|
HC SNARE
|
Facility
|
IP
|
$1,289.24
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200071
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$567.27 |
| Max. Negotiated Rate |
$1,160.32 |
| Rate for Payer: Aetna American Axle |
$838.01
|
| Rate for Payer: Aetna Commercial |
$1,095.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.01
|
| Rate for Payer: Cash Price |
$1,031.39
|
| Rate for Payer: Cofinity Commercial |
$1,108.75
|
| Rate for Payer: Cofinity Commercial |
$902.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$902.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.39
|
| Rate for Payer: Healthscope Commercial |
$1,160.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$902.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$966.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.85
|
| Rate for Payer: PHP Commercial |
$1,095.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$838.01
|
| Rate for Payer: Priority Health SBD |
$812.22
|
| Rate for Payer: UMR Bronson Commercial |
$567.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$966.93
|
|
|
HC SNARE
|
Facility
|
OP
|
$1,289.24
|
|
|
Service Code
|
HCPCS C1773
|
| Hospital Charge Code |
27200071
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$477.02 |
| Max. Negotiated Rate |
$1,160.32 |
| Rate for Payer: Aetna American Axle |
$838.01
|
| Rate for Payer: Aetna Commercial |
$1,095.85
|
| Rate for Payer: Aetna Medicare |
$644.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$838.01
|
| Rate for Payer: BCBS Complete |
$515.70
|
| Rate for Payer: Cash Price |
$1,031.39
|
| Rate for Payer: Cofinity Commercial |
$1,108.75
|
| Rate for Payer: Cofinity Commercial |
$902.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$902.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,031.39
|
| Rate for Payer: Healthscope Commercial |
$1,160.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$902.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$966.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,095.85
|
| Rate for Payer: PHP Commercial |
$1,095.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$838.01
|
| Rate for Payer: Priority Health SBD |
$812.22
|
| Rate for Payer: UMR Bronson Commercial |
$477.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$966.93
|
|
|
HC SODIUM BICARBONATE 4.2% SOL
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600214
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$9.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC SODIUM BICARBONATE 4.2% SOL
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
63600214
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.93 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$10.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: BCBS Complete |
$8.57
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.92
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$7.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC SODIUM LEVEL
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.58 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.01
|
| Rate for Payer: BCBS Complete |
$2.71
|
| Rate for Payer: BCBS MAPPO |
$4.81
|
| Rate for Payer: BCN Medicare Advantage |
$4.81
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.81
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$2.58
|
| Rate for Payer: Mclaren Medicare |
$4.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.05
|
| Rate for Payer: Meridian Medicaid |
$2.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$7.22
|
| Rate for Payer: PACE Medicare |
$4.57
|
| Rate for Payer: PACE SWMI |
$4.81
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$4.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.81
|
| Rate for Payer: Priority Health Medicare |
$4.81
|
| Rate for Payer: Priority Health Narrow Network |
$3.85
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$4.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.81
|
| Rate for Payer: UHC Exchange |
$4.81
|
| Rate for Payer: UHC Medicare Advantage |
$4.81
|
| Rate for Payer: UHCCP Medicaid |
$2.58
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$4.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC SODIUM LEVEL
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 84295
|
| Hospital Charge Code |
30100423
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: UMR Bronson Commercial |
$9.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC SODIUM OTHER SOURCE
|
Facility
|
OP
|
$21.64
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
30100555
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.60 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna American Axle |
$14.07
|
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna Medicare |
$5.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.08
|
| Rate for Payer: BCBS Complete |
$2.74
|
| Rate for Payer: BCBS MAPPO |
$4.86
|
| Rate for Payer: BCBS Trust/PPO |
$4.69
|
| Rate for Payer: BCN Commercial |
$4.69
|
| Rate for Payer: BCN Medicare Advantage |
$4.86
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Cofinity Commercial |
$15.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.86
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Mclaren Medicaid |
$2.60
|
| Rate for Payer: Mclaren Medicare |
$4.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.10
|
| Rate for Payer: Meridian Medicaid |
$2.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$7.29
|
| Rate for Payer: PACE Medicare |
$4.62
|
| Rate for Payer: PACE SWMI |
$4.86
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: PHP Medicare Advantage |
$4.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.86
|
| Rate for Payer: Priority Health Medicare |
$4.86
|
| Rate for Payer: Priority Health Narrow Network |
$3.89
|
| Rate for Payer: Priority Health SBD |
$13.63
|
| Rate for Payer: Railroad Medicare Medicare |
$4.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.86
|
| Rate for Payer: UHC Exchange |
$4.86
|
| Rate for Payer: UHC Medicare Advantage |
$4.86
|
| Rate for Payer: UHCCP Medicaid |
$2.60
|
| Rate for Payer: UMR Bronson Commercial |
$8.01
|
| Rate for Payer: VA VA |
$4.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC SODIUM OTHER SOURCE
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 84302
|
| Hospital Charge Code |
30100555
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Cofinity Medicare Advantage |
$15.15
|
| Rate for Payer: Aetna American Axle |
$14.07
|
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Commercial |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.07
|
| Rate for Payer: Priority Health SBD |
$13.63
|
| Rate for Payer: UMR Bronson Commercial |
$9.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC SODIUM URINE
|
Facility
|
OP
|
$35.19
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
30100424
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$31.67 |
| Rate for Payer: Priority Health Medicare |
$5.06
|
| Rate for Payer: Priority Health Narrow Network |
$4.05
|
| Rate for Payer: Priority Health SBD |
$22.17
|
| Rate for Payer: Railroad Medicare Medicare |
$5.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.06
|
| Rate for Payer: UHC Exchange |
$5.06
|
| Rate for Payer: UHC Medicare Advantage |
$5.06
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: UMR Bronson Commercial |
$13.02
|
| Rate for Payer: VA VA |
$5.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.39
|
| Rate for Payer: Aetna American Axle |
$22.87
|
| Rate for Payer: Aetna Commercial |
$29.91
|
| Rate for Payer: Aetna Medicare |
$5.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.32
|
| Rate for Payer: BCBS Complete |
$2.85
|
| Rate for Payer: BCBS MAPPO |
$5.06
|
| Rate for Payer: BCBS Trust/PPO |
$4.88
|
| Rate for Payer: BCN Commercial |
$4.88
|
| Rate for Payer: BCN Medicare Advantage |
$5.06
|
| Rate for Payer: Cash Price |
$28.15
|
| Rate for Payer: Cash Price |
$28.15
|
| Rate for Payer: Cofinity Commercial |
$30.26
|
| Rate for Payer: Cofinity Commercial |
$24.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.06
|
| Rate for Payer: Healthscope Commercial |
$31.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.39
|
| Rate for Payer: Mclaren Medicaid |
$2.71
|
| Rate for Payer: Mclaren Medicare |
$5.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.31
|
| Rate for Payer: Meridian Medicaid |
$2.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.91
|
| Rate for Payer: Nomi Health Commercial |
$7.59
|
| Rate for Payer: PACE Medicare |
$4.81
|
| Rate for Payer: PACE SWMI |
$5.06
|
| Rate for Payer: PHP Commercial |
$29.91
|
| Rate for Payer: PHP Medicare Advantage |
$5.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.06
|
|
|
HC SODIUM URINE
|
Facility
|
IP
|
$35.19
|
|
|
Service Code
|
CPT 84300
|
| Hospital Charge Code |
30100424
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.48 |
| Max. Negotiated Rate |
$31.67 |
| Rate for Payer: Aetna American Axle |
$22.87
|
| Rate for Payer: Aetna Commercial |
$29.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.87
|
| Rate for Payer: Cash Price |
$28.15
|
| Rate for Payer: Cofinity Commercial |
$24.63
|
| Rate for Payer: Cofinity Commercial |
$30.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.15
|
| Rate for Payer: Healthscope Commercial |
$31.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.91
|
| Rate for Payer: PHP Commercial |
$29.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.87
|
| Rate for Payer: Priority Health SBD |
$22.17
|
| Rate for Payer: UMR Bronson Commercial |
$15.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.39
|
|
|
HC SOFTGOOD FOOT DROP PREVENT
|
Facility
|
OP
|
$195.19
|
|
| Hospital Charge Code |
27000148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$72.22 |
| Max. Negotiated Rate |
$175.67 |
| Rate for Payer: Cofinity Commercial |
$167.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$136.63
|
| Rate for Payer: Aetna American Axle |
$126.87
|
| Rate for Payer: Aetna Commercial |
$165.91
|
| Rate for Payer: Aetna Medicare |
$97.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.87
|
| Rate for Payer: BCBS Complete |
$78.08
|
| Rate for Payer: Cash Price |
$156.15
|
| Rate for Payer: Cofinity Commercial |
$136.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.15
|
| Rate for Payer: Healthscope Commercial |
$175.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.91
|
| Rate for Payer: PHP Commercial |
$165.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.87
|
| Rate for Payer: Priority Health SBD |
$122.97
|
| Rate for Payer: UMR Bronson Commercial |
$72.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.39
|
|
|
HC SOFTGOOD FOOT DROP PREVENT
|
Facility
|
IP
|
$195.19
|
|
| Hospital Charge Code |
27000148
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$85.88 |
| Max. Negotiated Rate |
$175.67 |
| Rate for Payer: Aetna American Axle |
$126.87
|
| Rate for Payer: Aetna Commercial |
$165.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.87
|
| Rate for Payer: Cash Price |
$156.15
|
| Rate for Payer: Cofinity Commercial |
$136.63
|
| Rate for Payer: Cofinity Commercial |
$167.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$136.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.15
|
| Rate for Payer: Healthscope Commercial |
$175.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$165.91
|
| Rate for Payer: PHP Commercial |
$165.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.87
|
| Rate for Payer: Priority Health SBD |
$122.97
|
| Rate for Payer: UMR Bronson Commercial |
$85.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.39
|
|
|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
OP
|
$161.54
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.77 |
| Max. Negotiated Rate |
$145.39 |
| Rate for Payer: Aetna American Axle |
$105.00
|
| Rate for Payer: Aetna Commercial |
$137.31
|
| Rate for Payer: Aetna Medicare |
$80.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.00
|
| Rate for Payer: BCBS Complete |
$64.62
|
| Rate for Payer: Cash Price |
$129.23
|
| Rate for Payer: Cofinity Commercial |
$113.08
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.23
|
| Rate for Payer: Healthscope Commercial |
$145.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.31
|
| Rate for Payer: PHP Commercial |
$137.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health SBD |
$101.77
|
| Rate for Payer: UMR Bronson Commercial |
$59.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.16
|
|
|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
IP
|
$161.54
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$71.08 |
| Max. Negotiated Rate |
$145.39 |
| Rate for Payer: Aetna American Axle |
$105.00
|
| Rate for Payer: Aetna Commercial |
$137.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.00
|
| Rate for Payer: Cash Price |
$129.23
|
| Rate for Payer: Cofinity Commercial |
$113.08
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$113.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.23
|
| Rate for Payer: Healthscope Commercial |
$145.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.31
|
| Rate for Payer: PHP Commercial |
$137.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health SBD |
$101.77
|
| Rate for Payer: UMR Bronson Commercial |
$71.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.16
|
|
|
HC SOFTGOOD SHOULDER PILLOW ABD
|
Facility
|
OP
|
$239.20
|
|
| Hospital Charge Code |
27000150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$88.50 |
| Max. Negotiated Rate |
$215.28 |
| Rate for Payer: Aetna American Axle |
$155.48
|
| Rate for Payer: Aetna Commercial |
$203.32
|
| Rate for Payer: Aetna Medicare |
$119.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.48
|
| Rate for Payer: BCBS Complete |
$95.68
|
| Rate for Payer: Cash Price |
$191.36
|
| Rate for Payer: Cofinity Commercial |
$167.44
|
| Rate for Payer: Cofinity Commercial |
$205.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$167.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.36
|
| Rate for Payer: Healthscope Commercial |
$215.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.32
|
| Rate for Payer: PHP Commercial |
$203.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.48
|
| Rate for Payer: Priority Health SBD |
$150.70
|
| Rate for Payer: UMR Bronson Commercial |
$88.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.40
|
|
|
HC SOFTGOOD SHOULDER PILLOW ABD
|
Facility
|
IP
|
$239.20
|
|
| Hospital Charge Code |
27000150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.25 |
| Max. Negotiated Rate |
$215.28 |
| Rate for Payer: Aetna American Axle |
$155.48
|
| Rate for Payer: Aetna Commercial |
$203.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.48
|
| Rate for Payer: Cash Price |
$191.36
|
| Rate for Payer: Cofinity Commercial |
$167.44
|
| Rate for Payer: Cofinity Commercial |
$205.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$167.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.36
|
| Rate for Payer: Healthscope Commercial |
$215.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.32
|
| Rate for Payer: PHP Commercial |
$203.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.48
|
| Rate for Payer: Priority Health SBD |
$150.70
|
| Rate for Payer: UMR Bronson Commercial |
$105.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.40
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
OP
|
$59.82
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$54.86 |
| Rate for Payer: Aetna American Axle |
$38.88
|
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: Aetna Medicare |
$38.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.71
|
| Rate for Payer: BCBS Complete |
$20.58
|
| Rate for Payer: BCBS MAPPO |
$36.57
|
| Rate for Payer: BCBS Trust/PPO |
$35.24
|
| Rate for Payer: BCN Commercial |
$35.24
|
| Rate for Payer: BCN Medicare Advantage |
$36.57
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$51.45
|
| Rate for Payer: Cofinity Commercial |
$41.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.57
|
| Rate for Payer: Healthscope Commercial |
$53.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.86
|
| Rate for Payer: Mclaren Medicaid |
$19.60
|
| Rate for Payer: Mclaren Medicare |
$36.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.40
|
| Rate for Payer: Meridian Medicaid |
$20.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: Nomi Health Commercial |
$54.86
|
| Rate for Payer: PACE Medicare |
$34.74
|
| Rate for Payer: PACE SWMI |
$36.57
|
| Rate for Payer: PHP Commercial |
$50.85
|
| Rate for Payer: PHP Medicare Advantage |
$36.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.62
|
| Rate for Payer: Priority Health Medicare |
$36.57
|
| Rate for Payer: Priority Health Narrow Network |
$30.10
|
| Rate for Payer: Priority Health SBD |
$37.69
|
| Rate for Payer: Railroad Medicare Medicare |
$36.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.57
|
| Rate for Payer: UHC Exchange |
$36.57
|
| Rate for Payer: UHC Medicare Advantage |
$36.57
|
| Rate for Payer: UHCCP Medicaid |
$19.60
|
| Rate for Payer: UMR Bronson Commercial |
$22.13
|
| Rate for Payer: VA VA |
$36.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.86
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
IP
|
$59.82
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.32 |
| Max. Negotiated Rate |
$53.84 |
| Rate for Payer: Aetna American Axle |
$38.88
|
| Rate for Payer: Aetna Commercial |
$50.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.88
|
| Rate for Payer: Cash Price |
$47.86
|
| Rate for Payer: Cofinity Commercial |
$41.87
|
| Rate for Payer: Cofinity Commercial |
$51.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.86
|
| Rate for Payer: Healthscope Commercial |
$53.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.85
|
| Rate for Payer: PHP Commercial |
$50.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.88
|
| Rate for Payer: Priority Health SBD |
$37.69
|
| Rate for Payer: UMR Bronson Commercial |
$26.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.86
|
|
|
HC SOMATOMEDIN
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna American Axle |
$35.84
|
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: UMR Bronson Commercial |
$24.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.36
|
|
|
HC SOMATOMEDIN
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna American Axle |
$35.84
|
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna Medicare |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.58
|
| Rate for Payer: BCBS Complete |
$11.97
|
| Rate for Payer: BCBS MAPPO |
$21.26
|
| Rate for Payer: BCBS Trust/PPO |
$20.49
|
| Rate for Payer: BCN Commercial |
$20.49
|
| Rate for Payer: BCN Medicare Advantage |
$21.26
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.26
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.36
|
| Rate for Payer: Mclaren Medicaid |
$11.40
|
| Rate for Payer: Mclaren Medicare |
$21.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.32
|
| Rate for Payer: Meridian Medicaid |
$11.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$31.89
|
| Rate for Payer: PACE Medicare |
$20.20
|
| Rate for Payer: PACE SWMI |
$21.26
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: PHP Medicare Advantage |
$21.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.26
|
| Rate for Payer: Priority Health Medicare |
$21.26
|
| Rate for Payer: Priority Health Narrow Network |
$17.01
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: Railroad Medicare Medicare |
$21.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.26
|
| Rate for Payer: UHC Exchange |
$21.26
|
| Rate for Payer: UHC Medicare Advantage |
$21.26
|
| Rate for Payer: UHCCP Medicaid |
$11.40
|
| Rate for Payer: UMR Bronson Commercial |
$20.40
|
| Rate for Payer: VA VA |
$21.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.36
|
|
|
HC SOYBEAN IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SOYBEAN IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
OP
|
$6,048.60
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna American Axle |
$3,931.59
|
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: Aetna Medicare |
$3,024.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,931.59
|
| Rate for Payer: BCBS Complete |
$2,419.44
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$4,234.02
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,234.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,234.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,536.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,141.31
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.59
|
| Rate for Payer: Priority Health SBD |
$3,810.62
|
| Rate for Payer: UMR Bronson Commercial |
$2,237.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,536.45
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
IP
|
$6,048.60
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,661.38 |
| Max. Negotiated Rate |
$5,443.74 |
| Rate for Payer: Aetna American Axle |
$3,931.59
|
| Rate for Payer: Aetna Commercial |
$5,141.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,931.59
|
| Rate for Payer: Cash Price |
$4,838.88
|
| Rate for Payer: Cofinity Commercial |
$4,234.02
|
| Rate for Payer: Cofinity Commercial |
$5,201.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,234.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,838.88
|
| Rate for Payer: Healthscope Commercial |
$5,443.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,234.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,536.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,141.31
|
| Rate for Payer: PHP Commercial |
$5,141.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,931.59
|
| Rate for Payer: Priority Health SBD |
$3,810.62
|
| Rate for Payer: UMR Bronson Commercial |
$2,661.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,536.45
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$343.55 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,502.16
|
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| 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 |
$2,204.75
|
| Rate for Payer: BCN Commercial |
$2,204.75
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$2,694.64
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,694.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,079.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$3,464.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,694.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,887.11
|
| 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 |
$3,272.06
|
| 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 |
$3,272.06
|
| 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 |
$2,502.16
|
| 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 |
$2,425.17
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$377.90
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$343.55
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,424.31
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
