|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
OP
|
$97.10
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$35.93 |
| Max. Negotiated Rate |
$470.43 |
| Rate for Payer: Aetna American Axle |
$63.12
|
| Rate for Payer: Aetna Commercial |
$82.53
|
| Rate for Payer: Aetna Medicare |
$173.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.90
|
| Rate for Payer: BCBS Complete |
$94.06
|
| Rate for Payer: BCBS MAPPO |
$167.12
|
| Rate for Payer: BCN Medicare Advantage |
$167.12
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cofinity Commercial |
$67.97
|
| Rate for Payer: Cofinity Commercial |
$83.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.12
|
| Rate for Payer: Healthscope Commercial |
$87.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.83
|
| Rate for Payer: Mclaren Medicaid |
$89.58
|
| Rate for Payer: Mclaren Medicare |
$167.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.48
|
| Rate for Payer: Meridian Medicaid |
$94.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.53
|
| Rate for Payer: PACE Medicare |
$158.76
|
| Rate for Payer: PACE SWMI |
$167.12
|
| Rate for Payer: PHP Commercial |
$82.53
|
| Rate for Payer: PHP Medicare Advantage |
$167.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: Priority Health Medicare |
$167.12
|
| Rate for Payer: Priority Health SBD |
$61.17
|
| Rate for Payer: Railroad Medicare Medicare |
$167.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.43
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.12
|
| Rate for Payer: UHC Exchange |
$319.38
|
| Rate for Payer: UHC Medicare Advantage |
$167.12
|
| Rate for Payer: UHCCP Medicaid |
$89.58
|
| Rate for Payer: UMR Bronson Commercial |
$35.93
|
| Rate for Payer: VA VA |
$167.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.83
|
|
|
HC SPLITTING BLOOD/BLOOD PROD EA UNIT
|
Facility
|
IP
|
$97.10
|
|
|
Service Code
|
CPT 86985
|
| Hospital Charge Code |
39000029
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$42.72 |
| Max. Negotiated Rate |
$87.39 |
| Rate for Payer: Aetna American Axle |
$63.12
|
| Rate for Payer: Aetna Commercial |
$82.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.12
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cofinity Commercial |
$67.97
|
| Rate for Payer: Cofinity Commercial |
$83.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.68
|
| Rate for Payer: Healthscope Commercial |
$87.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.53
|
| Rate for Payer: PHP Commercial |
$82.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: Priority Health SBD |
$61.17
|
| Rate for Payer: UMR Bronson Commercial |
$42.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.83
|
|
|
HC SPORE CHECK
|
Facility
|
IP
|
$23.26
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.23 |
| Max. Negotiated Rate |
$20.93 |
| Rate for Payer: Aetna American Axle |
$15.12
|
| Rate for Payer: Aetna Commercial |
$19.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.12
|
| Rate for Payer: Cash Price |
$18.61
|
| Rate for Payer: Cofinity Commercial |
$16.28
|
| Rate for Payer: Cofinity Commercial |
$20.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.61
|
| Rate for Payer: Healthscope Commercial |
$20.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.77
|
| Rate for Payer: PHP Commercial |
$19.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.12
|
| Rate for Payer: Priority Health SBD |
$14.65
|
| Rate for Payer: UMR Bronson Commercial |
$10.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.45
|
|
|
HC SPORE CHECK
|
Facility
|
OP
|
$23.26
|
|
| Hospital Charge Code |
30600180
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$20.93 |
| Rate for Payer: Aetna American Axle |
$15.12
|
| Rate for Payer: Aetna Commercial |
$19.77
|
| Rate for Payer: Aetna Medicare |
$11.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.12
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: Cash Price |
$18.61
|
| Rate for Payer: Cofinity Commercial |
$16.28
|
| Rate for Payer: Cofinity Commercial |
$20.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.61
|
| Rate for Payer: Healthscope Commercial |
$20.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.77
|
| Rate for Payer: PHP Commercial |
$19.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.12
|
| Rate for Payer: Priority Health SBD |
$14.65
|
| Rate for Payer: UMR Bronson Commercial |
$8.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.45
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
OP
|
$4,707.35
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,645.35 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$3,059.78
|
| Rate for Payer: Aetna Commercial |
$4,001.25
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,059.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,765.88
|
| Rate for Payer: Cash Price |
$3,765.88
|
| Rate for Payer: Cofinity Commercial |
$4,048.32
|
| Rate for Payer: Cofinity Commercial |
$3,295.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,295.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,765.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$4,236.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,295.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,530.51
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,001.25
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$4,001.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,059.78
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,965.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,741.72
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,530.51
|
|
|
HC SP REMOVAL IVC FILTER
|
Facility
|
IP
|
$4,707.35
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,071.23 |
| Max. Negotiated Rate |
$4,236.61 |
| Rate for Payer: Aetna American Axle |
$3,059.78
|
| Rate for Payer: Aetna Commercial |
$4,001.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,059.78
|
| Rate for Payer: Cash Price |
$3,765.88
|
| Rate for Payer: Cofinity Commercial |
$3,295.14
|
| Rate for Payer: Cofinity Commercial |
$4,048.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,295.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,765.88
|
| Rate for Payer: Healthscope Commercial |
$4,236.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,295.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,530.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,001.25
|
| Rate for Payer: PHP Commercial |
$4,001.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,059.78
|
| Rate for Payer: Priority Health SBD |
$2,965.63
|
| Rate for Payer: UMR Bronson Commercial |
$2,071.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,530.51
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
OP
|
$3,767.45
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,393.96 |
| Max. Negotiated Rate |
$7,528.73 |
| Rate for Payer: Aetna American Axle |
$2,448.84
|
| Rate for Payer: Aetna Commercial |
$3,202.33
|
| Rate for Payer: Aetna Medicare |
$2,781.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,448.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,343.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,343.25
|
| Rate for Payer: BCBS Complete |
$1,505.26
|
| Rate for Payer: BCBS MAPPO |
$2,674.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,674.60
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cofinity Commercial |
$3,240.01
|
| Rate for Payer: Cofinity Commercial |
$2,637.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,637.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,674.60
|
| Rate for Payer: Healthscope Commercial |
$3,390.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,637.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.59
|
| Rate for Payer: Mclaren Medicaid |
$1,433.59
|
| Rate for Payer: Mclaren Medicare |
$2,674.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,808.33
|
| Rate for Payer: Meridian Medicaid |
$1,505.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,075.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.33
|
| Rate for Payer: PACE Medicare |
$2,540.87
|
| Rate for Payer: PACE SWMI |
$2,674.60
|
| Rate for Payer: PHP Commercial |
$3,202.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,674.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,433.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.84
|
| Rate for Payer: Priority Health Medicare |
$2,674.60
|
| Rate for Payer: Priority Health SBD |
$2,373.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,674.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,528.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,674.60
|
| Rate for Payer: UHC Exchange |
$5,111.43
|
| Rate for Payer: UHC Medicare Advantage |
$2,674.60
|
| Rate for Payer: UHCCP Medicaid |
$1,433.59
|
| Rate for Payer: UMR Bronson Commercial |
$1,393.96
|
| Rate for Payer: VA VA |
$2,674.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.59
|
|
|
HC SP REPAIR ANAL FISTULA W FIBRN GL
|
Facility
|
IP
|
$3,767.45
|
|
|
Service Code
|
CPT 46706
|
| Hospital Charge Code |
36100316
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,657.68 |
| Max. Negotiated Rate |
$3,390.70 |
| Rate for Payer: Aetna American Axle |
$2,448.84
|
| Rate for Payer: Aetna Commercial |
$3,202.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,448.84
|
| Rate for Payer: Cash Price |
$3,013.96
|
| Rate for Payer: Cofinity Commercial |
$2,637.22
|
| Rate for Payer: Cofinity Commercial |
$3,240.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,637.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.96
|
| Rate for Payer: Healthscope Commercial |
$3,390.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,637.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.33
|
| Rate for Payer: PHP Commercial |
$3,202.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.84
|
| Rate for Payer: Priority Health SBD |
$2,373.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,657.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.59
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
IP
|
$4,279.41
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,882.94 |
| Max. Negotiated Rate |
$3,851.47 |
| Rate for Payer: Aetna American Axle |
$2,781.62
|
| Rate for Payer: Aetna Commercial |
$3,637.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,781.62
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cofinity Commercial |
$2,995.59
|
| Rate for Payer: Cofinity Commercial |
$3,680.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,995.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,423.53
|
| Rate for Payer: Healthscope Commercial |
$3,851.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,995.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,209.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,637.50
|
| Rate for Payer: PHP Commercial |
$3,637.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,781.62
|
| Rate for Payer: Priority Health SBD |
$2,696.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,882.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,209.56
|
|
|
HC SP REPOSITION IVC FILTER
|
Facility
|
OP
|
$4,279.41
|
|
|
Service Code
|
CPT 37192
|
| Hospital Charge Code |
36100352
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,583.38 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,781.62
|
| Rate for Payer: Aetna Commercial |
$3,637.50
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,781.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cash Price |
$3,423.53
|
| Rate for Payer: Cofinity Commercial |
$3,680.29
|
| Rate for Payer: Cofinity Commercial |
$2,995.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,995.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,423.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,851.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,995.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,209.56
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,637.50
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,637.50
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,781.62
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,696.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,583.38
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,209.56
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
OP
|
$696.30
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$103.87 |
| Max. Negotiated Rate |
$626.67 |
| Rate for Payer: Aetna American Axle |
$452.60
|
| Rate for Payer: Aetna Commercial |
$591.86
|
| Rate for Payer: Aetna Medicare |
$201.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$242.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$242.24
|
| Rate for Payer: BCBS Complete |
$109.07
|
| Rate for Payer: BCBS MAPPO |
$193.79
|
| Rate for Payer: BCN Medicare Advantage |
$193.79
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cofinity Commercial |
$598.82
|
| Rate for Payer: Cofinity Commercial |
$487.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$487.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$193.79
|
| Rate for Payer: Healthscope Commercial |
$626.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$487.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.23
|
| Rate for Payer: Mclaren Medicaid |
$103.87
|
| Rate for Payer: Mclaren Medicare |
$193.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$203.48
|
| Rate for Payer: Meridian Medicaid |
$109.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$222.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.86
|
| Rate for Payer: PACE Medicare |
$184.10
|
| Rate for Payer: PACE SWMI |
$193.79
|
| Rate for Payer: PHP Commercial |
$591.86
|
| Rate for Payer: PHP Medicare Advantage |
$193.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.60
|
| Rate for Payer: Priority Health Medicare |
$193.79
|
| Rate for Payer: Priority Health SBD |
$438.67
|
| Rate for Payer: Railroad Medicare Medicare |
$193.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$545.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$193.79
|
| Rate for Payer: UHC Exchange |
$370.35
|
| Rate for Payer: UHC Medicare Advantage |
$193.79
|
| Rate for Payer: UHCCP Medicaid |
$103.87
|
| Rate for Payer: UMR Bronson Commercial |
$257.63
|
| Rate for Payer: VA VA |
$193.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.23
|
|
|
HC SP UNLISTED PROC SKIN SUBCUT TISS
|
Facility
|
IP
|
$696.30
|
|
|
Service Code
|
CPT 17999
|
| Hospital Charge Code |
36100314
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$306.37 |
| Max. Negotiated Rate |
$626.67 |
| Rate for Payer: Aetna American Axle |
$452.60
|
| Rate for Payer: Aetna Commercial |
$591.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.60
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cofinity Commercial |
$487.41
|
| Rate for Payer: Cofinity Commercial |
$598.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$487.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$557.04
|
| Rate for Payer: Healthscope Commercial |
$626.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$487.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$522.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.86
|
| Rate for Payer: PHP Commercial |
$591.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.60
|
| Rate for Payer: Priority Health SBD |
$438.67
|
| Rate for Payer: UMR Bronson Commercial |
$306.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.23
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
OP
|
$1,096.38
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$405.66 |
| Max. Negotiated Rate |
$986.74 |
| Rate for Payer: Aetna American Axle |
$712.65
|
| Rate for Payer: Aetna Commercial |
$931.92
|
| Rate for Payer: Aetna Medicare |
$548.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.65
|
| Rate for Payer: BCBS Complete |
$438.55
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cofinity Commercial |
$767.47
|
| Rate for Payer: Cofinity Commercial |
$942.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.10
|
| Rate for Payer: Healthscope Commercial |
$986.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$767.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$931.92
|
| Rate for Payer: PHP Commercial |
$931.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.65
|
| Rate for Payer: Priority Health SBD |
$690.72
|
| Rate for Payer: UMR Bronson Commercial |
$405.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.28
|
|
|
HC SP XR INJ ARTHROGRAM ANKLE
|
Facility
|
IP
|
$1,096.38
|
|
|
Service Code
|
CPT 27648
|
| Hospital Charge Code |
36100317
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$482.41 |
| Max. Negotiated Rate |
$986.74 |
| Rate for Payer: Aetna American Axle |
$712.65
|
| Rate for Payer: Aetna Commercial |
$931.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.65
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cofinity Commercial |
$767.47
|
| Rate for Payer: Cofinity Commercial |
$942.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$767.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$877.10
|
| Rate for Payer: Healthscope Commercial |
$986.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$767.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$931.92
|
| Rate for Payer: PHP Commercial |
$931.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$712.65
|
| Rate for Payer: Priority Health SBD |
$690.72
|
| Rate for Payer: UMR Bronson Commercial |
$482.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.28
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
OP
|
$6,262.87
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,317.26 |
| Max. Negotiated Rate |
$5,636.58 |
| Rate for Payer: Aetna American Axle |
$4,070.87
|
| Rate for Payer: Aetna Commercial |
$5,323.44
|
| Rate for Payer: Aetna Medicare |
$3,131.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,070.87
|
| Rate for Payer: BCBS Complete |
$2,505.15
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cofinity Commercial |
$4,384.01
|
| Rate for Payer: Cofinity Commercial |
$5,386.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,384.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,010.30
|
| Rate for Payer: Healthscope Commercial |
$5,636.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,384.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,697.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,323.44
|
| Rate for Payer: PHP Commercial |
$5,323.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.87
|
| Rate for Payer: Priority Health SBD |
$3,945.61
|
| Rate for Payer: UMR Bronson Commercial |
$2,317.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,697.15
|
|
|
HC SPYGLASS CHOLANGIOSCOPY
|
Facility
|
IP
|
$6,262.87
|
|
| Hospital Charge Code |
36000086
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,755.66 |
| Max. Negotiated Rate |
$5,636.58 |
| Rate for Payer: Aetna American Axle |
$4,070.87
|
| Rate for Payer: Aetna Commercial |
$5,323.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,070.87
|
| Rate for Payer: Cash Price |
$5,010.30
|
| Rate for Payer: Cofinity Commercial |
$4,384.01
|
| Rate for Payer: Cofinity Commercial |
$5,386.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,384.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,010.30
|
| Rate for Payer: Healthscope Commercial |
$5,636.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,384.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,697.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,323.44
|
| Rate for Payer: PHP Commercial |
$5,323.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,070.87
|
| Rate for Payer: Priority Health SBD |
$3,945.61
|
| Rate for Payer: UMR Bronson Commercial |
$2,755.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,697.15
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
IP
|
$2,444.83
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,075.73 |
| Max. Negotiated Rate |
$2,200.35 |
| Rate for Payer: Aetna American Axle |
$1,589.14
|
| Rate for Payer: Aetna Commercial |
$2,078.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,589.14
|
| Rate for Payer: Cash Price |
$1,955.86
|
| Rate for Payer: Cofinity Commercial |
$1,711.38
|
| Rate for Payer: Cofinity Commercial |
$2,102.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,711.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,955.86
|
| Rate for Payer: Healthscope Commercial |
$2,200.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,711.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,833.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,078.11
|
| Rate for Payer: PHP Commercial |
$2,078.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,589.14
|
| Rate for Payer: Priority Health SBD |
$1,540.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,075.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,833.62
|
|
|
HC SPYGLASS FORCEPS
|
Facility
|
OP
|
$2,444.83
|
|
| Hospital Charge Code |
27200151
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$904.59 |
| Max. Negotiated Rate |
$2,200.35 |
| Rate for Payer: Aetna American Axle |
$1,589.14
|
| Rate for Payer: Aetna Commercial |
$2,078.11
|
| Rate for Payer: Aetna Medicare |
$1,222.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,589.14
|
| Rate for Payer: BCBS Complete |
$977.93
|
| Rate for Payer: Cash Price |
$1,955.86
|
| Rate for Payer: Cofinity Commercial |
$1,711.38
|
| Rate for Payer: Cofinity Commercial |
$2,102.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,711.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,955.86
|
| Rate for Payer: Healthscope Commercial |
$2,200.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,711.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,833.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,078.11
|
| Rate for Payer: PHP Commercial |
$2,078.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,589.14
|
| Rate for Payer: Priority Health SBD |
$1,540.24
|
| Rate for Payer: UMR Bronson Commercial |
$904.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,833.62
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,424.31 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,502.16
|
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Cofinity Commercial |
$2,694.64
|
| 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 |
$3,069.69
|
| 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 |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,425.17
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,424.31
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP Z ANGIO SUPERSEL ECT RENAL BIL
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,693.77 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna American Axle |
$2,502.16
|
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| 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: 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: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health SBD |
$2,425.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,693.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,424.31 |
| Max. Negotiated Rate |
$14,840.35 |
| Rate for Payer: Aetna American Axle |
$2,502.16
|
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$5,482.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,590.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,590.09
|
| Rate for Payer: BCBS Complete |
$2,967.12
|
| Rate for Payer: BCBS MAPPO |
$5,272.07
|
| Rate for Payer: BCN Medicare Advantage |
$5,272.07
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cash Price |
$3,079.58
|
| Rate for Payer: Cofinity Commercial |
$3,310.55
|
| Rate for Payer: Cofinity Commercial |
$2,694.64
|
| 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 |
$5,272.07
|
| 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 |
$2,825.83
|
| Rate for Payer: Mclaren Medicare |
$5,272.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,535.67
|
| Rate for Payer: Meridian Medicaid |
$2,967.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,062.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: PACE Medicare |
$5,008.47
|
| Rate for Payer: PACE SWMI |
$5,272.07
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: PHP Medicare Advantage |
$5,272.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,825.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health Medicare |
$5,272.07
|
| Rate for Payer: Priority Health SBD |
$2,425.17
|
| Rate for Payer: Railroad Medicare Medicare |
$5,272.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14,840.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,272.07
|
| Rate for Payer: UHC Exchange |
$10,075.45
|
| Rate for Payer: UHC Medicare Advantage |
$5,272.07
|
| Rate for Payer: UHCCP Medicaid |
$2,825.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,424.31
|
| Rate for Payer: VA VA |
$5,272.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP Z ANGIO SUPERSELECT RENAL UNI
|
Facility
|
IP
|
$3,849.48
|
|
|
Service Code
|
CPT 36253
|
| Hospital Charge Code |
36100349
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,693.77 |
| Max. Negotiated Rate |
$3,464.53 |
| Rate for Payer: Aetna American Axle |
$2,502.16
|
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| 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: 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: Multiplan/Beech St/PHCS Commercial |
$3,272.06
|
| Rate for Payer: PHP Commercial |
$3,272.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,502.16
|
| Rate for Payer: Priority Health SBD |
$2,425.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,693.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
IP
|
$414.53
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.39 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna American Axle |
$269.44
|
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.44
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$290.17
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health SBD |
$261.15
|
| Rate for Payer: UMR Bronson Commercial |
$182.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.90
|
|
|
HC SP Z EMBOLIZATION COIL BODY
|
Facility
|
OP
|
$414.53
|
|
| Hospital Charge Code |
27800058
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$153.38 |
| Max. Negotiated Rate |
$373.08 |
| Rate for Payer: Aetna American Axle |
$269.44
|
| Rate for Payer: Aetna Commercial |
$352.35
|
| Rate for Payer: Aetna Medicare |
$207.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.44
|
| Rate for Payer: BCBS Complete |
$165.81
|
| Rate for Payer: Cash Price |
$331.62
|
| Rate for Payer: Cofinity Commercial |
$290.17
|
| Rate for Payer: Cofinity Commercial |
$356.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$290.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.62
|
| Rate for Payer: Healthscope Commercial |
$373.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.35
|
| Rate for Payer: PHP Commercial |
$352.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$269.44
|
| Rate for Payer: Priority Health SBD |
$261.15
|
| Rate for Payer: UMR Bronson Commercial |
$153.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.90
|
|
|
HC SP Z EMBOLIZATION SPHERES
|
Facility
|
OP
|
$1,024.11
|
|
| Hospital Charge Code |
27800057
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$378.92 |
| Max. Negotiated Rate |
$921.70 |
| Rate for Payer: Aetna American Axle |
$665.67
|
| Rate for Payer: Aetna Commercial |
$870.49
|
| Rate for Payer: Aetna Medicare |
$512.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$665.67
|
| Rate for Payer: BCBS Complete |
$409.64
|
| Rate for Payer: Cash Price |
$819.29
|
| Rate for Payer: Cofinity Commercial |
$716.88
|
| Rate for Payer: Cofinity Commercial |
$880.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$716.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$819.29
|
| Rate for Payer: Healthscope Commercial |
$921.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$716.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$768.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$870.49
|
| Rate for Payer: PHP Commercial |
$870.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$665.67
|
| Rate for Payer: Priority Health SBD |
$645.19
|
| Rate for Payer: UMR Bronson Commercial |
$378.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$768.08
|
|
