|
HC COCAINE CONFIRMATION URINE
|
Facility
|
OP
|
$62.00
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100597
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.94 |
| Max. Negotiated Rate |
$55.80 |
| Rate for Payer: Aetna American Axle |
$40.30
|
| Rate for Payer: Aetna Commercial |
$52.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.30
|
| Rate for Payer: BCBS Complete |
$24.80
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cash Price |
$49.60
|
| Rate for Payer: Cofinity Commercial |
$53.32
|
| Rate for Payer: Cofinity Commercial |
$43.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.60
|
| Rate for Payer: Healthscope Commercial |
$55.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.70
|
| Rate for Payer: PHP Commercial |
$52.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.40
|
| Rate for Payer: Priority Health SBD |
$39.06
|
| Rate for Payer: UHC Core |
$24.74
|
| Rate for Payer: UMR Bronson Commercial |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.50
|
|
|
HC COCAINE CONFIRM MECONIUM
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100573
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.74 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna American Axle |
$74.75
|
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.75
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$80.50
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health SBD |
$72.45
|
| Rate for Payer: UHC Core |
$24.74
|
| Rate for Payer: UMR Bronson Commercial |
$42.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC COCAINE CONFIRM MECONIUM
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100573
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna American Axle |
$74.75
|
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Cofinity Commercial |
$80.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health SBD |
$72.45
|
| Rate for Payer: UMR Bronson Commercial |
$50.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC COCAINE URIN
|
Facility
|
IP
|
$95.40
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000127
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.98 |
| Max. Negotiated Rate |
$85.86 |
| Rate for Payer: Aetna American Axle |
$62.01
|
| Rate for Payer: Aetna Commercial |
$81.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.01
|
| Rate for Payer: Cash Price |
$76.32
|
| Rate for Payer: Cofinity Commercial |
$66.78
|
| Rate for Payer: Cofinity Commercial |
$82.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.32
|
| Rate for Payer: Healthscope Commercial |
$85.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.09
|
| Rate for Payer: PHP Commercial |
$81.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.78
|
| Rate for Payer: Priority Health SBD |
$60.10
|
| Rate for Payer: UMR Bronson Commercial |
$41.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.55
|
|
|
HC COCAINE URIN
|
Facility
|
OP
|
$95.40
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000127
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$95.77 |
| Rate for Payer: Aetna American Axle |
$62.01
|
| Rate for Payer: Aetna Commercial |
$81.09
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$55.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$76.32
|
| Rate for Payer: Cash Price |
$76.32
|
| Rate for Payer: Cofinity Commercial |
$66.78
|
| Rate for Payer: Cofinity Commercial |
$82.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$85.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.55
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.09
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$81.09
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.58
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$38.86
|
| Rate for Payer: Priority Health SBD |
$60.10
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Core |
$95.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: UMR Bronson Commercial |
$35.30
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.55
|
|
|
HC COCCIDIOIDES TOTAL AB BY CF&ID
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
30200244
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$6.59
|
| Rate for Payer: BCBS MAPPO |
$11.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Medicare Advantage |
$11.47
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.47
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$6.27
|
| Rate for Payer: Mclaren Medicare |
$11.47
|
| Rate for Payer: Meridian Medicaid |
$6.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Medicare |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.47
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$11.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.74
|
| Rate for Payer: Priority Health Medicare |
$11.47
|
| Rate for Payer: Priority Health Narrow Network |
$12.59
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$11.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.76
|
| Rate for Payer: UHC Core |
$18.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.47
|
| Rate for Payer: UHC Exchange |
$11.47
|
| Rate for Payer: UHC Medicare Advantage |
$11.81
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: VA VA |
$11.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC COCCIDIOIDES TOTAL AB BY CF&ID
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
30200244
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC COCCIDIOIDES TOTAL AB CMPT
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
30200246
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC COCCIDIOIDES TOTAL AB CMPT
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 86635
|
| Hospital Charge Code |
30200246
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$6.59
|
| Rate for Payer: BCBS MAPPO |
$11.47
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Medicare Advantage |
$11.47
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.47
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$6.27
|
| Rate for Payer: Mclaren Medicare |
$11.47
|
| Rate for Payer: Meridian Medicaid |
$6.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.47
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$11.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.74
|
| Rate for Payer: Priority Health Medicare |
$11.47
|
| Rate for Payer: Priority Health Narrow Network |
$12.59
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$11.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.76
|
| Rate for Payer: UHC Core |
$18.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.47
|
| Rate for Payer: UHC Exchange |
$11.47
|
| Rate for Payer: UHC Medicare Advantage |
$11.81
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: VA VA |
$11.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC COCKROACH IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200034
|
|
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 COCKROACH IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200034
|
|
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 COCONUT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200079
|
|
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 COCONUT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200079
|
|
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 CODFISH IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200035
|
|
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 CODFISH IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200035
|
|
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 COGNITIVE EXAM
|
Facility
|
IP
|
$295.00
|
|
|
Service Code
|
CPT 96125
|
| Hospital Charge Code |
43400002
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$129.80 |
| Max. Negotiated Rate |
$265.50 |
| Rate for Payer: Aetna American Axle |
$191.75
|
| Rate for Payer: Aetna Commercial |
$250.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.75
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$206.50
|
| Rate for Payer: Cofinity Commercial |
$253.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$265.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$206.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.75
|
| Rate for Payer: PHP Commercial |
$250.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.50
|
| Rate for Payer: Priority Health SBD |
$185.85
|
| Rate for Payer: UMR Bronson Commercial |
$129.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.25
|
|
|
HC COGNITIVE EXAM
|
Facility
|
OP
|
$295.00
|
|
|
Service Code
|
CPT 96125
|
| Hospital Charge Code |
43400002
|
|
Hospital Revenue Code
|
434
|
| Min. Negotiated Rate |
$100.52 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$191.75
|
| Rate for Payer: Aetna Commercial |
$250.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.75
|
| Rate for Payer: BCBS Complete |
$118.00
|
| Rate for Payer: BCBS Trust/PPO |
$107.15
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cash Price |
$236.00
|
| Rate for Payer: Cofinity Commercial |
$253.70
|
| Rate for Payer: Cofinity Commercial |
$206.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.00
|
| Rate for Payer: Healthscope Commercial |
$265.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$206.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.75
|
| Rate for Payer: PHP Commercial |
$250.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$138.00
|
| Rate for Payer: Priority Health Narrow Network |
$110.40
|
| Rate for Payer: Priority Health SBD |
$185.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.57
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$100.52
|
| Rate for Payer: UMR Bronson Commercial |
$109.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.25
|
|
|
HC COGNITIVE FUNCTION, ADDL 15 MIN
|
Facility
|
OP
|
$111.26
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
43000023
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$72.32
|
| Rate for Payer: Aetna Commercial |
$94.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.32
|
| Rate for Payer: BCBS Complete |
$44.50
|
| Rate for Payer: BCBS Trust/PPO |
$22.48
|
| Rate for Payer: Cash Price |
$89.01
|
| Rate for Payer: Cash Price |
$89.01
|
| Rate for Payer: Cash Price |
$89.01
|
| Rate for Payer: Cofinity Commercial |
$77.88
|
| Rate for Payer: Cofinity Commercial |
$95.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.01
|
| Rate for Payer: Healthscope Commercial |
$100.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.57
|
| Rate for Payer: PHP Commercial |
$94.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.46
|
| Rate for Payer: Priority Health Narrow Network |
$18.77
|
| Rate for Payer: Priority Health SBD |
$70.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.69
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$20.63
|
| Rate for Payer: UMR Bronson Commercial |
$41.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC COGNITIVE FUNCTION, ADDL 15 MIN
|
Facility
|
IP
|
$111.26
|
|
|
Service Code
|
CPT 97130
|
| Hospital Charge Code |
43000023
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.95 |
| Max. Negotiated Rate |
$100.13 |
| Rate for Payer: Aetna American Axle |
$72.32
|
| Rate for Payer: Aetna Commercial |
$94.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.32
|
| Rate for Payer: Cash Price |
$89.01
|
| Rate for Payer: Cofinity Commercial |
$77.88
|
| Rate for Payer: Cofinity Commercial |
$95.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.01
|
| Rate for Payer: Healthscope Commercial |
$100.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$94.57
|
| Rate for Payer: PHP Commercial |
$94.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.88
|
| Rate for Payer: Priority Health SBD |
$70.09
|
| Rate for Payer: UMR Bronson Commercial |
$48.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC COGNITIVE FUNCTION, INITIAL 15 MIN
|
Facility
|
OP
|
$113.49
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
43000022
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$19.34 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$73.77
|
| Rate for Payer: Aetna Commercial |
$96.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.77
|
| Rate for Payer: BCBS Complete |
$45.40
|
| Rate for Payer: BCBS Trust/PPO |
$23.54
|
| Rate for Payer: Cash Price |
$90.79
|
| Rate for Payer: Cash Price |
$90.79
|
| Rate for Payer: Cash Price |
$90.79
|
| Rate for Payer: Cofinity Commercial |
$79.44
|
| Rate for Payer: Cofinity Commercial |
$97.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.79
|
| Rate for Payer: Healthscope Commercial |
$102.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.47
|
| Rate for Payer: PHP Commercial |
$96.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.18
|
| Rate for Payer: Priority Health Narrow Network |
$19.34
|
| Rate for Payer: Priority Health SBD |
$71.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.77
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$21.61
|
| Rate for Payer: UMR Bronson Commercial |
$41.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.12
|
|
|
HC COGNITIVE FUNCTION, INITIAL 15 MIN
|
Facility
|
IP
|
$113.49
|
|
|
Service Code
|
CPT 97129
|
| Hospital Charge Code |
43000022
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$49.94 |
| Max. Negotiated Rate |
$102.14 |
| Rate for Payer: Aetna American Axle |
$73.77
|
| Rate for Payer: Aetna Commercial |
$96.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.77
|
| Rate for Payer: Cash Price |
$90.79
|
| Rate for Payer: Cofinity Commercial |
$79.44
|
| Rate for Payer: Cofinity Commercial |
$97.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.79
|
| Rate for Payer: Healthscope Commercial |
$102.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.47
|
| Rate for Payer: PHP Commercial |
$96.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.44
|
| Rate for Payer: Priority Health SBD |
$71.50
|
| Rate for Payer: UMR Bronson Commercial |
$49.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.12
|
|
|
HC COLD AGGLUTININS
|
Facility
|
OP
|
$60.30
|
|
|
Service Code
|
CPT 86156
|
| Hospital Charge Code |
30200149
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.41 |
| Max. Negotiated Rate |
$54.27 |
| Rate for Payer: Aetna American Axle |
$39.20
|
| Rate for Payer: Aetna Commercial |
$51.26
|
| Rate for Payer: Aetna Medicare |
$8.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.09
|
| Rate for Payer: BCBS Complete |
$4.64
|
| Rate for Payer: BCBS MAPPO |
$8.07
|
| Rate for Payer: BCBS Trust/PPO |
$7.25
|
| Rate for Payer: BCN Medicare Advantage |
$8.07
|
| Rate for Payer: Cash Price |
$48.24
|
| Rate for Payer: Cash Price |
$48.24
|
| Rate for Payer: Cofinity Commercial |
$51.86
|
| Rate for Payer: Cofinity Commercial |
$42.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.07
|
| Rate for Payer: Healthscope Commercial |
$54.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.22
|
| Rate for Payer: Mclaren Medicaid |
$4.41
|
| Rate for Payer: Mclaren Medicare |
$8.07
|
| Rate for Payer: Meridian Medicaid |
$4.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.26
|
| Rate for Payer: PACE Medicare |
$7.67
|
| Rate for Payer: PACE SWMI |
$8.07
|
| Rate for Payer: PHP Commercial |
$51.26
|
| Rate for Payer: PHP Medicare Advantage |
$8.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.40
|
| Rate for Payer: Priority Health Medicare |
$8.07
|
| Rate for Payer: Priority Health Narrow Network |
$5.12
|
| Rate for Payer: Priority Health SBD |
$37.99
|
| Rate for Payer: Railroad Medicare Medicare |
$8.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.68
|
| Rate for Payer: UHC Core |
$11.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.07
|
| Rate for Payer: UHC Exchange |
$8.07
|
| Rate for Payer: UHC Medicare Advantage |
$8.31
|
| Rate for Payer: UMR Bronson Commercial |
$22.31
|
| Rate for Payer: VA VA |
$8.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.22
|
|
|
HC COLD AGGLUTININS
|
Facility
|
IP
|
$60.30
|
|
|
Service Code
|
CPT 86156
|
| Hospital Charge Code |
30200149
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.53 |
| Max. Negotiated Rate |
$54.27 |
| Rate for Payer: Aetna American Axle |
$39.20
|
| Rate for Payer: Aetna Commercial |
$51.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.20
|
| Rate for Payer: Cash Price |
$48.24
|
| Rate for Payer: Cofinity Commercial |
$42.21
|
| Rate for Payer: Cofinity Commercial |
$51.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.24
|
| Rate for Payer: Healthscope Commercial |
$54.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.26
|
| Rate for Payer: PHP Commercial |
$51.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.21
|
| Rate for Payer: Priority Health SBD |
$37.99
|
| Rate for Payer: UMR Bronson Commercial |
$26.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.22
|
|
|
HC COLD SNARE POLYPECTOMY
|
Facility
|
IP
|
$534.47
|
|
| Hospital Charge Code |
36000018
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$235.17 |
| Max. Negotiated Rate |
$481.02 |
| Rate for Payer: Aetna American Axle |
$347.41
|
| Rate for Payer: Aetna Commercial |
$454.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.41
|
| Rate for Payer: Cash Price |
$427.58
|
| Rate for Payer: Cofinity Commercial |
$374.13
|
| Rate for Payer: Cofinity Commercial |
$459.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.58
|
| Rate for Payer: Healthscope Commercial |
$481.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$400.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$454.30
|
| Rate for Payer: PHP Commercial |
$454.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.13
|
| Rate for Payer: Priority Health SBD |
$336.72
|
| Rate for Payer: UMR Bronson Commercial |
$235.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$400.85
|
|
|
HC COLD SNARE POLYPECTOMY
|
Facility
|
OP
|
$534.47
|
|
| Hospital Charge Code |
36000018
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$197.75 |
| Max. Negotiated Rate |
$481.02 |
| Rate for Payer: Aetna American Axle |
$347.41
|
| Rate for Payer: Aetna Commercial |
$454.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.41
|
| Rate for Payer: BCBS Complete |
$213.79
|
| Rate for Payer: Cash Price |
$427.58
|
| Rate for Payer: Cofinity Commercial |
$374.13
|
| Rate for Payer: Cofinity Commercial |
$459.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.58
|
| Rate for Payer: Healthscope Commercial |
$481.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$400.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$454.30
|
| Rate for Payer: PHP Commercial |
$454.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$374.13
|
| Rate for Payer: Priority Health SBD |
$336.72
|
| Rate for Payer: UMR Bronson Commercial |
$197.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$400.85
|
|
