|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.55 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$158.55
|
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna Medicare |
$58.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.81
|
| Rate for Payer: BCBS Complete |
$32.08
|
| Rate for Payer: BCBS MAPPO |
$55.85
|
| Rate for Payer: BCBS Trust/PPO |
$235.94
|
| Rate for Payer: BCN Medicare Advantage |
$55.85
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Cofinity Commercial |
$170.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.85
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Mclaren Medicaid |
$30.55
|
| Rate for Payer: Mclaren Medicare |
$55.85
|
| Rate for Payer: Meridian Medicaid |
$32.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Medicare |
$53.06
|
| Rate for Payer: PACE SWMI |
$55.85
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: PHP Medicare Advantage |
$55.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.82
|
| Rate for Payer: Priority Health Medicare |
$55.85
|
| Rate for Payer: Priority Health Narrow Network |
$140.66
|
| Rate for Payer: Priority Health SBD |
$153.67
|
| Rate for Payer: Railroad Medicare Medicare |
$55.85
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.85
|
| Rate for Payer: UHC Medicare Advantage |
$57.53
|
| Rate for Payer: UMR Bronson Commercial |
$90.25
|
| Rate for Payer: VA VA |
$55.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$107.32 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna American Axle |
$158.55
|
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.55
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Cofinity Commercial |
$170.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health SBD |
$153.67
|
| Rate for Payer: UMR Bronson Commercial |
$107.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
IP
|
$542.50
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$238.70 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna American Axle |
$352.62
|
| Rate for Payer: Aetna Commercial |
$461.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.62
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cofinity Commercial |
$379.75
|
| Rate for Payer: Cofinity Commercial |
$466.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.00
|
| Rate for Payer: Healthscope Commercial |
$488.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$461.12
|
| Rate for Payer: PHP Commercial |
$461.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.75
|
| Rate for Payer: Priority Health SBD |
$341.78
|
| Rate for Payer: UMR Bronson Commercial |
$238.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.88
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
OP
|
$542.50
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$97.34 |
| Max. Negotiated Rate |
$560.20 |
| Rate for Payer: Aetna American Axle |
$352.62
|
| Rate for Payer: Aetna Commercial |
$461.12
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$352.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$104.44
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cofinity Commercial |
$466.55
|
| Rate for Payer: Cofinity Commercial |
$379.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$488.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$379.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.88
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$461.12
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$461.12
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$448.16
|
| Rate for Payer: Priority Health SBD |
$341.78
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$154.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$140.15
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$200.72
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.88
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$14.45
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.28
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$16.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: VA VA |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.87 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.75 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna American Axle |
$29.17
|
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.17
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$31.42
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health SBD |
$28.27
|
| Rate for Payer: UMR Bronson Commercial |
$19.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.56 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna American Axle |
$29.17
|
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$14.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.28
|
| Rate for Payer: BCBS Complete |
$7.94
|
| Rate for Payer: BCBS MAPPO |
$13.82
|
| Rate for Payer: BCBS Trust/PPO |
$12.43
|
| Rate for Payer: BCN Medicare Advantage |
$13.82
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$31.42
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.82
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$7.56
|
| Rate for Payer: Mclaren Medicare |
$13.82
|
| Rate for Payer: Meridian Medicaid |
$7.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Medicare |
$13.13
|
| Rate for Payer: PACE SWMI |
$13.82
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$13.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$13.82
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$28.27
|
| Rate for Payer: Railroad Medicare Medicare |
$13.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.58
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.82
|
| Rate for Payer: UHC Exchange |
$13.82
|
| Rate for Payer: UHC Medicare Advantage |
$14.23
|
| Rate for Payer: UMR Bronson Commercial |
$16.61
|
| Rate for Payer: VA VA |
$13.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna American Axle |
$30.10
|
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.36
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.42
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: UMR Bronson Commercial |
$20.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna American Axle |
$30.10
|
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$7.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.16
|
| Rate for Payer: BCBS Complete |
$4.21
|
| Rate for Payer: BCBS MAPPO |
$7.33
|
| Rate for Payer: BCBS Trust/PPO |
$4.95
|
| Rate for Payer: BCN Medicare Advantage |
$7.33
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.33
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Mclaren Medicaid |
$4.01
|
| Rate for Payer: Mclaren Medicare |
$7.33
|
| Rate for Payer: Meridian Medicaid |
$4.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.36
|
| Rate for Payer: PACE Medicare |
$6.96
|
| Rate for Payer: PACE SWMI |
$7.33
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$7.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.17
|
| Rate for Payer: Priority Health Medicare |
$7.33
|
| Rate for Payer: Priority Health Narrow Network |
$4.14
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$7.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.80
|
| Rate for Payer: UHC Core |
$11.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.33
|
| Rate for Payer: UHC Exchange |
$7.33
|
| Rate for Payer: UHC Medicare Advantage |
$7.55
|
| Rate for Payer: UMR Bronson Commercial |
$17.13
|
| Rate for Payer: VA VA |
$7.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
IP
|
$2,937.41
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,292.46 |
| Max. Negotiated Rate |
$2,643.67 |
| Rate for Payer: Aetna American Axle |
$1,909.32
|
| Rate for Payer: Aetna Commercial |
$2,496.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,909.32
|
| Rate for Payer: Cash Price |
$2,349.93
|
| Rate for Payer: Cofinity Commercial |
$2,056.19
|
| Rate for Payer: Cofinity Commercial |
$2,526.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.93
|
| Rate for Payer: Healthscope Commercial |
$2,643.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,056.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,203.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,496.80
|
| Rate for Payer: PHP Commercial |
$2,496.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.19
|
| Rate for Payer: Priority Health SBD |
$1,850.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,292.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,203.06
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
OP
|
$2,937.41
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,086.84 |
| Max. Negotiated Rate |
$2,643.67 |
| Rate for Payer: Aetna American Axle |
$1,909.32
|
| Rate for Payer: Aetna Commercial |
$2,496.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,909.32
|
| Rate for Payer: BCBS Complete |
$1,174.96
|
| Rate for Payer: Cash Price |
$2,349.93
|
| Rate for Payer: Cofinity Commercial |
$2,056.19
|
| Rate for Payer: Cofinity Commercial |
$2,526.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.93
|
| Rate for Payer: Healthscope Commercial |
$2,643.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,056.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,203.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,496.80
|
| Rate for Payer: PHP Commercial |
$2,496.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.19
|
| Rate for Payer: Priority Health SBD |
$1,850.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,086.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,203.06
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
OP
|
$3,607.43
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,334.75 |
| Max. Negotiated Rate |
$3,246.69 |
| Rate for Payer: Aetna American Axle |
$2,344.83
|
| Rate for Payer: Aetna Commercial |
$3,066.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.83
|
| Rate for Payer: BCBS Complete |
$1,442.97
|
| Rate for Payer: Cash Price |
$2,885.94
|
| Rate for Payer: Cofinity Commercial |
$2,525.20
|
| Rate for Payer: Cofinity Commercial |
$3,102.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.94
|
| Rate for Payer: Healthscope Commercial |
$3,246.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,525.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,705.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,066.32
|
| Rate for Payer: PHP Commercial |
$3,066.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,525.20
|
| Rate for Payer: Priority Health SBD |
$2,272.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,334.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,705.57
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
IP
|
$3,607.43
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,587.27 |
| Max. Negotiated Rate |
$3,246.69 |
| Rate for Payer: Aetna American Axle |
$2,344.83
|
| Rate for Payer: Aetna Commercial |
$3,066.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,344.83
|
| Rate for Payer: Cash Price |
$2,885.94
|
| Rate for Payer: Cofinity Commercial |
$2,525.20
|
| Rate for Payer: Cofinity Commercial |
$3,102.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,885.94
|
| Rate for Payer: Healthscope Commercial |
$3,246.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,525.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,705.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,066.32
|
| Rate for Payer: PHP Commercial |
$3,066.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,525.20
|
| Rate for Payer: Priority Health SBD |
$2,272.68
|
| Rate for Payer: UMR Bronson Commercial |
$1,587.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,705.57
|
|
|
HC CSF LACTATE
|
Facility
|
OP
|
$21.42
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna Medicare |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.46
|
| Rate for Payer: BCBS Complete |
$6.65
|
| Rate for Payer: BCBS MAPPO |
$11.57
|
| Rate for Payer: BCBS Trust/PPO |
$10.41
|
| Rate for Payer: BCN Medicare Advantage |
$11.57
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.57
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Mclaren Medicaid |
$6.33
|
| Rate for Payer: Mclaren Medicare |
$11.57
|
| Rate for Payer: Meridian Medicaid |
$6.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PACE Medicare |
$10.99
|
| Rate for Payer: PACE SWMI |
$11.57
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: PHP Medicare Advantage |
$11.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.98
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health Narrow Network |
$6.38
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: Railroad Medicare Medicare |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.88
|
| Rate for Payer: UHC Core |
$17.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.57
|
| Rate for Payer: UHC Exchange |
$11.57
|
| Rate for Payer: UHC Medicare Advantage |
$11.92
|
| Rate for Payer: UMR Bronson Commercial |
$7.93
|
| Rate for Payer: VA VA |
$11.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC CSF LACTATE
|
Facility
|
IP
|
$21.42
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100482
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.42 |
| Max. Negotiated Rate |
$19.28 |
| Rate for Payer: Aetna American Axle |
$13.92
|
| Rate for Payer: Aetna Commercial |
$18.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.92
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$14.99
|
| Rate for Payer: Cofinity Commercial |
$18.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$19.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.21
|
| Rate for Payer: PHP Commercial |
$18.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.99
|
| Rate for Payer: Priority Health SBD |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$9.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.06
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
IP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$59.11 |
| Max. Negotiated Rate |
$120.90 |
| Rate for Payer: Aetna American Axle |
$87.31
|
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: UMR Bronson Commercial |
$59.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC CSU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200016
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$87.31
|
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.88
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$49.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC CSU R&B
|
Facility
|
IP
|
$7,165.38
|
|
| Hospital Charge Code |
21000002
|
|
Hospital Revenue Code
|
210
|
| Min. Negotiated Rate |
$3,152.77 |
| Max. Negotiated Rate |
$6,448.84 |
| Rate for Payer: Aetna American Axle |
$4,657.50
|
| Rate for Payer: Aetna Commercial |
$6,090.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,657.50
|
| Rate for Payer: Cash Price |
$5,732.30
|
| Rate for Payer: Cofinity Commercial |
$5,015.77
|
| Rate for Payer: Cofinity Commercial |
$6,162.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,732.30
|
| Rate for Payer: Healthscope Commercial |
$6,448.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,015.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,374.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,090.57
|
| Rate for Payer: PHP Commercial |
$6,090.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,015.77
|
| Rate for Payer: Priority Health SBD |
$4,514.19
|
| Rate for Payer: UMR Bronson Commercial |
$3,152.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,374.04
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
IP
|
$3,636.90
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,600.24 |
| Max. Negotiated Rate |
$3,273.21 |
| Rate for Payer: Aetna American Axle |
$2,363.98
|
| Rate for Payer: Aetna Commercial |
$3,091.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,363.98
|
| Rate for Payer: Cash Price |
$2,909.52
|
| Rate for Payer: Cofinity Commercial |
$2,545.83
|
| Rate for Payer: Cofinity Commercial |
$3,127.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,909.52
|
| Rate for Payer: Healthscope Commercial |
$3,273.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,545.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,727.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,091.36
|
| Rate for Payer: PHP Commercial |
$3,091.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,545.83
|
| Rate for Payer: Priority Health SBD |
$2,291.25
|
| Rate for Payer: UMR Bronson Commercial |
$1,600.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,727.68
|
|
|
HC CT ABDOMEN AND PELVIS W CON
|
Facility
|
OP
|
$3,636.90
|
|
|
Service Code
|
CPT 74177
|
| Hospital Charge Code |
35200027
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$186.99 |
| Max. Negotiated Rate |
$3,273.21 |
| Rate for Payer: Aetna American Axle |
$2,363.98
|
| Rate for Payer: Aetna Commercial |
$3,091.36
|
| Rate for Payer: Aetna Medicare |
$355.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,363.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$427.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$427.30
|
| Rate for Payer: BCBS Complete |
$196.35
|
| Rate for Payer: BCBS MAPPO |
$341.84
|
| Rate for Payer: BCBS Trust/PPO |
$439.64
|
| Rate for Payer: BCN Medicare Advantage |
$341.84
|
| Rate for Payer: Cash Price |
$2,909.52
|
| Rate for Payer: Cash Price |
$2,909.52
|
| Rate for Payer: Cofinity Commercial |
$2,545.83
|
| Rate for Payer: Cofinity Commercial |
$3,127.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,909.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$341.84
|
| Rate for Payer: Healthscope Commercial |
$3,273.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,545.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,727.68
|
| Rate for Payer: Mclaren Medicaid |
$186.99
|
| Rate for Payer: Mclaren Medicare |
$341.84
|
| Rate for Payer: Meridian Medicaid |
$196.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$358.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$393.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,091.36
|
| Rate for Payer: PACE Medicare |
$324.75
|
| Rate for Payer: PACE SWMI |
$341.84
|
| Rate for Payer: PHP Commercial |
$3,091.36
|
| Rate for Payer: PHP Medicare Advantage |
$341.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,545.83
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,076.13
|
| Rate for Payer: Priority Health Medicare |
$341.84
|
| Rate for Payer: Priority Health Narrow Network |
$860.90
|
| Rate for Payer: Priority Health SBD |
$2,291.25
|
| Rate for Payer: Railroad Medicare Medicare |
$341.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$336.41
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$341.84
|
| Rate for Payer: UHC Exchange |
$305.83
|
| Rate for Payer: UHC Medicare Advantage |
$352.10
|
| Rate for Payer: UMR Bronson Commercial |
$1,345.65
|
| Rate for Payer: VA VA |
$341.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,727.68
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
IP
|
$2,453.20
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$1,079.41 |
| Max. Negotiated Rate |
$2,207.88 |
| Rate for Payer: Aetna American Axle |
$1,594.58
|
| Rate for Payer: Aetna Commercial |
$2,085.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.58
|
| Rate for Payer: Cash Price |
$1,962.56
|
| Rate for Payer: Cofinity Commercial |
$1,717.24
|
| Rate for Payer: Cofinity Commercial |
$2,109.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.56
|
| Rate for Payer: Healthscope Commercial |
$2,207.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,717.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,839.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,085.22
|
| Rate for Payer: PHP Commercial |
$2,085.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,717.24
|
| Rate for Payer: Priority Health SBD |
$1,545.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,079.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,839.90
|
|
|
HC CT ABDOMEN AND PELVIS WO CON
|
Facility
|
OP
|
$2,453.20
|
|
|
Service Code
|
CPT 74176
|
| Hospital Charge Code |
35200026
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$119.14 |
| Max. Negotiated Rate |
$2,207.88 |
| Rate for Payer: Aetna American Axle |
$1,594.58
|
| Rate for Payer: Aetna Commercial |
$2,085.22
|
| Rate for Payer: Aetna Medicare |
$226.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,594.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.26
|
| Rate for Payer: BCBS Complete |
$125.11
|
| Rate for Payer: BCBS MAPPO |
$217.81
|
| Rate for Payer: BCBS Trust/PPO |
$203.34
|
| Rate for Payer: BCN Medicare Advantage |
$217.81
|
| Rate for Payer: Cash Price |
$1,962.56
|
| Rate for Payer: Cash Price |
$1,962.56
|
| Rate for Payer: Cofinity Commercial |
$2,109.75
|
| Rate for Payer: Cofinity Commercial |
$1,717.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,962.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.81
|
| Rate for Payer: Healthscope Commercial |
$2,207.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,717.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,839.90
|
| Rate for Payer: Mclaren Medicaid |
$119.14
|
| Rate for Payer: Mclaren Medicare |
$217.81
|
| Rate for Payer: Meridian Medicaid |
$125.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$228.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,085.22
|
| Rate for Payer: PACE Medicare |
$206.92
|
| Rate for Payer: PACE SWMI |
$217.81
|
| Rate for Payer: PHP Commercial |
$2,085.22
|
| Rate for Payer: PHP Medicare Advantage |
$217.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$119.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,717.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$685.66
|
| Rate for Payer: Priority Health Medicare |
$217.81
|
| Rate for Payer: Priority Health Narrow Network |
$548.53
|
| Rate for Payer: Priority Health SBD |
$1,545.52
|
| Rate for Payer: Railroad Medicare Medicare |
$217.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.78
|
| Rate for Payer: UHC Core |
$1,048.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.81
|
| Rate for Payer: UHC Exchange |
$184.35
|
| Rate for Payer: UHC Medicare Advantage |
$224.34
|
| Rate for Payer: UMR Bronson Commercial |
$907.68
|
| Rate for Payer: VA VA |
$217.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,839.90
|
|
