|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
OP
|
$3,891.10
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,439.71 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,529.22
|
| Rate for Payer: Aetna Commercial |
$3,307.43
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,529.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$3,112.88
|
| Rate for Payer: Cash Price |
$3,112.88
|
| Rate for Payer: Cofinity Commercial |
$3,346.35
|
| Rate for Payer: Cofinity Commercial |
$2,723.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,723.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,501.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,723.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,918.32
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.43
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,307.43
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,529.22
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,451.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,439.71
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.32
|
|
|
HC TRANS CATH RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ
|
Facility
|
IP
|
$16,004.00
|
|
|
Service Code
|
CPT 0644T
|
| Hospital Charge Code |
36000125
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$7,041.76 |
| Max. Negotiated Rate |
$14,403.60 |
| Rate for Payer: Aetna American Axle |
$10,402.60
|
| Rate for Payer: Aetna Commercial |
$13,603.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,402.60
|
| Rate for Payer: Cash Price |
$12,803.20
|
| Rate for Payer: Cofinity Commercial |
$11,202.80
|
| Rate for Payer: Cofinity Commercial |
$13,763.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,202.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,803.20
|
| Rate for Payer: Healthscope Commercial |
$14,403.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,202.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,003.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,603.40
|
| Rate for Payer: PHP Commercial |
$13,603.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,402.60
|
| Rate for Payer: Priority Health SBD |
$10,082.52
|
| Rate for Payer: UMR Bronson Commercial |
$7,041.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,003.00
|
|
|
HC TRANS CATH RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ
|
Facility
|
OP
|
$16,004.00
|
|
|
Service Code
|
CPT 0644T
|
| Hospital Charge Code |
36000125
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,980.47 |
| Max. Negotiated Rate |
$15,652.48 |
| Rate for Payer: Aetna American Axle |
$10,402.60
|
| Rate for Payer: Aetna Commercial |
$13,603.40
|
| Rate for Payer: Aetna Medicare |
$5,783.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,402.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,950.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,950.73
|
| Rate for Payer: BCBS Complete |
$3,129.49
|
| Rate for Payer: BCBS MAPPO |
$5,560.58
|
| Rate for Payer: BCN Medicare Advantage |
$5,560.58
|
| Rate for Payer: Cash Price |
$12,803.20
|
| Rate for Payer: Cash Price |
$12,803.20
|
| Rate for Payer: Cofinity Commercial |
$13,763.44
|
| Rate for Payer: Cofinity Commercial |
$11,202.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,202.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,803.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,560.58
|
| Rate for Payer: Healthscope Commercial |
$14,403.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,202.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,003.00
|
| Rate for Payer: Mclaren Medicaid |
$2,980.47
|
| Rate for Payer: Mclaren Medicare |
$5,560.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,838.61
|
| Rate for Payer: Meridian Medicaid |
$3,129.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,394.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,603.40
|
| Rate for Payer: PACE Medicare |
$5,282.55
|
| Rate for Payer: PACE SWMI |
$5,560.58
|
| Rate for Payer: PHP Commercial |
$13,603.40
|
| Rate for Payer: PHP Medicare Advantage |
$5,560.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,980.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,402.60
|
| Rate for Payer: Priority Health Medicare |
$5,560.58
|
| Rate for Payer: Priority Health SBD |
$10,082.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5,560.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,652.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,560.58
|
| Rate for Payer: UHC Exchange |
$10,626.82
|
| Rate for Payer: UHC Medicare Advantage |
$5,560.58
|
| Rate for Payer: UHCCP Medicaid |
$2,980.47
|
| Rate for Payer: UMR Bronson Commercial |
$5,921.48
|
| Rate for Payer: VA VA |
$5,560.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,003.00
|
|
|
HC TRANSCERVICAL AMNIOINFUSION
|
Facility
|
IP
|
$563.36
|
|
| Hospital Charge Code |
27000647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$247.88 |
| Max. Negotiated Rate |
$507.02 |
| Rate for Payer: Aetna American Axle |
$366.18
|
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.18
|
| Rate for Payer: Cash Price |
$450.69
|
| Rate for Payer: Cofinity Commercial |
$394.35
|
| Rate for Payer: Cofinity Commercial |
$484.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$394.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.69
|
| Rate for Payer: Healthscope Commercial |
$507.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.86
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.18
|
| Rate for Payer: Priority Health SBD |
$354.92
|
| Rate for Payer: UMR Bronson Commercial |
$247.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.52
|
|
|
HC TRANSCERVICAL AMNIOINFUSION
|
Facility
|
OP
|
$563.36
|
|
| Hospital Charge Code |
27000647
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$208.44 |
| Max. Negotiated Rate |
$507.02 |
| Rate for Payer: Aetna American Axle |
$366.18
|
| Rate for Payer: Aetna Commercial |
$478.86
|
| Rate for Payer: Aetna Medicare |
$281.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.18
|
| Rate for Payer: BCBS Complete |
$225.34
|
| Rate for Payer: Cash Price |
$450.69
|
| Rate for Payer: Cofinity Commercial |
$394.35
|
| Rate for Payer: Cofinity Commercial |
$484.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$394.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.69
|
| Rate for Payer: Healthscope Commercial |
$507.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.86
|
| Rate for Payer: PHP Commercial |
$478.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$366.18
|
| Rate for Payer: Priority Health SBD |
$354.92
|
| Rate for Payer: UMR Bronson Commercial |
$208.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.52
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
OP
|
$1,618.27
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.36 |
| Max. Negotiated Rate |
$1,456.44 |
| Rate for Payer: Aetna American Axle |
$1,051.88
|
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Aetna Medicare |
$245.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.68
|
| Rate for Payer: BCBS Complete |
$132.67
|
| Rate for Payer: BCBS MAPPO |
$235.74
|
| Rate for Payer: BCN Medicare Advantage |
$235.74
|
| Rate for Payer: Cash Price |
$1,294.62
|
| Rate for Payer: Cash Price |
$1,294.62
|
| Rate for Payer: Cash Price |
$1,294.62
|
| Rate for Payer: Cofinity Commercial |
$1,132.79
|
| Rate for Payer: Cofinity Commercial |
$1,391.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,132.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.74
|
| Rate for Payer: Healthscope Commercial |
$1,456.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,132.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.70
|
| Rate for Payer: Mclaren Medicaid |
$126.36
|
| Rate for Payer: Mclaren Medicare |
$235.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.53
|
| Rate for Payer: Meridian Medicaid |
$132.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.53
|
| Rate for Payer: PACE Medicare |
$223.95
|
| Rate for Payer: PACE SWMI |
$235.74
|
| Rate for Payer: PHP Commercial |
$1,375.53
|
| Rate for Payer: PHP Medicare Advantage |
$235.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.88
|
| Rate for Payer: Priority Health Medicare |
$235.74
|
| Rate for Payer: Priority Health SBD |
$1,019.51
|
| Rate for Payer: Railroad Medicare Medicare |
$235.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$663.58
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.74
|
| Rate for Payer: UHC Exchange |
$450.52
|
| Rate for Payer: UHC Medicare Advantage |
$235.74
|
| Rate for Payer: UHCCP Medicaid |
$126.36
|
| Rate for Payer: UMR Bronson Commercial |
$598.76
|
| Rate for Payer: VA VA |
$235.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.70
|
|
|
HC TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
IP
|
$1,618.27
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$712.04 |
| Max. Negotiated Rate |
$1,456.44 |
| Rate for Payer: Aetna American Axle |
$1,051.88
|
| Rate for Payer: Aetna Commercial |
$1,375.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.88
|
| Rate for Payer: Cash Price |
$1,294.62
|
| Rate for Payer: Cofinity Commercial |
$1,132.79
|
| Rate for Payer: Cofinity Commercial |
$1,391.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,132.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,294.62
|
| Rate for Payer: Healthscope Commercial |
$1,456.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,132.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,213.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.53
|
| Rate for Payer: PHP Commercial |
$1,375.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.88
|
| Rate for Payer: Priority Health SBD |
$1,019.51
|
| Rate for Payer: UMR Bronson Commercial |
$712.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,213.70
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
OP
|
$611.44
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.59 |
| Max. Negotiated Rate |
$587.00 |
| Rate for Payer: Aetna American Axle |
$397.44
|
| Rate for Payer: Aetna Commercial |
$519.72
|
| Rate for Payer: Aetna Medicare |
$107.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.64
|
| Rate for Payer: BCBS Complete |
$58.37
|
| Rate for Payer: BCBS MAPPO |
$103.71
|
| Rate for Payer: BCN Medicare Advantage |
$103.71
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$428.01
|
| Rate for Payer: Cofinity Commercial |
$525.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.71
|
| Rate for Payer: Healthscope Commercial |
$550.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$458.58
|
| Rate for Payer: Mclaren Medicaid |
$55.59
|
| Rate for Payer: Mclaren Medicare |
$103.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.90
|
| Rate for Payer: Meridian Medicaid |
$58.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$519.72
|
| Rate for Payer: PACE Medicare |
$98.52
|
| Rate for Payer: PACE SWMI |
$103.71
|
| Rate for Payer: PHP Commercial |
$519.72
|
| Rate for Payer: PHP Medicare Advantage |
$103.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.44
|
| Rate for Payer: Priority Health Medicare |
$103.71
|
| Rate for Payer: Priority Health SBD |
$385.21
|
| Rate for Payer: Railroad Medicare Medicare |
$103.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.93
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.71
|
| Rate for Payer: UHC Exchange |
$198.20
|
| Rate for Payer: UHC Medicare Advantage |
$103.71
|
| Rate for Payer: UHCCP Medicaid |
$55.59
|
| Rate for Payer: UMR Bronson Commercial |
$226.23
|
| Rate for Payer: VA VA |
$103.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$458.58
|
|
|
HC TRANSCRANIAL USN IMAGING LIMIT
|
Facility
|
IP
|
$611.44
|
|
|
Service Code
|
CPT 93888
|
| Hospital Charge Code |
92100003
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$269.03 |
| Max. Negotiated Rate |
$550.30 |
| Rate for Payer: Aetna American Axle |
$397.44
|
| Rate for Payer: Aetna Commercial |
$519.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.44
|
| Rate for Payer: Cash Price |
$489.15
|
| Rate for Payer: Cofinity Commercial |
$428.01
|
| Rate for Payer: Cofinity Commercial |
$525.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.15
|
| Rate for Payer: Healthscope Commercial |
$550.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$458.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$519.72
|
| Rate for Payer: PHP Commercial |
$519.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.44
|
| Rate for Payer: Priority Health SBD |
$385.21
|
| Rate for Payer: UMR Bronson Commercial |
$269.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$458.58
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$192.56 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: UMR Bronson Commercial |
$192.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC TRANSCRAN LE MOTOR STIM
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$161.92 |
| Max. Negotiated Rate |
$1,456.65 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$538.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.65
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$988.96
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$277.37
|
| Rate for Payer: UMR Bronson Commercial |
$161.92
|
| Rate for Payer: VA VA |
$517.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
IP
|
$626.24
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$275.55 |
| Max. Negotiated Rate |
$563.62 |
| Rate for Payer: Aetna American Axle |
$407.06
|
| Rate for Payer: Aetna Commercial |
$532.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.06
|
| Rate for Payer: Cash Price |
$500.99
|
| Rate for Payer: Cofinity Commercial |
$438.37
|
| Rate for Payer: Cofinity Commercial |
$538.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$438.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.99
|
| Rate for Payer: Healthscope Commercial |
$563.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$438.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.30
|
| Rate for Payer: PHP Commercial |
$532.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$407.06
|
| Rate for Payer: Priority Health SBD |
$394.53
|
| Rate for Payer: UMR Bronson Commercial |
$275.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.68
|
|
|
HC TRANSCRAN UE MOTOR STIM
|
Facility
|
OP
|
$626.24
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$231.71 |
| Max. Negotiated Rate |
$2,793.06 |
| Rate for Payer: Aetna American Axle |
$407.06
|
| Rate for Payer: Aetna Commercial |
$532.30
|
| Rate for Payer: Aetna Medicare |
$1,031.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,240.30
|
| Rate for Payer: BCBS Complete |
$558.43
|
| Rate for Payer: BCBS MAPPO |
$992.24
|
| Rate for Payer: BCN Medicare Advantage |
$992.24
|
| Rate for Payer: Cash Price |
$500.99
|
| Rate for Payer: Cash Price |
$500.99
|
| Rate for Payer: Cash Price |
$500.99
|
| Rate for Payer: Cofinity Commercial |
$438.37
|
| Rate for Payer: Cofinity Commercial |
$538.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$438.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$500.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$992.24
|
| Rate for Payer: Healthscope Commercial |
$563.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$438.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$469.68
|
| Rate for Payer: Mclaren Medicaid |
$531.84
|
| Rate for Payer: Mclaren Medicare |
$992.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,041.85
|
| Rate for Payer: Meridian Medicaid |
$558.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,141.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.30
|
| Rate for Payer: PACE Medicare |
$942.63
|
| Rate for Payer: PACE SWMI |
$992.24
|
| Rate for Payer: PHP Commercial |
$532.30
|
| Rate for Payer: PHP Medicare Advantage |
$992.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$531.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$407.06
|
| Rate for Payer: Priority Health Medicare |
$992.24
|
| Rate for Payer: Priority Health SBD |
$394.53
|
| Rate for Payer: Railroad Medicare Medicare |
$992.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,793.06
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$992.24
|
| Rate for Payer: UHC Exchange |
$1,896.27
|
| Rate for Payer: UHC Medicare Advantage |
$992.24
|
| Rate for Payer: UHCCP Medicaid |
$531.84
|
| Rate for Payer: UMR Bronson Commercial |
$231.71
|
| Rate for Payer: VA VA |
$992.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.68
|
|
|
HC TRANSFERRIN
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC TRANSFERRIN
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84466
|
| Hospital Charge Code |
30100443
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.95
|
| Rate for Payer: BCBS Complete |
$7.18
|
| Rate for Payer: BCBS MAPPO |
$12.76
|
| Rate for Payer: BCN Medicare Advantage |
$12.76
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.76
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$6.84
|
| Rate for Payer: Mclaren Medicare |
$12.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.40
|
| Rate for Payer: Meridian Medicaid |
$7.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$12.12
|
| Rate for Payer: PACE SWMI |
$12.76
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$12.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$12.76
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$12.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.76
|
| Rate for Payer: UHC Exchange |
$24.39
|
| Rate for Payer: UHC Medicare Advantage |
$12.76
|
| Rate for Payer: UHCCP Medicaid |
$6.84
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$12.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC TRANSFUSION
|
Facility
|
OP
|
$1,196.46
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$228.53 |
| Max. Negotiated Rate |
$1,200.19 |
| Rate for Payer: Aetna American Axle |
$777.70
|
| Rate for Payer: Aetna Commercial |
$1,016.99
|
| Rate for Payer: Aetna Medicare |
$443.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$777.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$532.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$532.96
|
| Rate for Payer: BCBS Complete |
$239.96
|
| Rate for Payer: BCBS MAPPO |
$426.37
|
| Rate for Payer: BCN Medicare Advantage |
$426.37
|
| Rate for Payer: Cash Price |
$957.17
|
| Rate for Payer: Cash Price |
$957.17
|
| Rate for Payer: Cash Price |
$957.17
|
| Rate for Payer: Cofinity Commercial |
$1,028.96
|
| Rate for Payer: Cofinity Commercial |
$837.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$837.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.37
|
| Rate for Payer: Healthscope Commercial |
$1,076.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$837.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$897.35
|
| Rate for Payer: Mclaren Medicaid |
$228.53
|
| Rate for Payer: Mclaren Medicare |
$426.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.69
|
| Rate for Payer: Meridian Medicaid |
$239.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$490.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.99
|
| Rate for Payer: PACE Medicare |
$405.05
|
| Rate for Payer: PACE SWMI |
$426.37
|
| Rate for Payer: PHP Commercial |
$1,016.99
|
| Rate for Payer: PHP Medicare Advantage |
$426.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.70
|
| Rate for Payer: Priority Health Medicare |
$426.37
|
| Rate for Payer: Priority Health SBD |
$753.77
|
| Rate for Payer: Railroad Medicare Medicare |
$426.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.19
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$426.37
|
| Rate for Payer: UHC Exchange |
$814.84
|
| Rate for Payer: UHC Medicare Advantage |
$426.37
|
| Rate for Payer: UHCCP Medicaid |
$228.53
|
| Rate for Payer: UMR Bronson Commercial |
$442.69
|
| Rate for Payer: VA VA |
$426.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$897.35
|
|
|
HC TRANSFUSION
|
Facility
|
IP
|
$1,196.46
|
|
|
Service Code
|
CPT 36430
|
| Hospital Charge Code |
39100000
|
|
Hospital Revenue Code
|
391
|
| Min. Negotiated Rate |
$526.44 |
| Max. Negotiated Rate |
$1,076.81 |
| Rate for Payer: Aetna American Axle |
$777.70
|
| Rate for Payer: Aetna Commercial |
$1,016.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$777.70
|
| Rate for Payer: Cash Price |
$957.17
|
| Rate for Payer: Cofinity Commercial |
$1,028.96
|
| Rate for Payer: Cofinity Commercial |
$837.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$837.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$957.17
|
| Rate for Payer: Healthscope Commercial |
$1,076.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$837.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$897.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.99
|
| Rate for Payer: PHP Commercial |
$1,016.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.70
|
| Rate for Payer: Priority Health SBD |
$753.77
|
| Rate for Payer: UMR Bronson Commercial |
$526.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$897.35
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
OP
|
$632.04
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$228.53 |
| Max. Negotiated Rate |
$1,200.19 |
| Rate for Payer: Aetna American Axle |
$410.83
|
| Rate for Payer: Aetna Commercial |
$537.23
|
| Rate for Payer: Aetna Medicare |
$443.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$532.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$532.96
|
| Rate for Payer: BCBS Complete |
$239.96
|
| Rate for Payer: BCBS MAPPO |
$426.37
|
| Rate for Payer: BCN Medicare Advantage |
$426.37
|
| Rate for Payer: Cash Price |
$505.63
|
| Rate for Payer: Cash Price |
$505.63
|
| Rate for Payer: Cofinity Commercial |
$543.55
|
| Rate for Payer: Cofinity Commercial |
$442.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$442.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$426.37
|
| Rate for Payer: Healthscope Commercial |
$568.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$442.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.03
|
| Rate for Payer: Mclaren Medicaid |
$228.53
|
| Rate for Payer: Mclaren Medicare |
$426.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$447.69
|
| Rate for Payer: Meridian Medicaid |
$239.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$490.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.23
|
| Rate for Payer: PACE Medicare |
$405.05
|
| Rate for Payer: PACE SWMI |
$426.37
|
| Rate for Payer: PHP Commercial |
$537.23
|
| Rate for Payer: PHP Medicare Advantage |
$426.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.83
|
| Rate for Payer: Priority Health Medicare |
$426.37
|
| Rate for Payer: Priority Health SBD |
$398.19
|
| Rate for Payer: Railroad Medicare Medicare |
$426.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,200.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$426.37
|
| Rate for Payer: UHC Exchange |
$814.84
|
| Rate for Payer: UHC Medicare Advantage |
$426.37
|
| Rate for Payer: UHCCP Medicaid |
$228.53
|
| Rate for Payer: UMR Bronson Commercial |
$233.85
|
| Rate for Payer: VA VA |
$426.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.03
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
IP
|
$632.04
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$278.10 |
| Max. Negotiated Rate |
$568.84 |
| Rate for Payer: Aetna American Axle |
$410.83
|
| Rate for Payer: Aetna Commercial |
$537.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.83
|
| Rate for Payer: Cash Price |
$505.63
|
| Rate for Payer: Cofinity Commercial |
$442.43
|
| Rate for Payer: Cofinity Commercial |
$543.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$442.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.63
|
| Rate for Payer: Healthscope Commercial |
$568.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$442.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.23
|
| Rate for Payer: PHP Commercial |
$537.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.83
|
| Rate for Payer: Priority Health SBD |
$398.19
|
| Rate for Payer: UMR Bronson Commercial |
$278.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.03
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
OP
|
$3,168.13
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,059.28
|
| Rate for Payer: Aetna Commercial |
$2,692.91
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,059.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,534.50
|
| Rate for Payer: Cash Price |
$2,534.50
|
| Rate for Payer: Cofinity Commercial |
$2,724.59
|
| Rate for Payer: Cofinity Commercial |
$2,217.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,217.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,534.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$2,851.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,217.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,376.10
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.91
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$2,692.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,059.28
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$1,995.92
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,172.21
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,376.10
|
|
|
HC TRANSHEPATIC PORTOGRAPHY
|
Facility
|
IP
|
$3,168.13
|
|
|
Service Code
|
CPT 75887
|
| Hospital Charge Code |
32000321
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,393.98 |
| Max. Negotiated Rate |
$2,851.32 |
| Rate for Payer: Aetna American Axle |
$2,059.28
|
| Rate for Payer: Aetna Commercial |
$2,692.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,059.28
|
| Rate for Payer: Cash Price |
$2,534.50
|
| Rate for Payer: Cofinity Commercial |
$2,217.69
|
| Rate for Payer: Cofinity Commercial |
$2,724.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,217.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,534.50
|
| Rate for Payer: Healthscope Commercial |
$2,851.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,217.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,376.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.91
|
| Rate for Payer: PHP Commercial |
$2,692.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,059.28
|
| Rate for Payer: Priority Health SBD |
$1,995.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,393.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,376.10
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
IP
|
$6,252.80
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,751.23 |
| Max. Negotiated Rate |
$5,627.52 |
| Rate for Payer: Aetna American Axle |
$4,064.32
|
| Rate for Payer: Aetna Commercial |
$5,314.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,064.32
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cofinity Commercial |
$4,376.96
|
| Rate for Payer: Cofinity Commercial |
$5,377.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,376.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,002.24
|
| Rate for Payer: Healthscope Commercial |
$5,627.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,376.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,689.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,314.88
|
| Rate for Payer: PHP Commercial |
$5,314.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,064.32
|
| Rate for Payer: Priority Health SBD |
$3,939.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,751.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,689.60
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
OP
|
$6,252.80
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,313.54 |
| Max. Negotiated Rate |
$13,956.13 |
| Rate for Payer: Aetna American Axle |
$4,064.32
|
| Rate for Payer: Aetna Commercial |
$5,314.88
|
| Rate for Payer: Aetna Medicare |
$5,156.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,064.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,197.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,197.44
|
| Rate for Payer: BCBS Complete |
$2,790.33
|
| Rate for Payer: BCBS MAPPO |
$4,957.95
|
| Rate for Payer: BCN Medicare Advantage |
$4,957.95
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cofinity Commercial |
$5,377.41
|
| Rate for Payer: Cofinity Commercial |
$4,376.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,376.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,002.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,957.95
|
| Rate for Payer: Healthscope Commercial |
$5,627.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,376.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,689.60
|
| Rate for Payer: Mclaren Medicaid |
$2,657.46
|
| Rate for Payer: Mclaren Medicare |
$4,957.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,205.85
|
| Rate for Payer: Meridian Medicaid |
$2,790.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,701.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,314.88
|
| Rate for Payer: PACE Medicare |
$4,710.05
|
| Rate for Payer: PACE SWMI |
$4,957.95
|
| Rate for Payer: PHP Commercial |
$5,314.88
|
| Rate for Payer: PHP Medicare Advantage |
$4,957.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,657.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,064.32
|
| Rate for Payer: Priority Health Medicare |
$4,957.95
|
| Rate for Payer: Priority Health SBD |
$3,939.26
|
| Rate for Payer: Railroad Medicare Medicare |
$4,957.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,956.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,957.95
|
| Rate for Payer: UHC Exchange |
$9,475.14
|
| Rate for Payer: UHC Medicare Advantage |
$4,957.95
|
| Rate for Payer: UHCCP Medicaid |
$2,657.46
|
| Rate for Payer: UMR Bronson Commercial |
$2,313.54
|
| Rate for Payer: VA VA |
$4,957.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,689.60
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
OP
|
$3,693.55
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,366.61 |
| Max. Negotiated Rate |
$3,324.20 |
| Rate for Payer: Aetna American Axle |
$2,400.81
|
| Rate for Payer: Aetna Commercial |
$3,139.52
|
| Rate for Payer: Aetna Medicare |
$1,846.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.81
|
| Rate for Payer: BCBS Complete |
$1,477.42
|
| Rate for Payer: Cash Price |
$2,954.84
|
| Rate for Payer: Cofinity Commercial |
$2,585.49
|
| Rate for Payer: Cofinity Commercial |
$3,176.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,585.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.84
|
| Rate for Payer: Healthscope Commercial |
$3,324.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.52
|
| Rate for Payer: PHP Commercial |
$3,139.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,400.81
|
| Rate for Payer: Priority Health SBD |
$2,326.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.16
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
IP
|
$3,693.55
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,625.16 |
| Max. Negotiated Rate |
$3,324.20 |
| Rate for Payer: Aetna American Axle |
$2,400.81
|
| Rate for Payer: Aetna Commercial |
$3,139.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.81
|
| Rate for Payer: Cash Price |
$2,954.84
|
| Rate for Payer: Cofinity Commercial |
$2,585.49
|
| Rate for Payer: Cofinity Commercial |
$3,176.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,585.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.84
|
| Rate for Payer: Healthscope Commercial |
$3,324.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.52
|
| Rate for Payer: PHP Commercial |
$3,139.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,400.81
|
| Rate for Payer: Priority Health SBD |
$2,326.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,625.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.16
|
|
