|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
IP
|
$32,044.32
|
|
|
Service Code
|
CPT C9764
|
| Hospital Charge Code |
48100124
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,099.50 |
| Max. Negotiated Rate |
$28,839.89 |
| Rate for Payer: Aetna American Axle |
$20,828.81
|
| Rate for Payer: Aetna Commercial |
$27,237.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20,828.81
|
| Rate for Payer: Cash Price |
$25,635.46
|
| Rate for Payer: Cofinity Advantage |
$22,431.02
|
| Rate for Payer: Cofinity Commercial |
$27,558.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,635.46
|
| Rate for Payer: Healthscope Commercial |
$28,839.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22,431.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24,033.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,237.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24,033.24
|
| Rate for Payer: PHP Commercial |
$27,237.67
|
| Rate for Payer: Priority Health SBD |
$20,187.92
|
| Rate for Payer: UMR Bronson Commercial |
$14,099.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24,033.24
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9766
|
| Hospital Charge Code |
48100126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,463.07 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: UMR Bronson Commercial |
$22,463.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9766
|
| Hospital Charge Code |
48100126
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$18,889.40
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9765
|
| Hospital Charge Code |
48100125
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,463.07 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: UMR Bronson Commercial |
$22,463.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9765
|
| Hospital Charge Code |
48100125
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$18,889.40
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9767
|
| Hospital Charge Code |
48100127
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,463.07 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: UMR Bronson Commercial |
$22,463.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC LOWER EXTR INTRAVASC LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9767
|
| Hospital Charge Code |
48100127
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$18,889.40
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
IP
|
$12,063.19
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,307.80 |
| Max. Negotiated Rate |
$10,856.87 |
| Rate for Payer: Aetna American Axle |
$7,841.07
|
| Rate for Payer: Aetna Commercial |
$10,253.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,841.07
|
| Rate for Payer: Cash Price |
$9,650.55
|
| Rate for Payer: Cofinity Advantage |
$8,444.23
|
| Rate for Payer: Cofinity Commercial |
$10,374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,650.55
|
| Rate for Payer: Healthscope Commercial |
$10,856.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,444.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,047.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,253.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,047.39
|
| Rate for Payer: PHP Commercial |
$10,253.71
|
| Rate for Payer: Priority Health SBD |
$7,599.81
|
| Rate for Payer: UMR Bronson Commercial |
$5,307.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,047.39
|
|
|
HC REVASC STENT TIB PERONL UNI INITIAL
|
Facility
|
OP
|
$12,063.19
|
|
|
Service Code
|
CPT 37230
|
| Hospital Charge Code |
36100174
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,463.38 |
| Max. Negotiated Rate |
$15,877.39 |
| Rate for Payer: Aetna American Axle |
$7,841.07
|
| Rate for Payer: Aetna Commercial |
$10,253.71
|
| Rate for Payer: Aetna Medicare |
$6,031.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,841.07
|
| Rate for Payer: BCBS Complete |
$4,825.28
|
| Rate for Payer: BCBS Trust/PPO |
$15,877.39
|
| Rate for Payer: BCN Commercial |
$15,877.39
|
| Rate for Payer: Cash Price |
$9,650.55
|
| Rate for Payer: Cash Price |
$9,650.55
|
| Rate for Payer: Cash Price |
$9,650.55
|
| Rate for Payer: Cofinity Advantage |
$8,444.23
|
| Rate for Payer: Cofinity Commercial |
$10,374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,650.55
|
| Rate for Payer: Healthscope Commercial |
$10,856.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,444.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,047.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,650.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,253.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,047.39
|
| Rate for Payer: PHP Commercial |
$10,253.71
|
| Rate for Payer: Priority Health SBD |
$7,599.81
|
| Rate for Payer: UMR Bronson Commercial |
$4,463.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,047.39
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
IP
|
$32,044.32
|
|
|
Service Code
|
CPT C9772
|
| Hospital Charge Code |
48100128
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$14,099.50 |
| Max. Negotiated Rate |
$28,839.89 |
| Rate for Payer: Aetna American Axle |
$20,828.81
|
| Rate for Payer: Aetna Commercial |
$27,237.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20,828.81
|
| Rate for Payer: Cash Price |
$25,635.46
|
| Rate for Payer: Cofinity Advantage |
$22,431.02
|
| Rate for Payer: Cofinity Commercial |
$27,558.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,635.46
|
| Rate for Payer: Healthscope Commercial |
$28,839.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22,431.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24,033.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,237.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24,033.24
|
| Rate for Payer: PHP Commercial |
$27,237.67
|
| Rate for Payer: Priority Health SBD |
$20,187.92
|
| Rate for Payer: UMR Bronson Commercial |
$14,099.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24,033.24
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY
|
Facility
|
OP
|
$32,044.32
|
|
|
Service Code
|
CPT C9772
|
| Hospital Charge Code |
48100128
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$20,828.81
|
| Rate for Payer: Aetna Commercial |
$27,237.67
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20,828.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$25,635.46
|
| Rate for Payer: Cash Price |
$25,635.46
|
| Rate for Payer: Cofinity Advantage |
$22,431.02
|
| Rate for Payer: Cofinity Commercial |
$27,558.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25,635.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$28,839.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22,431.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24,033.24
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27,237.67
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24,033.24
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$27,237.67
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$20,187.92
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$11,856.40
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24,033.24
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9774
|
| Hospital Charge Code |
48100130
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,463.07 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: UMR Bronson Commercial |
$22,463.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH ATHERECTOMY
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9774
|
| Hospital Charge Code |
48100130
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$18,889.40
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9773
|
| Hospital Charge Code |
48100129
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$18,889.40
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9773
|
| Hospital Charge Code |
48100129
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,463.07 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: UMR Bronson Commercial |
$22,463.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
OP
|
$51,052.43
|
|
|
Service Code
|
CPT C9775
|
| Hospital Charge Code |
48100131
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,552.97 |
| Max. Negotiated Rate |
$59,069.70 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna Medicare |
$18,996.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22,832.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22,832.15
|
| Rate for Payer: BCBS Complete |
$10,031.53
|
| Rate for Payer: BCBS MAPPO |
$18,265.72
|
| Rate for Payer: BCN Medicare Advantage |
$18,265.72
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,265.72
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Mclaren Medicaid |
$18,265.72
|
| Rate for Payer: Mclaren Medicare |
$18,265.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,179.01
|
| Rate for Payer: Meridian Medicaid |
$19,179.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,005.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$20,092.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Nomi Health Commercial |
$54,797.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PACE Medicare |
$17,352.43
|
| Rate for Payer: PACE SWMI |
$18,265.72
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: PHP Medicare Advantage |
$18,265.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,552.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$59,069.70
|
| Rate for Payer: Priority Health Medicare |
$18,265.72
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: Priority Health Tiered Network |
$47,255.76
|
| Rate for Payer: Railroad Medicare Medicare |
$18,265.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18,265.72
|
| Rate for Payer: UHC Medicaid |
$9,552.97
|
| Rate for Payer: UHCCP Medicaid |
$9,552.97
|
| Rate for Payer: UMR Bronson Commercial |
$18,889.40
|
| Rate for Payer: VA VA |
$18,265.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
IP
|
$51,052.43
|
|
|
Service Code
|
CPT C9775
|
| Hospital Charge Code |
48100131
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,463.07 |
| Max. Negotiated Rate |
$45,947.19 |
| Rate for Payer: Aetna American Axle |
$33,184.08
|
| Rate for Payer: Aetna Commercial |
$43,394.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33,184.08
|
| Rate for Payer: Cash Price |
$40,841.94
|
| Rate for Payer: Cofinity Advantage |
$35,736.70
|
| Rate for Payer: Cofinity Commercial |
$43,905.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,841.94
|
| Rate for Payer: Healthscope Commercial |
$45,947.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,736.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38,289.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43,394.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38,289.32
|
| Rate for Payer: PHP Commercial |
$43,394.57
|
| Rate for Payer: Priority Health SBD |
$32,163.03
|
| Rate for Payer: UMR Bronson Commercial |
$22,463.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38,289.32
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
IP
|
$13,269.50
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,838.58 |
| Max. Negotiated Rate |
$11,942.55 |
| Rate for Payer: Aetna American Axle |
$8,625.17
|
| Rate for Payer: Aetna Commercial |
$11,279.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,625.17
|
| Rate for Payer: Cash Price |
$10,615.60
|
| Rate for Payer: Cofinity Advantage |
$9,288.65
|
| Rate for Payer: Cofinity Commercial |
$11,411.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,615.60
|
| Rate for Payer: Healthscope Commercial |
$11,942.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,288.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,952.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,279.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,952.12
|
| Rate for Payer: PHP Commercial |
$11,279.08
|
| Rate for Payer: Priority Health SBD |
$8,359.78
|
| Rate for Payer: UMR Bronson Commercial |
$5,838.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,952.12
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
OP
|
$13,269.50
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,909.72 |
| Max. Negotiated Rate |
$11,942.55 |
| Rate for Payer: Aetna American Axle |
$8,625.17
|
| Rate for Payer: Aetna Commercial |
$11,279.08
|
| Rate for Payer: Aetna Medicare |
$6,634.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,625.17
|
| Rate for Payer: BCBS Complete |
$5,307.80
|
| Rate for Payer: BCBS Trust/PPO |
$11,655.56
|
| Rate for Payer: BCN Commercial |
$11,655.56
|
| Rate for Payer: Cash Price |
$10,615.60
|
| Rate for Payer: Cash Price |
$10,615.60
|
| Rate for Payer: Cash Price |
$10,615.60
|
| Rate for Payer: Cofinity Advantage |
$9,288.65
|
| Rate for Payer: Cofinity Commercial |
$11,411.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,615.60
|
| Rate for Payer: Healthscope Commercial |
$11,942.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,288.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,952.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10,615.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,279.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,952.12
|
| Rate for Payer: PHP Commercial |
$11,279.08
|
| Rate for Payer: Priority Health SBD |
$8,359.78
|
| Rate for Payer: UMR Bronson Commercial |
$4,909.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,952.12
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
OP
|
$19,483.94
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna American Axle |
$12,664.56
|
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna Medicare |
$9,741.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,664.56
|
| Rate for Payer: BCBS Complete |
$7,793.58
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Advantage |
$13,638.76
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,638.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15,587.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health SBD |
$12,274.88
|
| Rate for Payer: UMR Bronson Commercial |
$7,209.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
IP
|
$19,483.94
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,572.93 |
| Max. Negotiated Rate |
$17,535.55 |
| Rate for Payer: Aetna American Axle |
$12,664.56
|
| Rate for Payer: Aetna Commercial |
$16,561.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,664.56
|
| Rate for Payer: Cash Price |
$15,587.15
|
| Rate for Payer: Cofinity Advantage |
$13,638.76
|
| Rate for Payer: Cofinity Commercial |
$16,756.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,587.15
|
| Rate for Payer: Healthscope Commercial |
$17,535.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,638.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,612.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,561.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,612.95
|
| Rate for Payer: PHP Commercial |
$16,561.35
|
| Rate for Payer: Priority Health SBD |
$12,274.88
|
| Rate for Payer: UMR Bronson Commercial |
$8,572.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,612.95
|
|
|
HC REVAS DES/CABG INITIAL
|
Facility
|
IP
|
$29,741.77
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,086.38 |
| Max. Negotiated Rate |
$26,767.59 |
| Rate for Payer: Aetna American Axle |
$19,332.15
|
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,332.15
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Advantage |
$20,819.24
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,819.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: Priority Health SBD |
$18,737.32
|
| Rate for Payer: UMR Bronson Commercial |
$13,086.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC REVAS DES/CABG INITIAL
|
Facility
|
OP
|
$29,741.77
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$19,332.15
|
| Rate for Payer: Aetna Commercial |
$25,280.50
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,332.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$11,004.10
|
| Rate for Payer: BCN Commercial |
$11,004.10
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cash Price |
$23,793.42
|
| Rate for Payer: Cofinity Advantage |
$20,819.24
|
| Rate for Payer: Cofinity Commercial |
$25,577.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,793.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$26,767.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,819.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,306.33
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,280.50
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,306.33
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$25,280.50
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$18,737.32
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$11,004.45
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,306.33
|
|
|
HC REVAS MI/DES
|
Facility
|
OP
|
$30,266.82
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,198.72 |
| Max. Negotiated Rate |
$27,240.14 |
| Rate for Payer: Aetna American Axle |
$19,673.43
|
| Rate for Payer: Aetna Commercial |
$25,726.80
|
| Rate for Payer: Aetna Medicare |
$15,133.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,673.43
|
| Rate for Payer: BCBS Complete |
$12,106.73
|
| Rate for Payer: BCBS Trust/PPO |
$16,679.35
|
| Rate for Payer: BCN Commercial |
$16,679.35
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Advantage |
$21,186.77
|
| Rate for Payer: Cofinity Commercial |
$26,029.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$27,240.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,186.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,700.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,213.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: PHP Commercial |
$25,726.80
|
| Rate for Payer: Priority Health SBD |
$19,068.10
|
| Rate for Payer: UMR Bronson Commercial |
$11,198.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,700.12
|
|
|
HC REVAS MI/DES
|
Facility
|
IP
|
$30,266.82
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,317.40 |
| Max. Negotiated Rate |
$27,240.14 |
| Rate for Payer: Aetna American Axle |
$19,673.43
|
| Rate for Payer: Aetna Commercial |
$25,726.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,673.43
|
| Rate for Payer: Cash Price |
$24,213.46
|
| Rate for Payer: Cofinity Advantage |
$21,186.77
|
| Rate for Payer: Cofinity Commercial |
$26,029.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,213.46
|
| Rate for Payer: Healthscope Commercial |
$27,240.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,186.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,700.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,726.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,700.12
|
| Rate for Payer: PHP Commercial |
$25,726.80
|
| Rate for Payer: Priority Health SBD |
$19,068.10
|
| Rate for Payer: UMR Bronson Commercial |
$13,317.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,700.12
|
|
