|
EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC
|
Facility
|
IP
|
$20,485.16
|
|
|
Service Code
|
MS-DRG 148
|
| Min. Negotiated Rate |
$6,999.99 |
| Max. Negotiated Rate |
$20,485.16 |
| Rate for Payer: Aetna Medicare |
$7,663.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,210.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,210.51
|
| Rate for Payer: BCBS MAPPO |
$7,368.41
|
| Rate for Payer: BCBS Trust/PPO |
$20,485.16
|
| Rate for Payer: BCN Medicare Advantage |
$7,368.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,368.41
|
| Rate for Payer: Mclaren Medicare |
$7,368.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7,736.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,473.67
|
| Rate for Payer: PACE Medicare |
$6,999.99
|
| Rate for Payer: PACE SWMI |
$7,368.41
|
| Rate for Payer: PHP Medicare Advantage |
$7,368.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,767.12
|
| Rate for Payer: Priority Health Medicare |
$7,368.41
|
| Rate for Payer: Priority Health Narrow Network |
$10,213.70
|
| Rate for Payer: Railroad Medicare Medicare |
$7,368.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13,571.48
|
| Rate for Payer: UHC Core |
$11,128.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,368.41
|
| Rate for Payer: UHC Exchange |
$8,847.18
|
| Rate for Payer: UHC Medicare Advantage |
$7,589.46
|
| Rate for Payer: VA VA |
$7,368.41
|
|
|
ECHOCARDIOGRAPHY, TRANSESOPHAGEAL, REAL-TIME WITH IMAGE DOCUMENTATION (2D) (WITH OR WITHOUT M-MODE RECORDING); INCLUDING PROBE PLACEMENT, IMAGE ACQUISITION, INTERPRETATION AND REPORT
|
Facility
|
OP
|
$1,543.71
|
|
|
Service Code
|
CPT 93312
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$231.17 |
| Max. Negotiated Rate |
$1,543.71 |
| Rate for Payer: Aetna Medicare |
$509.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$612.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$612.96
|
| Rate for Payer: BCBS Complete |
$281.67
|
| Rate for Payer: BCBS MAPPO |
$490.37
|
| Rate for Payer: BCBS Trust/PPO |
$660.19
|
| Rate for Payer: BCN Medicare Advantage |
$490.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$490.37
|
| Rate for Payer: Mclaren Medicaid |
$268.23
|
| Rate for Payer: Mclaren Medicare |
$490.37
|
| Rate for Payer: Meridian Medicaid |
$281.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$514.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$563.93
|
| Rate for Payer: PACE Medicare |
$465.85
|
| Rate for Payer: PACE SWMI |
$490.37
|
| Rate for Payer: PHP Medicare Advantage |
$490.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$268.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,543.71
|
| Rate for Payer: Priority Health Medicare |
$490.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,234.97
|
| Rate for Payer: Railroad Medicare Medicare |
$490.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$254.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$490.37
|
| Rate for Payer: UHC Exchange |
$231.17
|
| Rate for Payer: UHC Medicare Advantage |
$505.08
|
| Rate for Payer: VA VA |
$490.37
|
|
|
ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES
|
Facility
|
IP
|
$472,643.82
|
|
|
Service Code
|
MS-DRG 003
|
| Min. Negotiated Rate |
$156,566.96 |
| Max. Negotiated Rate |
$472,643.82 |
| Rate for Payer: Aetna Medicare |
$171,399.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$206,009.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$206,009.16
|
| Rate for Payer: BCBS MAPPO |
$164,807.33
|
| Rate for Payer: BCBS Trust/PPO |
$472,643.82
|
| Rate for Payer: BCN Medicare Advantage |
$164,807.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$164,807.33
|
| Rate for Payer: Mclaren Medicare |
$164,807.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$173,047.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$189,528.43
|
| Rate for Payer: PACE Medicare |
$156,566.96
|
| Rate for Payer: PACE SWMI |
$164,807.33
|
| Rate for Payer: PHP Medicare Advantage |
$164,807.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$305,944.60
|
| Rate for Payer: Priority Health Medicare |
$164,807.33
|
| Rate for Payer: Priority Health Narrow Network |
$244,755.68
|
| Rate for Payer: Railroad Medicare Medicare |
$164,807.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$325,219.86
|
| Rate for Payer: UHC Core |
$266,674.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$164,807.33
|
| Rate for Payer: UHC Exchange |
$212,009.06
|
| Rate for Payer: UHC Medicare Advantage |
$169,751.55
|
| Rate for Payer: VA VA |
$164,807.33
|
|
|
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$16,959.78
|
|
|
Service Code
|
HCPCS J1300
|
| Hospital Charge Code |
81696
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7,462.30 |
| Max. Negotiated Rate |
$15,263.80 |
| Rate for Payer: Aetna American Axle |
$11,023.86
|
| Rate for Payer: Aetna Commercial |
$14,415.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,023.86
|
| Rate for Payer: Cash Price |
$13,567.82
|
| Rate for Payer: Cofinity Commercial |
$11,871.85
|
| Rate for Payer: Cofinity Commercial |
$14,585.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,567.82
|
| Rate for Payer: Healthscope Commercial |
$15,263.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,871.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,719.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,415.81
|
| Rate for Payer: PHP Commercial |
$14,415.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,871.85
|
| Rate for Payer: Priority Health SBD |
$10,684.66
|
| Rate for Payer: UMR Bronson Commercial |
$7,462.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,719.84
|
|
|
ECULIZUMAB 300 MG/30 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$16,959.78
|
|
|
Service Code
|
HCPCS J1300
|
| Hospital Charge Code |
81696
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$123.45 |
| Max. Negotiated Rate |
$15,263.80 |
| Rate for Payer: Aetna American Axle |
$11,023.86
|
| Rate for Payer: Aetna Commercial |
$14,415.81
|
| Rate for Payer: Aetna Medicare |
$234.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,023.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$282.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$282.11
|
| Rate for Payer: BCBS Complete |
$129.63
|
| Rate for Payer: BCBS MAPPO |
$225.68
|
| Rate for Payer: BCBS Trust/PPO |
$729.30
|
| Rate for Payer: BCN Medicare Advantage |
$225.68
|
| Rate for Payer: Cash Price |
$13,567.82
|
| Rate for Payer: Cash Price |
$13,567.82
|
| Rate for Payer: Cofinity Commercial |
$14,585.41
|
| Rate for Payer: Cofinity Commercial |
$11,871.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,567.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$225.68
|
| Rate for Payer: Healthscope Commercial |
$15,263.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,871.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,719.84
|
| Rate for Payer: Mclaren Medicaid |
$123.45
|
| Rate for Payer: Mclaren Medicare |
$225.68
|
| Rate for Payer: Meridian Medicaid |
$129.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$236.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$259.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$14,415.81
|
| Rate for Payer: PACE Medicare |
$214.40
|
| Rate for Payer: PACE SWMI |
$225.68
|
| Rate for Payer: PHP Commercial |
$14,415.81
|
| Rate for Payer: PHP Medicare Advantage |
$225.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,871.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$661.57
|
| Rate for Payer: Priority Health Medicare |
$225.68
|
| Rate for Payer: Priority Health Narrow Network |
$529.26
|
| Rate for Payer: Priority Health SBD |
$10,684.66
|
| Rate for Payer: Railroad Medicare Medicare |
$225.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$225.68
|
| Rate for Payer: UHC Medicare Advantage |
$232.46
|
| Rate for Payer: UMR Bronson Commercial |
$6,275.12
|
| Rate for Payer: VA VA |
$225.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,719.84
|
|
|
EDARAVONE 30 MG/100 ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$1,737.60
|
|
|
Service Code
|
HCPCS J1301
|
| Hospital Charge Code |
183348
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$1,563.84 |
| Rate for Payer: Aetna American Axle |
$1,129.44
|
| Rate for Payer: Aetna Commercial |
$1,476.96
|
| Rate for Payer: Aetna Medicare |
$22.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.27
|
| Rate for Payer: BCBS Complete |
$12.53
|
| Rate for Payer: BCBS MAPPO |
$21.82
|
| Rate for Payer: BCBS Trust/PPO |
$70.48
|
| Rate for Payer: BCN Medicare Advantage |
$21.82
|
| Rate for Payer: Cash Price |
$1,390.08
|
| Rate for Payer: Cash Price |
$1,390.08
|
| Rate for Payer: Cofinity Commercial |
$1,216.32
|
| Rate for Payer: Cofinity Commercial |
$1,494.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,390.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.82
|
| Rate for Payer: Healthscope Commercial |
$1,563.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,216.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,303.20
|
| Rate for Payer: Mclaren Medicaid |
$11.93
|
| Rate for Payer: Mclaren Medicare |
$21.82
|
| Rate for Payer: Meridian Medicaid |
$12.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,476.96
|
| Rate for Payer: PACE Medicare |
$20.72
|
| Rate for Payer: PACE SWMI |
$21.82
|
| Rate for Payer: PHP Commercial |
$1,476.96
|
| Rate for Payer: PHP Medicare Advantage |
$21.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.80
|
| Rate for Payer: Priority Health Medicare |
$21.82
|
| Rate for Payer: Priority Health Narrow Network |
$50.24
|
| Rate for Payer: Priority Health SBD |
$1,094.69
|
| Rate for Payer: Railroad Medicare Medicare |
$21.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.82
|
| Rate for Payer: UHC Medicare Advantage |
$22.47
|
| Rate for Payer: UMR Bronson Commercial |
$642.91
|
| Rate for Payer: VA VA |
$21.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,303.20
|
|
|
EDARAVONE 30 MG/100 ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$1,737.60
|
|
|
Service Code
|
HCPCS J1301
|
| Hospital Charge Code |
183348
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$764.54 |
| Max. Negotiated Rate |
$1,563.84 |
| Rate for Payer: Aetna American Axle |
$1,129.44
|
| Rate for Payer: Aetna Commercial |
$1,476.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,129.44
|
| Rate for Payer: Cash Price |
$1,390.08
|
| Rate for Payer: Cofinity Commercial |
$1,216.32
|
| Rate for Payer: Cofinity Commercial |
$1,494.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,390.08
|
| Rate for Payer: Healthscope Commercial |
$1,563.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,216.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,303.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,476.96
|
| Rate for Payer: PHP Commercial |
$1,476.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,216.32
|
| Rate for Payer: Priority Health SBD |
$1,094.69
|
| Rate for Payer: UMR Bronson Commercial |
$764.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,303.20
|
|
|
EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$15,779.40
|
|
|
Service Code
|
HCPCS J9332
|
| Hospital Charge Code |
198972
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6,942.94 |
| Max. Negotiated Rate |
$14,201.46 |
| Rate for Payer: Aetna American Axle |
$10,256.61
|
| Rate for Payer: Aetna Commercial |
$13,412.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,256.61
|
| Rate for Payer: Cash Price |
$12,623.52
|
| Rate for Payer: Cofinity Commercial |
$11,045.58
|
| Rate for Payer: Cofinity Commercial |
$13,570.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,623.52
|
| Rate for Payer: Healthscope Commercial |
$14,201.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,045.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,834.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,412.49
|
| Rate for Payer: PHP Commercial |
$13,412.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,045.58
|
| Rate for Payer: Priority Health SBD |
$9,941.02
|
| Rate for Payer: UMR Bronson Commercial |
$6,942.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,834.55
|
|
|
EFGARTIGIMOD ALFA-FCAB 20 MG/ML INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$15,779.40
|
|
|
Service Code
|
HCPCS J9332
|
| Hospital Charge Code |
198972
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$17.55 |
| Max. Negotiated Rate |
$14,201.46 |
| Rate for Payer: Aetna American Axle |
$10,256.61
|
| Rate for Payer: Aetna Commercial |
$13,412.49
|
| Rate for Payer: Aetna Medicare |
$33.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,256.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.10
|
| Rate for Payer: BCBS Complete |
$18.43
|
| Rate for Payer: BCBS MAPPO |
$32.08
|
| Rate for Payer: BCBS Trust/PPO |
$103.65
|
| Rate for Payer: BCN Medicare Advantage |
$32.08
|
| Rate for Payer: Cash Price |
$12,623.52
|
| Rate for Payer: Cash Price |
$12,623.52
|
| Rate for Payer: Cofinity Commercial |
$11,045.58
|
| Rate for Payer: Cofinity Commercial |
$13,570.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,623.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.08
|
| Rate for Payer: Healthscope Commercial |
$14,201.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,045.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,834.55
|
| Rate for Payer: Mclaren Medicaid |
$17.55
|
| Rate for Payer: Mclaren Medicare |
$32.08
|
| Rate for Payer: Meridian Medicaid |
$18.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$13,412.49
|
| Rate for Payer: PACE Medicare |
$30.48
|
| Rate for Payer: PACE SWMI |
$32.08
|
| Rate for Payer: PHP Commercial |
$13,412.49
|
| Rate for Payer: PHP Medicare Advantage |
$32.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,045.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.29
|
| Rate for Payer: Priority Health Medicare |
$32.08
|
| Rate for Payer: Priority Health Narrow Network |
$75.43
|
| Rate for Payer: Priority Health SBD |
$9,941.02
|
| Rate for Payer: Railroad Medicare Medicare |
$32.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.08
|
| Rate for Payer: UHC Medicare Advantage |
$33.04
|
| Rate for Payer: UMR Bronson Commercial |
$5,838.38
|
| Rate for Payer: VA VA |
$32.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,834.55
|
|
|
ELECARE INFANT UNFLAVORED INFANT CONTINUOUS FEED
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 7007453511
|
| Hospital Charge Code |
168951
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.19 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.66
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE INFANT UNFLAVORED ORAL POWDER CUSTOM
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 7007453511
|
| Hospital Charge Code |
150852
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.19 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.66
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE JR (VANILLA) ORAL POWDER CUSTOM
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 7007456586
|
| Hospital Charge Code |
163630
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.19 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.66
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECARE JUNIOR VANILLA CONTINUOUS FEED
|
Facility
|
IP
|
$113.96
|
|
|
Service Code
|
NDC 9900-0005-81
|
| Hospital Charge Code |
168952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$50.14 |
| Max. Negotiated Rate |
$102.56 |
| Rate for Payer: Aetna American Axle |
$74.07
|
| Rate for Payer: Aetna Commercial |
$96.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.07
|
| Rate for Payer: Cash Price |
$91.17
|
| Rate for Payer: Cofinity Commercial |
$79.77
|
| Rate for Payer: Cofinity Commercial |
$98.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.17
|
| Rate for Payer: Healthscope Commercial |
$102.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.87
|
| Rate for Payer: PHP Commercial |
$96.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.77
|
| Rate for Payer: Priority Health SBD |
$71.79
|
| Rate for Payer: UMR Bronson Commercial |
$50.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.47
|
|
|
ELECARE JUNIOR VANILLA CONTINUOUS FEED
|
Facility
|
IP
|
$109.52
|
|
|
Service Code
|
NDC 7007456586
|
| Hospital Charge Code |
168952
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$48.19 |
| Max. Negotiated Rate |
$98.57 |
| Rate for Payer: Aetna American Axle |
$71.19
|
| Rate for Payer: Aetna Commercial |
$93.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.19
|
| Rate for Payer: Cash Price |
$87.62
|
| Rate for Payer: Cofinity Commercial |
$76.66
|
| Rate for Payer: Cofinity Commercial |
$94.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.62
|
| Rate for Payer: Healthscope Commercial |
$98.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.09
|
| Rate for Payer: PHP Commercial |
$93.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.66
|
| Rate for Payer: Priority Health SBD |
$69.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.14
|
|
|
ELECTROCARDIOGRAM, ROUTINE ECG WITH AT LEAST 12 LEADS; TRACING ONLY, WITHOUT INTERPRETATION AND REPORT
|
Facility
|
OP
|
$171.15
|
|
|
Service Code
|
CPT 93005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$171.15 |
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$24.23
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: VA VA |
$54.37
|
|
|
ELECTROLYTE-A INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 0338-0221-04
|
| Hospital Charge Code |
28113
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Cofinity Commercial |
$33.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.50
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTROLYTE-A IV - BOLUS
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 0338-0221-04
|
| Hospital Charge Code |
168933
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.50
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.50
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTROLYTE-A IV - DKA
|
Facility
|
IP
|
$47.85
|
|
|
Service Code
|
NDC 0338-0221-04
|
| Hospital Charge Code |
168932
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$21.05 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$31.10
|
| Rate for Payer: Aetna Commercial |
$40.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.10
|
| Rate for Payer: Cash Price |
$38.28
|
| Rate for Payer: Cofinity Commercial |
$33.50
|
| Rate for Payer: Cofinity Commercial |
$41.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.28
|
| Rate for Payer: Healthscope Commercial |
$43.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$40.67
|
| Rate for Payer: PHP Commercial |
$40.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.50
|
| Rate for Payer: Priority Health SBD |
$30.15
|
| Rate for Payer: UMR Bronson Commercial |
$21.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.89
|
|
|
ELECTROLYTE-R INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$95.70
|
|
|
Service Code
|
NDC 0990-7967-09
|
| Hospital Charge Code |
28115
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$42.11 |
| Max. Negotiated Rate |
$86.13 |
| Rate for Payer: Aetna American Axle |
$62.20
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Commercial |
$66.99
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.34
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.99
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: UMR Bronson Commercial |
$42.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.78
|
|
|
ELECTROLYTE-R IV - DKA
|
Facility
|
IP
|
$95.70
|
|
|
Service Code
|
NDC 0990-7967-09
|
| Hospital Charge Code |
161521
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$42.11 |
| Max. Negotiated Rate |
$86.13 |
| Rate for Payer: Aetna American Axle |
$62.20
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Commercial |
$66.99
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.34
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.99
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: UMR Bronson Commercial |
$42.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.78
|
|
|
ELECTROLYTE-R (PH 7.4) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$95.70
|
|
|
Service Code
|
NDC 0990-7670-09
|
| Hospital Charge Code |
28116
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$42.11 |
| Max. Negotiated Rate |
$86.13 |
| Rate for Payer: Aetna American Axle |
$62.20
|
| Rate for Payer: Aetna Commercial |
$81.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.20
|
| Rate for Payer: Cash Price |
$76.56
|
| Rate for Payer: Cofinity Commercial |
$66.99
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.56
|
| Rate for Payer: Healthscope Commercial |
$86.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.34
|
| Rate for Payer: PHP Commercial |
$81.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.99
|
| Rate for Payer: Priority Health SBD |
$60.29
|
| Rate for Payer: UMR Bronson Commercial |
$42.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.78
|
|
|
ELECTRONIC ANALYSIS OF IMPLANTED NEUROSTIMULATOR PULSE GENERATOR/TRANSMITTER (EG, CONTACT GROUP[S], INTERLEAVING, AMPLITUDE, PULSE WIDTH, FREQUENCY [HZ], ON/OFF CYCLING, BURST, MAGNET MODE, DOSE LOCKOUT, PATIENT SELECTABLE PARAMETERS, RESPONSIVE NEUROSTIMULATION, DETECTION ALGORITHMS, CLOSED LOOP PARAMETERS, AND PASSIVE PARAMETERS) BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL; WITH COMPLEX SPINAL CORD OR PERIPHERAL NERVE (EG, SACRAL NERVE) NEUROSTIMULATOR PULSE GENERATOR/TRANSMITTER PROGRAMMING BY PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL
|
Facility
|
OP
|
$270.87
|
|
|
Service Code
|
CPT 95972
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$38.97 |
| Max. Negotiated Rate |
$270.87 |
| Rate for Payer: Aetna Medicare |
$89.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.55
|
| Rate for Payer: BCBS Complete |
$49.42
|
| Rate for Payer: BCBS MAPPO |
$86.04
|
| Rate for Payer: BCBS Trust/PPO |
$130.71
|
| Rate for Payer: BCN Medicare Advantage |
$86.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.04
|
| Rate for Payer: Mclaren Medicaid |
$47.06
|
| Rate for Payer: Mclaren Medicare |
$86.04
|
| Rate for Payer: Meridian Medicaid |
$49.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$90.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.95
|
| Rate for Payer: PACE Medicare |
$81.74
|
| Rate for Payer: PACE SWMI |
$86.04
|
| Rate for Payer: PHP Medicare Advantage |
$86.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$270.87
|
| Rate for Payer: Priority Health Medicare |
$86.04
|
| Rate for Payer: Priority Health Narrow Network |
$216.70
|
| Rate for Payer: Railroad Medicare Medicare |
$86.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.04
|
| Rate for Payer: UHC Exchange |
$38.97
|
| Rate for Payer: UHC Medicare Advantage |
$88.62
|
| Rate for Payer: VA VA |
$86.04
|
|
|
ELOSULFASE ALFA 5 MG/5 ML (1 MG/ML) INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$6,259.06
|
|
|
Service Code
|
HCPCS J1322
|
| Hospital Charge Code |
169847
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,753.99 |
| Max. Negotiated Rate |
$5,633.15 |
| Rate for Payer: Aetna American Axle |
$4,068.39
|
| Rate for Payer: Aetna Commercial |
$5,320.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,068.39
|
| Rate for Payer: Cash Price |
$5,007.25
|
| Rate for Payer: Cofinity Commercial |
$4,381.34
|
| Rate for Payer: Cofinity Commercial |
$5,382.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,007.25
|
| Rate for Payer: Healthscope Commercial |
$5,633.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,381.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,694.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,320.20
|
| Rate for Payer: PHP Commercial |
$5,320.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,381.34
|
| Rate for Payer: Priority Health SBD |
$3,943.21
|
| Rate for Payer: UMR Bronson Commercial |
$2,753.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,694.30
|
|
|
ELOTUZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
IP
|
$5,686.96
|
|
|
Service Code
|
HCPCS J9176
|
| Hospital Charge Code |
176616
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,502.26 |
| Max. Negotiated Rate |
$5,118.26 |
| Rate for Payer: Aetna American Axle |
$3,696.52
|
| Rate for Payer: Aetna Commercial |
$4,833.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,696.52
|
| Rate for Payer: Cash Price |
$4,549.57
|
| Rate for Payer: Cofinity Commercial |
$3,980.87
|
| Rate for Payer: Cofinity Commercial |
$4,890.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,549.57
|
| Rate for Payer: Healthscope Commercial |
$5,118.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,980.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,265.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,833.92
|
| Rate for Payer: PHP Commercial |
$4,833.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,980.87
|
| Rate for Payer: Priority Health SBD |
$3,582.78
|
| Rate for Payer: UMR Bronson Commercial |
$2,502.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,265.22
|
|
|
ELOTUZUMAB 300 MG INTRAVENOUS SOLUTION
|
Facility
|
OP
|
$5,686.96
|
|
|
Service Code
|
HCPCS J9176
|
| Hospital Charge Code |
176616
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$5,118.26 |
| Rate for Payer: Aetna American Axle |
$3,696.52
|
| Rate for Payer: Aetna Commercial |
$4,833.92
|
| Rate for Payer: Aetna Medicare |
$7.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,696.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.22
|
| Rate for Payer: BCBS Complete |
$4.24
|
| Rate for Payer: BCBS MAPPO |
$7.38
|
| Rate for Payer: BCBS Trust/PPO |
$23.82
|
| Rate for Payer: BCN Medicare Advantage |
$7.38
|
| Rate for Payer: Cash Price |
$4,549.57
|
| Rate for Payer: Cash Price |
$4,549.57
|
| Rate for Payer: Cofinity Commercial |
$3,980.87
|
| Rate for Payer: Cofinity Commercial |
$4,890.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,549.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.38
|
| Rate for Payer: Healthscope Commercial |
$5,118.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,980.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,265.22
|
| Rate for Payer: Mclaren Medicaid |
$4.04
|
| Rate for Payer: Mclaren Medicare |
$7.38
|
| Rate for Payer: Meridian Medicaid |
$4.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,833.92
|
| Rate for Payer: PACE Medicare |
$7.01
|
| Rate for Payer: PACE SWMI |
$7.38
|
| Rate for Payer: PHP Commercial |
$4,833.92
|
| Rate for Payer: PHP Medicare Advantage |
$7.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,980.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.20
|
| Rate for Payer: Priority Health Medicare |
$7.38
|
| Rate for Payer: Priority Health Narrow Network |
$16.96
|
| Rate for Payer: Priority Health SBD |
$3,582.78
|
| Rate for Payer: Railroad Medicare Medicare |
$7.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.38
|
| Rate for Payer: UHC Medicare Advantage |
$7.60
|
| Rate for Payer: UMR Bronson Commercial |
$2,104.18
|
| Rate for Payer: VA VA |
$7.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,265.22
|
|
