|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
IP
|
$862.45
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$379.48 |
| Max. Negotiated Rate |
$776.21 |
| Rate for Payer: Aetna American Axle |
$560.59
|
| Rate for Payer: Aetna Commercial |
$733.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$560.59
|
| Rate for Payer: Cash Price |
$689.96
|
| Rate for Payer: Cofinity Advantage |
$603.72
|
| Rate for Payer: Cofinity Commercial |
$741.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.96
|
| Rate for Payer: Healthscope Commercial |
$776.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$603.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$646.84
|
| Rate for Payer: PHP Commercial |
$733.08
|
| Rate for Payer: Priority Health SBD |
$543.34
|
| Rate for Payer: UMR Bronson Commercial |
$379.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.84
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
OP
|
$862.45
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$319.11 |
| Max. Negotiated Rate |
$8,224.23 |
| Rate for Payer: Aetna American Axle |
$560.59
|
| Rate for Payer: Aetna Commercial |
$733.08
|
| Rate for Payer: Aetna Medicare |
$431.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$560.59
|
| Rate for Payer: BCBS Complete |
$344.98
|
| Rate for Payer: BCBS Trust/PPO |
$8,224.23
|
| Rate for Payer: BCN Commercial |
$8,224.23
|
| Rate for Payer: Cash Price |
$689.96
|
| Rate for Payer: Cash Price |
$689.96
|
| Rate for Payer: Cash Price |
$689.96
|
| Rate for Payer: Cofinity Advantage |
$603.72
|
| Rate for Payer: Cofinity Commercial |
$741.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$689.96
|
| Rate for Payer: Healthscope Commercial |
$776.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$603.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$646.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$733.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$646.84
|
| Rate for Payer: PHP Commercial |
$733.08
|
| Rate for Payer: Priority Health SBD |
$543.34
|
| Rate for Payer: UMR Bronson Commercial |
$319.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$646.84
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,145.32
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$423.77 |
| Max. Negotiated Rate |
$1,030.79 |
| Rate for Payer: Aetna American Axle |
$744.46
|
| Rate for Payer: Aetna Commercial |
$973.52
|
| Rate for Payer: Aetna Medicare |
$572.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.46
|
| Rate for Payer: BCBS Complete |
$458.13
|
| Rate for Payer: BCBS Trust/PPO |
$804.40
|
| Rate for Payer: BCN Commercial |
$804.40
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cofinity Advantage |
$801.72
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.26
|
| Rate for Payer: Healthscope Commercial |
$1,030.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$801.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.99
|
| Rate for Payer: PHP Commercial |
$973.52
|
| Rate for Payer: Priority Health SBD |
$721.55
|
| Rate for Payer: UMR Bronson Commercial |
$423.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.99
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,145.32
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$503.94 |
| Max. Negotiated Rate |
$1,030.79 |
| Rate for Payer: Aetna American Axle |
$744.46
|
| Rate for Payer: Aetna Commercial |
$973.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$744.46
|
| Rate for Payer: Cash Price |
$916.26
|
| Rate for Payer: Cofinity Advantage |
$801.72
|
| Rate for Payer: Cofinity Commercial |
$984.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$916.26
|
| Rate for Payer: Healthscope Commercial |
$1,030.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$801.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$858.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$973.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$858.99
|
| Rate for Payer: PHP Commercial |
$973.52
|
| Rate for Payer: Priority Health SBD |
$721.55
|
| Rate for Payer: UMR Bronson Commercial |
$503.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$858.99
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
OP
|
$10,655.77
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,942.63 |
| Max. Negotiated Rate |
$9,590.19 |
| Rate for Payer: Aetna American Axle |
$6,926.25
|
| Rate for Payer: Aetna Commercial |
$9,057.40
|
| Rate for Payer: Aetna Medicare |
$5,327.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,926.25
|
| Rate for Payer: BCBS Complete |
$4,262.31
|
| Rate for Payer: BCBS Trust/PPO |
$5,560.16
|
| Rate for Payer: BCN Commercial |
$5,560.16
|
| Rate for Payer: Cash Price |
$8,524.62
|
| Rate for Payer: Cash Price |
$8,524.62
|
| Rate for Payer: Cash Price |
$8,524.62
|
| Rate for Payer: Cofinity Advantage |
$7,459.04
|
| Rate for Payer: Cofinity Commercial |
$9,163.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,524.62
|
| Rate for Payer: Healthscope Commercial |
$9,590.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,459.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,991.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,524.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,057.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,991.83
|
| Rate for Payer: PHP Commercial |
$9,057.40
|
| Rate for Payer: Priority Health SBD |
$6,713.14
|
| Rate for Payer: UMR Bronson Commercial |
$3,942.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,991.83
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
IP
|
$10,655.77
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,688.54 |
| Max. Negotiated Rate |
$9,590.19 |
| Rate for Payer: Aetna American Axle |
$6,926.25
|
| Rate for Payer: Aetna Commercial |
$9,057.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,926.25
|
| Rate for Payer: Cash Price |
$8,524.62
|
| Rate for Payer: Cofinity Advantage |
$7,459.04
|
| Rate for Payer: Cofinity Commercial |
$9,163.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,524.62
|
| Rate for Payer: Healthscope Commercial |
$9,590.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,459.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,991.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,057.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,991.83
|
| Rate for Payer: PHP Commercial |
$9,057.40
|
| Rate for Payer: Priority Health SBD |
$6,713.14
|
| Rate for Payer: UMR Bronson Commercial |
$4,688.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,991.83
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,071.82
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$396.57 |
| Max. Negotiated Rate |
$964.64 |
| Rate for Payer: Aetna American Axle |
$696.68
|
| Rate for Payer: Aetna Commercial |
$911.05
|
| Rate for Payer: Aetna Medicare |
$535.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.68
|
| Rate for Payer: BCBS Complete |
$428.73
|
| Rate for Payer: BCBS Trust/PPO |
$660.94
|
| Rate for Payer: BCN Commercial |
$660.94
|
| Rate for Payer: Cash Price |
$857.46
|
| Rate for Payer: Cash Price |
$857.46
|
| Rate for Payer: Cash Price |
$857.46
|
| Rate for Payer: Cofinity Advantage |
$750.27
|
| Rate for Payer: Cofinity Commercial |
$921.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.46
|
| Rate for Payer: Healthscope Commercial |
$964.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$750.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$857.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$803.87
|
| Rate for Payer: PHP Commercial |
$911.05
|
| Rate for Payer: Priority Health SBD |
$675.25
|
| Rate for Payer: UMR Bronson Commercial |
$396.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.87
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,071.82
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$471.60 |
| Max. Negotiated Rate |
$964.64 |
| Rate for Payer: Aetna American Axle |
$696.68
|
| Rate for Payer: Aetna Commercial |
$911.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$696.68
|
| Rate for Payer: Cash Price |
$857.46
|
| Rate for Payer: Cofinity Advantage |
$750.27
|
| Rate for Payer: Cofinity Commercial |
$921.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.46
|
| Rate for Payer: Healthscope Commercial |
$964.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$750.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$803.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$803.87
|
| Rate for Payer: PHP Commercial |
$911.05
|
| Rate for Payer: Priority Health SBD |
$675.25
|
| Rate for Payer: UMR Bronson Commercial |
$471.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$803.87
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
IP
|
$949.01
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$417.56 |
| Max. Negotiated Rate |
$854.11 |
| Rate for Payer: Aetna American Axle |
$616.86
|
| Rate for Payer: Aetna Commercial |
$806.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.86
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cofinity Advantage |
$664.31
|
| Rate for Payer: Cofinity Commercial |
$816.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.21
|
| Rate for Payer: Healthscope Commercial |
$854.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$664.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$711.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.76
|
| Rate for Payer: PHP Commercial |
$806.66
|
| Rate for Payer: Priority Health SBD |
$597.88
|
| Rate for Payer: UMR Bronson Commercial |
$417.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$711.76
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
OP
|
$949.01
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$351.13 |
| Max. Negotiated Rate |
$3,452.72 |
| Rate for Payer: Aetna American Axle |
$616.86
|
| Rate for Payer: Aetna Commercial |
$806.66
|
| Rate for Payer: Aetna Medicare |
$474.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.86
|
| Rate for Payer: BCBS Complete |
$379.60
|
| Rate for Payer: BCBS Trust/PPO |
$3,452.72
|
| Rate for Payer: BCN Commercial |
$3,452.72
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cash Price |
$759.21
|
| Rate for Payer: Cofinity Advantage |
$664.31
|
| Rate for Payer: Cofinity Commercial |
$816.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$759.21
|
| Rate for Payer: Healthscope Commercial |
$854.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$664.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$711.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$759.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$806.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$711.76
|
| Rate for Payer: PHP Commercial |
$806.66
|
| Rate for Payer: Priority Health SBD |
$597.88
|
| Rate for Payer: UMR Bronson Commercial |
$351.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$711.76
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
OP
|
$6,971.43
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,579.43 |
| Max. Negotiated Rate |
$6,274.29 |
| Rate for Payer: Aetna American Axle |
$4,531.43
|
| Rate for Payer: Aetna Commercial |
$5,925.72
|
| Rate for Payer: Aetna Medicare |
$3,485.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,531.43
|
| Rate for Payer: BCBS Complete |
$2,788.57
|
| Rate for Payer: BCBS Trust/PPO |
$4,366.18
|
| Rate for Payer: BCN Commercial |
$4,366.18
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cofinity Advantage |
$4,880.00
|
| Rate for Payer: Cofinity Commercial |
$5,995.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,577.14
|
| Rate for Payer: Healthscope Commercial |
$6,274.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,880.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,228.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,577.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,925.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,228.57
|
| Rate for Payer: PHP Commercial |
$5,925.72
|
| Rate for Payer: Priority Health SBD |
$4,392.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,579.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,228.57
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
IP
|
$6,971.43
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,067.43 |
| Max. Negotiated Rate |
$6,274.29 |
| Rate for Payer: Aetna American Axle |
$4,531.43
|
| Rate for Payer: Aetna Commercial |
$5,925.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,531.43
|
| Rate for Payer: Cash Price |
$5,577.14
|
| Rate for Payer: Cofinity Advantage |
$4,880.00
|
| Rate for Payer: Cofinity Commercial |
$5,995.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,577.14
|
| Rate for Payer: Healthscope Commercial |
$6,274.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,880.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,228.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,925.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,228.57
|
| Rate for Payer: PHP Commercial |
$5,925.72
|
| Rate for Payer: Priority Health SBD |
$4,392.00
|
| Rate for Payer: UMR Bronson Commercial |
$3,067.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,228.57
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
OP
|
$5,793.73
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,143.68 |
| Max. Negotiated Rate |
$5,214.36 |
| Rate for Payer: Aetna American Axle |
$3,765.92
|
| Rate for Payer: Aetna Commercial |
$4,924.67
|
| Rate for Payer: Aetna Medicare |
$2,896.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,765.92
|
| Rate for Payer: BCBS Complete |
$2,317.49
|
| Rate for Payer: BCBS Trust/PPO |
$4,452.00
|
| Rate for Payer: BCN Commercial |
$4,452.00
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cofinity Advantage |
$4,055.61
|
| Rate for Payer: Cofinity Commercial |
$4,982.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,634.98
|
| Rate for Payer: Healthscope Commercial |
$5,214.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,055.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,345.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,634.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,924.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,345.30
|
| Rate for Payer: PHP Commercial |
$4,924.67
|
| Rate for Payer: Priority Health SBD |
$3,650.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,143.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,345.30
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
IP
|
$5,793.73
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,549.24 |
| Max. Negotiated Rate |
$5,214.36 |
| Rate for Payer: Aetna American Axle |
$3,765.92
|
| Rate for Payer: Aetna Commercial |
$4,924.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,765.92
|
| Rate for Payer: Cash Price |
$4,634.98
|
| Rate for Payer: Cofinity Advantage |
$4,055.61
|
| Rate for Payer: Cofinity Commercial |
$4,982.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,634.98
|
| Rate for Payer: Healthscope Commercial |
$5,214.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,055.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,345.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,924.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,345.30
|
| Rate for Payer: PHP Commercial |
$4,924.67
|
| Rate for Payer: Priority Health SBD |
$3,650.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,549.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,345.30
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,515.62
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,546.87 |
| Max. Negotiated Rate |
$3,164.06 |
| Rate for Payer: Aetna American Axle |
$2,285.15
|
| Rate for Payer: Aetna Commercial |
$2,988.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,285.15
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cofinity Advantage |
$2,460.93
|
| Rate for Payer: Cofinity Commercial |
$3,023.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.50
|
| Rate for Payer: Healthscope Commercial |
$3,164.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,460.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,636.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,988.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.72
|
| Rate for Payer: PHP Commercial |
$2,988.28
|
| Rate for Payer: Priority Health SBD |
$2,214.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,546.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,636.72
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,515.62
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$2,285.15
|
| Rate for Payer: Aetna Commercial |
$2,988.28
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,285.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,925.34
|
| Rate for Payer: BCN Commercial |
$2,925.34
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cash Price |
$2,812.50
|
| Rate for Payer: Cofinity Advantage |
$2,460.93
|
| Rate for Payer: Cofinity Commercial |
$3,023.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$3,164.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,460.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,636.72
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,988.28
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.72
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,988.28
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$2,214.84
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,300.78
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,636.72
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
OP
|
$3,415.17
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,263.61 |
| Max. Negotiated Rate |
$11,358.48 |
| Rate for Payer: Aetna American Axle |
$2,219.86
|
| Rate for Payer: Aetna Commercial |
$2,902.89
|
| Rate for Payer: Aetna Medicare |
$3,652.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,219.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,390.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,390.39
|
| Rate for Payer: BCBS Complete |
$1,928.96
|
| Rate for Payer: BCBS MAPPO |
$3,512.31
|
| Rate for Payer: BCBS Trust/PPO |
$1,801.50
|
| Rate for Payer: BCN Commercial |
$1,801.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,512.31
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cofinity Advantage |
$2,390.62
|
| Rate for Payer: Cofinity Commercial |
$2,937.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,732.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,512.31
|
| Rate for Payer: Healthscope Commercial |
$3,073.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,390.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,561.38
|
| Rate for Payer: Mclaren Medicaid |
$3,512.31
|
| Rate for Payer: Mclaren Medicare |
$3,512.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,687.93
|
| Rate for Payer: Meridian Medicaid |
$3,687.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,039.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,863.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,902.89
|
| Rate for Payer: Nomi Health Commercial |
$10,536.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,561.38
|
| Rate for Payer: PACE Medicare |
$3,336.69
|
| Rate for Payer: PACE SWMI |
$3,512.31
|
| Rate for Payer: PHP Commercial |
$2,902.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,512.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,836.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,358.48
|
| Rate for Payer: Priority Health Medicare |
$3,512.31
|
| Rate for Payer: Priority Health SBD |
$2,151.56
|
| Rate for Payer: Priority Health Tiered Network |
$9,086.78
|
| Rate for Payer: Railroad Medicare Medicare |
$3,512.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,512.31
|
| Rate for Payer: UHC Medicaid |
$1,836.94
|
| Rate for Payer: UHCCP Medicaid |
$1,836.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,263.61
|
| Rate for Payer: VA VA |
$3,512.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,561.38
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
IP
|
$3,415.17
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,502.67 |
| Max. Negotiated Rate |
$3,073.65 |
| Rate for Payer: Aetna American Axle |
$2,219.86
|
| Rate for Payer: Aetna Commercial |
$2,902.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,219.86
|
| Rate for Payer: Cash Price |
$2,732.14
|
| Rate for Payer: Cofinity Advantage |
$2,390.62
|
| Rate for Payer: Cofinity Commercial |
$2,937.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,732.14
|
| Rate for Payer: Healthscope Commercial |
$3,073.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,390.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,561.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,902.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,561.38
|
| Rate for Payer: PHP Commercial |
$2,902.89
|
| Rate for Payer: Priority Health SBD |
$2,151.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,502.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,561.38
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
IP
|
$9,019.47
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,968.57 |
| Max. Negotiated Rate |
$8,117.52 |
| Rate for Payer: Aetna American Axle |
$5,862.66
|
| Rate for Payer: Aetna Commercial |
$7,666.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,862.66
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cofinity Advantage |
$6,313.63
|
| Rate for Payer: Cofinity Commercial |
$7,756.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,215.58
|
| Rate for Payer: Healthscope Commercial |
$8,117.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,313.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,764.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,666.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,764.60
|
| Rate for Payer: PHP Commercial |
$7,666.55
|
| Rate for Payer: Priority Health SBD |
$5,682.27
|
| Rate for Payer: UMR Bronson Commercial |
$3,968.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,764.60
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
OP
|
$9,019.47
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,337.20 |
| Max. Negotiated Rate |
$8,117.52 |
| Rate for Payer: Aetna American Axle |
$5,862.66
|
| Rate for Payer: Aetna Commercial |
$7,666.55
|
| Rate for Payer: Aetna Medicare |
$4,509.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,862.66
|
| Rate for Payer: BCBS Complete |
$3,607.79
|
| Rate for Payer: BCBS Trust/PPO |
$5,632.42
|
| Rate for Payer: BCN Commercial |
$5,632.42
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cash Price |
$7,215.58
|
| Rate for Payer: Cofinity Advantage |
$6,313.63
|
| Rate for Payer: Cofinity Commercial |
$7,756.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,215.58
|
| Rate for Payer: Healthscope Commercial |
$8,117.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,313.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,764.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,215.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,666.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,764.60
|
| Rate for Payer: PHP Commercial |
$7,666.55
|
| Rate for Payer: Priority Health SBD |
$5,682.27
|
| Rate for Payer: UMR Bronson Commercial |
$3,337.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,764.60
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
OP
|
$5,490.26
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,031.40 |
| Max. Negotiated Rate |
$4,941.23 |
| Rate for Payer: Aetna American Axle |
$3,568.67
|
| Rate for Payer: Aetna Commercial |
$4,666.72
|
| Rate for Payer: Aetna Medicare |
$2,745.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,568.67
|
| Rate for Payer: BCBS Complete |
$2,196.10
|
| Rate for Payer: BCBS Trust/PPO |
$4,192.98
|
| Rate for Payer: BCN Commercial |
$4,192.98
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cofinity Advantage |
$3,843.18
|
| Rate for Payer: Cofinity Commercial |
$4,721.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,392.21
|
| Rate for Payer: Healthscope Commercial |
$4,941.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,843.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,117.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,392.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,666.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,117.69
|
| Rate for Payer: PHP Commercial |
$4,666.72
|
| Rate for Payer: Priority Health SBD |
$3,458.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,031.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,117.69
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
IP
|
$5,490.26
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,415.71 |
| Max. Negotiated Rate |
$4,941.23 |
| Rate for Payer: Aetna American Axle |
$3,568.67
|
| Rate for Payer: Aetna Commercial |
$4,666.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,568.67
|
| Rate for Payer: Cash Price |
$4,392.21
|
| Rate for Payer: Cofinity Advantage |
$3,843.18
|
| Rate for Payer: Cofinity Commercial |
$4,721.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,392.21
|
| Rate for Payer: Healthscope Commercial |
$4,941.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,843.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,117.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,666.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,117.69
|
| Rate for Payer: PHP Commercial |
$4,666.72
|
| Rate for Payer: Priority Health SBD |
$3,458.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,415.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,117.69
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE
|
Facility
|
IP
|
$777.55
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
36100486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$342.12 |
| Max. Negotiated Rate |
$699.79 |
| Rate for Payer: Aetna American Axle |
$505.41
|
| Rate for Payer: Aetna Commercial |
$660.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.41
|
| Rate for Payer: Cash Price |
$622.04
|
| Rate for Payer: Cofinity Advantage |
$544.28
|
| Rate for Payer: Cofinity Commercial |
$668.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.04
|
| Rate for Payer: Healthscope Commercial |
$699.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$583.16
|
| Rate for Payer: PHP Commercial |
$660.92
|
| Rate for Payer: Priority Health SBD |
$489.86
|
| Rate for Payer: UMR Bronson Commercial |
$342.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.16
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE
|
Facility
|
OP
|
$777.55
|
|
|
Service Code
|
CPT 10035
|
| Hospital Charge Code |
36100486
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$287.69 |
| Max. Negotiated Rate |
$2,281.79 |
| Rate for Payer: Aetna American Axle |
$505.41
|
| Rate for Payer: Aetna Commercial |
$660.92
|
| Rate for Payer: Aetna Medicare |
$733.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$881.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$881.99
|
| Rate for Payer: BCBS Complete |
$387.51
|
| Rate for Payer: BCBS MAPPO |
$705.59
|
| Rate for Payer: BCBS Trust/PPO |
$608.31
|
| Rate for Payer: BCCCP Commercial |
$330.34
|
| Rate for Payer: BCN Commercial |
$608.31
|
| Rate for Payer: BCN Medicare Advantage |
$705.59
|
| Rate for Payer: Cash Price |
$622.04
|
| Rate for Payer: Cash Price |
$622.04
|
| Rate for Payer: Cash Price |
$622.04
|
| Rate for Payer: Cofinity Advantage |
$544.28
|
| Rate for Payer: Cofinity Commercial |
$668.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$699.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.16
|
| Rate for Payer: Mclaren Medicaid |
$705.59
|
| Rate for Payer: Mclaren Medicare |
$705.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$740.87
|
| Rate for Payer: Meridian Medicaid |
$740.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$811.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$776.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$660.92
|
| Rate for Payer: Nomi Health Commercial |
$2,116.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$583.16
|
| Rate for Payer: PACE Medicare |
$670.31
|
| Rate for Payer: PACE SWMI |
$705.59
|
| Rate for Payer: PHP Commercial |
$660.92
|
| Rate for Payer: PHP Medicare Advantage |
$705.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,281.79
|
| Rate for Payer: Priority Health Medicare |
$705.59
|
| Rate for Payer: Priority Health SBD |
$489.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,825.43
|
| Rate for Payer: Railroad Medicare Medicare |
$705.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$705.59
|
| Rate for Payer: UHC Medicaid |
$369.02
|
| Rate for Payer: UHCCP Medicaid |
$369.02
|
| Rate for Payer: UMR Bronson Commercial |
$287.69
|
| Rate for Payer: VA VA |
$705.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.16
|
|
|
HC PLACE SOFT TISSUE LOCALIZATION DEVICE EA ADDL LESION
|
Facility
|
IP
|
$442.62
|
|
|
Service Code
|
CPT 10036
|
| Hospital Charge Code |
36100487
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$194.75 |
| Max. Negotiated Rate |
$398.36 |
| Rate for Payer: Aetna American Axle |
$287.70
|
| Rate for Payer: Aetna Commercial |
$376.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.70
|
| Rate for Payer: Cash Price |
$354.10
|
| Rate for Payer: Cofinity Advantage |
$309.83
|
| Rate for Payer: Cofinity Commercial |
$380.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.10
|
| Rate for Payer: Healthscope Commercial |
$398.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$309.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$331.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$331.96
|
| Rate for Payer: PHP Commercial |
$376.23
|
| Rate for Payer: Priority Health SBD |
$278.85
|
| Rate for Payer: UMR Bronson Commercial |
$194.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$331.96
|
|
