|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
OP
|
$14,101.06
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,430.76 |
| Max. Negotiated Rate |
$18,017.25 |
| Rate for Payer: Aetna American Axle |
$9,165.69
|
| Rate for Payer: Aetna Commercial |
$11,985.90
|
| Rate for Payer: Aetna Medicare |
$6,656.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,165.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,000.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,000.84
|
| Rate for Payer: BCBS Complete |
$3,602.30
|
| Rate for Payer: BCBS MAPPO |
$6,400.67
|
| Rate for Payer: BCN Medicare Advantage |
$6,400.67
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cofinity Commercial |
$9,870.74
|
| Rate for Payer: Cofinity Commercial |
$12,126.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,870.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,280.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,400.67
|
| Rate for Payer: Healthscope Commercial |
$12,690.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,870.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,575.80
|
| Rate for Payer: Mclaren Medicaid |
$3,430.76
|
| Rate for Payer: Mclaren Medicare |
$6,400.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,720.70
|
| Rate for Payer: Meridian Medicaid |
$3,602.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,985.90
|
| Rate for Payer: PACE Medicare |
$6,080.64
|
| Rate for Payer: PACE SWMI |
$6,400.67
|
| Rate for Payer: PHP Commercial |
$11,985.90
|
| Rate for Payer: PHP Medicare Advantage |
$6,400.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,430.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,165.69
|
| Rate for Payer: Priority Health Medicare |
$6,400.67
|
| Rate for Payer: Priority Health SBD |
$8,883.67
|
| Rate for Payer: Railroad Medicare Medicare |
$6,400.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,017.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,400.67
|
| Rate for Payer: UHC Exchange |
$12,232.32
|
| Rate for Payer: UHC Medicare Advantage |
$6,400.67
|
| Rate for Payer: UHCCP Medicaid |
$3,430.76
|
| Rate for Payer: UMR Bronson Commercial |
$5,217.39
|
| Rate for Payer: VA VA |
$6,400.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,575.80
|
|
|
HC PERC IMPLANT OF NEUROSTIM EPIDURAL
|
Facility
|
IP
|
$14,101.06
|
|
|
Service Code
|
CPT 63650
|
| Hospital Charge Code |
36100610
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,204.47 |
| Max. Negotiated Rate |
$12,690.95 |
| Rate for Payer: Aetna American Axle |
$9,165.69
|
| Rate for Payer: Aetna Commercial |
$11,985.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,165.69
|
| Rate for Payer: Cash Price |
$11,280.85
|
| Rate for Payer: Cofinity Commercial |
$12,126.91
|
| Rate for Payer: Cofinity Commercial |
$9,870.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,870.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,280.85
|
| Rate for Payer: Healthscope Commercial |
$12,690.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,870.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,575.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,985.90
|
| Rate for Payer: PHP Commercial |
$11,985.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,165.69
|
| Rate for Payer: Priority Health SBD |
$8,883.67
|
| Rate for Payer: UMR Bronson Commercial |
$6,204.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,575.80
|
|
|
HC PERCLOSE
|
Facility
|
IP
|
$1,052.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$462.98 |
| Max. Negotiated Rate |
$947.01 |
| Rate for Payer: Aetna American Axle |
$683.95
|
| Rate for Payer: Aetna Commercial |
$894.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.95
|
| Rate for Payer: Cash Price |
$841.78
|
| Rate for Payer: Cofinity Commercial |
$736.56
|
| Rate for Payer: Cofinity Commercial |
$904.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$736.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.78
|
| Rate for Payer: Healthscope Commercial |
$947.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$736.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.40
|
| Rate for Payer: PHP Commercial |
$894.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.95
|
| Rate for Payer: Priority Health SBD |
$662.90
|
| Rate for Payer: UMR Bronson Commercial |
$462.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.17
|
|
|
HC PERCLOSE
|
Facility
|
OP
|
$1,052.23
|
|
|
Service Code
|
HCPCS C1760
|
| Hospital Charge Code |
27200060
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$389.33 |
| Max. Negotiated Rate |
$947.01 |
| Rate for Payer: Aetna American Axle |
$683.95
|
| Rate for Payer: Aetna Commercial |
$894.40
|
| Rate for Payer: Aetna Medicare |
$526.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$683.95
|
| Rate for Payer: BCBS Complete |
$420.89
|
| Rate for Payer: Cash Price |
$841.78
|
| Rate for Payer: Cofinity Commercial |
$736.56
|
| Rate for Payer: Cofinity Commercial |
$904.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$736.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.78
|
| Rate for Payer: Healthscope Commercial |
$947.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$736.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$789.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.40
|
| Rate for Payer: PHP Commercial |
$894.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$683.95
|
| Rate for Payer: Priority Health SBD |
$662.90
|
| Rate for Payer: UMR Bronson Commercial |
$389.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$789.17
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
OP
|
$6,509.34
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,408.46 |
| Max. Negotiated Rate |
$15,652.48 |
| Rate for Payer: Aetna American Axle |
$4,231.07
|
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna Medicare |
$5,783.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,231.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Cofinity Commercial |
$4,556.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,556.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,556.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.01
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health SBD |
$4,100.88
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,652.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$10,626.82
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: UMR Bronson Commercial |
$2,408.46
|
| Rate for Payer: VA VA |
$5,560.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.01
|
|
|
HC PERC THROMBECTOMY OR INFUSION DIALYSIS CIRCUIT W IMAGING
|
Facility
|
IP
|
$6,509.34
|
|
|
Service Code
|
CPT 36904
|
| Hospital Charge Code |
36100528
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,864.11 |
| Max. Negotiated Rate |
$5,858.41 |
| Rate for Payer: Aetna American Axle |
$4,231.07
|
| Rate for Payer: Aetna Commercial |
$5,532.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,231.07
|
| Rate for Payer: Cash Price |
$5,207.47
|
| Rate for Payer: Cofinity Commercial |
$4,556.54
|
| Rate for Payer: Cofinity Commercial |
$5,598.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,556.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,207.47
|
| Rate for Payer: Healthscope Commercial |
$5,858.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,556.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,532.94
|
| Rate for Payer: PHP Commercial |
$5,532.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.07
|
| Rate for Payer: Priority Health SBD |
$4,100.88
|
| Rate for Payer: UMR Bronson Commercial |
$2,864.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.01
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$17,692.54
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$11,500.15
|
| Rate for Payer: Aetna Commercial |
$15,038.66
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,500.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cofinity Commercial |
$15,215.58
|
| Rate for Payer: Cofinity Commercial |
$12,384.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,384.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,154.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$15,923.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,384.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,269.41
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,038.66
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$15,038.66
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,500.15
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$11,146.30
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$6,546.24
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,269.41
|
|
|
HC PERC THROMBECT OR INF W ANGIOPLASTY PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$17,692.54
|
|
|
Service Code
|
CPT 36905
|
| Hospital Charge Code |
36100529
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,784.72 |
| Max. Negotiated Rate |
$15,923.29 |
| Rate for Payer: Aetna American Axle |
$11,500.15
|
| Rate for Payer: Aetna Commercial |
$15,038.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,500.15
|
| Rate for Payer: Cash Price |
$14,154.03
|
| Rate for Payer: Cofinity Commercial |
$12,384.78
|
| Rate for Payer: Cofinity Commercial |
$15,215.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,384.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,154.03
|
| Rate for Payer: Healthscope Commercial |
$15,923.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,384.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,269.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,038.66
|
| Rate for Payer: PHP Commercial |
$15,038.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,500.15
|
| Rate for Payer: Priority Health SBD |
$11,146.30
|
| Rate for Payer: UMR Bronson Commercial |
$7,784.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,269.41
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
IP
|
$28,095.29
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,361.93 |
| Max. Negotiated Rate |
$25,285.76 |
| Rate for Payer: Aetna American Axle |
$18,261.94
|
| Rate for Payer: Aetna Commercial |
$23,881.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,261.94
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cofinity Commercial |
$19,666.70
|
| Rate for Payer: Cofinity Commercial |
$24,161.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$19,666.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,476.23
|
| Rate for Payer: Healthscope Commercial |
$25,285.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,666.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,071.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,881.00
|
| Rate for Payer: PHP Commercial |
$23,881.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,261.94
|
| Rate for Payer: Priority Health SBD |
$17,700.03
|
| Rate for Payer: UMR Bronson Commercial |
$12,361.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,071.47
|
|
|
HC PERC THROMBECT OR INF W STENT PERIPH DIALYSIS W IMAGING
|
Facility
|
OP
|
$28,095.29
|
|
|
Service Code
|
CPT 36906
|
| Hospital Charge Code |
36100530
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,386.88 |
| Max. Negotiated Rate |
$49,296.87 |
| Rate for Payer: Aetna American Axle |
$18,261.94
|
| Rate for Payer: Aetna Commercial |
$23,881.00
|
| Rate for Payer: Aetna Medicare |
$18,213.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,261.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,891.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,891.04
|
| Rate for Payer: BCBS Complete |
$9,856.22
|
| Rate for Payer: BCBS MAPPO |
$17,512.83
|
| Rate for Payer: BCN Medicare Advantage |
$17,512.83
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cash Price |
$22,476.23
|
| Rate for Payer: Cofinity Commercial |
$24,161.95
|
| Rate for Payer: Cofinity Commercial |
$19,666.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$19,666.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,476.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,512.83
|
| Rate for Payer: Healthscope Commercial |
$25,285.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19,666.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,071.47
|
| Rate for Payer: Mclaren Medicaid |
$9,386.88
|
| Rate for Payer: Mclaren Medicare |
$17,512.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,388.47
|
| Rate for Payer: Meridian Medicaid |
$9,856.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,139.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23,881.00
|
| Rate for Payer: PACE Medicare |
$16,637.19
|
| Rate for Payer: PACE SWMI |
$17,512.83
|
| Rate for Payer: PHP Commercial |
$23,881.00
|
| Rate for Payer: PHP Medicare Advantage |
$17,512.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,386.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,261.94
|
| Rate for Payer: Priority Health Medicare |
$17,512.83
|
| Rate for Payer: Priority Health SBD |
$17,700.03
|
| Rate for Payer: Railroad Medicare Medicare |
$17,512.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,296.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,512.83
|
| Rate for Payer: UHC Exchange |
$33,468.77
|
| Rate for Payer: UHC Medicare Advantage |
$17,512.83
|
| Rate for Payer: UHCCP Medicaid |
$9,386.88
|
| Rate for Payer: UMR Bronson Commercial |
$10,395.26
|
| Rate for Payer: VA VA |
$17,512.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,071.47
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
OP
|
$13.69
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Aetna American Axle |
$8.90
|
| Rate for Payer: Aetna Commercial |
$11.64
|
| Rate for Payer: Aetna Medicare |
$6.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.90
|
| Rate for Payer: BCBS Complete |
$5.48
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$11.77
|
| Rate for Payer: Cofinity Commercial |
$9.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: PHP Commercial |
$11.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.90
|
| Rate for Payer: Priority Health SBD |
$8.62
|
| Rate for Payer: UMR Bronson Commercial |
$5.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.27
|
|
|
HC PERCUTANEOUS NEEDLE
|
Facility
|
IP
|
$13.69
|
|
| Hospital Charge Code |
27200144
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$12.32 |
| Rate for Payer: Aetna American Axle |
$8.90
|
| Rate for Payer: Aetna Commercial |
$11.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.90
|
| Rate for Payer: Cash Price |
$10.95
|
| Rate for Payer: Cofinity Commercial |
$11.77
|
| Rate for Payer: Cofinity Commercial |
$9.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.95
|
| Rate for Payer: Healthscope Commercial |
$12.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.64
|
| Rate for Payer: PHP Commercial |
$11.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.90
|
| Rate for Payer: Priority Health SBD |
$8.62
|
| Rate for Payer: UMR Bronson Commercial |
$6.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.27
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
IP
|
$4,538.03
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,996.73 |
| Max. Negotiated Rate |
$4,084.23 |
| Rate for Payer: Aetna American Axle |
$2,949.72
|
| Rate for Payer: Aetna Commercial |
$3,857.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,949.72
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cofinity Commercial |
$3,176.62
|
| Rate for Payer: Cofinity Commercial |
$3,902.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,176.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,630.42
|
| Rate for Payer: Healthscope Commercial |
$4,084.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,176.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,403.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,857.33
|
| Rate for Payer: PHP Commercial |
$3,857.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,949.72
|
| Rate for Payer: Priority Health SBD |
$2,858.96
|
| Rate for Payer: UMR Bronson Commercial |
$1,996.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,403.52
|
|
|
HC PERCUTANEOUS TRACHEOSTOMY
|
Facility
|
OP
|
$4,538.03
|
|
|
Service Code
|
CPT 31600
|
| Hospital Charge Code |
36000001
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,679.07 |
| Max. Negotiated Rate |
$8,903.25 |
| Rate for Payer: Aetna American Axle |
$2,949.72
|
| Rate for Payer: Aetna Commercial |
$3,857.33
|
| Rate for Payer: Aetna Medicare |
$3,289.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,949.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cash Price |
$3,630.42
|
| Rate for Payer: Cofinity Commercial |
$3,902.71
|
| Rate for Payer: Cofinity Commercial |
$3,176.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,176.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,630.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$4,084.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,176.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,403.52
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,857.33
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$3,857.33
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,949.72
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health SBD |
$2,858.96
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,903.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$6,044.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,679.07
|
| Rate for Payer: VA VA |
$3,162.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,403.52
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| 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 |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PERENNIAL RYE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200097
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PERFUSION OPEN HEART
|
Facility
|
OP
|
$6,525.68
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,414.50 |
| Max. Negotiated Rate |
$5,873.11 |
| Rate for Payer: Aetna American Axle |
$4,241.69
|
| Rate for Payer: Aetna Commercial |
$5,546.83
|
| Rate for Payer: Aetna Medicare |
$3,262.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,241.69
|
| Rate for Payer: BCBS Complete |
$2,610.27
|
| Rate for Payer: Cash Price |
$5,220.54
|
| Rate for Payer: Cofinity Commercial |
$4,567.98
|
| Rate for Payer: Cofinity Commercial |
$5,612.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,567.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,220.54
|
| Rate for Payer: Healthscope Commercial |
$5,873.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,567.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,894.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.83
|
| Rate for Payer: PHP Commercial |
$5,546.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.69
|
| Rate for Payer: Priority Health SBD |
$4,111.18
|
| Rate for Payer: UMR Bronson Commercial |
$2,414.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,894.26
|
|
|
HC PERFUSION OPEN HEART
|
Facility
|
IP
|
$6,525.68
|
|
| Hospital Charge Code |
27000107
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,871.30 |
| Max. Negotiated Rate |
$5,873.11 |
| Rate for Payer: Aetna American Axle |
$4,241.69
|
| Rate for Payer: Aetna Commercial |
$5,546.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,241.69
|
| Rate for Payer: Cash Price |
$5,220.54
|
| Rate for Payer: Cofinity Commercial |
$4,567.98
|
| Rate for Payer: Cofinity Commercial |
$5,612.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,567.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,220.54
|
| Rate for Payer: Healthscope Commercial |
$5,873.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,567.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,894.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,546.83
|
| Rate for Payer: PHP Commercial |
$5,546.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,241.69
|
| Rate for Payer: Priority Health SBD |
$4,111.18
|
| Rate for Payer: UMR Bronson Commercial |
$2,871.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,894.26
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
OP
|
$2,545.27
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna American Axle |
$1,654.43
|
| Rate for Payer: Aetna Commercial |
$2,163.48
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$2,036.22
|
| Rate for Payer: Cash Price |
$2,036.22
|
| Rate for Payer: Cofinity Commercial |
$2,188.93
|
| Rate for Payer: Cofinity Commercial |
$1,781.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$2,290.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,781.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.95
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.48
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$2,163.48
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.43
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$1,603.52
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,895.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: UMR Bronson Commercial |
$941.75
|
| Rate for Payer: VA VA |
$1,515.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.95
|
|
|
HC PERIDARDIOCENTESIS WITH GUIDANCE
|
Facility
|
IP
|
$2,545.27
|
|
|
Service Code
|
CPT 33016
|
| Hospital Charge Code |
36100582
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,119.92 |
| Max. Negotiated Rate |
$2,290.74 |
| Rate for Payer: Aetna American Axle |
$1,654.43
|
| Rate for Payer: Aetna Commercial |
$2,163.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,654.43
|
| Rate for Payer: Cash Price |
$2,036.22
|
| Rate for Payer: Cofinity Commercial |
$1,781.69
|
| Rate for Payer: Cofinity Commercial |
$2,188.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,781.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,036.22
|
| Rate for Payer: Healthscope Commercial |
$2,290.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,781.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,908.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,163.48
|
| Rate for Payer: PHP Commercial |
$2,163.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,654.43
|
| Rate for Payer: Priority Health SBD |
$1,603.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,119.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,908.95
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
OP
|
$103.24
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$31.05 |
| Max. Negotiated Rate |
$196.00 |
| Rate for Payer: Aetna American Axle |
$67.11
|
| Rate for Payer: Aetna Commercial |
$87.75
|
| Rate for Payer: Aetna Medicare |
$60.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.41
|
| Rate for Payer: BCBS Complete |
$32.60
|
| Rate for Payer: BCBS MAPPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$57.93
|
| Rate for Payer: Cash Price |
$82.59
|
| Rate for Payer: Cash Price |
$82.59
|
| Rate for Payer: Cash Price |
$82.59
|
| Rate for Payer: Cofinity Commercial |
$72.27
|
| Rate for Payer: Cofinity Commercial |
$88.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.93
|
| Rate for Payer: Healthscope Commercial |
$92.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.43
|
| Rate for Payer: Mclaren Medicaid |
$31.05
|
| Rate for Payer: Mclaren Medicare |
$57.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.83
|
| Rate for Payer: Meridian Medicaid |
$32.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.75
|
| Rate for Payer: PACE Medicare |
$55.03
|
| Rate for Payer: PACE SWMI |
$57.93
|
| Rate for Payer: PHP Commercial |
$87.75
|
| Rate for Payer: PHP Medicare Advantage |
$57.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.11
|
| Rate for Payer: Priority Health Medicare |
$57.93
|
| Rate for Payer: Priority Health SBD |
$65.04
|
| Rate for Payer: Railroad Medicare Medicare |
$57.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.07
|
| Rate for Payer: UHC Core |
$196.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$57.93
|
| Rate for Payer: UHC Exchange |
$110.71
|
| Rate for Payer: UHC Medicare Advantage |
$57.93
|
| Rate for Payer: UHCCP Medicaid |
$31.05
|
| Rate for Payer: UMR Bronson Commercial |
$38.20
|
| Rate for Payer: VA VA |
$57.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.43
|
|
|
HC PERIPH ARTERY DISEASE REHAB
|
Facility
|
IP
|
$103.24
|
|
|
Service Code
|
CPT 93668
|
| Hospital Charge Code |
94000006
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$45.43 |
| Max. Negotiated Rate |
$92.92 |
| Rate for Payer: Aetna American Axle |
$67.11
|
| Rate for Payer: Aetna Commercial |
$87.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.11
|
| Rate for Payer: Cash Price |
$82.59
|
| Rate for Payer: Cofinity Commercial |
$72.27
|
| Rate for Payer: Cofinity Commercial |
$88.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.59
|
| Rate for Payer: Healthscope Commercial |
$92.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.75
|
| Rate for Payer: PHP Commercial |
$87.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.11
|
| Rate for Payer: Priority Health SBD |
$65.04
|
| Rate for Payer: UMR Bronson Commercial |
$45.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.43
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
OP
|
$283.83
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.02 |
| Max. Negotiated Rate |
$255.45 |
| Rate for Payer: Aetna American Axle |
$184.49
|
| Rate for Payer: Aetna Commercial |
$241.26
|
| Rate for Payer: Aetna Medicare |
$141.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.49
|
| Rate for Payer: BCBS Complete |
$113.53
|
| Rate for Payer: Cash Price |
$227.06
|
| Rate for Payer: Cofinity Commercial |
$198.68
|
| Rate for Payer: Cofinity Commercial |
$244.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.06
|
| Rate for Payer: Healthscope Commercial |
$255.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.26
|
| Rate for Payer: PHP Commercial |
$241.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.49
|
| Rate for Payer: Priority Health SBD |
$178.81
|
| Rate for Payer: UMR Bronson Commercial |
$105.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.87
|
|
|
HC PERIPHERAL DIAGNOSTIC CATHETER
|
Facility
|
IP
|
$283.83
|
|
| Hospital Charge Code |
27200145
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$124.89 |
| Max. Negotiated Rate |
$255.45 |
| Rate for Payer: Aetna American Axle |
$184.49
|
| Rate for Payer: Aetna Commercial |
$241.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.49
|
| Rate for Payer: Cash Price |
$227.06
|
| Rate for Payer: Cofinity Commercial |
$198.68
|
| Rate for Payer: Cofinity Commercial |
$244.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.06
|
| Rate for Payer: Healthscope Commercial |
$255.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.26
|
| Rate for Payer: PHP Commercial |
$241.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.49
|
| Rate for Payer: Priority Health SBD |
$178.81
|
| Rate for Payer: UMR Bronson Commercial |
$124.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.87
|
|
|
HC PERIPHERAL INTRODUCER
|
Facility
|
OP
|
$684.29
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$253.19 |
| Max. Negotiated Rate |
$615.86 |
| Rate for Payer: Aetna American Axle |
$444.79
|
| Rate for Payer: Aetna Commercial |
$581.65
|
| Rate for Payer: Aetna Medicare |
$342.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.79
|
| Rate for Payer: BCBS Complete |
$273.72
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cofinity Commercial |
$479.00
|
| Rate for Payer: Cofinity Commercial |
$588.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$479.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.43
|
| Rate for Payer: Healthscope Commercial |
$615.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$479.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.65
|
| Rate for Payer: PHP Commercial |
$581.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.79
|
| Rate for Payer: Priority Health SBD |
$431.10
|
| Rate for Payer: UMR Bronson Commercial |
$253.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.22
|
|
