|
HC TRANSCATH INSERT/REPLACE PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$24,969.60
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$10,986.62 |
| Max. Negotiated Rate |
$22,472.64 |
| Rate for Payer: Aetna American Axle |
$16,230.24
|
| Rate for Payer: Aetna Commercial |
$21,224.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,230.24
|
| Rate for Payer: Cash Price |
$19,975.68
|
| Rate for Payer: Cofinity Commercial |
$17,478.72
|
| Rate for Payer: Cofinity Commercial |
$21,473.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$17,478.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,975.68
|
| Rate for Payer: Healthscope Commercial |
$22,472.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,478.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,727.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,224.16
|
| Rate for Payer: PHP Commercial |
$21,224.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,230.24
|
| Rate for Payer: Priority Health SBD |
$15,730.85
|
| Rate for Payer: UMR Bronson Commercial |
$10,986.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,727.20
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
OP
|
$43,221.34
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,879.00 |
| Max. Negotiated Rate |
$38,899.21 |
| Rate for Payer: Aetna American Axle |
$28,093.87
|
| Rate for Payer: Aetna Commercial |
$36,738.14
|
| Rate for Payer: Aetna Medicare |
$21,610.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28,093.87
|
| Rate for Payer: BCBS Complete |
$17,288.54
|
| Rate for Payer: Cash Price |
$34,577.07
|
| Rate for Payer: Cash Price |
$34,577.07
|
| Rate for Payer: Cofinity Commercial |
$37,170.35
|
| Rate for Payer: Cofinity Commercial |
$30,254.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$30,254.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34,577.07
|
| Rate for Payer: Healthscope Commercial |
$38,899.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30,254.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32,416.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,738.14
|
| Rate for Payer: PHP Commercial |
$36,738.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28,093.87
|
| Rate for Payer: Priority Health SBD |
$27,229.44
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UMR Bronson Commercial |
$15,991.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32,416.00
|
|
|
HC TRANS CATH MITRAL VALVE IMPLNT/REPLACE
|
Facility
|
IP
|
$43,221.34
|
|
|
Service Code
|
CPT 0483T
|
| Hospital Charge Code |
48100121
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$19,017.39 |
| Max. Negotiated Rate |
$38,899.21 |
| Rate for Payer: Aetna American Axle |
$28,093.87
|
| Rate for Payer: Aetna Commercial |
$36,738.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28,093.87
|
| Rate for Payer: Cash Price |
$34,577.07
|
| Rate for Payer: Cofinity Commercial |
$30,254.94
|
| Rate for Payer: Cofinity Commercial |
$37,170.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$30,254.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34,577.07
|
| Rate for Payer: Healthscope Commercial |
$38,899.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30,254.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32,416.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36,738.14
|
| Rate for Payer: PHP Commercial |
$36,738.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28,093.87
|
| Rate for Payer: Priority Health SBD |
$27,229.44
|
| Rate for Payer: UMR Bronson Commercial |
$19,017.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32,416.00
|
|
|
HC TRANSCATH REMOVAL PERM LEADLESS PACEMAKER
|
Facility
|
IP
|
$3,891.10
|
|
|
Service Code
|
CPT 33275
|
| Hospital Charge Code |
48100116
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,712.08 |
| Max. Negotiated Rate |
$3,501.99 |
| Rate for Payer: Aetna American Axle |
$2,529.22
|
| Rate for Payer: Aetna Commercial |
$3,307.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,529.22
|
| Rate for Payer: Cash Price |
$3,112.88
|
| Rate for Payer: Cofinity Commercial |
$2,723.77
|
| Rate for Payer: Cofinity Commercial |
$3,346.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,723.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.88
|
| 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: Multiplan/Beech St/PHCS Commercial |
$3,307.44
|
| Rate for Payer: PHP Commercial |
$3,307.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,529.22
|
| Rate for Payer: Priority Health SBD |
$2,451.39
|
| Rate for Payer: UMR Bronson Commercial |
$1,712.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.32
|
|
|
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 |
$485.98 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,529.22
|
| Rate for Payer: Aetna Commercial |
$3,307.44
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,529.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,259.92
|
| Rate for Payer: BCN Commercial |
$2,259.92
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,112.88
|
| 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 |
$3,083.86
|
| 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 |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.44
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$3,307.44
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,529.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$2,451.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$534.58
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$485.98
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,439.71
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.32
|
|
|
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 |
$2,994.22 |
| Max. Negotiated Rate |
$17,557.45 |
| Rate for Payer: Aetna American Axle |
$10,402.60
|
| Rate for Payer: Aetna Commercial |
$13,603.40
|
| Rate for Payer: Aetna Medicare |
$5,809.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,402.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,982.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,982.80
|
| Rate for Payer: BCBS Complete |
$3,143.94
|
| Rate for Payer: BCBS MAPPO |
$5,586.24
|
| Rate for Payer: BCBS Trust/PPO |
$4,634.47
|
| Rate for Payer: BCN Commercial |
$4,634.47
|
| Rate for Payer: BCN Medicare Advantage |
$5,586.24
|
| Rate for Payer: Cash Price |
$12,803.20
|
| 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 |
$5,586.24
|
| 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 |
$2,994.22
|
| Rate for Payer: Mclaren Medicare |
$5,586.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,865.55
|
| Rate for Payer: Meridian Medicaid |
$3,143.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,424.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,603.40
|
| Rate for Payer: Nomi Health Commercial |
$11,731.10
|
| Rate for Payer: PACE Medicare |
$5,306.93
|
| Rate for Payer: PACE SWMI |
$5,586.24
|
| Rate for Payer: PHP Commercial |
$13,603.40
|
| Rate for Payer: PHP Medicare Advantage |
$5,586.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,994.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,402.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17,557.45
|
| Rate for Payer: Priority Health Medicare |
$5,586.24
|
| Rate for Payer: Priority Health Narrow Network |
$14,045.96
|
| Rate for Payer: Priority Health SBD |
$10,082.52
|
| Rate for Payer: Railroad Medicare Medicare |
$5,586.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15,724.71
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,586.24
|
| Rate for Payer: UHC Exchange |
$10,675.86
|
| Rate for Payer: UHC Medicare Advantage |
$5,586.24
|
| Rate for Payer: UHCCP Medicaid |
$2,994.22
|
| Rate for Payer: UMR Bronson Commercial |
$5,921.48
|
| Rate for Payer: VA VA |
$5,586.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,003.00
|
|
|
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 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: 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: 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: 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 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 TRANSCRANIAL USN IMAGING COMPL
|
Facility
|
OP
|
$1,618.27
|
|
|
Service Code
|
CPT 93886
|
| Hospital Charge Code |
92100002
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| 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 |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,051.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$968.32
|
| Rate for Payer: BCN Commercial |
$968.32
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| 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 |
$236.83
|
| 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 |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,375.53
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$1,375.53
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,051.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$1,019.51
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$273.72
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$248.84
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$598.76
|
| Rate for Payer: VA VA |
$236.83
|
| 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 |
$55.85 |
| 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 |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$572.26
|
| Rate for Payer: BCN Commercial |
$572.26
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| 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 |
$104.19
|
| 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 |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$519.72
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$519.72
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$385.21
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.25
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$144.77
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$226.23
|
| Rate for Payer: VA VA |
$104.19
|
| 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
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 95929
|
| Hospital Charge Code |
92200017
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$161.92 |
| Max. Negotiated Rate |
$1,633.95 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$540.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| 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 |
$703.33
|
| Rate for Payer: BCN Commercial |
$703.33
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| 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 |
$519.87
|
| 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 |
$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 |
$371.99
|
| 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 |
$371.99
|
| 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 |
$284.46
|
| 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 |
$275.71
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.10
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$222.82
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: UMR Bronson Commercial |
$161.92
|
| Rate for Payer: VA VA |
$519.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
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 UE MOTOR STIM
|
Facility
|
OP
|
$626.24
|
|
|
Service Code
|
CPT 95928
|
| Hospital Charge Code |
92200016
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$220.52 |
| Max. Negotiated Rate |
$3,132.99 |
| Rate for Payer: Aetna American Axle |
$407.06
|
| Rate for Payer: Aetna Commercial |
$532.30
|
| Rate for Payer: Aetna Medicare |
$1,036.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$407.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$690.63
|
| Rate for Payer: BCN Commercial |
$690.63
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| 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 |
$996.82
|
| 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 |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$532.30
|
| Rate for Payer: Nomi Health Commercial |
$2,990.46
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$532.30
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$407.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,132.99
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,506.39
|
| Rate for Payer: Priority Health SBD |
$394.53
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.57
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$220.52
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: UMR Bronson Commercial |
$231.71
|
| Rate for Payer: VA VA |
$996.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$469.68
|
|
|
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 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: BCBS Trust/PPO |
$12.29
|
| Rate for Payer: BCN Commercial |
$12.29
|
| 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: Nomi Health Commercial |
$19.14
|
| 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 HMO/PPO/Tiered Network |
$12.76
|
| Rate for Payer: Priority Health Medicare |
$12.76
|
| Rate for Payer: Priority Health Narrow Network |
$10.21
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$12.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.76
|
| Rate for Payer: UHC Exchange |
$12.76
|
| 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 |
$38.14 |
| Max. Negotiated Rate |
$1,346.26 |
| Rate for Payer: Aetna American Axle |
$777.70
|
| Rate for Payer: Aetna Commercial |
$1,016.99
|
| Rate for Payer: Aetna Medicare |
$445.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$777.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$535.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$535.42
|
| Rate for Payer: BCBS Complete |
$241.07
|
| Rate for Payer: BCBS MAPPO |
$428.34
|
| Rate for Payer: BCBS Trust/PPO |
$174.77
|
| Rate for Payer: BCN Commercial |
$174.77
|
| Rate for Payer: BCN Medicare Advantage |
$428.34
|
| 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 |
$428.34
|
| 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 |
$897.34
|
| Rate for Payer: Mclaren Medicaid |
$229.59
|
| Rate for Payer: Mclaren Medicare |
$428.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.76
|
| Rate for Payer: Meridian Medicaid |
$241.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$492.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,016.99
|
| Rate for Payer: Nomi Health Commercial |
$1,285.02
|
| Rate for Payer: PACE Medicare |
$406.92
|
| Rate for Payer: PACE SWMI |
$428.34
|
| Rate for Payer: PHP Commercial |
$1,016.99
|
| Rate for Payer: PHP Medicare Advantage |
$428.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$777.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,346.26
|
| Rate for Payer: Priority Health Medicare |
$428.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.01
|
| Rate for Payer: Priority Health SBD |
$753.77
|
| Rate for Payer: Railroad Medicare Medicare |
$428.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.95
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.34
|
| Rate for Payer: UHC Exchange |
$38.14
|
| Rate for Payer: UHC Medicare Advantage |
$428.34
|
| Rate for Payer: UHCCP Medicaid |
$229.59
|
| Rate for Payer: UMR Bronson Commercial |
$442.69
|
| Rate for Payer: VA VA |
$428.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$897.34
|
|
|
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 |
$897.34
|
| 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 |
$897.34
|
|
|
HC TRANSFUSION INTRAUTERINE FETAL
|
Facility
|
OP
|
$632.04
|
|
|
Service Code
|
CPT 36460
|
| Hospital Charge Code |
36100115
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$229.59 |
| Max. Negotiated Rate |
$1,346.26 |
| Rate for Payer: Aetna American Axle |
$410.83
|
| Rate for Payer: Aetna Commercial |
$537.23
|
| Rate for Payer: Aetna Medicare |
$445.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$410.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$535.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$535.42
|
| Rate for Payer: BCBS Complete |
$241.07
|
| Rate for Payer: BCBS MAPPO |
$428.34
|
| Rate for Payer: BCBS Trust/PPO |
$356.60
|
| Rate for Payer: BCN Commercial |
$356.60
|
| Rate for Payer: BCN Medicare Advantage |
$428.34
|
| Rate for Payer: Cash Price |
$505.63
|
| Rate for Payer: Cash Price |
$505.63
|
| 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: Health Alliance Plan Medicare Advantage |
$428.34
|
| 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 |
$229.59
|
| Rate for Payer: Mclaren Medicare |
$428.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$449.76
|
| Rate for Payer: Meridian Medicaid |
$241.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$492.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$537.23
|
| Rate for Payer: Nomi Health Commercial |
$1,285.02
|
| Rate for Payer: PACE Medicare |
$406.92
|
| Rate for Payer: PACE SWMI |
$428.34
|
| Rate for Payer: PHP Commercial |
$537.23
|
| Rate for Payer: PHP Medicare Advantage |
$428.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$410.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,346.26
|
| Rate for Payer: Priority Health Medicare |
$428.34
|
| Rate for Payer: Priority Health Narrow Network |
$1,077.01
|
| Rate for Payer: Priority Health SBD |
$398.19
|
| Rate for Payer: Railroad Medicare Medicare |
$428.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$367.76
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$428.34
|
| Rate for Payer: UHC Exchange |
$334.33
|
| Rate for Payer: UHC Medicare Advantage |
$428.34
|
| Rate for Payer: UHCCP Medicaid |
$229.59
|
| Rate for Payer: UMR Bronson Commercial |
$233.85
|
| Rate for Payer: VA VA |
$428.34
|
| 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 |
$128.13 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$2,059.28
|
| Rate for Payer: Aetna Commercial |
$2,692.91
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,059.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$149.84
|
| Rate for Payer: BCN Commercial |
$149.84
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$2,534.50
|
| Rate for Payer: Cash Price |
$2,534.50
|
| 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: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| 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 |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,692.91
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$2,692.91
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,059.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$1,995.92
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.94
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$128.13
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,172.21
|
| Rate for Payer: VA VA |
$3,083.86
|
| 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
|
|
