|
HC REVAS MI/STENT
|
Facility
|
IP
|
$30,266.82
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
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
|
|
|
HC REVAS MI/STENT
|
Facility
|
OP
|
$30,266.82
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$308.15 |
| 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 |
$308.15
|
| Rate for Payer: BCN Commercial |
$308.15
|
| 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 REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$16,344.72
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,321.09 |
| Max. Negotiated Rate |
$20,535.59 |
| Rate for Payer: Aetna American Axle |
$10,624.07
|
| Rate for Payer: Aetna Commercial |
$13,893.01
|
| Rate for Payer: Aetna Medicare |
$6,604.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,624.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,937.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,937.60
|
| Rate for Payer: BCBS Complete |
$3,487.46
|
| Rate for Payer: BCBS MAPPO |
$6,350.08
|
| Rate for Payer: BCBS Trust/PPO |
$7,922.64
|
| Rate for Payer: BCN Commercial |
$7,922.64
|
| Rate for Payer: BCN Medicare Advantage |
$6,350.08
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cofinity Advantage |
$11,441.30
|
| Rate for Payer: Cofinity Commercial |
$14,056.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,075.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,350.08
|
| Rate for Payer: Healthscope Commercial |
$14,710.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,441.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,258.54
|
| Rate for Payer: Mclaren Medicaid |
$6,350.08
|
| Rate for Payer: Mclaren Medicare |
$6,350.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,667.58
|
| Rate for Payer: Meridian Medicaid |
$6,667.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,302.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,985.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,893.01
|
| Rate for Payer: Nomi Health Commercial |
$19,050.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,258.54
|
| Rate for Payer: PACE Medicare |
$6,032.58
|
| Rate for Payer: PACE SWMI |
$6,350.08
|
| Rate for Payer: PHP Commercial |
$13,893.01
|
| Rate for Payer: PHP Medicare Advantage |
$6,350.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,321.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20,535.59
|
| Rate for Payer: Priority Health Medicare |
$6,350.08
|
| Rate for Payer: Priority Health SBD |
$10,297.17
|
| Rate for Payer: Priority Health Tiered Network |
$16,428.47
|
| Rate for Payer: Railroad Medicare Medicare |
$6,350.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,350.08
|
| Rate for Payer: UHC Medicaid |
$3,321.09
|
| Rate for Payer: UHCCP Medicaid |
$3,321.09
|
| Rate for Payer: UMR Bronson Commercial |
$6,047.55
|
| Rate for Payer: VA VA |
$6,350.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,258.54
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$16,344.72
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,191.68 |
| Max. Negotiated Rate |
$14,710.25 |
| Rate for Payer: Aetna American Axle |
$10,624.07
|
| Rate for Payer: Aetna Commercial |
$13,893.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,624.07
|
| Rate for Payer: Cash Price |
$13,075.78
|
| Rate for Payer: Cofinity Advantage |
$11,441.30
|
| Rate for Payer: Cofinity Commercial |
$14,056.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,075.78
|
| Rate for Payer: Healthscope Commercial |
$14,710.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,441.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,258.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,893.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,258.54
|
| Rate for Payer: PHP Commercial |
$13,893.01
|
| Rate for Payer: Priority Health SBD |
$10,297.17
|
| Rate for Payer: UMR Bronson Commercial |
$7,191.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,258.54
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
IP
|
$3,173.22
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,396.22 |
| Max. Negotiated Rate |
$2,855.90 |
| Rate for Payer: Aetna American Axle |
$2,062.59
|
| Rate for Payer: Aetna Commercial |
$2,697.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,062.59
|
| Rate for Payer: Cash Price |
$2,538.58
|
| Rate for Payer: Cofinity Advantage |
$2,221.25
|
| Rate for Payer: Cofinity Commercial |
$2,728.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.58
|
| Rate for Payer: Healthscope Commercial |
$2,855.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,221.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,379.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,697.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.91
|
| Rate for Payer: PHP Commercial |
$2,697.24
|
| Rate for Payer: Priority Health SBD |
$1,999.13
|
| Rate for Payer: UMR Bronson Commercial |
$1,396.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,379.91
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
OP
|
$3,173.22
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$2,855.90 |
| Rate for Payer: Aetna American Axle |
$2,062.59
|
| Rate for Payer: Aetna Commercial |
$2,697.24
|
| Rate for Payer: Aetna Medicare |
$1,586.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,062.59
|
| Rate for Payer: BCBS Complete |
$1,269.29
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,538.58
|
| Rate for Payer: Cash Price |
$2,538.58
|
| Rate for Payer: Cofinity Advantage |
$2,221.25
|
| Rate for Payer: Cofinity Commercial |
$2,728.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,538.58
|
| Rate for Payer: Healthscope Commercial |
$2,855.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,221.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,379.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,538.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,697.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,379.91
|
| Rate for Payer: PHP Commercial |
$2,697.24
|
| Rate for Payer: Priority Health SBD |
$1,999.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,062.59
|
| Rate for Payer: UHC Core |
$1,653.25
|
| Rate for Payer: UHC Exchange |
$1,247.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,174.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,379.91
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
OP
|
$7,935.33
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,936.07 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna American Axle |
$5,157.96
|
| Rate for Payer: Aetna Commercial |
$6,745.03
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,157.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$4,955.41
|
| Rate for Payer: BCN Commercial |
$4,955.41
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$6,348.26
|
| Rate for Payer: Cash Price |
$6,348.26
|
| Rate for Payer: Cash Price |
$6,348.26
|
| Rate for Payer: Cofinity Advantage |
$5,554.73
|
| Rate for Payer: Cofinity Commercial |
$6,824.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,348.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$7,141.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,554.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,951.50
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,745.03
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,951.50
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$6,745.03
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$4,999.26
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: UMR Bronson Commercial |
$2,936.07
|
| Rate for Payer: VA VA |
$6,023.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,951.50
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
IP
|
$7,935.33
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,491.55 |
| Max. Negotiated Rate |
$7,141.80 |
| Rate for Payer: Aetna American Axle |
$5,157.96
|
| Rate for Payer: Aetna Commercial |
$6,745.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,157.96
|
| Rate for Payer: Cash Price |
$6,348.26
|
| Rate for Payer: Cofinity Advantage |
$5,554.73
|
| Rate for Payer: Cofinity Commercial |
$6,824.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,348.26
|
| Rate for Payer: Healthscope Commercial |
$7,141.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,554.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,951.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,745.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,951.50
|
| Rate for Payer: PHP Commercial |
$6,745.03
|
| Rate for Payer: Priority Health SBD |
$4,999.26
|
| Rate for Payer: UMR Bronson Commercial |
$3,491.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,951.50
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
IP
|
$6,003.59
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,641.58 |
| Max. Negotiated Rate |
$5,403.23 |
| Rate for Payer: Aetna American Axle |
$3,902.33
|
| Rate for Payer: Aetna Commercial |
$5,103.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,902.33
|
| Rate for Payer: Cash Price |
$4,802.87
|
| Rate for Payer: Cofinity Advantage |
$4,202.51
|
| Rate for Payer: Cofinity Commercial |
$5,163.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,802.87
|
| Rate for Payer: Healthscope Commercial |
$5,403.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,202.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,502.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,103.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,502.69
|
| Rate for Payer: PHP Commercial |
$5,103.05
|
| Rate for Payer: Priority Health SBD |
$3,782.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,641.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,502.69
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
OP
|
$6,003.59
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,221.33 |
| Max. Negotiated Rate |
$19,480.40 |
| Rate for Payer: Aetna American Axle |
$3,902.33
|
| Rate for Payer: Aetna Commercial |
$5,103.05
|
| Rate for Payer: Aetna Medicare |
$6,264.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,902.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,529.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,529.74
|
| Rate for Payer: BCBS Complete |
$3,308.27
|
| Rate for Payer: BCBS MAPPO |
$6,023.79
|
| Rate for Payer: BCBS Trust/PPO |
$7,285.37
|
| Rate for Payer: BCN Commercial |
$7,285.37
|
| Rate for Payer: BCN Medicare Advantage |
$6,023.79
|
| Rate for Payer: Cash Price |
$4,802.87
|
| Rate for Payer: Cash Price |
$4,802.87
|
| Rate for Payer: Cash Price |
$4,802.87
|
| Rate for Payer: Cofinity Advantage |
$4,202.51
|
| Rate for Payer: Cofinity Commercial |
$5,163.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,802.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,023.79
|
| Rate for Payer: Healthscope Commercial |
$5,403.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,202.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,502.69
|
| Rate for Payer: Mclaren Medicaid |
$6,023.79
|
| Rate for Payer: Mclaren Medicare |
$6,023.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,324.98
|
| Rate for Payer: Meridian Medicaid |
$6,324.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,927.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,626.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,103.05
|
| Rate for Payer: Nomi Health Commercial |
$18,071.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,502.69
|
| Rate for Payer: PACE Medicare |
$5,722.60
|
| Rate for Payer: PACE SWMI |
$6,023.79
|
| Rate for Payer: PHP Commercial |
$5,103.05
|
| Rate for Payer: PHP Medicare Advantage |
$6,023.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,150.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19,480.40
|
| Rate for Payer: Priority Health Medicare |
$6,023.79
|
| Rate for Payer: Priority Health SBD |
$3,782.26
|
| Rate for Payer: Priority Health Tiered Network |
$15,584.32
|
| Rate for Payer: Railroad Medicare Medicare |
$6,023.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6,023.79
|
| Rate for Payer: UHC Medicaid |
$3,150.44
|
| Rate for Payer: UHCCP Medicaid |
$3,150.44
|
| Rate for Payer: UMR Bronson Commercial |
$2,221.33
|
| Rate for Payer: VA VA |
$6,023.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,502.69
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
OP
|
$2,736.88
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,012.65 |
| Max. Negotiated Rate |
$6,292.24 |
| Rate for Payer: Aetna American Axle |
$1,778.97
|
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: Aetna Medicare |
$2,023.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,432.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,432.12
|
| Rate for Payer: BCBS Complete |
$1,068.58
|
| Rate for Payer: BCBS MAPPO |
$1,945.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,945.70
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Advantage |
$1,915.82
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,945.70
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,915.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.66
|
| Rate for Payer: Mclaren Medicaid |
$1,945.70
|
| Rate for Payer: Mclaren Medicare |
$1,945.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,042.98
|
| Rate for Payer: Meridian Medicaid |
$2,042.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,237.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,140.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Nomi Health Commercial |
$5,837.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PACE Medicare |
$1,848.41
|
| Rate for Payer: PACE SWMI |
$1,945.70
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: PHP Medicare Advantage |
$1,945.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,017.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,292.24
|
| Rate for Payer: Priority Health Medicare |
$1,945.70
|
| Rate for Payer: Priority Health SBD |
$1,724.23
|
| Rate for Payer: Priority Health Tiered Network |
$5,033.79
|
| Rate for Payer: Railroad Medicare Medicare |
$1,945.70
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,945.70
|
| Rate for Payer: UHC Medicaid |
$1,017.60
|
| Rate for Payer: UHCCP Medicaid |
$1,017.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,012.65
|
| Rate for Payer: VA VA |
$1,945.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.66
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
IP
|
$2,736.88
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,204.23 |
| Max. Negotiated Rate |
$2,463.19 |
| Rate for Payer: Aetna American Axle |
$1,778.97
|
| Rate for Payer: Aetna Commercial |
$2,326.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,778.97
|
| Rate for Payer: Cash Price |
$2,189.50
|
| Rate for Payer: Cofinity Advantage |
$1,915.82
|
| Rate for Payer: Cofinity Commercial |
$2,353.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,189.50
|
| Rate for Payer: Healthscope Commercial |
$2,463.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,915.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,052.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,326.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,052.66
|
| Rate for Payer: PHP Commercial |
$2,326.35
|
| Rate for Payer: Priority Health SBD |
$1,724.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,204.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,052.66
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
OP
|
$1,824.29
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$674.99 |
| Max. Negotiated Rate |
$1,641.86 |
| Rate for Payer: Aetna American Axle |
$1,185.79
|
| Rate for Payer: Aetna Commercial |
$1,550.65
|
| Rate for Payer: Aetna Medicare |
$912.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.79
|
| Rate for Payer: BCBS Complete |
$729.72
|
| Rate for Payer: Cash Price |
$1,459.43
|
| Rate for Payer: Cofinity Advantage |
$1,277.00
|
| Rate for Payer: Cofinity Commercial |
$1,568.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,459.43
|
| Rate for Payer: Healthscope Commercial |
$1,641.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,277.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,368.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,459.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,550.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,368.22
|
| Rate for Payer: PHP Commercial |
$1,550.65
|
| Rate for Payer: Priority Health SBD |
$1,149.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,185.79
|
| Rate for Payer: UHC Core |
$950.46
|
| Rate for Payer: UHC Exchange |
$716.95
|
| Rate for Payer: UMR Bronson Commercial |
$674.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,368.22
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
IP
|
$1,824.29
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$802.69 |
| Max. Negotiated Rate |
$1,641.86 |
| Rate for Payer: Aetna American Axle |
$1,185.79
|
| Rate for Payer: Aetna Commercial |
$1,550.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,185.79
|
| Rate for Payer: Cash Price |
$1,459.43
|
| Rate for Payer: Cofinity Advantage |
$1,277.00
|
| Rate for Payer: Cofinity Commercial |
$1,568.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,459.43
|
| Rate for Payer: Healthscope Commercial |
$1,641.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,277.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,368.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,550.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,368.22
|
| Rate for Payer: PHP Commercial |
$1,550.65
|
| Rate for Payer: Priority Health SBD |
$1,149.30
|
| Rate for Payer: UMR Bronson Commercial |
$802.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,368.22
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.97 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$5.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.09
|
| Rate for Payer: BCBS Complete |
$3.11
|
| Rate for Payer: BCBS MAPPO |
$5.67
|
| Rate for Payer: BCBS Trust/PPO |
$6.55
|
| Rate for Payer: BCN Commercial |
$6.55
|
| Rate for Payer: BCN Medicare Advantage |
$5.67
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.67
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$5.67
|
| Rate for Payer: Mclaren Medicare |
$5.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.95
|
| Rate for Payer: Meridian Medicaid |
$5.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$8.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$5.39
|
| Rate for Payer: PACE SWMI |
$5.67
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$5.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.67
|
| Rate for Payer: Priority Health Medicare |
$5.67
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$4.54
|
| Rate for Payer: Railroad Medicare Medicare |
$5.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.51
|
| Rate for Payer: UHC Core |
$8.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.67
|
| Rate for Payer: UHC Exchange |
$8.51
|
| Rate for Payer: UHC Medicaid |
$2.97
|
| Rate for Payer: UHCCP Medicaid |
$2.97
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$5.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC RHOGAM
|
Facility
|
IP
|
$289.66
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$127.45 |
| Max. Negotiated Rate |
$260.69 |
| Rate for Payer: Aetna American Axle |
$188.28
|
| Rate for Payer: Aetna Commercial |
$246.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.28
|
| Rate for Payer: Cash Price |
$231.73
|
| Rate for Payer: Cofinity Advantage |
$202.76
|
| Rate for Payer: Cofinity Commercial |
$249.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.73
|
| Rate for Payer: Healthscope Commercial |
$260.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$202.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.25
|
| Rate for Payer: PHP Commercial |
$246.21
|
| Rate for Payer: Priority Health SBD |
$182.49
|
| Rate for Payer: UMR Bronson Commercial |
$127.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.25
|
|
|
HC RHOGAM
|
Facility
|
OP
|
$289.66
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$107.17 |
| Max. Negotiated Rate |
$271.51 |
| Rate for Payer: Aetna American Axle |
$188.28
|
| Rate for Payer: Aetna Commercial |
$246.21
|
| Rate for Payer: Aetna Medicare |
$144.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.28
|
| Rate for Payer: BCBS Complete |
$115.86
|
| Rate for Payer: BCBS Trust/PPO |
$271.51
|
| Rate for Payer: BCN Commercial |
$271.51
|
| Rate for Payer: Cash Price |
$231.73
|
| Rate for Payer: Cash Price |
$231.73
|
| Rate for Payer: Cofinity Advantage |
$202.76
|
| Rate for Payer: Cofinity Commercial |
$249.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$231.73
|
| Rate for Payer: Healthscope Commercial |
$260.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$202.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$246.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$217.25
|
| Rate for Payer: PHP Commercial |
$246.21
|
| Rate for Payer: Priority Health SBD |
$182.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.87
|
| Rate for Payer: UHC Core |
$132.87
|
| Rate for Payer: UHC Exchange |
$132.87
|
| Rate for Payer: UMR Bronson Commercial |
$107.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.25
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.78 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna American Axle |
$23.32
|
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.32
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Advantage |
$25.11
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health SBD |
$22.60
|
| Rate for Payer: UMR Bronson Commercial |
$15.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna American Axle |
$23.32
|
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$20.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Advantage |
$25.11
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$22.60
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$13.27
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC RIGHT VENTRICULAR RECORDING
|
Facility
|
OP
|
$3,842.58
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
48100031
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$634.48 |
| Max. Negotiated Rate |
$3,923.26 |
| Rate for Payer: Aetna American Axle |
$2,497.68
|
| Rate for Payer: Aetna Commercial |
$3,266.19
|
| Rate for Payer: Aetna Medicare |
$1,261.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,497.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,516.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,516.45
|
| Rate for Payer: BCBS Complete |
$666.27
|
| Rate for Payer: BCBS MAPPO |
$1,213.16
|
| Rate for Payer: BCBS Trust/PPO |
$3,211.37
|
| Rate for Payer: BCN Commercial |
$3,211.37
|
| Rate for Payer: BCN Medicare Advantage |
$1,213.16
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Advantage |
$2,689.81
|
| Rate for Payer: Cofinity Commercial |
$3,304.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,213.16
|
| Rate for Payer: Healthscope Commercial |
$3,458.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,689.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,881.93
|
| Rate for Payer: Mclaren Medicaid |
$1,213.16
|
| Rate for Payer: Mclaren Medicare |
$1,213.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,273.82
|
| Rate for Payer: Meridian Medicaid |
$1,273.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,395.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,334.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Nomi Health Commercial |
$3,639.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: PACE Medicare |
$1,152.50
|
| Rate for Payer: PACE SWMI |
$1,213.16
|
| Rate for Payer: PHP Commercial |
$3,266.19
|
| Rate for Payer: PHP Medicare Advantage |
$1,213.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3,923.26
|
| Rate for Payer: Priority Health Medicare |
$1,213.16
|
| Rate for Payer: Priority Health SBD |
$2,420.83
|
| Rate for Payer: Priority Health Tiered Network |
$3,138.61
|
| Rate for Payer: Railroad Medicare Medicare |
$1,213.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,213.16
|
| Rate for Payer: UHC Medicaid |
$634.48
|
| Rate for Payer: UHCCP Medicaid |
$634.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,421.75
|
| Rate for Payer: VA VA |
$1,213.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,881.93
|
|
|
HC RIGHT VENTRICULAR RECORDING
|
Facility
|
IP
|
$3,842.58
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
48100031
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,690.74 |
| Max. Negotiated Rate |
$3,458.32 |
| Rate for Payer: Aetna American Axle |
$2,497.68
|
| Rate for Payer: Aetna Commercial |
$3,266.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,497.68
|
| Rate for Payer: Cash Price |
$3,074.06
|
| Rate for Payer: Cofinity Advantage |
$2,689.81
|
| Rate for Payer: Cofinity Commercial |
$3,304.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,074.06
|
| Rate for Payer: Healthscope Commercial |
$3,458.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,689.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,881.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,266.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,881.93
|
| Rate for Payer: PHP Commercial |
$3,266.19
|
| Rate for Payer: Priority Health SBD |
$2,420.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,690.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,881.93
|
|
|
HC RISK ASCVD TEST ONCE PER 12 MO
|
Facility
|
OP
|
$95.00
|
|
|
Service Code
|
HCPCS G0537
|
| Hospital Charge Code |
51000135
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.52 |
| Max. Negotiated Rate |
$120.72 |
| Rate for Payer: Aetna American Axle |
$61.75
|
| Rate for Payer: Aetna Commercial |
$80.75
|
| Rate for Payer: Aetna Medicare |
$38.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.66
|
| Rate for Payer: BCBS Complete |
$20.50
|
| Rate for Payer: BCBS MAPPO |
$37.33
|
| Rate for Payer: BCN Medicare Advantage |
$37.33
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Advantage |
$66.50
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.33
|
| Rate for Payer: Healthscope Commercial |
$85.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.25
|
| Rate for Payer: Mclaren Medicaid |
$37.33
|
| Rate for Payer: Mclaren Medicare |
$37.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.20
|
| Rate for Payer: Meridian Medicaid |
$39.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.75
|
| Rate for Payer: Nomi Health Commercial |
$111.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: PACE Medicare |
$35.46
|
| Rate for Payer: PACE SWMI |
$37.33
|
| Rate for Payer: PHP Commercial |
$80.75
|
| Rate for Payer: PHP Medicare Advantage |
$37.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.72
|
| Rate for Payer: Priority Health Medicare |
$37.33
|
| Rate for Payer: Priority Health SBD |
$59.85
|
| Rate for Payer: Priority Health Tiered Network |
$96.58
|
| Rate for Payer: Railroad Medicare Medicare |
$37.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.75
|
| Rate for Payer: UHC Core |
$49.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$37.33
|
| Rate for Payer: UHC Exchange |
$37.34
|
| Rate for Payer: UHC Medicaid |
$19.52
|
| Rate for Payer: UHCCP Medicaid |
$19.52
|
| Rate for Payer: UMR Bronson Commercial |
$35.15
|
| Rate for Payer: VA VA |
$37.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.25
|
|
|
HC RISK ASCVD TEST ONCE PER 12 MO
|
Facility
|
IP
|
$95.00
|
|
|
Service Code
|
HCPCS G0537
|
| Hospital Charge Code |
51000135
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$41.80 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna American Axle |
$61.75
|
| Rate for Payer: Aetna Commercial |
$80.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.75
|
| Rate for Payer: Cash Price |
$76.00
|
| Rate for Payer: Cofinity Advantage |
$66.50
|
| Rate for Payer: Cofinity Commercial |
$81.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.00
|
| Rate for Payer: Healthscope Commercial |
$85.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.25
|
| Rate for Payer: PHP Commercial |
$80.75
|
| Rate for Payer: Priority Health SBD |
$59.85
|
| Rate for Payer: UMR Bronson Commercial |
$41.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.25
|
|
|
HC RISPERIDONE AND METABOLIT
|
Facility
|
OP
|
$115.48
|
|
|
Service Code
|
CPT 80342
|
| Hospital Charge Code |
30100691
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.73 |
| Max. Negotiated Rate |
$103.93 |
| Rate for Payer: Aetna American Axle |
$75.06
|
| Rate for Payer: Aetna Commercial |
$98.16
|
| Rate for Payer: Aetna Medicare |
$57.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.06
|
| Rate for Payer: BCBS Complete |
$46.19
|
| Rate for Payer: Cash Price |
$92.38
|
| Rate for Payer: Cofinity Advantage |
$80.84
|
| Rate for Payer: Cofinity Commercial |
$99.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.38
|
| Rate for Payer: Healthscope Commercial |
$103.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$86.61
|
| Rate for Payer: PHP Commercial |
$98.16
|
| Rate for Payer: Priority Health SBD |
$72.75
|
| Rate for Payer: UMR Bronson Commercial |
$42.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.61
|
|
