|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$187.00
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$168.30 |
| Rate for Payer: Aetna American Axle |
$121.55
|
| Rate for Payer: Aetna Commercial |
$158.95
|
| Rate for Payer: Aetna Medicare |
$26.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: BCBS Complete |
$14.83
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$23.21
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cash Price |
$149.60
|
| Rate for Payer: Cofinity Commercial |
$130.90
|
| Rate for Payer: Cofinity Commercial |
$160.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$149.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$168.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.25
|
| Rate for Payer: Mclaren Medicaid |
$14.12
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Medicaid |
$14.83
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.95
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$158.95
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.40
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health Narrow Network |
$28.32
|
| Rate for Payer: Priority Health SBD |
$117.81
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.97
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.81
|
| Rate for Payer: UHC Exchange |
$25.81
|
| Rate for Payer: UHC Medicare Advantage |
$26.58
|
| Rate for Payer: UMR Bronson Commercial |
$69.19
|
| Rate for Payer: VA VA |
$25.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.25
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING
|
Facility
|
OP
|
$193.07
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000097
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$66.85 |
| Max. Negotiated Rate |
$200.09 |
| Rate for Payer: Aetna American Axle |
$125.50
|
| Rate for Payer: Aetna Commercial |
$164.11
|
| Rate for Payer: Aetna Medicare |
$127.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.78
|
| Rate for Payer: BCBS Complete |
$70.20
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$109.92
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$154.46
|
| 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: Health Alliance Plan Medicare Advantage |
$122.22
|
| 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: Mclaren Medicaid |
$66.85
|
| Rate for Payer: Mclaren Medicare |
$122.22
|
| Rate for Payer: Meridian Medicaid |
$70.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.11
|
| Rate for Payer: PACE Medicare |
$116.11
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$164.11
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.66
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health Narrow Network |
$134.13
|
| Rate for Payer: Priority Health SBD |
$121.63
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.66
|
| Rate for Payer: UHC Core |
$200.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.22
|
| Rate for Payer: UHC Exchange |
$122.22
|
| Rate for Payer: UHC Medicare Advantage |
$125.89
|
| Rate for Payer: UMR Bronson Commercial |
$71.44
|
| Rate for Payer: VA VA |
$122.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.80
|
|
|
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
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
OP
|
$193.07
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$66.85 |
| Max. Negotiated Rate |
$200.09 |
| Rate for Payer: Aetna American Axle |
$125.50
|
| Rate for Payer: Aetna Commercial |
$164.11
|
| Rate for Payer: Aetna Medicare |
$127.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.78
|
| Rate for Payer: BCBS Complete |
$70.20
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$109.92
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$154.46
|
| 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: Health Alliance Plan Medicare Advantage |
$122.22
|
| 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: Mclaren Medicaid |
$66.85
|
| Rate for Payer: Mclaren Medicare |
$122.22
|
| Rate for Payer: Meridian Medicaid |
$70.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.11
|
| Rate for Payer: PACE Medicare |
$116.11
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$164.11
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$167.66
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health Narrow Network |
$134.13
|
| Rate for Payer: Priority Health SBD |
$121.63
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.66
|
| Rate for Payer: UHC Core |
$200.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.22
|
| Rate for Payer: UHC Exchange |
$122.22
|
| Rate for Payer: UHC Medicare Advantage |
$125.89
|
| Rate for Payer: UMR Bronson Commercial |
$71.44
|
| Rate for Payer: VA VA |
$122.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.80
|
|
|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
IP
|
$193.07
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
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
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
IP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna American Axle |
$18.10
|
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.10
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$19.50
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health SBD |
$17.55
|
| Rate for Payer: UMR Bronson Commercial |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
OP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna American Axle |
$18.10
|
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$19.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Mclaren Medicaid |
$6.31
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$12.66
|
| Rate for Payer: Priority Health SBD |
$17.55
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.84
|
| Rate for Payer: UHC Core |
$19.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$11.53
|
| Rate for Payer: UHC Medicare Advantage |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$10.30
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
IP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.25 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna American Axle |
$18.10
|
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.10
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$19.50
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health SBD |
$17.55
|
| Rate for Payer: UMR Bronson Commercial |
$12.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
OP
|
$27.85
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna American Axle |
$18.10
|
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$19.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Mclaren Medicaid |
$6.31
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$12.66
|
| Rate for Payer: Priority Health SBD |
$17.55
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.84
|
| Rate for Payer: UHC Core |
$19.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$11.53
|
| Rate for Payer: UHC Medicare Advantage |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$10.30
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,187.52
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$92.34 |
| Max. Negotiated Rate |
$2,550.52 |
| Rate for Payer: Aetna American Axle |
$771.89
|
| Rate for Payer: Aetna Commercial |
$1,009.39
|
| Rate for Payer: Aetna Medicare |
$842.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,012.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,012.74
|
| Rate for Payer: BCBS Complete |
$465.37
|
| Rate for Payer: BCBS MAPPO |
$810.19
|
| Rate for Payer: BCBS Trust/PPO |
$1,112.99
|
| Rate for Payer: BCN Medicare Advantage |
$810.19
|
| Rate for Payer: Cash Price |
$950.02
|
| Rate for Payer: Cash Price |
$950.02
|
| Rate for Payer: Cofinity Commercial |
$1,021.27
|
| Rate for Payer: Cofinity Commercial |
$831.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$810.19
|
| Rate for Payer: Healthscope Commercial |
$1,068.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$831.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$890.64
|
| Rate for Payer: Mclaren Medicaid |
$443.17
|
| Rate for Payer: Mclaren Medicare |
$810.19
|
| Rate for Payer: Meridian Medicaid |
$465.37
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$850.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$931.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,009.39
|
| Rate for Payer: PACE Medicare |
$769.68
|
| Rate for Payer: PACE SWMI |
$810.19
|
| Rate for Payer: PHP Commercial |
$1,009.39
|
| Rate for Payer: PHP Medicare Advantage |
$810.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$443.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$831.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,550.52
|
| Rate for Payer: Priority Health Medicare |
$810.19
|
| Rate for Payer: Priority Health Narrow Network |
$2,040.42
|
| Rate for Payer: Priority Health SBD |
$748.14
|
| Rate for Payer: Railroad Medicare Medicare |
$810.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.57
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$810.19
|
| Rate for Payer: UHC Exchange |
$92.34
|
| Rate for Payer: UHC Medicare Advantage |
$834.50
|
| Rate for Payer: UMR Bronson Commercial |
$439.38
|
| Rate for Payer: VA VA |
$810.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$890.64
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
IP
|
$1,187.52
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$522.51 |
| Max. Negotiated Rate |
$1,068.77 |
| Rate for Payer: Aetna American Axle |
$771.89
|
| Rate for Payer: Aetna Commercial |
$1,009.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$771.89
|
| Rate for Payer: Cash Price |
$950.02
|
| Rate for Payer: Cofinity Commercial |
$1,021.27
|
| Rate for Payer: Cofinity Commercial |
$831.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$950.02
|
| Rate for Payer: Healthscope Commercial |
$1,068.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$831.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$890.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,009.39
|
| Rate for Payer: PHP Commercial |
$1,009.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$831.26
|
| Rate for Payer: Priority Health SBD |
$748.14
|
| Rate for Payer: UMR Bronson Commercial |
$522.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$890.64
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
IP
|
$168.00
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$73.92 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna American Axle |
$109.20
|
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.20
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.80
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
| Rate for Payer: Priority Health SBD |
$105.84
|
| Rate for Payer: UMR Bronson Commercial |
$73.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.00
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$168.00
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$151.20 |
| Rate for Payer: Aetna American Axle |
$109.20
|
| Rate for Payer: Aetna Commercial |
$142.80
|
| Rate for Payer: Aetna Medicare |
$12.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.58
|
| Rate for Payer: BCBS Complete |
$7.16
|
| Rate for Payer: BCBS MAPPO |
$12.46
|
| Rate for Payer: BCBS Trust/PPO |
$11.21
|
| Rate for Payer: BCN Medicare Advantage |
$12.46
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cash Price |
$134.40
|
| Rate for Payer: Cofinity Commercial |
$117.60
|
| Rate for Payer: Cofinity Commercial |
$144.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.46
|
| Rate for Payer: Healthscope Commercial |
$151.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.00
|
| Rate for Payer: Mclaren Medicaid |
$6.82
|
| Rate for Payer: Mclaren Medicare |
$12.46
|
| Rate for Payer: Meridian Medicaid |
$7.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.80
|
| Rate for Payer: PACE Medicare |
$11.84
|
| Rate for Payer: PACE SWMI |
$12.46
|
| Rate for Payer: PHP Commercial |
$142.80
|
| Rate for Payer: PHP Medicare Advantage |
$12.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.09
|
| Rate for Payer: Priority Health Medicare |
$12.46
|
| Rate for Payer: Priority Health Narrow Network |
$13.67
|
| Rate for Payer: Priority Health SBD |
$105.84
|
| Rate for Payer: Railroad Medicare Medicare |
$12.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.95
|
| Rate for Payer: UHC Core |
$20.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.46
|
| Rate for Payer: UHC Exchange |
$12.46
|
| Rate for Payer: UHC Medicare Advantage |
$12.83
|
| Rate for Payer: UMR Bronson Commercial |
$62.16
|
| Rate for Payer: VA VA |
$12.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.00
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
IP
|
$90.40
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.78 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna American Axle |
$58.76
|
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.76
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health SBD |
$56.95
|
| Rate for Payer: UMR Bronson Commercial |
$39.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
OP
|
$90.40
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.06 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna American Axle |
$58.76
|
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: Aetna Medicare |
$5.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.00
|
| Rate for Payer: BCBS Complete |
$3.22
|
| Rate for Payer: BCBS MAPPO |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.60
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Cofinity Commercial |
$63.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.60
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Mclaren Medicaid |
$3.06
|
| Rate for Payer: Mclaren Medicare |
$5.60
|
| Rate for Payer: Meridian Medicaid |
$3.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PACE Medicare |
$5.32
|
| Rate for Payer: PACE SWMI |
$5.60
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: PHP Medicare Advantage |
$5.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.55
|
| Rate for Payer: Priority Health Medicare |
$5.60
|
| Rate for Payer: Priority Health Narrow Network |
$6.04
|
| Rate for Payer: Priority Health SBD |
$56.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.72
|
| Rate for Payer: UHC Core |
$9.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.60
|
| Rate for Payer: UHC Exchange |
$5.60
|
| Rate for Payer: UHC Medicare Advantage |
$5.77
|
| Rate for Payer: UMR Bronson Commercial |
$33.45
|
| Rate for Payer: VA VA |
$5.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
OP
|
$257.80
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$74.32 |
| Max. Negotiated Rate |
$232.02 |
| Rate for Payer: Aetna American Axle |
$167.57
|
| Rate for Payer: Aetna Commercial |
$219.13
|
| Rate for Payer: Aetna Medicare |
$141.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.82
|
| Rate for Payer: BCBS Complete |
$78.04
|
| Rate for Payer: BCBS MAPPO |
$135.86
|
| Rate for Payer: BCN Medicare Advantage |
$135.86
|
| Rate for Payer: Cash Price |
$206.24
|
| Rate for Payer: Cash Price |
$206.24
|
| Rate for Payer: Cofinity Commercial |
$221.71
|
| Rate for Payer: Cofinity Commercial |
$180.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$232.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.35
|
| Rate for Payer: Mclaren Medicaid |
$74.32
|
| Rate for Payer: Mclaren Medicare |
$135.86
|
| Rate for Payer: Meridian Medicaid |
$78.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$142.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.13
|
| Rate for Payer: PACE Medicare |
$129.07
|
| Rate for Payer: PACE SWMI |
$135.86
|
| Rate for Payer: PHP Commercial |
$219.13
|
| Rate for Payer: PHP Medicare Advantage |
$135.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$186.37
|
| Rate for Payer: Priority Health Medicare |
$135.86
|
| Rate for Payer: Priority Health Narrow Network |
$149.10
|
| Rate for Payer: Priority Health SBD |
$162.41
|
| Rate for Payer: Railroad Medicare Medicare |
$135.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$163.03
|
| Rate for Payer: UHC Core |
$224.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.86
|
| Rate for Payer: UHC Exchange |
$135.86
|
| Rate for Payer: UHC Medicare Advantage |
$139.94
|
| Rate for Payer: UMR Bronson Commercial |
$95.39
|
| Rate for Payer: VA VA |
$135.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.35
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
IP
|
$257.80
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$113.43 |
| Max. Negotiated Rate |
$232.02 |
| Rate for Payer: Aetna American Axle |
$167.57
|
| Rate for Payer: Aetna Commercial |
$219.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.57
|
| Rate for Payer: Cash Price |
$206.24
|
| Rate for Payer: Cofinity Commercial |
$180.46
|
| Rate for Payer: Cofinity Commercial |
$221.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.24
|
| Rate for Payer: Healthscope Commercial |
$232.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.13
|
| Rate for Payer: PHP Commercial |
$219.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.46
|
| Rate for Payer: Priority Health SBD |
$162.41
|
| Rate for Payer: UMR Bronson Commercial |
$113.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.35
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna American Axle |
$96.32
|
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.32
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$103.73
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.96
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.73
|
| Rate for Payer: Priority Health SBD |
$93.36
|
| Rate for Payer: UMR Bronson Commercial |
$65.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna American Axle |
$96.32
|
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.32
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: BCBS Trust/PPO |
$56.49
|
| Rate for Payer: BCCCP Commercial |
$22.00
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$103.73
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.96
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.73
|
| Rate for Payer: Priority Health SBD |
$93.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.36
|
| Rate for Payer: UHC Exchange |
$8.51
|
| Rate for Payer: UMR Bronson Commercial |
$54.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTROMERE AB
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna American Axle |
$22.41
|
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health SBD |
$21.72
|
| Rate for Payer: UMR Bronson Commercial |
$15.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC CENTROMERE AB
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna American Axle |
$22.41
|
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$16.13
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$9.81
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$21.72
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Core |
$29.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$18.47
|
| Rate for Payer: UMR Bronson Commercial |
$12.76
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$107.80 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna American Axle |
$159.25
|
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.25
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$171.50
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health SBD |
$154.35
|
| Rate for Payer: UMR Bronson Commercial |
$107.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.02 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna American Axle |
$159.25
|
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna Medicare |
$148.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: BCBS Complete |
$81.93
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCBS Trust/PPO |
$128.27
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Cofinity Commercial |
$171.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Mclaren Medicaid |
$78.02
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Medicaid |
$81.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$142.63
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health Narrow Network |
$114.10
|
| Rate for Payer: Priority Health SBD |
$154.35
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.16
|
| Rate for Payer: UHC Core |
$171.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.63
|
| Rate for Payer: UHC Exchange |
$142.63
|
| Rate for Payer: UHC Medicare Advantage |
$146.91
|
| Rate for Payer: UMR Bronson Commercial |
$90.65
|
| Rate for Payer: VA VA |
$142.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
OP
|
$4,054.86
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,500.30 |
| Max. Negotiated Rate |
$3,649.37 |
| Rate for Payer: Aetna American Axle |
$2,635.66
|
| Rate for Payer: Aetna Commercial |
$3,446.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,635.66
|
| Rate for Payer: BCBS Complete |
$1,621.94
|
| Rate for Payer: Cash Price |
$3,243.89
|
| Rate for Payer: Cofinity Commercial |
$2,838.40
|
| Rate for Payer: Cofinity Commercial |
$3,487.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,243.89
|
| Rate for Payer: Healthscope Commercial |
$3,649.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,838.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,041.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,446.63
|
| Rate for Payer: PHP Commercial |
$3,446.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,838.40
|
| Rate for Payer: Priority Health SBD |
$2,554.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,500.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,041.14
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
IP
|
$4,054.86
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,784.14 |
| Max. Negotiated Rate |
$3,649.37 |
| Rate for Payer: Aetna American Axle |
$2,635.66
|
| Rate for Payer: Aetna Commercial |
$3,446.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,635.66
|
| Rate for Payer: Cash Price |
$3,243.89
|
| Rate for Payer: Cofinity Commercial |
$2,838.40
|
| Rate for Payer: Cofinity Commercial |
$3,487.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,243.89
|
| Rate for Payer: Healthscope Commercial |
$3,649.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,838.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,041.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,446.63
|
| Rate for Payer: PHP Commercial |
$3,446.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,838.40
|
| Rate for Payer: Priority Health SBD |
$2,554.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,784.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,041.14
|
|
