|
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
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
IP
|
$294.78
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$129.70 |
| Max. Negotiated Rate |
$265.30 |
| Rate for Payer: Aetna American Axle |
$191.61
|
| Rate for Payer: Aetna Commercial |
$250.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.61
|
| Rate for Payer: Cash Price |
$235.82
|
| Rate for Payer: Cofinity Commercial |
$253.51
|
| Rate for Payer: Cofinity Commercial |
$206.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.82
|
| Rate for Payer: Healthscope Commercial |
$265.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$206.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.56
|
| Rate for Payer: PHP Commercial |
$250.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.35
|
| Rate for Payer: Priority Health SBD |
$185.71
|
| Rate for Payer: UMR Bronson Commercial |
$129.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.08
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$294.78
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.07 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$191.61
|
| Rate for Payer: Aetna Commercial |
$250.56
|
| Rate for Payer: Aetna Medicare |
$144.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.61
|
| 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 |
$235.82
|
| Rate for Payer: Cash Price |
$235.82
|
| Rate for Payer: Cash Price |
$235.82
|
| Rate for Payer: Cofinity Commercial |
$253.51
|
| Rate for Payer: Cofinity Commercial |
$206.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$235.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$265.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$206.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.08
|
| 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 |
$250.56
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$250.56
|
| 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 |
$206.35
|
| 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 |
$185.71
|
| 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 |
$109.07
|
| Rate for Payer: VA VA |
$139.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.08
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
OP
|
$80.08
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$29.63 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$52.05
|
| Rate for Payer: Aetna Commercial |
$68.07
|
| Rate for Payer: Aetna Medicare |
$144.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.05
|
| 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 |
$64.06
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cofinity Commercial |
$56.06
|
| Rate for Payer: Cofinity Commercial |
$68.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$72.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.06
|
| 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 |
$68.07
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$68.07
|
| 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 |
$56.06
|
| 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 |
$50.45
|
| 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 |
$29.63
|
| Rate for Payer: VA VA |
$139.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.06
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
IP
|
$80.08
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$35.24 |
| Max. Negotiated Rate |
$72.07 |
| Rate for Payer: Aetna American Axle |
$52.05
|
| Rate for Payer: Aetna Commercial |
$68.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.05
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cofinity Commercial |
$56.06
|
| Rate for Payer: Cofinity Commercial |
$68.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.06
|
| Rate for Payer: Healthscope Commercial |
$72.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$68.07
|
| Rate for Payer: PHP Commercial |
$68.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.06
|
| Rate for Payer: Priority Health SBD |
$50.45
|
| Rate for Payer: UMR Bronson Commercial |
$35.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.06
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$101.62
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$37.60 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$66.05
|
| Rate for Payer: Aetna Commercial |
$86.38
|
| Rate for Payer: Aetna Medicare |
$144.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.05
|
| 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 |
$81.30
|
| Rate for Payer: Cash Price |
$81.30
|
| Rate for Payer: Cash Price |
$81.30
|
| Rate for Payer: Cofinity Commercial |
$71.13
|
| Rate for Payer: Cofinity Commercial |
$87.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$139.07
|
| Rate for Payer: Healthscope Commercial |
$91.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.22
|
| 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 |
$86.38
|
| Rate for Payer: PACE Medicare |
$132.12
|
| Rate for Payer: PACE SWMI |
$139.07
|
| Rate for Payer: PHP Commercial |
$86.38
|
| 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 |
$71.13
|
| 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 |
$64.02
|
| 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 |
$37.60
|
| Rate for Payer: VA VA |
$139.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.22
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$101.62
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.71 |
| Max. Negotiated Rate |
$91.46 |
| Rate for Payer: Aetna American Axle |
$66.05
|
| Rate for Payer: Aetna Commercial |
$86.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.05
|
| Rate for Payer: Cash Price |
$81.30
|
| Rate for Payer: Cofinity Commercial |
$71.13
|
| Rate for Payer: Cofinity Commercial |
$87.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.30
|
| Rate for Payer: Healthscope Commercial |
$91.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$86.38
|
| Rate for Payer: PHP Commercial |
$86.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.13
|
| Rate for Payer: Priority Health SBD |
$64.02
|
| Rate for Payer: UMR Bronson Commercial |
$44.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.22
|
|
|
HC BLOOD TYPING RH
|
Facility
|
OP
|
$21.83
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$112.22 |
| Rate for Payer: Aetna American Axle |
$14.19
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Medicare |
$37.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.56
|
| Rate for Payer: BCBS Complete |
$20.48
|
| Rate for Payer: BCBS MAPPO |
$35.65
|
| Rate for Payer: BCBS Trust/PPO |
$2.69
|
| Rate for Payer: BCN Medicare Advantage |
$35.65
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.65
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Mclaren Medicaid |
$19.50
|
| Rate for Payer: Mclaren Medicare |
$35.65
|
| Rate for Payer: Meridian Medicaid |
$20.48
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$37.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.56
|
| Rate for Payer: PACE Medicare |
$33.87
|
| Rate for Payer: PACE SWMI |
$35.65
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicare Advantage |
$35.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$112.22
|
| Rate for Payer: Priority Health Medicare |
$35.65
|
| Rate for Payer: Priority Health Narrow Network |
$89.78
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: Railroad Medicare Medicare |
$35.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.59
|
| Rate for Payer: UHC Core |
$4.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.65
|
| Rate for Payer: UHC Exchange |
$2.99
|
| Rate for Payer: UHC Medicare Advantage |
$36.72
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: VA VA |
$35.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
|
|
HC BLOOD TYPING RH
|
Facility
|
IP
|
$21.83
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Aetna American Axle |
$14.19
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.56
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.28
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,500.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$103.65 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna American Axle |
$975.00
|
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna Medicare |
$197.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.85
|
| Rate for Payer: BCBS Complete |
$108.84
|
| Rate for Payer: BCBS MAPPO |
$189.48
|
| Rate for Payer: BCBS Trust/PPO |
$721.91
|
| Rate for Payer: BCN Medicare Advantage |
$189.48
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,050.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.48
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: Mclaren Medicaid |
$103.65
|
| Rate for Payer: Mclaren Medicare |
$189.48
|
| Rate for Payer: Meridian Medicaid |
$108.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.00
|
| Rate for Payer: PACE Medicare |
$180.01
|
| Rate for Payer: PACE SWMI |
$189.48
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: PHP Medicare Advantage |
$189.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.49
|
| Rate for Payer: Priority Health Medicare |
$189.48
|
| Rate for Payer: Priority Health Narrow Network |
$477.19
|
| Rate for Payer: Priority Health SBD |
$945.00
|
| Rate for Payer: Railroad Medicare Medicare |
$189.48
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.48
|
| Rate for Payer: UHC Medicare Advantage |
$195.16
|
| Rate for Payer: UMR Bronson Commercial |
$555.00
|
| Rate for Payer: VA VA |
$189.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,500.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$660.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna American Axle |
$975.00
|
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Commercial |
$1,050.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,050.00
|
| Rate for Payer: Priority Health SBD |
$945.00
|
| Rate for Payer: UMR Bronson Commercial |
$660.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$151.20
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$136.08 |
| Rate for Payer: Aetna American Axle |
$98.28
|
| Rate for Payer: Aetna Commercial |
$128.52
|
| Rate for Payer: Aetna Medicare |
$40.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: BCBS Complete |
$22.55
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$35.31
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$130.03
|
| Rate for Payer: Cofinity Commercial |
$105.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$136.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.40
|
| Rate for Payer: Mclaren Medicaid |
$21.48
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Medicaid |
$22.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.52
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$128.52
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$46.56
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health Narrow Network |
$37.25
|
| Rate for Payer: Priority Health SBD |
$95.26
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.11
|
| Rate for Payer: UHC Core |
$55.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.26
|
| Rate for Payer: UHC Exchange |
$39.26
|
| Rate for Payer: UHC Medicare Advantage |
$40.44
|
| Rate for Payer: UMR Bronson Commercial |
$55.94
|
| Rate for Payer: VA VA |
$39.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.40
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$151.20
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$66.53 |
| Max. Negotiated Rate |
$136.08 |
| Rate for Payer: Aetna American Axle |
$98.28
|
| Rate for Payer: Aetna Commercial |
$128.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.28
|
| Rate for Payer: Cash Price |
$120.96
|
| Rate for Payer: Cofinity Commercial |
$130.03
|
| Rate for Payer: Cofinity Commercial |
$105.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.96
|
| Rate for Payer: Healthscope Commercial |
$136.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.52
|
| Rate for Payer: PHP Commercial |
$128.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.84
|
| Rate for Payer: Priority Health SBD |
$95.26
|
| Rate for Payer: UMR Bronson Commercial |
$66.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.40
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$1,995.52
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$738.34 |
| Max. Negotiated Rate |
$1,795.97 |
| Rate for Payer: Aetna American Axle |
$1,297.09
|
| Rate for Payer: Aetna Commercial |
$1,696.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,297.09
|
| Rate for Payer: BCBS Complete |
$798.21
|
| Rate for Payer: Cash Price |
$1,596.42
|
| Rate for Payer: Cofinity Commercial |
$1,396.86
|
| Rate for Payer: Cofinity Commercial |
$1,716.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.42
|
| Rate for Payer: Healthscope Commercial |
$1,795.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,696.19
|
| Rate for Payer: PHP Commercial |
$1,696.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.86
|
| Rate for Payer: Priority Health SBD |
$1,257.18
|
| Rate for Payer: UMR Bronson Commercial |
$738.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.64
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$1,995.52
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$878.03 |
| Max. Negotiated Rate |
$1,795.97 |
| Rate for Payer: Aetna American Axle |
$1,297.09
|
| Rate for Payer: Aetna Commercial |
$1,696.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,297.09
|
| Rate for Payer: Cash Price |
$1,596.42
|
| Rate for Payer: Cofinity Commercial |
$1,396.86
|
| Rate for Payer: Cofinity Commercial |
$1,716.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.42
|
| Rate for Payer: Healthscope Commercial |
$1,795.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,696.19
|
| Rate for Payer: PHP Commercial |
$1,696.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,396.86
|
| Rate for Payer: Priority Health SBD |
$1,257.18
|
| Rate for Payer: UMR Bronson Commercial |
$878.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.64
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$1,348.03
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.16 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$876.22
|
| Rate for Payer: Aetna American Axle |
$1,381.51
|
| Rate for Payer: Aetna Commercial |
$1,806.59
|
| Rate for Payer: Aetna Commercial |
$1,145.83
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$876.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cash Price |
$1,078.42
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cash Price |
$1,078.42
|
| Rate for Payer: Cofinity Commercial |
$1,487.78
|
| Rate for Payer: Cofinity Commercial |
$1,827.84
|
| Rate for Payer: Cofinity Commercial |
$1,159.31
|
| Rate for Payer: Cofinity Commercial |
$943.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,700.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,912.86
|
| Rate for Payer: Healthscope Commercial |
$1,213.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,487.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$943.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,011.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,594.05
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,806.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,145.83
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,145.83
|
| Rate for Payer: PHP Commercial |
$1,806.59
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$849.26
|
| Rate for Payer: Priority Health SBD |
$1,339.00
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.68
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$65.16
|
| Rate for Payer: UHC Exchange |
$65.16
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$498.77
|
| Rate for Payer: UMR Bronson Commercial |
$786.40
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,594.05
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$1,348.03
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$593.13 |
| Max. Negotiated Rate |
$1,213.23 |
| Rate for Payer: Aetna American Axle |
$876.22
|
| Rate for Payer: Aetna American Axle |
$1,381.51
|
| Rate for Payer: Aetna Commercial |
$1,806.59
|
| Rate for Payer: Aetna Commercial |
$1,145.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,381.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$876.22
|
| Rate for Payer: Cash Price |
$1,078.42
|
| Rate for Payer: Cash Price |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$1,827.84
|
| Rate for Payer: Cofinity Commercial |
$943.62
|
| Rate for Payer: Cofinity Commercial |
$1,487.78
|
| Rate for Payer: Cofinity Commercial |
$1,159.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,078.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,700.32
|
| Rate for Payer: Healthscope Commercial |
$1,213.23
|
| Rate for Payer: Healthscope Commercial |
$1,912.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$943.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,487.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,594.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,011.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,806.59
|
| Rate for Payer: PHP Commercial |
$1,145.83
|
| Rate for Payer: PHP Commercial |
$1,806.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,487.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$943.62
|
| Rate for Payer: Priority Health SBD |
$1,339.00
|
| Rate for Payer: Priority Health SBD |
$849.26
|
| Rate for Payer: UMR Bronson Commercial |
$593.13
|
| Rate for Payer: UMR Bronson Commercial |
$935.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,594.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,011.02
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,024.19
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$890.64 |
| Max. Negotiated Rate |
$1,821.77 |
| Rate for Payer: Aetna American Axle |
$1,315.72
|
| Rate for Payer: Aetna Commercial |
$1,720.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.72
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,416.93
|
| Rate for Payer: Cofinity Commercial |
$1,740.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Healthscope Commercial |
$1,821.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,416.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,518.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,720.56
|
| Rate for Payer: PHP Commercial |
$1,720.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.93
|
| Rate for Payer: Priority Health SBD |
$1,275.24
|
| Rate for Payer: UMR Bronson Commercial |
$890.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,518.14
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,024.19
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$68.11 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,315.72
|
| Rate for Payer: Aetna Commercial |
$1,720.56
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.62
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,740.80
|
| Rate for Payer: Cofinity Commercial |
$1,416.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,821.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,416.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,518.14
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,720.56
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,720.56
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,275.24
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.92
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$68.11
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$748.95
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,518.14
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,024.19
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$890.64 |
| Max. Negotiated Rate |
$1,821.77 |
| Rate for Payer: Aetna American Axle |
$1,315.72
|
| Rate for Payer: Aetna Commercial |
$1,720.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.72
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,416.93
|
| Rate for Payer: Cofinity Commercial |
$1,740.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Healthscope Commercial |
$1,821.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,416.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,518.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,720.56
|
| Rate for Payer: PHP Commercial |
$1,720.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.93
|
| Rate for Payer: Priority Health SBD |
$1,275.24
|
| Rate for Payer: UMR Bronson Commercial |
$890.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,518.14
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,024.19
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.69 |
| Max. Negotiated Rate |
$7,951.14 |
| Rate for Payer: Aetna American Axle |
$1,315.72
|
| Rate for Payer: Aetna Commercial |
$1,720.56
|
| Rate for Payer: Aetna Medicare |
$2,626.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,315.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,157.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,157.18
|
| Rate for Payer: BCBS Complete |
$1,450.79
|
| Rate for Payer: BCBS MAPPO |
$2,525.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,762.53
|
| Rate for Payer: BCN Medicare Advantage |
$2,525.74
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cash Price |
$1,619.35
|
| Rate for Payer: Cofinity Commercial |
$1,416.93
|
| Rate for Payer: Cofinity Commercial |
$1,740.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,619.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,525.74
|
| Rate for Payer: Healthscope Commercial |
$1,821.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,416.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,518.14
|
| Rate for Payer: Mclaren Medicaid |
$1,381.58
|
| Rate for Payer: Mclaren Medicare |
$2,525.74
|
| Rate for Payer: Meridian Medicaid |
$1,450.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,652.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,904.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,720.56
|
| Rate for Payer: PACE Medicare |
$2,399.45
|
| Rate for Payer: PACE SWMI |
$2,525.74
|
| Rate for Payer: PHP Commercial |
$1,720.56
|
| Rate for Payer: PHP Medicare Advantage |
$2,525.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,381.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,416.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7,951.14
|
| Rate for Payer: Priority Health Medicare |
$2,525.74
|
| Rate for Payer: Priority Health Narrow Network |
$6,360.91
|
| Rate for Payer: Priority Health SBD |
$1,275.24
|
| Rate for Payer: Railroad Medicare Medicare |
$2,525.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.96
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,525.74
|
| Rate for Payer: UHC Exchange |
$72.69
|
| Rate for Payer: UHC Medicare Advantage |
$2,601.51
|
| Rate for Payer: UMR Bronson Commercial |
$748.95
|
| Rate for Payer: VA VA |
$2,525.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,518.14
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$164.44
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$72.35 |
| Max. Negotiated Rate |
$148.00 |
| Rate for Payer: Aetna American Axle |
$106.89
|
| Rate for Payer: Aetna Commercial |
$139.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.89
|
| Rate for Payer: Cash Price |
$131.55
|
| Rate for Payer: Cofinity Commercial |
$115.11
|
| Rate for Payer: Cofinity Commercial |
$141.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.55
|
| Rate for Payer: Healthscope Commercial |
$148.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.77
|
| Rate for Payer: PHP Commercial |
$139.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.11
|
| Rate for Payer: Priority Health SBD |
$103.60
|
| Rate for Payer: UMR Bronson Commercial |
$72.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.33
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$164.44
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$45.72 |
| Max. Negotiated Rate |
$2,406.16 |
| Rate for Payer: Aetna American Axle |
$106.89
|
| Rate for Payer: Aetna Commercial |
$139.77
|
| Rate for Payer: Aetna Medicare |
$794.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$955.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$955.41
|
| Rate for Payer: BCBS Complete |
$439.03
|
| Rate for Payer: BCBS MAPPO |
$764.33
|
| Rate for Payer: BCBS Trust/PPO |
$96.92
|
| Rate for Payer: BCN Medicare Advantage |
$764.33
|
| Rate for Payer: Cash Price |
$131.55
|
| Rate for Payer: Cash Price |
$131.55
|
| Rate for Payer: Cofinity Commercial |
$141.42
|
| Rate for Payer: Cofinity Commercial |
$115.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$764.33
|
| Rate for Payer: Healthscope Commercial |
$148.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.33
|
| Rate for Payer: Mclaren Medicaid |
$418.09
|
| Rate for Payer: Mclaren Medicare |
$764.33
|
| Rate for Payer: Meridian Medicaid |
$439.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$802.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$878.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$139.77
|
| Rate for Payer: PACE Medicare |
$726.11
|
| Rate for Payer: PACE SWMI |
$764.33
|
| Rate for Payer: PHP Commercial |
$139.77
|
| Rate for Payer: PHP Medicare Advantage |
$764.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,406.16
|
| Rate for Payer: Priority Health Medicare |
$764.33
|
| Rate for Payer: Priority Health Narrow Network |
$1,924.93
|
| Rate for Payer: Priority Health SBD |
$103.60
|
| Rate for Payer: Railroad Medicare Medicare |
$764.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.79
|
| Rate for Payer: UHC Core |
$45.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$764.33
|
| Rate for Payer: UHC Exchange |
$46.17
|
| Rate for Payer: UHC Medicare Advantage |
$787.26
|
| Rate for Payer: UMR Bronson Commercial |
$60.84
|
| Rate for Payer: VA VA |
$764.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.33
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$145.26
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$63.91 |
| Max. Negotiated Rate |
$130.73 |
| Rate for Payer: Aetna American Axle |
$94.42
|
| Rate for Payer: Aetna Commercial |
$123.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.42
|
| Rate for Payer: Cash Price |
$116.21
|
| Rate for Payer: Cofinity Commercial |
$101.68
|
| Rate for Payer: Cofinity Commercial |
$124.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.21
|
| Rate for Payer: Healthscope Commercial |
$130.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$123.47
|
| Rate for Payer: PHP Commercial |
$123.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.68
|
| Rate for Payer: Priority Health SBD |
$91.51
|
| Rate for Payer: UMR Bronson Commercial |
$63.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.94
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$145.26
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$53.75 |
| Max. Negotiated Rate |
$130.73 |
| Rate for Payer: Aetna American Axle |
$94.42
|
| Rate for Payer: Aetna Commercial |
$123.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.42
|
| Rate for Payer: BCBS Complete |
$58.10
|
| Rate for Payer: Cash Price |
$116.21
|
| Rate for Payer: Cofinity Commercial |
$101.68
|
| Rate for Payer: Cofinity Commercial |
$124.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.21
|
| Rate for Payer: Healthscope Commercial |
$130.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$123.47
|
| Rate for Payer: PHP Commercial |
$123.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.68
|
| Rate for Payer: Priority Health SBD |
$91.51
|
| Rate for Payer: UMR Bronson Commercial |
$53.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.94
|
|
