$6,761.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,568.43
|
| Rate for Payer: Priority Health SBD |
$5,011.59
|
| Rate for Payer: UMR Bronson Commercial |
$3,500.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,966.18
|
|
|
HC VIABAHN 2
|
Facility
|
OP
|
$7,954.90
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800034
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,943.31 |
| Max. Negotiated Rate |
$7,159.41 |
| Rate for Payer: Aetna American Axle |
$5,170.68
|
| Rate for Payer: Aetna Commercial |
$6,761.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,170.68
|
| Rate for Payer: BCBS Complete |
$3,181.96
|
| Rate for Payer: Cash Price |
$6,363.92
|
| Rate for Payer: Cofinity Commercial |
$5,568.43
|
| Rate for Payer: Cofinity Commercial |
$6,841.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,363.92
|
| Rate for Payer: Healthscope Commercial |
$7,159.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,568.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,966.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,761.66
|
| Rate for Payer: PHP Commercial |
$6,761.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,568.43
|
| Rate for Payer: Priority Health SBD |
$5,011.59
|
| Rate for Payer: UMR Bronson Commercial |
$2,943.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,966.18
|
|
|
HC VISCOSITY
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 85810
|
| Hospital Charge Code |
30500065
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: UMR Bronson Commercial |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC VISCOSITY
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 85810
|
| Hospital Charge Code |
30500065
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.38 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.59
|
| Rate for Payer: BCBS Complete |
$6.70
|
| Rate for Payer: BCBS MAPPO |
$11.67
|
| Rate for Payer: BCBS Trust/PPO |
$10.49
|
| Rate for Payer: BCN Medicare Advantage |
$11.67
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.67
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Mclaren Medicaid |
$6.38
|
| Rate for Payer: Mclaren Medicare |
$11.67
|
| Rate for Payer: Meridian Medicaid |
$6.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PACE Medicare |
$11.09
|
| Rate for Payer: PACE SWMI |
$11.67
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$11.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.01
|
| Rate for Payer: Priority Health Medicare |
$11.67
|
| Rate for Payer: Priority Health Narrow Network |
$12.81
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: Railroad Medicare Medicare |
$11.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.00
|
| Rate for Payer: UHC Core |
$19.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.67
|
| Rate for Payer: UHC Exchange |
$11.67
|
| Rate for Payer: UHC Medicare Advantage |
$12.02
|
| Rate for Payer: UMR Bronson Commercial |
$25.66
|
| Rate for Payer: VA VA |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC VISIPAQUE 320 PER ML
|
Facility
|
IP
|
$2.78
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600019
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.22 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Aetna American Axle |
$1.81
|
| Rate for Payer: Aetna Commercial |
$2.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.81
|
| Rate for Payer: Cash Price |
$2.22
|
| Rate for Payer: Cofinity Commercial |
$1.95
|
| Rate for Payer: Cofinity Commercial |
$2.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.22
|
| Rate for Payer: Healthscope Commercial |
$2.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.36
|
| Rate for Payer: PHP Commercial |
$2.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.95
|
| Rate for Payer: Priority Health SBD |
$1.75
|
| Rate for Payer: UMR Bronson Commercial |
$1.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.08
|
|
