|
HC PEJ FDG TUBE INSERTION/REPLACE
|
Facility
|
IP
|
$1,555.53
|
|
| Hospital Charge Code |
36000059
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$684.43 |
| Max. Negotiated Rate |
$1,399.98 |
| Rate for Payer: Aetna American Axle |
$1,011.09
|
| Rate for Payer: Aetna Commercial |
$1,322.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.09
|
| Rate for Payer: Cash Price |
$1,244.42
|
| Rate for Payer: Cofinity Advantage |
$1,088.87
|
| Rate for Payer: Cofinity Commercial |
$1,337.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.42
|
| Rate for Payer: Healthscope Commercial |
$1,399.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,088.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,166.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,322.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,166.65
|
| Rate for Payer: PHP Commercial |
$1,322.20
|
| Rate for Payer: Priority Health SBD |
$979.98
|
| Rate for Payer: UMR Bronson Commercial |
$684.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,166.65
|
|
|
HC PELVIC EXAMINATION
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 99459
|
| Hospital Charge Code |
51000129
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$16.76 |
| Max. Negotiated Rate |
$90.18 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$23.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: BCBS Complete |
$19.18
|
| Rate for Payer: BCBS Trust/PPO |
$90.18
|
| Rate for Payer: BCCCP Commercial |
$16.76
|
| Rate for Payer: BCN Commercial |
$90.18
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Advantage |
$33.56
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.95
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.16
|
| Rate for Payer: UHC Core |
$24.98
|
| Rate for Payer: UHC Exchange |
$18.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC PELVIC EXAMINATION
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 99459
|
| Hospital Charge Code |
51000129
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Advantage |
$33.56
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.95
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: UMR Bronson Commercial |
$21.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.95
|
|
|
HC PENICILLIUM IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200055
|
|
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 PENICILLIUM IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200055
|
|
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 PENTAMIDINE THERAPY
|
Facility
|
IP
|
$1,054.22
|
|
|
Service Code
|
CPT 94642
|
| Hospital Charge Code |
41000005
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$463.86 |
| Max. Negotiated Rate |
$948.80 |
| Rate for Payer: Aetna American Axle |
$685.24
|
| Rate for Payer: Aetna Commercial |
$896.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.24
|
| Rate for Payer: Cash Price |
$843.38
|
| Rate for Payer: Cofinity Advantage |
$737.95
|
| Rate for Payer: Cofinity Commercial |
$906.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.38
|
| Rate for Payer: Healthscope Commercial |
$948.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$737.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$790.66
|
| Rate for Payer: PHP Commercial |
$896.09
|
| Rate for Payer: Priority Health SBD |
$664.16
|
| Rate for Payer: UMR Bronson Commercial |
$463.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.66
|
|
|
HC PENTAMIDINE THERAPY
|
Facility
|
OP
|
$1,054.22
|
|
|
Service Code
|
CPT 94642
|
| Hospital Charge Code |
41000005
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$114.11 |
| Max. Negotiated Rate |
$948.80 |
| Rate for Payer: Aetna American Axle |
$685.24
|
| Rate for Payer: Aetna Commercial |
$896.09
|
| Rate for Payer: Aetna Medicare |
$226.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.74
|
| Rate for Payer: BCBS Complete |
$119.83
|
| Rate for Payer: BCBS MAPPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$538.03
|
| Rate for Payer: BCN Commercial |
$538.03
|
| Rate for Payer: BCN Medicare Advantage |
$218.19
|
| Rate for Payer: Cash Price |
$843.38
|
| Rate for Payer: Cash Price |
$843.38
|
| Rate for Payer: Cofinity Advantage |
$737.95
|
| Rate for Payer: Cofinity Commercial |
$906.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.19
|
| Rate for Payer: Healthscope Commercial |
$948.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$737.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.66
|
| Rate for Payer: Mclaren Medicaid |
$218.19
|
| Rate for Payer: Mclaren Medicare |
$218.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.10
|
| Rate for Payer: Meridian Medicaid |
$229.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$240.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.09
|
| Rate for Payer: Nomi Health Commercial |
$654.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$790.66
|
| Rate for Payer: PACE Medicare |
$207.28
|
| Rate for Payer: PACE SWMI |
$218.19
|
| Rate for Payer: PHP Commercial |
$896.09
|
| Rate for Payer: PHP Medicare Advantage |
$218.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$705.61
|
| Rate for Payer: Priority Health Medicare |
$218.19
|
| Rate for Payer: Priority Health SBD |
$664.16
|
| Rate for Payer: Priority Health Tiered Network |
$564.49
|
| Rate for Payer: Railroad Medicare Medicare |
$218.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$685.24
|
| Rate for Payer: UHC Core |
$549.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$218.19
|
| Rate for Payer: UHC Exchange |
$414.31
|
| Rate for Payer: UHC Medicaid |
$114.11
|
| Rate for Payer: UHCCP Medicaid |
$114.11
|
| Rate for Payer: UMR Bronson Commercial |
$390.06
|
| Rate for Payer: VA VA |
$218.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.66
|
|
|
HC PENTOBARBITOL NEMBUTAL LVL
|
Facility
|
OP
|
$182.07
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100572
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.37 |
| Max. Negotiated Rate |
$163.86 |
| Rate for Payer: Aetna American Axle |
$118.35
|
| Rate for Payer: Aetna Commercial |
$154.76
|
| Rate for Payer: Aetna Medicare |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.35
|
| Rate for Payer: BCBS Complete |
$72.83
|
| Rate for Payer: Cash Price |
$145.66
|
| Rate for Payer: Cofinity Advantage |
$127.45
|
| Rate for Payer: Cofinity Commercial |
$156.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.66
|
| Rate for Payer: Healthscope Commercial |
$163.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.55
|
| Rate for Payer: PHP Commercial |
$154.76
|
| Rate for Payer: Priority Health SBD |
$114.70
|
| Rate for Payer: UMR Bronson Commercial |
$67.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.55
|
|
|
HC PENTOBARBITOL NEMBUTAL LVL
|
Facility
|
IP
|
$182.07
|
|
|
Service Code
|
CPT 80345
|
| Hospital Charge Code |
30100572
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$80.11 |
| Max. Negotiated Rate |
$163.86 |
| Rate for Payer: Aetna American Axle |
$118.35
|
| Rate for Payer: Aetna Commercial |
$154.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.35
|
| Rate for Payer: Cash Price |
$145.66
|
| Rate for Payer: Cofinity Advantage |
$127.45
|
| Rate for Payer: Cofinity Commercial |
$156.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.66
|
| Rate for Payer: Healthscope Commercial |
$163.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.55
|
| Rate for Payer: PHP Commercial |
$154.76
|
| Rate for Payer: Priority Health SBD |
$114.70
|
| Rate for Payer: UMR Bronson Commercial |
$80.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.55
|
|
|
HC PEP VALVE SUPPLY
|
Facility
|
IP
|
$55.67
|
|
| Hospital Charge Code |
27000134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$24.49 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Aetna American Axle |
$36.19
|
| Rate for Payer: Aetna Commercial |
$47.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.19
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cofinity Advantage |
$38.97
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Healthscope Commercial |
$50.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.75
|
| Rate for Payer: PHP Commercial |
$47.32
|
| Rate for Payer: Priority Health SBD |
$35.07
|
| Rate for Payer: UMR Bronson Commercial |
$24.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.75
|
|
|
HC PEP VALVE SUPPLY
|
Facility
|
OP
|
$55.67
|
|
| Hospital Charge Code |
27000134
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$50.10 |
| Rate for Payer: Aetna American Axle |
$36.19
|
| Rate for Payer: Aetna Commercial |
$47.32
|
| Rate for Payer: Aetna Medicare |
$27.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.19
|
| Rate for Payer: BCBS Complete |
$22.27
|
| Rate for Payer: Cash Price |
$44.54
|
| Rate for Payer: Cofinity Advantage |
$38.97
|
| Rate for Payer: Cofinity Commercial |
$47.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.54
|
| Rate for Payer: Healthscope Commercial |
$50.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.75
|
| Rate for Payer: PHP Commercial |
$47.32
|
| Rate for Payer: Priority Health SBD |
$35.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.19
|
| Rate for Payer: UHC Core |
$29.00
|
| Rate for Payer: UHC Exchange |
$21.88
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.75
|
|
|
HC PERC CHOLECYSTOSTOMY
|
Facility
|
OP
|
$5,268.14
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
36100200
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,865.82 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna American Axle |
$3,424.29
|
| Rate for Payer: Aetna Commercial |
$4,477.92
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,424.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,230.13
|
| Rate for Payer: BCN Commercial |
$3,230.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$4,214.51
|
| Rate for Payer: Cash Price |
$4,214.51
|
| Rate for Payer: Cash Price |
$4,214.51
|
| Rate for Payer: Cofinity Advantage |
$3,687.70
|
| Rate for Payer: Cofinity Commercial |
$4,530.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,214.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$4,741.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,687.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,951.11
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,477.92
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,951.11
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$4,477.92
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$3,318.93
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,949.21
|
| Rate for Payer: VA VA |
$3,567.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,951.11
|
|
|
HC PERC CHOLECYSTOSTOMY
|
Facility
|
IP
|
$5,268.14
|
|
|
Service Code
|
CPT 47490
|
| Hospital Charge Code |
36100200
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,317.98 |
| Max. Negotiated Rate |
$4,741.33 |
| Rate for Payer: Aetna American Axle |
$3,424.29
|
| Rate for Payer: Aetna Commercial |
$4,477.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,424.29
|
| Rate for Payer: Cash Price |
$4,214.51
|
| Rate for Payer: Cofinity Advantage |
$3,687.70
|
| Rate for Payer: Cofinity Commercial |
$4,530.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,214.51
|
| Rate for Payer: Healthscope Commercial |
$4,741.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,687.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,951.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,477.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,951.11
|
| Rate for Payer: PHP Commercial |
$4,477.92
|
| Rate for Payer: Priority Health SBD |
$3,318.93
|
| Rate for Payer: UMR Bronson Commercial |
$2,317.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,951.11
|
|
|
HC PERCH OCEAN IGE
|
Facility
|
IP
|
$74.29
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200481
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.69 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna American Axle |
$48.29
|
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.29
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Advantage |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: Priority Health SBD |
$46.80
|
| Rate for Payer: UMR Bronson Commercial |
$32.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC PERCH OCEAN IGE
|
Facility
|
OP
|
$74.29
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200481
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna American Axle |
$48.29
|
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.29
|
| 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 |
$59.43
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Advantage |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| 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 |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$63.15
|
| 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 |
$46.80
|
| 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 |
$27.49
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
OP
|
$14,383.08
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,321.09 |
| Max. Negotiated Rate |
$20,535.59 |
| Rate for Payer: Aetna American Axle |
$9,349.00
|
| Rate for Payer: Aetna Commercial |
$12,225.62
|
| Rate for Payer: Aetna Medicare |
$6,604.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,349.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,937.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,937.60
|
| Rate for Payer: BCBS Complete |
$3,487.46
|
| Rate for Payer: BCBS MAPPO |
$6,350.08
|
| Rate for Payer: BCBS Trust/PPO |
$8,262.26
|
| Rate for Payer: BCN Commercial |
$8,262.26
|
| Rate for Payer: BCN Medicare Advantage |
$6,350.08
|
| Rate for Payer: Cash Price |
$11,506.46
|
| Rate for Payer: Cash Price |
$11,506.46
|
| Rate for Payer: Cash Price |
$11,506.46
|
| Rate for Payer: Cofinity Advantage |
$10,068.16
|
| Rate for Payer: Cofinity Commercial |
$12,369.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,506.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,350.08
|
| Rate for Payer: Healthscope Commercial |
$12,944.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,068.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,787.31
|
| Rate for Payer: Mclaren Medicaid |
$6,350.08
|
| Rate for Payer: Mclaren Medicare |
$6,350.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,667.58
|
| Rate for Payer: Meridian Medicaid |
$6,667.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,302.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,985.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,225.62
|
| Rate for Payer: Nomi Health Commercial |
$19,050.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,787.31
|
| Rate for Payer: PACE Medicare |
$6,032.58
|
| Rate for Payer: PACE SWMI |
$6,350.08
|
| Rate for Payer: PHP Commercial |
$12,225.62
|
| Rate for Payer: PHP Medicare Advantage |
$6,350.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,321.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,535.59
|
| Rate for Payer: Priority Health Medicare |
$6,350.08
|
| Rate for Payer: Priority Health SBD |
$9,061.34
|
| Rate for Payer: Priority Health Tiered Network |
$16,428.47
|
| Rate for Payer: Railroad Medicare Medicare |
$6,350.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,350.08
|
| Rate for Payer: UHC Medicaid |
$3,321.09
|
| Rate for Payer: UHCCP Medicaid |
$3,321.09
|
| Rate for Payer: UMR Bronson Commercial |
$5,321.74
|
| Rate for Payer: VA VA |
$6,350.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,787.31
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
IP
|
$14,383.08
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,328.56 |
| Max. Negotiated Rate |
$12,944.77 |
| Rate for Payer: Aetna American Axle |
$9,349.00
|
| Rate for Payer: Aetna Commercial |
$12,225.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,349.00
|
| Rate for Payer: Cash Price |
$11,506.46
|
| Rate for Payer: Cofinity Advantage |
$10,068.16
|
| Rate for Payer: Cofinity Commercial |
$12,369.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,506.46
|
| Rate for Payer: Healthscope Commercial |
$12,944.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,068.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,787.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,225.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,787.31
|
| Rate for Payer: PHP Commercial |
$12,225.62
|
| Rate for Payer: Priority Health SBD |
$9,061.34
|
| Rate for Payer: UMR Bronson Commercial |
$6,328.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,787.31
|
|
|
HC PERCLOSE
|
Facility
|
OP
|
$1,073.27
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$397.11 |
| Max. Negotiated Rate |
$965.94 |
| Rate for Payer: Aetna American Axle |
$697.63
|
| Rate for Payer: Aetna Commercial |
$912.28
|
| Rate for Payer: Aetna Medicare |
$536.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.63
|
| Rate for Payer: BCBS Complete |
$429.31
|
| Rate for Payer: Cash Price |
$858.62
|
| Rate for Payer: Cofinity Advantage |
$751.29
|
| Rate for Payer: Cofinity Commercial |
$923.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.62
|
| Rate for Payer: Healthscope Commercial |
$965.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$751.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$858.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.95
|
| Rate for Payer: PHP Commercial |
$912.28
|
| Rate for Payer: Priority Health SBD |
$676.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$697.63
|
| Rate for Payer: UHC Core |
$559.17
|
| Rate for Payer: UHC Exchange |
$421.80
|
| Rate for Payer: UMR Bronson Commercial |
$397.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.95
|
|
|
HC PERCLOSE
|
Facility
|
IP
|
$1,073.27
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$472.24 |
| Max. Negotiated Rate |
$965.94 |
| Rate for Payer: Aetna American Axle |
$697.63
|
| Rate for Payer: Aetna Commercial |
$912.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.63
|
| Rate for Payer: Cash Price |
$858.62
|
| Rate for Payer: Cofinity Advantage |
$751.29
|
| Rate for Payer: Cofinity Commercial |
$923.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$858.62
|
| Rate for Payer: Healthscope Commercial |
$965.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$751.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$912.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.95
|
| Rate for Payer: PHP Commercial |
$912.28
|
| Rate for Payer: Priority Health SBD |
$676.16
|
| Rate for Payer: UMR Bronson Commercial |
$472.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.95
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$6,639.53
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,456.63 |
| Max. Negotiated Rate |
$18,339.80 |
| Rate for Payer: Aetna American Axle |
$4,315.69
|
| Rate for Payer: Aetna Commercial |
$5,643.60
|
| Rate for Payer: Aetna Medicare |
$5,897.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,315.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,088.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,088.88
|
| Rate for Payer: BCBS Complete |
$3,114.57
|
| Rate for Payer: BCBS MAPPO |
$5,671.10
|
| Rate for Payer: BCBS Trust/PPO |
$6,545.53
|
| Rate for Payer: BCN Commercial |
$6,545.53
|
| Rate for Payer: BCN Medicare Advantage |
$5,671.10
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cofinity Advantage |
$4,647.67
|
| Rate for Payer: Cofinity Commercial |
$5,710.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,671.10
|
| Rate for Payer: Healthscope Commercial |
$5,975.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,647.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,979.65
|
| Rate for Payer: Mclaren Medicaid |
$5,671.10
|
| Rate for Payer: Mclaren Medicare |
$5,671.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,954.65
|
| Rate for Payer: Meridian Medicaid |
$5,954.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,521.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,238.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.60
|
| Rate for Payer: Nomi Health Commercial |
$17,013.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,979.65
|
| Rate for Payer: PACE Medicare |
$5,387.55
|
| Rate for Payer: PACE SWMI |
$5,671.10
|
| Rate for Payer: PHP Commercial |
$5,643.60
|
| Rate for Payer: PHP Medicare Advantage |
$5,671.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,965.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18,339.80
|
| Rate for Payer: Priority Health Medicare |
$5,671.10
|
| Rate for Payer: Priority Health SBD |
$4,182.90
|
| Rate for Payer: Priority Health Tiered Network |
$14,671.84
|
| Rate for Payer: Railroad Medicare Medicare |
$5,671.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,671.10
|
| Rate for Payer: UHC Medicaid |
$2,965.99
|
| Rate for Payer: UHCCP Medicaid |
$2,965.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,456.63
|
| Rate for Payer: VA VA |
$5,671.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,979.65
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$6,639.53
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,921.39 |
| Max. Negotiated Rate |
$5,975.58 |
| Rate for Payer: Aetna American Axle |
$4,315.69
|
| Rate for Payer: Aetna Commercial |
$5,643.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,315.69
|
| Rate for Payer: Cash Price |
$5,311.62
|
| Rate for Payer: Cofinity Advantage |
$4,647.67
|
| Rate for Payer: Cofinity Commercial |
$5,710.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.62
|
| Rate for Payer: Healthscope Commercial |
$5,975.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,647.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,979.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,979.65
|
| Rate for Payer: PHP Commercial |
$5,643.60
|
| Rate for Payer: Priority Health SBD |
$4,182.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,921.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,979.65
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$18,046.39
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,940.41 |
| Max. Negotiated Rate |
$16,241.75 |
| Rate for Payer: Aetna American Axle |
$11,730.15
|
| Rate for Payer: Aetna Commercial |
$15,339.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,730.15
|
| Rate for Payer: Cash Price |
$14,437.11
|
| Rate for Payer: Cofinity Advantage |
$12,632.47
|
| Rate for Payer: Cofinity Commercial |
$15,519.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,437.11
|
| Rate for Payer: Healthscope Commercial |
$16,241.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,632.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,534.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,339.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,534.79
|
| Rate for Payer: PHP Commercial |
$15,339.43
|
| Rate for Payer: Priority Health SBD |
$11,369.23
|
| Rate for Payer: UMR Bronson Commercial |
$7,940.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,534.79
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$18,046.39
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$11,730.15
|
| Rate for Payer: Aetna Commercial |
$15,339.43
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,730.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$12,402.80
|
| Rate for Payer: BCN Commercial |
$12,402.80
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$14,437.11
|
| Rate for Payer: Cash Price |
$14,437.11
|
| Rate for Payer: Cash Price |
$14,437.11
|
| Rate for Payer: Cofinity Advantage |
$12,632.47
|
| Rate for Payer: Cofinity Commercial |
$15,519.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,437.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$16,241.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,632.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,534.79
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,339.43
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,534.79
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$15,339.43
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$11,369.23
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$6,677.16
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,534.79
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$28,657.20
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,609.17 |
| Max. Negotiated Rate |
$25,791.48 |
| Rate for Payer: Aetna American Axle |
$18,627.18
|
| Rate for Payer: Aetna Commercial |
$24,358.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,627.18
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cofinity Advantage |
$20,060.04
|
| Rate for Payer: Cofinity Commercial |
$24,645.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,925.76
|
| Rate for Payer: Healthscope Commercial |
$25,791.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,060.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,492.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,358.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,492.90
|
| Rate for Payer: PHP Commercial |
$24,358.62
|
| Rate for Payer: Priority Health SBD |
$18,054.04
|
| Rate for Payer: UMR Bronson Commercial |
$12,609.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,492.90
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$28,657.20
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$18,627.18
|
| Rate for Payer: Aetna Commercial |
$24,358.62
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,627.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCBS Trust/PPO |
$19,417.48
|
| Rate for Payer: BCN Commercial |
$19,417.48
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cash Price |
$22,925.76
|
| Rate for Payer: Cofinity Advantage |
$20,060.04
|
| Rate for Payer: Cofinity Commercial |
$24,645.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,925.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$25,791.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,060.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,492.90
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,358.62
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,492.90
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$24,358.62
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$18,054.04
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$10,603.16
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,492.90
|
|
