|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
IP
|
$122.08
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.72 |
| Max. Negotiated Rate |
$109.87 |
| Rate for Payer: Aetna American Axle |
$79.35
|
| Rate for Payer: Aetna Commercial |
$103.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.35
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$104.99
|
| Rate for Payer: Cofinity Commercial |
$85.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.66
|
| Rate for Payer: Healthscope Commercial |
$109.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.77
|
| Rate for Payer: PHP Commercial |
$103.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.46
|
| Rate for Payer: Priority Health SBD |
$76.91
|
| Rate for Payer: UMR Bronson Commercial |
$53.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.56
|
|
|
HC BLD DRAW CENTRAL/PERIPH VENOUS CATH
|
Facility
|
OP
|
$122.08
|
|
|
Service Code
|
CPT 36592
|
| Hospital Charge Code |
76100004
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$29.47 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$79.35
|
| Rate for Payer: Aetna Commercial |
$103.77
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.35
|
| 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 |
$41.33
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cash Price |
$97.66
|
| Rate for Payer: Cofinity Commercial |
$85.46
|
| Rate for Payer: Cofinity Commercial |
$104.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$109.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.56
|
| 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 |
$103.77
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$103.77
|
| 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 |
$85.46
|
| 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 |
$76.91
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$29.47
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$45.17
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.56
|
|
|
HC BLEEDING TIME
|
Facility
|
IP
|
$75.40
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$33.18 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna American Axle |
$49.01
|
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.01
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$52.78
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health SBD |
$47.50
|
| Rate for Payer: UMR Bronson Commercial |
$33.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC BLEEDING TIME
|
Facility
|
OP
|
$75.40
|
|
|
Service Code
|
CPT 85002
|
| Hospital Charge Code |
30500001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$67.86 |
| Rate for Payer: Aetna American Axle |
$49.01
|
| Rate for Payer: Aetna Commercial |
$64.09
|
| Rate for Payer: Aetna Medicare |
$5.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.02
|
| Rate for Payer: BCBS Complete |
$2.77
|
| Rate for Payer: BCBS MAPPO |
$4.82
|
| Rate for Payer: BCBS Trust/PPO |
$4.34
|
| Rate for Payer: BCN Medicare Advantage |
$4.82
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cash Price |
$60.32
|
| Rate for Payer: Cofinity Commercial |
$52.78
|
| Rate for Payer: Cofinity Commercial |
$64.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.82
|
| Rate for Payer: Healthscope Commercial |
$67.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.55
|
| Rate for Payer: Mclaren Medicaid |
$2.64
|
| Rate for Payer: Mclaren Medicare |
$4.82
|
| Rate for Payer: Meridian Medicaid |
$2.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.09
|
| Rate for Payer: PACE Medicare |
$4.58
|
| Rate for Payer: PACE SWMI |
$4.82
|
| Rate for Payer: PHP Commercial |
$64.09
|
| Rate for Payer: PHP Medicare Advantage |
$4.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.19
|
| Rate for Payer: Priority Health Medicare |
$4.82
|
| Rate for Payer: Priority Health Narrow Network |
$4.95
|
| Rate for Payer: Priority Health SBD |
$47.50
|
| Rate for Payer: Railroad Medicare Medicare |
$4.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.78
|
| Rate for Payer: UHC Core |
$7.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.82
|
| Rate for Payer: UHC Exchange |
$4.82
|
| Rate for Payer: UHC Medicare Advantage |
$4.96
|
| Rate for Payer: UMR Bronson Commercial |
$27.90
|
| Rate for Payer: VA VA |
$4.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.55
|
|
|
HC BLOOD CULTURE
|
Facility
|
OP
|
$95.78
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$86.20 |
| Rate for Payer: Aetna American Axle |
$62.26
|
| Rate for Payer: Aetna Commercial |
$81.41
|
| Rate for Payer: Aetna Medicare |
$10.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: BCBS Complete |
$5.93
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$9.28
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cofinity Commercial |
$67.05
|
| Rate for Payer: Cofinity Commercial |
$82.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$86.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.84
|
| Rate for Payer: Mclaren Medicaid |
$5.65
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Medicaid |
$5.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.41
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$81.41
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.98
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health Narrow Network |
$6.38
|
| Rate for Payer: Priority Health SBD |
$60.34
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.38
|
| Rate for Payer: UHC Core |
$17.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.32
|
| Rate for Payer: UHC Exchange |
$10.32
|
| Rate for Payer: UHC Medicare Advantage |
$10.63
|
| Rate for Payer: UMR Bronson Commercial |
$35.44
|
| Rate for Payer: VA VA |
$10.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.84
|
|
|
HC BLOOD CULTURE
|
Facility
|
IP
|
$95.78
|
|
|
Service Code
|
CPT 87040
|
| Hospital Charge Code |
30600072
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.14 |
| Max. Negotiated Rate |
$86.20 |
| Rate for Payer: Aetna American Axle |
$62.26
|
| Rate for Payer: Aetna Commercial |
$81.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.26
|
| Rate for Payer: Cash Price |
$76.62
|
| Rate for Payer: Cofinity Commercial |
$82.37
|
| Rate for Payer: Cofinity Commercial |
$67.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.62
|
| Rate for Payer: Healthscope Commercial |
$86.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.41
|
| Rate for Payer: PHP Commercial |
$81.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.05
|
| Rate for Payer: Priority Health SBD |
$60.34
|
| Rate for Payer: UMR Bronson Commercial |
$42.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.84
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
IP
|
$164.48
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$72.37 |
| Max. Negotiated Rate |
$148.03 |
| Rate for Payer: Aetna American Axle |
$106.91
|
| Rate for Payer: Aetna Commercial |
$139.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.91
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$115.14
|
| Rate for Payer: Cofinity Commercial |
$141.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.58
|
| Rate for Payer: Healthscope Commercial |
$148.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.81
|
| Rate for Payer: PHP Commercial |
$139.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.14
|
| Rate for Payer: Priority Health SBD |
$103.62
|
| Rate for Payer: UMR Bronson Commercial |
$72.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.36
|
|
|
HC BLOOD DRAW IMPLANTED DEVICE
|
Facility
|
OP
|
$164.48
|
|
|
Service Code
|
CPT 36591
|
| Hospital Charge Code |
76100003
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$27.18 |
| Max. Negotiated Rate |
$357.43 |
| Rate for Payer: Aetna American Axle |
$106.91
|
| Rate for Payer: Aetna Commercial |
$139.81
|
| Rate for Payer: Aetna Medicare |
$118.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.91
|
| 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 |
$38.01
|
| Rate for Payer: BCN Medicare Advantage |
$113.55
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cash Price |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$115.14
|
| Rate for Payer: Cofinity Commercial |
$141.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$113.55
|
| Rate for Payer: Healthscope Commercial |
$148.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.36
|
| 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 |
$139.81
|
| Rate for Payer: PACE Medicare |
$107.87
|
| Rate for Payer: PACE SWMI |
$113.55
|
| Rate for Payer: PHP Commercial |
$139.81
|
| 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 |
$115.14
|
| 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 |
$103.62
|
| Rate for Payer: Railroad Medicare Medicare |
$113.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$113.55
|
| Rate for Payer: UHC Exchange |
$27.18
|
| Rate for Payer: UHC Medicare Advantage |
$116.96
|
| Rate for Payer: UMR Bronson Commercial |
$60.86
|
| Rate for Payer: VA VA |
$113.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.36
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
OP
|
$173.50
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.41 |
| Max. Negotiated Rate |
$156.15 |
| Rate for Payer: Aetna American Axle |
$112.78
|
| Rate for Payer: Aetna Commercial |
$147.48
|
| Rate for Payer: Aetna Medicare |
$27.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.59
|
| Rate for Payer: BCBS Complete |
$14.97
|
| Rate for Payer: BCBS MAPPO |
$26.07
|
| Rate for Payer: BCBS Trust/PPO |
$23.44
|
| Rate for Payer: BCN Medicare Advantage |
$26.07
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cofinity Commercial |
$149.21
|
| Rate for Payer: Cofinity Commercial |
$121.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$156.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.12
|
| Rate for Payer: Mclaren Medicaid |
$14.26
|
| Rate for Payer: Mclaren Medicare |
$26.07
|
| Rate for Payer: Meridian Medicaid |
$14.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.48
|
| Rate for Payer: PACE Medicare |
$24.77
|
| Rate for Payer: PACE SWMI |
$26.07
|
| Rate for Payer: PHP Commercial |
$147.48
|
| Rate for Payer: PHP Medicare Advantage |
$26.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.01
|
| Rate for Payer: Priority Health Medicare |
$26.07
|
| Rate for Payer: Priority Health Narrow Network |
$10.41
|
| Rate for Payer: Priority Health SBD |
$109.30
|
| Rate for Payer: Railroad Medicare Medicare |
$26.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.28
|
| Rate for Payer: UHC Core |
$31.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.07
|
| Rate for Payer: UHC Exchange |
$26.07
|
| Rate for Payer: UHC Medicare Advantage |
$26.85
|
| Rate for Payer: UMR Bronson Commercial |
$64.20
|
| Rate for Payer: VA VA |
$26.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.12
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
IP
|
$173.50
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$76.34 |
| Max. Negotiated Rate |
$156.15 |
| Rate for Payer: Aetna American Axle |
$112.78
|
| Rate for Payer: Aetna Commercial |
$147.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.78
|
| Rate for Payer: Cash Price |
$138.80
|
| Rate for Payer: Cofinity Commercial |
$121.45
|
| Rate for Payer: Cofinity Commercial |
$149.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.80
|
| Rate for Payer: Healthscope Commercial |
$156.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.48
|
| Rate for Payer: PHP Commercial |
$147.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.45
|
| Rate for Payer: Priority Health SBD |
$109.30
|
| Rate for Payer: UMR Bronson Commercial |
$76.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.12
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
IP
|
$184.31
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.10 |
| Max. Negotiated Rate |
$165.88 |
| Rate for Payer: Aetna American Axle |
$119.80
|
| Rate for Payer: Aetna Commercial |
$156.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.80
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cofinity Commercial |
$129.02
|
| Rate for Payer: Cofinity Commercial |
$158.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.45
|
| Rate for Payer: Healthscope Commercial |
$165.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.66
|
| Rate for Payer: PHP Commercial |
$156.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.02
|
| Rate for Payer: Priority Health SBD |
$116.12
|
| Rate for Payer: UMR Bronson Commercial |
$81.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.23
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
OP
|
$184.31
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.03 |
| Max. Negotiated Rate |
$165.88 |
| Rate for Payer: Aetna American Axle |
$119.80
|
| Rate for Payer: Aetna Commercial |
$156.66
|
| Rate for Payer: Aetna Medicare |
$81.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.46
|
| Rate for Payer: BCBS Complete |
$45.25
|
| Rate for Payer: BCBS MAPPO |
$78.77
|
| Rate for Payer: BCBS Trust/PPO |
$70.84
|
| Rate for Payer: BCN Medicare Advantage |
$78.77
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cash Price |
$147.45
|
| Rate for Payer: Cofinity Commercial |
$129.02
|
| Rate for Payer: Cofinity Commercial |
$158.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.77
|
| Rate for Payer: Healthscope Commercial |
$165.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.23
|
| Rate for Payer: Mclaren Medicaid |
$43.09
|
| Rate for Payer: Mclaren Medicare |
$78.77
|
| Rate for Payer: Meridian Medicaid |
$45.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$82.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.66
|
| Rate for Payer: PACE Medicare |
$74.83
|
| Rate for Payer: PACE SWMI |
$78.77
|
| Rate for Payer: PHP Commercial |
$156.66
|
| Rate for Payer: PHP Medicare Advantage |
$78.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.79
|
| Rate for Payer: Priority Health Medicare |
$78.77
|
| Rate for Payer: Priority Health Narrow Network |
$23.03
|
| Rate for Payer: Priority Health SBD |
$116.12
|
| Rate for Payer: Railroad Medicare Medicare |
$78.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.52
|
| Rate for Payer: UHC Core |
$46.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$78.77
|
| Rate for Payer: UHC Exchange |
$78.77
|
| Rate for Payer: UHC Medicare Advantage |
$81.13
|
| Rate for Payer: UMR Bronson Commercial |
$68.19
|
| Rate for Payer: VA VA |
$78.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.23
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
OP
|
$30.68
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$27.61 |
| Rate for Payer: Aetna American Axle |
$19.94
|
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: BCBS Complete |
$10.37
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$16.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cofinity Commercial |
$26.38
|
| Rate for Payer: Cofinity Commercial |
$21.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.05
|
| Rate for Payer: Healthscope Commercial |
$27.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.01
|
| Rate for Payer: Mclaren Medicaid |
$9.87
|
| Rate for Payer: Mclaren Medicare |
$18.05
|
| Rate for Payer: Meridian Medicaid |
$10.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.08
|
| Rate for Payer: PACE Medicare |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$26.08
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.82
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow Network |
$17.46
|
| Rate for Payer: Priority Health SBD |
$19.33
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.66
|
| Rate for Payer: UHC Core |
$26.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Exchange |
$18.05
|
| Rate for Payer: UHC Medicare Advantage |
$18.59
|
| Rate for Payer: UMR Bronson Commercial |
$11.35
|
| Rate for Payer: VA VA |
$18.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.01
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
IP
|
$30.68
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.50 |
| Max. Negotiated Rate |
$27.61 |
| Rate for Payer: Aetna American Axle |
$19.94
|
| Rate for Payer: Aetna Commercial |
$26.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.94
|
| Rate for Payer: Cash Price |
$24.54
|
| Rate for Payer: Cofinity Commercial |
$21.48
|
| Rate for Payer: Cofinity Commercial |
$26.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.54
|
| Rate for Payer: Healthscope Commercial |
$27.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.08
|
| Rate for Payer: PHP Commercial |
$26.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.48
|
| Rate for Payer: Priority Health SBD |
$19.33
|
| Rate for Payer: UMR Bronson Commercial |
$13.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.01
|
|
|
HC BLOOD PATCH
|
Facility
|
IP
|
$1,188.74
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$523.05 |
| Max. Negotiated Rate |
$1,069.87 |
| Rate for Payer: Aetna American Axle |
$772.68
|
| Rate for Payer: Aetna Commercial |
$1,010.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.68
|
| Rate for Payer: Cash Price |
$950.99
|
| Rate for Payer: Cofinity Commercial |
$1,022.32
|
| Rate for Payer: Cofinity Commercial |
$832.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.99
|
| Rate for Payer: Healthscope Commercial |
$1,069.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$832.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$891.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,010.43
|
| Rate for Payer: PHP Commercial |
$1,010.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.12
|
| Rate for Payer: Priority Health SBD |
$748.91
|
| Rate for Payer: UMR Bronson Commercial |
$523.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$891.56
|
|
|
HC BLOOD PATCH
|
Facility
|
OP
|
$1,188.74
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$772.68
|
| Rate for Payer: Aetna Commercial |
$1,010.43
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$664.56
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$950.99
|
| Rate for Payer: Cash Price |
$950.99
|
| Rate for Payer: Cofinity Commercial |
$832.12
|
| Rate for Payer: Cofinity Commercial |
$1,022.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,069.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$832.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$891.56
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,010.43
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$1,010.43
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$748.91
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.38
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$110.35
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$439.83
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$891.56
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
OP
|
$1,188.74
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$110.35 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$772.68
|
| Rate for Payer: Aetna Commercial |
$1,010.43
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$664.56
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$950.99
|
| Rate for Payer: Cash Price |
$950.99
|
| Rate for Payer: Cofinity Commercial |
$1,022.32
|
| Rate for Payer: Cofinity Commercial |
$832.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$1,069.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$832.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$891.56
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,010.43
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$1,010.43
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$748.91
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.38
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$110.35
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$439.83
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$891.56
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
IP
|
$1,188.74
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$523.05 |
| Max. Negotiated Rate |
$1,069.87 |
| Rate for Payer: Aetna American Axle |
$772.68
|
| Rate for Payer: Aetna Commercial |
$1,010.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$772.68
|
| Rate for Payer: Cash Price |
$950.99
|
| Rate for Payer: Cofinity Commercial |
$1,022.32
|
| Rate for Payer: Cofinity Commercial |
$832.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.99
|
| Rate for Payer: Healthscope Commercial |
$1,069.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$832.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$891.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,010.43
|
| Rate for Payer: PHP Commercial |
$1,010.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$832.12
|
| Rate for Payer: Priority Health SBD |
$748.91
|
| Rate for Payer: UMR Bronson Commercial |
$523.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$891.56
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
OP
|
$22.60
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.88 |
| Max. Negotiated Rate |
$20.34 |
| Rate for Payer: Aetna American Axle |
$14.69
|
| Rate for Payer: Aetna Commercial |
$19.21
|
| Rate for Payer: Aetna Medicare |
$3.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.29
|
| Rate for Payer: BCBS Complete |
$1.97
|
| Rate for Payer: BCBS MAPPO |
$3.43
|
| Rate for Payer: BCBS Trust/PPO |
$3.08
|
| Rate for Payer: BCN Medicare Advantage |
$3.43
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Cofinity Commercial |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$19.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.43
|
| Rate for Payer: Healthscope Commercial |
$20.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.95
|
| Rate for Payer: Mclaren Medicaid |
$1.88
|
| Rate for Payer: Mclaren Medicare |
$3.43
|
| Rate for Payer: Meridian Medicaid |
$1.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.21
|
| Rate for Payer: PACE Medicare |
$3.26
|
| Rate for Payer: PACE SWMI |
$3.43
|
| Rate for Payer: PHP Commercial |
$19.21
|
| Rate for Payer: PHP Medicare Advantage |
$3.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.95
|
| Rate for Payer: Priority Health Medicare |
$3.43
|
| Rate for Payer: Priority Health Narrow Network |
$3.16
|
| Rate for Payer: Priority Health SBD |
$14.24
|
| Rate for Payer: Railroad Medicare Medicare |
$3.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.12
|
| Rate for Payer: UHC Core |
$5.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.43
|
| Rate for Payer: UHC Exchange |
$3.43
|
| Rate for Payer: UHC Medicare Advantage |
$3.53
|
| Rate for Payer: UMR Bronson Commercial |
$8.36
|
| Rate for Payer: VA VA |
$3.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.95
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
IP
|
$22.60
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.94 |
| Max. Negotiated Rate |
$20.34 |
| Rate for Payer: Aetna American Axle |
$14.69
|
| Rate for Payer: Aetna Commercial |
$19.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.69
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Cofinity Commercial |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$19.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.08
|
| Rate for Payer: Healthscope Commercial |
$20.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.21
|
| Rate for Payer: PHP Commercial |
$19.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.82
|
| Rate for Payer: Priority Health SBD |
$14.24
|
| Rate for Payer: UMR Bronson Commercial |
$9.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.95
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$107.32 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna American Axle |
$158.55
|
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.55
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$170.74
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health SBD |
$153.67
|
| Rate for Payer: UMR Bronson Commercial |
$107.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.07 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$158.55
|
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna Medicare |
$144.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$441.02
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Cofinity Commercial |
$170.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.81
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$350.25
|
| Rate for Payer: Priority Health SBD |
$153.67
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.07
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: UMR Bronson Commercial |
$90.25
|
| Rate for Payer: VA VA |
$139.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
IP
|
$45.52
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$20.03 |
| Max. Negotiated Rate |
$40.97 |
| Rate for Payer: Aetna American Axle |
$29.59
|
| Rate for Payer: Aetna Commercial |
$38.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.59
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$31.86
|
| Rate for Payer: Cofinity Commercial |
$39.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Healthscope Commercial |
$40.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.69
|
| Rate for Payer: PHP Commercial |
$38.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.86
|
| Rate for Payer: Priority Health SBD |
$28.68
|
| Rate for Payer: UMR Bronson Commercial |
$20.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.14
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
OP
|
$45.52
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$16.84 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$29.59
|
| Rate for Payer: Aetna Commercial |
$38.69
|
| Rate for Payer: Aetna Medicare |
$144.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$441.02
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cash Price |
$36.42
|
| Rate for Payer: Cofinity Commercial |
$39.15
|
| Rate for Payer: Cofinity Commercial |
$31.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$40.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.14
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.69
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$38.69
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.81
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$350.25
|
| Rate for Payer: Priority Health SBD |
$28.68
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.07
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: UMR Bronson Commercial |
$16.84
|
| Rate for Payer: VA VA |
$139.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.14
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
OP
|
$351.55
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.07 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$228.51
|
| Rate for Payer: Aetna Commercial |
$298.82
|
| Rate for Payer: Aetna Medicare |
$144.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.84
|
| Rate for Payer: BCBS Complete |
$79.88
|
| Rate for Payer: BCBS MAPPO |
$139.07
|
| Rate for Payer: BCBS Trust/PPO |
$441.02
|
| Rate for Payer: BCN Medicare Advantage |
$139.07
|
| Rate for Payer: Cash Price |
$281.24
|
| Rate for Payer: Cash Price |
$281.24
|
| Rate for Payer: Cash Price |
$281.24
|
| Rate for Payer: Cofinity Commercial |
$246.08
|
| Rate for Payer: Cofinity Commercial |
$302.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$281.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$316.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$246.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.66
|
| Rate for Payer: Mclaren Medicaid |
$76.07
|
| Rate for Payer: Mclaren Medicare |
$139.07
|
| Rate for Payer: Meridian Medicaid |
$79.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$146.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$298.82
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$298.82
|
| Rate for Payer: PHP Medicare Advantage |
$139.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.81
|
| Rate for Payer: Priority Health Medicare |
$139.07
|
| Rate for Payer: Priority Health Narrow Network |
$350.25
|
| Rate for Payer: Priority Health SBD |
$221.48
|
| Rate for Payer: Railroad Medicare Medicare |
$139.07
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$139.07
|
| Rate for Payer: UHC Medicare Advantage |
$143.24
|
| Rate for Payer: UMR Bronson Commercial |
$130.07
|
| Rate for Payer: VA VA |
$139.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.66
|
|
