|
HC ACETYLCHOLINESTERASE AMNIOTIC
|
Facility
|
OP
|
$110.78
|
|
|
Service Code
|
CPT 82013
|
| Hospital Charge Code |
30100069
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$99.70 |
| Rate for Payer: Aetna American Axle |
$72.01
|
| Rate for Payer: Aetna Commercial |
$94.16
|
| Rate for Payer: Aetna Medicare |
$12.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.36
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS MAPPO |
$12.29
|
| Rate for Payer: BCBS Trust/PPO |
$14.21
|
| Rate for Payer: BCN Commercial |
$14.21
|
| Rate for Payer: BCN Medicare Advantage |
$12.29
|
| Rate for Payer: Cash Price |
$88.62
|
| Rate for Payer: Cash Price |
$88.62
|
| Rate for Payer: Cofinity Advantage |
$77.55
|
| Rate for Payer: Cofinity Commercial |
$95.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.29
|
| Rate for Payer: Healthscope Commercial |
$99.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.08
|
| Rate for Payer: Mclaren Medicaid |
$12.29
|
| Rate for Payer: Mclaren Medicare |
$12.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.90
|
| Rate for Payer: Meridian Medicaid |
$12.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.16
|
| Rate for Payer: Nomi Health Commercial |
$18.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.08
|
| Rate for Payer: PACE Medicare |
$11.68
|
| Rate for Payer: PACE SWMI |
$12.29
|
| Rate for Payer: PHP Commercial |
$94.16
|
| Rate for Payer: PHP Medicare Advantage |
$12.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.29
|
| Rate for Payer: Priority Health Medicare |
$12.29
|
| Rate for Payer: Priority Health SBD |
$69.79
|
| Rate for Payer: Priority Health Tiered Network |
$9.83
|
| Rate for Payer: Railroad Medicare Medicare |
$12.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.44
|
| Rate for Payer: UHC Core |
$18.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.29
|
| Rate for Payer: UHC Exchange |
$18.44
|
| Rate for Payer: UHC Medicaid |
$6.43
|
| Rate for Payer: UHCCP Medicaid |
$6.43
|
| Rate for Payer: UMR Bronson Commercial |
$40.99
|
| Rate for Payer: VA VA |
$12.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.08
|
|
|
HC ACETYLCHOLINESTERASE AMNIOTIC
|
Facility
|
IP
|
$110.78
|
|
|
Service Code
|
CPT 82013
|
| Hospital Charge Code |
30100069
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.74 |
| Max. Negotiated Rate |
$99.70 |
| Rate for Payer: Aetna American Axle |
$72.01
|
| Rate for Payer: Aetna Commercial |
$94.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.01
|
| Rate for Payer: Cash Price |
$88.62
|
| Rate for Payer: Cofinity Advantage |
$77.55
|
| Rate for Payer: Cofinity Commercial |
$95.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.62
|
| Rate for Payer: Healthscope Commercial |
$99.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.08
|
| Rate for Payer: PHP Commercial |
$94.16
|
| Rate for Payer: Priority Health SBD |
$69.79
|
| Rate for Payer: UMR Bronson Commercial |
$48.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.08
|
|
|
HC ACH RECEPTOR MUSCLE MOD AB
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30000061
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna American Axle |
$65.53
|
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$63.52
|
| Rate for Payer: Priority Health Tiered Network |
$14.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.60
|
| Rate for Payer: UHC Core |
$27.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$27.60
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UMR Bronson Commercial |
$37.30
|
| Rate for Payer: VA VA |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC ACH RECEPTOR MUSCLE MOD AB
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30000061
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.36 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna American Axle |
$65.53
|
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: Priority Health SBD |
$63.52
|
| Rate for Payer: UMR Bronson Commercial |
$44.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC ACHR GANGLIONIC NEURONAL AB
|
Facility
|
OP
|
$91.26
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$82.13 |
| Rate for Payer: Aetna American Axle |
$59.32
|
| Rate for Payer: Aetna Commercial |
$77.57
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cofinity Advantage |
$63.88
|
| Rate for Payer: Cofinity Commercial |
$78.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$82.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.44
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.57
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.44
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$77.57
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$57.49
|
| Rate for Payer: Priority Health Tiered Network |
$14.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.60
|
| Rate for Payer: UHC Core |
$27.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$27.60
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UMR Bronson Commercial |
$33.77
|
| Rate for Payer: VA VA |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.44
|
|
|
HC ACHR GANGLIONIC NEURONAL AB
|
Facility
|
IP
|
$91.26
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.15 |
| Max. Negotiated Rate |
$82.13 |
| Rate for Payer: Aetna American Axle |
$59.32
|
| Rate for Payer: Aetna Commercial |
$77.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.32
|
| Rate for Payer: Cash Price |
$73.01
|
| Rate for Payer: Cofinity Advantage |
$63.88
|
| Rate for Payer: Cofinity Commercial |
$78.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.01
|
| Rate for Payer: Healthscope Commercial |
$82.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.44
|
| Rate for Payer: PHP Commercial |
$77.57
|
| Rate for Payer: Priority Health SBD |
$57.49
|
| Rate for Payer: UMR Bronson Commercial |
$40.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.44
|
|
|
HC ACHR MODULATING FLOW CYTOMETRY S
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 86043
|
| Hospital Charge Code |
30200519
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.20 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna American Axle |
$52.00
|
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Advantage |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: Priority Health SBD |
$50.40
|
| Rate for Payer: UMR Bronson Commercial |
$35.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC ACHR MODULATING FLOW CYTOMETRY S
|
Facility
|
OP
|
$80.00
|
|
|
Service Code
|
CPT 86043
|
| Hospital Charge Code |
30200519
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna American Axle |
$52.00
|
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.93
|
| Rate for Payer: BCN Commercial |
$13.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Advantage |
$56.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.00
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$50.40
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$29.60
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$66.84 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna American Axle |
$98.73
|
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.73
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Advantage |
$106.33
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: Priority Health SBD |
$95.70
|
| Rate for Payer: UMR Bronson Commercial |
$66.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$54.94 |
| Max. Negotiated Rate |
$414.63 |
| Rate for Payer: Aetna American Axle |
$98.73
|
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$54.94
|
| Rate for Payer: BCN Commercial |
$54.94
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Advantage |
$106.33
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$95.70
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.73
|
| Rate for Payer: UHC Core |
$79.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$59.70
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: UMR Bronson Commercial |
$56.20
|
| Rate for Payer: VA VA |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC ACTIGRAPHY
|
Facility
|
OP
|
$281.07
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$30.74 |
| Max. Negotiated Rate |
$252.96 |
| Rate for Payer: Aetna American Axle |
$182.70
|
| Rate for Payer: Aetna Commercial |
$238.91
|
| Rate for Payer: Aetna Medicare |
$61.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$73.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$73.47
|
| Rate for Payer: BCBS Complete |
$32.28
|
| Rate for Payer: BCBS MAPPO |
$58.78
|
| Rate for Payer: BCN Medicare Advantage |
$58.78
|
| Rate for Payer: Cash Price |
$224.86
|
| Rate for Payer: Cash Price |
$224.86
|
| Rate for Payer: Cofinity Advantage |
$196.75
|
| Rate for Payer: Cofinity Commercial |
$241.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.78
|
| Rate for Payer: Healthscope Commercial |
$252.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.80
|
| Rate for Payer: Mclaren Medicaid |
$58.78
|
| Rate for Payer: Mclaren Medicare |
$58.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.72
|
| Rate for Payer: Meridian Medicaid |
$61.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$67.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$64.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.91
|
| Rate for Payer: Nomi Health Commercial |
$176.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.80
|
| Rate for Payer: PACE Medicare |
$55.84
|
| Rate for Payer: PACE SWMI |
$58.78
|
| Rate for Payer: PHP Commercial |
$238.91
|
| Rate for Payer: PHP Medicare Advantage |
$58.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$190.09
|
| Rate for Payer: Priority Health Medicare |
$58.78
|
| Rate for Payer: Priority Health SBD |
$177.07
|
| Rate for Payer: Priority Health Tiered Network |
$152.07
|
| Rate for Payer: Railroad Medicare Medicare |
$58.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$182.70
|
| Rate for Payer: UHC Core |
$146.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$58.78
|
| Rate for Payer: UHC Exchange |
$110.46
|
| Rate for Payer: UHC Medicaid |
$30.74
|
| Rate for Payer: UHCCP Medicaid |
$30.74
|
| Rate for Payer: UMR Bronson Commercial |
$104.00
|
| Rate for Payer: VA VA |
$58.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.80
|
|
|
HC ACTIGRAPHY
|
Facility
|
IP
|
$281.07
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$123.67 |
| Max. Negotiated Rate |
$252.96 |
| Rate for Payer: Aetna American Axle |
$182.70
|
| Rate for Payer: Aetna Commercial |
$238.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.70
|
| Rate for Payer: Cash Price |
$224.86
|
| Rate for Payer: Cofinity Advantage |
$196.75
|
| Rate for Payer: Cofinity Commercial |
$241.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.86
|
| Rate for Payer: Healthscope Commercial |
$252.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.80
|
| Rate for Payer: PHP Commercial |
$238.91
|
| Rate for Payer: Priority Health SBD |
$177.07
|
| Rate for Payer: UMR Bronson Commercial |
$123.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.80
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
IP
|
$94.45
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.56 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna American Axle |
$61.39
|
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.39
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Advantage |
$66.11
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: Priority Health SBD |
$59.50
|
| Rate for Payer: UMR Bronson Commercial |
$41.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
OP
|
$94.45
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna American Axle |
$61.39
|
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: Aetna Medicare |
$15.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$17.71
|
| Rate for Payer: BCN Commercial |
$17.71
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Advantage |
$66.11
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Mclaren Medicaid |
$15.32
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: Meridian Medicaid |
$16.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.32
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health SBD |
$59.50
|
| Rate for Payer: Priority Health Tiered Network |
$12.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.98
|
| Rate for Payer: UHC Core |
$22.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.32
|
| Rate for Payer: UHC Exchange |
$22.98
|
| Rate for Payer: UHC Medicaid |
$8.01
|
| Rate for Payer: UHCCP Medicaid |
$8.01
|
| Rate for Payer: UMR Bronson Commercial |
$34.95
|
| Rate for Payer: VA VA |
$15.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
OP
|
$67.92
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna American Axle |
$44.15
|
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna Medicare |
$15.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$17.71
|
| Rate for Payer: BCN Commercial |
$17.71
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Advantage |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Mclaren Medicaid |
$15.32
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: Meridian Medicaid |
$16.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.32
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health SBD |
$42.79
|
| Rate for Payer: Priority Health Tiered Network |
$12.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.98
|
| Rate for Payer: UHC Core |
$22.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.32
|
| Rate for Payer: UHC Exchange |
$22.98
|
| Rate for Payer: UHC Medicaid |
$8.01
|
| Rate for Payer: UHCCP Medicaid |
$8.01
|
| Rate for Payer: UMR Bronson Commercial |
$25.13
|
| Rate for Payer: VA VA |
$15.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
IP
|
$67.92
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.88 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna American Axle |
$44.15
|
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.15
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Advantage |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: Priority Health SBD |
$42.79
|
| Rate for Payer: UMR Bronson Commercial |
$29.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC ACUNAV CATHETER
|
Facility
|
IP
|
$5,836.64
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,568.12 |
| Max. Negotiated Rate |
$5,252.98 |
| Rate for Payer: Aetna American Axle |
$3,793.82
|
| Rate for Payer: Aetna Commercial |
$4,961.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,793.82
|
| Rate for Payer: Cash Price |
$4,669.31
|
| Rate for Payer: Cofinity Advantage |
$4,085.65
|
| Rate for Payer: Cofinity Commercial |
$5,019.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,669.31
|
| Rate for Payer: Healthscope Commercial |
$5,252.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,085.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,377.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,961.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,377.48
|
| Rate for Payer: PHP Commercial |
$4,961.14
|
| Rate for Payer: Priority Health SBD |
$3,677.08
|
| Rate for Payer: UMR Bronson Commercial |
$2,568.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,377.48
|
|
|
HC ACUNAV CATHETER
|
Facility
|
OP
|
$5,836.64
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,252.98 |
| Rate for Payer: Aetna American Axle |
$3,793.82
|
| Rate for Payer: Aetna Commercial |
$4,961.14
|
| Rate for Payer: Aetna Medicare |
$2,918.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,793.82
|
| Rate for Payer: BCBS Complete |
$2,334.66
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$4,669.31
|
| Rate for Payer: Cash Price |
$4,669.31
|
| Rate for Payer: Cofinity Advantage |
$4,085.65
|
| Rate for Payer: Cofinity Commercial |
$5,019.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,669.31
|
| Rate for Payer: Healthscope Commercial |
$5,252.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,085.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,377.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,669.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,961.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,377.48
|
| Rate for Payer: PHP Commercial |
$4,961.14
|
| Rate for Payer: Priority Health SBD |
$3,677.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,793.82
|
| Rate for Payer: UHC Core |
$3,040.89
|
| Rate for Payer: UHC Exchange |
$2,293.80
|
| Rate for Payer: UMR Bronson Commercial |
$2,159.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,377.48
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
OP
|
$147.98
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$54.75 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna American Axle |
$96.19
|
| Rate for Payer: Aetna Commercial |
$125.78
|
| Rate for Payer: Aetna Medicare |
$73.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.19
|
| Rate for Payer: BCBS Complete |
$59.19
|
| Rate for Payer: BCBS Trust/PPO |
$107.13
|
| Rate for Payer: BCN Commercial |
$107.13
|
| Rate for Payer: Cash Price |
$118.38
|
| Rate for Payer: Cash Price |
$118.38
|
| Rate for Payer: Cash Price |
$118.38
|
| Rate for Payer: Cash Price |
$118.38
|
| Rate for Payer: Cofinity Advantage |
$103.59
|
| Rate for Payer: Cofinity Commercial |
$127.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.38
|
| Rate for Payer: Healthscope Commercial |
$133.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.98
|
| Rate for Payer: PHP Commercial |
$125.78
|
| Rate for Payer: Priority Health SBD |
$93.23
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: UMR Bronson Commercial |
$54.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.98
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
IP
|
$147.98
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$65.11 |
| Max. Negotiated Rate |
$133.18 |
| Rate for Payer: Aetna American Axle |
$96.19
|
| Rate for Payer: Aetna Commercial |
$125.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.19
|
| Rate for Payer: Cash Price |
$118.38
|
| Rate for Payer: Cofinity Advantage |
$103.59
|
| Rate for Payer: Cofinity Commercial |
$127.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.38
|
| Rate for Payer: Healthscope Commercial |
$133.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.98
|
| Rate for Payer: PHP Commercial |
$125.78
|
| Rate for Payer: Priority Health SBD |
$93.23
|
| Rate for Payer: UMR Bronson Commercial |
$65.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.98
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
OP
|
$139.76
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$51.71 |
| Max. Negotiated Rate |
$125.78 |
| Rate for Payer: Aetna American Axle |
$90.84
|
| Rate for Payer: Aetna Commercial |
$118.80
|
| Rate for Payer: Aetna Medicare |
$69.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.84
|
| Rate for Payer: BCBS Complete |
$55.90
|
| Rate for Payer: Cash Price |
$111.81
|
| Rate for Payer: Cofinity Advantage |
$97.83
|
| Rate for Payer: Cofinity Commercial |
$120.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.81
|
| Rate for Payer: Healthscope Commercial |
$125.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.82
|
| Rate for Payer: PHP Commercial |
$118.80
|
| Rate for Payer: Priority Health SBD |
$88.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.84
|
| Rate for Payer: UHC Core |
$72.81
|
| Rate for Payer: UHC Exchange |
$54.93
|
| Rate for Payer: UMR Bronson Commercial |
$51.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.82
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
IP
|
$139.76
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$61.49 |
| Max. Negotiated Rate |
$125.78 |
| Rate for Payer: Aetna American Axle |
$90.84
|
| Rate for Payer: Aetna Commercial |
$118.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.84
|
| Rate for Payer: Cash Price |
$111.81
|
| Rate for Payer: Cofinity Advantage |
$97.83
|
| Rate for Payer: Cofinity Commercial |
$120.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.81
|
| Rate for Payer: Healthscope Commercial |
$125.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.82
|
| Rate for Payer: PHP Commercial |
$118.80
|
| Rate for Payer: Priority Health SBD |
$88.05
|
| Rate for Payer: UMR Bronson Commercial |
$61.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.82
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Advantage |
$26.94
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.87
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$24.77
|
| Rate for Payer: BCN Commercial |
$24.77
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Advantage |
$26.94
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.87
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: UMR Bronson Commercial |
$14.24
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$44.36 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna American Axle |
$65.53
|
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: Priority Health SBD |
$63.52
|
| Rate for Payer: UMR Bronson Commercial |
$44.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
