|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$619.82 |
| Max. Negotiated Rate |
$1,267.82 |
| Rate for Payer: Aetna American Axle |
$915.65
|
| Rate for Payer: Aetna Commercial |
$1,197.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$915.65
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,211.47
|
| Rate for Payer: Cofinity Commercial |
$986.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$986.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Healthscope Commercial |
$1,267.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$986.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: PHP Commercial |
$1,197.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: Priority Health SBD |
$887.47
|
| Rate for Payer: UMR Bronson Commercial |
$619.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.52
|
|
|
HC VEIN MAPPING BILATERAL LOWER
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100024
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,267.82 |
| Rate for Payer: Aetna American Axle |
$915.65
|
| Rate for Payer: Aetna Commercial |
$1,197.39
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$915.65
|
| 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 |
$654.00
|
| Rate for Payer: BCN Commercial |
$654.00
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,211.47
|
| Rate for Payer: Cofinity Commercial |
$986.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$986.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,267.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$986.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.52
|
| 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 |
$1,197.39
|
| 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 |
$1,197.39
|
| 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 |
$915.65
|
| 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 |
$887.47
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.18
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$170.16
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$521.22
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.52
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,267.82 |
| Rate for Payer: Aetna American Axle |
$915.65
|
| Rate for Payer: Aetna Commercial |
$1,197.39
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$915.65
|
| 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 |
$654.00
|
| Rate for Payer: BCN Commercial |
$654.00
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,211.47
|
| Rate for Payer: Cofinity Commercial |
$986.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$986.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,267.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$986.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.52
|
| 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 |
$1,197.39
|
| 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 |
$1,197.39
|
| 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 |
$915.65
|
| 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 |
$887.47
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.18
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$170.16
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$521.22
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.52
|
|
|
HC VEIN MAPPING BILATERAL UPPER
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100025
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$619.82 |
| Max. Negotiated Rate |
$1,267.82 |
| Rate for Payer: Aetna American Axle |
$915.65
|
| Rate for Payer: Aetna Commercial |
$1,197.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$915.65
|
| Rate for Payer: Cash Price |
$1,126.95
|
| Rate for Payer: Cofinity Commercial |
$1,211.47
|
| Rate for Payer: Cofinity Commercial |
$986.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$986.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,126.95
|
| Rate for Payer: Healthscope Commercial |
$1,267.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$986.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,056.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,197.39
|
| Rate for Payer: PHP Commercial |
$1,197.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$915.65
|
| Rate for Payer: Priority Health SBD |
$887.47
|
| Rate for Payer: UMR Bronson Commercial |
$619.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,056.52
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$381.76 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna American Axle |
$563.96
|
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.96
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$607.34
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$607.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$607.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: PHP Commercial |
$737.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health SBD |
$546.61
|
| Rate for Payer: UMR Bronson Commercial |
$381.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC VEIN MAPPING UNILAT LOWER EXTREMITY (R OR L)
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100011
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna American Axle |
$563.96
|
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.96
|
| 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 |
$415.80
|
| Rate for Payer: BCN Commercial |
$415.80
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$607.34
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$607.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$607.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| 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 |
$737.49
|
| 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 |
$737.49
|
| 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 |
$563.96
|
| 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 |
$546.61
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.05
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$108.23
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$321.02
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna American Axle |
$563.96
|
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.96
|
| 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 |
$415.80
|
| Rate for Payer: BCN Commercial |
$415.80
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$607.34
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$607.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$607.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| 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 |
$737.49
|
| 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 |
$737.49
|
| 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 |
$563.96
|
| 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 |
$546.61
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.05
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$108.23
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$321.02
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC VEIN MAPPING UNILAT UPPER EXTREMITY (R OR L)
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100029
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$381.76 |
| Max. Negotiated Rate |
$780.87 |
| Rate for Payer: Aetna American Axle |
$563.96
|
| Rate for Payer: Aetna Commercial |
$737.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$563.96
|
| Rate for Payer: Cash Price |
$694.10
|
| Rate for Payer: Cofinity Commercial |
$607.34
|
| Rate for Payer: Cofinity Commercial |
$746.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$607.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$694.10
|
| Rate for Payer: Healthscope Commercial |
$780.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$607.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$650.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$737.49
|
| Rate for Payer: PHP Commercial |
$737.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$563.96
|
| Rate for Payer: Priority Health SBD |
$546.61
|
| Rate for Payer: UMR Bronson Commercial |
$381.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$650.72
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
IP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,061.70 |
| Max. Negotiated Rate |
$2,171.66 |
| Rate for Payer: Aetna American Axle |
$1,568.42
|
| Rate for Payer: Aetna Commercial |
$2,051.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,568.42
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Commercial |
$1,689.07
|
| Rate for Payer: Cofinity Commercial |
$2,075.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,689.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Healthscope Commercial |
$2,171.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,689.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,809.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: PHP Commercial |
$2,051.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,568.42
|
| Rate for Payer: Priority Health SBD |
$1,520.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,061.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,809.72
|
|
|
HC VENA CAVA FILTER LVL 5
|
Facility
|
OP
|
$2,412.96
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800093
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$892.80 |
| Max. Negotiated Rate |
$2,171.66 |
| Rate for Payer: Aetna American Axle |
$1,568.42
|
| Rate for Payer: Aetna Commercial |
$2,051.02
|
| Rate for Payer: Aetna Medicare |
$1,206.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,568.42
|
| Rate for Payer: BCBS Complete |
$965.18
|
| Rate for Payer: Cash Price |
$1,930.37
|
| Rate for Payer: Cofinity Commercial |
$1,689.07
|
| Rate for Payer: Cofinity Commercial |
$2,075.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,689.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,930.37
|
| Rate for Payer: Healthscope Commercial |
$2,171.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,689.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,809.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,051.02
|
| Rate for Payer: PHP Commercial |
$2,051.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,568.42
|
| Rate for Payer: Priority Health SBD |
$1,520.16
|
| Rate for Payer: UMR Bronson Commercial |
$892.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,809.72
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
IP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,297.32 |
| Max. Negotiated Rate |
$2,653.61 |
| Rate for Payer: Aetna American Axle |
$1,916.50
|
| Rate for Payer: Aetna Commercial |
$2,506.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,916.50
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Commercial |
$2,063.92
|
| Rate for Payer: Cofinity Commercial |
$2,535.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,063.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Healthscope Commercial |
$2,653.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,063.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,211.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: PHP Commercial |
$2,506.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,916.50
|
| Rate for Payer: Priority Health SBD |
$1,857.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,297.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,211.34
|
|
|
HC VENA CAVA FILTER LVL 6
|
Facility
|
OP
|
$2,948.46
|
|
|
Service Code
|
HCPCS C1880
|
| Hospital Charge Code |
27800094
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,090.93 |
| Max. Negotiated Rate |
$2,653.61 |
| Rate for Payer: Healthscope Commercial |
$2,653.61
|
| Rate for Payer: Aetna American Axle |
$1,916.50
|
| Rate for Payer: Aetna Commercial |
$2,506.19
|
| Rate for Payer: Aetna Medicare |
$1,474.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,916.50
|
| Rate for Payer: BCBS Complete |
$1,179.38
|
| Rate for Payer: Cash Price |
$2,358.77
|
| Rate for Payer: Cofinity Commercial |
$2,063.92
|
| Rate for Payer: Cofinity Commercial |
$2,535.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,063.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,358.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,063.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,211.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,506.19
|
| Rate for Payer: PHP Commercial |
$2,506.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,916.50
|
| Rate for Payer: Priority Health SBD |
$1,857.53
|
| Rate for Payer: UMR Bronson Commercial |
$1,090.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,211.34
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
OP
|
$408.07
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$150.99 |
| Max. Negotiated Rate |
$367.26 |
| Rate for Payer: Aetna American Axle |
$265.25
|
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: Aetna Medicare |
$204.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.25
|
| Rate for Payer: BCBS Complete |
$163.23
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$285.65
|
| Rate for Payer: Cofinity Commercial |
$350.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$367.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: PHP Commercial |
$346.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health SBD |
$257.08
|
| Rate for Payer: UMR Bronson Commercial |
$150.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.05
|
|
|
HC VEN ADDL VEIN INTRAOP
|
Facility
|
IP
|
$408.07
|
|
| Hospital Charge Code |
36000051
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$179.55 |
| Max. Negotiated Rate |
$367.26 |
| Rate for Payer: Aetna American Axle |
$265.25
|
| Rate for Payer: Aetna Commercial |
$346.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.25
|
| Rate for Payer: Cash Price |
$326.46
|
| Rate for Payer: Cofinity Commercial |
$285.65
|
| Rate for Payer: Cofinity Commercial |
$350.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.46
|
| Rate for Payer: Healthscope Commercial |
$367.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.86
|
| Rate for Payer: PHP Commercial |
$346.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.25
|
| Rate for Payer: Priority Health SBD |
$257.08
|
| Rate for Payer: UMR Bronson Commercial |
$179.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.05
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$8.75 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$22.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: BCBS Complete |
$18.36
|
| Rate for Payer: BCBS Trust/PPO |
$27.19
|
| Rate for Payer: BCN Commercial |
$27.19
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.62
|
| Rate for Payer: UHC Exchange |
$8.75
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC VENIPUNCT BY PHYS/QHP 3/> YRS
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 36410
|
| Hospital Charge Code |
45000105
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.84
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
IP
|
$8,817.94
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$3,879.89 |
| Max. Negotiated Rate |
$7,936.15 |
| Rate for Payer: Aetna American Axle |
$5,731.66
|
| Rate for Payer: Aetna Commercial |
$7,495.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,731.66
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cofinity Commercial |
$6,172.56
|
| Rate for Payer: Cofinity Commercial |
$7,583.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,172.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,054.35
|
| Rate for Payer: Healthscope Commercial |
$7,936.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,172.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,613.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,495.25
|
| Rate for Payer: PHP Commercial |
$7,495.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,731.66
|
| Rate for Payer: Priority Health SBD |
$5,555.30
|
| Rate for Payer: UMR Bronson Commercial |
$3,879.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,613.46
|
|
|
HC VENOGRAM ADRENAL
|
Facility
|
OP
|
$8,817.94
|
|
|
Service Code
|
CPT 75840
|
| Hospital Charge Code |
32000334
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$118.85 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$5,731.66
|
| Rate for Payer: Aetna Commercial |
$7,495.25
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,731.66
|
| 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 |
$153.95
|
| Rate for Payer: BCN Commercial |
$153.95
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cash Price |
$7,054.35
|
| Rate for Payer: Cofinity Commercial |
$7,583.43
|
| Rate for Payer: Cofinity Commercial |
$6,172.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,172.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,054.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$7,936.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,172.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,613.46
|
| 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 |
$7,495.25
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$7,495.25
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,731.66
|
| 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 |
$5,555.30
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.74
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$118.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$3,262.64
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,613.46
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
OP
|
$5,018.21
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$116.43 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$3,261.84
|
| Rate for Payer: Aetna Commercial |
$4,265.48
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,261.84
|
| 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 |
$4,014.57
|
| Rate for Payer: Cash Price |
$4,014.57
|
| Rate for Payer: Cofinity Commercial |
$4,315.66
|
| Rate for Payer: Cofinity Commercial |
$3,512.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,512.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,014.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,516.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,512.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,763.66
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,265.48
|
| Rate for Payer: Nomi Health Commercial |
$9,251.58
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$4,265.48
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,261.84
|
| 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 |
$3,161.47
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.07
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$116.43
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,856.74
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,763.66
|
|
|
HC VENOGRAM INTERNAL JUGULAR
|
Facility
|
IP
|
$5,018.21
|
|
|
Service Code
|
CPT 75860
|
| Hospital Charge Code |
32000319
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$2,208.01 |
| Max. Negotiated Rate |
$4,516.39 |
| Rate for Payer: Aetna American Axle |
$3,261.84
|
| Rate for Payer: Aetna Commercial |
$4,265.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,261.84
|
| Rate for Payer: Cash Price |
$4,014.57
|
| Rate for Payer: Cofinity Commercial |
$3,512.75
|
| Rate for Payer: Cofinity Commercial |
$4,315.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,512.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,014.57
|
| Rate for Payer: Healthscope Commercial |
$4,516.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,512.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,763.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,265.48
|
| Rate for Payer: PHP Commercial |
$4,265.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,261.84
|
| Rate for Payer: Priority Health SBD |
$3,161.47
|
| Rate for Payer: UMR Bronson Commercial |
$2,208.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,763.66
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
OP
|
$2,442.36
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$143.96 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$1,587.53
|
| Rate for Payer: Aetna Commercial |
$2,076.01
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.53
|
| 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 |
$201.14
|
| Rate for Payer: BCN Commercial |
$201.14
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$1,953.89
|
| Rate for Payer: Cash Price |
$1,953.89
|
| Rate for Payer: Cash Price |
$1,953.89
|
| Rate for Payer: Cofinity Commercial |
$1,709.65
|
| Rate for Payer: Cofinity Commercial |
$2,100.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,709.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$2,198.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,709.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,831.77
|
| 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 |
$2,076.01
|
| 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 |
$2,076.01
|
| 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 |
$1,587.53
|
| 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 |
$1,538.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.36
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$143.96
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$903.67
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,831.77
|
|
|
HC VENOGRAM SUPERIOR SAGITTAL SINUS
|
Facility
|
IP
|
$2,442.36
|
|
|
Service Code
|
CPT 75870
|
| Hospital Charge Code |
32000320
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,074.64 |
| Max. Negotiated Rate |
$2,198.12 |
| Rate for Payer: Aetna American Axle |
$1,587.53
|
| Rate for Payer: Aetna Commercial |
$2,076.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,587.53
|
| Rate for Payer: Cash Price |
$1,953.89
|
| Rate for Payer: Cofinity Commercial |
$1,709.65
|
| Rate for Payer: Cofinity Commercial |
$2,100.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,709.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,953.89
|
| Rate for Payer: Healthscope Commercial |
$2,198.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,709.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,831.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,076.01
|
| Rate for Payer: PHP Commercial |
$2,076.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,587.53
|
| Rate for Payer: Priority Health SBD |
$1,538.69
|
| Rate for Payer: UMR Bronson Commercial |
$1,074.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,831.77
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
IP
|
$1,796.10
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$790.28 |
| Max. Negotiated Rate |
$1,616.49 |
| Rate for Payer: Aetna American Axle |
$1,167.46
|
| Rate for Payer: Aetna Commercial |
$1,526.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.46
|
| Rate for Payer: Cash Price |
$1,436.88
|
| Rate for Payer: Cofinity Commercial |
$1,257.27
|
| Rate for Payer: Cofinity Commercial |
$1,544.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,257.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,436.88
|
| Rate for Payer: Healthscope Commercial |
$1,616.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,257.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,347.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,526.68
|
| Rate for Payer: PHP Commercial |
$1,526.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,167.46
|
| Rate for Payer: Priority Health SBD |
$1,131.54
|
| Rate for Payer: UMR Bronson Commercial |
$790.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,347.08
|
|
|
HC VENOUS INSUFFICIENCY BIL
|
Facility
|
OP
|
$1,796.10
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92000033
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,616.49 |
| Rate for Payer: Aetna American Axle |
$1,167.46
|
| Rate for Payer: Aetna Commercial |
$1,526.68
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,167.46
|
| 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 |
$654.00
|
| Rate for Payer: BCN Commercial |
$654.00
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,436.88
|
| Rate for Payer: Cash Price |
$1,436.88
|
| Rate for Payer: Cash Price |
$1,436.88
|
| Rate for Payer: Cofinity Commercial |
$1,257.27
|
| Rate for Payer: Cofinity Commercial |
$1,544.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,257.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,436.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,616.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,257.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,347.08
|
| 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 |
$1,526.68
|
| 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 |
$1,526.68
|
| 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 |
$1,167.46
|
| 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 |
$1,131.54
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.18
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$170.16
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$664.56
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,347.08
|
|
|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,644.53
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$323.20 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$3,018.94
|
| Rate for Payer: Aetna Commercial |
$3,947.85
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,018.94
|
| 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 |
$1,986.82
|
| Rate for Payer: BCN Commercial |
$1,986.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$3,994.30
|
| Rate for Payer: Cofinity Commercial |
$3,251.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,251.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,180.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,251.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,483.40
|
| 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 |
$3,947.85
|
| 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 |
$3,947.85
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| 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 |
$2,926.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$355.52
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$323.20
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,718.48
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,483.40
|
|
