|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
OP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$80.88 |
| Max. Negotiated Rate |
$943.06 |
| Rate for Payer: Aetna American Axle |
$681.10
|
| Rate for Payer: Aetna Commercial |
$890.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.10
|
| Rate for Payer: BCBS Complete |
$419.14
|
| Rate for Payer: BCBS Trust/PPO |
$733.81
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$901.15
|
| Rate for Payer: Cofinity Commercial |
$733.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.28
|
| Rate for Payer: Healthscope Commercial |
$943.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$733.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$785.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$890.67
|
| Rate for Payer: PHP Commercial |
$890.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$323.52
|
| Rate for Payer: Priority Health Narrow Network |
$258.82
|
| Rate for Payer: Priority Health SBD |
$660.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.97
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$80.88
|
| Rate for Payer: UMR Bronson Commercial |
$387.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$785.89
|
|
|
HC ARTHROGRAM SACROILIAC BIL
|
Facility
|
IP
|
$1,047.85
|
|
|
Service Code
|
CPT 27096
|
| Hospital Charge Code |
36100586
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$461.05 |
| Max. Negotiated Rate |
$943.06 |
| Rate for Payer: Aetna American Axle |
$681.10
|
| Rate for Payer: Aetna Commercial |
$890.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$681.10
|
| Rate for Payer: Cash Price |
$838.28
|
| Rate for Payer: Cofinity Commercial |
$733.50
|
| Rate for Payer: Cofinity Commercial |
$901.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$838.28
|
| Rate for Payer: Healthscope Commercial |
$943.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$733.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$785.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$890.67
|
| Rate for Payer: PHP Commercial |
$890.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$733.50
|
| Rate for Payer: Priority Health SBD |
$660.15
|
| Rate for Payer: UMR Bronson Commercial |
$461.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$785.89
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
IP
|
$1,781.24
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$783.75 |
| Max. Negotiated Rate |
$1,603.12 |
| Rate for Payer: Aetna American Axle |
$1,157.81
|
| Rate for Payer: Aetna Commercial |
$1,514.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,157.81
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cofinity Commercial |
$1,246.87
|
| Rate for Payer: Cofinity Commercial |
$1,531.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,424.99
|
| Rate for Payer: Healthscope Commercial |
$1,603.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,246.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,335.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,514.05
|
| Rate for Payer: PHP Commercial |
$1,514.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.87
|
| Rate for Payer: Priority Health SBD |
$1,122.18
|
| Rate for Payer: UMR Bronson Commercial |
$783.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,335.93
|
|
|
HC ARTHROTOMY W/EXP, DRAIN, REMOVAL FB METACARPOPHALANGEAL JT EACH
|
Facility
|
OP
|
$1,781.24
|
|
|
Service Code
|
CPT 26075
|
| Hospital Charge Code |
76100135
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$341.52 |
| Max. Negotiated Rate |
$9,057.42 |
| Rate for Payer: Aetna American Axle |
$1,157.81
|
| Rate for Payer: Aetna Commercial |
$1,514.05
|
| Rate for Payer: Aetna Medicare |
$2,992.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,157.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,596.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,596.44
|
| Rate for Payer: BCBS Complete |
$1,652.63
|
| Rate for Payer: BCBS MAPPO |
$2,877.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,810.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,877.15
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cash Price |
$1,424.99
|
| Rate for Payer: Cofinity Commercial |
$1,531.87
|
| Rate for Payer: Cofinity Commercial |
$1,246.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,424.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,877.15
|
| Rate for Payer: Healthscope Commercial |
$1,603.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,246.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,335.93
|
| Rate for Payer: Mclaren Medicaid |
$1,573.80
|
| Rate for Payer: Mclaren Medicare |
$2,877.15
|
| Rate for Payer: Meridian Medicaid |
$1,652.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,021.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,308.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,514.05
|
| Rate for Payer: PACE Medicare |
$2,733.29
|
| Rate for Payer: PACE SWMI |
$2,877.15
|
| Rate for Payer: PHP Commercial |
$1,514.05
|
| Rate for Payer: PHP Medicare Advantage |
$2,877.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,573.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,246.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,057.42
|
| Rate for Payer: Priority Health Medicare |
$2,877.15
|
| Rate for Payer: Priority Health Narrow Network |
$7,245.94
|
| Rate for Payer: Priority Health SBD |
$1,122.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,877.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,877.15
|
| Rate for Payer: UHC Exchange |
$341.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,963.46
|
| Rate for Payer: UMR Bronson Commercial |
$659.06
|
| Rate for Payer: VA VA |
$2,877.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,335.93
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
OP
|
$4,016.66
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$402.43 |
| Max. Negotiated Rate |
$4,497.31 |
| Rate for Payer: Aetna American Axle |
$2,610.83
|
| Rate for Payer: Aetna Commercial |
$3,414.16
|
| Rate for Payer: Aetna Medicare |
$1,485.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,610.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,785.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,785.76
|
| Rate for Payer: BCBS Complete |
$820.59
|
| Rate for Payer: BCBS MAPPO |
$1,428.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,204.96
|
| Rate for Payer: BCN Medicare Advantage |
$1,428.61
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cofinity Commercial |
$3,454.33
|
| Rate for Payer: Cofinity Commercial |
$2,811.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,213.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,428.61
|
| Rate for Payer: Healthscope Commercial |
$3,614.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,811.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,012.50
|
| Rate for Payer: Mclaren Medicaid |
$781.45
|
| Rate for Payer: Mclaren Medicare |
$1,428.61
|
| Rate for Payer: Meridian Medicaid |
$820.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,500.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,642.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.16
|
| Rate for Payer: PACE Medicare |
$1,357.18
|
| Rate for Payer: PACE SWMI |
$1,428.61
|
| Rate for Payer: PHP Commercial |
$3,414.16
|
| Rate for Payer: PHP Medicare Advantage |
$1,428.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$781.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,811.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,497.31
|
| Rate for Payer: Priority Health Medicare |
$1,428.61
|
| Rate for Payer: Priority Health Narrow Network |
$3,597.85
|
| Rate for Payer: Priority Health SBD |
$2,530.50
|
| Rate for Payer: Railroad Medicare Medicare |
$1,428.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,428.61
|
| Rate for Payer: UHC Exchange |
$402.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,471.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,486.16
|
| Rate for Payer: VA VA |
$1,428.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,012.50
|
|
|
HC ARTHRT EXPL DRAIN RMV FOREIGN BODY FINGER JT
|
Facility
|
IP
|
$4,016.66
|
|
|
Service Code
|
CPT 26080
|
| Hospital Charge Code |
76100373
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,767.33 |
| Max. Negotiated Rate |
$3,614.99 |
| Rate for Payer: Aetna American Axle |
$2,610.83
|
| Rate for Payer: Aetna Commercial |
$3,414.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,610.83
|
| Rate for Payer: Cash Price |
$3,213.33
|
| Rate for Payer: Cofinity Commercial |
$2,811.66
|
| Rate for Payer: Cofinity Commercial |
$3,454.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,213.33
|
| Rate for Payer: Healthscope Commercial |
$3,614.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,811.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,012.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.16
|
| Rate for Payer: PHP Commercial |
$3,414.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,811.66
|
| Rate for Payer: Priority Health SBD |
$2,530.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,767.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,012.50
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
OP
|
$904.13
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$813.72 |
| Rate for Payer: Aetna American Axle |
$587.68
|
| Rate for Payer: Aetna Commercial |
$768.51
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$604.91
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cofinity Commercial |
$632.89
|
| Rate for Payer: Cofinity Commercial |
$777.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$813.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$632.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.10
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.51
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$768.51
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$569.60
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$155.60
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$141.45
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$334.53
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.10
|
|
|
HC ART IMG UNILAT LOWER EXTREMITY
|
Facility
|
IP
|
$904.13
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100012
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$397.82 |
| Max. Negotiated Rate |
$813.72 |
| Rate for Payer: Aetna American Axle |
$587.68
|
| Rate for Payer: Aetna Commercial |
$768.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.68
|
| Rate for Payer: Cash Price |
$723.30
|
| Rate for Payer: Cofinity Commercial |
$632.89
|
| Rate for Payer: Cofinity Commercial |
$777.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.30
|
| Rate for Payer: Healthscope Commercial |
$813.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$632.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$768.51
|
| Rate for Payer: PHP Commercial |
$768.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$632.89
|
| Rate for Payer: Priority Health SBD |
$569.60
|
| Rate for Payer: UMR Bronson Commercial |
$397.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.10
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
OP
|
$741.52
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$667.37 |
| Rate for Payer: Aetna American Axle |
$481.99
|
| Rate for Payer: Aetna Commercial |
$630.29
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$481.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$506.04
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cofinity Commercial |
$519.06
|
| Rate for Payer: Cofinity Commercial |
$637.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$593.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$667.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$519.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$556.14
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$630.29
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$630.29
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$467.16
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.63
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$121.48
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$274.36
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$556.14
|
|
|
HC ART IMG UNILAT UPPER EXTREM
|
Facility
|
IP
|
$741.52
|
|
|
Service Code
|
CPT 93931
|
| Hospital Charge Code |
92100009
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$326.27 |
| Max. Negotiated Rate |
$667.37 |
| Rate for Payer: Aetna American Axle |
$481.99
|
| Rate for Payer: Aetna Commercial |
$630.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$481.99
|
| Rate for Payer: Cash Price |
$593.22
|
| Rate for Payer: Cofinity Commercial |
$519.06
|
| Rate for Payer: Cofinity Commercial |
$637.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$593.22
|
| Rate for Payer: Healthscope Commercial |
$667.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$519.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$556.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$630.29
|
| Rate for Payer: PHP Commercial |
$630.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.06
|
| Rate for Payer: Priority Health SBD |
$467.16
|
| Rate for Payer: UMR Bronson Commercial |
$326.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$556.14
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
IP
|
$4,553.46
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,003.52 |
| Max. Negotiated Rate |
$4,098.11 |
| Rate for Payer: Aetna American Axle |
$2,959.75
|
| Rate for Payer: Aetna Commercial |
$3,870.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,959.75
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$3,187.42
|
| Rate for Payer: Cofinity Commercial |
$3,915.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Healthscope Commercial |
$4,098.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,187.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,415.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PHP Commercial |
$3,870.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health SBD |
$2,868.68
|
| Rate for Payer: UMR Bronson Commercial |
$2,003.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,415.10
|
|
|
HC ART&VEN TRANSCATH THROMBOLYSIS
|
Facility
|
OP
|
$4,553.46
|
|
|
Service Code
|
CPT 37213
|
| Hospital Charge Code |
36100373
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$220.04 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,959.75
|
| Rate for Payer: Aetna Commercial |
$3,870.44
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,959.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$609.22
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cash Price |
$3,642.77
|
| Rate for Payer: Cofinity Commercial |
$3,915.98
|
| Rate for Payer: Cofinity Commercial |
$3,187.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,642.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$4,098.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,187.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,415.10
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,870.44
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,870.44
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,868.68
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.04
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$220.04
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,684.78
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,415.10
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
IP
|
$191.82
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$84.40 |
| Max. Negotiated Rate |
$172.64 |
| Rate for Payer: Aetna American Axle |
$124.68
|
| Rate for Payer: Aetna Commercial |
$163.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.68
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cofinity Commercial |
$134.27
|
| Rate for Payer: Cofinity Commercial |
$164.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.46
|
| Rate for Payer: Healthscope Commercial |
$172.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$134.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.05
|
| Rate for Payer: PHP Commercial |
$163.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.27
|
| Rate for Payer: Priority Health SBD |
$120.85
|
| Rate for Payer: UMR Bronson Commercial |
$84.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.86
|
|
|
HC ASMT VERTEBRAL FX VIA DXA
|
Facility
|
OP
|
$191.82
|
|
|
Service Code
|
CPT 77086
|
| Hospital Charge Code |
32000302
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$33.07 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$124.68
|
| Rate for Payer: Aetna Commercial |
$163.05
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$124.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$47.51
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cash Price |
$153.46
|
| Rate for Payer: Cofinity Commercial |
$134.27
|
| Rate for Payer: Cofinity Commercial |
$164.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$172.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$134.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.86
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$163.05
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$163.05
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$120.85
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.38
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$33.07
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$70.97
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.86
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
OP
|
$1,210.75
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$90.37 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$786.99
|
| Rate for Payer: Aetna Commercial |
$1,029.14
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$786.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$644.98
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$968.60
|
| Rate for Payer: Cash Price |
$968.60
|
| Rate for Payer: Cofinity Commercial |
$1,041.24
|
| Rate for Payer: Cofinity Commercial |
$847.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$1,089.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$847.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$908.06
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,029.14
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$1,029.14
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$762.77
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.41
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$90.37
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$447.98
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$908.06
|
|
|
HC ASP AND OR INJ RENAL CYST OR PELVIS
|
Facility
|
IP
|
$1,210.75
|
|
|
Service Code
|
CPT 50390
|
| Hospital Charge Code |
36100242
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$532.73 |
| Max. Negotiated Rate |
$1,089.68 |
| Rate for Payer: Aetna American Axle |
$786.99
|
| Rate for Payer: Aetna Commercial |
$1,029.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$786.99
|
| Rate for Payer: Cash Price |
$968.60
|
| Rate for Payer: Cofinity Commercial |
$1,041.24
|
| Rate for Payer: Cofinity Commercial |
$847.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$968.60
|
| Rate for Payer: Healthscope Commercial |
$1,089.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$847.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$908.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,029.14
|
| Rate for Payer: PHP Commercial |
$1,029.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$847.52
|
| Rate for Payer: Priority Health SBD |
$762.77
|
| Rate for Payer: UMR Bronson Commercial |
$532.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$908.06
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ASPERGILLIS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200028
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC ASPERGILLUS ANTIBODIES
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200221
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.54
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| Rate for Payer: UHC Core |
$24.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$15.05
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
IP
|
$39.78
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.50 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna American Axle |
$25.86
|
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.86
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$27.85
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.81
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health SBD |
$25.06
|
| Rate for Payer: UMR Bronson Commercial |
$17.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC ASPERGILLUS ANTIBODIES CMPT
|
Facility
|
OP
|
$39.78
|
|
|
Service Code
|
CPT 86606
|
| Hospital Charge Code |
30200222
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna American Axle |
$25.86
|
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.54
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Cofinity Commercial |
$27.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.81
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$25.06
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| Rate for Payer: UHC Core |
$24.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$15.05
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Aetna American Axle |
$53.30
|
| Rate for Payer: Aetna Commercial |
$69.70
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$70.52
|
| Rate for Payer: Cofinity Commercial |
$57.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$73.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.50
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.70
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$69.70
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$51.66
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: UMR Bronson Commercial |
$30.34
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.50
|
|
|
HC ASPERGILLUS ANTIGEN
|
Facility
|
IP
|
$82.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600135
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.08 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Aetna American Axle |
$53.30
|
| Rate for Payer: Aetna Commercial |
$69.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.30
|
| Rate for Payer: Cash Price |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$57.40
|
| Rate for Payer: Cofinity Commercial |
$70.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.60
|
| Rate for Payer: Healthscope Commercial |
$73.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.70
|
| Rate for Payer: PHP Commercial |
$69.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.40
|
| Rate for Payer: Priority Health SBD |
$51.66
|
| Rate for Payer: UMR Bronson Commercial |
$36.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.50
|
|
|
HC ASPERGILLUS ANTIGEN, BAL
|
Facility
|
OP
|
$89.00
|
|
|
Service Code
|
CPT 87305
|
| Hospital Charge Code |
30600290
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Aetna American Axle |
$57.85
|
| Rate for Payer: Aetna Commercial |
$75.65
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cash Price |
$71.20
|
| Rate for Payer: Cofinity Commercial |
$76.54
|
| Rate for Payer: Cofinity Commercial |
$62.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$80.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.75
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$75.65
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$75.65
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$56.07
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: UMR Bronson Commercial |
$32.93
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.75
|
|
