|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 1ST ORDER
|
Facility
|
OP
|
$7,265.88
|
|
|
Service Code
|
CPT 36215
|
| Hospital Charge Code |
36100106
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$202.54 |
| Max. Negotiated Rate |
$6,539.29 |
| Rate for Payer: Aetna American Axle |
$4,722.82
|
| Rate for Payer: Aetna Commercial |
$6,176.00
|
| Rate for Payer: Aetna Medicare |
$3,632.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,722.82
|
| Rate for Payer: BCBS Complete |
$2,906.35
|
| Rate for Payer: BCBS Trust/PPO |
$4,022.92
|
| Rate for Payer: BCN Commercial |
$4,022.92
|
| Rate for Payer: Cash Price |
$5,812.70
|
| Rate for Payer: Cash Price |
$5,812.70
|
| Rate for Payer: Cash Price |
$5,812.70
|
| Rate for Payer: Cofinity Commercial |
$6,248.66
|
| Rate for Payer: Cofinity Commercial |
$5,086.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,086.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,812.70
|
| Rate for Payer: Healthscope Commercial |
$6,539.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,086.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,449.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,176.00
|
| Rate for Payer: PHP Commercial |
$6,176.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,722.82
|
| Rate for Payer: Priority Health SBD |
$4,577.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$222.79
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$202.54
|
| Rate for Payer: UMR Bronson Commercial |
$2,688.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,449.41
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
IP
|
$1,020.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$448.80 |
| Max. Negotiated Rate |
$918.00 |
| Rate for Payer: Aetna American Axle |
$663.00
|
| Rate for Payer: Aetna Commercial |
$867.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cofinity Commercial |
$714.00
|
| Rate for Payer: Cofinity Commercial |
$877.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.00
|
| Rate for Payer: Healthscope Commercial |
$918.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.00
|
| Rate for Payer: PHP Commercial |
$867.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
| Rate for Payer: Priority Health SBD |
$642.60
|
| Rate for Payer: UMR Bronson Commercial |
$448.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.00
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 2ND ORDER
|
Facility
|
OP
|
$1,020.00
|
|
|
Service Code
|
CPT 36216
|
| Hospital Charge Code |
36100107
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$262.45 |
| Max. Negotiated Rate |
$4,159.34 |
| Rate for Payer: Aetna American Axle |
$663.00
|
| Rate for Payer: Aetna Commercial |
$867.00
|
| Rate for Payer: Aetna Medicare |
$510.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.00
|
| Rate for Payer: BCBS Complete |
$408.00
|
| Rate for Payer: BCBS Trust/PPO |
$4,159.34
|
| Rate for Payer: BCN Commercial |
$4,159.34
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cash Price |
$816.00
|
| Rate for Payer: Cofinity Commercial |
$877.20
|
| Rate for Payer: Cofinity Commercial |
$714.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.00
|
| Rate for Payer: Healthscope Commercial |
$918.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.00
|
| Rate for Payer: PHP Commercial |
$867.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.00
|
| Rate for Payer: Priority Health SBD |
$642.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.70
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$262.45
|
| Rate for Payer: UMR Bronson Commercial |
$377.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.00
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
IP
|
$845.54
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$372.04 |
| Max. Negotiated Rate |
$760.99 |
| Rate for Payer: Aetna American Axle |
$549.60
|
| Rate for Payer: Aetna Commercial |
$718.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.60
|
| Rate for Payer: Cash Price |
$676.43
|
| Rate for Payer: Cofinity Commercial |
$591.88
|
| Rate for Payer: Cofinity Commercial |
$727.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$591.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$676.43
|
| Rate for Payer: Healthscope Commercial |
$760.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$591.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$634.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$718.71
|
| Rate for Payer: PHP Commercial |
$718.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.60
|
| Rate for Payer: Priority Health SBD |
$532.69
|
| Rate for Payer: UMR Bronson Commercial |
$372.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$634.16
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH 3RD ORDER
|
Facility
|
OP
|
$845.54
|
|
|
Service Code
|
CPT 36217
|
| Hospital Charge Code |
36100108
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$312.85 |
| Max. Negotiated Rate |
$6,807.60 |
| Rate for Payer: Aetna American Axle |
$549.60
|
| Rate for Payer: Aetna Commercial |
$718.71
|
| Rate for Payer: Aetna Medicare |
$422.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$549.60
|
| Rate for Payer: BCBS Complete |
$338.22
|
| Rate for Payer: BCBS Trust/PPO |
$6,807.60
|
| Rate for Payer: BCN Commercial |
$6,807.60
|
| Rate for Payer: Cash Price |
$676.43
|
| Rate for Payer: Cash Price |
$676.43
|
| Rate for Payer: Cash Price |
$676.43
|
| Rate for Payer: Cofinity Commercial |
$727.16
|
| Rate for Payer: Cofinity Commercial |
$591.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$591.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$676.43
|
| Rate for Payer: Healthscope Commercial |
$760.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$591.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$634.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$718.71
|
| Rate for Payer: PHP Commercial |
$718.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$549.60
|
| Rate for Payer: Priority Health SBD |
$532.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.85
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$322.59
|
| Rate for Payer: UMR Bronson Commercial |
$312.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$634.16
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,122.86
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$494.06 |
| Max. Negotiated Rate |
$1,010.57 |
| Rate for Payer: Aetna American Axle |
$729.86
|
| Rate for Payer: Aetna Commercial |
$954.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.86
|
| Rate for Payer: Cash Price |
$898.29
|
| Rate for Payer: Cofinity Commercial |
$786.00
|
| Rate for Payer: Cofinity Commercial |
$965.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$786.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.29
|
| Rate for Payer: Healthscope Commercial |
$1,010.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$786.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.43
|
| Rate for Payer: PHP Commercial |
$954.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.86
|
| Rate for Payer: Priority Health SBD |
$707.40
|
| Rate for Payer: UMR Bronson Commercial |
$494.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.14
|
|
|
HC PLACEMENT SELECTIVE ART ABOVE ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,122.86
|
|
|
Service Code
|
CPT 36218
|
| Hospital Charge Code |
36100109
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$50.68 |
| Max. Negotiated Rate |
$1,010.57 |
| Rate for Payer: Aetna American Axle |
$729.86
|
| Rate for Payer: Aetna Commercial |
$954.43
|
| Rate for Payer: Aetna Medicare |
$561.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.86
|
| Rate for Payer: BCBS Complete |
$449.14
|
| Rate for Payer: BCBS Trust/PPO |
$665.84
|
| Rate for Payer: BCN Commercial |
$665.84
|
| Rate for Payer: Cash Price |
$898.29
|
| Rate for Payer: Cash Price |
$898.29
|
| Rate for Payer: Cash Price |
$898.29
|
| Rate for Payer: Cofinity Commercial |
$965.66
|
| Rate for Payer: Cofinity Commercial |
$786.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$786.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.29
|
| Rate for Payer: Healthscope Commercial |
$1,010.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$786.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.43
|
| Rate for Payer: PHP Commercial |
$954.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.86
|
| Rate for Payer: Priority Health SBD |
$707.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.75
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$50.68
|
| Rate for Payer: UMR Bronson Commercial |
$415.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.14
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
IP
|
$10,446.83
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,596.61 |
| Max. Negotiated Rate |
$9,402.15 |
| Rate for Payer: Aetna American Axle |
$6,790.44
|
| Rate for Payer: Aetna Commercial |
$8,879.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,790.44
|
| Rate for Payer: Cash Price |
$8,357.46
|
| Rate for Payer: Cofinity Commercial |
$7,312.78
|
| Rate for Payer: Cofinity Commercial |
$8,984.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,312.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,357.46
|
| Rate for Payer: Healthscope Commercial |
$9,402.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,312.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,835.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,879.81
|
| Rate for Payer: PHP Commercial |
$8,879.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,790.44
|
| Rate for Payer: Priority Health SBD |
$6,581.50
|
| Rate for Payer: UMR Bronson Commercial |
$4,596.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,835.12
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH 3RD ORDER
|
Facility
|
OP
|
$10,446.83
|
|
|
Service Code
|
CPT 36247
|
| Hospital Charge Code |
36100112
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$285.66 |
| Max. Negotiated Rate |
$9,402.15 |
| Rate for Payer: Aetna American Axle |
$6,790.44
|
| Rate for Payer: Aetna Commercial |
$8,879.81
|
| Rate for Payer: Aetna Medicare |
$5,223.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,790.44
|
| Rate for Payer: BCBS Complete |
$4,178.73
|
| Rate for Payer: BCBS Trust/PPO |
$4,602.42
|
| Rate for Payer: BCN Commercial |
$4,602.42
|
| Rate for Payer: Cash Price |
$8,357.46
|
| Rate for Payer: Cash Price |
$8,357.46
|
| Rate for Payer: Cash Price |
$8,357.46
|
| Rate for Payer: Cofinity Commercial |
$8,984.27
|
| Rate for Payer: Cofinity Commercial |
$7,312.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,312.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,357.46
|
| Rate for Payer: Healthscope Commercial |
$9,402.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,312.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,835.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,879.81
|
| Rate for Payer: PHP Commercial |
$8,879.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,790.44
|
| Rate for Payer: Priority Health SBD |
$6,581.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$314.23
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$285.66
|
| Rate for Payer: UMR Bronson Commercial |
$3,865.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,835.12
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
IP
|
$1,020.78
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$449.14 |
| Max. Negotiated Rate |
$918.70 |
| Rate for Payer: Aetna American Axle |
$663.51
|
| Rate for Payer: Aetna Commercial |
$867.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.51
|
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Cofinity Commercial |
$714.55
|
| Rate for Payer: Cofinity Commercial |
$877.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.62
|
| Rate for Payer: Healthscope Commercial |
$918.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.66
|
| Rate for Payer: PHP Commercial |
$867.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.51
|
| Rate for Payer: Priority Health SBD |
$643.09
|
| Rate for Payer: UMR Bronson Commercial |
$449.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.58
|
|
|
HC PLACEMENT SELECTIVE ART BELOW ARCH ADDL 2ND OR 3RD ORDER
|
Facility
|
OP
|
$1,020.78
|
|
|
Service Code
|
CPT 36248
|
| Hospital Charge Code |
36100113
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$45.73 |
| Max. Negotiated Rate |
$918.70 |
| Rate for Payer: Aetna American Axle |
$663.51
|
| Rate for Payer: Aetna Commercial |
$867.66
|
| Rate for Payer: Aetna Medicare |
$510.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.51
|
| Rate for Payer: BCBS Complete |
$408.31
|
| Rate for Payer: BCBS Trust/PPO |
$547.09
|
| Rate for Payer: BCN Commercial |
$547.09
|
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Cash Price |
$816.62
|
| Rate for Payer: Cofinity Commercial |
$877.87
|
| Rate for Payer: Cofinity Commercial |
$714.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.62
|
| Rate for Payer: Healthscope Commercial |
$918.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.66
|
| Rate for Payer: PHP Commercial |
$867.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.51
|
| Rate for Payer: Priority Health SBD |
$643.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.30
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$45.73
|
| Rate for Payer: UMR Bronson Commercial |
$377.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.58
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
OP
|
$930.40
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$144.47 |
| Max. Negotiated Rate |
$2,857.98 |
| Rate for Payer: Aetna American Axle |
$604.76
|
| Rate for Payer: Aetna Commercial |
$790.84
|
| Rate for Payer: Aetna Medicare |
$465.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.76
|
| Rate for Payer: BCBS Complete |
$372.16
|
| Rate for Payer: BCBS Trust/PPO |
$2,857.98
|
| Rate for Payer: BCN Commercial |
$2,857.98
|
| Rate for Payer: Cash Price |
$744.32
|
| Rate for Payer: Cash Price |
$744.32
|
| Rate for Payer: Cash Price |
$744.32
|
| Rate for Payer: Cofinity Commercial |
$800.14
|
| Rate for Payer: Cofinity Commercial |
$651.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$651.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$744.32
|
| Rate for Payer: Healthscope Commercial |
$837.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$651.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$697.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.84
|
| Rate for Payer: PHP Commercial |
$790.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.76
|
| Rate for Payer: Priority Health SBD |
$586.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.92
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$144.47
|
| Rate for Payer: UMR Bronson Commercial |
$344.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$697.80
|
|
|
HC PLACEMENT SELECTIVE PULMONARY
|
Facility
|
IP
|
$930.40
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
36100100
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$409.38 |
| Max. Negotiated Rate |
$837.36 |
| Rate for Payer: Aetna American Axle |
$604.76
|
| Rate for Payer: Aetna Commercial |
$790.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$604.76
|
| Rate for Payer: Cash Price |
$744.32
|
| Rate for Payer: Cofinity Commercial |
$651.28
|
| Rate for Payer: Cofinity Commercial |
$800.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$651.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$744.32
|
| Rate for Payer: Healthscope Commercial |
$837.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$651.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$697.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$790.84
|
| Rate for Payer: PHP Commercial |
$790.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$604.76
|
| Rate for Payer: Priority Health SBD |
$586.15
|
| Rate for Payer: UMR Bronson Commercial |
$409.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$697.80
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
OP
|
$6,639.46
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$149.34 |
| Max. Negotiated Rate |
$5,975.51 |
| Rate for Payer: Aetna American Axle |
$4,315.65
|
| Rate for Payer: Aetna Commercial |
$5,643.54
|
| Rate for Payer: Aetna Medicare |
$3,319.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,315.65
|
| Rate for Payer: BCBS Complete |
$2,655.78
|
| Rate for Payer: BCBS Trust/PPO |
$3,614.10
|
| Rate for Payer: BCN Commercial |
$3,614.10
|
| Rate for Payer: Cash Price |
$5,311.57
|
| Rate for Payer: Cash Price |
$5,311.57
|
| Rate for Payer: Cash Price |
$5,311.57
|
| Rate for Payer: Cofinity Commercial |
$5,709.94
|
| Rate for Payer: Cofinity Commercial |
$4,647.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,647.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.57
|
| Rate for Payer: Healthscope Commercial |
$5,975.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,647.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,979.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.54
|
| Rate for Payer: PHP Commercial |
$5,643.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,315.65
|
| Rate for Payer: Priority Health SBD |
$4,182.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$164.27
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$149.34
|
| Rate for Payer: UMR Bronson Commercial |
$2,456.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,979.60
|
|
|
HC PLACEMENT SELECTIVE VENOUS 1ST ORDER
|
Facility
|
IP
|
$6,639.46
|
|
|
Service Code
|
CPT 36011
|
| Hospital Charge Code |
36100097
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,921.36 |
| Max. Negotiated Rate |
$5,975.51 |
| Rate for Payer: Aetna American Axle |
$4,315.65
|
| Rate for Payer: Aetna Commercial |
$5,643.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,315.65
|
| Rate for Payer: Cash Price |
$5,311.57
|
| Rate for Payer: Cofinity Commercial |
$4,647.62
|
| Rate for Payer: Cofinity Commercial |
$5,709.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,647.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,311.57
|
| Rate for Payer: Healthscope Commercial |
$5,975.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,647.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,979.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,643.54
|
| Rate for Payer: PHP Commercial |
$5,643.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,315.65
|
| Rate for Payer: Priority Health SBD |
$4,182.86
|
| Rate for Payer: UMR Bronson Commercial |
$2,921.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,979.60
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
OP
|
$5,517.84
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$166.36 |
| Max. Negotiated Rate |
$4,966.06 |
| Rate for Payer: Aetna American Axle |
$3,586.60
|
| Rate for Payer: Aetna Commercial |
$4,690.16
|
| Rate for Payer: Aetna Medicare |
$2,758.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,586.60
|
| Rate for Payer: BCBS Complete |
$2,207.14
|
| Rate for Payer: BCBS Trust/PPO |
$3,685.14
|
| Rate for Payer: BCN Commercial |
$3,685.14
|
| Rate for Payer: Cash Price |
$4,414.27
|
| Rate for Payer: Cash Price |
$4,414.27
|
| Rate for Payer: Cash Price |
$4,414.27
|
| Rate for Payer: Cofinity Commercial |
$4,745.34
|
| Rate for Payer: Cofinity Commercial |
$3,862.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,862.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,414.27
|
| Rate for Payer: Healthscope Commercial |
$4,966.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,862.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,138.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,690.16
|
| Rate for Payer: PHP Commercial |
$4,690.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,586.60
|
| Rate for Payer: Priority Health SBD |
$3,476.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.00
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$166.36
|
| Rate for Payer: UMR Bronson Commercial |
$2,041.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,138.38
|
|
|
HC PLACEMENT SELECTIVE VENOUS 2ND ORDER
|
Facility
|
IP
|
$5,517.84
|
|
|
Service Code
|
CPT 36012
|
| Hospital Charge Code |
36100098
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,427.85 |
| Max. Negotiated Rate |
$4,966.06 |
| Rate for Payer: Aetna American Axle |
$3,586.60
|
| Rate for Payer: Aetna Commercial |
$4,690.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,586.60
|
| Rate for Payer: Cash Price |
$4,414.27
|
| Rate for Payer: Cofinity Commercial |
$3,862.49
|
| Rate for Payer: Cofinity Commercial |
$4,745.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,862.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,414.27
|
| Rate for Payer: Healthscope Commercial |
$4,966.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,862.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,138.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,690.16
|
| Rate for Payer: PHP Commercial |
$4,690.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,586.60
|
| Rate for Payer: Priority Health SBD |
$3,476.24
|
| Rate for Payer: UMR Bronson Commercial |
$2,427.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,138.38
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
IP
|
$3,348.21
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,473.21 |
| Max. Negotiated Rate |
$3,013.39 |
| Rate for Payer: Aetna American Axle |
$2,176.34
|
| Rate for Payer: Aetna Commercial |
$2,845.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,176.34
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cofinity Commercial |
$2,343.75
|
| Rate for Payer: Cofinity Commercial |
$2,879.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,343.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,678.57
|
| Rate for Payer: Healthscope Commercial |
$3,013.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,343.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,511.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,845.98
|
| Rate for Payer: PHP Commercial |
$2,845.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.34
|
| Rate for Payer: Priority Health SBD |
$2,109.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,473.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,511.16
|
|
|
HC PLACE NEPHROSTOMY CATHETER
|
Facility
|
OP
|
$3,348.21
|
|
|
Service Code
|
CPT 50432
|
| Hospital Charge Code |
36100504
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$192.88 |
| Max. Negotiated Rate |
$6,308.24 |
| Rate for Payer: Aetna American Axle |
$2,176.34
|
| Rate for Payer: Aetna Commercial |
$2,845.98
|
| Rate for Payer: Aetna Medicare |
$2,087.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,176.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,508.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,508.86
|
| Rate for Payer: BCBS Complete |
$1,129.59
|
| Rate for Payer: BCBS MAPPO |
$2,007.09
|
| Rate for Payer: BCBS Trust/PPO |
$2,773.35
|
| Rate for Payer: BCN Commercial |
$2,773.35
|
| Rate for Payer: BCN Medicare Advantage |
$2,007.09
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cofinity Commercial |
$2,879.46
|
| Rate for Payer: Cofinity Commercial |
$2,343.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,343.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,678.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,007.09
|
| Rate for Payer: Healthscope Commercial |
$3,013.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,343.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,511.16
|
| Rate for Payer: Mclaren Medicaid |
$1,075.80
|
| Rate for Payer: Mclaren Medicare |
$2,007.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,107.44
|
| Rate for Payer: Meridian Medicaid |
$1,129.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,308.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,845.98
|
| Rate for Payer: Nomi Health Commercial |
$4,214.89
|
| Rate for Payer: PACE Medicare |
$1,906.74
|
| Rate for Payer: PACE SWMI |
$2,007.09
|
| Rate for Payer: PHP Commercial |
$2,845.98
|
| Rate for Payer: PHP Medicare Advantage |
$2,007.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,308.24
|
| Rate for Payer: Priority Health Medicare |
$2,007.09
|
| Rate for Payer: Priority Health Narrow Network |
$5,046.59
|
| Rate for Payer: Priority Health SBD |
$2,109.37
|
| Rate for Payer: Railroad Medicare Medicare |
$2,007.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.17
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,007.09
|
| Rate for Payer: UHC Exchange |
$192.88
|
| Rate for Payer: UHC Medicare Advantage |
$2,007.09
|
| Rate for Payer: UHCCP Medicaid |
$1,075.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,238.84
|
| Rate for Payer: VA VA |
$2,007.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,511.16
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
IP
|
$3,348.21
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,473.21 |
| Max. Negotiated Rate |
$3,013.39 |
| Rate for Payer: Aetna American Axle |
$2,176.34
|
| Rate for Payer: Aetna Commercial |
$2,845.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,176.34
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cofinity Commercial |
$2,343.75
|
| Rate for Payer: Cofinity Commercial |
$2,879.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,343.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,678.57
|
| Rate for Payer: Healthscope Commercial |
$3,013.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,343.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,511.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,845.98
|
| Rate for Payer: PHP Commercial |
$2,845.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.34
|
| Rate for Payer: Priority Health SBD |
$2,109.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,473.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,511.16
|
|
|
HC PLACE NEPHROURETERAL CATHETER
|
Facility
|
OP
|
$3,348.21
|
|
|
Service Code
|
CPT 50433
|
| Hospital Charge Code |
36100505
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$239.92 |
| Max. Negotiated Rate |
$10,620.87 |
| Rate for Payer: Aetna American Axle |
$2,176.34
|
| Rate for Payer: Aetna Commercial |
$2,845.98
|
| Rate for Payer: Aetna Medicare |
$3,514.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,176.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,224.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,224.04
|
| Rate for Payer: BCBS Complete |
$1,901.83
|
| Rate for Payer: BCBS MAPPO |
$3,379.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,707.90
|
| Rate for Payer: BCN Commercial |
$1,707.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,379.23
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cash Price |
$2,678.57
|
| Rate for Payer: Cofinity Commercial |
$2,879.46
|
| Rate for Payer: Cofinity Commercial |
$2,343.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,343.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,678.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,379.23
|
| Rate for Payer: Healthscope Commercial |
$3,013.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,343.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,511.16
|
| Rate for Payer: Mclaren Medicaid |
$1,811.27
|
| Rate for Payer: Mclaren Medicare |
$3,379.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,548.19
|
| Rate for Payer: Meridian Medicaid |
$1,901.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,845.98
|
| Rate for Payer: Nomi Health Commercial |
$7,096.38
|
| Rate for Payer: PACE Medicare |
$3,210.27
|
| Rate for Payer: PACE SWMI |
$3,379.23
|
| Rate for Payer: PHP Commercial |
$2,845.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,379.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,811.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,176.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,620.87
|
| Rate for Payer: Priority Health Medicare |
$3,379.23
|
| Rate for Payer: Priority Health Narrow Network |
$8,496.70
|
| Rate for Payer: Priority Health SBD |
$2,109.37
|
| Rate for Payer: Railroad Medicare Medicare |
$3,379.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.91
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,379.23
|
| Rate for Payer: UHC Exchange |
$239.92
|
| Rate for Payer: UHC Medicare Advantage |
$3,379.23
|
| Rate for Payer: UHCCP Medicaid |
$1,811.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,238.84
|
| Rate for Payer: VA VA |
$3,379.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,511.16
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
OP
|
$8,589.97
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$225.90 |
| Max. Negotiated Rate |
$7,730.97 |
| Rate for Payer: Aetna American Axle |
$5,583.48
|
| Rate for Payer: Aetna Commercial |
$7,301.47
|
| Rate for Payer: Aetna Medicare |
$4,294.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,583.48
|
| Rate for Payer: BCBS Complete |
$3,435.99
|
| Rate for Payer: BCBS Trust/PPO |
$4,662.23
|
| Rate for Payer: BCN Commercial |
$4,662.23
|
| Rate for Payer: Cash Price |
$6,871.98
|
| Rate for Payer: Cash Price |
$6,871.98
|
| Rate for Payer: Cash Price |
$6,871.98
|
| Rate for Payer: Cofinity Commercial |
$7,387.37
|
| Rate for Payer: Cofinity Commercial |
$6,012.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,012.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,871.98
|
| Rate for Payer: Healthscope Commercial |
$7,730.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,012.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,442.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,301.47
|
| Rate for Payer: PHP Commercial |
$7,301.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,583.48
|
| Rate for Payer: Priority Health SBD |
$5,411.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$248.49
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$225.90
|
| Rate for Payer: UMR Bronson Commercial |
$3,178.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,442.48
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 1ST ORDER
|
Facility
|
IP
|
$8,589.97
|
|
|
Service Code
|
CPT 36245
|
| Hospital Charge Code |
36100474
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,779.59 |
| Max. Negotiated Rate |
$7,730.97 |
| Rate for Payer: Aetna American Axle |
$5,583.48
|
| Rate for Payer: Aetna Commercial |
$7,301.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,583.48
|
| Rate for Payer: Cash Price |
$6,871.98
|
| Rate for Payer: Cofinity Commercial |
$6,012.98
|
| Rate for Payer: Cofinity Commercial |
$7,387.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,012.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,871.98
|
| Rate for Payer: Healthscope Commercial |
$7,730.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,012.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,442.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,301.47
|
| Rate for Payer: PHP Commercial |
$7,301.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,583.48
|
| Rate for Payer: Priority Health SBD |
$5,411.68
|
| Rate for Payer: UMR Bronson Commercial |
$3,779.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,442.48
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
IP
|
$5,382.61
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,368.35 |
| Max. Negotiated Rate |
$4,844.35 |
| Rate for Payer: Aetna American Axle |
$3,498.70
|
| Rate for Payer: Aetna Commercial |
$4,575.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,498.70
|
| Rate for Payer: Cash Price |
$4,306.09
|
| Rate for Payer: Cofinity Commercial |
$3,767.83
|
| Rate for Payer: Cofinity Commercial |
$4,629.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,767.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.09
|
| Rate for Payer: Healthscope Commercial |
$4,844.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,767.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,036.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.22
|
| Rate for Payer: PHP Commercial |
$4,575.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,498.70
|
| Rate for Payer: Priority Health SBD |
$3,391.04
|
| Rate for Payer: UMR Bronson Commercial |
$2,368.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,036.96
|
|
|
HC PLACE SELECTIVE ART BELOW ARCH 2ND ORDER
|
Facility
|
OP
|
$5,382.61
|
|
|
Service Code
|
CPT 36246
|
| Hospital Charge Code |
36100475
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$4,844.35 |
| Rate for Payer: Aetna American Axle |
$3,498.70
|
| Rate for Payer: Aetna Commercial |
$4,575.22
|
| Rate for Payer: Aetna Medicare |
$2,691.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,498.70
|
| Rate for Payer: BCBS Complete |
$2,153.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,470.74
|
| Rate for Payer: BCN Commercial |
$3,470.74
|
| Rate for Payer: Cash Price |
$4,306.09
|
| Rate for Payer: Cash Price |
$4,306.09
|
| Rate for Payer: Cash Price |
$4,306.09
|
| Rate for Payer: Cofinity Commercial |
$4,629.04
|
| Rate for Payer: Cofinity Commercial |
$3,767.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,767.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,306.09
|
| Rate for Payer: Healthscope Commercial |
$4,844.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,767.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,036.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,575.22
|
| Rate for Payer: PHP Commercial |
$4,575.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,498.70
|
| Rate for Payer: Priority Health SBD |
$3,391.04
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,991.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,036.96
|
|
