|
HC SCL70 SCLERODERMA AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| 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: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC SCL70 SCLERODERMA AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200161
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$31.65 |
| 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: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| 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: Nomi Health Commercial |
$26.90
|
| 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 HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| 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
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
IP
|
$2,550.48
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,122.21 |
| Max. Negotiated Rate |
$2,295.43 |
| Rate for Payer: Aetna American Axle |
$1,657.81
|
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.81
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$1,785.34
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,785.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,785.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.81
|
| Rate for Payer: Priority Health SBD |
$1,606.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,122.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.86
|
|
|
HC SCLEROTHERAPY OF FLUID COLLECTION
|
Facility
|
OP
|
$2,550.48
|
|
|
Service Code
|
CPT 49185
|
| Hospital Charge Code |
36100501
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$113.27 |
| Max. Negotiated Rate |
$4,989.41 |
| Rate for Payer: Aetna American Axle |
$1,657.81
|
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: Aetna Medicare |
$1,650.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,984.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,984.35
|
| Rate for Payer: BCBS Complete |
$893.43
|
| Rate for Payer: BCBS MAPPO |
$1,587.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,509.65
|
| Rate for Payer: BCN Commercial |
$1,509.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,587.48
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Cofinity Commercial |
$1,785.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,785.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,587.48
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,785.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.86
|
| Rate for Payer: Mclaren Medicaid |
$850.89
|
| Rate for Payer: Mclaren Medicare |
$1,587.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,666.85
|
| Rate for Payer: Meridian Medicaid |
$893.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,825.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$3,333.71
|
| Rate for Payer: PACE Medicare |
$1,508.11
|
| Rate for Payer: PACE SWMI |
$1,587.48
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,587.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$850.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,989.41
|
| Rate for Payer: Priority Health Medicare |
$1,587.48
|
| Rate for Payer: Priority Health Narrow Network |
$3,991.53
|
| Rate for Payer: Priority Health SBD |
$1,606.80
|
| Rate for Payer: Railroad Medicare Medicare |
$1,587.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.60
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,587.48
|
| Rate for Payer: UHC Exchange |
$113.27
|
| Rate for Payer: UHC Medicare Advantage |
$1,587.48
|
| Rate for Payer: UHCCP Medicaid |
$850.89
|
| Rate for Payer: UMR Bronson Commercial |
$943.68
|
| Rate for Payer: VA VA |
$1,587.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.86
|
|
|
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 |
$12.86 |
| Max. Negotiated Rate |
$75.43 |
| Rate for Payer: Aetna American Axle |
$51.08
|
| Rate for Payer: Aetna Commercial |
$66.80
|
| Rate for Payer: Aetna Medicare |
$24.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.99
|
| Rate for Payer: BCBS Complete |
$13.50
|
| Rate for Payer: BCBS MAPPO |
$23.99
|
| Rate for Payer: BCBS Trust/PPO |
$53.82
|
| Rate for Payer: BCCCP Commercial |
$17.38
|
| Rate for Payer: BCN Commercial |
$53.82
|
| Rate for Payer: BCN Medicare Advantage |
$23.99
|
| 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 |
$23.99
|
| 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 |
$12.86
|
| Rate for Payer: Mclaren Medicare |
$23.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.19
|
| Rate for Payer: Meridian Medicaid |
$13.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.80
|
| Rate for Payer: Nomi Health Commercial |
$71.97
|
| Rate for Payer: PACE Medicare |
$22.79
|
| Rate for Payer: PACE SWMI |
$23.99
|
| Rate for Payer: PHP Commercial |
$66.80
|
| Rate for Payer: PHP Medicare Advantage |
$23.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$75.43
|
| Rate for Payer: Priority Health Medicare |
$23.99
|
| Rate for Payer: Priority Health Narrow Network |
$60.34
|
| Rate for Payer: Priority Health SBD |
$49.51
|
| Rate for Payer: Railroad Medicare Medicare |
$23.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.99
|
| Rate for Payer: UHC Exchange |
$17.36
|
| Rate for Payer: UHC Medicare Advantage |
$23.99
|
| Rate for Payer: UHCCP Medicaid |
$12.86
|
| Rate for Payer: UMR Bronson Commercial |
$29.08
|
| Rate for Payer: VA VA |
$23.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.94
|
|
|
HC SCREENING TOMOSYNTHESIS
|
Facility
|
OP
|
$103.21
|
|
|
Service Code
|
CPT 77063
|
| Hospital Charge Code |
32000301
|
|
Hospital Revenue Code
|
403
|
| Min. Negotiated Rate |
$20.38 |
| 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: BCBS Trust/PPO |
$49.26
|
| Rate for Payer: BCCCP Commercial |
$49.44
|
| Rate for Payer: BCN Commercial |
$49.26
|
| Rate for Payer: Cash Price |
$82.57
|
| 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 HMO/PPO/Tiered Network |
$25.48
|
| Rate for Payer: Priority Health Narrow Network |
$20.38
|
| Rate for Payer: Priority Health SBD |
$65.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.39
|
| Rate for Payer: UHC Core |
$332.00
|
| Rate for Payer: UHC Exchange |
$48.54
|
| Rate for Payer: UMR Bronson Commercial |
$38.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.41
|
|
|
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 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 |
$278.65 |
| 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 |
$540.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,671.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,589.88
|
| Rate for Payer: BCN Commercial |
$1,589.88
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| 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 |
$519.87
|
| 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 |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,186.36
|
| Rate for Payer: Nomi Health Commercial |
$1,559.61
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$2,186.36
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,671.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,633.95
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,307.16
|
| Rate for Payer: Priority Health SBD |
$1,620.48
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$430.62
|
| Rate for Payer: UHC Core |
$4,571.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$391.47
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: UMR Bronson Commercial |
$951.71
|
| Rate for Payer: VA VA |
$519.87
|
| 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 |
$534.30 |
| 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 |
$1,036.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,314.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,695.02
|
| Rate for Payer: BCN Commercial |
$1,695.02
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| 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 |
$996.82
|
| 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 |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,026.33
|
| Rate for Payer: Nomi Health Commercial |
$2,990.46
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$3,026.33
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,314.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,132.99
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,506.39
|
| Rate for Payer: Priority Health SBD |
$2,243.05
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$624.54
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$567.76
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,317.34
|
| Rate for Payer: VA VA |
$996.82
|
| 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 |
$534.30 |
| 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 |
$1,036.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,558.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,773.93
|
| Rate for Payer: BCN Commercial |
$1,773.93
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| 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 |
$996.82
|
| 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 |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,345.79
|
| Rate for Payer: Nomi Health Commercial |
$2,990.46
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$3,345.79
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,558.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,132.99
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,506.39
|
| Rate for Payer: Priority Health SBD |
$2,479.82
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$652.94
|
| Rate for Payer: UHC Core |
$1,633.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$593.58
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,456.40
|
| Rate for Payer: VA VA |
$996.82
|
| 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: BCBS Trust/PPO |
$2.61
|
| Rate for Payer: BCN Commercial |
$2.61
|
| 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 |
$2.84
|
| 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: Nomi Health Commercial |
$4.05
|
| 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 HMO/PPO/Tiered Network |
$2.78
|
| Rate for Payer: Priority Health Medicare |
$2.70
|
| Rate for Payer: Priority Health Narrow Network |
$2.22
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.70
|
| Rate for Payer: UHC Exchange |
$2.70
|
| 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
|
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 |
$4,470.34 |
| 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 |
$3,476.94
|
| Rate for Payer: Cofinity Commercial |
$4,271.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,476.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Healthscope Commercial |
$4,470.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,476.94
|
| 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 EACH INTRACRANIAL UNI
|
Facility
|
OP
|
$4,967.05
|
|
|
Service Code
|
CPT 36228
|
| Hospital Charge Code |
36100386
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$244.20 |
| Max. Negotiated Rate |
$5,244.28 |
| Rate for Payer: Aetna American Axle |
$3,228.58
|
| Rate for Payer: Aetna Commercial |
$4,221.99
|
| Rate for Payer: Aetna Medicare |
$2,483.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,228.58
|
| Rate for Payer: BCBS Complete |
$1,986.82
|
| Rate for Payer: BCBS Trust/PPO |
$5,244.28
|
| Rate for Payer: BCN Commercial |
$5,244.28
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cash Price |
$3,973.64
|
| Rate for Payer: Cofinity Commercial |
$4,271.66
|
| Rate for Payer: Cofinity Commercial |
$3,476.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,476.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,973.64
|
| Rate for Payer: Healthscope Commercial |
$4,470.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,476.94
|
| 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: UHC All Payor (Choice/PPO) |
$268.62
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$244.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,837.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,725.29
|
|
|
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 |
$118.29 |
| Max. Negotiated Rate |
$5,171.67 |
| Rate for Payer: Aetna American Axle |
$3,735.10
|
| Rate for Payer: Aetna Commercial |
$4,884.36
|
| Rate for Payer: Aetna Medicare |
$2,873.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,735.10
|
| Rate for Payer: BCBS Complete |
$2,298.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,041.90
|
| Rate for Payer: BCN Commercial |
$1,041.90
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cash Price |
$4,597.04
|
| Rate for Payer: Cofinity Commercial |
$4,941.82
|
| Rate for Payer: Cofinity Commercial |
$4,022.41
|
| 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 |
$4,309.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,884.36
|
| Rate for Payer: PHP Commercial |
$4,884.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,735.10
|
| Rate for Payer: Priority Health SBD |
$3,620.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.12
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$118.29
|
| Rate for Payer: UMR Bronson Commercial |
$2,126.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,309.72
|
|
|
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 |
$3,735.10
|
| Rate for Payer: Aetna Commercial |
$4,884.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,735.10
|
| 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 |
$4,309.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,884.36
|
| Rate for Payer: PHP Commercial |
$4,884.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,735.10
|
| 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 |
$4,309.72
|
|
|
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 EXTRACRANIAL ARTERY UNI
|
Facility
|
OP
|
$9,547.08
|
|
|
Service Code
|
CPT 36222
|
| Hospital Charge Code |
36100377
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$277.71 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$6,205.60
|
| Rate for Payer: Aetna Commercial |
$8,115.02
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,205.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,525.16
|
| Rate for Payer: BCN Commercial |
$2,525.16
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$7,637.66
|
| Rate for Payer: Cash Price |
$7,637.66
|
| 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: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| 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 |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,115.02
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$8,115.02
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,205.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$6,014.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.48
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$277.71
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$3,532.42
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,160.31
|
|
|
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
|
|
