|
HC OXYTOCIN CHALLENGE TEST
|
Facility
|
IP
|
$818.25
|
|
|
Service Code
|
CPT 59020
|
| Hospital Charge Code |
92000003
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$360.03 |
| Max. Negotiated Rate |
$736.42 |
| Rate for Payer: Aetna American Axle |
$531.86
|
| Rate for Payer: Aetna Commercial |
$695.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.86
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cofinity Advantage |
$572.77
|
| Rate for Payer: Cofinity Commercial |
$703.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$654.60
|
| Rate for Payer: Healthscope Commercial |
$736.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$572.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$613.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$613.69
|
| Rate for Payer: PHP Commercial |
$695.51
|
| Rate for Payer: Priority Health SBD |
$515.50
|
| Rate for Payer: UMR Bronson Commercial |
$360.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$613.69
|
|
|
HC OXYTOCIN CHALLENGE TEST
|
Facility
|
OP
|
$818.25
|
|
|
Service Code
|
CPT 59020
|
| Hospital Charge Code |
92000003
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$736.42 |
| Rate for Payer: Aetna American Axle |
$531.86
|
| Rate for Payer: Aetna Commercial |
$695.51
|
| Rate for Payer: Aetna Medicare |
$209.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$531.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.80
|
| Rate for Payer: BCBS Complete |
$110.63
|
| Rate for Payer: BCBS MAPPO |
$201.44
|
| Rate for Payer: BCBS Trust/PPO |
$54.48
|
| Rate for Payer: BCN Commercial |
$54.48
|
| Rate for Payer: BCN Medicare Advantage |
$201.44
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cash Price |
$654.60
|
| Rate for Payer: Cofinity Advantage |
$572.77
|
| Rate for Payer: Cofinity Commercial |
$703.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$654.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$201.44
|
| Rate for Payer: Healthscope Commercial |
$736.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$572.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$613.69
|
| Rate for Payer: Mclaren Medicaid |
$201.44
|
| Rate for Payer: Mclaren Medicare |
$201.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.51
|
| Rate for Payer: Meridian Medicaid |
$211.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$221.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$695.51
|
| Rate for Payer: Nomi Health Commercial |
$604.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$613.69
|
| Rate for Payer: PACE Medicare |
$191.37
|
| Rate for Payer: PACE SWMI |
$201.44
|
| Rate for Payer: PHP Commercial |
$695.51
|
| Rate for Payer: PHP Medicare Advantage |
$201.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$651.46
|
| Rate for Payer: Priority Health Medicare |
$201.44
|
| Rate for Payer: Priority Health SBD |
$515.50
|
| Rate for Payer: Priority Health Tiered Network |
$521.17
|
| Rate for Payer: Railroad Medicare Medicare |
$201.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$531.86
|
| Rate for Payer: UHC Core |
$426.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$201.44
|
| Rate for Payer: UHC Exchange |
$321.57
|
| Rate for Payer: UHC Medicaid |
$105.35
|
| Rate for Payer: UHCCP Medicaid |
$105.35
|
| Rate for Payer: UMR Bronson Commercial |
$302.75
|
| Rate for Payer: VA VA |
$201.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$613.69
|
|
|
HC OYSTER IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200053
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC OYSTER IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200053
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC PACEMAKER AVEIR LEADLESS DUAL CHAMBER
|
Facility
|
IP
|
$87,549.66
|
|
|
Service Code
|
HCPCS C1605
|
| Hospital Charge Code |
27500014
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$38,521.85 |
| Max. Negotiated Rate |
$78,794.69 |
| Rate for Payer: Aetna American Axle |
$56,907.28
|
| Rate for Payer: Aetna Commercial |
$74,417.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56,907.28
|
| Rate for Payer: Cash Price |
$70,039.73
|
| Rate for Payer: Cofinity Advantage |
$61,284.76
|
| Rate for Payer: Cofinity Commercial |
$75,292.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70,039.73
|
| Rate for Payer: Healthscope Commercial |
$78,794.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61,284.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65,662.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,417.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65,662.24
|
| Rate for Payer: PHP Commercial |
$74,417.21
|
| Rate for Payer: Priority Health SBD |
$55,156.29
|
| Rate for Payer: UMR Bronson Commercial |
$38,521.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65,662.24
|
|
|
HC PACEMAKER AVEIR LEADLESS DUAL CHAMBER
|
Facility
|
OP
|
$87,549.66
|
|
|
Service Code
|
HCPCS C1605
|
| Hospital Charge Code |
27500014
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$78,794.69 |
| Rate for Payer: Aetna American Axle |
$56,907.28
|
| Rate for Payer: Aetna Commercial |
$74,417.21
|
| Rate for Payer: Aetna Medicare |
$43,774.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56,907.28
|
| Rate for Payer: BCBS Complete |
$35,019.86
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$70,039.73
|
| Rate for Payer: Cash Price |
$70,039.73
|
| Rate for Payer: Cofinity Advantage |
$61,284.76
|
| Rate for Payer: Cofinity Commercial |
$75,292.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70,039.73
|
| Rate for Payer: Healthscope Commercial |
$78,794.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61,284.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65,662.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70,039.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74,417.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65,662.24
|
| Rate for Payer: PHP Commercial |
$74,417.21
|
| Rate for Payer: Priority Health SBD |
$55,156.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56,907.28
|
| Rate for Payer: UHC Core |
$45,613.37
|
| Rate for Payer: UHC Exchange |
$34,407.02
|
| Rate for Payer: UMR Bronson Commercial |
$32,393.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65,662.24
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 7
|
Facility
|
IP
|
$7,952.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500354
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,498.88 |
| Max. Negotiated Rate |
$7,156.80 |
| Rate for Payer: Aetna American Axle |
$5,168.80
|
| Rate for Payer: Aetna Commercial |
$6,759.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,168.80
|
| Rate for Payer: Cash Price |
$6,361.60
|
| Rate for Payer: Cofinity Advantage |
$5,566.40
|
| Rate for Payer: Cofinity Commercial |
$6,838.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,361.60
|
| Rate for Payer: Healthscope Commercial |
$7,156.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,566.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,964.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,759.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,964.00
|
| Rate for Payer: PHP Commercial |
$6,759.20
|
| Rate for Payer: Priority Health SBD |
$5,009.76
|
| Rate for Payer: UMR Bronson Commercial |
$3,498.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,964.00
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 7
|
Facility
|
OP
|
$7,952.00
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500354
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,942.24 |
| Max. Negotiated Rate |
$7,156.80 |
| Rate for Payer: Aetna American Axle |
$5,168.80
|
| Rate for Payer: Aetna Commercial |
$6,759.20
|
| Rate for Payer: Aetna Medicare |
$3,976.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,168.80
|
| Rate for Payer: BCBS Complete |
$3,180.80
|
| Rate for Payer: Cash Price |
$6,361.60
|
| Rate for Payer: Cofinity Advantage |
$5,566.40
|
| Rate for Payer: Cofinity Commercial |
$6,838.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,361.60
|
| Rate for Payer: Healthscope Commercial |
$7,156.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,566.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,964.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,361.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,759.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,964.00
|
| Rate for Payer: PHP Commercial |
$6,759.20
|
| Rate for Payer: Priority Health SBD |
$5,009.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,168.80
|
| Rate for Payer: UHC Core |
$4,142.99
|
| Rate for Payer: UHC Exchange |
$3,125.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,942.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,964.00
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 9
|
Facility
|
IP
|
$9,233.04
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500349
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,062.54 |
| Max. Negotiated Rate |
$8,309.74 |
| Rate for Payer: Aetna American Axle |
$6,001.48
|
| Rate for Payer: Aetna Commercial |
$7,848.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,001.48
|
| Rate for Payer: Cash Price |
$7,386.43
|
| Rate for Payer: Cofinity Advantage |
$6,463.13
|
| Rate for Payer: Cofinity Commercial |
$7,940.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,386.43
|
| Rate for Payer: Healthscope Commercial |
$8,309.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,463.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,924.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,848.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,924.78
|
| Rate for Payer: PHP Commercial |
$7,848.08
|
| Rate for Payer: Priority Health SBD |
$5,816.82
|
| Rate for Payer: UMR Bronson Commercial |
$4,062.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,924.78
|
|
|
HC PACEMAKER DUAL CHAMBER LVL 9
|
Facility
|
OP
|
$9,233.04
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500349
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,416.22 |
| Max. Negotiated Rate |
$8,309.74 |
| Rate for Payer: Aetna American Axle |
$6,001.48
|
| Rate for Payer: Aetna Commercial |
$7,848.08
|
| Rate for Payer: Aetna Medicare |
$4,616.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,001.48
|
| Rate for Payer: BCBS Complete |
$3,693.22
|
| Rate for Payer: Cash Price |
$7,386.43
|
| Rate for Payer: Cofinity Advantage |
$6,463.13
|
| Rate for Payer: Cofinity Commercial |
$7,940.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,386.43
|
| Rate for Payer: Healthscope Commercial |
$8,309.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,463.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,924.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,386.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,848.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,924.78
|
| Rate for Payer: PHP Commercial |
$7,848.08
|
| Rate for Payer: Priority Health SBD |
$5,816.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,001.48
|
| Rate for Payer: UHC Core |
$4,810.41
|
| Rate for Payer: UHC Exchange |
$3,628.58
|
| Rate for Payer: UMR Bronson Commercial |
$3,416.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,924.78
|
|
|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
IP
|
$20,314.40
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,938.34 |
| Max. Negotiated Rate |
$18,282.96 |
| Rate for Payer: Aetna American Axle |
$13,204.36
|
| Rate for Payer: Aetna Commercial |
$17,267.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,204.36
|
| Rate for Payer: Cash Price |
$16,251.52
|
| Rate for Payer: Cofinity Advantage |
$14,220.08
|
| Rate for Payer: Cofinity Commercial |
$17,470.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,251.52
|
| Rate for Payer: Healthscope Commercial |
$18,282.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,220.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,235.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,267.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,235.80
|
| Rate for Payer: PHP Commercial |
$17,267.24
|
| Rate for Payer: Priority Health SBD |
$12,798.07
|
| Rate for Payer: UMR Bronson Commercial |
$8,938.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,235.80
|
|
|
HC PACEMAKER IMPLANT, DUAL
|
Facility
|
OP
|
$20,314.40
|
|
|
Service Code
|
CPT 33208
|
| Hospital Charge Code |
36100059
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,446.74 |
| Max. Negotiated Rate |
$33,679.26 |
| Rate for Payer: Aetna American Axle |
$13,204.36
|
| Rate for Payer: Aetna Commercial |
$17,267.24
|
| Rate for Payer: Aetna Medicare |
$10,830.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,204.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,018.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,018.01
|
| Rate for Payer: BCBS Complete |
$5,719.59
|
| Rate for Payer: BCBS MAPPO |
$10,414.41
|
| Rate for Payer: BCBS Trust/PPO |
$16,577.99
|
| Rate for Payer: BCN Commercial |
$16,577.99
|
| Rate for Payer: BCN Medicare Advantage |
$10,414.41
|
| Rate for Payer: Cash Price |
$16,251.52
|
| Rate for Payer: Cash Price |
$16,251.52
|
| Rate for Payer: Cash Price |
$16,251.52
|
| Rate for Payer: Cofinity Advantage |
$14,220.08
|
| Rate for Payer: Cofinity Commercial |
$17,470.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,251.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,414.41
|
| Rate for Payer: Healthscope Commercial |
$18,282.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,220.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,235.80
|
| Rate for Payer: Mclaren Medicaid |
$10,414.41
|
| Rate for Payer: Mclaren Medicare |
$10,414.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,935.13
|
| Rate for Payer: Meridian Medicaid |
$10,935.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,976.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$11,455.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17,267.24
|
| Rate for Payer: Nomi Health Commercial |
$31,243.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15,235.80
|
| Rate for Payer: PACE Medicare |
$9,893.69
|
| Rate for Payer: PACE SWMI |
$10,414.41
|
| Rate for Payer: PHP Commercial |
$17,267.24
|
| Rate for Payer: PHP Medicare Advantage |
$10,414.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,446.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33,679.26
|
| Rate for Payer: Priority Health Medicare |
$10,414.41
|
| Rate for Payer: Priority Health SBD |
$12,798.07
|
| Rate for Payer: Priority Health Tiered Network |
$26,943.41
|
| Rate for Payer: Railroad Medicare Medicare |
$10,414.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10,414.41
|
| Rate for Payer: UHC Medicaid |
$5,446.74
|
| Rate for Payer: UHCCP Medicaid |
$5,446.74
|
| Rate for Payer: UMR Bronson Commercial |
$7,516.33
|
| Rate for Payer: VA VA |
$10,414.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,235.80
|
|
|
HC PACEMAKER LEAD
|
Facility
|
OP
|
$1,988.20
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$735.63 |
| Max. Negotiated Rate |
$1,789.38 |
| Rate for Payer: Aetna American Axle |
$1,292.33
|
| Rate for Payer: Aetna Commercial |
$1,689.97
|
| Rate for Payer: Aetna Medicare |
$994.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.33
|
| Rate for Payer: BCBS Complete |
$795.28
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cofinity Advantage |
$1,391.74
|
| Rate for Payer: Cofinity Commercial |
$1,709.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.56
|
| Rate for Payer: Healthscope Commercial |
$1,789.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,391.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,491.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,590.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,689.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.15
|
| Rate for Payer: PHP Commercial |
$1,689.97
|
| Rate for Payer: Priority Health SBD |
$1,252.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,292.33
|
| Rate for Payer: UHC Core |
$1,035.85
|
| Rate for Payer: UHC Exchange |
$781.36
|
| Rate for Payer: UMR Bronson Commercial |
$735.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,491.15
|
|
|
HC PACEMAKER LEAD
|
Facility
|
IP
|
$1,988.20
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800024
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$874.81 |
| Max. Negotiated Rate |
$1,789.38 |
| Rate for Payer: Aetna American Axle |
$1,292.33
|
| Rate for Payer: Aetna Commercial |
$1,689.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,292.33
|
| Rate for Payer: Cash Price |
$1,590.56
|
| Rate for Payer: Cofinity Advantage |
$1,391.74
|
| Rate for Payer: Cofinity Commercial |
$1,709.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,590.56
|
| Rate for Payer: Healthscope Commercial |
$1,789.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,391.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,491.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,689.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,491.15
|
| Rate for Payer: PHP Commercial |
$1,689.97
|
| Rate for Payer: Priority Health SBD |
$1,252.57
|
| Rate for Payer: UMR Bronson Commercial |
$874.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,491.15
|
|
|
HC PACEMAKER OTHER SINGLE OR DUAL LVL 11
|
Facility
|
OP
|
$11,889.00
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500348
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,398.93 |
| Max. Negotiated Rate |
$10,700.10 |
| Rate for Payer: Aetna American Axle |
$7,727.85
|
| Rate for Payer: Aetna Commercial |
$10,105.65
|
| Rate for Payer: Aetna Medicare |
$5,944.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,727.85
|
| Rate for Payer: BCBS Complete |
$4,755.60
|
| Rate for Payer: Cash Price |
$9,511.20
|
| Rate for Payer: Cofinity Advantage |
$8,322.30
|
| Rate for Payer: Cofinity Commercial |
$10,224.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,511.20
|
| Rate for Payer: Healthscope Commercial |
$10,700.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,322.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,916.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,511.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,105.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,916.75
|
| Rate for Payer: PHP Commercial |
$10,105.65
|
| Rate for Payer: Priority Health SBD |
$7,490.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,727.85
|
| Rate for Payer: UHC Core |
$6,194.17
|
| Rate for Payer: UHC Exchange |
$4,672.38
|
| Rate for Payer: UMR Bronson Commercial |
$4,398.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,916.75
|
|
|
HC PACEMAKER OTHER SINGLE OR DUAL LVL 11
|
Facility
|
IP
|
$11,889.00
|
|
|
Service Code
|
HCPCS C2621
|
| Hospital Charge Code |
27500348
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,231.16 |
| Max. Negotiated Rate |
$10,700.10 |
| Rate for Payer: Aetna American Axle |
$7,727.85
|
| Rate for Payer: Aetna Commercial |
$10,105.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,727.85
|
| Rate for Payer: Cash Price |
$9,511.20
|
| Rate for Payer: Cofinity Advantage |
$8,322.30
|
| Rate for Payer: Cofinity Commercial |
$10,224.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,511.20
|
| Rate for Payer: Healthscope Commercial |
$10,700.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,322.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,916.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,105.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,916.75
|
| Rate for Payer: PHP Commercial |
$10,105.65
|
| Rate for Payer: Priority Health SBD |
$7,490.07
|
| Rate for Payer: UMR Bronson Commercial |
$5,231.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,916.75
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
IP
|
$13,770.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,058.80 |
| Max. Negotiated Rate |
$12,393.00 |
| Rate for Payer: Aetna American Axle |
$8,950.50
|
| Rate for Payer: Aetna Commercial |
$11,704.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,950.50
|
| Rate for Payer: Cash Price |
$11,016.00
|
| Rate for Payer: Cofinity Advantage |
$9,639.00
|
| Rate for Payer: Cofinity Commercial |
$11,842.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,016.00
|
| Rate for Payer: Healthscope Commercial |
$12,393.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,639.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,327.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,704.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,327.50
|
| Rate for Payer: PHP Commercial |
$11,704.50
|
| Rate for Payer: Priority Health SBD |
$8,675.10
|
| Rate for Payer: UMR Bronson Commercial |
$6,058.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,327.50
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 13
|
Facility
|
OP
|
$13,770.00
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500351
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,094.90 |
| Max. Negotiated Rate |
$12,393.00 |
| Rate for Payer: Aetna American Axle |
$8,950.50
|
| Rate for Payer: Aetna Commercial |
$11,704.50
|
| Rate for Payer: Aetna Medicare |
$6,885.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,950.50
|
| Rate for Payer: BCBS Complete |
$5,508.00
|
| Rate for Payer: Cash Price |
$11,016.00
|
| Rate for Payer: Cofinity Advantage |
$9,639.00
|
| Rate for Payer: Cofinity Commercial |
$11,842.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,016.00
|
| Rate for Payer: Healthscope Commercial |
$12,393.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,639.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,327.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,016.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,704.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,327.50
|
| Rate for Payer: PHP Commercial |
$11,704.50
|
| Rate for Payer: Priority Health SBD |
$8,675.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,950.50
|
| Rate for Payer: UHC Core |
$7,174.17
|
| Rate for Payer: UHC Exchange |
$5,411.61
|
| Rate for Payer: UMR Bronson Commercial |
$5,094.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,327.50
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 15
|
Facility
|
OP
|
$15,812.50
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500015
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$5,850.62 |
| Max. Negotiated Rate |
$14,231.25 |
| Rate for Payer: Aetna American Axle |
$10,278.12
|
| Rate for Payer: Aetna Commercial |
$13,440.62
|
| Rate for Payer: Aetna Medicare |
$7,906.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,278.12
|
| Rate for Payer: BCBS Complete |
$6,325.00
|
| Rate for Payer: Cash Price |
$12,650.00
|
| Rate for Payer: Cofinity Advantage |
$11,068.75
|
| Rate for Payer: Cofinity Commercial |
$13,598.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,650.00
|
| Rate for Payer: Healthscope Commercial |
$14,231.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,068.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,859.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,650.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,440.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,859.38
|
| Rate for Payer: PHP Commercial |
$13,440.62
|
| Rate for Payer: Priority Health SBD |
$9,961.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,278.12
|
| Rate for Payer: UHC Core |
$8,238.31
|
| Rate for Payer: UHC Exchange |
$6,214.31
|
| Rate for Payer: UMR Bronson Commercial |
$5,850.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,859.38
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 15
|
Facility
|
IP
|
$15,812.50
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500015
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,957.50 |
| Max. Negotiated Rate |
$14,231.25 |
| Rate for Payer: Aetna American Axle |
$10,278.12
|
| Rate for Payer: Aetna Commercial |
$13,440.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,278.12
|
| Rate for Payer: Cash Price |
$12,650.00
|
| Rate for Payer: Cofinity Advantage |
$11,068.75
|
| Rate for Payer: Cofinity Commercial |
$13,598.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,650.00
|
| Rate for Payer: Healthscope Commercial |
$14,231.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,068.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,859.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,440.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,859.38
|
| Rate for Payer: PHP Commercial |
$13,440.62
|
| Rate for Payer: Priority Health SBD |
$9,961.88
|
| Rate for Payer: UMR Bronson Commercial |
$6,957.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,859.38
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
IP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$7,419.79 |
| Max. Negotiated Rate |
$15,176.83 |
| Rate for Payer: Aetna American Axle |
$10,961.05
|
| Rate for Payer: Aetna Commercial |
$14,333.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,961.05
|
| Rate for Payer: Cash Price |
$13,490.52
|
| Rate for Payer: Cofinity Advantage |
$11,804.20
|
| Rate for Payer: Cofinity Commercial |
$14,502.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,490.52
|
| Rate for Payer: Healthscope Commercial |
$15,176.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,804.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,647.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,333.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,647.36
|
| Rate for Payer: PHP Commercial |
$14,333.68
|
| Rate for Payer: Priority Health SBD |
$10,623.78
|
| Rate for Payer: UMR Bronson Commercial |
$7,419.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,647.36
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 16
|
Facility
|
OP
|
$16,863.15
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500350
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,239.37 |
| Max. Negotiated Rate |
$15,176.83 |
| Rate for Payer: Aetna American Axle |
$10,961.05
|
| Rate for Payer: Aetna Commercial |
$14,333.68
|
| Rate for Payer: Aetna Medicare |
$8,431.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,961.05
|
| Rate for Payer: BCBS Complete |
$6,745.26
|
| Rate for Payer: Cash Price |
$13,490.52
|
| Rate for Payer: Cofinity Advantage |
$11,804.20
|
| Rate for Payer: Cofinity Commercial |
$14,502.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,490.52
|
| Rate for Payer: Healthscope Commercial |
$15,176.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,804.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,647.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,490.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,333.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,647.36
|
| Rate for Payer: PHP Commercial |
$14,333.68
|
| Rate for Payer: Priority Health SBD |
$10,623.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,961.05
|
| Rate for Payer: UHC Core |
$8,785.70
|
| Rate for Payer: UHC Exchange |
$6,627.22
|
| Rate for Payer: UMR Bronson Commercial |
$6,239.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,647.36
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
OP
|
$6,319.92
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,338.37 |
| Max. Negotiated Rate |
$5,687.93 |
| Rate for Payer: Aetna American Axle |
$4,107.95
|
| Rate for Payer: Aetna Commercial |
$5,371.93
|
| Rate for Payer: Aetna Medicare |
$3,159.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,107.95
|
| Rate for Payer: BCBS Complete |
$2,527.97
|
| Rate for Payer: Cash Price |
$5,055.94
|
| Rate for Payer: Cofinity Advantage |
$4,423.94
|
| Rate for Payer: Cofinity Commercial |
$5,435.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,055.94
|
| Rate for Payer: Healthscope Commercial |
$5,687.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,423.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,739.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,055.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,371.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,739.94
|
| Rate for Payer: PHP Commercial |
$5,371.93
|
| Rate for Payer: Priority Health SBD |
$3,981.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,107.95
|
| Rate for Payer: UHC Core |
$3,292.68
|
| Rate for Payer: UHC Exchange |
$2,483.73
|
| Rate for Payer: UMR Bronson Commercial |
$2,338.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,739.94
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 6
|
Facility
|
IP
|
$6,319.92
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500352
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$2,780.76 |
| Max. Negotiated Rate |
$5,687.93 |
| Rate for Payer: Aetna American Axle |
$4,107.95
|
| Rate for Payer: Aetna Commercial |
$5,371.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,107.95
|
| Rate for Payer: Cash Price |
$5,055.94
|
| Rate for Payer: Cofinity Advantage |
$4,423.94
|
| Rate for Payer: Cofinity Commercial |
$5,435.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,055.94
|
| Rate for Payer: Healthscope Commercial |
$5,687.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,423.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,739.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,371.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,739.94
|
| Rate for Payer: PHP Commercial |
$5,371.93
|
| Rate for Payer: Priority Health SBD |
$3,981.55
|
| Rate for Payer: UMR Bronson Commercial |
$2,780.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,739.94
|
|
|
HC PACEMAKER SINGLE CHAMBER LVL 8
|
Facility
|
IP
|
$8,315.04
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500353
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,658.62 |
| Max. Negotiated Rate |
$7,483.54 |
| Rate for Payer: Aetna American Axle |
$5,404.78
|
| Rate for Payer: Aetna Commercial |
$7,067.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,404.78
|
| Rate for Payer: Cash Price |
$6,652.03
|
| Rate for Payer: Cofinity Advantage |
$5,820.53
|
| Rate for Payer: Cofinity Commercial |
$7,150.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,652.03
|
| Rate for Payer: Healthscope Commercial |
$7,483.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,820.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,236.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,067.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,236.28
|
| Rate for Payer: PHP Commercial |
$7,067.78
|
| Rate for Payer: Priority Health SBD |
$5,238.48
|
| Rate for Payer: UMR Bronson Commercial |
$3,658.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,236.28
|
|
