|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
OP
|
$1,666.35
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$281.38 |
| Max. Negotiated Rate |
$1,499.71 |
| Rate for Payer: Aetna American Axle |
$1,083.13
|
| Rate for Payer: Aetna Commercial |
$1,416.40
|
| Rate for Payer: Aetna Medicare |
$545.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.20
|
| Rate for Payer: BCBS Complete |
$295.45
|
| Rate for Payer: BCBS MAPPO |
$524.96
|
| Rate for Payer: BCN Medicare Advantage |
$524.96
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,433.06
|
| Rate for Payer: Cofinity Commercial |
$1,166.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,166.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.96
|
| Rate for Payer: Healthscope Commercial |
$1,499.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,166.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,249.76
|
| Rate for Payer: Mclaren Medicaid |
$281.38
|
| Rate for Payer: Mclaren Medicare |
$524.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.21
|
| Rate for Payer: Meridian Medicaid |
$295.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: PACE Medicare |
$498.71
|
| Rate for Payer: PACE SWMI |
$524.96
|
| Rate for Payer: PHP Commercial |
$1,416.40
|
| Rate for Payer: PHP Medicare Advantage |
$524.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: Priority Health Medicare |
$524.96
|
| Rate for Payer: Priority Health SBD |
$1,049.80
|
| Rate for Payer: Railroad Medicare Medicare |
$524.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,477.71
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.96
|
| Rate for Payer: UHC Exchange |
$1,003.25
|
| Rate for Payer: UHC Medicare Advantage |
$524.96
|
| Rate for Payer: UHCCP Medicaid |
$281.38
|
| Rate for Payer: UMR Bronson Commercial |
$616.55
|
| Rate for Payer: VA VA |
$524.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,249.76
|
|
|
HC NM VENT AEROSOL/GAS AND PERFUS
|
Facility
|
IP
|
$1,666.35
|
|
|
Service Code
|
CPT 78582
|
| Hospital Charge Code |
34100068
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$733.19 |
| Max. Negotiated Rate |
$1,499.71 |
| Rate for Payer: Aetna American Axle |
$1,083.13
|
| Rate for Payer: Aetna Commercial |
$1,416.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.13
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,166.44
|
| Rate for Payer: Cofinity Commercial |
$1,433.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,166.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Healthscope Commercial |
$1,499.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,166.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,249.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: PHP Commercial |
$1,416.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: Priority Health SBD |
$1,049.80
|
| Rate for Payer: UMR Bronson Commercial |
$733.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,249.76
|
|
|
HC NM VENTILATION AEROSOL OR GAS
|
Facility
|
IP
|
$1,219.18
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$536.44 |
| Max. Negotiated Rate |
$1,097.26 |
| Rate for Payer: Aetna American Axle |
$792.47
|
| Rate for Payer: Aetna Commercial |
$1,036.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.47
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cofinity Commercial |
$1,048.49
|
| Rate for Payer: Cofinity Commercial |
$853.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$853.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$975.34
|
| Rate for Payer: Healthscope Commercial |
$1,097.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$853.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$914.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,036.30
|
| Rate for Payer: PHP Commercial |
$1,036.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.47
|
| Rate for Payer: Priority Health SBD |
$768.08
|
| Rate for Payer: UMR Bronson Commercial |
$536.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$914.38
|
|
|
HC NM VENTILATION AEROSOL OR GAS
|
Facility
|
OP
|
$1,219.18
|
|
|
Service Code
|
CPT 78579
|
| Hospital Charge Code |
34100071
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$792.47
|
| Rate for Payer: Aetna Commercial |
$1,036.30
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$792.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cash Price |
$975.34
|
| Rate for Payer: Cofinity Commercial |
$853.43
|
| Rate for Payer: Cofinity Commercial |
$1,048.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$853.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$975.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$1,097.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$853.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$914.38
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,036.30
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$1,036.30
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$792.47
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$768.08
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$451.10
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$914.38
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
IP
|
$1,666.35
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$733.19 |
| Max. Negotiated Rate |
$1,499.71 |
| Rate for Payer: Aetna American Axle |
$1,083.13
|
| Rate for Payer: Aetna Commercial |
$1,416.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.13
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,166.44
|
| Rate for Payer: Cofinity Commercial |
$1,433.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,166.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Healthscope Commercial |
$1,499.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,166.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,249.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: PHP Commercial |
$1,416.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: Priority Health SBD |
$1,049.80
|
| Rate for Payer: UMR Bronson Commercial |
$733.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,249.76
|
|
|
HC NM VENTILATION PERFUS QUANT DIFF
|
Facility
|
OP
|
$1,666.35
|
|
|
Service Code
|
CPT 78598
|
| Hospital Charge Code |
34100070
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$281.38 |
| Max. Negotiated Rate |
$1,499.71 |
| Rate for Payer: Aetna American Axle |
$1,083.13
|
| Rate for Payer: Aetna Commercial |
$1,416.40
|
| Rate for Payer: Aetna Medicare |
$545.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,083.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.20
|
| Rate for Payer: BCBS Complete |
$295.45
|
| Rate for Payer: BCBS MAPPO |
$524.96
|
| Rate for Payer: BCN Medicare Advantage |
$524.96
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cash Price |
$1,333.08
|
| Rate for Payer: Cofinity Commercial |
$1,433.06
|
| Rate for Payer: Cofinity Commercial |
$1,166.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,166.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,333.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$524.96
|
| Rate for Payer: Healthscope Commercial |
$1,499.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,166.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,249.76
|
| Rate for Payer: Mclaren Medicaid |
$281.38
|
| Rate for Payer: Mclaren Medicare |
$524.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.21
|
| Rate for Payer: Meridian Medicaid |
$295.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$603.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,416.40
|
| Rate for Payer: PACE Medicare |
$498.71
|
| Rate for Payer: PACE SWMI |
$524.96
|
| Rate for Payer: PHP Commercial |
$1,416.40
|
| Rate for Payer: PHP Medicare Advantage |
$524.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,083.13
|
| Rate for Payer: Priority Health Medicare |
$524.96
|
| Rate for Payer: Priority Health SBD |
$1,049.80
|
| Rate for Payer: Railroad Medicare Medicare |
$524.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,477.71
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$524.96
|
| Rate for Payer: UHC Exchange |
$1,003.25
|
| Rate for Payer: UHC Medicare Advantage |
$524.96
|
| Rate for Payer: UHCCP Medicaid |
$281.38
|
| Rate for Payer: UMR Bronson Commercial |
$616.55
|
| Rate for Payer: VA VA |
$524.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,249.76
|
|
|
HC NM VOID CYSTO
|
Facility
|
OP
|
$1,069.28
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
34100049
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$695.03
|
| Rate for Payer: Aetna Commercial |
$908.89
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cofinity Commercial |
$919.58
|
| Rate for Payer: Cofinity Commercial |
$748.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$748.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$962.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.96
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.89
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$908.89
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.03
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$673.65
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$395.63
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.96
|
|
|
HC NM VOID CYSTO
|
Facility
|
IP
|
$1,069.28
|
|
|
Service Code
|
CPT 78740
|
| Hospital Charge Code |
34100049
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$470.48 |
| Max. Negotiated Rate |
$962.35 |
| Rate for Payer: Aetna American Axle |
$695.03
|
| Rate for Payer: Aetna Commercial |
$908.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$695.03
|
| Rate for Payer: Cash Price |
$855.42
|
| Rate for Payer: Cofinity Commercial |
$748.50
|
| Rate for Payer: Cofinity Commercial |
$919.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$748.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$855.42
|
| Rate for Payer: Healthscope Commercial |
$962.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$748.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$801.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$908.89
|
| Rate for Payer: PHP Commercial |
$908.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$695.03
|
| Rate for Payer: Priority Health SBD |
$673.65
|
| Rate for Payer: UMR Bronson Commercial |
$470.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$801.96
|
|
|
HC NM ZEVALIN Y-90 THERAPY
|
Facility
|
IP
|
$1,939.87
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
34100065
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$853.54 |
| Max. Negotiated Rate |
$1,745.88 |
| Rate for Payer: Aetna American Axle |
$1,260.92
|
| Rate for Payer: Aetna Commercial |
$1,648.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.92
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cofinity Commercial |
$1,357.91
|
| Rate for Payer: Cofinity Commercial |
$1,668.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,357.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.90
|
| Rate for Payer: Healthscope Commercial |
$1,745.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,454.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.89
|
| Rate for Payer: PHP Commercial |
$1,648.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.92
|
| Rate for Payer: Priority Health SBD |
$1,222.12
|
| Rate for Payer: UMR Bronson Commercial |
$853.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,454.90
|
|
|
HC NM ZEVALIN Y-90 THERAPY
|
Facility
|
OP
|
$1,939.87
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
34100065
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$117.16 |
| Max. Negotiated Rate |
$1,745.88 |
| Rate for Payer: Aetna American Axle |
$1,260.92
|
| Rate for Payer: Aetna Commercial |
$1,648.89
|
| Rate for Payer: Aetna Medicare |
$227.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,260.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$273.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$273.24
|
| Rate for Payer: BCBS Complete |
$123.02
|
| Rate for Payer: BCBS MAPPO |
$218.59
|
| Rate for Payer: BCN Medicare Advantage |
$218.59
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cash Price |
$1,551.90
|
| Rate for Payer: Cofinity Commercial |
$1,668.29
|
| Rate for Payer: Cofinity Commercial |
$1,357.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,357.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,551.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.59
|
| Rate for Payer: Healthscope Commercial |
$1,745.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,357.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,454.90
|
| Rate for Payer: Mclaren Medicaid |
$117.16
|
| Rate for Payer: Mclaren Medicare |
$218.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.52
|
| Rate for Payer: Meridian Medicaid |
$123.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$251.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,648.89
|
| Rate for Payer: PACE Medicare |
$207.66
|
| Rate for Payer: PACE SWMI |
$218.59
|
| Rate for Payer: PHP Commercial |
$1,648.89
|
| Rate for Payer: PHP Medicare Advantage |
$218.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,260.92
|
| Rate for Payer: Priority Health Medicare |
$218.59
|
| Rate for Payer: Priority Health SBD |
$1,222.12
|
| Rate for Payer: Railroad Medicare Medicare |
$218.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$615.31
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$218.59
|
| Rate for Payer: UHC Exchange |
$417.75
|
| Rate for Payer: UHC Medicare Advantage |
$218.59
|
| Rate for Payer: UHCCP Medicaid |
$117.16
|
| Rate for Payer: UMR Bronson Commercial |
$717.75
|
| Rate for Payer: VA VA |
$218.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,454.90
|
|
|
HC NO IMPLANT/INSERT DEVICE W/DEVICE-INTENS PROC
|
Facility
|
IP
|
$1.02
|
|
|
Service Code
|
HCPCS C1890
|
| Hospital Charge Code |
27800125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.45 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna American Axle |
$0.66
|
| Rate for Payer: Aetna Commercial |
$0.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.66
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Commercial |
$0.71
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$0.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.87
|
| Rate for Payer: PHP Commercial |
$0.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.66
|
| Rate for Payer: Priority Health SBD |
$0.64
|
| Rate for Payer: UMR Bronson Commercial |
$0.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.77
|
|
|
HC NO IMPLANT/INSERT DEVICE W/DEVICE-INTENS PROC
|
Facility
|
OP
|
$1.02
|
|
|
Service Code
|
HCPCS C1890
|
| Hospital Charge Code |
27800125
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Aetna American Axle |
$0.66
|
| Rate for Payer: Aetna Commercial |
$0.87
|
| Rate for Payer: Aetna Medicare |
$0.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.66
|
| Rate for Payer: BCBS Complete |
$0.41
|
| Rate for Payer: Cash Price |
$0.82
|
| Rate for Payer: Cofinity Commercial |
$0.71
|
| Rate for Payer: Cofinity Commercial |
$0.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.82
|
| Rate for Payer: Healthscope Commercial |
$0.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.87
|
| Rate for Payer: PHP Commercial |
$0.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.66
|
| Rate for Payer: Priority Health SBD |
$0.64
|
| Rate for Payer: UMR Bronson Commercial |
$0.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.77
|
|
|
HC NONCONC SLIDES W/INTERP
|
Facility
|
OP
|
$87.30
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
31100001
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.52 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: Aetna American Axle |
$56.74
|
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna Medicare |
$39.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.85
|
| Rate for Payer: BCBS Complete |
$21.54
|
| Rate for Payer: BCBS MAPPO |
$38.28
|
| Rate for Payer: BCN Medicare Advantage |
$38.28
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cofinity Commercial |
$75.08
|
| Rate for Payer: Cofinity Commercial |
$61.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$78.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.47
|
| Rate for Payer: Mclaren Medicaid |
$20.52
|
| Rate for Payer: Mclaren Medicare |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.19
|
| Rate for Payer: Meridian Medicaid |
$21.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: PACE Medicare |
$36.37
|
| Rate for Payer: PACE SWMI |
$38.28
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: PHP Medicare Advantage |
$38.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.74
|
| Rate for Payer: Priority Health Medicare |
$38.28
|
| Rate for Payer: Priority Health SBD |
$55.00
|
| Rate for Payer: Railroad Medicare Medicare |
$38.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.28
|
| Rate for Payer: UHC Exchange |
$73.16
|
| Rate for Payer: UHC Medicare Advantage |
$38.28
|
| Rate for Payer: UHCCP Medicaid |
$20.52
|
| Rate for Payer: UMR Bronson Commercial |
$32.30
|
| Rate for Payer: VA VA |
$38.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.47
|
|
|
HC NONCONC SLIDES W/INTERP
|
Facility
|
IP
|
$87.30
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
31100001
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$38.41 |
| Max. Negotiated Rate |
$78.57 |
| Rate for Payer: Aetna American Axle |
$56.74
|
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Cash Price |
$69.84
|
| Rate for Payer: Cofinity Commercial |
$61.11
|
| Rate for Payer: Cofinity Commercial |
$75.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.84
|
| Rate for Payer: Healthscope Commercial |
$78.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.74
|
| Rate for Payer: Priority Health SBD |
$55.00
|
| Rate for Payer: UMR Bronson Commercial |
$38.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.47
|
|
|
HC NONINVASIVE PROGRAM STIM
|
Facility
|
IP
|
$2,469.74
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
48100043
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,086.69 |
| Max. Negotiated Rate |
$2,222.77 |
| Rate for Payer: Aetna American Axle |
$1,605.33
|
| Rate for Payer: Aetna Commercial |
$2,099.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,605.33
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cofinity Commercial |
$1,728.82
|
| Rate for Payer: Cofinity Commercial |
$2,123.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,728.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,975.79
|
| Rate for Payer: Healthscope Commercial |
$2,222.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,728.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,852.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.28
|
| Rate for Payer: PHP Commercial |
$2,099.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.33
|
| Rate for Payer: Priority Health SBD |
$1,555.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,086.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,852.31
|
|
|
HC NONINVASIVE PROGRAM STIM
|
Facility
|
OP
|
$2,469.74
|
|
|
Service Code
|
CPT 93642
|
| Hospital Charge Code |
48100043
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$634.61 |
| Max. Negotiated Rate |
$3,332.79 |
| Rate for Payer: Aetna American Axle |
$1,605.33
|
| Rate for Payer: Aetna Commercial |
$2,099.28
|
| Rate for Payer: Aetna Medicare |
$1,231.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,605.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,479.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,479.97
|
| Rate for Payer: BCBS Complete |
$666.34
|
| Rate for Payer: BCBS MAPPO |
$1,183.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,183.98
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cash Price |
$1,975.79
|
| Rate for Payer: Cofinity Commercial |
$2,123.98
|
| Rate for Payer: Cofinity Commercial |
$1,728.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,728.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,975.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,183.98
|
| Rate for Payer: Healthscope Commercial |
$2,222.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,728.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,852.31
|
| Rate for Payer: Mclaren Medicaid |
$634.61
|
| Rate for Payer: Mclaren Medicare |
$1,183.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,243.18
|
| Rate for Payer: Meridian Medicaid |
$666.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,361.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,099.28
|
| Rate for Payer: PACE Medicare |
$1,124.78
|
| Rate for Payer: PACE SWMI |
$1,183.98
|
| Rate for Payer: PHP Commercial |
$2,099.28
|
| Rate for Payer: PHP Medicare Advantage |
$1,183.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,605.33
|
| Rate for Payer: Priority Health Medicare |
$1,183.98
|
| Rate for Payer: Priority Health SBD |
$1,555.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,183.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,332.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,183.98
|
| Rate for Payer: UHC Exchange |
$2,262.70
|
| Rate for Payer: UHC Medicare Advantage |
$1,183.98
|
| Rate for Payer: UHCCP Medicaid |
$634.61
|
| Rate for Payer: UMR Bronson Commercial |
$913.80
|
| Rate for Payer: VA VA |
$1,183.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,852.31
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
OP
|
$1,132.67
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$419.09 |
| Max. Negotiated Rate |
$1,019.40 |
| Rate for Payer: Aetna American Axle |
$736.24
|
| Rate for Payer: Aetna Commercial |
$962.77
|
| Rate for Payer: Aetna Medicare |
$566.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.24
|
| Rate for Payer: BCBS Complete |
$453.07
|
| Rate for Payer: Cash Price |
$906.14
|
| Rate for Payer: Cofinity Commercial |
$792.87
|
| Rate for Payer: Cofinity Commercial |
$974.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$792.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$906.14
|
| Rate for Payer: Healthscope Commercial |
$1,019.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$792.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$849.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$962.77
|
| Rate for Payer: PHP Commercial |
$962.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.24
|
| Rate for Payer: Priority Health SBD |
$713.58
|
| Rate for Payer: UMR Bronson Commercial |
$419.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$849.50
|
|
|
HC NON OPEN HEART PLATELET MAPPING
|
Facility
|
IP
|
$1,132.67
|
|
| Hospital Charge Code |
27000389
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$498.37 |
| Max. Negotiated Rate |
$1,019.40 |
| Rate for Payer: Aetna American Axle |
$736.24
|
| Rate for Payer: Aetna Commercial |
$962.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$736.24
|
| Rate for Payer: Cash Price |
$906.14
|
| Rate for Payer: Cofinity Commercial |
$792.87
|
| Rate for Payer: Cofinity Commercial |
$974.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$792.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$906.14
|
| Rate for Payer: Healthscope Commercial |
$1,019.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$792.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$849.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$962.77
|
| Rate for Payer: PHP Commercial |
$962.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$736.24
|
| Rate for Payer: Priority Health SBD |
$713.58
|
| Rate for Payer: UMR Bronson Commercial |
$498.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$849.50
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
OP
|
$924.31
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$341.99 |
| Max. Negotiated Rate |
$831.88 |
| Rate for Payer: Aetna American Axle |
$600.80
|
| Rate for Payer: Aetna Commercial |
$785.66
|
| Rate for Payer: Aetna Medicare |
$462.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.80
|
| Rate for Payer: BCBS Complete |
$369.72
|
| Rate for Payer: Cash Price |
$739.45
|
| Rate for Payer: Cofinity Commercial |
$647.02
|
| Rate for Payer: Cofinity Commercial |
$794.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$647.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.45
|
| Rate for Payer: Healthscope Commercial |
$831.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$647.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.66
|
| Rate for Payer: PHP Commercial |
$785.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.80
|
| Rate for Payer: Priority Health SBD |
$582.32
|
| Rate for Payer: UMR Bronson Commercial |
$341.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.23
|
|
|
HC NON OPEN HEART TEG
|
Facility
|
IP
|
$924.31
|
|
| Hospital Charge Code |
27000197
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$406.70 |
| Max. Negotiated Rate |
$831.88 |
| Rate for Payer: Aetna American Axle |
$600.80
|
| Rate for Payer: Aetna Commercial |
$785.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.80
|
| Rate for Payer: Cash Price |
$739.45
|
| Rate for Payer: Cofinity Commercial |
$647.02
|
| Rate for Payer: Cofinity Commercial |
$794.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$647.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$739.45
|
| Rate for Payer: Healthscope Commercial |
$831.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$647.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$693.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.66
|
| Rate for Payer: PHP Commercial |
$785.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.80
|
| Rate for Payer: Priority Health SBD |
$582.32
|
| Rate for Payer: UMR Bronson Commercial |
$406.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$693.23
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
IP
|
$358.94
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.93 |
| Max. Negotiated Rate |
$323.05 |
| Rate for Payer: Aetna American Axle |
$233.31
|
| Rate for Payer: Aetna Commercial |
$305.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.31
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cofinity Commercial |
$251.26
|
| Rate for Payer: Cofinity Commercial |
$308.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.15
|
| Rate for Payer: Healthscope Commercial |
$323.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.10
|
| Rate for Payer: PHP Commercial |
$305.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.31
|
| Rate for Payer: Priority Health SBD |
$226.13
|
| Rate for Payer: UMR Bronson Commercial |
$157.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.20
|
|
|
HC NON-SELECTIVE DEBRIDEMENT
|
Facility
|
OP
|
$358.94
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
42000037
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$545.50 |
| Rate for Payer: Aetna American Axle |
$233.31
|
| Rate for Payer: Aetna Commercial |
$305.10
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cash Price |
$287.15
|
| Rate for Payer: Cofinity Commercial |
$308.69
|
| Rate for Payer: Cofinity Commercial |
$251.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$323.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.20
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.10
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$305.10
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.31
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$226.13
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$132.81
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.20
|
|
|
HC NON-SELECTIVE THORACIC AORTA W ANGIO
|
Facility
|
OP
|
$3,955.19
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
36100376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,463.42 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,570.87
|
| Rate for Payer: Aetna Commercial |
$3,361.91
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,570.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cofinity Commercial |
$3,401.46
|
| Rate for Payer: Cofinity Commercial |
$2,768.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,768.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,559.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,768.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,966.39
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,361.91
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,361.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,570.87
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,491.77
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,463.42
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,966.39
|
|
|
HC NON-SELECTIVE THORACIC AORTA W ANGIO
|
Facility
|
IP
|
$3,955.19
|
|
|
Service Code
|
CPT 36221
|
| Hospital Charge Code |
36100376
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,740.28 |
| Max. Negotiated Rate |
$3,559.67 |
| Rate for Payer: Aetna American Axle |
$2,570.87
|
| Rate for Payer: Aetna Commercial |
$3,361.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,570.87
|
| Rate for Payer: Cash Price |
$3,164.15
|
| Rate for Payer: Cofinity Commercial |
$2,768.63
|
| Rate for Payer: Cofinity Commercial |
$3,401.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,768.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.15
|
| Rate for Payer: Healthscope Commercial |
$3,559.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,768.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,966.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,361.91
|
| Rate for Payer: PHP Commercial |
$3,361.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,570.87
|
| Rate for Payer: Priority Health SBD |
$2,491.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,740.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,966.39
|
|
|
HC NON-SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
IP
|
$9,547.08
|
|
|
Service Code
|
CPT 36225
|
| Hospital Charge Code |
36100380
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,200.72 |
| Max. Negotiated Rate |
$8,592.37 |
| Rate for Payer: Aetna American Axle |
$6,205.60
|
| Rate for Payer: Aetna Commercial |
$8,115.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,205.60
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cofinity Commercial |
$6,682.96
|
| Rate for Payer: Cofinity Commercial |
$8,210.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,682.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,637.66
|
| Rate for Payer: Healthscope Commercial |
$8,592.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,682.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,160.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,115.02
|
| Rate for Payer: PHP Commercial |
$8,115.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,205.60
|
| Rate for Payer: Priority Health SBD |
$6,014.66
|
| Rate for Payer: UMR Bronson Commercial |
$4,200.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,160.31
|
|
