|
HC ANGLE TOLERANCE TEST 60 MINUTES
|
Facility
|
OP
|
$65.48
|
|
|
Service Code
|
CPT 94780
|
| Hospital Charge Code |
51000085
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.50 |
| Max. Negotiated Rate |
$170.92 |
| Rate for Payer: Aetna American Axle |
$42.56
|
| Rate for Payer: Aetna Commercial |
$55.66
|
| Rate for Payer: Aetna Medicare |
$37.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.56
|
| Rate for Payer: BCBS Complete |
$20.48
|
| Rate for Payer: BCBS MAPPO |
$35.65
|
| Rate for Payer: BCBS Trust/PPO |
$170.92
|
| Rate for Payer: BCN Medicare Advantage |
$35.65
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cash Price |
$52.38
|
| Rate for Payer: Cofinity Commercial |
$56.31
|
| Rate for Payer: Cofinity Commercial |
$45.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.65
|
| Rate for Payer: Healthscope Commercial |
$58.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.11
|
| Rate for Payer: Mclaren Medicaid |
$19.50
|
| Rate for Payer: Mclaren Medicare |
$35.65
|
| Rate for Payer: Meridian Medicaid |
$20.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.66
|
| Rate for Payer: PACE Medicare |
$33.87
|
| Rate for Payer: PACE SWMI |
$35.65
|
| Rate for Payer: PHP Commercial |
$55.66
|
| Rate for Payer: PHP Medicare Advantage |
$35.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.22
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow Network |
$89.78
|
| Rate for Payer: Priority Health SBD |
$41.25
|
| Rate for Payer: Railroad Medicare Medicare |
$35.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.65
|
| Rate for Payer: UHC Exchange |
$22.59
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: UMR Bronson Commercial |
$24.23
|
| Rate for Payer: VA VA |
$35.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.11
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
IP
|
$32.75
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.41 |
| Max. Negotiated Rate |
$29.48 |
| Rate for Payer: Aetna American Axle |
$21.29
|
| Rate for Payer: Aetna Commercial |
$27.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.29
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cofinity Commercial |
$22.92
|
| Rate for Payer: Cofinity Commercial |
$28.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.20
|
| Rate for Payer: Healthscope Commercial |
$29.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.84
|
| Rate for Payer: PHP Commercial |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.92
|
| Rate for Payer: Priority Health SBD |
$20.63
|
| Rate for Payer: UMR Bronson Commercial |
$14.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.56
|
|
|
HC ANGLE TOLERANCE TEST EACH ADDL 30 MIN
|
Facility
|
OP
|
$32.75
|
|
|
Service Code
|
CPT 94781
|
| Hospital Charge Code |
51000088
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$72.06 |
| Rate for Payer: Aetna American Axle |
$21.29
|
| Rate for Payer: Aetna Commercial |
$27.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.29
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$72.06
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cash Price |
$26.20
|
| Rate for Payer: Cofinity Commercial |
$28.16
|
| Rate for Payer: Cofinity Commercial |
$22.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.20
|
| Rate for Payer: Healthscope Commercial |
$29.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.84
|
| Rate for Payer: PHP Commercial |
$27.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.92
|
| Rate for Payer: Priority Health SBD |
$20.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.65
|
| Rate for Payer: UHC Exchange |
$7.86
|
| Rate for Payer: UMR Bronson Commercial |
$12.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.56
|
|
|
HC ANOGENITAL EXAM CHILD/SUSPECT TRAUMA W IMAG
|
Facility
|
IP
|
$500.00
|
|
|
Service Code
|
CPT 99170
|
| Hospital Charge Code |
76100440
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$220.00 |
| Max. Negotiated Rate |
$450.00 |
| Rate for Payer: Aetna American Axle |
$325.00
|
| Rate for Payer: Aetna Commercial |
$425.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$350.00
|
| Rate for Payer: Cofinity Commercial |
$430.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.00
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.00
|
| Rate for Payer: PHP Commercial |
$425.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: Priority Health SBD |
$315.00
|
| Rate for Payer: UMR Bronson Commercial |
$220.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.00
|
|
|
HC ANOGENITAL EXAM CHILD/SUSPECT TRAUMA W IMAG
|
Facility
|
OP
|
$500.00
|
|
|
Service Code
|
CPT 99170
|
| Hospital Charge Code |
76100440
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$82.19 |
| Max. Negotiated Rate |
$557.61 |
| Rate for Payer: Aetna American Axle |
$325.00
|
| Rate for Payer: Aetna Commercial |
$425.00
|
| Rate for Payer: Aetna Medicare |
$184.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$325.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.40
|
| Rate for Payer: BCBS Complete |
$101.74
|
| Rate for Payer: BCBS MAPPO |
$177.12
|
| Rate for Payer: BCBS Trust/PPO |
$497.67
|
| Rate for Payer: BCN Medicare Advantage |
$177.12
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cash Price |
$400.00
|
| Rate for Payer: Cofinity Commercial |
$430.00
|
| Rate for Payer: Cofinity Commercial |
$350.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$400.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.12
|
| Rate for Payer: Healthscope Commercial |
$450.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$350.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$375.00
|
| Rate for Payer: Mclaren Medicaid |
$96.88
|
| Rate for Payer: Mclaren Medicare |
$177.12
|
| Rate for Payer: Meridian Medicaid |
$101.74
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$185.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$425.00
|
| Rate for Payer: PACE Medicare |
$168.26
|
| Rate for Payer: PACE SWMI |
$177.12
|
| Rate for Payer: PHP Commercial |
$425.00
|
| Rate for Payer: PHP Medicare Advantage |
$177.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$350.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$557.61
|
| Rate for Payer: Priority Health Medicare |
$177.12
|
| Rate for Payer: Priority Health Narrow Network |
$446.09
|
| Rate for Payer: Priority Health SBD |
$315.00
|
| Rate for Payer: Railroad Medicare Medicare |
$177.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.12
|
| Rate for Payer: UHC Exchange |
$82.19
|
| Rate for Payer: UHC Medicare Advantage |
$182.43
|
| Rate for Payer: UMR Bronson Commercial |
$185.00
|
| Rate for Payer: VA VA |
$177.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$375.00
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
OP
|
$1,020.22
|
|
| Hospital Charge Code |
75000002
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$377.48 |
| Max. Negotiated Rate |
$918.20 |
| Rate for Payer: Aetna American Axle |
$663.14
|
| Rate for Payer: Aetna Commercial |
$867.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.14
|
| Rate for Payer: BCBS Complete |
$408.09
|
| Rate for Payer: Cash Price |
$816.18
|
| Rate for Payer: Cofinity Commercial |
$714.15
|
| Rate for Payer: Cofinity Commercial |
$877.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.18
|
| Rate for Payer: Healthscope Commercial |
$918.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$867.19
|
| Rate for Payer: PHP Commercial |
$867.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$714.15
|
| Rate for Payer: Priority Health SBD |
$642.74
|
| Rate for Payer: UMR Bronson Commercial |
$377.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.16
|
|
|
HC ANORECTAL MANOMETRY
|
Facility
|
IP
|
$1,020.22
|
|
| Hospital Charge Code |
75000002
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$448.90 |
| Max. Negotiated Rate |
$918.20 |
| Rate for Payer: Aetna American Axle |
$663.14
|
| Rate for Payer: Aetna Commercial |
$867.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$663.14
|
| Rate for Payer: Cash Price |
$816.18
|
| Rate for Payer: Cofinity Commercial |
$714.15
|
| Rate for Payer: Cofinity Commercial |
$877.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$816.18
|
| Rate for Payer: Healthscope Commercial |
$918.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$714.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$765.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$867.19
|
| Rate for Payer: PHP Commercial |
$867.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$714.15
|
| Rate for Payer: Priority Health SBD |
$642.74
|
| Rate for Payer: UMR Bronson Commercial |
$448.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$765.16
|
|
|
HC ANOSCOPY
|
Facility
|
IP
|
$159.73
|
|
| Hospital Charge Code |
36000005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$70.28 |
| Max. Negotiated Rate |
$143.76 |
| Rate for Payer: Aetna American Axle |
$103.82
|
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.82
|
| Rate for Payer: Cash Price |
$127.78
|
| Rate for Payer: Cofinity Commercial |
$111.81
|
| Rate for Payer: Cofinity Commercial |
$137.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.78
|
| Rate for Payer: Healthscope Commercial |
$143.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$135.77
|
| Rate for Payer: PHP Commercial |
$135.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.81
|
| Rate for Payer: Priority Health SBD |
$100.63
|
| Rate for Payer: UMR Bronson Commercial |
$70.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.80
|
|
|
HC ANOSCOPY
|
Facility
|
OP
|
$159.73
|
|
| Hospital Charge Code |
36000005
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$59.10 |
| Max. Negotiated Rate |
$143.76 |
| Rate for Payer: Aetna American Axle |
$103.82
|
| Rate for Payer: Aetna Commercial |
$135.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.82
|
| Rate for Payer: BCBS Complete |
$63.89
|
| Rate for Payer: Cash Price |
$127.78
|
| Rate for Payer: Cofinity Commercial |
$111.81
|
| Rate for Payer: Cofinity Commercial |
$137.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.78
|
| Rate for Payer: Healthscope Commercial |
$143.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$135.77
|
| Rate for Payer: PHP Commercial |
$135.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.81
|
| Rate for Payer: Priority Health SBD |
$100.63
|
| Rate for Payer: UMR Bronson Commercial |
$59.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.80
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
OP
|
$147.32
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$95.76
|
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$141.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$141.94
|
| Rate for Payer: BCBS Complete |
$65.22
|
| Rate for Payer: BCBS MAPPO |
$113.55
|
| Rate for Payer: BCBS Trust/PPO |
$90.01
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$117.86
|
| Rate for Payer: Cash Price |
$117.86
|
| Rate for Payer: Cofinity Commercial |
$126.70
|
| Rate for Payer: Cofinity Commercial |
$103.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$132.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.49
|
| Rate for Payer: Mclaren Medicaid |
$62.11
|
| Rate for Payer: Mclaren Medicare |
$113.55
|
| Rate for Payer: Meridian Medicaid |
$65.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$119.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.22
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$125.22
|
| Rate for Payer: PHP Medicare Advantage |
$113.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$357.43
|
| Rate for Payer: Priority Health Medicare |
$113.55
|
| Rate for Payer: Priority Health Narrow Network |
$285.94
|
| Rate for Payer: Priority Health SBD |
$92.81
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$40.60
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$54.51
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.49
|
|
|
HC ANOSCOPY DIAGNOSTIC
|
Facility
|
IP
|
$147.32
|
|
|
Service Code
|
CPT 46600
|
| Hospital Charge Code |
76100138
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.82 |
| Max. Negotiated Rate |
$132.59 |
| Rate for Payer: Aetna American Axle |
$95.76
|
| Rate for Payer: Aetna Commercial |
$125.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.76
|
| Rate for Payer: Cash Price |
$117.86
|
| Rate for Payer: Cofinity Commercial |
$103.12
|
| Rate for Payer: Cofinity Commercial |
$126.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.86
|
| Rate for Payer: Healthscope Commercial |
$132.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.22
|
| Rate for Payer: PHP Commercial |
$125.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.12
|
| Rate for Payer: Priority Health SBD |
$92.81
|
| Rate for Payer: UMR Bronson Commercial |
$64.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.49
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
OP
|
$1,536.46
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$63.20 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$998.70
|
| Rate for Payer: Aetna Commercial |
$1,305.99
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$113.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cofinity Commercial |
$1,321.36
|
| Rate for Payer: Cofinity Commercial |
$1,075.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,382.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,075.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.34
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,305.99
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,305.99
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$967.97
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$63.20
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$568.49
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.34
|
|
|
HC ANOSCOPY W/CONTROL BLEEDING
|
Facility
|
IP
|
$1,536.46
|
|
|
Service Code
|
CPT 46614
|
| Hospital Charge Code |
76100276
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$676.04 |
| Max. Negotiated Rate |
$1,382.81 |
| Rate for Payer: Aetna American Axle |
$998.70
|
| Rate for Payer: Aetna Commercial |
$1,305.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$998.70
|
| Rate for Payer: Cash Price |
$1,229.17
|
| Rate for Payer: Cofinity Commercial |
$1,075.52
|
| Rate for Payer: Cofinity Commercial |
$1,321.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.17
|
| Rate for Payer: Healthscope Commercial |
$1,382.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,075.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,305.99
|
| Rate for Payer: PHP Commercial |
$1,305.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,075.52
|
| Rate for Payer: Priority Health SBD |
$967.97
|
| Rate for Payer: UMR Bronson Commercial |
$676.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.34
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
IP
|
$2,033.68
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$894.82 |
| Max. Negotiated Rate |
$1,830.31 |
| Rate for Payer: Aetna American Axle |
$1,321.89
|
| Rate for Payer: Aetna Commercial |
$1,728.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,321.89
|
| Rate for Payer: Cash Price |
$1,626.94
|
| Rate for Payer: Cofinity Commercial |
$1,423.58
|
| Rate for Payer: Cofinity Commercial |
$1,748.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,626.94
|
| Rate for Payer: Healthscope Commercial |
$1,830.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,423.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,525.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,728.63
|
| Rate for Payer: PHP Commercial |
$1,728.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.58
|
| Rate for Payer: Priority Health SBD |
$1,281.22
|
| Rate for Payer: UMR Bronson Commercial |
$894.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,525.26
|
|
|
HC ANOSCOPY WITH DILATION
|
Facility
|
OP
|
$2,033.68
|
|
|
Service Code
|
CPT 46604
|
| Hospital Charge Code |
76100139
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$64.83 |
| Max. Negotiated Rate |
$3,302.11 |
| Rate for Payer: Aetna American Axle |
$1,321.89
|
| Rate for Payer: Aetna Commercial |
$1,728.63
|
| Rate for Payer: Aetna Medicare |
$1,090.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,321.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,311.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,311.18
|
| Rate for Payer: BCBS Complete |
$602.51
|
| Rate for Payer: BCBS MAPPO |
$1,048.94
|
| Rate for Payer: BCBS Trust/PPO |
$598.63
|
| Rate for Payer: BCN Medicare Advantage |
$1,048.94
|
| Rate for Payer: Cash Price |
$1,626.94
|
| Rate for Payer: Cash Price |
$1,626.94
|
| Rate for Payer: Cofinity Commercial |
$1,423.58
|
| Rate for Payer: Cofinity Commercial |
$1,748.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,626.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,048.94
|
| Rate for Payer: Healthscope Commercial |
$1,830.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,423.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,525.26
|
| Rate for Payer: Mclaren Medicaid |
$573.77
|
| Rate for Payer: Mclaren Medicare |
$1,048.94
|
| Rate for Payer: Meridian Medicaid |
$602.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,101.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,728.63
|
| Rate for Payer: PACE Medicare |
$996.49
|
| Rate for Payer: PACE SWMI |
$1,048.94
|
| Rate for Payer: PHP Commercial |
$1,728.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,048.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$573.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,423.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,302.11
|
| Rate for Payer: Priority Health Medicare |
$1,048.94
|
| Rate for Payer: Priority Health Narrow Network |
$2,641.69
|
| Rate for Payer: Priority Health SBD |
$1,281.22
|
| Rate for Payer: Railroad Medicare Medicare |
$1,048.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,048.94
|
| Rate for Payer: UHC Exchange |
$64.83
|
| Rate for Payer: UHC Medicare Advantage |
$1,080.41
|
| Rate for Payer: UMR Bronson Commercial |
$752.46
|
| Rate for Payer: VA VA |
$1,048.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,525.26
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
IP
|
$115.50
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$50.82 |
| Max. Negotiated Rate |
$103.95 |
| Rate for Payer: Aetna American Axle |
$75.08
|
| Rate for Payer: Aetna Commercial |
$98.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.08
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cofinity Commercial |
$99.33
|
| Rate for Payer: Cofinity Commercial |
$80.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.40
|
| Rate for Payer: Healthscope Commercial |
$103.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.18
|
| Rate for Payer: PHP Commercial |
$98.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.85
|
| Rate for Payer: Priority Health SBD |
$72.76
|
| Rate for Payer: UMR Bronson Commercial |
$50.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.62
|
|
|
HC ANTIBODY ABSORPTION
|
Facility
|
OP
|
$115.50
|
|
|
Service Code
|
CPT 86978
|
| Hospital Charge Code |
39000028
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$75.08
|
| Rate for Payer: Aetna Commercial |
$98.18
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.08
|
| 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 |
$11.02
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cash Price |
$92.40
|
| Rate for Payer: Cofinity Commercial |
$99.33
|
| Rate for Payer: Cofinity Commercial |
$80.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$103.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.62
|
| 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: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$98.18
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$98.18
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.85
|
| 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: Priority Health SBD |
$72.76
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$42.74
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.62
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$21.49 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.72
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$7.13
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$7.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.87
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.30
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.64
|
| Rate for Payer: UHC Core |
$21.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Exchange |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.42
|
| Rate for Payer: UMR Bronson Commercial |
$7.55
|
| Rate for Payer: VA VA |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ANTIBODY COXSACKIE A
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200261
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: UMR Bronson Commercial |
$8.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: UMR Bronson Commercial |
$8.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ANTIBODY COXSACKIE B
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200260
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$21.49 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.72
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$7.13
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$7.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.87
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.30
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.64
|
| Rate for Payer: UHC Core |
$21.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Exchange |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.42
|
| Rate for Payer: UMR Bronson Commercial |
$7.55
|
| Rate for Payer: VA VA |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$21.49 |
| Rate for Payer: Aetna American Axle |
$14.59
|
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.72
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Mclaren Medicaid |
$7.13
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$7.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.87
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.30
|
| Rate for Payer: Priority Health SBD |
$14.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.64
|
| Rate for Payer: UHC Core |
$21.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Exchange |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.42
|
| Rate for Payer: UMR Bronson Commercial |
$8.30
|
| Rate for Payer: VA VA |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC ANTIBODY ECHOVIRUS
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200262
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna American Axle |
$14.59
|
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.59
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health SBD |
$14.14
|
| Rate for Payer: UMR Bronson Commercial |
$9.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$21.49 |
| Rate for Payer: Aetna American Axle |
$14.59
|
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$13.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.29
|
| Rate for Payer: BCBS Complete |
$7.48
|
| Rate for Payer: BCBS MAPPO |
$13.03
|
| Rate for Payer: BCBS Trust/PPO |
$11.72
|
| Rate for Payer: BCN Medicare Advantage |
$13.03
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.03
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Mclaren Medicaid |
$7.13
|
| Rate for Payer: Mclaren Medicare |
$13.03
|
| Rate for Payer: Meridian Medicaid |
$7.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Medicare |
$12.38
|
| Rate for Payer: PACE SWMI |
$13.03
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$13.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.87
|
| Rate for Payer: Priority Health Medicare |
$13.03
|
| Rate for Payer: Priority Health Narrow Network |
$14.30
|
| Rate for Payer: Priority Health SBD |
$14.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.64
|
| Rate for Payer: UHC Core |
$21.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.03
|
| Rate for Payer: UHC Exchange |
$13.03
|
| Rate for Payer: UHC Medicare Advantage |
$13.42
|
| Rate for Payer: UMR Bronson Commercial |
$8.30
|
| Rate for Payer: VA VA |
$13.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC ANTIBODY ECHOVIRUS CMPT
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
30200263
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna American Axle |
$14.59
|
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.59
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health SBD |
$14.14
|
| Rate for Payer: UMR Bronson Commercial |
$9.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
