|
HC DUODERM CGF 6X6
|
Facility
|
IP
|
$74.12
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$32.61 |
| Max. Negotiated Rate |
$66.71 |
| Rate for Payer: Aetna American Axle |
$48.18
|
| Rate for Payer: Aetna Commercial |
$63.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.18
|
| Rate for Payer: Cash Price |
$59.30
|
| Rate for Payer: Cofinity Commercial |
$51.88
|
| Rate for Payer: Cofinity Commercial |
$63.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.30
|
| Rate for Payer: Healthscope Commercial |
$66.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$63.00
|
| Rate for Payer: PHP Commercial |
$63.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.88
|
| Rate for Payer: Priority Health SBD |
$46.70
|
| Rate for Payer: UMR Bronson Commercial |
$32.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.59
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
OP
|
$103.46
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$38.28 |
| Max. Negotiated Rate |
$93.11 |
| Rate for Payer: Aetna American Axle |
$67.25
|
| Rate for Payer: Aetna Commercial |
$87.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.25
|
| Rate for Payer: BCBS Complete |
$41.38
|
| Rate for Payer: Cash Price |
$82.77
|
| Rate for Payer: Cofinity Commercial |
$72.42
|
| Rate for Payer: Cofinity Commercial |
$88.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.77
|
| Rate for Payer: Healthscope Commercial |
$93.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.94
|
| Rate for Payer: PHP Commercial |
$87.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.42
|
| Rate for Payer: Priority Health SBD |
$65.18
|
| Rate for Payer: UMR Bronson Commercial |
$38.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.60
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
IP
|
$103.46
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$45.52 |
| Max. Negotiated Rate |
$93.11 |
| Rate for Payer: Aetna American Axle |
$67.25
|
| Rate for Payer: Aetna Commercial |
$87.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.25
|
| Rate for Payer: Cash Price |
$82.77
|
| Rate for Payer: Cofinity Commercial |
$72.42
|
| Rate for Payer: Cofinity Commercial |
$88.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.77
|
| Rate for Payer: Healthscope Commercial |
$93.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$87.94
|
| Rate for Payer: PHP Commercial |
$87.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.42
|
| Rate for Payer: Priority Health SBD |
$65.18
|
| Rate for Payer: UMR Bronson Commercial |
$45.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.60
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
IP
|
$637.47
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$280.49 |
| Max. Negotiated Rate |
$573.72 |
| Rate for Payer: Aetna American Axle |
$414.36
|
| Rate for Payer: Aetna Commercial |
$541.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.36
|
| Rate for Payer: Cash Price |
$509.98
|
| Rate for Payer: Cofinity Commercial |
$446.23
|
| Rate for Payer: Cofinity Commercial |
$548.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.98
|
| Rate for Payer: Healthscope Commercial |
$573.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$446.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.85
|
| Rate for Payer: PHP Commercial |
$541.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.23
|
| Rate for Payer: Priority Health SBD |
$401.61
|
| Rate for Payer: UMR Bronson Commercial |
$280.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.10
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
OP
|
$637.47
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$235.86 |
| Max. Negotiated Rate |
$573.72 |
| Rate for Payer: Aetna American Axle |
$414.36
|
| Rate for Payer: Aetna Commercial |
$541.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$414.36
|
| Rate for Payer: BCBS Complete |
$254.99
|
| Rate for Payer: Cash Price |
$509.98
|
| Rate for Payer: Cofinity Commercial |
$446.23
|
| Rate for Payer: Cofinity Commercial |
$548.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.98
|
| Rate for Payer: Healthscope Commercial |
$573.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$446.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$478.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$541.85
|
| Rate for Payer: PHP Commercial |
$541.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$446.23
|
| Rate for Payer: Priority Health SBD |
$401.61
|
| Rate for Payer: UMR Bronson Commercial |
$235.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$478.10
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
OP
|
$948.45
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$853.60 |
| Rate for Payer: Aetna American Axle |
$616.49
|
| Rate for Payer: Aetna Commercial |
$806.18
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$619.97
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$758.76
|
| Rate for Payer: Cash Price |
$758.76
|
| Rate for Payer: Cash Price |
$758.76
|
| Rate for Payer: Cofinity Commercial |
$815.67
|
| Rate for Payer: Cofinity Commercial |
$663.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$758.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$853.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$663.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$711.34
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$806.18
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$806.18
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$597.52
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.84
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$144.40
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$350.93
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$711.34
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
IP
|
$948.45
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$417.32 |
| Max. Negotiated Rate |
$853.60 |
| Rate for Payer: Aetna American Axle |
$616.49
|
| Rate for Payer: Aetna Commercial |
$806.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$616.49
|
| Rate for Payer: Cash Price |
$758.76
|
| Rate for Payer: Cofinity Commercial |
$663.92
|
| Rate for Payer: Cofinity Commercial |
$815.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$758.76
|
| Rate for Payer: Healthscope Commercial |
$853.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$663.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$711.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$806.18
|
| Rate for Payer: PHP Commercial |
$806.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$663.92
|
| Rate for Payer: Priority Health SBD |
$597.52
|
| Rate for Payer: UMR Bronson Commercial |
$417.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$711.34
|
|
|
HC DUST MITE DF IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
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 DUST MITE DF IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
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 DUST MITE DP IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
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 DUST MITE DP IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
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 |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| 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 DXA BONE DENSITY W FX ASSESS
|
Facility
|
OP
|
$767.51
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$52.39 |
| Max. Negotiated Rate |
$690.76 |
| Rate for Payer: Aetna American Axle |
$498.88
|
| Rate for Payer: Aetna Commercial |
$652.38
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$70.95
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$614.01
|
| Rate for Payer: Cash Price |
$614.01
|
| Rate for Payer: Cofinity Commercial |
$537.26
|
| Rate for Payer: Cofinity Commercial |
$660.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$690.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$537.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$575.63
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$652.38
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$652.38
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$483.53
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.63
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$52.39
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$283.98
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$575.63
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
IP
|
$767.51
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$337.70 |
| Max. Negotiated Rate |
$690.76 |
| Rate for Payer: Aetna American Axle |
$498.88
|
| Rate for Payer: Aetna Commercial |
$652.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$498.88
|
| Rate for Payer: Cash Price |
$614.01
|
| Rate for Payer: Cofinity Commercial |
$537.26
|
| Rate for Payer: Cofinity Commercial |
$660.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.01
|
| Rate for Payer: Healthscope Commercial |
$690.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$537.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$575.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$652.38
|
| Rate for Payer: PHP Commercial |
$652.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.26
|
| Rate for Payer: Priority Health SBD |
$483.53
|
| Rate for Payer: UMR Bronson Commercial |
$337.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$575.63
|
|
|
HC E72 MOUSE URINE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
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 E72 MOUSE URINE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
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 |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| 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 EAKIN SEAL 2"
|
Facility
|
IP
|
$12.29
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$11.06 |
| Rate for Payer: Aetna American Axle |
$7.99
|
| Rate for Payer: Aetna Commercial |
$10.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.99
|
| Rate for Payer: Cash Price |
$9.83
|
| Rate for Payer: Cofinity Commercial |
$10.57
|
| Rate for Payer: Cofinity Commercial |
$8.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.83
|
| Rate for Payer: Healthscope Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.45
|
| Rate for Payer: PHP Commercial |
$10.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.60
|
| Rate for Payer: Priority Health SBD |
$7.74
|
| Rate for Payer: UMR Bronson Commercial |
$5.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.22
|
|
|
HC EAKIN SEAL 2"
|
Facility
|
OP
|
$12.29
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.55 |
| Max. Negotiated Rate |
$11.06 |
| Rate for Payer: Aetna American Axle |
$7.99
|
| Rate for Payer: Aetna Commercial |
$10.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.99
|
| Rate for Payer: BCBS Complete |
$4.92
|
| Rate for Payer: Cash Price |
$9.83
|
| Rate for Payer: Cofinity Commercial |
$10.57
|
| Rate for Payer: Cofinity Commercial |
$8.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.83
|
| Rate for Payer: Healthscope Commercial |
$11.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.45
|
| Rate for Payer: PHP Commercial |
$10.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.60
|
| Rate for Payer: Priority Health SBD |
$7.74
|
| Rate for Payer: UMR Bronson Commercial |
$4.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.22
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
OP
|
$25.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$29.93 |
| Rate for Payer: Aetna American Axle |
$16.25
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.68
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.14
|
| Rate for Payer: BCBS Trust/PPO |
$16.32
|
| Rate for Payer: BCN Medicare Advantage |
$18.14
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.14
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PACE Medicare |
$17.23
|
| Rate for Payer: PACE SWMI |
$18.14
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: PHP Medicare Advantage |
$18.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$18.14
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: Railroad Medicare Medicare |
$18.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.77
|
| Rate for Payer: UHC Core |
$29.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.14
|
| Rate for Payer: UHC Exchange |
$18.14
|
| Rate for Payer: UHC Medicare Advantage |
$18.68
|
| Rate for Payer: UMR Bronson Commercial |
$9.25
|
| Rate for Payer: VA VA |
$18.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
IP
|
$25.00
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna American Axle |
$16.25
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.50
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$11.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
OP
|
$36.29
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.36 |
| Max. Negotiated Rate |
$32.66 |
| Rate for Payer: Aetna American Axle |
$23.59
|
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: Aetna Medicare |
$15.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.11
|
| Rate for Payer: BCBS Complete |
$8.78
|
| Rate for Payer: BCBS MAPPO |
$15.29
|
| Rate for Payer: BCBS Trust/PPO |
$13.75
|
| Rate for Payer: BCN Medicare Advantage |
$15.29
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$25.40
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.29
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.22
|
| Rate for Payer: Mclaren Medicaid |
$8.36
|
| Rate for Payer: Mclaren Medicare |
$15.29
|
| Rate for Payer: Meridian Medicaid |
$8.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PACE Medicare |
$14.53
|
| Rate for Payer: PACE SWMI |
$15.29
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: PHP Medicare Advantage |
$15.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$15.29
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$22.86
|
| Rate for Payer: Railroad Medicare Medicare |
$15.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.35
|
| Rate for Payer: UHC Core |
$25.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.29
|
| Rate for Payer: UHC Exchange |
$15.29
|
| Rate for Payer: UHC Medicare Advantage |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$13.43
|
| Rate for Payer: VA VA |
$15.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.22
|
|
|
HC EBV ANTIBODY PANEL, S
|
Facility
|
IP
|
$36.29
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200507
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.97 |
| Max. Negotiated Rate |
$32.66 |
| Rate for Payer: Aetna American Axle |
$23.59
|
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.59
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$25.40
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health SBD |
$22.86
|
| Rate for Payer: UMR Bronson Commercial |
$15.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.22
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.16 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: UMR Bronson Commercial |
$16.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EBV HETEROPHILE AB
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86309
|
| Hospital Charge Code |
30000169
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$5.82
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.87
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$7.10
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.76
|
| Rate for Payer: UHC Core |
$10.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicare Advantage |
$6.66
|
| Rate for Payer: UMR Bronson Commercial |
$13.59
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$28.48
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$40.80
|
| 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 |
$54.37
|
| 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 |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.84
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC ECG 1-3 LEADS TRACING ONLY
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 93041
|
| Hospital Charge Code |
73000003
|
|
Hospital Revenue Code
|
730
|
| 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
|
|
