|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
OP
|
$499.09
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$24.56 |
| Max. Negotiated Rate |
$449.18 |
| Rate for Payer: Aetna American Axle |
$324.41
|
| Rate for Payer: Aetna Commercial |
$424.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.41
|
| Rate for Payer: BCBS Complete |
$199.64
|
| Rate for Payer: BCBS Trust/PPO |
$139.75
|
| Rate for Payer: Cash Price |
$399.27
|
| Rate for Payer: Cash Price |
$399.27
|
| Rate for Payer: Cofinity Commercial |
$349.36
|
| Rate for Payer: Cofinity Commercial |
$429.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.27
|
| Rate for Payer: Healthscope Commercial |
$449.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$424.23
|
| Rate for Payer: PHP Commercial |
$424.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.36
|
| Rate for Payer: Priority Health SBD |
$314.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.02
|
| Rate for Payer: UHC Exchange |
$24.56
|
| Rate for Payer: UMR Bronson Commercial |
$184.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.32
|
|
|
HC DEBRIDE SQ TISSUE EACH ADDL 20SQ CM
|
Facility
|
IP
|
$499.09
|
|
|
Service Code
|
CPT 11045
|
| Hospital Charge Code |
36100405
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$219.60 |
| Max. Negotiated Rate |
$449.18 |
| Rate for Payer: Aetna American Axle |
$324.41
|
| Rate for Payer: Aetna Commercial |
$424.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$324.41
|
| Rate for Payer: Cash Price |
$399.27
|
| Rate for Payer: Cofinity Commercial |
$349.36
|
| Rate for Payer: Cofinity Commercial |
$429.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.27
|
| Rate for Payer: Healthscope Commercial |
$449.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$349.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$424.23
|
| Rate for Payer: PHP Commercial |
$424.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$349.36
|
| Rate for Payer: Priority Health SBD |
$314.43
|
| Rate for Payer: UMR Bronson Commercial |
$219.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.32
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
OP
|
$632.43
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$59.27 |
| Max. Negotiated Rate |
$1,115.78 |
| Rate for Payer: Aetna American Axle |
$411.08
|
| Rate for Payer: Aetna Commercial |
$537.57
|
| Rate for Payer: Aetna Medicare |
$368.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$443.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$443.04
|
| Rate for Payer: BCBS Complete |
$203.58
|
| Rate for Payer: BCBS MAPPO |
$354.43
|
| Rate for Payer: BCBS Trust/PPO |
$306.39
|
| Rate for Payer: BCN Medicare Advantage |
$354.43
|
| Rate for Payer: Cash Price |
$505.94
|
| Rate for Payer: Cash Price |
$505.94
|
| Rate for Payer: Cofinity Commercial |
$442.70
|
| Rate for Payer: Cofinity Commercial |
$543.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.43
|
| Rate for Payer: Healthscope Commercial |
$569.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$442.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.32
|
| Rate for Payer: Mclaren Medicaid |
$193.87
|
| Rate for Payer: Mclaren Medicare |
$354.43
|
| Rate for Payer: Meridian Medicaid |
$203.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$372.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$537.57
|
| Rate for Payer: PACE Medicare |
$336.71
|
| Rate for Payer: PACE SWMI |
$354.43
|
| Rate for Payer: PHP Commercial |
$537.57
|
| Rate for Payer: PHP Medicare Advantage |
$354.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,115.78
|
| Rate for Payer: Priority Health Medicare |
$354.43
|
| Rate for Payer: Priority Health Narrow Network |
$892.62
|
| Rate for Payer: Priority Health SBD |
$398.43
|
| Rate for Payer: Railroad Medicare Medicare |
$354.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.43
|
| Rate for Payer: UHC Exchange |
$59.27
|
| Rate for Payer: UHC Medicare Advantage |
$365.06
|
| Rate for Payer: UMR Bronson Commercial |
$234.00
|
| Rate for Payer: VA VA |
$354.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.32
|
|
|
HC DEBRIDE SQ TISSUE FIRST 20 SQ CM OR LESS
|
Facility
|
IP
|
$632.43
|
|
|
Service Code
|
CPT 11042
|
| Hospital Charge Code |
76100025
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$278.27 |
| Max. Negotiated Rate |
$569.19 |
| Rate for Payer: Aetna American Axle |
$411.08
|
| Rate for Payer: Aetna Commercial |
$537.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$411.08
|
| Rate for Payer: Cash Price |
$505.94
|
| Rate for Payer: Cofinity Commercial |
$442.70
|
| Rate for Payer: Cofinity Commercial |
$543.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$505.94
|
| Rate for Payer: Healthscope Commercial |
$569.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$442.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$474.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$537.57
|
| Rate for Payer: PHP Commercial |
$537.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$442.70
|
| Rate for Payer: Priority Health SBD |
$398.43
|
| Rate for Payer: UMR Bronson Commercial |
$278.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$474.32
|
|
|
HC DECALCIFICATION
|
Facility
|
OP
|
$36.82
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
31000051
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.88 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Aetna American Axle |
$23.93
|
| Rate for Payer: Aetna Commercial |
$31.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.93
|
| Rate for Payer: BCBS Complete |
$14.73
|
| Rate for Payer: BCBS Trust/PPO |
$11.88
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$31.67
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.46
|
| Rate for Payer: Healthscope Commercial |
$33.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.30
|
| Rate for Payer: PHP Commercial |
$31.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.77
|
| Rate for Payer: Priority Health SBD |
$23.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.97
|
| Rate for Payer: UHC Core |
$15.25
|
| Rate for Payer: UHC Exchange |
$19.97
|
| Rate for Payer: UMR Bronson Commercial |
$13.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.62
|
|
|
HC DECALCIFICATION
|
Facility
|
IP
|
$36.82
|
|
|
Service Code
|
CPT 88311
|
| Hospital Charge Code |
31000051
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Aetna American Axle |
$23.93
|
| Rate for Payer: Aetna Commercial |
$31.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.93
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Cofinity Commercial |
$31.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.46
|
| Rate for Payer: Healthscope Commercial |
$33.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.30
|
| Rate for Payer: PHP Commercial |
$31.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.77
|
| Rate for Payer: Priority Health SBD |
$23.20
|
| Rate for Payer: UMR Bronson Commercial |
$16.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.62
|
|
|
HC DECLOT BY THROMBOLYTIC
|
Facility
|
IP
|
$473.69
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
76100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$208.42 |
| Max. Negotiated Rate |
$426.32 |
| Rate for Payer: Aetna American Axle |
$307.90
|
| Rate for Payer: Aetna Commercial |
$402.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.90
|
| Rate for Payer: Cash Price |
$378.95
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Cofinity Commercial |
$407.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.95
|
| Rate for Payer: Healthscope Commercial |
$426.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$331.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$355.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$402.64
|
| Rate for Payer: PHP Commercial |
$402.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.58
|
| Rate for Payer: Priority Health SBD |
$298.42
|
| Rate for Payer: UMR Bronson Commercial |
$208.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$355.27
|
|
|
HC DECLOT BY THROMBOLYTIC
|
Facility
|
OP
|
$473.69
|
|
|
Service Code
|
CPT 36593
|
| Hospital Charge Code |
76100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$34.05 |
| Max. Negotiated Rate |
$947.66 |
| Rate for Payer: Aetna American Axle |
$307.90
|
| Rate for Payer: Aetna Commercial |
$402.64
|
| Rate for Payer: Aetna Medicare |
$313.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$376.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$376.29
|
| Rate for Payer: BCBS Complete |
$172.91
|
| Rate for Payer: BCBS MAPPO |
$301.03
|
| Rate for Payer: BCBS Trust/PPO |
$355.70
|
| Rate for Payer: BCN Medicare Advantage |
$301.03
|
| Rate for Payer: Cash Price |
$378.95
|
| Rate for Payer: Cash Price |
$378.95
|
| Rate for Payer: Cofinity Commercial |
$331.58
|
| Rate for Payer: Cofinity Commercial |
$407.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$301.03
|
| Rate for Payer: Healthscope Commercial |
$426.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$331.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$355.27
|
| Rate for Payer: Mclaren Medicaid |
$164.66
|
| Rate for Payer: Mclaren Medicare |
$301.03
|
| Rate for Payer: Meridian Medicaid |
$172.91
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$316.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$346.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$402.64
|
| Rate for Payer: PACE Medicare |
$285.98
|
| Rate for Payer: PACE SWMI |
$301.03
|
| Rate for Payer: PHP Commercial |
$402.64
|
| Rate for Payer: PHP Medicare Advantage |
$301.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$331.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$947.66
|
| Rate for Payer: Priority Health Medicare |
$301.03
|
| Rate for Payer: Priority Health Narrow Network |
$758.13
|
| Rate for Payer: Priority Health SBD |
$298.42
|
| Rate for Payer: Railroad Medicare Medicare |
$301.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$301.03
|
| Rate for Payer: UHC Exchange |
$34.05
|
| Rate for Payer: UHC Medicare Advantage |
$310.06
|
| Rate for Payer: UMR Bronson Commercial |
$175.27
|
| Rate for Payer: VA VA |
$301.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$355.27
|
|
|
HC DECONTAMINATION AMB/SELF-DIRECTED
|
Facility
|
OP
|
$140.57
|
|
| Hospital Charge Code |
27000613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$52.01 |
| Max. Negotiated Rate |
$126.51 |
| Rate for Payer: Aetna American Axle |
$91.37
|
| Rate for Payer: Aetna Commercial |
$119.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.37
|
| Rate for Payer: BCBS Complete |
$56.23
|
| Rate for Payer: Cash Price |
$112.46
|
| Rate for Payer: Cofinity Commercial |
$120.89
|
| Rate for Payer: Cofinity Commercial |
$98.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.46
|
| Rate for Payer: Healthscope Commercial |
$126.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.48
|
| Rate for Payer: PHP Commercial |
$119.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.40
|
| Rate for Payer: Priority Health SBD |
$88.56
|
| Rate for Payer: UMR Bronson Commercial |
$52.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.43
|
|
|
HC DECONTAMINATION AMB/SELF-DIRECTED
|
Facility
|
IP
|
$140.57
|
|
| Hospital Charge Code |
27000613
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$61.85 |
| Max. Negotiated Rate |
$126.51 |
| Rate for Payer: Aetna American Axle |
$91.37
|
| Rate for Payer: Aetna Commercial |
$119.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.37
|
| Rate for Payer: Cash Price |
$112.46
|
| Rate for Payer: Cofinity Commercial |
$120.89
|
| Rate for Payer: Cofinity Commercial |
$98.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.46
|
| Rate for Payer: Healthscope Commercial |
$126.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.48
|
| Rate for Payer: PHP Commercial |
$119.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.40
|
| Rate for Payer: Priority Health SBD |
$88.56
|
| Rate for Payer: UMR Bronson Commercial |
$61.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.43
|
|
|
HC DECONTAMINATION AMB W/ASSIST
|
Facility
|
OP
|
$807.11
|
|
| Hospital Charge Code |
27000026
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$298.63 |
| Max. Negotiated Rate |
$726.40 |
| Rate for Payer: Aetna American Axle |
$524.62
|
| Rate for Payer: Aetna Commercial |
$686.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.62
|
| Rate for Payer: BCBS Complete |
$322.84
|
| Rate for Payer: Cash Price |
$645.69
|
| Rate for Payer: Cofinity Commercial |
$564.98
|
| Rate for Payer: Cofinity Commercial |
$694.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.69
|
| Rate for Payer: Healthscope Commercial |
$726.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$564.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$605.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$686.04
|
| Rate for Payer: PHP Commercial |
$686.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.98
|
| Rate for Payer: Priority Health SBD |
$508.48
|
| Rate for Payer: UMR Bronson Commercial |
$298.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$605.33
|
|
|
HC DECONTAMINATION AMB W/ASSIST
|
Facility
|
IP
|
$807.11
|
|
| Hospital Charge Code |
27000026
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$355.13 |
| Max. Negotiated Rate |
$726.40 |
| Rate for Payer: Aetna American Axle |
$524.62
|
| Rate for Payer: Aetna Commercial |
$686.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$524.62
|
| Rate for Payer: Cash Price |
$645.69
|
| Rate for Payer: Cofinity Commercial |
$564.98
|
| Rate for Payer: Cofinity Commercial |
$694.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$645.69
|
| Rate for Payer: Healthscope Commercial |
$726.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$564.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$605.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$686.04
|
| Rate for Payer: PHP Commercial |
$686.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$564.98
|
| Rate for Payer: Priority Health SBD |
$508.48
|
| Rate for Payer: UMR Bronson Commercial |
$355.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$605.33
|
|
|
HC DECONTAMINATION NON AMBULATORY
|
Facility
|
OP
|
$1,614.20
|
|
| Hospital Charge Code |
27000126
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$597.25 |
| Max. Negotiated Rate |
$1,452.78 |
| Rate for Payer: Aetna American Axle |
$1,049.23
|
| Rate for Payer: Aetna Commercial |
$1,372.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.23
|
| Rate for Payer: BCBS Complete |
$645.68
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cofinity Commercial |
$1,129.94
|
| Rate for Payer: Cofinity Commercial |
$1,388.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.36
|
| Rate for Payer: Healthscope Commercial |
$1,452.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,129.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,372.07
|
| Rate for Payer: PHP Commercial |
$1,372.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.94
|
| Rate for Payer: Priority Health SBD |
$1,016.95
|
| Rate for Payer: UMR Bronson Commercial |
$597.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.65
|
|
|
HC DECONTAMINATION NON AMBULATORY
|
Facility
|
IP
|
$1,614.20
|
|
| Hospital Charge Code |
27000126
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$710.25 |
| Max. Negotiated Rate |
$1,452.78 |
| Rate for Payer: Aetna American Axle |
$1,049.23
|
| Rate for Payer: Aetna Commercial |
$1,372.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,049.23
|
| Rate for Payer: Cash Price |
$1,291.36
|
| Rate for Payer: Cofinity Commercial |
$1,129.94
|
| Rate for Payer: Cofinity Commercial |
$1,388.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,291.36
|
| Rate for Payer: Healthscope Commercial |
$1,452.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,129.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,210.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,372.07
|
| Rate for Payer: PHP Commercial |
$1,372.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,129.94
|
| Rate for Payer: Priority Health SBD |
$1,016.95
|
| Rate for Payer: UMR Bronson Commercial |
$710.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,210.65
|
|
|
HC DEFINITY CONTRAST 1ST ML
|
Facility
|
OP
|
$290.29
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600002
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.18 |
| Max. Negotiated Rate |
$261.26 |
| Rate for Payer: Aetna American Axle |
$188.69
|
| Rate for Payer: Aetna Commercial |
$246.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.69
|
| Rate for Payer: BCBS Complete |
$116.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.18
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$249.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.23
|
| Rate for Payer: Healthscope Commercial |
$261.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.75
|
| Rate for Payer: PHP Commercial |
$246.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.20
|
| Rate for Payer: Priority Health SBD |
$182.88
|
| Rate for Payer: UMR Bronson Commercial |
$107.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.72
|
|
|
HC DEFINITY CONTRAST 1ST ML
|
Facility
|
IP
|
$290.29
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600002
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$127.73 |
| Max. Negotiated Rate |
$261.26 |
| Rate for Payer: Aetna American Axle |
$188.69
|
| Rate for Payer: Aetna Commercial |
$246.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.69
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$249.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.23
|
| Rate for Payer: Healthscope Commercial |
$261.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.75
|
| Rate for Payer: PHP Commercial |
$246.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.20
|
| Rate for Payer: Priority Health SBD |
$182.88
|
| Rate for Payer: UMR Bronson Commercial |
$127.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.72
|
|
|
HC DEFINITY CONTRAST 2ND ML
|
Facility
|
OP
|
$290.29
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$52.18 |
| Max. Negotiated Rate |
$261.26 |
| Rate for Payer: Aetna American Axle |
$188.69
|
| Rate for Payer: Aetna Commercial |
$246.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.69
|
| Rate for Payer: BCBS Complete |
$116.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.18
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$249.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.23
|
| Rate for Payer: Healthscope Commercial |
$261.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.75
|
| Rate for Payer: PHP Commercial |
$246.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.20
|
| Rate for Payer: Priority Health SBD |
$182.88
|
| Rate for Payer: UMR Bronson Commercial |
$107.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.72
|
|
|
HC DEFINITY CONTRAST 2ND ML
|
Facility
|
IP
|
$290.29
|
|
|
Service Code
|
HCPCS Q9957
|
| Hospital Charge Code |
63600003
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$127.73 |
| Max. Negotiated Rate |
$261.26 |
| Rate for Payer: Aetna American Axle |
$188.69
|
| Rate for Payer: Aetna Commercial |
$246.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$188.69
|
| Rate for Payer: Cash Price |
$232.23
|
| Rate for Payer: Cofinity Commercial |
$203.20
|
| Rate for Payer: Cofinity Commercial |
$249.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$232.23
|
| Rate for Payer: Healthscope Commercial |
$261.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$203.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$217.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$246.75
|
| Rate for Payer: PHP Commercial |
$246.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$203.20
|
| Rate for Payer: Priority Health SBD |
$182.88
|
| Rate for Payer: UMR Bronson Commercial |
$127.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$217.72
|
|
|
HC DEGARELIX INJECTION PER 1MG
|
Facility
|
IP
|
$6.12
|
|
|
Service Code
|
HCPCS J9155
|
| Hospital Charge Code |
63600146
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$5.51 |
| Rate for Payer: Aetna American Axle |
$3.98
|
| Rate for Payer: Aetna Commercial |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.98
|
| Rate for Payer: Cash Price |
$4.90
|
| Rate for Payer: Cofinity Commercial |
$4.28
|
| Rate for Payer: Cofinity Commercial |
$5.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.90
|
| Rate for Payer: Healthscope Commercial |
$5.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.20
|
| Rate for Payer: PHP Commercial |
$5.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.28
|
| Rate for Payer: Priority Health SBD |
$3.86
|
| Rate for Payer: UMR Bronson Commercial |
$2.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.59
|
|
|
HC DEGARELIX INJECTION PER 1MG
|
Facility
|
OP
|
$6.12
|
|
|
Service Code
|
HCPCS J9155
|
| Hospital Charge Code |
63600146
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$13.51 |
| Rate for Payer: Aetna American Axle |
$3.98
|
| Rate for Payer: Aetna Commercial |
$5.20
|
| Rate for Payer: Aetna Medicare |
$4.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.23
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.19
|
| Rate for Payer: BCBS Trust/PPO |
$13.51
|
| Rate for Payer: BCN Medicare Advantage |
$4.19
|
| Rate for Payer: Cash Price |
$4.90
|
| Rate for Payer: Cash Price |
$4.90
|
| Rate for Payer: Cofinity Commercial |
$5.26
|
| Rate for Payer: Cofinity Commercial |
$4.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.19
|
| Rate for Payer: Healthscope Commercial |
$5.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.59
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.19
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.20
|
| Rate for Payer: PACE Medicare |
$3.98
|
| Rate for Payer: PACE SWMI |
$4.19
|
| Rate for Payer: PHP Commercial |
$5.20
|
| Rate for Payer: PHP Medicare Advantage |
$4.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.11
|
| Rate for Payer: Priority Health Medicare |
$4.19
|
| Rate for Payer: Priority Health Narrow Network |
$9.69
|
| Rate for Payer: Priority Health SBD |
$3.86
|
| Rate for Payer: Railroad Medicare Medicare |
$4.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.19
|
| Rate for Payer: UHC Medicare Advantage |
$4.31
|
| Rate for Payer: UMR Bronson Commercial |
$2.26
|
| Rate for Payer: VA VA |
$4.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.59
|
|
|
HC DEGLYCEROLIZED RED BLOOD CELLS
|
Facility
|
IP
|
$925.55
|
|
|
Service Code
|
HCPCS P9039
|
| Hospital Charge Code |
39000049
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$407.24 |
| Max. Negotiated Rate |
$833.00 |
| Rate for Payer: Aetna American Axle |
$601.61
|
| Rate for Payer: Aetna Commercial |
$786.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.61
|
| Rate for Payer: Cash Price |
$740.44
|
| Rate for Payer: Cofinity Commercial |
$647.88
|
| Rate for Payer: Cofinity Commercial |
$795.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$740.44
|
| Rate for Payer: Healthscope Commercial |
$833.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$647.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$694.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$786.72
|
| Rate for Payer: PHP Commercial |
$786.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.88
|
| Rate for Payer: Priority Health SBD |
$583.10
|
| Rate for Payer: UMR Bronson Commercial |
$407.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$694.16
|
|
|
HC DEGLYCEROLIZED RED BLOOD CELLS
|
Facility
|
OP
|
$925.55
|
|
|
Service Code
|
HCPCS P9039
|
| Hospital Charge Code |
39000049
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$158.76 |
| Max. Negotiated Rate |
$1,310.64 |
| Rate for Payer: Aetna American Axle |
$601.61
|
| Rate for Payer: Aetna Commercial |
$786.72
|
| Rate for Payer: Aetna Medicare |
$301.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$601.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$362.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$362.80
|
| Rate for Payer: BCBS Complete |
$166.71
|
| Rate for Payer: BCBS MAPPO |
$290.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,310.64
|
| Rate for Payer: BCN Medicare Advantage |
$290.24
|
| Rate for Payer: Cash Price |
$740.44
|
| Rate for Payer: Cash Price |
$740.44
|
| Rate for Payer: Cash Price |
$740.44
|
| Rate for Payer: Cofinity Commercial |
$647.88
|
| Rate for Payer: Cofinity Commercial |
$795.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$740.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$290.24
|
| Rate for Payer: Healthscope Commercial |
$833.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$647.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$694.16
|
| Rate for Payer: Mclaren Medicaid |
$158.76
|
| Rate for Payer: Mclaren Medicare |
$290.24
|
| Rate for Payer: Meridian Medicaid |
$166.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$304.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$333.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$786.72
|
| Rate for Payer: PACE Medicare |
$275.73
|
| Rate for Payer: PACE SWMI |
$290.24
|
| Rate for Payer: PHP Commercial |
$786.72
|
| Rate for Payer: PHP Medicare Advantage |
$290.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$647.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$913.71
|
| Rate for Payer: Priority Health Medicare |
$290.24
|
| Rate for Payer: Priority Health Narrow Network |
$730.97
|
| Rate for Payer: Priority Health SBD |
$583.10
|
| Rate for Payer: Railroad Medicare Medicare |
$290.24
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$290.24
|
| Rate for Payer: UHC Medicare Advantage |
$298.95
|
| Rate for Payer: UMR Bronson Commercial |
$342.45
|
| Rate for Payer: VA VA |
$290.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$694.16
|
|
|
HC DELIVERY/BIRTH RM RESUSCITATION
|
Facility
|
IP
|
$820.78
|
|
|
Service Code
|
CPT 99465
|
| Hospital Charge Code |
72000011
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$361.14 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$533.51
|
| Rate for Payer: Aetna Commercial |
$697.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.51
|
| Rate for Payer: Cash Price |
$656.62
|
| Rate for Payer: Cofinity Commercial |
$574.55
|
| Rate for Payer: Cofinity Commercial |
$705.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.62
|
| Rate for Payer: Healthscope Commercial |
$738.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$697.66
|
| Rate for Payer: PHP Commercial |
$697.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.55
|
| Rate for Payer: Priority Health SBD |
$517.09
|
| Rate for Payer: UMR Bronson Commercial |
$361.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.58
|
|
|
HC DELIVERY/BIRTH RM RESUSCITATION
|
Facility
|
OP
|
$820.78
|
|
|
Service Code
|
CPT 99465
|
| Hospital Charge Code |
72000011
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$137.85 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna American Axle |
$533.51
|
| Rate for Payer: Aetna Commercial |
$697.66
|
| Rate for Payer: Aetna Medicare |
$601.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$533.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$723.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$723.12
|
| Rate for Payer: BCBS Complete |
$332.29
|
| Rate for Payer: BCBS MAPPO |
$578.50
|
| Rate for Payer: BCN Medicare Advantage |
$578.50
|
| Rate for Payer: Cash Price |
$656.62
|
| Rate for Payer: Cash Price |
$656.62
|
| Rate for Payer: Cash Price |
$656.62
|
| Rate for Payer: Cofinity Commercial |
$705.87
|
| Rate for Payer: Cofinity Commercial |
$574.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$656.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$578.50
|
| Rate for Payer: Healthscope Commercial |
$738.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$574.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$615.58
|
| Rate for Payer: Mclaren Medicaid |
$316.44
|
| Rate for Payer: Mclaren Medicare |
$578.50
|
| Rate for Payer: Meridian Medicaid |
$332.29
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$607.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$665.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$697.66
|
| Rate for Payer: PACE Medicare |
$549.58
|
| Rate for Payer: PACE SWMI |
$578.50
|
| Rate for Payer: PHP Commercial |
$697.66
|
| Rate for Payer: PHP Medicare Advantage |
$578.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$316.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,821.15
|
| Rate for Payer: Priority Health Medicare |
$578.50
|
| Rate for Payer: Priority Health Narrow Network |
$1,456.92
|
| Rate for Payer: Priority Health SBD |
$517.09
|
| Rate for Payer: Railroad Medicare Medicare |
$578.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.64
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$578.50
|
| Rate for Payer: UHC Exchange |
$137.85
|
| Rate for Payer: UHC Medicare Advantage |
$595.86
|
| Rate for Payer: UMR Bronson Commercial |
$303.69
|
| Rate for Payer: VA VA |
$578.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$615.58
|
|
|
HC DEMO EVAL NEB MDI IPPB
|
Facility
|
OP
|
$240.13
|
|
|
Service Code
|
CPT 94664
|
| Hospital Charge Code |
41000009
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$17.68 |
| Max. Negotiated Rate |
$596.84 |
| Rate for Payer: Aetna American Axle |
$156.08
|
| Rate for Payer: Aetna Commercial |
$204.11
|
| Rate for Payer: Aetna Medicare |
$197.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$83.80
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$192.10
|
| Rate for Payer: Cash Price |
$192.10
|
| Rate for Payer: Cash Price |
$192.10
|
| Rate for Payer: Cofinity Commercial |
$206.51
|
| Rate for Payer: Cofinity Commercial |
$168.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$216.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.10
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$204.11
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$204.11
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.84
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$477.47
|
| Rate for Payer: Priority Health SBD |
$151.28
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.45
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.59
|
| Rate for Payer: UHC Exchange |
$17.68
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: UMR Bronson Commercial |
$88.85
|
| Rate for Payer: VA VA |
$189.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.10
|
|
