|
HC THIN PREP PAP SCREENING
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
HCPCS G0123
|
| Hospital Charge Code |
31100028
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC THIN PREP PAP SCREENING
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
HCPCS G0123
|
| Hospital Charge Code |
31100028
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$21.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.32
|
| Rate for Payer: BCBS Complete |
$11.40
|
| Rate for Payer: BCBS MAPPO |
$20.26
|
| Rate for Payer: BCN Medicare Advantage |
$20.26
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.26
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$10.86
|
| Rate for Payer: Mclaren Medicare |
$20.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.27
|
| Rate for Payer: Meridian Medicaid |
$11.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PACE Medicare |
$19.25
|
| Rate for Payer: PACE SWMI |
$20.26
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$20.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health Medicare |
$20.26
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Railroad Medicare Medicare |
$20.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.26
|
| Rate for Payer: UHC Exchange |
$38.72
|
| Rate for Payer: UHC Medicare Advantage |
$20.26
|
| Rate for Payer: UHCCP Medicaid |
$10.86
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$20.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC THIN PREP PAP SCREENING AUTO
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
HCPCS G0145
|
| Hospital Charge Code |
31100032
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$14.20 |
| Max. Negotiated Rate |
$74.57 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$27.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.11
|
| Rate for Payer: BCBS Complete |
$14.91
|
| Rate for Payer: BCBS MAPPO |
$26.49
|
| Rate for Payer: BCN Medicare Advantage |
$26.49
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.49
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$14.20
|
| Rate for Payer: Mclaren Medicare |
$26.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.81
|
| Rate for Payer: Meridian Medicaid |
$14.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PACE Medicare |
$25.17
|
| Rate for Payer: PACE SWMI |
$26.49
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$26.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health Medicare |
$26.49
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Railroad Medicare Medicare |
$26.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.49
|
| Rate for Payer: UHC Exchange |
$50.63
|
| Rate for Payer: UHC Medicare Advantage |
$26.49
|
| Rate for Payer: UHCCP Medicaid |
$14.20
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$26.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC THIN PREP PAP SCREENING AUTO
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
HCPCS G0145
|
| Hospital Charge Code |
31100032
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC THIOPURINE METABOLITES
|
Facility
|
IP
|
$295.80
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$130.15 |
| Max. Negotiated Rate |
$266.22 |
| Rate for Payer: Aetna American Axle |
$192.27
|
| Rate for Payer: Aetna Commercial |
$251.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.27
|
| Rate for Payer: Cash Price |
$236.64
|
| Rate for Payer: Cofinity Commercial |
$207.06
|
| Rate for Payer: Cofinity Commercial |
$254.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.64
|
| Rate for Payer: Healthscope Commercial |
$266.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.43
|
| Rate for Payer: PHP Commercial |
$251.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.27
|
| Rate for Payer: Priority Health SBD |
$186.35
|
| Rate for Payer: UMR Bronson Commercial |
$130.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.85
|
|
|
HC THIOPURINE METABOLITES
|
Facility
|
OP
|
$295.80
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$266.22 |
| Rate for Payer: Aetna American Axle |
$192.27
|
| Rate for Payer: Aetna Commercial |
$251.43
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$236.64
|
| Rate for Payer: Cash Price |
$236.64
|
| Rate for Payer: Cofinity Commercial |
$254.39
|
| Rate for Payer: Cofinity Commercial |
$207.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$207.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$266.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.85
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$251.43
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$251.43
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.27
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$186.35
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$35.62
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: UMR Bronson Commercial |
$109.45
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.85
|
|
|
HC THIOPURINE METHYLTRANSFERASE RBC
|
Facility
|
IP
|
$330.48
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
30100621
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$145.41 |
| Max. Negotiated Rate |
$297.43 |
| Rate for Payer: Aetna American Axle |
$214.81
|
| Rate for Payer: Aetna Commercial |
$280.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.81
|
| Rate for Payer: Cash Price |
$264.38
|
| Rate for Payer: Cofinity Commercial |
$231.34
|
| Rate for Payer: Cofinity Commercial |
$284.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.38
|
| Rate for Payer: Healthscope Commercial |
$297.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.91
|
| Rate for Payer: PHP Commercial |
$280.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.81
|
| Rate for Payer: Priority Health SBD |
$208.20
|
| Rate for Payer: UMR Bronson Commercial |
$145.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.86
|
|
|
HC THIOPURINE METHYLTRANSFERASE RBC
|
Facility
|
OP
|
$330.48
|
|
|
Service Code
|
CPT 82657
|
| Hospital Charge Code |
30100621
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.88 |
| Max. Negotiated Rate |
$297.43 |
| Rate for Payer: Aetna American Axle |
$214.81
|
| Rate for Payer: Aetna Commercial |
$280.91
|
| Rate for Payer: Aetna Medicare |
$23.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.71
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: BCBS MAPPO |
$22.17
|
| Rate for Payer: BCN Medicare Advantage |
$22.17
|
| Rate for Payer: Cash Price |
$264.38
|
| Rate for Payer: Cash Price |
$264.38
|
| Rate for Payer: Cofinity Commercial |
$284.21
|
| Rate for Payer: Cofinity Commercial |
$231.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$231.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.17
|
| Rate for Payer: Healthscope Commercial |
$297.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$231.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.86
|
| Rate for Payer: Mclaren Medicaid |
$11.88
|
| Rate for Payer: Mclaren Medicare |
$22.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.28
|
| Rate for Payer: Meridian Medicaid |
$12.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.91
|
| Rate for Payer: PACE Medicare |
$21.06
|
| Rate for Payer: PACE SWMI |
$22.17
|
| Rate for Payer: PHP Commercial |
$280.91
|
| Rate for Payer: PHP Medicare Advantage |
$22.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.81
|
| Rate for Payer: Priority Health Medicare |
$22.17
|
| Rate for Payer: Priority Health SBD |
$208.20
|
| Rate for Payer: Railroad Medicare Medicare |
$22.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.17
|
| Rate for Payer: UHC Exchange |
$42.37
|
| Rate for Payer: UHC Medicare Advantage |
$22.17
|
| Rate for Payer: UHCCP Medicaid |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$122.28
|
| Rate for Payer: VA VA |
$22.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.86
|
|
|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
OP
|
$142.80
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$128.52 |
| Rate for Payer: Aetna American Axle |
$92.82
|
| Rate for Payer: Aetna Commercial |
$121.38
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.56
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$114.24
|
| Rate for Payer: Cash Price |
$114.24
|
| Rate for Payer: Cofinity Commercial |
$99.96
|
| Rate for Payer: Cofinity Commercial |
$122.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$128.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.10
|
| Rate for Payer: Mclaren Medicaid |
$12.91
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$13.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.38
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$121.38
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.82
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health SBD |
$89.96
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.09
|
| Rate for Payer: UHC Exchange |
$46.04
|
| Rate for Payer: UHC Medicare Advantage |
$24.09
|
| Rate for Payer: UHCCP Medicaid |
$12.91
|
| Rate for Payer: UMR Bronson Commercial |
$52.84
|
| Rate for Payer: VA VA |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.10
|
|
|
HC THIOPURINE METHYLTRANSFERASE T
|
Facility
|
IP
|
$142.80
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100290
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$62.83 |
| Max. Negotiated Rate |
$128.52 |
| Rate for Payer: Aetna American Axle |
$92.82
|
| Rate for Payer: Aetna Commercial |
$121.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.82
|
| Rate for Payer: Cash Price |
$114.24
|
| Rate for Payer: Cofinity Commercial |
$122.81
|
| Rate for Payer: Cofinity Commercial |
$99.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$99.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.24
|
| Rate for Payer: Healthscope Commercial |
$128.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.38
|
| Rate for Payer: PHP Commercial |
$121.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.82
|
| Rate for Payer: Priority Health SBD |
$89.96
|
| Rate for Payer: UMR Bronson Commercial |
$62.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.10
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
IP
|
$69.79
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$30.71 |
| Max. Negotiated Rate |
$62.81 |
| Rate for Payer: Aetna American Axle |
$45.36
|
| Rate for Payer: Aetna Commercial |
$59.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.36
|
| Rate for Payer: Cash Price |
$55.83
|
| Rate for Payer: Cofinity Commercial |
$48.85
|
| Rate for Payer: Cofinity Commercial |
$60.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.83
|
| Rate for Payer: Healthscope Commercial |
$62.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.32
|
| Rate for Payer: PHP Commercial |
$59.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.36
|
| Rate for Payer: Priority Health SBD |
$43.97
|
| Rate for Payer: UMR Bronson Commercial |
$30.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.34
|
|
|
HC THIRD STEP GEL 8 OZ
|
Facility
|
OP
|
$69.79
|
|
| Hospital Charge Code |
27100018
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$25.82 |
| Max. Negotiated Rate |
$62.81 |
| Rate for Payer: Aetna American Axle |
$45.36
|
| Rate for Payer: Aetna Commercial |
$59.32
|
| Rate for Payer: Aetna Medicare |
$34.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.36
|
| Rate for Payer: BCBS Complete |
$27.92
|
| Rate for Payer: Cash Price |
$55.83
|
| Rate for Payer: Cofinity Commercial |
$48.85
|
| Rate for Payer: Cofinity Commercial |
$60.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.83
|
| Rate for Payer: Healthscope Commercial |
$62.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.32
|
| Rate for Payer: PHP Commercial |
$59.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.36
|
| Rate for Payer: Priority Health SBD |
$43.97
|
| Rate for Payer: UMR Bronson Commercial |
$25.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.34
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
OP
|
$847.90
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$313.72 |
| Max. Negotiated Rate |
$763.11 |
| Rate for Payer: Aetna American Axle |
$551.13
|
| Rate for Payer: Aetna Commercial |
$720.72
|
| Rate for Payer: Aetna Medicare |
$423.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.13
|
| Rate for Payer: BCBS Complete |
$339.16
|
| Rate for Payer: Cash Price |
$678.32
|
| Rate for Payer: Cofinity Commercial |
$593.53
|
| Rate for Payer: Cofinity Commercial |
$729.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$593.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$678.32
|
| Rate for Payer: Healthscope Commercial |
$763.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$593.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$635.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$720.72
|
| Rate for Payer: PHP Commercial |
$720.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.13
|
| Rate for Payer: Priority Health SBD |
$534.18
|
| Rate for Payer: UMR Bronson Commercial |
$313.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$635.92
|
|
|
HC THORACENTESIS/PARACENTESIS
|
Facility
|
IP
|
$847.90
|
|
| Hospital Charge Code |
45000054
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$373.08 |
| Max. Negotiated Rate |
$763.11 |
| Rate for Payer: Aetna American Axle |
$551.13
|
| Rate for Payer: Aetna Commercial |
$720.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$551.13
|
| Rate for Payer: Cash Price |
$678.32
|
| Rate for Payer: Cofinity Commercial |
$593.53
|
| Rate for Payer: Cofinity Commercial |
$729.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$593.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$678.32
|
| Rate for Payer: Healthscope Commercial |
$763.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$593.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$635.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$720.72
|
| Rate for Payer: PHP Commercial |
$720.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.13
|
| Rate for Payer: Priority Health SBD |
$534.18
|
| Rate for Payer: UMR Bronson Commercial |
$373.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$635.92
|
|
|
HC THORACENT WO TUBE
|
Facility
|
IP
|
$1,305.83
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$574.57 |
| Max. Negotiated Rate |
$1,175.25 |
| Rate for Payer: Aetna American Axle |
$848.79
|
| Rate for Payer: Aetna Commercial |
$1,109.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.79
|
| Rate for Payer: Cash Price |
$1,044.66
|
| Rate for Payer: Cofinity Commercial |
$1,123.01
|
| Rate for Payer: Cofinity Commercial |
$914.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$914.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,044.66
|
| Rate for Payer: Healthscope Commercial |
$1,175.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$914.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$979.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,109.96
|
| Rate for Payer: PHP Commercial |
$1,109.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$848.79
|
| Rate for Payer: Priority Health SBD |
$822.67
|
| Rate for Payer: UMR Bronson Commercial |
$574.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$979.37
|
|
|
HC THORACENT WO TUBE
|
Facility
|
OP
|
$1,305.83
|
|
|
Service Code
|
CPT 32555
|
| Hospital Charge Code |
36100383
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$1,697.33 |
| Rate for Payer: Aetna American Axle |
$848.79
|
| Rate for Payer: Aetna Commercial |
$1,109.96
|
| Rate for Payer: Aetna Medicare |
$627.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$848.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$753.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$753.73
|
| Rate for Payer: BCBS Complete |
$339.36
|
| Rate for Payer: BCBS MAPPO |
$602.98
|
| Rate for Payer: BCN Medicare Advantage |
$602.98
|
| Rate for Payer: Cash Price |
$1,044.66
|
| Rate for Payer: Cash Price |
$1,044.66
|
| Rate for Payer: Cofinity Commercial |
$914.08
|
| Rate for Payer: Cofinity Commercial |
$1,123.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$914.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,044.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$602.98
|
| Rate for Payer: Healthscope Commercial |
$1,175.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$914.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$979.37
|
| Rate for Payer: Mclaren Medicaid |
$323.20
|
| Rate for Payer: Mclaren Medicare |
$602.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$633.13
|
| Rate for Payer: Meridian Medicaid |
$339.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$693.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,109.96
|
| Rate for Payer: PACE Medicare |
$572.83
|
| Rate for Payer: PACE SWMI |
$602.98
|
| Rate for Payer: PHP Commercial |
$1,109.96
|
| Rate for Payer: PHP Medicare Advantage |
$602.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$323.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$848.79
|
| Rate for Payer: Priority Health Medicare |
$602.98
|
| Rate for Payer: Priority Health SBD |
$822.67
|
| Rate for Payer: Railroad Medicare Medicare |
$602.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,697.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$602.98
|
| Rate for Payer: UHC Exchange |
$1,152.36
|
| Rate for Payer: UHC Medicare Advantage |
$602.98
|
| Rate for Payer: UHCCP Medicaid |
$323.20
|
| Rate for Payer: UMR Bronson Commercial |
$483.16
|
| Rate for Payer: VA VA |
$602.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$979.37
|
|
|
HC THORACENT W TUBE
|
Facility
|
OP
|
$1,414.47
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$523.35 |
| Max. Negotiated Rate |
$4,264.69 |
| Rate for Payer: Aetna American Axle |
$919.41
|
| Rate for Payer: Aetna Commercial |
$1,202.30
|
| Rate for Payer: Aetna Medicare |
$1,575.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$919.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,893.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,893.80
|
| Rate for Payer: BCBS Complete |
$852.66
|
| Rate for Payer: BCBS MAPPO |
$1,515.04
|
| Rate for Payer: BCN Medicare Advantage |
$1,515.04
|
| Rate for Payer: Cash Price |
$1,131.58
|
| Rate for Payer: Cash Price |
$1,131.58
|
| Rate for Payer: Cofinity Commercial |
$990.13
|
| Rate for Payer: Cofinity Commercial |
$1,216.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$990.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,131.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,515.04
|
| Rate for Payer: Healthscope Commercial |
$1,273.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$990.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,060.85
|
| Rate for Payer: Mclaren Medicaid |
$812.06
|
| Rate for Payer: Mclaren Medicare |
$1,515.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,590.79
|
| Rate for Payer: Meridian Medicaid |
$852.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,742.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,202.30
|
| Rate for Payer: PACE Medicare |
$1,439.29
|
| Rate for Payer: PACE SWMI |
$1,515.04
|
| Rate for Payer: PHP Commercial |
$1,202.30
|
| Rate for Payer: PHP Medicare Advantage |
$1,515.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$812.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.41
|
| Rate for Payer: Priority Health Medicare |
$1,515.04
|
| Rate for Payer: Priority Health SBD |
$891.12
|
| Rate for Payer: Railroad Medicare Medicare |
$1,515.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,264.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,515.04
|
| Rate for Payer: UHC Exchange |
$2,895.39
|
| Rate for Payer: UHC Medicare Advantage |
$1,515.04
|
| Rate for Payer: UHCCP Medicaid |
$812.06
|
| Rate for Payer: UMR Bronson Commercial |
$523.35
|
| Rate for Payer: VA VA |
$1,515.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,060.85
|
|
|
HC THORACENT W TUBE
|
Facility
|
IP
|
$1,414.47
|
|
|
Service Code
|
CPT 32557
|
| Hospital Charge Code |
36100384
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$622.37 |
| Max. Negotiated Rate |
$1,273.02 |
| Rate for Payer: Aetna American Axle |
$919.41
|
| Rate for Payer: Aetna Commercial |
$1,202.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$919.41
|
| Rate for Payer: Cash Price |
$1,131.58
|
| Rate for Payer: Cofinity Commercial |
$1,216.44
|
| Rate for Payer: Cofinity Commercial |
$990.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$990.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,131.58
|
| Rate for Payer: Healthscope Commercial |
$1,273.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$990.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,060.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,202.30
|
| Rate for Payer: PHP Commercial |
$1,202.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$919.41
|
| Rate for Payer: Priority Health SBD |
$891.12
|
| Rate for Payer: UMR Bronson Commercial |
$622.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,060.85
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
IP
|
$704.90
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$310.16 |
| Max. Negotiated Rate |
$634.41 |
| Rate for Payer: Aetna American Axle |
$458.19
|
| Rate for Payer: Aetna Commercial |
$599.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.19
|
| Rate for Payer: Cash Price |
$563.92
|
| Rate for Payer: Cofinity Commercial |
$493.43
|
| Rate for Payer: Cofinity Commercial |
$606.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.92
|
| Rate for Payer: Healthscope Commercial |
$634.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.16
|
| Rate for Payer: PHP Commercial |
$599.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.19
|
| Rate for Payer: Priority Health SBD |
$444.09
|
| Rate for Payer: UMR Bronson Commercial |
$310.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.67
|
|
|
HC THORACIC GAS/RAW
|
Facility
|
OP
|
$704.90
|
|
|
Service Code
|
CPT 94726
|
| Hospital Charge Code |
46000015
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna American Axle |
$458.19
|
| Rate for Payer: Aetna Commercial |
$599.16
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$458.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$563.92
|
| Rate for Payer: Cash Price |
$563.92
|
| Rate for Payer: Cash Price |
$563.92
|
| Rate for Payer: Cofinity Commercial |
$493.43
|
| Rate for Payer: Cofinity Commercial |
$606.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$493.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$563.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$634.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$493.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$528.67
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$599.16
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$599.16
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$458.19
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$444.09
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$580.40
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: UMR Bronson Commercial |
$260.81
|
| Rate for Payer: VA VA |
$303.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$528.67
|
|
|
HC THORACOTOMY
|
Facility
|
OP
|
$2,091.88
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$774.00 |
| Max. Negotiated Rate |
$1,882.69 |
| Rate for Payer: Aetna American Axle |
$1,359.72
|
| Rate for Payer: Aetna Commercial |
$1,778.10
|
| Rate for Payer: Aetna Medicare |
$1,045.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.72
|
| Rate for Payer: BCBS Complete |
$836.75
|
| Rate for Payer: Cash Price |
$1,673.50
|
| Rate for Payer: Cofinity Commercial |
$1,464.32
|
| Rate for Payer: Cofinity Commercial |
$1,799.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,464.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.50
|
| Rate for Payer: Healthscope Commercial |
$1,882.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,464.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,568.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.10
|
| Rate for Payer: PHP Commercial |
$1,778.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.72
|
| Rate for Payer: Priority Health SBD |
$1,317.88
|
| Rate for Payer: UMR Bronson Commercial |
$774.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,568.91
|
|
|
HC THORACOTOMY
|
Facility
|
IP
|
$2,091.88
|
|
| Hospital Charge Code |
27000156
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$920.43 |
| Max. Negotiated Rate |
$1,882.69 |
| Rate for Payer: Aetna American Axle |
$1,359.72
|
| Rate for Payer: Aetna Commercial |
$1,778.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.72
|
| Rate for Payer: Cash Price |
$1,673.50
|
| Rate for Payer: Cofinity Commercial |
$1,464.32
|
| Rate for Payer: Cofinity Commercial |
$1,799.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,464.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,673.50
|
| Rate for Payer: Healthscope Commercial |
$1,882.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,464.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,568.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,778.10
|
| Rate for Payer: PHP Commercial |
$1,778.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,359.72
|
| Rate for Payer: Priority Health SBD |
$1,317.88
|
| Rate for Payer: UMR Bronson Commercial |
$920.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,568.91
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
IP
|
$4,968.12
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,185.97 |
| Max. Negotiated Rate |
$4,471.31 |
| Rate for Payer: Aetna American Axle |
$3,229.28
|
| Rate for Payer: Aetna Commercial |
$4,222.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,229.28
|
| Rate for Payer: Cash Price |
$3,974.50
|
| Rate for Payer: Cofinity Commercial |
$3,477.68
|
| Rate for Payer: Cofinity Commercial |
$4,272.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,477.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,974.50
|
| Rate for Payer: Healthscope Commercial |
$4,471.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,477.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,726.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,222.90
|
| Rate for Payer: PHP Commercial |
$4,222.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,229.28
|
| Rate for Payer: Priority Health SBD |
$3,129.92
|
| Rate for Payer: UMR Bronson Commercial |
$2,185.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,726.09
|
|
|
HC THROMBECTOMY MECH AND OR THROMBOLYSIS ARTERIAL INTRACRANIAL
|
Facility
|
OP
|
$4,968.12
|
|
|
Service Code
|
CPT 61645
|
| Hospital Charge Code |
36100513
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,838.20 |
| Max. Negotiated Rate |
$4,471.31 |
| Rate for Payer: Aetna American Axle |
$3,229.28
|
| Rate for Payer: Aetna Commercial |
$4,222.90
|
| Rate for Payer: Aetna Medicare |
$2,484.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,229.28
|
| Rate for Payer: BCBS Complete |
$1,987.25
|
| Rate for Payer: Cash Price |
$3,974.50
|
| Rate for Payer: Cofinity Commercial |
$3,477.68
|
| Rate for Payer: Cofinity Commercial |
$4,272.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,477.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,974.50
|
| Rate for Payer: Healthscope Commercial |
$4,471.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,477.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,726.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,222.90
|
| Rate for Payer: PHP Commercial |
$4,222.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,229.28
|
| Rate for Payer: Priority Health SBD |
$3,129.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,838.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,726.09
|
|
|
HC THROMBIN TIME
|
Facility
|
IP
|
$75.95
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500062
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$33.42 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna American Axle |
$49.37
|
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.37
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$53.16
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health SBD |
$47.85
|
| Rate for Payer: UMR Bronson Commercial |
$33.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
