|
HC REVAS DES/CABG ADD.
|
Facility
|
OP
|
$19,101.90
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,067.70 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna American Axle |
$12,416.24
|
| Rate for Payer: Aetna Commercial |
$16,236.61
|
| Rate for Payer: Aetna Medicare |
$9,550.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,416.24
|
| Rate for Payer: BCBS Complete |
$7,640.76
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$13,371.33
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,371.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$17,191.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,371.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,326.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: PHP Commercial |
$16,236.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health SBD |
$12,034.20
|
| Rate for Payer: UMR Bronson Commercial |
$7,067.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,326.42
|
|
|
HC REVAS DES/CABG ADD.
|
Facility
|
IP
|
$19,101.90
|
|
|
Service Code
|
CPT C9605
|
| Hospital Charge Code |
48100084
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,404.84 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna American Axle |
$12,416.24
|
| Rate for Payer: Aetna Commercial |
$16,236.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,416.24
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$13,371.33
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,371.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,281.52
|
| Rate for Payer: Healthscope Commercial |
$17,191.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,371.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,326.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,236.61
|
| Rate for Payer: PHP Commercial |
$16,236.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health SBD |
$12,034.20
|
| Rate for Payer: UMR Bronson Commercial |
$8,404.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,326.42
|
|
|
HC REVAS DES/CABG INITIAL
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,928.28 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$18,953.09
|
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,953.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Cofinity Commercial |
$20,411.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,411.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,411.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$18,369.92
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$10,788.68
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
|
HC REVAS DES/CABG INITIAL
|
Facility
|
IP
|
$29,158.60
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$12,829.78 |
| Max. Negotiated Rate |
$26,242.74 |
| Rate for Payer: Aetna American Axle |
$18,953.09
|
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,953.09
|
| Rate for Payer: Cash Price |
$23,326.88
|
| Rate for Payer: Cofinity Commercial |
$20,411.02
|
| Rate for Payer: Cofinity Commercial |
$25,076.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,411.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,326.88
|
| Rate for Payer: Healthscope Commercial |
$26,242.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,411.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,868.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health SBD |
$18,369.92
|
| Rate for Payer: UMR Bronson Commercial |
$12,829.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,868.95
|
|
|
HC REVAS MI/DES
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,056.27 |
| Max. Negotiated Rate |
$26,706.01 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$20,771.35
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health SBD |
$18,694.21
|
| Rate for Payer: UMR Bronson Commercial |
$13,056.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC REVAS MI/DES
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT C9606
|
| Hospital Charge Code |
48100086
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,979.14 |
| Max. Negotiated Rate |
$26,706.01 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna Medicare |
$14,836.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: BCBS Complete |
$11,869.34
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$20,771.35
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health SBD |
$18,694.21
|
| Rate for Payer: UMR Bronson Commercial |
$10,979.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC REVAS MI/STENT
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,056.27 |
| Max. Negotiated Rate |
$26,706.01 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$20,771.35
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health SBD |
$18,694.21
|
| Rate for Payer: UMR Bronson Commercial |
$13,056.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC REVAS MI/STENT
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT 92941
|
| Hospital Charge Code |
48100085
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,979.14 |
| Max. Negotiated Rate |
$26,706.01 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna Medicare |
$14,836.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: BCBS Complete |
$11,869.34
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$20,771.35
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health SBD |
$18,694.21
|
| Rate for Payer: UMR Bronson Commercial |
$10,979.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
IP
|
$16,024.24
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,050.67 |
| Max. Negotiated Rate |
$14,421.82 |
| Rate for Payer: Aetna American Axle |
$10,415.76
|
| Rate for Payer: Aetna Commercial |
$13,620.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,415.76
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cofinity Commercial |
$11,216.97
|
| Rate for Payer: Cofinity Commercial |
$13,780.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,216.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,819.39
|
| Rate for Payer: Healthscope Commercial |
$14,421.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,216.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,018.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,620.60
|
| Rate for Payer: PHP Commercial |
$13,620.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,415.76
|
| Rate for Payer: Priority Health SBD |
$10,095.27
|
| Rate for Payer: UMR Bronson Commercial |
$7,050.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,018.18
|
|
|
HC REVISE/REPLACE SPINAL NEUROSTIM ELECTRODE PERC
|
Facility
|
OP
|
$16,024.24
|
|
|
Service Code
|
CPT 63663
|
| Hospital Charge Code |
36100612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,430.76 |
| Max. Negotiated Rate |
$18,017.25 |
| Rate for Payer: Aetna American Axle |
$10,415.76
|
| Rate for Payer: Aetna Commercial |
$13,620.60
|
| Rate for Payer: Aetna Medicare |
$6,656.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,415.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,000.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,000.84
|
| Rate for Payer: BCBS Complete |
$3,602.30
|
| Rate for Payer: BCBS MAPPO |
$6,400.67
|
| Rate for Payer: BCN Medicare Advantage |
$6,400.67
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cash Price |
$12,819.39
|
| Rate for Payer: Cofinity Commercial |
$13,780.85
|
| Rate for Payer: Cofinity Commercial |
$11,216.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,216.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,819.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,400.67
|
| Rate for Payer: Healthscope Commercial |
$14,421.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,216.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,018.18
|
| Rate for Payer: Mclaren Medicaid |
$3,430.76
|
| Rate for Payer: Mclaren Medicare |
$6,400.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,720.70
|
| Rate for Payer: Meridian Medicaid |
$3,602.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,620.60
|
| Rate for Payer: PACE Medicare |
$6,080.64
|
| Rate for Payer: PACE SWMI |
$6,400.67
|
| Rate for Payer: PHP Commercial |
$13,620.60
|
| Rate for Payer: PHP Medicare Advantage |
$6,400.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,430.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,415.76
|
| Rate for Payer: Priority Health Medicare |
$6,400.67
|
| Rate for Payer: Priority Health SBD |
$10,095.27
|
| Rate for Payer: Railroad Medicare Medicare |
$6,400.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18,017.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,400.67
|
| Rate for Payer: UHC Exchange |
$12,232.32
|
| Rate for Payer: UHC Medicare Advantage |
$6,400.67
|
| Rate for Payer: UHCCP Medicaid |
$3,430.76
|
| Rate for Payer: UMR Bronson Commercial |
$5,928.97
|
| Rate for Payer: VA VA |
$6,400.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,018.18
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
OP
|
$3,111.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,151.07 |
| Max. Negotiated Rate |
$2,799.90 |
| Rate for Payer: Aetna American Axle |
$2,022.15
|
| Rate for Payer: Aetna Commercial |
$2,644.35
|
| Rate for Payer: Aetna Medicare |
$1,555.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,022.15
|
| Rate for Payer: BCBS Complete |
$1,244.40
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$2,177.70
|
| Rate for Payer: Cofinity Commercial |
$2,675.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,177.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,488.80
|
| Rate for Payer: Healthscope Commercial |
$2,799.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,177.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,333.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,644.35
|
| Rate for Payer: PHP Commercial |
$2,644.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health SBD |
$1,959.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,151.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,333.25
|
|
|
HC REZUM DELIVERY DEVICE
|
Facility
|
IP
|
$3,111.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,368.84 |
| Max. Negotiated Rate |
$2,799.90 |
| Rate for Payer: Aetna American Axle |
$2,022.15
|
| Rate for Payer: Aetna Commercial |
$2,644.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,022.15
|
| Rate for Payer: Cash Price |
$2,488.80
|
| Rate for Payer: Cofinity Commercial |
$2,177.70
|
| Rate for Payer: Cofinity Commercial |
$2,675.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,177.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,488.80
|
| Rate for Payer: Healthscope Commercial |
$2,799.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,177.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,333.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,644.35
|
| Rate for Payer: PHP Commercial |
$2,644.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,022.15
|
| Rate for Payer: Priority Health SBD |
$1,959.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,368.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,333.25
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
OP
|
$7,557.46
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,796.26 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna American Axle |
$4,912.35
|
| Rate for Payer: Aetna Commercial |
$6,423.84
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,912.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cofinity Commercial |
$6,499.42
|
| Rate for Payer: Cofinity Commercial |
$5,290.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,290.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,045.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$6,801.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,290.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,668.10
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,423.84
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$6,423.84
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,912.35
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$4,761.20
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$10,874.41
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,796.26
|
| Rate for Payer: VA VA |
$5,690.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,668.10
|
|
|
HC RF ABLATION KIDNEY TUMOR
|
Facility
|
IP
|
$7,557.46
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,325.28 |
| Max. Negotiated Rate |
$6,801.71 |
| Rate for Payer: Aetna American Axle |
$4,912.35
|
| Rate for Payer: Aetna Commercial |
$6,423.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,912.35
|
| Rate for Payer: Cash Price |
$6,045.97
|
| Rate for Payer: Cofinity Commercial |
$5,290.22
|
| Rate for Payer: Cofinity Commercial |
$6,499.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,290.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,045.97
|
| Rate for Payer: Healthscope Commercial |
$6,801.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,290.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,668.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,423.84
|
| Rate for Payer: PHP Commercial |
$6,423.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,912.35
|
| Rate for Payer: Priority Health SBD |
$4,761.20
|
| Rate for Payer: UMR Bronson Commercial |
$3,325.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,668.10
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
OP
|
$5,885.87
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,177.77 |
| Max. Negotiated Rate |
$16,017.15 |
| Rate for Payer: Aetna American Axle |
$3,825.82
|
| Rate for Payer: Aetna Commercial |
$5,002.99
|
| Rate for Payer: Aetna Medicare |
$5,917.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,825.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,112.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,112.66
|
| Rate for Payer: BCBS Complete |
$3,202.41
|
| Rate for Payer: BCBS MAPPO |
$5,690.13
|
| Rate for Payer: BCN Medicare Advantage |
$5,690.13
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cofinity Commercial |
$5,061.85
|
| Rate for Payer: Cofinity Commercial |
$4,120.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,120.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,708.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,690.13
|
| Rate for Payer: Healthscope Commercial |
$5,297.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,120.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,414.40
|
| Rate for Payer: Mclaren Medicaid |
$3,049.91
|
| Rate for Payer: Mclaren Medicare |
$5,690.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,974.64
|
| Rate for Payer: Meridian Medicaid |
$3,202.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,543.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,002.99
|
| Rate for Payer: PACE Medicare |
$5,405.62
|
| Rate for Payer: PACE SWMI |
$5,690.13
|
| Rate for Payer: PHP Commercial |
$5,002.99
|
| Rate for Payer: PHP Medicare Advantage |
$5,690.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,049.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.82
|
| Rate for Payer: Priority Health Medicare |
$5,690.13
|
| Rate for Payer: Priority Health SBD |
$3,708.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5,690.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16,017.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,690.13
|
| Rate for Payer: UHC Exchange |
$10,874.41
|
| Rate for Payer: UHC Medicare Advantage |
$5,690.13
|
| Rate for Payer: UHCCP Medicaid |
$3,049.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,177.77
|
| Rate for Payer: VA VA |
$5,690.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,414.40
|
|
|
HC RF ABLATION LIVER TUMOR
|
Facility
|
IP
|
$5,885.87
|
|
|
Service Code
|
CPT 47382
|
| Hospital Charge Code |
36100199
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,589.78 |
| Max. Negotiated Rate |
$5,297.28 |
| Rate for Payer: Aetna American Axle |
$3,825.82
|
| Rate for Payer: Aetna Commercial |
$5,002.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,825.82
|
| Rate for Payer: Cash Price |
$4,708.70
|
| Rate for Payer: Cofinity Commercial |
$4,120.11
|
| Rate for Payer: Cofinity Commercial |
$5,061.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,120.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,708.70
|
| Rate for Payer: Healthscope Commercial |
$5,297.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,120.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,414.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,002.99
|
| Rate for Payer: PHP Commercial |
$5,002.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.82
|
| Rate for Payer: Priority Health SBD |
$3,708.10
|
| Rate for Payer: UMR Bronson Commercial |
$2,589.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,414.40
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
IP
|
$2,683.22
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,180.62 |
| Max. Negotiated Rate |
$2,414.90 |
| Rate for Payer: Aetna American Axle |
$1,744.09
|
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,744.09
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$1,878.25
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,878.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,878.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health SBD |
$1,690.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,180.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.41
|
|
|
HC RFABLATION NRV INNERVATING SI JT W IMAG
|
Facility
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$992.79 |
| Max. Negotiated Rate |
$5,360.98 |
| Rate for Payer: Aetna American Axle |
$1,744.09
|
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna Medicare |
$1,980.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,744.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,380.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,380.62
|
| Rate for Payer: BCBS Complete |
$1,071.85
|
| Rate for Payer: BCBS MAPPO |
$1,904.50
|
| Rate for Payer: BCN Medicare Advantage |
$1,904.50
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cash Price |
$2,146.58
|
| Rate for Payer: Cofinity Commercial |
$2,307.57
|
| Rate for Payer: Cofinity Commercial |
$1,878.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,878.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,146.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,904.50
|
| Rate for Payer: Healthscope Commercial |
$2,414.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,878.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,012.41
|
| Rate for Payer: Mclaren Medicaid |
$1,020.81
|
| Rate for Payer: Mclaren Medicare |
$1,904.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,999.72
|
| Rate for Payer: Meridian Medicaid |
$1,071.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,190.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: PACE Medicare |
$1,809.28
|
| Rate for Payer: PACE SWMI |
$1,904.50
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,904.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,020.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health Medicare |
$1,904.50
|
| Rate for Payer: Priority Health SBD |
$1,690.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,904.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,360.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,904.50
|
| Rate for Payer: UHC Exchange |
$3,639.69
|
| Rate for Payer: UHC Medicare Advantage |
$1,904.50
|
| Rate for Payer: UHCCP Medicaid |
$1,020.81
|
| Rate for Payer: UMR Bronson Commercial |
$992.79
|
| Rate for Payer: VA VA |
$1,904.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.41
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
IP
|
$1,788.52
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$786.95 |
| Max. Negotiated Rate |
$1,609.67 |
| Rate for Payer: Aetna American Axle |
$1,162.54
|
| Rate for Payer: Aetna Commercial |
$1,520.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,162.54
|
| Rate for Payer: Cash Price |
$1,430.82
|
| Rate for Payer: Cofinity Commercial |
$1,251.96
|
| Rate for Payer: Cofinity Commercial |
$1,538.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,251.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.82
|
| Rate for Payer: Healthscope Commercial |
$1,609.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,251.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,341.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.24
|
| Rate for Payer: PHP Commercial |
$1,520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.54
|
| Rate for Payer: Priority Health SBD |
$1,126.77
|
| Rate for Payer: UMR Bronson Commercial |
$786.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,341.39
|
|
|
HC RF TRANSSEPTAL NEEDLE
|
Facility
|
OP
|
$1,788.52
|
|
| Hospital Charge Code |
27200285
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$661.75 |
| Max. Negotiated Rate |
$1,609.67 |
| Rate for Payer: Aetna American Axle |
$1,162.54
|
| Rate for Payer: Aetna Commercial |
$1,520.24
|
| Rate for Payer: Aetna Medicare |
$894.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,162.54
|
| Rate for Payer: BCBS Complete |
$715.41
|
| Rate for Payer: Cash Price |
$1,430.82
|
| Rate for Payer: Cofinity Commercial |
$1,251.96
|
| Rate for Payer: Cofinity Commercial |
$1,538.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,251.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,430.82
|
| Rate for Payer: Healthscope Commercial |
$1,609.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,251.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,341.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,520.24
|
| Rate for Payer: PHP Commercial |
$1,520.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,162.54
|
| Rate for Payer: Priority Health SBD |
$1,126.77
|
| Rate for Payer: UMR Bronson Commercial |
$661.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,341.39
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RHEUMATOID FACTOR
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$5.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.09
|
| Rate for Payer: BCBS Complete |
$3.19
|
| Rate for Payer: BCBS MAPPO |
$5.67
|
| Rate for Payer: BCN Medicare Advantage |
$5.67
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.67
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$3.04
|
| Rate for Payer: Mclaren Medicare |
$5.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.95
|
| Rate for Payer: Meridian Medicaid |
$3.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$5.39
|
| Rate for Payer: PACE SWMI |
$5.67
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$5.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$5.67
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$5.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.67
|
| Rate for Payer: UHC Exchange |
$10.84
|
| Rate for Payer: UHC Medicare Advantage |
$5.67
|
| Rate for Payer: UHCCP Medicaid |
$3.04
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$5.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RHOGAM
|
Facility
|
IP
|
$283.98
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$124.95 |
| Max. Negotiated Rate |
$255.58 |
| Rate for Payer: Aetna American Axle |
$184.59
|
| Rate for Payer: Aetna Commercial |
$241.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.59
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cofinity Commercial |
$198.79
|
| Rate for Payer: Cofinity Commercial |
$244.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.18
|
| Rate for Payer: Healthscope Commercial |
$255.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.38
|
| Rate for Payer: PHP Commercial |
$241.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.59
|
| Rate for Payer: Priority Health SBD |
$178.91
|
| Rate for Payer: UMR Bronson Commercial |
$124.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.99
|
|
|
HC RHOGAM
|
Facility
|
OP
|
$283.98
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$105.07 |
| Max. Negotiated Rate |
$255.58 |
| Rate for Payer: Aetna American Axle |
$184.59
|
| Rate for Payer: Aetna Commercial |
$241.38
|
| Rate for Payer: Aetna Medicare |
$141.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.59
|
| Rate for Payer: BCBS Complete |
$113.59
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cofinity Commercial |
$198.79
|
| Rate for Payer: Cofinity Commercial |
$244.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.18
|
| Rate for Payer: Healthscope Commercial |
$255.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.38
|
| Rate for Payer: PHP Commercial |
$241.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.59
|
| Rate for Payer: Priority Health SBD |
$178.91
|
| Rate for Payer: UMR Bronson Commercial |
$105.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.99
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$50.47 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$34.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
