|
HC SPLINT SHORT ARM STATIC
|
Facility
|
IP
|
$239.29
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$105.29 |
| Max. Negotiated Rate |
$215.36 |
| Rate for Payer: Aetna American Axle |
$155.54
|
| Rate for Payer: Aetna Commercial |
$203.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.54
|
| Rate for Payer: Cash Price |
$191.43
|
| Rate for Payer: Cofinity Commercial |
$167.50
|
| Rate for Payer: Cofinity Commercial |
$205.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$167.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.43
|
| Rate for Payer: Healthscope Commercial |
$215.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.40
|
| Rate for Payer: PHP Commercial |
$203.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.54
|
| Rate for Payer: Priority Health SBD |
$150.75
|
| Rate for Payer: UMR Bronson Commercial |
$105.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.47
|
|
|
HC SPLINT SHORT ARM STATIC
|
Facility
|
OP
|
$239.29
|
|
|
Service Code
|
CPT 29125
|
| Hospital Charge Code |
43000002
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$38.62 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$155.54
|
| Rate for Payer: Aetna Commercial |
$203.40
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$155.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$100.06
|
| Rate for Payer: BCN Commercial |
$100.06
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$191.43
|
| Rate for Payer: Cash Price |
$191.43
|
| Rate for Payer: Cash Price |
$191.43
|
| Rate for Payer: Cofinity Commercial |
$167.50
|
| Rate for Payer: Cofinity Commercial |
$205.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$167.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$191.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$215.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$167.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$179.47
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$203.40
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$203.40
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$155.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$150.75
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.48
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$38.62
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$88.54
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$179.47
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
IP
|
$377.75
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$166.21 |
| Max. Negotiated Rate |
$339.98 |
| Rate for Payer: Aetna American Axle |
$245.54
|
| Rate for Payer: Aetna Commercial |
$321.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.54
|
| Rate for Payer: Cash Price |
$302.20
|
| Rate for Payer: Cofinity Commercial |
$264.42
|
| Rate for Payer: Cofinity Commercial |
$324.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$264.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.20
|
| Rate for Payer: Healthscope Commercial |
$339.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$264.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.09
|
| Rate for Payer: PHP Commercial |
$321.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.54
|
| Rate for Payer: Priority Health SBD |
$237.98
|
| Rate for Payer: UMR Bronson Commercial |
$166.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.31
|
|
|
HC SPLINT SHORT LEG
|
Facility
|
OP
|
$377.75
|
|
|
Service Code
|
CPT 29515
|
| Hospital Charge Code |
70000013
|
|
Hospital Revenue Code
|
700
|
| Min. Negotiated Rate |
$47.82 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$245.54
|
| Rate for Payer: Aetna Commercial |
$321.09
|
| Rate for Payer: Aetna Medicare |
$160.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$193.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$193.25
|
| Rate for Payer: BCBS Complete |
$87.01
|
| Rate for Payer: BCBS MAPPO |
$154.60
|
| Rate for Payer: BCBS Trust/PPO |
$110.39
|
| Rate for Payer: BCN Commercial |
$110.39
|
| Rate for Payer: BCN Medicare Advantage |
$154.60
|
| Rate for Payer: Cash Price |
$302.20
|
| Rate for Payer: Cash Price |
$302.20
|
| Rate for Payer: Cash Price |
$302.20
|
| Rate for Payer: Cofinity Commercial |
$324.86
|
| Rate for Payer: Cofinity Commercial |
$264.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$264.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$302.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$154.60
|
| Rate for Payer: Healthscope Commercial |
$339.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$264.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.31
|
| Rate for Payer: Mclaren Medicaid |
$82.87
|
| Rate for Payer: Mclaren Medicare |
$154.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$162.33
|
| Rate for Payer: Meridian Medicaid |
$87.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$177.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$321.09
|
| Rate for Payer: Nomi Health Commercial |
$324.66
|
| Rate for Payer: PACE Medicare |
$146.87
|
| Rate for Payer: PACE SWMI |
$154.60
|
| Rate for Payer: PHP Commercial |
$321.09
|
| Rate for Payer: PHP Medicare Advantage |
$154.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$245.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$485.91
|
| Rate for Payer: Priority Health Medicare |
$154.60
|
| Rate for Payer: Priority Health Narrow Network |
$388.73
|
| Rate for Payer: Priority Health SBD |
$237.98
|
| Rate for Payer: Railroad Medicare Medicare |
$154.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.60
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$154.60
|
| Rate for Payer: UHC Exchange |
$47.82
|
| Rate for Payer: UHC Medicare Advantage |
$154.60
|
| Rate for Payer: UHCCP Medicaid |
$82.87
|
| Rate for Payer: UMR Bronson Commercial |
$139.77
|
| Rate for Payer: VA VA |
$154.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.31
|
|
|
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 |
$82.54
|
| 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 |
$72.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.54
|
| Rate for Payer: PHP Commercial |
$82.54
|
| 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 |
$72.82
|
|
|
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 |
$11.81 |
| Max. Negotiated Rate |
$527.71 |
| Rate for Payer: Aetna American Axle |
$63.12
|
| Rate for Payer: Aetna Commercial |
$82.54
|
| Rate for Payer: Aetna Medicare |
$174.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$11.81
|
| Rate for Payer: BCN Commercial |
$11.81
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| 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 |
$167.90
|
| 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 |
$72.82
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.54
|
| Rate for Payer: Nomi Health Commercial |
$503.70
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$82.54
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.71
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$422.17
|
| Rate for Payer: Priority Health SBD |
$61.17
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$472.62
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$320.87
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: UMR Bronson Commercial |
$35.93
|
| Rate for Payer: VA VA |
$167.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.82
|
|
|
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 |
$17.44
|
| 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 |
$17.44
|
|
|
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 |
$17.44
|
| 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 |
$17.44
|
|
|
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 |
$4,236.62 |
| 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 |
$4,236.62
|
| 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 REMOVAL IVC FILTER
|
Facility
|
OP
|
$4,707.35
|
|
|
Service Code
|
CPT 37193
|
| Hospital Charge Code |
36100353
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$330.77 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$3,059.78
|
| Rate for Payer: Aetna Commercial |
$4,001.25
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,059.78
|
| 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 |
$2,944.10
|
| Rate for Payer: BCN Commercial |
$2,944.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,765.88
|
| 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 |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,236.62
|
| 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 |
$1,652.95
|
| 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 |
$4,001.25
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$4,001.25
|
| 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 |
$3,059.78
|
| 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 |
$2,965.63
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$363.85
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$330.77
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,741.72
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,530.51
|
|
|
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 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 |
$175.00 |
| Max. Negotiated Rate |
$8,445.02 |
| Rate for Payer: Aetna American Axle |
$2,448.84
|
| Rate for Payer: Aetna Commercial |
$3,202.33
|
| Rate for Payer: Aetna Medicare |
$2,794.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,448.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,358.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,358.68
|
| Rate for Payer: BCBS Complete |
$1,512.21
|
| Rate for Payer: BCBS MAPPO |
$2,686.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.18
|
| Rate for Payer: BCN Commercial |
$1,735.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,686.94
|
| Rate for Payer: Cash Price |
$3,013.96
|
| 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 |
$2,686.94
|
| 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 |
$1,440.20
|
| Rate for Payer: Mclaren Medicare |
$2,686.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,821.29
|
| Rate for Payer: Meridian Medicaid |
$1,512.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,089.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.33
|
| Rate for Payer: Nomi Health Commercial |
$5,642.57
|
| Rate for Payer: PACE Medicare |
$2,552.59
|
| Rate for Payer: PACE SWMI |
$2,686.94
|
| Rate for Payer: PHP Commercial |
$3,202.33
|
| Rate for Payer: PHP Medicare Advantage |
$2,686.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,440.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,445.02
|
| Rate for Payer: Priority Health Medicare |
$2,686.94
|
| Rate for Payer: Priority Health Narrow Network |
$6,756.02
|
| Rate for Payer: Priority Health SBD |
$2,373.49
|
| Rate for Payer: Railroad Medicare Medicare |
$2,686.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.50
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,686.94
|
| Rate for Payer: UHC Exchange |
$175.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,686.94
|
| Rate for Payer: UHCCP Medicaid |
$1,440.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,393.96
|
| Rate for Payer: VA VA |
$2,686.94
|
| 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 |
$335.50 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,781.62
|
| Rate for Payer: Aetna Commercial |
$3,637.50
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,781.62
|
| 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 |
$3,423.53
|
| 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 |
$3,083.86
|
| 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 |
$1,652.95
|
| 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 |
$3,637.50
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,637.50
|
| 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 |
$2,781.62
|
| 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 |
$2,696.03
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.05
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$335.50
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,583.38
|
| Rate for Payer: VA VA |
$3,083.86
|
| 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 |
$104.35 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$452.60
|
| Rate for Payer: Aetna Commercial |
$591.86
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$452.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$143.02
|
| Rate for Payer: BCN Commercial |
$143.02
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$557.04
|
| Rate for Payer: Cash Price |
$557.04
|
| 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: Health Alliance Plan Medicare Advantage |
$194.68
|
| 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 |
$522.22
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$591.86
|
| Rate for Payer: Nomi Health Commercial |
$584.04
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$591.86
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$452.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$438.67
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$548.00
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$372.05
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: UMR Bronson Commercial |
$257.63
|
| Rate for Payer: VA VA |
$194.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$522.22
|
|
|
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 |
$522.22
|
| 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 |
$522.22
|
|
|
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 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 |
$49.64 |
| 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: BCBS Trust/PPO |
$595.06
|
| Rate for Payer: BCN Commercial |
$595.06
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cash Price |
$877.10
|
| Rate for Payer: Cofinity Commercial |
$942.89
|
| Rate for Payer: Cofinity Commercial |
$767.47
|
| 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: UHC All Payor (Choice/PPO) |
$54.60
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$49.64
|
| Rate for Payer: UMR Bronson Commercial |
$405.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.28
|
|
|
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: Cash Price |
$5,010.30
|
| 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: 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 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 |
$3,131.44
|
| 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 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 |
$1,222.42
|
| 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 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 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 SUPERSEL ECT RENAL BIL
|
Facility
|
OP
|
$3,849.48
|
|
|
Service Code
|
CPT 36254
|
| Hospital Charge Code |
36100350
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$400.51 |
| 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) |
$440.56
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$400.51
|
| 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
|
|
|
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 |
$335.77 |
| Max. Negotiated Rate |
$16,646.50 |
| Rate for Payer: Aetna American Axle |
$2,502.16
|
| Rate for Payer: Aetna Commercial |
$3,272.06
|
| Rate for Payer: Aetna Medicare |
$5,508.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,502.16
|
| 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 |
$2,750.97
|
| Rate for Payer: BCN Commercial |
$2,750.97
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| 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 |
$5,296.40
|
| 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 |
$2,838.87
|
| 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 |
$3,272.06
|
| 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 |
$3,272.06
|
| 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 |
$2,502.16
|
| 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 |
$2,425.17
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$369.35
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$335.77
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,424.31
|
| Rate for Payer: VA VA |
$5,296.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,887.11
|
|
