|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
OP
|
$50,051.40
|
|
|
Service Code
|
CPT C9775
|
| Hospital Charge Code |
48100131
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,430.19 |
| Max. Negotiated Rate |
$55,296.52 |
| Rate for Payer: Aetna American Axle |
$32,533.41
|
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: Aetna Medicare |
$18,297.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32,533.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Cofinity Commercial |
$35,035.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$35,035.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,035.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: Nomi Health Commercial |
$36,946.64
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55,296.52
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$44,237.22
|
| Rate for Payer: Priority Health SBD |
$31,532.38
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,524.34
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$33,623.21
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: UMR Bronson Commercial |
$18,519.02
|
| Rate for Payer: VA VA |
$17,593.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASC TIBIAL/PERIONEAL LITHOTRIPSY INCL ANGIOPLASTY WITH STENT AND ATHERECT
|
Facility
|
IP
|
$50,051.40
|
|
|
Service Code
|
CPT C9775
|
| Hospital Charge Code |
48100131
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$22,022.62 |
| Max. Negotiated Rate |
$45,046.26 |
| Rate for Payer: Aetna American Axle |
$32,533.41
|
| Rate for Payer: Aetna Commercial |
$42,543.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32,533.41
|
| Rate for Payer: Cash Price |
$40,041.12
|
| Rate for Payer: Cofinity Commercial |
$35,035.98
|
| Rate for Payer: Cofinity Commercial |
$43,044.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$35,035.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40,041.12
|
| Rate for Payer: Healthscope Commercial |
$45,046.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35,035.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,538.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42,543.69
|
| Rate for Payer: PHP Commercial |
$42,543.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32,533.41
|
| Rate for Payer: Priority Health SBD |
$31,532.38
|
| Rate for Payer: UMR Bronson Commercial |
$22,022.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,538.55
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
IP
|
$13,009.31
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,724.10 |
| Max. Negotiated Rate |
$11,708.38 |
| Rate for Payer: Aetna American Axle |
$8,456.05
|
| Rate for Payer: Aetna Commercial |
$11,057.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,456.05
|
| Rate for Payer: Cash Price |
$10,407.45
|
| Rate for Payer: Cofinity Commercial |
$11,188.01
|
| Rate for Payer: Cofinity Commercial |
$9,106.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,106.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,407.45
|
| Rate for Payer: Healthscope Commercial |
$11,708.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,106.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,756.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,057.91
|
| Rate for Payer: PHP Commercial |
$11,057.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,456.05
|
| Rate for Payer: Priority Health SBD |
$8,195.87
|
| Rate for Payer: UMR Bronson Commercial |
$5,724.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,756.98
|
|
|
HC REVASCULARIZATION STENT FEM POP UNI
|
Facility
|
OP
|
$13,009.31
|
|
|
Service Code
|
CPT 37226
|
| Hospital Charge Code |
36100170
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$499.96 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna American Axle |
$8,456.05
|
| Rate for Payer: Aetna Commercial |
$11,057.91
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,456.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$9,647.88
|
| Rate for Payer: BCN Commercial |
$9,647.88
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$10,407.45
|
| Rate for Payer: Cash Price |
$10,407.45
|
| Rate for Payer: Cash Price |
$10,407.45
|
| Rate for Payer: Cofinity Commercial |
$9,106.52
|
| Rate for Payer: Cofinity Commercial |
$11,188.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,106.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,407.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$11,708.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,106.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,756.98
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,057.91
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$11,057.91
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,456.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$8,195.87
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$549.96
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$499.96
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: UMR Bronson Commercial |
$4,813.44
|
| Rate for Payer: VA VA |
$11,111.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,756.98
|
|
|
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 |
$0.01 |
| Max. Negotiated Rate |
$17,191.71 |
| Rate for Payer: Aetna American Axle |
$12,416.24
|
| Rate for Payer: Aetna Commercial |
$16,236.62
|
| 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: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cash Price |
$15,281.52
|
| Rate for Payer: Cofinity Commercial |
$16,427.63
|
| Rate for Payer: Cofinity Commercial |
$13,371.33
|
| 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 |
$16,236.62
|
| Rate for Payer: PHP Commercial |
$16,236.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,416.24
|
| Rate for Payer: Priority Health SBD |
$12,034.20
|
| Rate for Payer: UHC Core |
$700.00
|
| 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 |
$16,236.62
|
| 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 |
$16,236.62
|
| Rate for Payer: PHP Commercial |
$16,236.62
|
| 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
|
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 DES/CABG INITIAL
|
Facility
|
OP
|
$29,158.60
|
|
|
Service Code
|
CPT C9604
|
| Hospital Charge Code |
48100083
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,955.64 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna American Axle |
$18,953.09
|
| Rate for Payer: Aetna Commercial |
$24,784.81
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,953.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$10,432.38
|
| Rate for Payer: BCN Commercial |
$10,432.38
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$23,326.88
|
| 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 |
$11,111.26
|
| 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 |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,784.81
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$24,784.81
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,953.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$18,369.92
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,277.09
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$21,234.73
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: UMR Bronson Commercial |
$10,788.68
|
| Rate for Payer: VA VA |
$11,111.26
|
| 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 |
$26,706.02 |
| 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 |
$20,771.34
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.34
|
| 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 |
$1,879.00 |
| Max. Negotiated Rate |
$26,706.02 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna Medicare |
$14,836.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: BCBS Complete |
$11,869.34
|
| Rate for Payer: BCBS Trust/PPO |
$15,812.76
|
| Rate for Payer: BCN Commercial |
$15,812.76
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Commercial |
$20,771.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.34
|
| 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: UHC Core |
$1,879.00
|
| 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 |
$26,706.02 |
| 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 |
$20,771.34
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.34
|
| 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 |
$593.38 |
| Max. Negotiated Rate |
$26,706.02 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna Medicare |
$14,836.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: BCBS Complete |
$11,869.34
|
| Rate for Payer: BCBS Trust/PPO |
$593.38
|
| Rate for Payer: BCN Commercial |
$593.38
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Commercial |
$20,771.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.34
|
| 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: UHC All Payor (Choice/PPO) |
$698.98
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Exchange |
$635.44
|
| 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 |
$436.86 |
| Max. Negotiated Rate |
$20,210.02 |
| Rate for Payer: Aetna American Axle |
$10,415.76
|
| Rate for Payer: Aetna Commercial |
$13,620.60
|
| Rate for Payer: Aetna Medicare |
$6,687.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,415.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,037.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,037.75
|
| Rate for Payer: BCBS Complete |
$3,618.92
|
| Rate for Payer: BCBS MAPPO |
$6,430.20
|
| Rate for Payer: BCBS Trust/PPO |
$6,557.96
|
| Rate for Payer: BCN Commercial |
$6,557.96
|
| Rate for Payer: BCN Medicare Advantage |
$6,430.20
|
| Rate for Payer: Cash Price |
$12,819.39
|
| 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 |
$6,430.20
|
| 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 |
$3,446.59
|
| Rate for Payer: Mclaren Medicare |
$6,430.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,751.71
|
| Rate for Payer: Meridian Medicaid |
$3,618.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,394.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,620.60
|
| Rate for Payer: Nomi Health Commercial |
$13,503.42
|
| Rate for Payer: PACE Medicare |
$6,108.69
|
| Rate for Payer: PACE SWMI |
$6,430.20
|
| Rate for Payer: PHP Commercial |
$13,620.60
|
| Rate for Payer: PHP Medicare Advantage |
$6,430.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,446.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,415.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20,210.02
|
| Rate for Payer: Priority Health Medicare |
$6,430.20
|
| Rate for Payer: Priority Health Narrow Network |
$16,168.02
|
| Rate for Payer: Priority Health SBD |
$10,095.27
|
| Rate for Payer: Railroad Medicare Medicare |
$6,430.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.55
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,430.20
|
| Rate for Payer: UHC Exchange |
$436.86
|
| Rate for Payer: UHC Medicare Advantage |
$6,430.20
|
| Rate for Payer: UHCCP Medicaid |
$3,446.59
|
| Rate for Payer: UMR Bronson Commercial |
$5,928.97
|
| Rate for Payer: VA VA |
$6,430.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,018.18
|
|
|
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 REZUM DELIVERY DEVICE
|
Facility
|
OP
|
$3,111.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800149
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$2,799.90 |
| Rate for Payer: Aetna Medicare |
$1,555.50
|
| 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: BCBS Complete |
$1,244.40
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$2,488.80
|
| 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 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 KIDNEY TUMOR
|
Facility
|
OP
|
$7,557.46
|
|
|
Service Code
|
CPT 50592
|
| Hospital Charge Code |
36100247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$324.33 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$4,912.35
|
| Rate for Payer: Aetna Commercial |
$6,423.84
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,912.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$4,101.84
|
| Rate for Payer: BCN Commercial |
$4,101.84
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$6,045.97
|
| 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 |
$5,716.39
|
| 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 |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,423.84
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$6,423.84
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,912.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$4,761.20
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$356.76
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$324.33
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,796.26
|
| Rate for Payer: VA VA |
$5,716.39
|
| 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 |
$698.82 |
| Max. Negotiated Rate |
$17,966.53 |
| Rate for Payer: Aetna American Axle |
$3,825.82
|
| Rate for Payer: Aetna Commercial |
$5,002.99
|
| Rate for Payer: Aetna Medicare |
$5,945.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,825.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,145.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,145.49
|
| Rate for Payer: BCBS Complete |
$3,217.18
|
| Rate for Payer: BCBS MAPPO |
$5,716.39
|
| Rate for Payer: BCBS Trust/PPO |
$6,030.46
|
| Rate for Payer: BCN Commercial |
$6,030.46
|
| Rate for Payer: BCN Medicare Advantage |
$5,716.39
|
| Rate for Payer: Cash Price |
$4,708.70
|
| 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 |
$5,716.39
|
| 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 |
$3,063.99
|
| Rate for Payer: Mclaren Medicare |
$5,716.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,002.21
|
| Rate for Payer: Meridian Medicaid |
$3,217.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,573.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,002.99
|
| Rate for Payer: Nomi Health Commercial |
$12,004.42
|
| Rate for Payer: PACE Medicare |
$5,430.57
|
| Rate for Payer: PACE SWMI |
$5,716.39
|
| Rate for Payer: PHP Commercial |
$5,002.99
|
| Rate for Payer: PHP Medicare Advantage |
$5,716.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,063.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,825.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,966.53
|
| Rate for Payer: Priority Health Medicare |
$5,716.39
|
| Rate for Payer: Priority Health Narrow Network |
$14,373.22
|
| Rate for Payer: Priority Health SBD |
$3,708.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5,716.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$768.70
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,716.39
|
| Rate for Payer: UHC Exchange |
$698.82
|
| Rate for Payer: UHC Medicare Advantage |
$5,716.39
|
| Rate for Payer: UHCCP Medicaid |
$3,063.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,177.77
|
| Rate for Payer: VA VA |
$5,716.39
|
| 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
|
OP
|
$2,683.22
|
|
|
Service Code
|
CPT 64625
|
| Hospital Charge Code |
36100594
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$186.83 |
| Max. Negotiated Rate |
$6,013.44 |
| Rate for Payer: Aetna American Axle |
$1,744.09
|
| Rate for Payer: Aetna Commercial |
$2,280.74
|
| Rate for Payer: Aetna Medicare |
$1,989.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,744.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,391.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,391.60
|
| Rate for Payer: BCBS Complete |
$1,076.79
|
| Rate for Payer: BCBS MAPPO |
$1,913.28
|
| Rate for Payer: BCN Medicare Advantage |
$1,913.28
|
| Rate for Payer: Cash Price |
$2,146.58
|
| 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 |
$1,913.28
|
| 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 |
$2,012.42
|
| Rate for Payer: Mclaren Medicaid |
$1,025.52
|
| Rate for Payer: Mclaren Medicare |
$1,913.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,008.94
|
| Rate for Payer: Meridian Medicaid |
$1,076.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,200.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,280.74
|
| Rate for Payer: Nomi Health Commercial |
$4,017.89
|
| Rate for Payer: PACE Medicare |
$1,817.62
|
| Rate for Payer: PACE SWMI |
$1,913.28
|
| Rate for Payer: PHP Commercial |
$2,280.74
|
| Rate for Payer: PHP Medicare Advantage |
$1,913.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,025.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,744.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,013.44
|
| Rate for Payer: Priority Health Medicare |
$1,913.28
|
| Rate for Payer: Priority Health Narrow Network |
$4,810.75
|
| Rate for Payer: Priority Health SBD |
$1,690.43
|
| Rate for Payer: Railroad Medicare Medicare |
$1,913.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.51
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,913.28
|
| Rate for Payer: UHC Exchange |
$186.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,913.28
|
| Rate for Payer: UHCCP Medicaid |
$1,025.52
|
| Rate for Payer: UMR Bronson Commercial |
$992.79
|
| Rate for Payer: VA VA |
$1,913.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,012.42
|
|
|
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 |
$2,012.42
|
| 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 |
$2,012.42
|
|
|
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: PHP Commercial |
$1,520.24
|
| 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: 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
|
|
