|
HC SED RATE WESTERGREN
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$2.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.38
|
| Rate for Payer: BCBS Complete |
$1.48
|
| Rate for Payer: BCBS MAPPO |
$2.70
|
| Rate for Payer: BCBS Trust/PPO |
$3.13
|
| Rate for Payer: BCN Commercial |
$3.13
|
| Rate for Payer: BCN Medicare Advantage |
$2.70
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Mclaren Medicaid |
$2.70
|
| Rate for Payer: Mclaren Medicare |
$2.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.83
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$4.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Medicare |
$2.56
|
| Rate for Payer: PACE SWMI |
$2.70
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$2.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.70
|
| Rate for Payer: Priority Health Medicare |
$2.70
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: Priority Health Tiered Network |
$2.16
|
| Rate for Payer: Railroad Medicare Medicare |
$2.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.05
|
| Rate for Payer: UHC Core |
$4.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.70
|
| Rate for Payer: UHC Exchange |
$4.05
|
| Rate for Payer: UHC Medicaid |
$1.41
|
| Rate for Payer: UHCCP Medicaid |
$1.41
|
| Rate for Payer: UMR Bronson Commercial |
$5.89
|
| Rate for Payer: VA VA |
$2.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
IP
|
$5,066.39
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,229.21 |
| Max. Negotiated Rate |
$4,559.75 |
| Rate for Payer: Aetna American Axle |
$3,293.15
|
| Rate for Payer: Aetna Commercial |
$4,306.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,293.15
|
| Rate for Payer: Cash Price |
$4,053.11
|
| Rate for Payer: Cofinity Advantage |
$3,546.47
|
| Rate for Payer: Cofinity Commercial |
$4,357.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,053.11
|
| Rate for Payer: Healthscope Commercial |
$4,559.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,546.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,799.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,306.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,799.79
|
| Rate for Payer: PHP Commercial |
$4,306.43
|
| Rate for Payer: Priority Health SBD |
$3,191.83
|
| Rate for Payer: UMR Bronson Commercial |
$2,229.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,799.79
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
OP
|
$5,066.39
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,874.56 |
| Max. Negotiated Rate |
$5,531.68 |
| Rate for Payer: Aetna American Axle |
$3,293.15
|
| Rate for Payer: Aetna Commercial |
$4,306.43
|
| Rate for Payer: Aetna Medicare |
$2,533.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,293.15
|
| Rate for Payer: BCBS Complete |
$2,026.56
|
| Rate for Payer: BCBS Trust/PPO |
$5,531.68
|
| Rate for Payer: BCN Commercial |
$5,531.68
|
| Rate for Payer: Cash Price |
$4,053.11
|
| Rate for Payer: Cash Price |
$4,053.11
|
| Rate for Payer: Cash Price |
$4,053.11
|
| Rate for Payer: Cofinity Advantage |
$3,546.47
|
| Rate for Payer: Cofinity Commercial |
$4,357.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,053.11
|
| Rate for Payer: Healthscope Commercial |
$4,559.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,546.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,799.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,053.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,306.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,799.79
|
| Rate for Payer: PHP Commercial |
$4,306.43
|
| Rate for Payer: Priority Health SBD |
$3,191.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,874.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,799.79
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
OP
|
$5,861.23
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,099.00 |
| Max. Negotiated Rate |
$5,275.11 |
| Rate for Payer: Aetna American Axle |
$3,809.80
|
| Rate for Payer: Aetna Commercial |
$4,982.05
|
| Rate for Payer: Aetna Medicare |
$2,930.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,809.80
|
| Rate for Payer: BCBS Complete |
$2,344.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,099.00
|
| Rate for Payer: BCN Commercial |
$1,099.00
|
| Rate for Payer: Cash Price |
$4,688.98
|
| Rate for Payer: Cash Price |
$4,688.98
|
| Rate for Payer: Cash Price |
$4,688.98
|
| Rate for Payer: Cofinity Advantage |
$4,102.86
|
| Rate for Payer: Cofinity Commercial |
$5,040.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,688.98
|
| Rate for Payer: Healthscope Commercial |
$5,275.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,102.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,395.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,688.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,982.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,395.92
|
| Rate for Payer: PHP Commercial |
$4,982.05
|
| Rate for Payer: Priority Health SBD |
$3,692.57
|
| Rate for Payer: UMR Bronson Commercial |
$2,168.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,395.92
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
IP
|
$5,861.23
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,578.94 |
| Max. Negotiated Rate |
$5,275.11 |
| Rate for Payer: Aetna American Axle |
$3,809.80
|
| Rate for Payer: Aetna Commercial |
$4,982.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,809.80
|
| Rate for Payer: Cash Price |
$4,688.98
|
| Rate for Payer: Cofinity Advantage |
$4,102.86
|
| Rate for Payer: Cofinity Commercial |
$5,040.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,688.98
|
| Rate for Payer: Healthscope Commercial |
$5,275.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,102.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,395.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,982.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,395.92
|
| Rate for Payer: PHP Commercial |
$4,982.05
|
| Rate for Payer: Priority Health SBD |
$3,692.57
|
| Rate for Payer: UMR Bronson Commercial |
$2,578.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,395.92
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$9,738.02
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,284.73 |
| Max. Negotiated Rate |
$8,764.22 |
| Rate for Payer: Aetna American Axle |
$6,329.71
|
| Rate for Payer: Aetna Commercial |
$8,277.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,329.71
|
| Rate for Payer: Cash Price |
$7,790.42
|
| Rate for Payer: Cofinity Advantage |
$6,816.61
|
| Rate for Payer: Cofinity Commercial |
$8,374.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,790.42
|
| Rate for Payer: Healthscope Commercial |
$8,764.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,816.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,303.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,277.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,303.52
|
| Rate for Payer: PHP Commercial |
$8,277.32
|
| Rate for Payer: Priority Health SBD |
$6,134.95
|
| Rate for Payer: UMR Bronson Commercial |
$4,284.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,303.52
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$9,738.02
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.43 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$6,329.71
|
| Rate for Payer: Aetna Commercial |
$8,277.32
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,329.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,663.55
|
| Rate for Payer: BCN Commercial |
$2,663.55
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$7,790.42
|
| Rate for Payer: Cash Price |
$7,790.42
|
| Rate for Payer: Cash Price |
$7,790.42
|
| Rate for Payer: Cofinity Advantage |
$6,816.61
|
| Rate for Payer: Cofinity Commercial |
$8,374.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,790.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$8,764.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,816.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,303.52
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,277.32
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,303.52
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$8,277.32
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$6,134.95
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$3,603.07
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,303.52
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$11,185.55
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,921.64 |
| Max. Negotiated Rate |
$10,067.00 |
| Rate for Payer: Aetna American Axle |
$7,270.61
|
| Rate for Payer: Aetna Commercial |
$9,507.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,270.61
|
| Rate for Payer: Cash Price |
$8,948.44
|
| Rate for Payer: Cofinity Advantage |
$7,829.89
|
| Rate for Payer: Cofinity Commercial |
$9,619.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,948.44
|
| Rate for Payer: Healthscope Commercial |
$10,067.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,829.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,389.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,507.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,389.16
|
| Rate for Payer: PHP Commercial |
$9,507.72
|
| Rate for Payer: Priority Health SBD |
$7,046.90
|
| Rate for Payer: UMR Bronson Commercial |
$4,921.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,389.16
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$11,185.55
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,899.76 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna American Axle |
$7,270.61
|
| Rate for Payer: Aetna Commercial |
$9,507.72
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,270.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$5,994.05
|
| Rate for Payer: BCN Commercial |
$5,994.05
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$8,948.44
|
| Rate for Payer: Cash Price |
$8,948.44
|
| Rate for Payer: Cash Price |
$8,948.44
|
| Rate for Payer: Cofinity Advantage |
$7,829.89
|
| Rate for Payer: Cofinity Commercial |
$9,619.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,948.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$10,067.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,829.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,389.16
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$5,821.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,507.72
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,389.16
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$9,507.72
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,930.33
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health SBD |
$7,046.90
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: UMR Bronson Commercial |
$4,138.65
|
| Rate for Payer: VA VA |
$5,544.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,389.16
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
OP
|
$13,546.53
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,899.76 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna American Axle |
$8,805.24
|
| Rate for Payer: Aetna Commercial |
$11,514.55
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,805.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$7,461.04
|
| Rate for Payer: BCN Commercial |
$7,461.04
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$10,837.22
|
| Rate for Payer: Cash Price |
$10,837.22
|
| Rate for Payer: Cash Price |
$10,837.22
|
| Rate for Payer: Cofinity Advantage |
$9,482.57
|
| Rate for Payer: Cofinity Commercial |
$11,650.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,837.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$12,191.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,482.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,159.90
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$5,821.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,514.55
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,159.90
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$11,514.55
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,930.33
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health SBD |
$8,534.31
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: UMR Bronson Commercial |
$5,012.22
|
| Rate for Payer: VA VA |
$5,544.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,159.90
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
IP
|
$13,546.53
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,960.47 |
| Max. Negotiated Rate |
$12,191.88 |
| Rate for Payer: Aetna American Axle |
$8,805.24
|
| Rate for Payer: Aetna Commercial |
$11,514.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,805.24
|
| Rate for Payer: Cash Price |
$10,837.22
|
| Rate for Payer: Cofinity Advantage |
$9,482.57
|
| Rate for Payer: Cofinity Commercial |
$11,650.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,837.22
|
| Rate for Payer: Healthscope Commercial |
$12,191.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,482.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,159.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,514.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,159.90
|
| Rate for Payer: PHP Commercial |
$11,514.55
|
| Rate for Payer: Priority Health SBD |
$8,534.31
|
| Rate for Payer: UMR Bronson Commercial |
$5,960.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,159.90
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
OP
|
$13,546.53
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,899.76 |
| Max. Negotiated Rate |
$17,930.33 |
| Rate for Payer: Aetna American Axle |
$8,805.24
|
| Rate for Payer: Aetna Commercial |
$11,514.55
|
| Rate for Payer: Aetna Medicare |
$5,766.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,805.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,930.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,930.60
|
| Rate for Payer: BCBS Complete |
$3,045.03
|
| Rate for Payer: BCBS MAPPO |
$5,544.48
|
| Rate for Payer: BCBS Trust/PPO |
$10,539.52
|
| Rate for Payer: BCN Commercial |
$10,539.52
|
| Rate for Payer: BCN Medicare Advantage |
$5,544.48
|
| Rate for Payer: Cash Price |
$10,837.22
|
| Rate for Payer: Cash Price |
$10,837.22
|
| Rate for Payer: Cash Price |
$10,837.22
|
| Rate for Payer: Cofinity Advantage |
$9,482.57
|
| Rate for Payer: Cofinity Commercial |
$11,650.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,837.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,544.48
|
| Rate for Payer: Healthscope Commercial |
$12,191.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,482.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,159.90
|
| Rate for Payer: Mclaren Medicaid |
$5,544.48
|
| Rate for Payer: Mclaren Medicare |
$5,544.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,821.70
|
| Rate for Payer: Meridian Medicaid |
$5,821.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,376.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$6,098.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,514.55
|
| Rate for Payer: Nomi Health Commercial |
$16,633.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,159.90
|
| Rate for Payer: PACE Medicare |
$5,267.26
|
| Rate for Payer: PACE SWMI |
$5,544.48
|
| Rate for Payer: PHP Commercial |
$11,514.55
|
| Rate for Payer: PHP Medicare Advantage |
$5,544.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,899.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17,930.33
|
| Rate for Payer: Priority Health Medicare |
$5,544.48
|
| Rate for Payer: Priority Health SBD |
$8,534.31
|
| Rate for Payer: Priority Health Tiered Network |
$14,344.26
|
| Rate for Payer: Railroad Medicare Medicare |
$5,544.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5,544.48
|
| Rate for Payer: UHC Medicaid |
$2,899.76
|
| Rate for Payer: UHCCP Medicaid |
$2,899.76
|
| Rate for Payer: UMR Bronson Commercial |
$5,012.22
|
| Rate for Payer: VA VA |
$5,544.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,159.90
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
IP
|
$13,546.53
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,960.47 |
| Max. Negotiated Rate |
$12,191.88 |
| Rate for Payer: Aetna American Axle |
$8,805.24
|
| Rate for Payer: Aetna Commercial |
$11,514.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,805.24
|
| Rate for Payer: Cash Price |
$10,837.22
|
| Rate for Payer: Cofinity Advantage |
$9,482.57
|
| Rate for Payer: Cofinity Commercial |
$11,650.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,837.22
|
| Rate for Payer: Healthscope Commercial |
$12,191.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,482.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,159.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,514.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,159.90
|
| Rate for Payer: PHP Commercial |
$11,514.55
|
| Rate for Payer: Priority Health SBD |
$8,534.31
|
| Rate for Payer: UMR Bronson Commercial |
$5,960.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,159.90
|
|
|
HC SELECT SPECIALTY CATHETER INSERTION
|
Facility
|
OP
|
$1,686.32
|
|
| Hospital Charge Code |
36100565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$623.94 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna American Axle |
$1,096.11
|
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna Medicare |
$843.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.11
|
| Rate for Payer: BCBS Complete |
$674.53
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Advantage |
$1,180.42
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,180.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,349.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,264.74
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health SBD |
$1,062.38
|
| Rate for Payer: UMR Bronson Commercial |
$623.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC SELECT SPECIALTY CATHETER INSERTION
|
Facility
|
IP
|
$1,686.32
|
|
| Hospital Charge Code |
36100565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$741.98 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna American Axle |
$1,096.11
|
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.11
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Advantage |
$1,180.42
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,180.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,264.74
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health SBD |
$1,062.38
|
| Rate for Payer: UMR Bronson Commercial |
$741.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC SELENIUM LEVEL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
30100420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$26.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.91
|
| Rate for Payer: BCBS Complete |
$14.02
|
| Rate for Payer: BCBS MAPPO |
$25.53
|
| Rate for Payer: BCBS Trust/PPO |
$29.52
|
| Rate for Payer: BCN Commercial |
$29.52
|
| Rate for Payer: BCN Medicare Advantage |
$25.53
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.53
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$25.53
|
| Rate for Payer: Mclaren Medicare |
$25.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.81
|
| Rate for Payer: Meridian Medicaid |
$26.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$38.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$24.25
|
| Rate for Payer: PACE SWMI |
$25.53
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$25.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25.53
|
| Rate for Payer: Priority Health Medicare |
$25.53
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$20.42
|
| Rate for Payer: Railroad Medicare Medicare |
$25.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.30
|
| Rate for Payer: UHC Core |
$38.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$25.53
|
| Rate for Payer: UHC Exchange |
$38.30
|
| Rate for Payer: UHC Medicaid |
$13.35
|
| Rate for Payer: UHCCP Medicaid |
$13.35
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$25.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC SELENIUM LEVEL
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
30100420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC SELF-ADMINISTRABLE DRUG
|
Facility
|
OP
|
$0.53
|
|
| Hospital Charge Code |
63700003
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Aetna American Axle |
$0.34
|
| Rate for Payer: Aetna Commercial |
$0.45
|
| Rate for Payer: Aetna Medicare |
$0.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.34
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Advantage |
$0.37
|
| Rate for Payer: Cofinity Commercial |
$0.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.40
|
| Rate for Payer: PHP Commercial |
$0.45
|
| Rate for Payer: Priority Health SBD |
$0.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.34
|
| Rate for Payer: UHC Core |
$0.28
|
| Rate for Payer: UHC Exchange |
$0.21
|
| Rate for Payer: UMR Bronson Commercial |
$0.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.40
|
|
|
HC SELF-ADMINISTRABLE DRUG
|
Facility
|
IP
|
$0.53
|
|
| Hospital Charge Code |
63700003
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$0.48 |
| Rate for Payer: Aetna American Axle |
$0.34
|
| Rate for Payer: Aetna Commercial |
$0.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.34
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Advantage |
$0.37
|
| Rate for Payer: Cofinity Commercial |
$0.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.40
|
| Rate for Payer: PHP Commercial |
$0.45
|
| Rate for Payer: Priority Health SBD |
$0.33
|
| Rate for Payer: UMR Bronson Commercial |
$0.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.40
|
|
|
HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN
|
Facility
|
IP
|
$57.53
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
94200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$25.31 |
| Max. Negotiated Rate |
$51.78 |
| Rate for Payer: Aetna American Axle |
$37.39
|
| Rate for Payer: Aetna Commercial |
$48.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.39
|
| Rate for Payer: Cash Price |
$46.02
|
| Rate for Payer: Cofinity Advantage |
$40.27
|
| Rate for Payer: Cofinity Commercial |
$49.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.02
|
| Rate for Payer: Healthscope Commercial |
$51.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.15
|
| Rate for Payer: PHP Commercial |
$48.90
|
| Rate for Payer: Priority Health SBD |
$36.24
|
| Rate for Payer: UMR Bronson Commercial |
$25.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.15
|
|
|
HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN
|
Facility
|
OP
|
$57.53
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
94200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$21.29 |
| Max. Negotiated Rate |
$129.62 |
| Rate for Payer: Aetna American Axle |
$37.39
|
| Rate for Payer: Aetna Commercial |
$48.90
|
| Rate for Payer: Aetna Medicare |
$28.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.39
|
| Rate for Payer: BCBS Complete |
$23.01
|
| Rate for Payer: BCBS Trust/PPO |
$129.62
|
| Rate for Payer: BCN Commercial |
$129.62
|
| Rate for Payer: Cash Price |
$46.02
|
| Rate for Payer: Cash Price |
$46.02
|
| Rate for Payer: Cofinity Advantage |
$40.27
|
| Rate for Payer: Cofinity Commercial |
$49.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.02
|
| Rate for Payer: Healthscope Commercial |
$51.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.15
|
| Rate for Payer: PHP Commercial |
$48.90
|
| Rate for Payer: Priority Health SBD |
$36.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.39
|
| Rate for Payer: UHC Core |
$29.97
|
| Rate for Payer: UHC Exchange |
$22.61
|
| Rate for Payer: UMR Bronson Commercial |
$21.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.15
|
|
|
HC SEMEN EXAM FERTILITY
|
Facility
|
OP
|
$117.57
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
30000006
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.44 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna American Axle |
$76.42
|
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna Medicare |
$12.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.39
|
| Rate for Payer: BCBS Complete |
$6.76
|
| Rate for Payer: BCBS MAPPO |
$12.31
|
| Rate for Payer: BCBS Trust/PPO |
$14.23
|
| Rate for Payer: BCN Commercial |
$14.23
|
| Rate for Payer: BCN Medicare Advantage |
$12.31
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Advantage |
$82.30
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.31
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Mclaren Medicaid |
$12.31
|
| Rate for Payer: Mclaren Medicare |
$12.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.93
|
| Rate for Payer: Meridian Medicaid |
$12.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$18.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PACE Medicare |
$11.69
|
| Rate for Payer: PACE SWMI |
$12.31
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: PHP Medicare Advantage |
$12.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.31
|
| Rate for Payer: Priority Health Medicare |
$12.31
|
| Rate for Payer: Priority Health SBD |
$74.07
|
| Rate for Payer: Priority Health Tiered Network |
$9.85
|
| Rate for Payer: Railroad Medicare Medicare |
$12.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.47
|
| Rate for Payer: UHC Core |
$18.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.31
|
| Rate for Payer: UHC Exchange |
$18.47
|
| Rate for Payer: UHC Medicaid |
$6.44
|
| Rate for Payer: UHCCP Medicaid |
$6.44
|
| Rate for Payer: UMR Bronson Commercial |
$43.50
|
| Rate for Payer: VA VA |
$12.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC SEMEN EXAM FERTILITY
|
Facility
|
IP
|
$117.57
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
30000006
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.73 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna American Axle |
$76.42
|
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.42
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Advantage |
$82.30
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: Priority Health SBD |
$74.07
|
| Rate for Payer: UMR Bronson Commercial |
$51.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC SEMEN EXAM VASECTOMY
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
30000007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna American Axle |
$50.99
|
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.93
|
| Rate for Payer: BCN Commercial |
$13.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$29.03
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC SEMEN EXAM VASECTOMY
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
30000007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$34.52 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna American Axle |
$50.99
|
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: UMR Bronson Commercial |
$34.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
