|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
IP
|
$78.59
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$34.58 |
| Max. Negotiated Rate |
$70.73 |
| Rate for Payer: Aetna American Axle |
$51.08
|
| Rate for Payer: Aetna Commercial |
$66.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.08
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$55.01
|
| Rate for Payer: Cofinity Commercial |
$67.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.87
|
| Rate for Payer: Healthscope Commercial |
$70.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: PHP Commercial |
$66.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: Priority Health SBD |
$49.51
|
| Rate for Payer: UMR Bronson Commercial |
$34.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.94
|
|
|
HC SCREENING PAP SMEAR, OBTAIN PREP TO LAB
|
Facility
|
OP
|
$78.59
|
|
|
Service Code
|
CPT Q0091
|
| Hospital Charge Code |
31100043
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$70.73 |
| Rate for Payer: Aetna American Axle |
$51.08
|
| Rate for Payer: Aetna Commercial |
$66.80
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cash Price |
$62.87
|
| Rate for Payer: Cofinity Commercial |
$67.59
|
| Rate for Payer: Cofinity Commercial |
$55.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$70.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.94
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$66.80
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health SBD |
$49.51
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$45.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: UMR Bronson Commercial |
$29.08
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.94
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
IP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$45.41 |
| Max. Negotiated Rate |
$92.89 |
| Rate for Payer: Aetna American Axle |
$67.09
|
| Rate for Payer: Aetna Commercial |
$87.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.09
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$72.25
|
| Rate for Payer: Cofinity Commercial |
$88.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$92.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: PHP Commercial |
$87.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health SBD |
$65.02
|
| Rate for Payer: UMR Bronson Commercial |
$45.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.41
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$38.19 |
| Max. Negotiated Rate |
$332.00 |
| Rate for Payer: Aetna American Axle |
$67.09
|
| Rate for Payer: Aetna Commercial |
$87.73
|
| Rate for Payer: Aetna Medicare |
$51.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.09
|
| Rate for Payer: BCBS Complete |
$41.28
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cash Price |
$82.57
|
| Rate for Payer: Cofinity Commercial |
$88.76
|
| Rate for Payer: Cofinity Commercial |
$72.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.57
|
| Rate for Payer: Healthscope Commercial |
$92.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.73
|
| Rate for Payer: PHP Commercial |
$87.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.09
|
| Rate for Payer: Priority Health SBD |
$65.02
|
| Rate for Payer: UHC Core |
$332.00
|
| Rate for Payer: UMR Bronson Commercial |
$38.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.41
|
|
|
HC SDL MSLT/MWT
|
Facility
|
IP
|
$2,572.19
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,131.76 |
| Max. Negotiated Rate |
$2,314.97 |
| Rate for Payer: Aetna American Axle |
$1,671.92
|
| Rate for Payer: Aetna Commercial |
$2,186.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.92
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cofinity Commercial |
$1,800.53
|
| Rate for Payer: Cofinity Commercial |
$2,212.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,800.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.75
|
| Rate for Payer: Healthscope Commercial |
$2,314.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,800.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,929.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: PHP Commercial |
$2,186.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: Priority Health SBD |
$1,620.48
|
| Rate for Payer: UMR Bronson Commercial |
$1,131.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.14
|
|
|
HC SDL MSLT/MWT
|
Facility
|
OP
|
$2,572.19
|
|
|
Service Code
|
CPT 95805
|
| Hospital Charge Code |
92000005
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$4,571.00 |
| Rate for Payer: Aetna American Axle |
$1,671.92
|
| Rate for Payer: Aetna Commercial |
$2,186.36
|
| Rate for Payer: Aetna Medicare |
$538.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cash Price |
$2,057.75
|
| Rate for Payer: Cofinity Commercial |
$1,800.53
|
| Rate for Payer: Cofinity Commercial |
$2,212.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,800.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,057.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$2,314.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,800.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,929.14
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$2,186.36
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health SBD |
$1,620.48
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.65
|
| Rate for Payer: UHC Core |
$4,571.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$988.96
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$277.37
|
| Rate for Payer: UMR Bronson Commercial |
$951.71
|
| Rate for Payer: VA VA |
$517.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,929.14
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
OP
|
$3,560.39
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$531.84 |
| Max. Negotiated Rate |
$3,204.35 |
| Rate for Payer: Aetna American Axle |
$2,314.25
|
| Rate for Payer: Aetna Commercial |
$3,026.33
|
| Rate for Payer: Aetna Medicare |
$1,031.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,314.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,240.30
|
| Rate for Payer: BCBS Complete |
$558.43
|
| Rate for Payer: BCBS MAPPO |
$992.24
|
| Rate for Payer: BCN Medicare Advantage |
$992.24
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cofinity Commercial |
$2,492.27
|
| Rate for Payer: Cofinity Commercial |
$3,061.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,492.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.24
|
| Rate for Payer: Healthscope Commercial |
$3,204.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,492.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,670.29
|
| Rate for Payer: Mclaren Medicaid |
$531.84
|
| Rate for Payer: Mclaren Medicare |
$992.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.85
|
| Rate for Payer: Meridian Medicaid |
$558.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,141.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: PACE Medicare |
$942.63
|
| Rate for Payer: PACE SWMI |
$992.24
|
| Rate for Payer: PHP Commercial |
$3,026.33
|
| Rate for Payer: PHP Medicare Advantage |
$992.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: Priority Health Medicare |
$992.24
|
| Rate for Payer: Priority Health SBD |
$2,243.05
|
| Rate for Payer: Railroad Medicare Medicare |
$992.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,793.06
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.24
|
| Rate for Payer: UHC Exchange |
$1,896.27
|
| Rate for Payer: UHC Medicare Advantage |
$992.24
|
| Rate for Payer: UHCCP Medicaid |
$531.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,317.34
|
| Rate for Payer: VA VA |
$992.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,670.29
|
|
|
HC SDL POLYSOMNOGRAPHY
|
Facility
|
IP
|
$3,560.39
|
|
|
Service Code
|
CPT 95810
|
| Hospital Charge Code |
74000001
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,566.57 |
| Max. Negotiated Rate |
$3,204.35 |
| Rate for Payer: Aetna American Axle |
$2,314.25
|
| Rate for Payer: Aetna Commercial |
$3,026.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,314.25
|
| Rate for Payer: Cash Price |
$2,848.31
|
| Rate for Payer: Cofinity Commercial |
$2,492.27
|
| Rate for Payer: Cofinity Commercial |
$3,061.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,492.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,848.31
|
| Rate for Payer: Healthscope Commercial |
$3,204.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,492.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,670.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: PHP Commercial |
$3,026.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: Priority Health SBD |
$2,243.05
|
| Rate for Payer: UMR Bronson Commercial |
$1,566.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,670.29
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
IP
|
$3,936.22
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$1,731.94 |
| Max. Negotiated Rate |
$3,542.60 |
| Rate for Payer: Aetna American Axle |
$2,558.54
|
| Rate for Payer: Aetna Commercial |
$3,345.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,558.54
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cofinity Commercial |
$2,755.35
|
| Rate for Payer: Cofinity Commercial |
$3,385.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,755.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,148.98
|
| Rate for Payer: Healthscope Commercial |
$3,542.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,755.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,952.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: PHP Commercial |
$3,345.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: Priority Health SBD |
$2,479.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,731.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,952.16
|
|
|
HC SDL PSG WITH CPAP/BIPAP
|
Facility
|
OP
|
$3,936.22
|
|
|
Service Code
|
CPT 95811
|
| Hospital Charge Code |
74000002
|
|
Hospital Revenue Code
|
740
|
| Min. Negotiated Rate |
$531.84 |
| Max. Negotiated Rate |
$3,542.60 |
| Rate for Payer: Aetna American Axle |
$2,558.54
|
| Rate for Payer: Aetna Commercial |
$3,345.79
|
| Rate for Payer: Aetna Medicare |
$1,031.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,558.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,240.30
|
| Rate for Payer: BCBS Complete |
$558.43
|
| Rate for Payer: BCBS MAPPO |
$992.24
|
| Rate for Payer: BCN Medicare Advantage |
$992.24
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cash Price |
$3,148.98
|
| Rate for Payer: Cofinity Commercial |
$2,755.35
|
| Rate for Payer: Cofinity Commercial |
$3,385.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,755.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,148.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.24
|
| Rate for Payer: Healthscope Commercial |
$3,542.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,755.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,952.16
|
| Rate for Payer: Mclaren Medicaid |
$531.84
|
| Rate for Payer: Mclaren Medicare |
$992.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.85
|
| Rate for Payer: Meridian Medicaid |
$558.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,141.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: PACE Medicare |
$942.63
|
| Rate for Payer: PACE SWMI |
$992.24
|
| Rate for Payer: PHP Commercial |
$3,345.79
|
| Rate for Payer: PHP Medicare Advantage |
$992.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: Priority Health Medicare |
$992.24
|
| Rate for Payer: Priority Health SBD |
$2,479.82
|
| Rate for Payer: Railroad Medicare Medicare |
$992.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,793.06
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.24
|
| Rate for Payer: UHC Exchange |
$1,896.27
|
| Rate for Payer: UHC Medicare Advantage |
$992.24
|
| Rate for Payer: UHCCP Medicaid |
$531.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,456.40
|
| Rate for Payer: VA VA |
$992.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,952.16
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
IP
|
$734.88
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$323.35 |
| Max. Negotiated Rate |
$661.39 |
| Rate for Payer: Aetna American Axle |
$477.67
|
| Rate for Payer: Aetna Commercial |
$624.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.67
|
| Rate for Payer: Cash Price |
$587.90
|
| Rate for Payer: Cofinity Commercial |
$514.42
|
| Rate for Payer: Cofinity Commercial |
$632.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$514.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.90
|
| Rate for Payer: Healthscope Commercial |
$661.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$514.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.65
|
| Rate for Payer: PHP Commercial |
$624.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.67
|
| Rate for Payer: Priority Health SBD |
$462.97
|
| Rate for Payer: UMR Bronson Commercial |
$323.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.16
|
|
|
HC SEDATION IV / IM OR INHALANT
|
Facility
|
OP
|
$734.88
|
|
| Hospital Charge Code |
37000005
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$271.91 |
| Max. Negotiated Rate |
$661.39 |
| Rate for Payer: Aetna American Axle |
$477.67
|
| Rate for Payer: Aetna Commercial |
$624.65
|
| Rate for Payer: Aetna Medicare |
$367.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$477.67
|
| Rate for Payer: BCBS Complete |
$293.95
|
| Rate for Payer: Cash Price |
$587.90
|
| Rate for Payer: Cofinity Commercial |
$514.42
|
| Rate for Payer: Cofinity Commercial |
$632.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$514.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$587.90
|
| Rate for Payer: Healthscope Commercial |
$661.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$514.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$551.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$624.65
|
| Rate for Payer: PHP Commercial |
$624.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$477.67
|
| Rate for Payer: Priority Health SBD |
$462.97
|
| Rate for Payer: UMR Bronson Commercial |
$271.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$551.16
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$6.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC SED RATE WESTERGREN
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 85652
|
| Hospital Charge Code |
30500060
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$2.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.38
|
| Rate for Payer: BCBS Complete |
$1.52
|
| Rate for Payer: BCBS MAPPO |
$2.70
|
| Rate for Payer: BCN Medicare Advantage |
$2.70
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Cofinity Commercial |
$10.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.70
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Mclaren Medicaid |
$1.45
|
| Rate for Payer: Mclaren Medicare |
$2.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.83
|
| Rate for Payer: Meridian Medicaid |
$1.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: PACE Medicare |
$2.56
|
| Rate for Payer: PACE SWMI |
$2.70
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$2.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.15
|
| Rate for Payer: Priority Health Medicare |
$2.70
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.70
|
| Rate for Payer: UHC Exchange |
$5.16
|
| Rate for Payer: UHC Medicare Advantage |
$2.70
|
| Rate for Payer: UHCCP Medicaid |
$1.45
|
| Rate for Payer: UMR Bronson Commercial |
$5.78
|
| Rate for Payer: VA VA |
$2.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
OP
|
$4,967.05
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,837.81 |
| Max. Negotiated Rate |
$4,470.35 |
| Rate for Payer: Aetna American Axle |
$3,228.58
|
| Rate for Payer: Aetna Commercial |
$4,221.99
|
| Rate for Payer: Aetna Medicare |
$2,483.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,228.58
|
| Rate for Payer: BCBS Complete |
$1,986.82
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cofinity Commercial |
$3,476.93
|
| Rate for Payer: Cofinity Commercial |
$4,271.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,476.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Healthscope Commercial |
$4,470.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,476.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,725.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,221.99
|
| Rate for Payer: PHP Commercial |
$4,221.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,228.58
|
| Rate for Payer: Priority Health SBD |
$3,129.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,837.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,725.29
|
|
|
HC SELECTIVE EACH INTRACRANIAL UNI
|
Facility
|
IP
|
$4,967.05
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,185.50 |
| Max. Negotiated Rate |
$4,470.35 |
| Rate for Payer: Aetna American Axle |
$3,228.58
|
| Rate for Payer: Aetna Commercial |
$4,221.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,228.58
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cofinity Commercial |
$3,476.93
|
| Rate for Payer: Cofinity Commercial |
$4,271.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,476.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Healthscope Commercial |
$4,470.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,476.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,725.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,221.99
|
| Rate for Payer: PHP Commercial |
$4,221.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,228.58
|
| Rate for Payer: Priority Health SBD |
$3,129.24
|
| Rate for Payer: UMR Bronson Commercial |
$2,185.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,725.29
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
IP
|
$5,746.30
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,528.37 |
| Max. Negotiated Rate |
$5,171.67 |
| Rate for Payer: Aetna American Axle |
$3,735.09
|
| Rate for Payer: Aetna Commercial |
$4,884.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,735.09
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cofinity Commercial |
$4,022.41
|
| Rate for Payer: Cofinity Commercial |
$4,941.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,022.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,597.04
|
| Rate for Payer: Healthscope Commercial |
$5,171.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,022.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,309.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,884.35
|
| Rate for Payer: PHP Commercial |
$4,884.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,735.09
|
| Rate for Payer: Priority Health SBD |
$3,620.17
|
| Rate for Payer: UMR Bronson Commercial |
$2,528.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,309.73
|
|
|
HC SELECTIVE EXTERNAL CAROTID UNI
|
Facility
|
OP
|
$5,746.30
|
|
|
Service Code
|
CPT 36227
|
| Hospital Charge Code |
36100382
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,126.13 |
| Max. Negotiated Rate |
$5,171.67 |
| Rate for Payer: Aetna American Axle |
$3,735.09
|
| Rate for Payer: Aetna Commercial |
$4,884.35
|
| Rate for Payer: Aetna Medicare |
$2,873.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,735.09
|
| Rate for Payer: BCBS Complete |
$2,298.52
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cofinity Commercial |
$4,022.41
|
| Rate for Payer: Cofinity Commercial |
$4,941.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,022.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,597.04
|
| Rate for Payer: Healthscope Commercial |
$5,171.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,022.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,309.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,884.35
|
| Rate for Payer: PHP Commercial |
$4,884.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,735.09
|
| Rate for Payer: Priority Health SBD |
$3,620.17
|
| Rate for Payer: UMR Bronson Commercial |
$2,126.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,309.73
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$9,547.08
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$6,205.60
|
| Rate for Payer: Aetna Commercial |
$8,115.02
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,205.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cofinity Commercial |
$8,210.49
|
| Rate for Payer: Cofinity Commercial |
$6,682.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,682.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,637.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$8,592.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,682.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,160.31
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,115.02
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$8,115.02
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,205.60
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$6,014.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$3,532.42
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,160.31
|
|
|
HC SELECTIVE EXTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$9,547.08
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,200.72 |
| Max. Negotiated Rate |
$8,592.37 |
| Rate for Payer: Aetna American Axle |
$6,205.60
|
| Rate for Payer: Aetna Commercial |
$8,115.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,205.60
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cofinity Commercial |
$6,682.96
|
| Rate for Payer: Cofinity Commercial |
$8,210.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,682.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,637.66
|
| Rate for Payer: Healthscope Commercial |
$8,592.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,682.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,160.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,115.02
|
| Rate for Payer: PHP Commercial |
$8,115.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,205.60
|
| Rate for Payer: Priority Health SBD |
$6,014.66
|
| Rate for Payer: UMR Bronson Commercial |
$4,200.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,160.31
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$10,966.23
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna American Axle |
$7,128.05
|
| Rate for Payer: Aetna Commercial |
$9,321.30
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,128.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cofinity Commercial |
$9,430.96
|
| Rate for Payer: Cofinity Commercial |
$7,676.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,676.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,772.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$9,869.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,676.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,224.67
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,321.30
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$9,321.30
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,128.05
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$6,908.72
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$10,075.45
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: UMR Bronson Commercial |
$4,057.51
|
| Rate for Payer: VA VA |
$5,272.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,224.67
|
|
|
HC SELECTIVE EXTRA/INTRACRANIAL ARTERY UNI
|
Facility
|
IP
|
$10,966.23
|
|
|
Service Code
|
CPT 36223
|
| Hospital Charge Code |
36100378
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,825.14 |
| Max. Negotiated Rate |
$9,869.61 |
| Rate for Payer: Aetna American Axle |
$7,128.05
|
| Rate for Payer: Aetna Commercial |
$9,321.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,128.05
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cofinity Commercial |
$7,676.36
|
| Rate for Payer: Cofinity Commercial |
$9,430.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,676.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,772.98
|
| Rate for Payer: Healthscope Commercial |
$9,869.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,676.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,224.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,321.30
|
| Rate for Payer: PHP Commercial |
$9,321.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,128.05
|
| Rate for Payer: Priority Health SBD |
$6,908.72
|
| Rate for Payer: UMR Bronson Commercial |
$4,825.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,224.67
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
OP
|
$12,901.46
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna American Axle |
$8,385.95
|
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,385.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$9,031.02
|
| Rate for Payer: Cofinity Commercial |
$11,095.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,031.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$11,611.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,031.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,676.09
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$8,127.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$10,075.45
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: UMR Bronson Commercial |
$4,773.54
|
| Rate for Payer: VA VA |
$5,272.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.09
|
|
|
HC SELECTIVE INTRACRANIAL ART UNI
|
Facility
|
IP
|
$12,901.46
|
|
|
Service Code
|
CPT 36224
|
| Hospital Charge Code |
36100385
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,676.64 |
| Max. Negotiated Rate |
$11,611.31 |
| Rate for Payer: Aetna American Axle |
$8,385.95
|
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,385.95
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$11,095.26
|
| Rate for Payer: Cofinity Commercial |
$9,031.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,031.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Healthscope Commercial |
$11,611.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,031.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,676.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health SBD |
$8,127.92
|
| Rate for Payer: UMR Bronson Commercial |
$5,676.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.09
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
OP
|
$12,901.46
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,825.83 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna American Axle |
$8,385.95
|
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,385.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cofinity Commercial |
$9,031.02
|
| Rate for Payer: Cofinity Commercial |
$11,095.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,031.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,321.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,272.07
|
| Rate for Payer: Healthscope Commercial |
$11,611.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,031.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,676.09
|
| Rate for Payer: Mclaren Medicaid |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$8,127.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$10,075.45
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: UMR Bronson Commercial |
$4,773.54
|
| Rate for Payer: VA VA |
$5,272.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.09
|
|
