|
HC VENOUS TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,644.53
|
|
|
Service Code
|
CPT 37212
|
| Hospital Charge Code |
36100372
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,043.59 |
| Max. Negotiated Rate |
$4,180.08 |
| Rate for Payer: Aetna American Axle |
$3,018.94
|
| Rate for Payer: Aetna Commercial |
$3,947.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,018.94
|
| Rate for Payer: Cash Price |
$3,715.62
|
| Rate for Payer: Cofinity Commercial |
$3,251.17
|
| Rate for Payer: Cofinity Commercial |
$3,994.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,251.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,715.62
|
| 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: Multiplan/Beech St/PHCS Commercial |
$3,947.85
|
| Rate for Payer: PHP Commercial |
$3,947.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,018.94
|
| Rate for Payer: Priority Health SBD |
$2,926.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,043.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,483.40
|
|
|
HC VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
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 VENOUS ULTR IMAG BIL LOWER EXTREMITY
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100010
|
|
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 VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
OP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
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 VENOUS ULTR IMAG BIL UPPER EXTREMITY
|
Facility
|
IP
|
$1,408.69
|
|
|
Service Code
|
CPT 93970
|
| Hospital Charge Code |
92100028
|
|
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 VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
OP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
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 VENOUS ULTR IMAG UNILATERAL LOWER (R OR L)
|
Facility
|
IP
|
$867.63
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100022
|
|
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 VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
IP
|
$1,020.74
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$449.13 |
| Max. Negotiated Rate |
$918.67 |
| Rate for Payer: Aetna American Axle |
$663.48
|
| Rate for Payer: Aetna Commercial |
$867.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.48
|
| Rate for Payer: Cash Price |
$816.59
|
| Rate for Payer: Cofinity Commercial |
$714.52
|
| Rate for Payer: Cofinity Commercial |
$877.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.59
|
| Rate for Payer: Healthscope Commercial |
$918.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$867.63
|
| Rate for Payer: PHP Commercial |
$867.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.48
|
| Rate for Payer: Priority Health SBD |
$643.07
|
| Rate for Payer: UMR Bronson Commercial |
$449.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.56
|
|
|
HC VENOUS ULTR IMAG UNILATERAL UPPER (R OR L)
|
Facility
|
OP
|
$1,020.74
|
|
|
Service Code
|
CPT 93971
|
| Hospital Charge Code |
92100023
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$918.67 |
| Rate for Payer: Aetna American Axle |
$663.48
|
| Rate for Payer: Aetna Commercial |
$867.63
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.48
|
| 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 |
$816.59
|
| Rate for Payer: Cash Price |
$816.59
|
| Rate for Payer: Cash Price |
$816.59
|
| Rate for Payer: Cofinity Commercial |
$714.52
|
| Rate for Payer: Cofinity Commercial |
$877.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$714.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$918.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.56
|
| 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 |
$867.63
|
| 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 |
$867.63
|
| 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 |
$663.48
|
| 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 |
$643.07
|
| 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 |
$377.67
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.56
|
|
|
HC VENT CPS Y
|
Facility
|
IP
|
$30.60
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC VENT CPS Y
|
Facility
|
OP
|
$30.60
|
|
| Hospital Charge Code |
27000058
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.32 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$15.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: BCBS Complete |
$12.24
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.89
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
IP
|
$8,122.26
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,573.79 |
| Max. Negotiated Rate |
$7,310.03 |
| Rate for Payer: Aetna American Axle |
$5,279.47
|
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,279.47
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$5,685.58
|
| Rate for Payer: Cofinity Commercial |
$6,985.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,685.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,685.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,091.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: PHP Commercial |
$6,903.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health SBD |
$5,117.02
|
| Rate for Payer: UMR Bronson Commercial |
$3,573.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,091.70
|
|
|
HC VENT TUBE RMVL REQ GENERAL ANES
|
Facility
|
OP
|
$8,122.26
|
|
|
Service Code
|
CPT 69424
|
| Hospital Charge Code |
76100485
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.63 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna American Axle |
$5,279.47
|
| Rate for Payer: Aetna Commercial |
$6,903.92
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,279.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$3,190.99
|
| Rate for Payer: BCN Commercial |
$3,190.99
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cash Price |
$6,497.81
|
| Rate for Payer: Cofinity Commercial |
$5,685.58
|
| Rate for Payer: Cofinity Commercial |
$6,985.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,685.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,497.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,310.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,685.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,091.70
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,903.92
|
| Rate for Payer: Nomi Health Commercial |
$9,532.50
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,903.92
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,279.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,117.02
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.39
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$57.63
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: UMR Bronson Commercial |
$3,005.24
|
| Rate for Payer: VA VA |
$3,177.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,091.70
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
IP
|
$858.34
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$377.67 |
| Max. Negotiated Rate |
$772.51 |
| Rate for Payer: Aetna American Axle |
$557.92
|
| Rate for Payer: Aetna Commercial |
$729.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.92
|
| Rate for Payer: Cash Price |
$686.67
|
| Rate for Payer: Cofinity Commercial |
$600.84
|
| Rate for Payer: Cofinity Commercial |
$738.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$600.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.67
|
| Rate for Payer: Healthscope Commercial |
$772.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$600.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.59
|
| Rate for Payer: PHP Commercial |
$729.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.92
|
| Rate for Payer: Priority Health SBD |
$540.75
|
| Rate for Payer: UMR Bronson Commercial |
$377.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.76
|
|
|
HC VEN ULTRA IMAG INTRAOP
|
Facility
|
OP
|
$858.34
|
|
| Hospital Charge Code |
36000052
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$317.59 |
| Max. Negotiated Rate |
$772.51 |
| Rate for Payer: Aetna American Axle |
$557.92
|
| Rate for Payer: Aetna Commercial |
$729.59
|
| Rate for Payer: Aetna Medicare |
$429.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.92
|
| Rate for Payer: BCBS Complete |
$343.34
|
| Rate for Payer: Cash Price |
$686.67
|
| Rate for Payer: Cofinity Commercial |
$600.84
|
| Rate for Payer: Cofinity Commercial |
$738.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$600.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.67
|
| Rate for Payer: Healthscope Commercial |
$772.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$600.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.59
|
| Rate for Payer: PHP Commercial |
$729.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$557.92
|
| Rate for Payer: Priority Health SBD |
$540.75
|
| Rate for Payer: UMR Bronson Commercial |
$317.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.76
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
OP
|
$5,102.97
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$415.61 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$3,316.93
|
| Rate for Payer: Aetna Commercial |
$4,337.52
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,316.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,808.46
|
| Rate for Payer: BCN Commercial |
$2,808.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cofinity Commercial |
$4,388.55
|
| Rate for Payer: Cofinity Commercial |
$3,572.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,572.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,082.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$4,592.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,572.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,827.23
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,337.52
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$4,337.52
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,316.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$3,214.87
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$457.17
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$415.61
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,888.10
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,827.23
|
|
|
HC VERPLSTY W WO BONE BX C TH 1ST
|
Facility
|
IP
|
$5,102.97
|
|
|
Service Code
|
CPT 22510
|
| Hospital Charge Code |
36100465
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,245.31 |
| Max. Negotiated Rate |
$4,592.67 |
| Rate for Payer: Aetna American Axle |
$3,316.93
|
| Rate for Payer: Aetna Commercial |
$4,337.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,316.93
|
| Rate for Payer: Cash Price |
$4,082.38
|
| Rate for Payer: Cofinity Commercial |
$3,572.08
|
| Rate for Payer: Cofinity Commercial |
$4,388.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,572.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,082.38
|
| Rate for Payer: Healthscope Commercial |
$4,592.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,572.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,827.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,337.52
|
| Rate for Payer: PHP Commercial |
$4,337.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,316.93
|
| Rate for Payer: Priority Health SBD |
$3,214.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,245.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,827.23
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
IP
|
$5,456.20
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,400.73 |
| Max. Negotiated Rate |
$4,910.58 |
| Rate for Payer: Aetna American Axle |
$3,546.53
|
| Rate for Payer: Aetna Commercial |
$4,637.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,546.53
|
| Rate for Payer: Cash Price |
$4,364.96
|
| Rate for Payer: Cofinity Commercial |
$3,819.34
|
| Rate for Payer: Cofinity Commercial |
$4,692.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,819.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,364.96
|
| Rate for Payer: Healthscope Commercial |
$4,910.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,819.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,092.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,637.77
|
| Rate for Payer: PHP Commercial |
$4,637.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,546.53
|
| Rate for Payer: Priority Health SBD |
$3,437.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,400.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,092.15
|
|
|
HC VERPLSTY W WO BONE BX EA ADD
|
Facility
|
OP
|
$5,456.20
|
|
|
Service Code
|
CPT 22512
|
| Hospital Charge Code |
36100466
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$200.69 |
| Max. Negotiated Rate |
$4,910.58 |
| Rate for Payer: Aetna American Axle |
$3,546.53
|
| Rate for Payer: Aetna Commercial |
$4,637.77
|
| Rate for Payer: Aetna Medicare |
$2,728.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,546.53
|
| Rate for Payer: BCBS Complete |
$2,182.48
|
| Rate for Payer: BCBS Trust/PPO |
$3,933.19
|
| Rate for Payer: BCN Commercial |
$3,933.19
|
| Rate for Payer: Cash Price |
$4,364.96
|
| Rate for Payer: Cash Price |
$4,364.96
|
| Rate for Payer: Cash Price |
$4,364.96
|
| Rate for Payer: Cofinity Commercial |
$4,692.33
|
| Rate for Payer: Cofinity Commercial |
$3,819.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,819.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,364.96
|
| Rate for Payer: Healthscope Commercial |
$4,910.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,819.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,092.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,637.77
|
| Rate for Payer: PHP Commercial |
$4,637.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,546.53
|
| Rate for Payer: Priority Health SBD |
$3,437.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.76
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$200.69
|
| Rate for Payer: UMR Bronson Commercial |
$2,018.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,092.15
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
OP
|
$4,768.21
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$390.89 |
| Max. Negotiated Rate |
$9,991.56 |
| Rate for Payer: Aetna American Axle |
$3,099.34
|
| Rate for Payer: Aetna Commercial |
$4,052.98
|
| Rate for Payer: Aetna Medicare |
$3,306.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,099.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,973.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,973.75
|
| Rate for Payer: BCBS Complete |
$1,789.14
|
| Rate for Payer: BCBS MAPPO |
$3,179.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,808.46
|
| Rate for Payer: BCN Commercial |
$2,808.46
|
| Rate for Payer: BCN Medicare Advantage |
$3,179.00
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cofinity Commercial |
$4,100.66
|
| Rate for Payer: Cofinity Commercial |
$3,337.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,337.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,814.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,179.00
|
| Rate for Payer: Healthscope Commercial |
$4,291.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,337.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,576.16
|
| Rate for Payer: Mclaren Medicaid |
$1,703.94
|
| Rate for Payer: Mclaren Medicare |
$3,179.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,337.95
|
| Rate for Payer: Meridian Medicaid |
$1,789.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,655.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,052.98
|
| Rate for Payer: Nomi Health Commercial |
$6,675.90
|
| Rate for Payer: PACE Medicare |
$3,020.05
|
| Rate for Payer: PACE SWMI |
$3,179.00
|
| Rate for Payer: PHP Commercial |
$4,052.98
|
| Rate for Payer: PHP Medicare Advantage |
$3,179.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,099.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,991.56
|
| Rate for Payer: Priority Health Medicare |
$3,179.00
|
| Rate for Payer: Priority Health Narrow Network |
$7,993.25
|
| Rate for Payer: Priority Health SBD |
$3,003.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,179.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.98
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,179.00
|
| Rate for Payer: UHC Exchange |
$390.89
|
| Rate for Payer: UHC Medicare Advantage |
$3,179.00
|
| Rate for Payer: UHCCP Medicaid |
$1,703.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,764.24
|
| Rate for Payer: VA VA |
$3,179.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,576.16
|
|
|
HC VERPLSTY W WO BONE BX L S 1ST
|
Facility
|
IP
|
$4,768.21
|
|
|
Service Code
|
CPT 22511
|
| Hospital Charge Code |
36100464
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,098.01 |
| Max. Negotiated Rate |
$4,291.39 |
| Rate for Payer: Aetna American Axle |
$3,099.34
|
| Rate for Payer: Aetna Commercial |
$4,052.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,099.34
|
| Rate for Payer: Cash Price |
$3,814.57
|
| Rate for Payer: Cofinity Commercial |
$3,337.75
|
| Rate for Payer: Cofinity Commercial |
$4,100.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,337.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,814.57
|
| Rate for Payer: Healthscope Commercial |
$4,291.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,337.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,576.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,052.98
|
| Rate for Payer: PHP Commercial |
$4,052.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,099.34
|
| Rate for Payer: Priority Health SBD |
$3,003.97
|
| Rate for Payer: UMR Bronson Commercial |
$2,098.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,576.16
|
|
|
HC VERSACROSS KIT
|
Facility
|
OP
|
$3,641.40
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,347.32 |
| Max. Negotiated Rate |
$3,277.26 |
| Rate for Payer: Aetna American Axle |
$2,366.91
|
| Rate for Payer: Aetna Commercial |
$3,095.19
|
| Rate for Payer: Aetna Medicare |
$1,820.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,366.91
|
| Rate for Payer: BCBS Complete |
$1,456.56
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$2,548.98
|
| Rate for Payer: Cofinity Commercial |
$3,131.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,548.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.12
|
| Rate for Payer: Healthscope Commercial |
$3,277.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,548.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.19
|
| Rate for Payer: PHP Commercial |
$3,095.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,366.91
|
| Rate for Payer: Priority Health SBD |
$2,294.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,347.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.05
|
|
|
HC VERSACROSS KIT
|
Facility
|
IP
|
$3,641.40
|
|
| Hospital Charge Code |
27200346
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,602.22 |
| Max. Negotiated Rate |
$3,277.26 |
| Rate for Payer: Aetna American Axle |
$2,366.91
|
| Rate for Payer: Aetna Commercial |
$3,095.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,366.91
|
| Rate for Payer: Cash Price |
$2,913.12
|
| Rate for Payer: Cofinity Commercial |
$2,548.98
|
| Rate for Payer: Cofinity Commercial |
$3,131.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,548.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,913.12
|
| Rate for Payer: Healthscope Commercial |
$3,277.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,548.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,731.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,095.19
|
| Rate for Payer: PHP Commercial |
$3,095.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,366.91
|
| Rate for Payer: Priority Health SBD |
$2,294.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,602.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,731.05
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
IP
|
$11,606.79
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,106.99 |
| Max. Negotiated Rate |
$10,446.11 |
| Rate for Payer: Aetna American Axle |
$7,544.41
|
| Rate for Payer: Aetna Commercial |
$9,865.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,544.41
|
| Rate for Payer: Cash Price |
$9,285.43
|
| Rate for Payer: Cofinity Commercial |
$8,124.75
|
| Rate for Payer: Cofinity Commercial |
$9,981.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,124.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,285.43
|
| Rate for Payer: Healthscope Commercial |
$10,446.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,124.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,705.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,865.77
|
| Rate for Payer: PHP Commercial |
$9,865.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,544.41
|
| Rate for Payer: Priority Health SBD |
$7,312.28
|
| Rate for Payer: UMR Bronson Commercial |
$5,106.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,705.09
|
|
|
HC VERT AUG W MECH DEV EA ADD
|
Facility
|
OP
|
$11,606.79
|
|
|
Service Code
|
CPT 22515
|
| Hospital Charge Code |
36100469
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$210.92 |
| Max. Negotiated Rate |
$13,605.01 |
| Rate for Payer: Aetna American Axle |
$7,544.41
|
| Rate for Payer: Aetna Commercial |
$9,865.77
|
| Rate for Payer: Aetna Medicare |
$5,803.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,544.41
|
| Rate for Payer: BCBS Complete |
$4,642.72
|
| Rate for Payer: BCBS Trust/PPO |
$13,605.01
|
| Rate for Payer: BCN Commercial |
$13,605.01
|
| Rate for Payer: Cash Price |
$9,285.43
|
| Rate for Payer: Cash Price |
$9,285.43
|
| Rate for Payer: Cash Price |
$9,285.43
|
| Rate for Payer: Cofinity Commercial |
$9,981.84
|
| Rate for Payer: Cofinity Commercial |
$8,124.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,124.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,285.43
|
| Rate for Payer: Healthscope Commercial |
$10,446.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,124.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,705.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,865.77
|
| Rate for Payer: PHP Commercial |
$9,865.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,544.41
|
| Rate for Payer: Priority Health SBD |
$7,312.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.01
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$210.92
|
| Rate for Payer: UMR Bronson Commercial |
$4,294.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,705.09
|
|
