|
HC STENT NON COATED W SYS LVL 67
|
Facility
|
IP
|
$6,779.33
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,982.91 |
| Max. Negotiated Rate |
$6,101.40 |
| Rate for Payer: Aetna American Axle |
$4,406.56
|
| Rate for Payer: Aetna Commercial |
$5,762.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,406.56
|
| Rate for Payer: Cash Price |
$5,423.46
|
| Rate for Payer: Cofinity Advantage |
$4,745.53
|
| Rate for Payer: Cofinity Commercial |
$5,830.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,423.46
|
| Rate for Payer: Healthscope Commercial |
$6,101.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,745.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,084.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,762.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,084.50
|
| Rate for Payer: PHP Commercial |
$5,762.43
|
| Rate for Payer: Priority Health SBD |
$4,270.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,982.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,084.50
|
|
|
HC STENT NON CORONARY LVL 2
|
Facility
|
OP
|
$244.19
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$90.35 |
| Max. Negotiated Rate |
$219.77 |
| Rate for Payer: Aetna American Axle |
$158.72
|
| Rate for Payer: Aetna Commercial |
$207.56
|
| Rate for Payer: Aetna Medicare |
$122.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.72
|
| Rate for Payer: BCBS Complete |
$97.68
|
| Rate for Payer: Cash Price |
$195.35
|
| Rate for Payer: Cofinity Advantage |
$170.93
|
| Rate for Payer: Cofinity Commercial |
$210.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.35
|
| Rate for Payer: Healthscope Commercial |
$219.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.14
|
| Rate for Payer: PHP Commercial |
$207.56
|
| Rate for Payer: Priority Health SBD |
$153.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.72
|
| Rate for Payer: UHC Core |
$127.22
|
| Rate for Payer: UHC Exchange |
$95.97
|
| Rate for Payer: UMR Bronson Commercial |
$90.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.14
|
|
|
HC STENT NON CORONARY LVL 2
|
Facility
|
IP
|
$244.19
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800101
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$107.44 |
| Max. Negotiated Rate |
$219.77 |
| Rate for Payer: Aetna American Axle |
$158.72
|
| Rate for Payer: Aetna Commercial |
$207.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.72
|
| Rate for Payer: Cash Price |
$195.35
|
| Rate for Payer: Cofinity Advantage |
$170.93
|
| Rate for Payer: Cofinity Commercial |
$210.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.35
|
| Rate for Payer: Healthscope Commercial |
$219.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$183.14
|
| Rate for Payer: PHP Commercial |
$207.56
|
| Rate for Payer: Priority Health SBD |
$153.84
|
| Rate for Payer: UMR Bronson Commercial |
$107.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.14
|
|
|
HC STENT NON CORONARY LVL 3
|
Facility
|
IP
|
$501.23
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$220.54 |
| Max. Negotiated Rate |
$451.11 |
| Rate for Payer: Aetna American Axle |
$325.80
|
| Rate for Payer: Aetna Commercial |
$426.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.80
|
| Rate for Payer: Cash Price |
$400.98
|
| Rate for Payer: Cofinity Advantage |
$350.86
|
| Rate for Payer: Cofinity Commercial |
$431.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.98
|
| Rate for Payer: Healthscope Commercial |
$451.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$426.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.92
|
| Rate for Payer: PHP Commercial |
$426.05
|
| Rate for Payer: Priority Health SBD |
$315.77
|
| Rate for Payer: UMR Bronson Commercial |
$220.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.92
|
|
|
HC STENT NON CORONARY LVL 3
|
Facility
|
OP
|
$501.23
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27800102
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$185.46 |
| Max. Negotiated Rate |
$451.11 |
| Rate for Payer: Aetna American Axle |
$325.80
|
| Rate for Payer: Aetna Commercial |
$426.05
|
| Rate for Payer: Aetna Medicare |
$250.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.80
|
| Rate for Payer: BCBS Complete |
$200.49
|
| Rate for Payer: Cash Price |
$400.98
|
| Rate for Payer: Cofinity Advantage |
$350.86
|
| Rate for Payer: Cofinity Commercial |
$431.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.98
|
| Rate for Payer: Healthscope Commercial |
$451.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$400.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$426.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$375.92
|
| Rate for Payer: PHP Commercial |
$426.05
|
| Rate for Payer: Priority Health SBD |
$315.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325.80
|
| Rate for Payer: UHC Core |
$261.14
|
| Rate for Payer: UHC Exchange |
$196.98
|
| Rate for Payer: UMR Bronson Commercial |
$185.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.92
|
|
|
HC STENT NON CORONARY LVL 4
|
Facility
|
OP
|
$838.73
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27200103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$310.33 |
| Max. Negotiated Rate |
$754.86 |
| Rate for Payer: Aetna American Axle |
$545.17
|
| Rate for Payer: Aetna Commercial |
$712.92
|
| Rate for Payer: Aetna Medicare |
$419.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.17
|
| Rate for Payer: BCBS Complete |
$335.49
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cofinity Advantage |
$587.11
|
| Rate for Payer: Cofinity Commercial |
$721.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.98
|
| Rate for Payer: Healthscope Commercial |
$754.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$587.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$629.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$670.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.05
|
| Rate for Payer: PHP Commercial |
$712.92
|
| Rate for Payer: Priority Health SBD |
$528.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.17
|
| Rate for Payer: UHC Core |
$436.98
|
| Rate for Payer: UHC Exchange |
$329.62
|
| Rate for Payer: UMR Bronson Commercial |
$310.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$629.05
|
|
|
HC STENT NON CORONARY LVL 4
|
Facility
|
IP
|
$838.73
|
|
|
Service Code
|
HCPCS C2625
|
| Hospital Charge Code |
27200103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$369.04 |
| Max. Negotiated Rate |
$754.86 |
| Rate for Payer: Aetna American Axle |
$545.17
|
| Rate for Payer: Aetna Commercial |
$712.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$545.17
|
| Rate for Payer: Cash Price |
$670.98
|
| Rate for Payer: Cofinity Advantage |
$587.11
|
| Rate for Payer: Cofinity Commercial |
$721.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$670.98
|
| Rate for Payer: Healthscope Commercial |
$754.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$587.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$629.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$712.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$629.05
|
| Rate for Payer: PHP Commercial |
$712.92
|
| Rate for Payer: Priority Health SBD |
$528.40
|
| Rate for Payer: UMR Bronson Commercial |
$369.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$629.05
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CER CAROTID INTRACRAN EA ADDLL
|
Facility
|
IP
|
$10,828.91
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
36100425
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,764.72 |
| Max. Negotiated Rate |
$9,746.02 |
| Rate for Payer: Aetna American Axle |
$7,038.79
|
| Rate for Payer: Aetna Commercial |
$9,204.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,038.79
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Advantage |
$7,580.24
|
| Rate for Payer: Cofinity Commercial |
$9,312.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$9,746.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,580.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,121.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: PHP Commercial |
$9,204.57
|
| Rate for Payer: Priority Health SBD |
$6,822.21
|
| Rate for Payer: UMR Bronson Commercial |
$4,764.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,121.68
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CER CAROTID INTRACRAN EA ADDLL
|
Facility
|
OP
|
$10,828.91
|
|
|
Service Code
|
CPT 37237
|
| Hospital Charge Code |
36100425
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,006.70 |
| Max. Negotiated Rate |
$10,439.03 |
| Rate for Payer: Aetna American Axle |
$7,038.79
|
| Rate for Payer: Aetna Commercial |
$9,204.57
|
| Rate for Payer: Aetna Medicare |
$5,414.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,038.79
|
| Rate for Payer: BCBS Complete |
$4,331.56
|
| Rate for Payer: BCBS Trust/PPO |
$10,439.03
|
| Rate for Payer: BCN Commercial |
$10,439.03
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Advantage |
$7,580.24
|
| Rate for Payer: Cofinity Commercial |
$9,312.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$9,746.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,580.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,121.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,663.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: PHP Commercial |
$9,204.57
|
| Rate for Payer: Priority Health SBD |
$6,822.21
|
| Rate for Payer: UMR Bronson Commercial |
$4,006.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,121.68
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
OP
|
$16,731.58
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$10,875.53
|
| Rate for Payer: Aetna Commercial |
$14,221.84
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,875.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$14,184.26
|
| Rate for Payer: BCN Commercial |
$14,184.26
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cofinity Advantage |
$11,712.11
|
| Rate for Payer: Cofinity Commercial |
$14,389.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,385.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$15,058.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,712.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,548.68
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,221.84
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,548.68
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$14,221.84
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$10,540.90
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$6,190.68
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,548.68
|
|
|
HC STENT PLACE OTHER THAN LOWER EXTREM CERV CAROTID INTRACRAN
|
Facility
|
IP
|
$16,731.58
|
|
|
Service Code
|
CPT 37236
|
| Hospital Charge Code |
36100424
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,361.90 |
| Max. Negotiated Rate |
$15,058.42 |
| Rate for Payer: Aetna American Axle |
$10,875.53
|
| Rate for Payer: Aetna Commercial |
$14,221.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,875.53
|
| Rate for Payer: Cash Price |
$13,385.26
|
| Rate for Payer: Cofinity Advantage |
$11,712.11
|
| Rate for Payer: Cofinity Commercial |
$14,389.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,385.26
|
| Rate for Payer: Healthscope Commercial |
$15,058.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,712.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,548.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,221.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12,548.68
|
| Rate for Payer: PHP Commercial |
$14,221.84
|
| Rate for Payer: Priority Health SBD |
$10,540.90
|
| Rate for Payer: UMR Bronson Commercial |
$7,361.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,548.68
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
OP
|
$19,121.79
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$12,429.16
|
| Rate for Payer: Aetna Commercial |
$16,253.52
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,429.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$18,433.00
|
| Rate for Payer: BCN Commercial |
$18,433.00
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cofinity Advantage |
$13,385.25
|
| Rate for Payer: Cofinity Commercial |
$16,444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,297.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$17,209.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,385.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,341.34
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,253.52
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,341.34
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$16,253.52
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$12,046.73
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$7,075.06
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,341.34
|
|
|
HC STENT PLACE VENOUS
|
Facility
|
IP
|
$19,121.79
|
|
|
Service Code
|
CPT 37238
|
| Hospital Charge Code |
36100426
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,413.59 |
| Max. Negotiated Rate |
$17,209.61 |
| Rate for Payer: Aetna American Axle |
$12,429.16
|
| Rate for Payer: Aetna Commercial |
$16,253.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,429.16
|
| Rate for Payer: Cash Price |
$15,297.43
|
| Rate for Payer: Cofinity Advantage |
$13,385.25
|
| Rate for Payer: Cofinity Commercial |
$16,444.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,297.43
|
| Rate for Payer: Healthscope Commercial |
$17,209.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,385.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,341.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,253.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14,341.34
|
| Rate for Payer: PHP Commercial |
$16,253.52
|
| Rate for Payer: Priority Health SBD |
$12,046.73
|
| Rate for Payer: UMR Bronson Commercial |
$8,413.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,341.34
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
OP
|
$10,828.91
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,006.70 |
| Max. Negotiated Rate |
$9,746.02 |
| Rate for Payer: Aetna American Axle |
$7,038.79
|
| Rate for Payer: Aetna Commercial |
$9,204.57
|
| Rate for Payer: Aetna Medicare |
$5,414.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,038.79
|
| Rate for Payer: BCBS Complete |
$4,331.56
|
| Rate for Payer: BCBS Trust/PPO |
$8,656.19
|
| Rate for Payer: BCN Commercial |
$8,656.19
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Advantage |
$7,580.24
|
| Rate for Payer: Cofinity Commercial |
$9,312.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$9,746.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,580.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,121.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,663.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: PHP Commercial |
$9,204.57
|
| Rate for Payer: Priority Health SBD |
$6,822.21
|
| Rate for Payer: UMR Bronson Commercial |
$4,006.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,121.68
|
|
|
HC STENT PLACE VENOUS EA ADDL VEIN
|
Facility
|
IP
|
$10,828.91
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100427
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,764.72 |
| Max. Negotiated Rate |
$9,746.02 |
| Rate for Payer: Aetna American Axle |
$7,038.79
|
| Rate for Payer: Aetna Commercial |
$9,204.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,038.79
|
| Rate for Payer: Cash Price |
$8,663.13
|
| Rate for Payer: Cofinity Advantage |
$7,580.24
|
| Rate for Payer: Cofinity Commercial |
$9,312.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,663.13
|
| Rate for Payer: Healthscope Commercial |
$9,746.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,580.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,121.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,204.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,121.68
|
| Rate for Payer: PHP Commercial |
$9,204.57
|
| Rate for Payer: Priority Health SBD |
$6,822.21
|
| Rate for Payer: UMR Bronson Commercial |
$4,764.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,121.68
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
OP
|
$6,992.43
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,587.20 |
| Max. Negotiated Rate |
$8,656.19 |
| Rate for Payer: Aetna American Axle |
$4,545.08
|
| Rate for Payer: Aetna Commercial |
$5,943.57
|
| Rate for Payer: Aetna Medicare |
$3,496.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,545.08
|
| Rate for Payer: BCBS Complete |
$2,796.97
|
| Rate for Payer: BCBS Trust/PPO |
$8,656.19
|
| Rate for Payer: BCN Commercial |
$8,656.19
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cofinity Advantage |
$4,894.70
|
| Rate for Payer: Cofinity Commercial |
$6,013.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,593.94
|
| Rate for Payer: Healthscope Commercial |
$6,293.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,894.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,244.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,593.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,943.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,244.32
|
| Rate for Payer: PHP Commercial |
$5,943.57
|
| Rate for Payer: Priority Health SBD |
$4,405.23
|
| Rate for Payer: UMR Bronson Commercial |
$2,587.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,244.32
|
|
|
HC STENT TRASCATH VEIN EACH ADDL
|
Facility
|
IP
|
$6,992.43
|
|
|
Service Code
|
CPT 37239
|
| Hospital Charge Code |
36100441
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,076.67 |
| Max. Negotiated Rate |
$6,293.19 |
| Rate for Payer: Aetna American Axle |
$4,545.08
|
| Rate for Payer: Aetna Commercial |
$5,943.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,545.08
|
| Rate for Payer: Cash Price |
$5,593.94
|
| Rate for Payer: Cofinity Advantage |
$4,894.70
|
| Rate for Payer: Cofinity Commercial |
$6,013.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,593.94
|
| Rate for Payer: Healthscope Commercial |
$6,293.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,894.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,244.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,943.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,244.32
|
| Rate for Payer: PHP Commercial |
$5,943.57
|
| Rate for Payer: Priority Health SBD |
$4,405.23
|
| Rate for Payer: UMR Bronson Commercial |
$3,076.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,244.32
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
IP
|
$25,160.93
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,070.81 |
| Max. Negotiated Rate |
$22,644.84 |
| Rate for Payer: Aetna American Axle |
$16,354.60
|
| Rate for Payer: Aetna Commercial |
$21,386.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,354.60
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Advantage |
$17,612.65
|
| Rate for Payer: Cofinity Commercial |
$21,638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Healthscope Commercial |
$22,644.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,612.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,870.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PHP Commercial |
$21,386.79
|
| Rate for Payer: Priority Health SBD |
$15,851.39
|
| Rate for Payer: UMR Bronson Commercial |
$11,070.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,870.70
|
|
|
HC STENT VESSEL/BRANCH
|
Facility
|
OP
|
$25,160.93
|
|
|
Service Code
|
CPT 92928
|
| Hospital Charge Code |
48100073
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,015.90 |
| Max. Negotiated Rate |
$37,198.61 |
| Rate for Payer: Aetna American Axle |
$16,354.60
|
| Rate for Payer: Aetna Commercial |
$21,386.79
|
| Rate for Payer: Aetna Medicare |
$11,962.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,354.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,378.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,378.35
|
| Rate for Payer: BCBS Complete |
$6,317.27
|
| Rate for Payer: BCBS MAPPO |
$11,502.68
|
| Rate for Payer: BCBS Trust/PPO |
$12,177.52
|
| Rate for Payer: BCN Commercial |
$12,177.52
|
| Rate for Payer: BCN Medicare Advantage |
$11,502.68
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cash Price |
$20,128.74
|
| Rate for Payer: Cofinity Advantage |
$17,612.65
|
| Rate for Payer: Cofinity Commercial |
$21,638.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20,128.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,502.68
|
| Rate for Payer: Healthscope Commercial |
$22,644.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,612.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,870.70
|
| Rate for Payer: Mclaren Medicaid |
$11,502.68
|
| Rate for Payer: Mclaren Medicare |
$11,502.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,077.81
|
| Rate for Payer: Meridian Medicaid |
$12,077.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,228.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,652.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,386.79
|
| Rate for Payer: Nomi Health Commercial |
$34,508.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18,870.70
|
| Rate for Payer: PACE Medicare |
$10,927.55
|
| Rate for Payer: PACE SWMI |
$11,502.68
|
| Rate for Payer: PHP Commercial |
$21,386.79
|
| Rate for Payer: PHP Medicare Advantage |
$11,502.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,015.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$37,198.61
|
| Rate for Payer: Priority Health Medicare |
$11,502.68
|
| Rate for Payer: Priority Health SBD |
$15,851.39
|
| Rate for Payer: Priority Health Tiered Network |
$29,758.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,502.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11,502.68
|
| Rate for Payer: UHC Medicaid |
$6,015.90
|
| Rate for Payer: UHCCP Medicaid |
$6,015.90
|
| Rate for Payer: UMR Bronson Commercial |
$9,309.54
|
| Rate for Payer: VA VA |
$11,502.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,870.70
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
IP
|
$28,652.62
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$12,607.15 |
| Max. Negotiated Rate |
$25,787.36 |
| Rate for Payer: Aetna American Axle |
$18,624.20
|
| Rate for Payer: Aetna Commercial |
$24,354.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,624.20
|
| Rate for Payer: Cash Price |
$22,922.10
|
| Rate for Payer: Cofinity Advantage |
$20,056.83
|
| Rate for Payer: Cofinity Commercial |
$24,641.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,922.10
|
| Rate for Payer: Healthscope Commercial |
$25,787.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,056.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,489.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,354.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,489.47
|
| Rate for Payer: PHP Commercial |
$24,354.73
|
| Rate for Payer: Priority Health SBD |
$18,051.15
|
| Rate for Payer: UMR Bronson Commercial |
$12,607.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,489.47
|
|
|
HC ST JUDE CRT ICD
|
Facility
|
OP
|
$28,652.62
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500009
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$25,787.36 |
| Rate for Payer: Aetna American Axle |
$18,624.20
|
| Rate for Payer: Aetna Commercial |
$24,354.73
|
| Rate for Payer: Aetna Medicare |
$14,326.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,624.20
|
| Rate for Payer: BCBS Complete |
$11,461.05
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$22,922.10
|
| Rate for Payer: Cash Price |
$22,922.10
|
| Rate for Payer: Cofinity Advantage |
$20,056.83
|
| Rate for Payer: Cofinity Commercial |
$24,641.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22,922.10
|
| Rate for Payer: Healthscope Commercial |
$25,787.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,056.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,489.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22,922.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,354.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21,489.47
|
| Rate for Payer: PHP Commercial |
$24,354.73
|
| Rate for Payer: Priority Health SBD |
$18,051.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,624.20
|
| Rate for Payer: UHC Core |
$14,928.02
|
| Rate for Payer: UHC Exchange |
$11,260.48
|
| Rate for Payer: UMR Bronson Commercial |
$10,601.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,489.47
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
OP
|
$5,942.76
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,348.48 |
| Rate for Payer: Aetna American Axle |
$3,862.79
|
| Rate for Payer: Aetna Commercial |
$5,051.35
|
| Rate for Payer: Aetna Medicare |
$2,971.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,862.79
|
| Rate for Payer: BCBS Complete |
$2,377.10
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,754.21
|
| Rate for Payer: Cash Price |
$4,754.21
|
| Rate for Payer: Cofinity Advantage |
$4,159.93
|
| Rate for Payer: Cofinity Commercial |
$5,110.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,754.21
|
| Rate for Payer: Healthscope Commercial |
$5,348.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,159.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,457.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,754.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,051.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,457.07
|
| Rate for Payer: PHP Commercial |
$5,051.35
|
| Rate for Payer: Priority Health SBD |
$3,743.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,862.79
|
| Rate for Payer: UHC Core |
$3,096.18
|
| Rate for Payer: UHC Exchange |
$2,335.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,198.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,457.07
|
|
|
HC ST JUDE CRT LEAD
|
Facility
|
IP
|
$5,942.76
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800026
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,614.81 |
| Max. Negotiated Rate |
$5,348.48 |
| Rate for Payer: Aetna American Axle |
$3,862.79
|
| Rate for Payer: Aetna Commercial |
$5,051.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,862.79
|
| Rate for Payer: Cash Price |
$4,754.21
|
| Rate for Payer: Cofinity Advantage |
$4,159.93
|
| Rate for Payer: Cofinity Commercial |
$5,110.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,754.21
|
| Rate for Payer: Healthscope Commercial |
$5,348.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,159.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,457.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,051.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,457.07
|
| Rate for Payer: PHP Commercial |
$5,051.35
|
| Rate for Payer: Priority Health SBD |
$3,743.94
|
| Rate for Payer: UMR Bronson Commercial |
$2,614.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,457.07
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
OP
|
$9,550.87
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$3,533.82 |
| Max. Negotiated Rate |
$8,595.78 |
| Rate for Payer: Aetna American Axle |
$6,208.07
|
| Rate for Payer: Aetna Commercial |
$8,118.24
|
| Rate for Payer: Aetna Medicare |
$4,775.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,208.07
|
| Rate for Payer: BCBS Complete |
$3,820.35
|
| Rate for Payer: Cash Price |
$7,640.70
|
| Rate for Payer: Cofinity Advantage |
$6,685.61
|
| Rate for Payer: Cofinity Commercial |
$8,213.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,640.70
|
| Rate for Payer: Healthscope Commercial |
$8,595.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,685.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,163.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,640.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,163.15
|
| Rate for Payer: PHP Commercial |
$8,118.24
|
| Rate for Payer: Priority Health SBD |
$6,017.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,208.07
|
| Rate for Payer: UHC Core |
$4,976.00
|
| Rate for Payer: UHC Exchange |
$3,753.49
|
| Rate for Payer: UMR Bronson Commercial |
$3,533.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,163.15
|
|
|
HC ST JUDE DUAL PACEMAKER
|
Facility
|
IP
|
$9,550.87
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500010
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,202.38 |
| Max. Negotiated Rate |
$8,595.78 |
| Rate for Payer: Aetna American Axle |
$6,208.07
|
| Rate for Payer: Aetna Commercial |
$8,118.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,208.07
|
| Rate for Payer: Cash Price |
$7,640.70
|
| Rate for Payer: Cofinity Advantage |
$6,685.61
|
| Rate for Payer: Cofinity Commercial |
$8,213.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,640.70
|
| Rate for Payer: Healthscope Commercial |
$8,595.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,685.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,163.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,163.15
|
| Rate for Payer: PHP Commercial |
$8,118.24
|
| Rate for Payer: Priority Health SBD |
$6,017.05
|
| Rate for Payer: UMR Bronson Commercial |
$4,202.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,163.15
|
|
