|
HC CATHETER, TRANSLUMIN NON-LASER
|
Facility
|
OP
|
$2,400.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200024
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$2,160.00 |
| Rate for Payer: Aetna American Axle |
$1,560.00
|
| Rate for Payer: Aetna Commercial |
$2,040.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,560.00
|
| Rate for Payer: BCBS Complete |
$960.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$1,680.00
|
| Rate for Payer: Cofinity Commercial |
$2,064.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.00
|
| Rate for Payer: Healthscope Commercial |
$2,160.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,680.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,800.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,040.00
|
| Rate for Payer: PHP Commercial |
$2,040.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,680.00
|
| Rate for Payer: Priority Health SBD |
$1,512.00
|
| Rate for Payer: UMR Bronson Commercial |
$888.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,800.00
|
|
|
HC CATHETER, TRANSLUMIN NON-LASER
|
Facility
|
IP
|
$2,400.00
|
|
|
Service Code
|
HCPCS C1725
|
| Hospital Charge Code |
27200024
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,056.00 |
| Max. Negotiated Rate |
$2,160.00 |
| Rate for Payer: Aetna American Axle |
$1,560.00
|
| Rate for Payer: Aetna Commercial |
$2,040.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,560.00
|
| Rate for Payer: Cash Price |
$1,920.00
|
| Rate for Payer: Cofinity Commercial |
$1,680.00
|
| Rate for Payer: Cofinity Commercial |
$2,064.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,920.00
|
| Rate for Payer: Healthscope Commercial |
$2,160.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,680.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,800.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,040.00
|
| Rate for Payer: PHP Commercial |
$2,040.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,680.00
|
| Rate for Payer: Priority Health SBD |
$1,512.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,056.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,800.00
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
IP
|
$9,520.00
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,188.80 |
| Max. Negotiated Rate |
$8,568.00 |
| Rate for Payer: Aetna American Axle |
$6,188.00
|
| Rate for Payer: Aetna Commercial |
$8,092.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,188.00
|
| Rate for Payer: Cash Price |
$7,616.00
|
| Rate for Payer: Cofinity Commercial |
$6,664.00
|
| Rate for Payer: Cofinity Commercial |
$8,187.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,616.00
|
| Rate for Payer: Healthscope Commercial |
$8,568.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,664.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,140.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,092.00
|
| Rate for Payer: PHP Commercial |
$8,092.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,664.00
|
| Rate for Payer: Priority Health SBD |
$5,997.60
|
| Rate for Payer: UMR Bronson Commercial |
$4,188.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,140.00
|
|
|
HC CATHETER TRANSLUM INTRAVAS LITHOTRIPSY CORONARY
|
Facility
|
OP
|
$9,520.00
|
|
|
Service Code
|
CPT C1761
|
| Hospital Charge Code |
27200350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,351.04 |
| Max. Negotiated Rate |
$8,568.00 |
| Rate for Payer: Aetna American Axle |
$6,188.00
|
| Rate for Payer: Aetna Commercial |
$8,092.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,188.00
|
| Rate for Payer: BCBS Complete |
$3,808.00
|
| Rate for Payer: Cash Price |
$7,616.00
|
| Rate for Payer: Cofinity Commercial |
$6,664.00
|
| Rate for Payer: Cofinity Commercial |
$8,187.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,616.00
|
| Rate for Payer: Healthscope Commercial |
$8,568.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,664.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,140.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,092.00
|
| Rate for Payer: PHP Commercial |
$8,092.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,664.00
|
| Rate for Payer: Priority Health SBD |
$5,997.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,351.04
|
| Rate for Payer: UHC Exchange |
$3,903.20
|
| Rate for Payer: UMR Bronson Commercial |
$3,522.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,140.00
|
|
|
HC CATH LAB STANDBY
|
Facility
|
OP
|
$489.91
|
|
| Hospital Charge Code |
27000042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$181.27 |
| Max. Negotiated Rate |
$440.92 |
| Rate for Payer: Aetna American Axle |
$318.44
|
| Rate for Payer: Aetna Commercial |
$416.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.44
|
| Rate for Payer: BCBS Complete |
$195.96
|
| Rate for Payer: Cash Price |
$391.93
|
| Rate for Payer: Cofinity Commercial |
$342.94
|
| Rate for Payer: Cofinity Commercial |
$421.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.93
|
| Rate for Payer: Healthscope Commercial |
$440.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$342.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.42
|
| Rate for Payer: PHP Commercial |
$416.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.94
|
| Rate for Payer: Priority Health SBD |
$308.64
|
| Rate for Payer: UMR Bronson Commercial |
$181.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.43
|
|
|
HC CATH LAB STANDBY
|
Facility
|
IP
|
$489.91
|
|
| Hospital Charge Code |
27000042
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$215.56 |
| Max. Negotiated Rate |
$440.92 |
| Rate for Payer: Aetna American Axle |
$318.44
|
| Rate for Payer: Aetna Commercial |
$416.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.44
|
| Rate for Payer: Cash Price |
$391.93
|
| Rate for Payer: Cofinity Commercial |
$342.94
|
| Rate for Payer: Cofinity Commercial |
$421.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$391.93
|
| Rate for Payer: Healthscope Commercial |
$440.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$342.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.42
|
| Rate for Payer: PHP Commercial |
$416.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$342.94
|
| Rate for Payer: Priority Health SBD |
$308.64
|
| Rate for Payer: UMR Bronson Commercial |
$215.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.43
|
|
|
HC CATH PULM ART VENT 14FR
|
Facility
|
OP
|
$150.00
|
|
| Hospital Charge Code |
27000284
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$97.50
|
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.50
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$105.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health SBD |
$94.50
|
| Rate for Payer: UMR Bronson Commercial |
$55.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC CATH PULM ART VENT 14FR
|
Facility
|
IP
|
$150.00
|
|
| Hospital Charge Code |
27000284
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$97.50
|
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$105.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health SBD |
$94.50
|
| Rate for Payer: UMR Bronson Commercial |
$66.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC CATHTER NOS LVL 7
|
Facility
|
IP
|
$720.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$316.80 |
| Max. Negotiated Rate |
$648.00 |
| Rate for Payer: Aetna American Axle |
$468.00
|
| Rate for Payer: Aetna Commercial |
$612.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cofinity Commercial |
$504.00
|
| Rate for Payer: Cofinity Commercial |
$619.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.00
|
| Rate for Payer: Healthscope Commercial |
$648.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.00
|
| Rate for Payer: PHP Commercial |
$612.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.00
|
| Rate for Payer: Priority Health SBD |
$453.60
|
| Rate for Payer: UMR Bronson Commercial |
$316.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.00
|
|
|
HC CATHTER NOS LVL 7
|
Facility
|
OP
|
$720.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800352
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$648.00 |
| Rate for Payer: Aetna American Axle |
$468.00
|
| Rate for Payer: Aetna Commercial |
$612.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.00
|
| Rate for Payer: BCBS Complete |
$288.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cash Price |
$576.00
|
| Rate for Payer: Cofinity Commercial |
$619.20
|
| Rate for Payer: Cofinity Commercial |
$504.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.00
|
| Rate for Payer: Healthscope Commercial |
$648.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$612.00
|
| Rate for Payer: PHP Commercial |
$612.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.00
|
| Rate for Payer: Priority Health SBD |
$453.60
|
| Rate for Payer: UMR Bronson Commercial |
$266.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.00
|
|
|
HC CAT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200031
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CAT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200031
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
OP
|
$29.85
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$26.86 |
| Rate for Payer: Aetna American Axle |
$19.40
|
| Rate for Payer: Aetna Commercial |
$25.37
|
| Rate for Payer: Aetna Medicare |
$8.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.71
|
| Rate for Payer: BCBS Complete |
$4.46
|
| Rate for Payer: BCBS MAPPO |
$7.77
|
| Rate for Payer: BCBS Trust/PPO |
$6.99
|
| Rate for Payer: BCN Medicare Advantage |
$7.77
|
| Rate for Payer: Cash Price |
$23.88
|
| Rate for Payer: Cash Price |
$23.88
|
| Rate for Payer: Cofinity Commercial |
$20.90
|
| Rate for Payer: Cofinity Commercial |
$25.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.77
|
| Rate for Payer: Healthscope Commercial |
$26.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.39
|
| Rate for Payer: Mclaren Medicaid |
$4.25
|
| Rate for Payer: Mclaren Medicare |
$7.77
|
| Rate for Payer: Meridian Medicaid |
$4.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.37
|
| Rate for Payer: PACE Medicare |
$7.38
|
| Rate for Payer: PACE SWMI |
$7.77
|
| Rate for Payer: PHP Commercial |
$25.37
|
| Rate for Payer: PHP Medicare Advantage |
$7.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.65
|
| Rate for Payer: Priority Health Medicare |
$7.77
|
| Rate for Payer: Priority Health Narrow Network |
$8.52
|
| Rate for Payer: Priority Health SBD |
$18.81
|
| Rate for Payer: Railroad Medicare Medicare |
$7.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.32
|
| Rate for Payer: UHC Core |
$12.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.77
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicare Advantage |
$8.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
| Rate for Payer: VA VA |
$7.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.39
|
|
|
HC CBC INCLUDES DIFF & PLATELETS
|
Facility
|
IP
|
$29.85
|
|
|
Service Code
|
CPT 85025
|
| Hospital Charge Code |
30500007
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.13 |
| Max. Negotiated Rate |
$26.86 |
| Rate for Payer: Aetna American Axle |
$19.40
|
| Rate for Payer: Aetna Commercial |
$25.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.40
|
| Rate for Payer: Cash Price |
$23.88
|
| Rate for Payer: Cofinity Commercial |
$20.90
|
| Rate for Payer: Cofinity Commercial |
$25.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$26.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.37
|
| Rate for Payer: PHP Commercial |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.90
|
| Rate for Payer: Priority Health SBD |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$13.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.39
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
OP
|
$18.36
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna American Axle |
$11.93
|
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$5.82
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$12.85
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.37
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$5.10
|
| Rate for Payer: Priority Health SBD |
$11.57
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.76
|
| Rate for Payer: UHC Core |
$10.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicare Advantage |
$6.66
|
| Rate for Payer: UMR Bronson Commercial |
$6.79
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC CBC NO DIFF INCLUDES PLATELETS
|
Facility
|
IP
|
$18.36
|
|
|
Service Code
|
CPT 85027
|
| Hospital Charge Code |
30500008
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$16.52 |
| Rate for Payer: Aetna American Axle |
$11.93
|
| Rate for Payer: Aetna Commercial |
$15.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11.93
|
| Rate for Payer: Cash Price |
$14.69
|
| Rate for Payer: Cofinity Commercial |
$12.85
|
| Rate for Payer: Cofinity Commercial |
$15.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.69
|
| Rate for Payer: Healthscope Commercial |
$16.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.61
|
| Rate for Payer: PHP Commercial |
$15.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health SBD |
$11.57
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.77
|
|
|
HC C DIFFICILE PCR
|
Facility
|
IP
|
$137.90
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$60.68 |
| Max. Negotiated Rate |
$124.11 |
| Rate for Payer: Aetna American Axle |
$89.64
|
| Rate for Payer: Aetna Commercial |
$117.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.64
|
| Rate for Payer: Cash Price |
$110.32
|
| Rate for Payer: Cofinity Commercial |
$118.59
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.32
|
| Rate for Payer: Healthscope Commercial |
$124.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.22
|
| Rate for Payer: PHP Commercial |
$117.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.53
|
| Rate for Payer: Priority Health SBD |
$86.88
|
| Rate for Payer: UMR Bronson Commercial |
$60.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.42
|
|
|
HC C DIFFICILE PCR
|
Facility
|
OP
|
$137.90
|
|
|
Service Code
|
CPT 87493
|
| Hospital Charge Code |
30600183
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.39 |
| Max. Negotiated Rate |
$124.11 |
| Rate for Payer: Aetna American Axle |
$89.64
|
| Rate for Payer: Aetna Commercial |
$117.22
|
| Rate for Payer: Aetna Medicare |
$38.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.59
|
| Rate for Payer: BCBS Complete |
$21.41
|
| Rate for Payer: BCBS MAPPO |
$37.27
|
| Rate for Payer: BCBS Trust/PPO |
$33.51
|
| Rate for Payer: BCN Medicare Advantage |
$37.27
|
| Rate for Payer: Cash Price |
$110.32
|
| Rate for Payer: Cash Price |
$110.32
|
| Rate for Payer: Cofinity Commercial |
$96.53
|
| Rate for Payer: Cofinity Commercial |
$118.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.27
|
| Rate for Payer: Healthscope Commercial |
$124.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.42
|
| Rate for Payer: Mclaren Medicaid |
$20.39
|
| Rate for Payer: Mclaren Medicare |
$37.27
|
| Rate for Payer: Meridian Medicaid |
$21.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.22
|
| Rate for Payer: PACE Medicare |
$35.41
|
| Rate for Payer: PACE SWMI |
$37.27
|
| Rate for Payer: PHP Commercial |
$117.22
|
| Rate for Payer: PHP Medicare Advantage |
$37.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$37.27
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Priority Health SBD |
$86.88
|
| Rate for Payer: Railroad Medicare Medicare |
$37.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.72
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.27
|
| Rate for Payer: UHC Exchange |
$37.27
|
| Rate for Payer: UHC Medicare Advantage |
$38.39
|
| Rate for Payer: UMR Bronson Commercial |
$51.02
|
| Rate for Payer: VA VA |
$37.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.42
|
|
|
HC C DIFF TOXIN
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: UMR Bronson Commercial |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC C DIFF TOXIN
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 87324
|
| Hospital Charge Code |
30600327
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: UMR Bronson Commercial |
$15.10
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
IP
|
$128.20
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$56.41 |
| Max. Negotiated Rate |
$115.38 |
| Rate for Payer: Aetna American Axle |
$83.33
|
| Rate for Payer: Aetna Commercial |
$108.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.33
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cofinity Commercial |
$89.74
|
| Rate for Payer: Cofinity Commercial |
$110.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.56
|
| Rate for Payer: Healthscope Commercial |
$115.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.97
|
| Rate for Payer: PHP Commercial |
$108.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.74
|
| Rate for Payer: Priority Health SBD |
$80.77
|
| Rate for Payer: UMR Bronson Commercial |
$56.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.15
|
|
|
HC CEA (CARCINOEMBRYONIC ANTIGEN)
|
Facility
|
OP
|
$128.20
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100135
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$115.38 |
| Rate for Payer: Aetna American Axle |
$83.33
|
| Rate for Payer: Aetna Commercial |
$108.97
|
| Rate for Payer: Aetna Medicare |
$19.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.70
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$17.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cash Price |
$102.56
|
| Rate for Payer: Cofinity Commercial |
$89.74
|
| Rate for Payer: Cofinity Commercial |
$110.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$115.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.15
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$18.96
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.97
|
| Rate for Payer: PACE Medicare |
$18.01
|
| Rate for Payer: PACE SWMI |
$18.96
|
| Rate for Payer: PHP Commercial |
$108.97
|
| Rate for Payer: PHP Medicare Advantage |
$18.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.01
|
| Rate for Payer: Priority Health Medicare |
$18.96
|
| Rate for Payer: Priority Health Narrow Network |
$20.81
|
| Rate for Payer: Priority Health SBD |
$80.77
|
| Rate for Payer: Railroad Medicare Medicare |
$18.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.75
|
| Rate for Payer: UHC Core |
$31.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.96
|
| Rate for Payer: UHC Exchange |
$18.96
|
| Rate for Payer: UHC Medicare Advantage |
$19.53
|
| Rate for Payer: UMR Bronson Commercial |
$47.43
|
| Rate for Payer: VA VA |
$18.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.15
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
IP
|
$180.75
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.53 |
| Max. Negotiated Rate |
$162.68 |
| Rate for Payer: Aetna American Axle |
$117.49
|
| Rate for Payer: Aetna Commercial |
$153.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.49
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cofinity Commercial |
$155.44
|
| Rate for Payer: Cofinity Commercial |
$126.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.60
|
| Rate for Payer: Healthscope Commercial |
$162.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.64
|
| Rate for Payer: PHP Commercial |
$153.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.52
|
| Rate for Payer: Priority Health SBD |
$113.87
|
| Rate for Payer: UMR Bronson Commercial |
$79.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.56
|
|
|
HC CEA PANCREATIC CYST
|
Facility
|
OP
|
$180.75
|
|
|
Service Code
|
CPT 82378
|
| Hospital Charge Code |
30100712
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$162.68 |
| Rate for Payer: Aetna American Axle |
$117.49
|
| Rate for Payer: Aetna Commercial |
$153.64
|
| Rate for Payer: Aetna Medicare |
$19.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.70
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$18.96
|
| Rate for Payer: BCBS Trust/PPO |
$17.05
|
| Rate for Payer: BCN Medicare Advantage |
$18.96
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cash Price |
$144.60
|
| Rate for Payer: Cofinity Commercial |
$126.52
|
| Rate for Payer: Cofinity Commercial |
$155.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.96
|
| Rate for Payer: Healthscope Commercial |
$162.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.56
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$18.96
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.64
|
| Rate for Payer: PACE Medicare |
$18.01
|
| Rate for Payer: PACE SWMI |
$18.96
|
| Rate for Payer: PHP Commercial |
$153.64
|
| Rate for Payer: PHP Medicare Advantage |
$18.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.01
|
| Rate for Payer: Priority Health Medicare |
$18.96
|
| Rate for Payer: Priority Health Narrow Network |
$20.81
|
| Rate for Payer: Priority Health SBD |
$113.87
|
| Rate for Payer: Railroad Medicare Medicare |
$18.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.75
|
| Rate for Payer: UHC Core |
$31.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.96
|
| Rate for Payer: UHC Exchange |
$18.96
|
| Rate for Payer: UHC Medicare Advantage |
$19.53
|
| Rate for Payer: UMR Bronson Commercial |
$66.88
|
| Rate for Payer: VA VA |
$18.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.56
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
IP
|
$193.07
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$84.95 |
| Max. Negotiated Rate |
$173.76 |
| Rate for Payer: Aetna American Axle |
$125.50
|
| Rate for Payer: Aetna Commercial |
$164.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.50
|
| Rate for Payer: Cash Price |
$154.46
|
| Rate for Payer: Cofinity Commercial |
$135.15
|
| Rate for Payer: Cofinity Commercial |
$166.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.46
|
| Rate for Payer: Healthscope Commercial |
$173.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.11
|
| Rate for Payer: PHP Commercial |
$164.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.15
|
| Rate for Payer: Priority Health SBD |
$121.63
|
| Rate for Payer: UMR Bronson Commercial |
$84.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.80
|
|
