|
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 |
$321.07 |
| Max. Negotiated Rate |
$16,646.50 |
| Rate for Payer: Aetna American Axle |
$7,128.05
|
| Rate for Payer: Aetna Commercial |
$9,321.30
|
| Rate for Payer: Aetna Medicare |
$5,508.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,128.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$5,682.62
|
| Rate for Payer: BCN Commercial |
$5,682.62
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$8,772.98
|
| Rate for Payer: Cash Price |
$8,772.98
|
| 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: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| 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 |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,321.30
|
| Rate for Payer: Nomi Health Commercial |
$15,889.20
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$9,321.30
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,128.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,646.50
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$13,317.20
|
| Rate for Payer: Priority Health SBD |
$6,908.72
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$353.18
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$321.07
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: UMR Bronson Commercial |
$4,057.51
|
| Rate for Payer: VA VA |
$5,296.40
|
| 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 |
$360.64 |
| Max. Negotiated Rate |
$16,646.50 |
| Rate for Payer: Aetna American Axle |
$8,385.95
|
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: Aetna Medicare |
$5,508.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,385.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$7,073.39
|
| Rate for Payer: BCN Commercial |
$7,073.39
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cash Price |
$10,321.17
|
| 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: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| 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 |
$9,676.10
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$15,889.20
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,646.50
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$13,317.20
|
| Rate for Payer: Priority Health SBD |
$8,127.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.70
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$360.64
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: UMR Bronson Commercial |
$4,773.54
|
| Rate for Payer: VA VA |
$5,296.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.10
|
|
|
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 |
$9,676.10
|
| 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 |
$9,676.10
|
|
|
HC SELECTIVE VERTEBRAL ARTERY UNI
|
Facility
|
IP
|
$12,901.46
|
|
|
Service Code
|
CPT 36226
|
| Hospital Charge Code |
36100381
|
|
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 |
$9,676.10
|
| 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 |
$9,676.10
|
|
|
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 |
$358.30 |
| Max. Negotiated Rate |
$16,646.50 |
| Rate for Payer: Aetna American Axle |
$8,385.95
|
| Rate for Payer: Aetna Commercial |
$10,966.24
|
| Rate for Payer: Aetna Medicare |
$5,508.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,385.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$9,991.93
|
| Rate for Payer: BCN Commercial |
$9,991.93
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$10,321.17
|
| Rate for Payer: Cash Price |
$10,321.17
|
| 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: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| 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 |
$9,676.10
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,966.24
|
| Rate for Payer: Nomi Health Commercial |
$15,889.20
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$10,966.24
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,385.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,646.50
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$13,317.20
|
| Rate for Payer: Priority Health SBD |
$8,127.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.13
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$358.30
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: UMR Bronson Commercial |
$4,773.54
|
| Rate for Payer: VA VA |
$5,296.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,676.10
|
|
|
HC SELECT SPECIALTY CATHETER INSERTION
|
Facility
|
OP
|
$1,686.32
|
|
| Hospital Charge Code |
36100565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$623.94 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna American Axle |
$1,096.11
|
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna Medicare |
$843.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.11
|
| Rate for Payer: BCBS Complete |
$674.53
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,180.42
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,180.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,180.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.37
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.11
|
| Rate for Payer: Priority Health SBD |
$1,062.38
|
| Rate for Payer: UMR Bronson Commercial |
$623.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC SELECT SPECIALTY CATHETER INSERTION
|
Facility
|
IP
|
$1,686.32
|
|
| Hospital Charge Code |
36100565
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$741.98 |
| Max. Negotiated Rate |
$1,517.69 |
| Rate for Payer: Aetna American Axle |
$1,096.11
|
| Rate for Payer: Aetna Commercial |
$1,433.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,096.11
|
| Rate for Payer: Cash Price |
$1,349.06
|
| Rate for Payer: Cofinity Commercial |
$1,180.42
|
| Rate for Payer: Cofinity Commercial |
$1,450.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,180.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,349.06
|
| Rate for Payer: Healthscope Commercial |
$1,517.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,180.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,264.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,433.37
|
| Rate for Payer: PHP Commercial |
$1,433.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,096.11
|
| Rate for Payer: Priority Health SBD |
$1,062.38
|
| Rate for Payer: UMR Bronson Commercial |
$741.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,264.74
|
|
|
HC SELENIUM LEVEL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
30100420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC SELENIUM LEVEL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84255
|
| Hospital Charge Code |
30100420
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.68 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$26.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.91
|
| Rate for Payer: BCBS Complete |
$14.37
|
| Rate for Payer: BCBS MAPPO |
$25.53
|
| Rate for Payer: BCBS Trust/PPO |
$24.60
|
| Rate for Payer: BCN Commercial |
$24.60
|
| Rate for Payer: BCN Medicare Advantage |
$25.53
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.53
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$13.68
|
| Rate for Payer: Mclaren Medicare |
$25.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.81
|
| Rate for Payer: Meridian Medicaid |
$14.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$38.30
|
| Rate for Payer: PACE Medicare |
$24.25
|
| Rate for Payer: PACE SWMI |
$25.53
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$25.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.53
|
| Rate for Payer: Priority Health Medicare |
$25.53
|
| Rate for Payer: Priority Health Narrow Network |
$20.42
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$25.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.53
|
| Rate for Payer: UHC Exchange |
$25.53
|
| Rate for Payer: UHC Medicare Advantage |
$25.53
|
| Rate for Payer: UHCCP Medicaid |
$13.68
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$25.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC SELF-ADMINISTRABLE DRUG
|
Facility
|
IP
|
$0.52
|
|
| Hospital Charge Code |
63700003
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.23 |
| Max. Negotiated Rate |
$0.47 |
| Rate for Payer: Aetna American Axle |
$0.34
|
| Rate for Payer: Aetna Commercial |
$0.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.34
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.36
|
| Rate for Payer: Cofinity Commercial |
$0.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.44
|
| Rate for Payer: PHP Commercial |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.34
|
| Rate for Payer: Priority Health SBD |
$0.33
|
| Rate for Payer: UMR Bronson Commercial |
$0.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.39
|
|
|
HC SELF-ADMINISTRABLE DRUG
|
Facility
|
OP
|
$0.52
|
|
| Hospital Charge Code |
63700003
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$0.47 |
| Rate for Payer: Aetna American Axle |
$0.34
|
| Rate for Payer: Aetna Commercial |
$0.44
|
| Rate for Payer: Aetna Medicare |
$0.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.34
|
| Rate for Payer: BCBS Complete |
$0.21
|
| Rate for Payer: Cash Price |
$0.42
|
| Rate for Payer: Cofinity Commercial |
$0.36
|
| Rate for Payer: Cofinity Commercial |
$0.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.42
|
| Rate for Payer: Healthscope Commercial |
$0.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.44
|
| Rate for Payer: PHP Commercial |
$0.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.34
|
| Rate for Payer: Priority Health SBD |
$0.33
|
| Rate for Payer: UMR Bronson Commercial |
$0.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.39
|
|
|
HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
94200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: UMR Bronson Commercial |
$21.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC SELF-MGMT EDUC & TRAIN 1 PT PER 30 MIN
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 98960
|
| Hospital Charge Code |
94200039
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$23.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: BCBS Complete |
$19.18
|
| Rate for Payer: BCBS Trust/PPO |
$126.84
|
| Rate for Payer: BCN Commercial |
$126.84
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$17.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC SEMEN EXAM FERTILITY
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
30000006
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$50.71 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna American Axle |
$74.92
|
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: UMR Bronson Commercial |
$50.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC SEMEN EXAM FERTILITY
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 89320
|
| Hospital Charge Code |
30000006
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Mclaren Medicare |
$12.31
|
| Rate for Payer: Aetna American Axle |
$74.92
|
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$12.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.39
|
| Rate for Payer: BCBS Complete |
$6.93
|
| Rate for Payer: BCBS MAPPO |
$12.31
|
| Rate for Payer: BCBS Trust/PPO |
$11.86
|
| Rate for Payer: BCN Commercial |
$11.86
|
| Rate for Payer: BCN Medicare Advantage |
$12.31
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.31
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Mclaren Medicaid |
$6.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.93
|
| Rate for Payer: Meridian Medicaid |
$6.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$18.46
|
| Rate for Payer: PACE Medicare |
$11.69
|
| Rate for Payer: PACE SWMI |
$12.31
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$12.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.40
|
| Rate for Payer: Priority Health Medicare |
$12.31
|
| Rate for Payer: Priority Health Narrow Network |
$9.92
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: Railroad Medicare Medicare |
$12.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.31
|
| Rate for Payer: UHC Exchange |
$12.31
|
| Rate for Payer: UHC Medicare Advantage |
$12.31
|
| Rate for Payer: UHCCP Medicaid |
$6.60
|
| Rate for Payer: UMR Bronson Commercial |
$42.65
|
| Rate for Payer: VA VA |
$12.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC SEMEN EXAM VASECTOMY
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
30000007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$28.46
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$11.61
|
| Rate for Payer: BCN Commercial |
$11.61
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$18.08
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.40
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$9.92
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC SEMEN EXAM VASECTOMY
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 89321
|
| Hospital Charge Code |
30000007
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.84 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: UMR Bronson Commercial |
$33.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC SENSOR CDI 550 ART SHUNT
|
Facility
|
OP
|
$382.50
|
|
| Hospital Charge Code |
27000655
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$141.52 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna American Axle |
$248.62
|
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna Medicare |
$191.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.62
|
| Rate for Payer: BCBS Complete |
$153.00
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$267.75
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health SBD |
$240.98
|
| Rate for Payer: UMR Bronson Commercial |
$141.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC SENSOR CDI 550 ART SHUNT
|
Facility
|
IP
|
$382.50
|
|
| Hospital Charge Code |
27000655
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$168.30 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna American Axle |
$248.62
|
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.62
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$267.75
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health SBD |
$240.98
|
| Rate for Payer: UMR Bronson Commercial |
$168.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC SENSOR PAD LEVEL DETECTOR
|
Facility
|
IP
|
$17.60
|
|
| Hospital Charge Code |
27000656
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.74 |
| Max. Negotiated Rate |
$15.84 |
| Rate for Payer: Aetna American Axle |
$11.44
|
| Rate for Payer: Aetna Commercial |
$14.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.44
|
| Rate for Payer: Cash Price |
$14.08
|
| Rate for Payer: Cofinity Commercial |
$12.32
|
| Rate for Payer: Cofinity Commercial |
$15.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.08
|
| Rate for Payer: Healthscope Commercial |
$15.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.96
|
| Rate for Payer: PHP Commercial |
$14.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.44
|
| Rate for Payer: Priority Health SBD |
$11.09
|
| Rate for Payer: UMR Bronson Commercial |
$7.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.20
|
|
|
HC SENSOR PAD LEVEL DETECTOR
|
Facility
|
OP
|
$17.60
|
|
| Hospital Charge Code |
27000656
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$15.84 |
| Rate for Payer: Aetna American Axle |
$11.44
|
| Rate for Payer: Aetna Commercial |
$14.96
|
| Rate for Payer: Aetna Medicare |
$8.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.44
|
| Rate for Payer: BCBS Complete |
$7.04
|
| Rate for Payer: Cash Price |
$14.08
|
| Rate for Payer: Cofinity Commercial |
$12.32
|
| Rate for Payer: Cofinity Commercial |
$15.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$12.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.08
|
| Rate for Payer: Healthscope Commercial |
$15.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.96
|
| Rate for Payer: PHP Commercial |
$14.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.44
|
| Rate for Payer: Priority Health SBD |
$11.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.20
|
|
|
HC SENSORS CEREBRAL OXIMETER
|
Facility
|
OP
|
$244.80
|
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.58 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna American Axle |
$159.12
|
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna Medicare |
$122.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: BCBS Complete |
$97.92
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health SBD |
$154.22
|
| Rate for Payer: UMR Bronson Commercial |
$90.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC SENSORS CEREBRAL OXIMETER
|
Facility
|
IP
|
$244.80
|
|
| Hospital Charge Code |
27000043
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$107.71 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Aetna American Axle |
$159.12
|
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health SBD |
$154.22
|
| Rate for Payer: UMR Bronson Commercial |
$107.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC SENSORY INTEGRATION
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
42000029
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$59.01
|
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna Medicare |
$45.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.01
|
| Rate for Payer: BCBS Complete |
$36.31
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.00
|
| Rate for Payer: Priority Health Narrow Network |
$22.40
|
| Rate for Payer: Priority Health SBD |
$57.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.00
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$57.27
|
| Rate for Payer: UMR Bronson Commercial |
$33.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC SENSORY INTEGRATION
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
42000029
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.94 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna American Axle |
$59.01
|
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.01
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.16
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.01
|
| Rate for Payer: Priority Health SBD |
$57.19
|
| Rate for Payer: UMR Bronson Commercial |
$39.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
