|
HC REPLACE SINGLE CHAMBER ICD
|
Facility
|
OP
|
$17,881.43
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100357
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,616.13 |
| Max. Negotiated Rate |
$61,621.88 |
| Rate for Payer: Aetna American Axle |
$11,622.93
|
| Rate for Payer: Aetna Commercial |
$15,199.22
|
| Rate for Payer: Aetna Medicare |
$22,766.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,622.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,364.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,364.15
|
| Rate for Payer: BCBS Complete |
$12,320.43
|
| Rate for Payer: BCBS MAPPO |
$21,891.32
|
| Rate for Payer: BCN Medicare Advantage |
$21,891.32
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cash Price |
$14,305.14
|
| Rate for Payer: Cofinity Commercial |
$15,378.03
|
| Rate for Payer: Cofinity Commercial |
$12,517.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,517.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,305.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,891.32
|
| Rate for Payer: Healthscope Commercial |
$16,093.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,517.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,411.07
|
| Rate for Payer: Mclaren Medicaid |
$11,733.75
|
| Rate for Payer: Mclaren Medicare |
$21,891.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,985.89
|
| Rate for Payer: Meridian Medicaid |
$12,320.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,175.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,199.22
|
| Rate for Payer: PACE Medicare |
$20,796.75
|
| Rate for Payer: PACE SWMI |
$21,891.32
|
| Rate for Payer: PHP Commercial |
$15,199.22
|
| Rate for Payer: PHP Medicare Advantage |
$21,891.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,733.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,622.93
|
| Rate for Payer: Priority Health Medicare |
$21,891.32
|
| Rate for Payer: Priority Health SBD |
$11,265.30
|
| Rate for Payer: Railroad Medicare Medicare |
$21,891.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,621.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,891.32
|
| Rate for Payer: UHC Exchange |
$41,836.50
|
| Rate for Payer: UHC Medicare Advantage |
$21,891.32
|
| Rate for Payer: UHCCP Medicaid |
$11,733.75
|
| Rate for Payer: UMR Bronson Commercial |
$6,616.13
|
| Rate for Payer: VA VA |
$21,891.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,411.07
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
IP
|
$12,181.07
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,359.67 |
| Max. Negotiated Rate |
$10,962.96 |
| Rate for Payer: Aetna American Axle |
$7,917.70
|
| Rate for Payer: Aetna Commercial |
$10,353.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,917.70
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cofinity Commercial |
$10,475.72
|
| Rate for Payer: Cofinity Commercial |
$8,526.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,526.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,744.86
|
| Rate for Payer: Healthscope Commercial |
$10,962.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,526.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,135.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,353.91
|
| Rate for Payer: PHP Commercial |
$10,353.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,917.70
|
| Rate for Payer: Priority Health SBD |
$7,674.07
|
| Rate for Payer: UMR Bronson Commercial |
$5,359.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,135.80
|
|
|
HC REPLACE SINGLE CHAMBER PPM
|
Facility
|
OP
|
$12,181.07
|
|
|
Service Code
|
CPT 33227
|
| Hospital Charge Code |
36100354
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,326.27 |
| Max. Negotiated Rate |
$22,720.18 |
| Rate for Payer: Aetna American Axle |
$7,917.70
|
| Rate for Payer: Aetna Commercial |
$10,353.91
|
| Rate for Payer: Aetna Medicare |
$8,394.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,917.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,089.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,089.25
|
| Rate for Payer: BCBS Complete |
$4,542.58
|
| Rate for Payer: BCBS MAPPO |
$8,071.40
|
| Rate for Payer: BCN Medicare Advantage |
$8,071.40
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cash Price |
$9,744.86
|
| Rate for Payer: Cofinity Commercial |
$8,526.75
|
| Rate for Payer: Cofinity Commercial |
$10,475.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,526.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,744.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,071.40
|
| Rate for Payer: Healthscope Commercial |
$10,962.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,526.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,135.80
|
| Rate for Payer: Mclaren Medicaid |
$4,326.27
|
| Rate for Payer: Mclaren Medicare |
$8,071.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,474.97
|
| Rate for Payer: Meridian Medicaid |
$4,542.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,282.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,353.91
|
| Rate for Payer: PACE Medicare |
$7,667.83
|
| Rate for Payer: PACE SWMI |
$8,071.40
|
| Rate for Payer: PHP Commercial |
$10,353.91
|
| Rate for Payer: PHP Medicare Advantage |
$8,071.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,326.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,917.70
|
| Rate for Payer: Priority Health Medicare |
$8,071.40
|
| Rate for Payer: Priority Health SBD |
$7,674.07
|
| Rate for Payer: Railroad Medicare Medicare |
$8,071.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22,720.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,071.40
|
| Rate for Payer: UHC Exchange |
$15,425.25
|
| Rate for Payer: UHC Medicare Advantage |
$8,071.40
|
| Rate for Payer: UHCCP Medicaid |
$4,326.27
|
| Rate for Payer: UMR Bronson Commercial |
$4,507.00
|
| Rate for Payer: VA VA |
$8,071.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,135.80
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
OP
|
$36,230.98
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$11,733.75 |
| Max. Negotiated Rate |
$61,621.88 |
| Rate for Payer: Aetna American Axle |
$23,550.14
|
| Rate for Payer: Aetna Commercial |
$30,796.33
|
| Rate for Payer: Aetna Medicare |
$22,766.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23,550.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27,364.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27,364.15
|
| Rate for Payer: BCBS Complete |
$12,320.43
|
| Rate for Payer: BCBS MAPPO |
$21,891.32
|
| Rate for Payer: BCN Medicare Advantage |
$21,891.32
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cofinity Commercial |
$31,158.64
|
| Rate for Payer: Cofinity Commercial |
$25,361.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$25,361.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,984.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,891.32
|
| Rate for Payer: Healthscope Commercial |
$32,607.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25,361.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27,173.24
|
| Rate for Payer: Mclaren Medicaid |
$11,733.75
|
| Rate for Payer: Mclaren Medicare |
$21,891.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22,985.89
|
| Rate for Payer: Meridian Medicaid |
$12,320.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25,175.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,796.33
|
| Rate for Payer: PACE Medicare |
$20,796.75
|
| Rate for Payer: PACE SWMI |
$21,891.32
|
| Rate for Payer: PHP Commercial |
$30,796.33
|
| Rate for Payer: PHP Medicare Advantage |
$21,891.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,733.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23,550.14
|
| Rate for Payer: Priority Health Medicare |
$21,891.32
|
| Rate for Payer: Priority Health SBD |
$22,825.52
|
| Rate for Payer: Railroad Medicare Medicare |
$21,891.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61,621.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,891.32
|
| Rate for Payer: UHC Exchange |
$41,836.50
|
| Rate for Payer: UHC Medicare Advantage |
$21,891.32
|
| Rate for Payer: UHCCP Medicaid |
$11,733.75
|
| Rate for Payer: UMR Bronson Commercial |
$13,405.46
|
| Rate for Payer: VA VA |
$21,891.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27,173.24
|
|
|
HC REPLACE SQ ICD ONLY
|
Facility
|
IP
|
$36,230.98
|
|
|
Service Code
|
CPT 33262
|
| Hospital Charge Code |
36100551
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$15,941.63 |
| Max. Negotiated Rate |
$32,607.88 |
| Rate for Payer: Aetna American Axle |
$23,550.14
|
| Rate for Payer: Aetna Commercial |
$30,796.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23,550.14
|
| Rate for Payer: Cash Price |
$28,984.78
|
| Rate for Payer: Cofinity Commercial |
$25,361.69
|
| Rate for Payer: Cofinity Commercial |
$31,158.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$25,361.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28,984.78
|
| Rate for Payer: Healthscope Commercial |
$32,607.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25,361.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27,173.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30,796.33
|
| Rate for Payer: PHP Commercial |
$30,796.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23,550.14
|
| Rate for Payer: Priority Health SBD |
$22,825.52
|
| Rate for Payer: UMR Bronson Commercial |
$15,941.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27,173.24
|
|
|
HC REPOSITION CVAC
|
Facility
|
OP
|
$2,508.82
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$812.06 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna American Axle |
$1,630.73
|
| Rate for Payer: Aetna Commercial |
$2,132.50
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cofinity Commercial |
$2,157.59
|
| Rate for Payer: Cofinity Commercial |
$1,756.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,756.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$2,257.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,756.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,881.62
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.50
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$2,132.50
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.73
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$1,580.56
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,895.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: UMR Bronson Commercial |
$928.26
|
| Rate for Payer: VA VA |
$1,515.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,881.62
|
|
|
HC REPOSITION CVAC
|
Facility
|
IP
|
$2,508.82
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,103.88 |
| Max. Negotiated Rate |
$2,257.94 |
| Rate for Payer: Aetna American Axle |
$1,630.73
|
| Rate for Payer: Aetna Commercial |
$2,132.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,630.73
|
| Rate for Payer: Cash Price |
$2,007.06
|
| Rate for Payer: Cofinity Commercial |
$1,756.17
|
| Rate for Payer: Cofinity Commercial |
$2,157.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,756.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,007.06
|
| Rate for Payer: Healthscope Commercial |
$2,257.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,756.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,881.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,132.50
|
| Rate for Payer: PHP Commercial |
$2,132.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,630.73
|
| Rate for Payer: Priority Health SBD |
$1,580.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,103.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,881.62
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
IP
|
$2,941.63
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,294.32 |
| Max. Negotiated Rate |
$2,647.47 |
| Rate for Payer: Aetna American Axle |
$1,912.06
|
| Rate for Payer: Aetna Commercial |
$2,500.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,912.06
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cofinity Commercial |
$2,059.14
|
| Rate for Payer: Cofinity Commercial |
$2,529.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,059.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,353.30
|
| Rate for Payer: Healthscope Commercial |
$2,647.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,059.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,206.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,500.39
|
| Rate for Payer: PHP Commercial |
$2,500.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.06
|
| Rate for Payer: Priority Health SBD |
$1,853.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,294.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,206.22
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
OP
|
$2,941.63
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,088.40 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$1,912.06
|
| Rate for Payer: Aetna Commercial |
$2,500.39
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,912.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cash Price |
$2,353.30
|
| Rate for Payer: Cofinity Commercial |
$2,529.80
|
| Rate for Payer: Cofinity Commercial |
$2,059.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,059.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,353.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,647.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,059.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,206.22
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,500.39
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,500.39
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,912.06
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,853.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,088.40
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,206.22
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
OP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$39.63 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.61
|
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna Medicare |
$53.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: BCBS Complete |
$42.84
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$39.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
IP
|
$107.10
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.61
|
| Rate for Payer: Aetna Commercial |
$91.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.61
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.03
|
| Rate for Payer: PHP Commercial |
$91.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.61
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.33
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
OP
|
$841.50
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$311.36 |
| Max. Negotiated Rate |
$757.35 |
| Rate for Payer: Aetna American Axle |
$546.98
|
| Rate for Payer: Aetna Commercial |
$715.27
|
| Rate for Payer: Aetna Medicare |
$420.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.98
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$589.05
|
| Rate for Payer: Cofinity Commercial |
$723.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$589.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Healthscope Commercial |
$757.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$589.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.27
|
| Rate for Payer: PHP Commercial |
$715.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health SBD |
$530.14
|
| Rate for Payer: UMR Bronson Commercial |
$311.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.12
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
IP
|
$841.50
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$370.26 |
| Max. Negotiated Rate |
$757.35 |
| Rate for Payer: Aetna American Axle |
$546.98
|
| Rate for Payer: Aetna Commercial |
$715.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.98
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$589.05
|
| Rate for Payer: Cofinity Commercial |
$723.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$589.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Healthscope Commercial |
$757.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$589.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.27
|
| Rate for Payer: PHP Commercial |
$715.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health SBD |
$530.14
|
| Rate for Payer: UMR Bronson Commercial |
$370.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.12
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
IP
|
$178.41
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$78.50 |
| Max. Negotiated Rate |
$160.57 |
| Rate for Payer: Aetna American Axle |
$115.97
|
| Rate for Payer: Aetna Commercial |
$151.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.97
|
| Rate for Payer: Cash Price |
$142.73
|
| Rate for Payer: Cofinity Commercial |
$124.89
|
| Rate for Payer: Cofinity Commercial |
$153.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$124.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.73
|
| Rate for Payer: Healthscope Commercial |
$160.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.65
|
| Rate for Payer: PHP Commercial |
$151.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.97
|
| Rate for Payer: Priority Health SBD |
$112.40
|
| Rate for Payer: UMR Bronson Commercial |
$78.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.81
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
OP
|
$178.41
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$66.01 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna American Axle |
$115.97
|
| Rate for Payer: Aetna Commercial |
$151.65
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$142.73
|
| Rate for Payer: Cash Price |
$142.73
|
| Rate for Payer: Cash Price |
$142.73
|
| Rate for Payer: Cofinity Commercial |
$124.89
|
| Rate for Payer: Cofinity Commercial |
$153.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$124.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$160.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.81
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.65
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$151.65
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.97
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$112.40
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$580.40
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: UMR Bronson Commercial |
$66.01
|
| Rate for Payer: VA VA |
$303.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.81
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
OP
|
$1,054.61
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$390.21 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$685.50
|
| Rate for Payer: Aetna Commercial |
$896.42
|
| Rate for Payer: Aetna Medicare |
$527.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.50
|
| Rate for Payer: BCBS Complete |
$421.84
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Cofinity Commercial |
$738.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$738.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.69
|
| Rate for Payer: Healthscope Commercial |
$949.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$738.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.42
|
| Rate for Payer: PHP Commercial |
$896.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.50
|
| Rate for Payer: Priority Health SBD |
$664.40
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$390.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.96
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$1,054.61
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$464.03 |
| Max. Negotiated Rate |
$949.15 |
| Rate for Payer: Aetna American Axle |
$685.50
|
| Rate for Payer: Aetna Commercial |
$896.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.50
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cofinity Commercial |
$738.23
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$738.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.69
|
| Rate for Payer: Healthscope Commercial |
$949.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$738.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.42
|
| Rate for Payer: PHP Commercial |
$896.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.50
|
| Rate for Payer: Priority Health SBD |
$664.40
|
| Rate for Payer: UMR Bronson Commercial |
$464.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.96
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$101.59
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.70 |
| Max. Negotiated Rate |
$91.43 |
| Rate for Payer: Aetna American Axle |
$66.03
|
| Rate for Payer: Aetna Commercial |
$86.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.03
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$71.11
|
| Rate for Payer: Cofinity Commercial |
$87.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.27
|
| Rate for Payer: Healthscope Commercial |
$91.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.35
|
| Rate for Payer: PHP Commercial |
$86.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.03
|
| Rate for Payer: Priority Health SBD |
$64.00
|
| Rate for Payer: UMR Bronson Commercial |
$44.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.19
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$101.59
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$91.43 |
| Rate for Payer: Aetna American Axle |
$66.03
|
| Rate for Payer: Aetna Commercial |
$86.35
|
| Rate for Payer: Aetna Medicare |
$13.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$87.37
|
| Rate for Payer: Cofinity Commercial |
$71.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$91.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.35
|
| Rate for Payer: PACE Medicare |
$12.45
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$86.35
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.03
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health SBD |
$64.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.10
|
| Rate for Payer: UHC Exchange |
$25.04
|
| Rate for Payer: UHC Medicare Advantage |
$13.10
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: UMR Bronson Commercial |
$37.59
|
| Rate for Payer: VA VA |
$13.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.19
|
|
