|
HC CANNULA VEN TRIPLE STAGE
|
Facility
|
OP
|
$72.00
|
|
| Hospital Charge Code |
27000035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.64 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna American Axle |
$46.80
|
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.80
|
| Rate for Payer: BCBS Complete |
$28.80
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health SBD |
$45.36
|
| Rate for Payer: UMR Bronson Commercial |
$26.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC CANNULA VEN TRIPLE STAGE
|
Facility
|
IP
|
$72.00
|
|
| Hospital Charge Code |
27000035
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.68 |
| Max. Negotiated Rate |
$64.80 |
| Rate for Payer: Aetna American Axle |
$46.80
|
| Rate for Payer: Aetna Commercial |
$61.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.80
|
| Rate for Payer: Cash Price |
$57.60
|
| Rate for Payer: Cofinity Commercial |
$50.40
|
| Rate for Payer: Cofinity Commercial |
$61.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.60
|
| Rate for Payer: Healthscope Commercial |
$64.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.20
|
| Rate for Payer: PHP Commercial |
$61.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.40
|
| Rate for Payer: Priority Health SBD |
$45.36
|
| Rate for Payer: UMR Bronson Commercial |
$31.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.00
|
|
|
HC CARB 10,11 EPXID
|
Facility
|
IP
|
$43.88
|
|
|
Service Code
|
CPT 80161
|
| Hospital Charge Code |
30100742
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.31 |
| Max. Negotiated Rate |
$39.49 |
| Rate for Payer: Aetna American Axle |
$28.52
|
| Rate for Payer: Aetna Commercial |
$37.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.52
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cofinity Commercial |
$30.72
|
| Rate for Payer: Cofinity Commercial |
$37.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.10
|
| Rate for Payer: Healthscope Commercial |
$39.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.30
|
| Rate for Payer: PHP Commercial |
$37.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.72
|
| Rate for Payer: Priority Health SBD |
$27.64
|
| Rate for Payer: UMR Bronson Commercial |
$19.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.91
|
|
|
HC CARB 10,11 EPXID
|
Facility
|
OP
|
$43.88
|
|
|
Service Code
|
CPT 80161
|
| Hospital Charge Code |
30100742
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$39.49 |
| Rate for Payer: Aetna American Axle |
$28.52
|
| Rate for Payer: Aetna Commercial |
$37.30
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.71
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$16.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cofinity Commercial |
$30.72
|
| Rate for Payer: Cofinity Commercial |
$37.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$39.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.91
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Medicaid |
$10.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.30
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$37.30
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.64
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health Narrow Network |
$14.91
|
| Rate for Payer: Priority Health SBD |
$27.64
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.37
|
| Rate for Payer: UHC Core |
$22.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$16.24
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.91
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100022
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.75 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna American Axle |
$29.17
|
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.17
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$31.42
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health SBD |
$28.27
|
| Rate for Payer: UMR Bronson Commercial |
$19.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 80156
|
| Hospital Charge Code |
30100022
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.97 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna American Axle |
$29.17
|
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$15.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.21
|
| Rate for Payer: BCBS Complete |
$8.37
|
| Rate for Payer: BCBS MAPPO |
$14.57
|
| Rate for Payer: BCBS Trust/PPO |
$13.11
|
| Rate for Payer: BCN Medicare Advantage |
$14.57
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Commercial |
$31.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.57
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$7.97
|
| Rate for Payer: Mclaren Medicare |
$14.57
|
| Rate for Payer: Meridian Medicaid |
$8.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Medicare |
$13.84
|
| Rate for Payer: PACE SWMI |
$14.57
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$14.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.98
|
| Rate for Payer: Priority Health Medicare |
$14.57
|
| Rate for Payer: Priority Health Narrow Network |
$15.98
|
| Rate for Payer: Priority Health SBD |
$28.27
|
| Rate for Payer: Railroad Medicare Medicare |
$14.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.48
|
| Rate for Payer: UHC Core |
$24.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.57
|
| Rate for Payer: UHC Exchange |
$14.57
|
| Rate for Payer: UHC Medicare Advantage |
$15.01
|
| Rate for Payer: UMR Bronson Commercial |
$16.61
|
| Rate for Payer: VA VA |
$14.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE CMPT
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100060
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna American Axle |
$28.51
|
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.71
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$16.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Medicaid |
$10.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$27.63
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.37
|
| Rate for Payer: UHC Core |
$22.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$16.23
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC CARBAMAZEPINE 10 11 EPOXIDE CMPT
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100060
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.30 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna American Axle |
$28.51
|
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.51
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health SBD |
$27.63
|
| Rate for Payer: UMR Bronson Commercial |
$19.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
OP
|
$21.22
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna American Axle |
$13.79
|
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna Medicare |
$5.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.10
|
| Rate for Payer: BCBS Complete |
$2.80
|
| Rate for Payer: BCBS MAPPO |
$4.88
|
| Rate for Payer: BCN Medicare Advantage |
$4.88
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Cofinity Commercial |
$14.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.88
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$2.67
|
| Rate for Payer: Mclaren Medicare |
$4.88
|
| Rate for Payer: Meridian Medicaid |
$2.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.04
|
| Rate for Payer: PACE Medicare |
$4.64
|
| Rate for Payer: PACE SWMI |
$4.88
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: PHP Medicare Advantage |
$4.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.70
|
| Rate for Payer: Priority Health Medicare |
$4.88
|
| Rate for Payer: Priority Health Narrow Network |
$5.36
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Railroad Medicare Medicare |
$4.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.86
|
| Rate for Payer: UHC Core |
$8.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.88
|
| Rate for Payer: UHC Exchange |
$4.88
|
| Rate for Payer: UHC Medicare Advantage |
$5.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.85
|
| Rate for Payer: VA VA |
$4.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CARBON DIOXIDE (BICARB)
|
Facility
|
IP
|
$21.22
|
|
|
Service Code
|
CPT 82374
|
| Hospital Charge Code |
30100133
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.10 |
| Rate for Payer: Aetna American Axle |
$13.79
|
| Rate for Payer: Aetna Commercial |
$18.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.79
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$14.85
|
| Rate for Payer: Cofinity Commercial |
$18.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.04
|
| Rate for Payer: PHP Commercial |
$18.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.85
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.74 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$12.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.40
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS MAPPO |
$12.32
|
| Rate for Payer: BCBS Trust/PPO |
$11.08
|
| Rate for Payer: BCN Medicare Advantage |
$12.32
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.32
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.74
|
| Rate for Payer: Mclaren Medicare |
$12.32
|
| Rate for Payer: Meridian Medicaid |
$7.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.37
|
| Rate for Payer: PACE Medicare |
$11.70
|
| Rate for Payer: PACE SWMI |
$12.32
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$12.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.90
|
| Rate for Payer: Priority Health Medicare |
$12.32
|
| Rate for Payer: Priority Health Narrow Network |
$13.52
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.78
|
| Rate for Payer: UHC Core |
$20.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.32
|
| Rate for Payer: UHC Exchange |
$12.32
|
| Rate for Payer: UHC Medicare Advantage |
$12.69
|
| Rate for Payer: UMR Bronson Commercial |
$28.46
|
| Rate for Payer: VA VA |
$12.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC CARBOXYHEMOGLOBIN
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82375
|
| Hospital Charge Code |
30100134
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.84 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.37
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.84
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: UMR Bronson Commercial |
$33.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
OP
|
$194.03
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$369.75 |
| Rate for Payer: Aetna American Axle |
$126.12
|
| Rate for Payer: Aetna Commercial |
$164.93
|
| Rate for Payer: Aetna Medicare |
$122.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.81
|
| Rate for Payer: BCBS Complete |
$67.46
|
| Rate for Payer: BCBS MAPPO |
$117.45
|
| Rate for Payer: BCBS Trust/PPO |
$51.95
|
| Rate for Payer: BCN Medicare Advantage |
$117.45
|
| Rate for Payer: Cash Price |
$155.22
|
| Rate for Payer: Cash Price |
$155.22
|
| Rate for Payer: Cash Price |
$155.22
|
| Rate for Payer: Cofinity Commercial |
$166.87
|
| Rate for Payer: Cofinity Commercial |
$135.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.45
|
| Rate for Payer: Healthscope Commercial |
$174.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.52
|
| Rate for Payer: Mclaren Medicaid |
$64.25
|
| Rate for Payer: Mclaren Medicare |
$117.45
|
| Rate for Payer: Meridian Medicaid |
$67.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.93
|
| Rate for Payer: PACE Medicare |
$111.58
|
| Rate for Payer: PACE SWMI |
$117.45
|
| Rate for Payer: PHP Commercial |
$164.93
|
| Rate for Payer: PHP Medicare Advantage |
$117.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.75
|
| Rate for Payer: Priority Health Medicare |
$117.45
|
| Rate for Payer: Priority Health Narrow Network |
$295.80
|
| Rate for Payer: Priority Health SBD |
$122.24
|
| Rate for Payer: Railroad Medicare Medicare |
$117.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.36
|
| Rate for Payer: UHC Core |
$196.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.45
|
| Rate for Payer: UHC Exchange |
$8.51
|
| Rate for Payer: UHC Medicare Advantage |
$120.97
|
| Rate for Payer: UMR Bronson Commercial |
$71.79
|
| Rate for Payer: VA VA |
$117.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.52
|
|
|
HC CARDIAC REH OP PH 2 WO MONITOR
|
Facility
|
IP
|
$194.03
|
|
|
Service Code
|
CPT 93797
|
| Hospital Charge Code |
94300007
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$85.37 |
| Max. Negotiated Rate |
$174.63 |
| Rate for Payer: Aetna American Axle |
$126.12
|
| Rate for Payer: Aetna Commercial |
$164.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.12
|
| Rate for Payer: Cash Price |
$155.22
|
| Rate for Payer: Cofinity Commercial |
$135.82
|
| Rate for Payer: Cofinity Commercial |
$166.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.22
|
| Rate for Payer: Healthscope Commercial |
$174.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.93
|
| Rate for Payer: PHP Commercial |
$164.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.82
|
| Rate for Payer: Priority Health SBD |
$122.24
|
| Rate for Payer: UMR Bronson Commercial |
$85.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.52
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.07 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna American Axle |
$32.61
|
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.61
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$35.12
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health SBD |
$31.61
|
| Rate for Payer: UMR Bronson Commercial |
$22.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGA
|
Facility
|
OP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200146
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna American Axle |
$32.61
|
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$35.12
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.54
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$14.83
|
| Rate for Payer: Priority Health SBD |
$31.61
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC Core |
$41.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$25.45
|
| Rate for Payer: UHC Medicare Advantage |
$26.21
|
| Rate for Payer: UMR Bronson Commercial |
$18.56
|
| Rate for Payer: VA VA |
$25.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
OP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna American Axle |
$32.61
|
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Cofinity Commercial |
$35.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.54
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$14.83
|
| Rate for Payer: Priority Health SBD |
$31.61
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC Core |
$41.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$25.45
|
| Rate for Payer: UHC Medicare Advantage |
$26.21
|
| Rate for Payer: UMR Bronson Commercial |
$18.56
|
| Rate for Payer: VA VA |
$25.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGG
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200144
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.07 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna American Axle |
$32.61
|
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.61
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$35.12
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health SBD |
$31.61
|
| Rate for Payer: UMR Bronson Commercial |
$22.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
OP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna American Axle |
$32.61
|
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna Medicare |
$26.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.81
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$25.45
|
| Rate for Payer: BCBS Trust/PPO |
$22.89
|
| Rate for Payer: BCN Medicare Advantage |
$25.45
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$35.12
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.45
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Mclaren Medicare |
$25.45
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PACE Medicare |
$24.18
|
| Rate for Payer: PACE SWMI |
$25.45
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: PHP Medicare Advantage |
$25.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.54
|
| Rate for Payer: Priority Health Medicare |
$25.45
|
| Rate for Payer: Priority Health Narrow Network |
$14.83
|
| Rate for Payer: Priority Health SBD |
$31.61
|
| Rate for Payer: Railroad Medicare Medicare |
$25.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC Core |
$41.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.45
|
| Rate for Payer: UHC Exchange |
$25.45
|
| Rate for Payer: UHC Medicare Advantage |
$26.21
|
| Rate for Payer: UMR Bronson Commercial |
$18.56
|
| Rate for Payer: VA VA |
$25.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLIPIN AB IGM
|
Facility
|
IP
|
$50.17
|
|
|
Service Code
|
CPT 86147
|
| Hospital Charge Code |
30200145
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.07 |
| Max. Negotiated Rate |
$45.15 |
| Rate for Payer: Aetna American Axle |
$32.61
|
| Rate for Payer: Aetna Commercial |
$42.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.61
|
| Rate for Payer: Cash Price |
$40.14
|
| Rate for Payer: Cofinity Commercial |
$35.12
|
| Rate for Payer: Cofinity Commercial |
$43.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.14
|
| Rate for Payer: Healthscope Commercial |
$45.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.64
|
| Rate for Payer: PHP Commercial |
$42.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.12
|
| Rate for Payer: Priority Health SBD |
$31.61
|
| Rate for Payer: UMR Bronson Commercial |
$22.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.63
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
IP
|
$505.43
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$222.39 |
| Max. Negotiated Rate |
$454.89 |
| Rate for Payer: Aetna American Axle |
$328.53
|
| Rate for Payer: Aetna Commercial |
$429.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.53
|
| Rate for Payer: Cash Price |
$404.34
|
| Rate for Payer: Cofinity Commercial |
$353.80
|
| Rate for Payer: Cofinity Commercial |
$434.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.34
|
| Rate for Payer: Healthscope Commercial |
$454.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$379.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$429.62
|
| Rate for Payer: PHP Commercial |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.80
|
| Rate for Payer: Priority Health SBD |
$318.42
|
| Rate for Payer: UMR Bronson Commercial |
$222.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$379.07
|
|
|
HC CARDIOLITE/MIRALUMA STUDY
|
Facility
|
OP
|
$505.43
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300001
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$153.60 |
| Max. Negotiated Rate |
$454.89 |
| Rate for Payer: Aetna American Axle |
$328.53
|
| Rate for Payer: Aetna Commercial |
$429.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$328.53
|
| Rate for Payer: BCBS Complete |
$202.17
|
| Rate for Payer: BCBS Trust/PPO |
$153.60
|
| Rate for Payer: Cash Price |
$404.34
|
| Rate for Payer: Cash Price |
$404.34
|
| Rate for Payer: Cofinity Commercial |
$353.80
|
| Rate for Payer: Cofinity Commercial |
$434.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$404.34
|
| Rate for Payer: Healthscope Commercial |
$454.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$353.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$379.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$429.62
|
| Rate for Payer: PHP Commercial |
$429.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$353.80
|
| Rate for Payer: Priority Health SBD |
$318.42
|
| Rate for Payer: UMR Bronson Commercial |
$187.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$379.07
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
OP
|
$1,100.68
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$151.93 |
| Max. Negotiated Rate |
$990.61 |
| Rate for Payer: Aetna American Axle |
$715.44
|
| Rate for Payer: Aetna Commercial |
$935.58
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$430.62
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cofinity Commercial |
$946.58
|
| Rate for Payer: Cofinity Commercial |
$770.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$990.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$770.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.51
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.58
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$935.58
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$693.43
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.12
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$151.93
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$407.25
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.51
|
|
|
HC CARDIOPULMONARY EX TEST
|
Facility
|
IP
|
$1,100.68
|
|
|
Service Code
|
CPT 94621
|
| Hospital Charge Code |
46000007
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$484.30 |
| Max. Negotiated Rate |
$990.61 |
| Rate for Payer: Aetna American Axle |
$715.44
|
| Rate for Payer: Aetna Commercial |
$935.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$715.44
|
| Rate for Payer: Cash Price |
$880.54
|
| Rate for Payer: Cofinity Commercial |
$770.48
|
| Rate for Payer: Cofinity Commercial |
$946.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$880.54
|
| Rate for Payer: Healthscope Commercial |
$990.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$770.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$825.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$935.58
|
| Rate for Payer: PHP Commercial |
$935.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$770.48
|
| Rate for Payer: Priority Health SBD |
$693.43
|
| Rate for Payer: UMR Bronson Commercial |
$484.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$825.51
|
|
|
HC CARDIOVERSION
|
Facility
|
OP
|
$1,174.36
|
|
|
Service Code
|
CPT 92960
|
| Hospital Charge Code |
48000002
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$104.13 |
| Max. Negotiated Rate |
$1,821.15 |
| Rate for Payer: Aetna American Axle |
$763.33
|
| Rate for Payer: Aetna Commercial |
$998.21
|
| Rate for Payer: Aetna Medicare |
$601.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$763.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$723.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$723.12
|
| Rate for Payer: BCBS Complete |
$332.29
|
| Rate for Payer: BCBS MAPPO |
$578.50
|
| Rate for Payer: BCBS Trust/PPO |
$597.69
|
| Rate for Payer: BCN Medicare Advantage |
$578.50
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cash Price |
$939.49
|
| Rate for Payer: Cofinity Commercial |
$822.05
|
| Rate for Payer: Cofinity Commercial |
$1,009.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$939.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.50
|
| Rate for Payer: Healthscope Commercial |
$1,056.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$822.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$880.77
|
| Rate for Payer: Mclaren Medicaid |
$316.44
|
| Rate for Payer: Mclaren Medicare |
$578.50
|
| Rate for Payer: Meridian Medicaid |
$332.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$607.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$665.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$998.21
|
| Rate for Payer: PACE Medicare |
$549.58
|
| Rate for Payer: PACE SWMI |
$578.50
|
| Rate for Payer: PHP Commercial |
$998.21
|
| Rate for Payer: PHP Medicare Advantage |
$578.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$822.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,821.15
|
| Rate for Payer: Priority Health Medicare |
$578.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,456.92
|
| Rate for Payer: Priority Health SBD |
$739.85
|
| Rate for Payer: Railroad Medicare Medicare |
$578.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.54
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$578.50
|
| Rate for Payer: UHC Exchange |
$104.13
|
| Rate for Payer: UHC Medicare Advantage |
$595.86
|
| Rate for Payer: UMR Bronson Commercial |
$434.51
|
| Rate for Payer: VA VA |
$578.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$880.77
|
|
