|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna American Axle |
$72.93
|
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.93
|
| Rate for Payer: Priority Health SBD |
$70.69
|
| Rate for Payer: UMR Bronson Commercial |
$49.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$41.51 |
| Max. Negotiated Rate |
$396.95 |
| Rate for Payer: Aetna American Axle |
$72.93
|
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| 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 |
$109.82
|
| Rate for Payer: BCN Commercial |
$109.82
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Cofinity Commercial |
$78.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| 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 |
$95.37
|
| 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 |
$95.37
|
| 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 |
$72.93
|
| 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 |
$70.69
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$75.15
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$41.51
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
OP
|
$933.30
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$345.32 |
| Max. Negotiated Rate |
$839.97 |
| Rate for Payer: Aetna American Axle |
$606.64
|
| Rate for Payer: Aetna Commercial |
$793.30
|
| Rate for Payer: Aetna Medicare |
$466.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.64
|
| Rate for Payer: BCBS Complete |
$373.32
|
| Rate for Payer: Cash Price |
$746.64
|
| Rate for Payer: Cofinity Commercial |
$653.31
|
| Rate for Payer: Cofinity Commercial |
$802.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$653.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.64
|
| Rate for Payer: Healthscope Commercial |
$839.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$653.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.30
|
| Rate for Payer: PHP Commercial |
$793.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.64
|
| Rate for Payer: Priority Health SBD |
$587.98
|
| Rate for Payer: UMR Bronson Commercial |
$345.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.98
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
IP
|
$933.30
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$410.65 |
| Max. Negotiated Rate |
$839.97 |
| Rate for Payer: Aetna American Axle |
$606.64
|
| Rate for Payer: Aetna Commercial |
$793.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$606.64
|
| Rate for Payer: Cash Price |
$746.64
|
| Rate for Payer: Cofinity Commercial |
$653.31
|
| Rate for Payer: Cofinity Commercial |
$802.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$653.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$746.64
|
| Rate for Payer: Healthscope Commercial |
$839.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$653.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$699.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$793.30
|
| Rate for Payer: PHP Commercial |
$793.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$606.64
|
| Rate for Payer: Priority Health SBD |
$587.98
|
| Rate for Payer: UMR Bronson Commercial |
$410.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$699.98
|
|
|
HC STACLOT LA.
|
Facility
|
OP
|
$148.92
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.64 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna American Axle |
$96.80
|
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: Aetna Medicare |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: BCBS Complete |
$10.12
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$17.33
|
| Rate for Payer: BCN Commercial |
$17.33
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Cofinity Commercial |
$104.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Mclaren Medicaid |
$9.64
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: Meridian Medicaid |
$10.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: Nomi Health Commercial |
$26.97
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.98
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health Narrow Network |
$14.38
|
| Rate for Payer: Priority Health SBD |
$93.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.98
|
| Rate for Payer: UHC Exchange |
$17.98
|
| Rate for Payer: UHC Medicare Advantage |
$17.98
|
| Rate for Payer: UHCCP Medicaid |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$55.10
|
| Rate for Payer: VA VA |
$17.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC STACLOT LA.
|
Facility
|
IP
|
$148.92
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$65.52 |
| Max. Negotiated Rate |
$134.03 |
| Rate for Payer: Aetna American Axle |
$96.80
|
| Rate for Payer: Aetna Commercial |
$126.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.80
|
| Rate for Payer: Cash Price |
$119.14
|
| Rate for Payer: Cofinity Commercial |
$104.24
|
| Rate for Payer: Cofinity Commercial |
$128.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.14
|
| Rate for Payer: Healthscope Commercial |
$134.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.58
|
| Rate for Payer: PHP Commercial |
$126.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.80
|
| Rate for Payer: Priority Health SBD |
$93.82
|
| Rate for Payer: UMR Bronson Commercial |
$65.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.69
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
OP
|
$2,417.64
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$894.53 |
| Max. Negotiated Rate |
$2,175.88 |
| Rate for Payer: Aetna American Axle |
$1,571.47
|
| Rate for Payer: Aetna Commercial |
$2,054.99
|
| Rate for Payer: Aetna Medicare |
$1,208.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.47
|
| Rate for Payer: BCBS Complete |
$967.06
|
| Rate for Payer: Cash Price |
$1,934.11
|
| Rate for Payer: Cofinity Commercial |
$1,692.35
|
| Rate for Payer: Cofinity Commercial |
$2,079.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,692.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,934.11
|
| Rate for Payer: Healthscope Commercial |
$2,175.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,692.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,813.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,054.99
|
| Rate for Payer: PHP Commercial |
$2,054.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.47
|
| Rate for Payer: Priority Health SBD |
$1,523.11
|
| Rate for Payer: UMR Bronson Commercial |
$894.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,813.23
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
IP
|
$2,417.64
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,063.76 |
| Max. Negotiated Rate |
$2,175.88 |
| Rate for Payer: Aetna American Axle |
$1,571.47
|
| Rate for Payer: Aetna Commercial |
$2,054.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,571.47
|
| Rate for Payer: Cash Price |
$1,934.11
|
| Rate for Payer: Cofinity Commercial |
$1,692.35
|
| Rate for Payer: Cofinity Commercial |
$2,079.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,692.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,934.11
|
| Rate for Payer: Healthscope Commercial |
$2,175.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,692.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,813.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,054.99
|
| Rate for Payer: PHP Commercial |
$2,054.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,571.47
|
| Rate for Payer: Priority Health SBD |
$1,523.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,063.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,813.23
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$36.46
|
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.68
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$35.34
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$20.76
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.68 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna American Axle |
$36.46
|
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.68
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.46
|
| Rate for Payer: Priority Health SBD |
$35.34
|
| Rate for Payer: UMR Bronson Commercial |
$24.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
IP
|
$61.69
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.14 |
| Max. Negotiated Rate |
$55.52 |
| Rate for Payer: Aetna American Axle |
$40.10
|
| Rate for Payer: Aetna Commercial |
$52.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.10
|
| Rate for Payer: Cash Price |
$49.35
|
| Rate for Payer: Cofinity Commercial |
$43.18
|
| Rate for Payer: Cofinity Commercial |
$53.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.35
|
| Rate for Payer: Healthscope Commercial |
$55.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.44
|
| Rate for Payer: PHP Commercial |
$52.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.10
|
| Rate for Payer: Priority Health SBD |
$38.86
|
| Rate for Payer: UMR Bronson Commercial |
$27.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.27
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
OP
|
$61.69
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$55.52 |
| Rate for Payer: Aetna American Axle |
$40.10
|
| Rate for Payer: Aetna Commercial |
$52.44
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$49.35
|
| Rate for Payer: Cash Price |
$49.35
|
| Rate for Payer: Cofinity Commercial |
$53.05
|
| Rate for Payer: Cofinity Commercial |
$43.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$55.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.27
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.44
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$52.44
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$38.86
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$22.83
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.27
|
|
|
HC STATLOCK
|
Facility
|
IP
|
$143.69
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.22 |
| Max. Negotiated Rate |
$129.32 |
| Rate for Payer: Aetna American Axle |
$93.40
|
| Rate for Payer: Aetna Commercial |
$122.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.40
|
| Rate for Payer: Cash Price |
$114.95
|
| Rate for Payer: Cofinity Commercial |
$100.58
|
| Rate for Payer: Cofinity Commercial |
$123.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.95
|
| Rate for Payer: Healthscope Commercial |
$129.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.14
|
| Rate for Payer: PHP Commercial |
$122.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.40
|
| Rate for Payer: Priority Health SBD |
$90.52
|
| Rate for Payer: UMR Bronson Commercial |
$63.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.77
|
|
|
HC STATLOCK
|
Facility
|
OP
|
$143.69
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$53.17 |
| Max. Negotiated Rate |
$129.32 |
| Rate for Payer: Aetna American Axle |
$93.40
|
| Rate for Payer: Aetna Commercial |
$122.14
|
| Rate for Payer: Aetna Medicare |
$71.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.40
|
| Rate for Payer: BCBS Complete |
$57.48
|
| Rate for Payer: Cash Price |
$114.95
|
| Rate for Payer: Cofinity Commercial |
$100.58
|
| Rate for Payer: Cofinity Commercial |
$123.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.95
|
| Rate for Payer: Healthscope Commercial |
$129.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$122.14
|
| Rate for Payer: PHP Commercial |
$122.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.40
|
| Rate for Payer: Priority Health SBD |
$90.52
|
| Rate for Payer: UMR Bronson Commercial |
$53.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.77
|
|
|
HC STENGER TEST PURE TONE
|
Facility
|
OP
|
$34.68
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$12.83 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$22.54
|
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$87.38
|
| Rate for Payer: BCN Commercial |
$87.38
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$24.28
|
| Rate for Payer: Cofinity Commercial |
$29.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.01
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.48
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$21.85
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.77
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$18.88
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: UMR Bronson Commercial |
$12.83
|
| Rate for Payer: VA VA |
$58.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC STENGER TEST PURE TONE
|
Facility
|
IP
|
$34.68
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$15.26 |
| Max. Negotiated Rate |
$31.21 |
| Rate for Payer: Aetna American Axle |
$22.54
|
| Rate for Payer: Aetna Commercial |
$29.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.54
|
| Rate for Payer: Cash Price |
$27.74
|
| Rate for Payer: Cofinity Commercial |
$24.28
|
| Rate for Payer: Cofinity Commercial |
$29.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.74
|
| Rate for Payer: Healthscope Commercial |
$31.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.48
|
| Rate for Payer: PHP Commercial |
$29.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.54
|
| Rate for Payer: Priority Health SBD |
$21.85
|
| Rate for Payer: UMR Bronson Commercial |
$15.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.01
|
|
|
HC STENGER TEST SPEECH
|
Facility
|
OP
|
$1,449.42
|
|
|
Service Code
|
CPT 92577
|
| Hospital Charge Code |
76100488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$19.77 |
| Max. Negotiated Rate |
$1,633.95 |
| Rate for Payer: Aetna American Axle |
$942.12
|
| Rate for Payer: Aetna Commercial |
$1,232.01
|
| Rate for Payer: Aetna Medicare |
$540.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCBS Trust/PPO |
$91.62
|
| Rate for Payer: BCN Commercial |
$91.62
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| Rate for Payer: Cash Price |
$1,159.54
|
| Rate for Payer: Cash Price |
$1,159.54
|
| Rate for Payer: Cofinity Commercial |
$1,246.50
|
| Rate for Payer: Cofinity Commercial |
$1,014.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,014.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.87
|
| Rate for Payer: Healthscope Commercial |
$1,304.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,014.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,087.06
|
| Rate for Payer: Mclaren Medicaid |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,232.01
|
| Rate for Payer: Nomi Health Commercial |
$1,559.61
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$1,232.01
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$942.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,633.95
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,307.16
|
| Rate for Payer: Priority Health SBD |
$913.13
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$19.77
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: UMR Bronson Commercial |
$536.29
|
| Rate for Payer: VA VA |
$519.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,087.06
|
|
|
HC STENGER TEST SPEECH
|
Facility
|
IP
|
$1,449.42
|
|
|
Service Code
|
CPT 92577
|
| Hospital Charge Code |
76100488
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$637.74 |
| Max. Negotiated Rate |
$1,304.48 |
| Rate for Payer: Aetna American Axle |
$942.12
|
| Rate for Payer: Aetna Commercial |
$1,232.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.12
|
| Rate for Payer: Cash Price |
$1,159.54
|
| Rate for Payer: Cofinity Commercial |
$1,014.59
|
| Rate for Payer: Cofinity Commercial |
$1,246.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,014.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.54
|
| Rate for Payer: Healthscope Commercial |
$1,304.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,014.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,087.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,232.01
|
| Rate for Payer: PHP Commercial |
$1,232.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$942.12
|
| Rate for Payer: Priority Health SBD |
$913.13
|
| Rate for Payer: UMR Bronson Commercial |
$637.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,087.06
|
|
|
HC STENT
|
Facility
|
IP
|
$953.16
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$419.39 |
| Max. Negotiated Rate |
$857.84 |
| Rate for Payer: Aetna American Axle |
$619.55
|
| Rate for Payer: Aetna Commercial |
$810.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.55
|
| Rate for Payer: Cash Price |
$762.53
|
| Rate for Payer: Cofinity Commercial |
$667.21
|
| Rate for Payer: Cofinity Commercial |
$819.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$667.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$762.53
|
| Rate for Payer: Healthscope Commercial |
$857.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$667.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$714.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$810.19
|
| Rate for Payer: PHP Commercial |
$810.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.55
|
| Rate for Payer: Priority Health SBD |
$600.49
|
| Rate for Payer: UMR Bronson Commercial |
$419.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$714.87
|
|
|
HC STENT
|
Facility
|
OP
|
$953.16
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800030
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$352.67 |
| Max. Negotiated Rate |
$857.84 |
| Rate for Payer: Aetna Commercial |
$810.19
|
| Rate for Payer: Aetna Medicare |
$476.58
|
| Rate for Payer: Aetna American Axle |
$619.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$619.55
|
| Rate for Payer: BCBS Complete |
$381.26
|
| Rate for Payer: Cash Price |
$762.53
|
| Rate for Payer: Cofinity Commercial |
$667.21
|
| Rate for Payer: Cofinity Commercial |
$819.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$667.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$762.53
|
| Rate for Payer: Healthscope Commercial |
$857.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$667.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$714.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$810.19
|
| Rate for Payer: PHP Commercial |
$810.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$619.55
|
| Rate for Payer: Priority Health SBD |
$600.49
|
| Rate for Payer: UMR Bronson Commercial |
$352.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$714.87
|
|
|
HC STENT ADD.BRANCH
|
Facility
|
OP
|
$17,010.57
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
48100074
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$607.36 |
| Max. Negotiated Rate |
$15,309.51 |
| Rate for Payer: Aetna American Axle |
$11,056.87
|
| Rate for Payer: Aetna Commercial |
$14,458.98
|
| Rate for Payer: Aetna Medicare |
$8,505.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,056.87
|
| Rate for Payer: BCBS Complete |
$6,804.23
|
| Rate for Payer: BCBS Trust/PPO |
$607.36
|
| Rate for Payer: BCN Commercial |
$607.36
|
| Rate for Payer: Cash Price |
$13,608.46
|
| Rate for Payer: Cash Price |
$13,608.46
|
| Rate for Payer: Cash Price |
$13,608.46
|
| Rate for Payer: Cofinity Commercial |
$14,629.09
|
| Rate for Payer: Cofinity Commercial |
$11,907.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,907.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,608.46
|
| Rate for Payer: Healthscope Commercial |
$15,309.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,907.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,757.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,458.98
|
| Rate for Payer: PHP Commercial |
$14,458.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,056.87
|
| Rate for Payer: Priority Health SBD |
$10,716.66
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UMR Bronson Commercial |
$6,293.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,757.93
|
|
|
HC STENT ADD.BRANCH
|
Facility
|
IP
|
$17,010.57
|
|
|
Service Code
|
CPT 92929
|
| Hospital Charge Code |
48100074
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,484.65 |
| Max. Negotiated Rate |
$15,309.51 |
| Rate for Payer: Aetna American Axle |
$11,056.87
|
| Rate for Payer: Aetna Commercial |
$14,458.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,056.87
|
| Rate for Payer: Cash Price |
$13,608.46
|
| Rate for Payer: Cofinity Commercial |
$11,907.40
|
| Rate for Payer: Cofinity Commercial |
$14,629.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,907.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,608.46
|
| Rate for Payer: Healthscope Commercial |
$15,309.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,907.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,757.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,458.98
|
| Rate for Payer: PHP Commercial |
$14,458.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,056.87
|
| Rate for Payer: Priority Health SBD |
$10,716.66
|
| Rate for Payer: UMR Bronson Commercial |
$7,484.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,757.93
|
|
|
HC STENT COATED W DELIVERY SYSTEM
|
Facility
|
OP
|
$11,875.31
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,393.86 |
| Max. Negotiated Rate |
$10,687.78 |
| Rate for Payer: Cofinity Commercial |
$8,312.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,312.72
|
| Rate for Payer: Aetna American Axle |
$7,718.95
|
| Rate for Payer: Aetna Commercial |
$10,094.01
|
| Rate for Payer: Aetna Medicare |
$5,937.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,718.95
|
| Rate for Payer: BCBS Complete |
$4,750.12
|
| Rate for Payer: Cash Price |
$9,500.25
|
| Rate for Payer: Cofinity Commercial |
$10,212.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,500.25
|
| Rate for Payer: Healthscope Commercial |
$10,687.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,312.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,906.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,094.01
|
| Rate for Payer: PHP Commercial |
$10,094.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,718.95
|
| Rate for Payer: Priority Health SBD |
$7,481.45
|
| Rate for Payer: UMR Bronson Commercial |
$4,393.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,906.48
|
|
|
HC STENT COATED W DELIVERY SYSTEM
|
Facility
|
IP
|
$11,875.31
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800111
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,225.14 |
| Max. Negotiated Rate |
$10,687.78 |
| Rate for Payer: Aetna American Axle |
$7,718.95
|
| Rate for Payer: Aetna Commercial |
$10,094.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,718.95
|
| Rate for Payer: Cash Price |
$9,500.25
|
| Rate for Payer: Cofinity Commercial |
$10,212.77
|
| Rate for Payer: Cofinity Commercial |
$8,312.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,312.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,500.25
|
| Rate for Payer: Healthscope Commercial |
$10,687.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,312.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,906.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,094.01
|
| Rate for Payer: PHP Commercial |
$10,094.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,718.95
|
| Rate for Payer: Priority Health SBD |
$7,481.45
|
| Rate for Payer: UMR Bronson Commercial |
$5,225.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,906.48
|
|
|
HC STENT COATED W DELIVERY SYSTEM LVL 12
|
Facility
|
OP
|
$5,572.41
|
|
|
Service Code
|
HCPCS C1874
|
| Hospital Charge Code |
27800096
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,061.79 |
| Max. Negotiated Rate |
$5,015.17 |
| Rate for Payer: Aetna American Axle |
$3,622.07
|
| Rate for Payer: Aetna Commercial |
$4,736.55
|
| Rate for Payer: Aetna Medicare |
$2,786.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,622.07
|
| Rate for Payer: BCBS Complete |
$2,228.96
|
| Rate for Payer: Cash Price |
$4,457.93
|
| Rate for Payer: Cofinity Commercial |
$3,900.69
|
| Rate for Payer: Cofinity Commercial |
$4,792.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,900.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,457.93
|
| Rate for Payer: Healthscope Commercial |
$5,015.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,900.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,179.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,736.55
|
| Rate for Payer: PHP Commercial |
$4,736.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,622.07
|
| Rate for Payer: Priority Health SBD |
$3,510.62
|
| Rate for Payer: UMR Bronson Commercial |
$2,061.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,179.31
|
|
