|
HC ADENOVIRUS PCR
|
Facility
|
IP
|
$100.98
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600279
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.43 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna American Axle |
$65.64
|
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.64
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$70.69
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health SBD |
$63.62
|
| Rate for Payer: UMR Bronson Commercial |
$44.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.74
|
|
|
HC ADENOVIRUS PCR
|
Facility
|
OP
|
$100.98
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600279
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$90.88 |
| Rate for Payer: Aetna American Axle |
$65.64
|
| Rate for Payer: Aetna Commercial |
$85.83
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cash Price |
$80.78
|
| Rate for Payer: Cofinity Commercial |
$70.69
|
| Rate for Payer: Cofinity Commercial |
$86.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$90.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.74
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.83
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$85.83
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.69
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$63.62
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$37.36
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.74
|
|
|
HC ADHESIVE RELEASER 50 ML
|
Facility
|
IP
|
$26.08
|
|
|
Service Code
|
HCPCS A4455
|
| Hospital Charge Code |
27000626
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$23.47 |
| Rate for Payer: Aetna American Axle |
$16.95
|
| Rate for Payer: Aetna Commercial |
$22.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.95
|
| Rate for Payer: Cash Price |
$20.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.86
|
| Rate for Payer: Healthscope Commercial |
$23.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.17
|
| Rate for Payer: PHP Commercial |
$22.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health SBD |
$16.43
|
| Rate for Payer: UMR Bronson Commercial |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.56
|
|
|
HC ADHESIVE RELEASER 50 ML
|
Facility
|
OP
|
$26.08
|
|
|
Service Code
|
HCPCS A4455
|
| Hospital Charge Code |
27000626
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.94 |
| Max. Negotiated Rate |
$23.47 |
| Rate for Payer: Aetna American Axle |
$16.95
|
| Rate for Payer: Aetna Commercial |
$22.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.95
|
| Rate for Payer: BCBS Complete |
$10.43
|
| Rate for Payer: BCBS Trust/PPO |
$5.99
|
| Rate for Payer: Cash Price |
$20.86
|
| Rate for Payer: Cash Price |
$20.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Cofinity Commercial |
$22.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.86
|
| Rate for Payer: Healthscope Commercial |
$23.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$22.17
|
| Rate for Payer: PHP Commercial |
$22.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.26
|
| Rate for Payer: Priority Health SBD |
$16.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.33
|
| Rate for Payer: UHC Exchange |
$1.94
|
| Rate for Payer: UMR Bronson Commercial |
$9.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.56
|
|
|
HC ADL TRAINING EA 15 MIN
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
42000030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.98 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna American Axle |
$64.97
|
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health SBD |
$62.97
|
| Rate for Payer: UMR Bronson Commercial |
$43.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC ADL TRAINING EA 15 MIN
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
42000030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$22.98 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$64.97
|
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: BCBS Complete |
$39.98
|
| Rate for Payer: BCBS Trust/PPO |
$22.98
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Narrow Network |
$24.00
|
| Rate for Payer: Priority Health SBD |
$62.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.30
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$32.09
|
| Rate for Payer: UMR Bronson Commercial |
$36.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC ADMIN INTRAPULMONARY SURFACTANT
|
Facility
|
IP
|
$574.00
|
|
|
Service Code
|
CPT 94610
|
| Hospital Charge Code |
46000034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$252.56 |
| Max. Negotiated Rate |
$516.60 |
| Rate for Payer: Aetna American Axle |
$373.10
|
| Rate for Payer: Aetna Commercial |
$487.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.10
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$401.80
|
| Rate for Payer: Cofinity Commercial |
$493.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.20
|
| Rate for Payer: Healthscope Commercial |
$516.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.90
|
| Rate for Payer: PHP Commercial |
$487.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.80
|
| Rate for Payer: Priority Health SBD |
$361.62
|
| Rate for Payer: UMR Bronson Commercial |
$252.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.50
|
|
|
HC ADMIN INTRAPULMONARY SURFACTANT
|
Facility
|
OP
|
$574.00
|
|
|
Service Code
|
CPT 94610
|
| Hospital Charge Code |
46000034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$54.68 |
| Max. Negotiated Rate |
$596.84 |
| Rate for Payer: Aetna American Axle |
$373.10
|
| Rate for Payer: Aetna Commercial |
$487.90
|
| Rate for Payer: Aetna Medicare |
$197.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$373.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$70.38
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cash Price |
$459.20
|
| Rate for Payer: Cofinity Commercial |
$401.80
|
| Rate for Payer: Cofinity Commercial |
$493.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$459.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$516.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$401.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$430.50
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$487.90
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$487.90
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$401.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.84
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$477.47
|
| Rate for Payer: Priority Health SBD |
$361.62
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.15
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.59
|
| Rate for Payer: UHC Exchange |
$54.68
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: UMR Bronson Commercial |
$212.38
|
| Rate for Payer: VA VA |
$189.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$430.50
|
|
|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
IP
|
$83.04
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$36.54 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna American Axle |
$53.98
|
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.98
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$58.13
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health SBD |
$52.32
|
| Rate for Payer: UMR Bronson Commercial |
$36.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
OP
|
$83.04
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$19.32 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna American Axle |
$53.98
|
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.98
|
| Rate for Payer: BCBS Complete |
$33.22
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Cofinity Commercial |
$58.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health SBD |
$52.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.25
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Exchange |
$19.32
|
| Rate for Payer: UMR Bronson Commercial |
$30.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
IP
|
$83.04
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$36.54 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna American Axle |
$53.98
|
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.98
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$58.13
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health SBD |
$52.32
|
| Rate for Payer: UMR Bronson Commercial |
$36.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
OP
|
$83.04
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$22.27 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna American Axle |
$53.98
|
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.98
|
| Rate for Payer: BCBS Complete |
$33.22
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Cofinity Commercial |
$58.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health SBD |
$52.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.50
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Exchange |
$22.27
|
| Rate for Payer: UMR Bronson Commercial |
$30.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
OP
|
$524.28
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$525.35 |
| Rate for Payer: Aetna American Axle |
$340.78
|
| Rate for Payer: Aetna Commercial |
$445.64
|
| Rate for Payer: Aetna Medicare |
$437.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$525.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$525.35
|
| Rate for Payer: BCBS Complete |
$241.41
|
| Rate for Payer: BCBS MAPPO |
$420.28
|
| Rate for Payer: BCN Medicare Advantage |
$420.28
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cofinity Commercial |
$450.88
|
| Rate for Payer: Cofinity Commercial |
$367.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.28
|
| Rate for Payer: Healthscope Commercial |
$471.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.21
|
| Rate for Payer: Mclaren Medicaid |
$229.89
|
| Rate for Payer: Mclaren Medicare |
$420.28
|
| Rate for Payer: Meridian Medicaid |
$241.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$441.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$483.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.64
|
| Rate for Payer: PACE Medicare |
$399.27
|
| Rate for Payer: PACE SWMI |
$420.28
|
| Rate for Payer: PHP Commercial |
$445.64
|
| Rate for Payer: PHP Medicare Advantage |
$420.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$450.50
|
| Rate for Payer: Priority Health Medicare |
$420.28
|
| Rate for Payer: Priority Health Narrow Network |
$360.40
|
| Rate for Payer: Priority Health SBD |
$330.30
|
| Rate for Payer: Railroad Medicare Medicare |
$420.28
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.28
|
| Rate for Payer: UHC Medicare Advantage |
$432.89
|
| Rate for Payer: UMR Bronson Commercial |
$193.98
|
| Rate for Payer: VA VA |
$420.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.21
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
IP
|
$524.28
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$230.68 |
| Max. Negotiated Rate |
$471.85 |
| Rate for Payer: Aetna American Axle |
$340.78
|
| Rate for Payer: Aetna Commercial |
$445.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.78
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cofinity Commercial |
$367.00
|
| Rate for Payer: Cofinity Commercial |
$450.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.42
|
| Rate for Payer: Healthscope Commercial |
$471.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.64
|
| Rate for Payer: PHP Commercial |
$445.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.00
|
| Rate for Payer: Priority Health SBD |
$330.30
|
| Rate for Payer: UMR Bronson Commercial |
$230.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.21
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
OP
|
$524.28
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$525.35 |
| Rate for Payer: Aetna American Axle |
$340.78
|
| Rate for Payer: Aetna Commercial |
$445.64
|
| Rate for Payer: Aetna Medicare |
$437.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$525.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$525.35
|
| Rate for Payer: BCBS Complete |
$241.41
|
| Rate for Payer: BCBS MAPPO |
$420.28
|
| Rate for Payer: BCN Medicare Advantage |
$420.28
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cofinity Commercial |
$450.88
|
| Rate for Payer: Cofinity Commercial |
$367.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$420.28
|
| Rate for Payer: Healthscope Commercial |
$471.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.21
|
| Rate for Payer: Mclaren Medicaid |
$229.89
|
| Rate for Payer: Mclaren Medicare |
$420.28
|
| Rate for Payer: Meridian Medicaid |
$241.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$441.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$483.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.64
|
| Rate for Payer: PACE Medicare |
$399.27
|
| Rate for Payer: PACE SWMI |
$420.28
|
| Rate for Payer: PHP Commercial |
$445.64
|
| Rate for Payer: PHP Medicare Advantage |
$420.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$450.50
|
| Rate for Payer: Priority Health Medicare |
$420.28
|
| Rate for Payer: Priority Health Narrow Network |
$360.40
|
| Rate for Payer: Priority Health SBD |
$330.30
|
| Rate for Payer: Railroad Medicare Medicare |
$420.28
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$420.28
|
| Rate for Payer: UHC Medicare Advantage |
$432.89
|
| Rate for Payer: UMR Bronson Commercial |
$193.98
|
| Rate for Payer: VA VA |
$420.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.21
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
IP
|
$524.28
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$230.68 |
| Max. Negotiated Rate |
$471.85 |
| Rate for Payer: Aetna American Axle |
$340.78
|
| Rate for Payer: Aetna Commercial |
$445.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$340.78
|
| Rate for Payer: Cash Price |
$419.42
|
| Rate for Payer: Cofinity Commercial |
$367.00
|
| Rate for Payer: Cofinity Commercial |
$450.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.42
|
| Rate for Payer: Healthscope Commercial |
$471.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$367.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$445.64
|
| Rate for Payer: PHP Commercial |
$445.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.00
|
| Rate for Payer: Priority Health SBD |
$330.30
|
| Rate for Payer: UMR Bronson Commercial |
$230.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.21
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
IP
|
$83.04
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$36.54 |
| Max. Negotiated Rate |
$74.74 |
| Rate for Payer: Aetna American Axle |
$53.98
|
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.98
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$58.13
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health SBD |
$52.32
|
| Rate for Payer: UMR Bronson Commercial |
$36.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
OP
|
$83.04
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$21.19 |
| Max. Negotiated Rate |
$121.95 |
| Rate for Payer: Aetna American Axle |
$53.98
|
| Rate for Payer: Aetna Commercial |
$70.58
|
| Rate for Payer: Aetna Medicare |
$40.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.41
|
| Rate for Payer: BCBS Complete |
$22.25
|
| Rate for Payer: BCBS MAPPO |
$38.73
|
| Rate for Payer: BCN Medicare Advantage |
$38.73
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cash Price |
$66.43
|
| Rate for Payer: Cofinity Commercial |
$71.41
|
| Rate for Payer: Cofinity Commercial |
$58.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.73
|
| Rate for Payer: Healthscope Commercial |
$74.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.28
|
| Rate for Payer: Mclaren Medicaid |
$21.19
|
| Rate for Payer: Mclaren Medicare |
$38.73
|
| Rate for Payer: Meridian Medicaid |
$22.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$70.58
|
| Rate for Payer: PACE Medicare |
$36.79
|
| Rate for Payer: PACE SWMI |
$38.73
|
| Rate for Payer: PHP Commercial |
$70.58
|
| Rate for Payer: PHP Medicare Advantage |
$38.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.95
|
| Rate for Payer: Priority Health Medicare |
$38.73
|
| Rate for Payer: Priority Health Narrow Network |
$97.56
|
| Rate for Payer: Priority Health SBD |
$52.32
|
| Rate for Payer: Railroad Medicare Medicare |
$38.73
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.73
|
| Rate for Payer: UHC Medicare Advantage |
$39.89
|
| Rate for Payer: UMR Bronson Commercial |
$30.72
|
| Rate for Payer: VA VA |
$38.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.28
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$87.31
|
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.88
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$49.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$59.11 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna American Axle |
$87.31
|
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: UMR Bronson Commercial |
$59.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
OP
|
$60.50
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.13 |
| Max. Negotiated Rate |
$63.72 |
| Rate for Payer: Aetna American Axle |
$39.32
|
| Rate for Payer: Aetna Commercial |
$51.42
|
| Rate for Payer: Aetna Medicare |
$40.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.28
|
| Rate for Payer: BCBS Complete |
$22.18
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$34.74
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Cofinity Commercial |
$52.03
|
| Rate for Payer: Cofinity Commercial |
$42.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$54.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.38
|
| Rate for Payer: Mclaren Medicaid |
$21.13
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Medicaid |
$22.18
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.42
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$51.42
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.98
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health Narrow Network |
$42.38
|
| Rate for Payer: Priority Health SBD |
$38.12
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.34
|
| Rate for Payer: UHC Core |
$63.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.62
|
| Rate for Payer: UHC Exchange |
$38.62
|
| Rate for Payer: UHC Medicare Advantage |
$39.78
|
| Rate for Payer: UMR Bronson Commercial |
$22.38
|
| Rate for Payer: VA VA |
$38.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.38
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
IP
|
$60.50
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.62 |
| Max. Negotiated Rate |
$54.45 |
| Rate for Payer: Aetna American Axle |
$39.32
|
| Rate for Payer: Aetna Commercial |
$51.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.32
|
| Rate for Payer: Cash Price |
$48.40
|
| Rate for Payer: Cofinity Commercial |
$42.35
|
| Rate for Payer: Cofinity Commercial |
$52.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.40
|
| Rate for Payer: Healthscope Commercial |
$54.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.42
|
| Rate for Payer: PHP Commercial |
$51.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.35
|
| Rate for Payer: Priority Health SBD |
$38.12
|
| Rate for Payer: UMR Bronson Commercial |
$26.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.38
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
IP
|
$15.00
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna American Axle |
$9.75
|
| Rate for Payer: Aetna Commercial |
$12.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.75
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$10.50
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$13.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.75
|
| Rate for Payer: PHP Commercial |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.50
|
| Rate for Payer: Priority Health SBD |
$9.45
|
| Rate for Payer: UMR Bronson Commercial |
$6.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.25
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
OP
|
$15.00
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna American Axle |
$9.75
|
| Rate for Payer: Aetna Commercial |
$12.75
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.25
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$1.95
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$10.50
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$13.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.25
|
| Rate for Payer: Mclaren Medicaid |
$1.19
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Medicaid |
$1.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12.75
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$12.75
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.97
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health Narrow Network |
$2.38
|
| Rate for Payer: Priority Health SBD |
$9.45
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.60
|
| Rate for Payer: UHC Core |
$3.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Exchange |
$2.17
|
| Rate for Payer: UHC Medicare Advantage |
$2.24
|
| Rate for Payer: UMR Bronson Commercial |
$5.55
|
| Rate for Payer: VA VA |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.25
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
IP
|
$32.64
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.36 |
| Max. Negotiated Rate |
$29.38 |
| Rate for Payer: Aetna American Axle |
$21.22
|
| Rate for Payer: Aetna Commercial |
$27.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cofinity Commercial |
$28.07
|
| Rate for Payer: Cofinity Commercial |
$22.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$29.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.74
|
| Rate for Payer: PHP Commercial |
$27.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.85
|
| Rate for Payer: Priority Health SBD |
$20.56
|
| Rate for Payer: UMR Bronson Commercial |
$14.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.48
|
|
