|
HC CHROMOSOME ANALYSIS CHORIONIC VILLUS
|
Facility
|
OP
|
$368.22
|
|
|
Service Code
|
CPT 88267
|
| Hospital Charge Code |
31000021
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$103.15 |
| Max. Negotiated Rate |
$331.40 |
| Rate for Payer: Aetna American Axle |
$239.34
|
| Rate for Payer: Aetna Commercial |
$312.99
|
| Rate for Payer: Aetna Medicare |
$196.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$239.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$235.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$235.71
|
| Rate for Payer: BCBS Complete |
$108.31
|
| Rate for Payer: BCBS MAPPO |
$188.57
|
| Rate for Payer: BCBS Trust/PPO |
$169.59
|
| Rate for Payer: BCN Medicare Advantage |
$188.57
|
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Cash Price |
$294.58
|
| Rate for Payer: Cofinity Commercial |
$316.67
|
| Rate for Payer: Cofinity Commercial |
$257.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$294.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$188.57
|
| Rate for Payer: Healthscope Commercial |
$331.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$257.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$276.16
|
| Rate for Payer: Mclaren Medicaid |
$103.15
|
| Rate for Payer: Mclaren Medicare |
$188.57
|
| Rate for Payer: Meridian Medicaid |
$108.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$198.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$216.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$312.99
|
| Rate for Payer: PACE Medicare |
$179.14
|
| Rate for Payer: PACE SWMI |
$188.57
|
| Rate for Payer: PHP Commercial |
$312.99
|
| Rate for Payer: PHP Medicare Advantage |
$188.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$257.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.29
|
| Rate for Payer: Priority Health Medicare |
$188.57
|
| Rate for Payer: Priority Health Narrow Network |
$165.83
|
| Rate for Payer: Priority Health SBD |
$231.98
|
| Rate for Payer: Railroad Medicare Medicare |
$188.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.28
|
| Rate for Payer: UHC Core |
$296.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$188.57
|
| Rate for Payer: UHC Exchange |
$188.57
|
| Rate for Payer: UHC Medicare Advantage |
$194.23
|
| Rate for Payer: UMR Bronson Commercial |
$136.24
|
| Rate for Payer: VA VA |
$188.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$276.16
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
OP
|
$217.26
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.72 |
| Max. Negotiated Rate |
$195.53 |
| Rate for Payer: Aetna American Axle |
$141.22
|
| Rate for Payer: Aetna Commercial |
$184.67
|
| Rate for Payer: Aetna Medicare |
$121.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$145.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$145.61
|
| Rate for Payer: BCBS Complete |
$66.91
|
| Rate for Payer: BCBS MAPPO |
$116.49
|
| Rate for Payer: BCBS Trust/PPO |
$104.77
|
| Rate for Payer: BCN Medicare Advantage |
$116.49
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cofinity Commercial |
$152.08
|
| Rate for Payer: Cofinity Commercial |
$186.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$116.49
|
| Rate for Payer: Healthscope Commercial |
$195.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.94
|
| Rate for Payer: Mclaren Medicaid |
$63.72
|
| Rate for Payer: Mclaren Medicare |
$116.49
|
| Rate for Payer: Meridian Medicaid |
$66.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$122.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$133.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.67
|
| Rate for Payer: PACE Medicare |
$110.67
|
| Rate for Payer: PACE SWMI |
$116.49
|
| Rate for Payer: PHP Commercial |
$184.67
|
| Rate for Payer: PHP Medicare Advantage |
$116.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.23
|
| Rate for Payer: Priority Health Medicare |
$116.49
|
| Rate for Payer: Priority Health Narrow Network |
$120.98
|
| Rate for Payer: Priority Health SBD |
$136.87
|
| Rate for Payer: Railroad Medicare Medicare |
$116.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.79
|
| Rate for Payer: UHC Core |
$192.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$116.49
|
| Rate for Payer: UHC Exchange |
$116.49
|
| Rate for Payer: UHC Medicare Advantage |
$119.98
|
| Rate for Payer: UMR Bronson Commercial |
$80.39
|
| Rate for Payer: VA VA |
$116.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.94
|
|
|
HC CHROMOSOME ANALYSIS CONGENITAL
|
Facility
|
IP
|
$217.26
|
|
|
Service Code
|
CPT 88230
|
| Hospital Charge Code |
31000013
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$95.59 |
| Max. Negotiated Rate |
$195.53 |
| Rate for Payer: Aetna American Axle |
$141.22
|
| Rate for Payer: Aetna Commercial |
$184.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.22
|
| Rate for Payer: Cash Price |
$173.81
|
| Rate for Payer: Cofinity Commercial |
$152.08
|
| Rate for Payer: Cofinity Commercial |
$186.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.81
|
| Rate for Payer: Healthscope Commercial |
$195.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.67
|
| Rate for Payer: PHP Commercial |
$184.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.08
|
| Rate for Payer: Priority Health SBD |
$136.87
|
| Rate for Payer: UMR Bronson Commercial |
$95.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.94
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
IP
|
$224.88
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$98.95 |
| Max. Negotiated Rate |
$202.39 |
| Rate for Payer: Aetna American Axle |
$146.17
|
| Rate for Payer: Aetna Commercial |
$191.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.17
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cofinity Commercial |
$157.42
|
| Rate for Payer: Cofinity Commercial |
$193.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.90
|
| Rate for Payer: Healthscope Commercial |
$202.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.15
|
| Rate for Payer: PHP Commercial |
$191.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.42
|
| Rate for Payer: Priority Health SBD |
$141.67
|
| Rate for Payer: UMR Bronson Commercial |
$98.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.66
|
|
|
HC CHROMOSOME ANALYSIS HEMATOLOGIAL
|
Facility
|
OP
|
$224.88
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000017
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.63 |
| Max. Negotiated Rate |
$208.34 |
| Rate for Payer: Aetna American Axle |
$146.17
|
| Rate for Payer: Aetna Commercial |
$191.15
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.69
|
| Rate for Payer: BCBS Complete |
$82.57
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$129.27
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cash Price |
$179.90
|
| Rate for Payer: Cofinity Commercial |
$157.42
|
| Rate for Payer: Cofinity Commercial |
$193.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$202.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.66
|
| Rate for Payer: Mclaren Medicaid |
$78.63
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Medicaid |
$82.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.15
|
| Rate for Payer: PACE Medicare |
$136.56
|
| Rate for Payer: PACE SWMI |
$143.75
|
| Rate for Payer: PHP Commercial |
$191.15
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.23
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health Narrow Network |
$120.98
|
| Rate for Payer: Priority Health SBD |
$141.67
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.50
|
| Rate for Payer: UHC Core |
$208.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.75
|
| Rate for Payer: UHC Exchange |
$143.75
|
| Rate for Payer: UHC Medicare Advantage |
$148.06
|
| Rate for Payer: UMR Bronson Commercial |
$83.21
|
| Rate for Payer: VA VA |
$143.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.66
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
OP
|
$225.75
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.63 |
| Max. Negotiated Rate |
$208.34 |
| Rate for Payer: Aetna American Axle |
$146.74
|
| Rate for Payer: Aetna Commercial |
$191.89
|
| Rate for Payer: Aetna Medicare |
$149.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.69
|
| Rate for Payer: BCBS Complete |
$82.57
|
| Rate for Payer: BCBS MAPPO |
$143.75
|
| Rate for Payer: BCBS Trust/PPO |
$129.27
|
| Rate for Payer: BCN Medicare Advantage |
$143.75
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cofinity Commercial |
$194.14
|
| Rate for Payer: Cofinity Commercial |
$158.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.75
|
| Rate for Payer: Healthscope Commercial |
$203.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.31
|
| Rate for Payer: Mclaren Medicaid |
$78.63
|
| Rate for Payer: Mclaren Medicare |
$143.75
|
| Rate for Payer: Meridian Medicaid |
$82.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$150.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.89
|
| Rate for Payer: PACE Medicare |
$136.56
|
| Rate for Payer: PACE SWMI |
$143.75
|
| Rate for Payer: PHP Commercial |
$191.89
|
| Rate for Payer: PHP Medicare Advantage |
$143.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.23
|
| Rate for Payer: Priority Health Medicare |
$143.75
|
| Rate for Payer: Priority Health Narrow Network |
$120.98
|
| Rate for Payer: Priority Health SBD |
$142.22
|
| Rate for Payer: Railroad Medicare Medicare |
$143.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.50
|
| Rate for Payer: UHC Core |
$208.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.75
|
| Rate for Payer: UHC Exchange |
$143.75
|
| Rate for Payer: UHC Medicare Advantage |
$148.06
|
| Rate for Payer: UMR Bronson Commercial |
$83.53
|
| Rate for Payer: VA VA |
$143.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.31
|
|
|
HC CHROMOSOME ANALYSIS MARROW
|
Facility
|
IP
|
$225.75
|
|
|
Service Code
|
CPT 88237
|
| Hospital Charge Code |
31000016
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.33 |
| Max. Negotiated Rate |
$203.18 |
| Rate for Payer: Aetna American Axle |
$146.74
|
| Rate for Payer: Aetna Commercial |
$191.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.74
|
| Rate for Payer: Cash Price |
$180.60
|
| Rate for Payer: Cofinity Commercial |
$158.02
|
| Rate for Payer: Cofinity Commercial |
$194.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.60
|
| Rate for Payer: Healthscope Commercial |
$203.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$191.89
|
| Rate for Payer: PHP Commercial |
$191.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.02
|
| Rate for Payer: Priority Health SBD |
$142.22
|
| Rate for Payer: UMR Bronson Commercial |
$99.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.31
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
IP
|
$198.90
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.52 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna American Axle |
$129.28
|
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.28
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$139.23
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.06
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.23
|
| Rate for Payer: Priority Health SBD |
$125.31
|
| Rate for Payer: UMR Bronson Commercial |
$87.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC CHROMOSOME CELL COUNT 15 TO 20
|
Facility
|
OP
|
$198.90
|
|
|
Service Code
|
CPT 88262
|
| Hospital Charge Code |
31000019
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.64 |
| Max. Negotiated Rate |
$205.60 |
| Rate for Payer: Aetna American Axle |
$129.28
|
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: Aetna Medicare |
$130.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.86
|
| Rate for Payer: BCBS Complete |
$72.08
|
| Rate for Payer: BCBS MAPPO |
$125.49
|
| Rate for Payer: BCBS Trust/PPO |
$112.86
|
| Rate for Payer: BCN Medicare Advantage |
$125.49
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Cofinity Commercial |
$139.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$125.49
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Mclaren Medicaid |
$68.64
|
| Rate for Payer: Mclaren Medicare |
$125.49
|
| Rate for Payer: Meridian Medicaid |
$72.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$131.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$144.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$169.06
|
| Rate for Payer: PACE Medicare |
$119.22
|
| Rate for Payer: PACE SWMI |
$125.49
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: PHP Medicare Advantage |
$125.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.23
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$170.98
|
| Rate for Payer: Priority Health Medicare |
$125.49
|
| Rate for Payer: Priority Health Narrow Network |
$136.78
|
| Rate for Payer: Priority Health SBD |
$125.31
|
| Rate for Payer: Railroad Medicare Medicare |
$125.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.59
|
| Rate for Payer: UHC Core |
$205.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$125.49
|
| Rate for Payer: UHC Exchange |
$125.49
|
| Rate for Payer: UHC Medicare Advantage |
$129.25
|
| Rate for Payer: UMR Bronson Commercial |
$73.59
|
| Rate for Payer: VA VA |
$125.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
OP
|
$298.86
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$82.21 |
| Max. Negotiated Rate |
$268.97 |
| Rate for Payer: Aetna American Axle |
$194.26
|
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: Aetna Medicare |
$156.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.88
|
| Rate for Payer: BCBS Complete |
$86.33
|
| Rate for Payer: BCBS MAPPO |
$150.30
|
| Rate for Payer: BCBS Trust/PPO |
$135.17
|
| Rate for Payer: BCN Medicare Advantage |
$150.30
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Cofinity Commercial |
$209.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.30
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Mclaren Medicaid |
$82.21
|
| Rate for Payer: Mclaren Medicare |
$150.30
|
| Rate for Payer: Meridian Medicaid |
$86.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PACE Medicare |
$142.78
|
| Rate for Payer: PACE SWMI |
$150.30
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: PHP Medicare Advantage |
$150.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.23
|
| Rate for Payer: Priority Health Medicare |
$150.30
|
| Rate for Payer: Priority Health Narrow Network |
$120.98
|
| Rate for Payer: Priority Health SBD |
$188.28
|
| Rate for Payer: Railroad Medicare Medicare |
$150.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.36
|
| Rate for Payer: UHC Core |
$242.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.30
|
| Rate for Payer: UHC Exchange |
$150.30
|
| Rate for Payer: UHC Medicare Advantage |
$154.81
|
| Rate for Payer: UMR Bronson Commercial |
$110.58
|
| Rate for Payer: VA VA |
$150.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC CHROMOSOME CULTURE
|
Facility
|
IP
|
$298.86
|
|
|
Service Code
|
CPT 88235
|
| Hospital Charge Code |
31000015
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$131.50 |
| Max. Negotiated Rate |
$268.97 |
| Rate for Payer: Aetna American Axle |
$194.26
|
| Rate for Payer: Aetna Commercial |
$254.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.26
|
| Rate for Payer: Cash Price |
$239.09
|
| Rate for Payer: Cofinity Commercial |
$209.20
|
| Rate for Payer: Cofinity Commercial |
$257.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.09
|
| Rate for Payer: Healthscope Commercial |
$268.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$254.03
|
| Rate for Payer: PHP Commercial |
$254.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.20
|
| Rate for Payer: Priority Health SBD |
$188.28
|
| Rate for Payer: UMR Bronson Commercial |
$131.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.14
|
|
|
HC CIRCUMCISION
|
Facility
|
IP
|
$2,710.48
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,192.61 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna American Axle |
$1,761.81
|
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.81
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$1,897.34
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,897.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health SBD |
$1,707.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,192.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CIRCUMCISION
|
Facility
|
OP
|
$2,710.48
|
|
| Hospital Charge Code |
72300001
|
|
Hospital Revenue Code
|
723
|
| Min. Negotiated Rate |
$1,002.88 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna American Axle |
$1,761.81
|
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.81
|
| Rate for Payer: BCBS Complete |
$1,084.19
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$1,897.34
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,897.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health SBD |
$1,707.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,002.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
OP
|
$2,661.82
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$93.32 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,730.18
|
| Rate for Payer: Aetna Commercial |
$2,262.55
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,030.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$1,863.27
|
| Rate for Payer: Cofinity Commercial |
$2,289.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,395.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,863.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,996.36
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$2,262.55
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$1,676.95
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$93.32
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$984.87
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,996.36
|
|
|
HC CIRCUMCISION CLAMP NEWBORN
|
Facility
|
IP
|
$2,661.82
|
|
|
Service Code
|
CPT 54150
|
| Hospital Charge Code |
76100198
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,171.20 |
| Max. Negotiated Rate |
$2,395.64 |
| Rate for Payer: Aetna American Axle |
$1,730.18
|
| Rate for Payer: Aetna Commercial |
$2,262.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,730.18
|
| Rate for Payer: Cash Price |
$2,129.46
|
| Rate for Payer: Cofinity Commercial |
$1,863.27
|
| Rate for Payer: Cofinity Commercial |
$2,289.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,129.46
|
| Rate for Payer: Healthscope Commercial |
$2,395.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,863.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,996.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,262.55
|
| Rate for Payer: PHP Commercial |
$2,262.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,863.27
|
| Rate for Payer: Priority Health SBD |
$1,676.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,171.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,996.36
|
|
|
HC CIRCUMCISION, SURG OTHER THAN CLAMP >28 DAYS OLD
|
Facility
|
OP
|
$2,710.48
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
76100256
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$193.85 |
| Max. Negotiated Rate |
$5,699.47 |
| Rate for Payer: Aetna American Axle |
$1,761.81
|
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna Medicare |
$1,882.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,263.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,263.10
|
| Rate for Payer: BCBS Complete |
$1,039.94
|
| Rate for Payer: BCBS MAPPO |
$1,810.48
|
| Rate for Payer: BCBS Trust/PPO |
$2,840.75
|
| Rate for Payer: BCN Medicare Advantage |
$1,810.48
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$1,897.34
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,810.48
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,897.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Mclaren Medicaid |
$990.33
|
| Rate for Payer: Mclaren Medicare |
$1,810.48
|
| Rate for Payer: Meridian Medicaid |
$1,039.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,901.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,082.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PACE Medicare |
$1,719.96
|
| Rate for Payer: PACE SWMI |
$1,810.48
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: PHP Medicare Advantage |
$1,810.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$990.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,699.47
|
| Rate for Payer: Priority Health Medicare |
$1,810.48
|
| Rate for Payer: Priority Health Narrow Network |
$4,559.58
|
| Rate for Payer: Priority Health SBD |
$1,707.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,810.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,810.48
|
| Rate for Payer: UHC Exchange |
$193.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,864.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,002.88
|
| Rate for Payer: VA VA |
$1,810.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CIRCUMCISION, SURG OTHER THAN CLAMP >28 DAYS OLD
|
Facility
|
IP
|
$2,710.48
|
|
|
Service Code
|
CPT 54161
|
| Hospital Charge Code |
76100256
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,192.61 |
| Max. Negotiated Rate |
$2,439.43 |
| Rate for Payer: Aetna American Axle |
$1,761.81
|
| Rate for Payer: Aetna Commercial |
$2,303.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,761.81
|
| Rate for Payer: Cash Price |
$2,168.38
|
| Rate for Payer: Cofinity Commercial |
$2,331.01
|
| Rate for Payer: Cofinity Commercial |
$1,897.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,168.38
|
| Rate for Payer: Healthscope Commercial |
$2,439.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,897.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,032.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,303.91
|
| Rate for Payer: PHP Commercial |
$2,303.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,897.34
|
| Rate for Payer: Priority Health SBD |
$1,707.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,192.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,032.86
|
|
|
HC CITRIC ACID URINE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
30100166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.21 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$28.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.75
|
| Rate for Payer: BCBS Complete |
$15.97
|
| Rate for Payer: BCBS MAPPO |
$27.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.00
|
| Rate for Payer: BCN Medicare Advantage |
$27.80
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.80
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$15.21
|
| Rate for Payer: Mclaren Medicare |
$27.80
|
| Rate for Payer: Meridian Medicaid |
$15.97
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PACE Medicare |
$26.41
|
| Rate for Payer: PACE SWMI |
$27.80
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$27.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.14
|
| Rate for Payer: Priority Health Medicare |
$27.80
|
| Rate for Payer: Priority Health Narrow Network |
$30.51
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$27.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.36
|
| Rate for Payer: UHC Core |
$45.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.80
|
| Rate for Payer: UHC Exchange |
$27.80
|
| Rate for Payer: UHC Medicare Advantage |
$28.63
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$27.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CITRIC ACID URINE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 82507
|
| Hospital Charge Code |
30100166
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.41
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CK-MB FRACTION
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
30100179
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna American Axle |
$64.97
|
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Medicare |
$12.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.44
|
| Rate for Payer: BCBS Complete |
$6.63
|
| Rate for Payer: BCBS MAPPO |
$11.55
|
| Rate for Payer: BCBS Trust/PPO |
$10.38
|
| Rate for Payer: BCN Medicare Advantage |
$11.55
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.55
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Mclaren Medicare |
$11.55
|
| Rate for Payer: Meridian Medicaid |
$6.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PACE Medicare |
$10.97
|
| Rate for Payer: PACE SWMI |
$11.55
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: PHP Medicare Advantage |
$11.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.61
|
| Rate for Payer: Priority Health Medicare |
$11.55
|
| Rate for Payer: Priority Health Narrow Network |
$7.69
|
| Rate for Payer: Priority Health SBD |
$62.97
|
| Rate for Payer: Railroad Medicare Medicare |
$11.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.86
|
| Rate for Payer: UHC Core |
$19.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.55
|
| Rate for Payer: UHC Exchange |
$11.55
|
| Rate for Payer: UHC Medicare Advantage |
$11.90
|
| Rate for Payer: UMR Bronson Commercial |
$36.99
|
| Rate for Payer: VA VA |
$11.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC CK-MB FRACTION
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 82553
|
| Hospital Charge Code |
30100179
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.98 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna American Axle |
$64.97
|
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.97
|
| Rate for Payer: Priority Health SBD |
$62.97
|
| Rate for Payer: UMR Bronson Commercial |
$43.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC CLADOSPORIUM IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200032
|
|
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 |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| 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 CLADOSPORIUM IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200032
|
|
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 |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| 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 CLAM IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200033
|
|
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 CLAM IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200033
|
|
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 |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| 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
|
|
