|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.20 |
| 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 |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| 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 |
$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 |
$21.42
|
| 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 |
$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 |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$85.70
|
| 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 |
$63.52
|
| 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 |
$37.30
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$59.17
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Advantage |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: UMR Bronson Commercial |
$34.65
|
| Rate for Payer: VA VA |
$51.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Advantage |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: UMR Bronson Commercial |
$41.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
IP
|
$801.41
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$352.62 |
| Max. Negotiated Rate |
$721.27 |
| Rate for Payer: Aetna American Axle |
$520.92
|
| Rate for Payer: Aetna Commercial |
$681.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.92
|
| Rate for Payer: Cash Price |
$641.13
|
| Rate for Payer: Cofinity Advantage |
$560.99
|
| Rate for Payer: Cofinity Commercial |
$689.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.13
|
| Rate for Payer: Healthscope Commercial |
$721.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.06
|
| Rate for Payer: PHP Commercial |
$681.20
|
| Rate for Payer: Priority Health SBD |
$504.89
|
| Rate for Payer: UMR Bronson Commercial |
$352.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.06
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
OP
|
$801.41
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$296.52 |
| Max. Negotiated Rate |
$2,211.50 |
| Rate for Payer: Aetna American Axle |
$520.92
|
| Rate for Payer: Aetna Commercial |
$681.20
|
| Rate for Payer: Aetna Medicare |
$711.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$520.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$854.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$854.81
|
| Rate for Payer: BCBS Complete |
$375.57
|
| Rate for Payer: BCBS MAPPO |
$683.85
|
| Rate for Payer: BCN Medicare Advantage |
$683.85
|
| Rate for Payer: Cash Price |
$641.13
|
| Rate for Payer: Cash Price |
$641.13
|
| Rate for Payer: Cofinity Advantage |
$560.99
|
| Rate for Payer: Cofinity Commercial |
$689.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.85
|
| Rate for Payer: Healthscope Commercial |
$721.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$560.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.06
|
| Rate for Payer: Mclaren Medicaid |
$683.85
|
| Rate for Payer: Mclaren Medicare |
$683.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.04
|
| Rate for Payer: Meridian Medicaid |
$718.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.20
|
| Rate for Payer: Nomi Health Commercial |
$2,051.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.06
|
| Rate for Payer: PACE Medicare |
$649.66
|
| Rate for Payer: PACE SWMI |
$683.85
|
| Rate for Payer: PHP Commercial |
$681.20
|
| Rate for Payer: PHP Medicare Advantage |
$683.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,211.50
|
| Rate for Payer: Priority Health Medicare |
$683.85
|
| Rate for Payer: Priority Health SBD |
$504.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,769.20
|
| Rate for Payer: Railroad Medicare Medicare |
$683.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$520.92
|
| Rate for Payer: UHC Core |
$417.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.85
|
| Rate for Payer: UHC Exchange |
$314.95
|
| Rate for Payer: UHC Medicaid |
$357.65
|
| Rate for Payer: UHCCP Medicaid |
$357.65
|
| Rate for Payer: UMR Bronson Commercial |
$296.52
|
| Rate for Payer: VA VA |
$683.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.06
|
|
|
HC ACYLCARNITINES
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$17.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.09
|
| Rate for Payer: BCBS Complete |
$9.27
|
| Rate for Payer: BCBS MAPPO |
$16.87
|
| Rate for Payer: BCBS Trust/PPO |
$19.50
|
| Rate for Payer: BCN Commercial |
$19.50
|
| Rate for Payer: BCN Medicare Advantage |
$16.87
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.87
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$16.87
|
| Rate for Payer: Mclaren Medicare |
$16.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.71
|
| Rate for Payer: Meridian Medicaid |
$17.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$25.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$16.03
|
| Rate for Payer: PACE SWMI |
$16.87
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$16.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.87
|
| Rate for Payer: Priority Health Medicare |
$16.87
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Priority Health Tiered Network |
$13.50
|
| Rate for Payer: Railroad Medicare Medicare |
$16.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.31
|
| Rate for Payer: UHC Core |
$25.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.87
|
| Rate for Payer: UHC Exchange |
$25.31
|
| Rate for Payer: UHC Medicaid |
$8.82
|
| Rate for Payer: UHCCP Medicaid |
$8.82
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$16.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ACYLCARNITINES
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
OP
|
$210.16
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$189.14 |
| Rate for Payer: Aetna American Axle |
$136.60
|
| Rate for Payer: Aetna Commercial |
$178.64
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$168.13
|
| Rate for Payer: Cash Price |
$168.13
|
| Rate for Payer: Cofinity Advantage |
$147.11
|
| Rate for Payer: Cofinity Commercial |
$180.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$189.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.62
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.64
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.62
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$178.64
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$132.40
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$77.76
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.62
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
IP
|
$210.16
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.47 |
| Max. Negotiated Rate |
$189.14 |
| Rate for Payer: Aetna American Axle |
$136.60
|
| Rate for Payer: Aetna Commercial |
$178.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.60
|
| Rate for Payer: Cash Price |
$168.13
|
| Rate for Payer: Cofinity Advantage |
$147.11
|
| Rate for Payer: Cofinity Commercial |
$180.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.13
|
| Rate for Payer: Healthscope Commercial |
$189.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.62
|
| Rate for Payer: PHP Commercial |
$178.64
|
| Rate for Payer: Priority Health SBD |
$132.40
|
| Rate for Payer: UMR Bronson Commercial |
$92.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.62
|
|
|
HC ADALIMUMAB, S
|
Facility
|
IP
|
$306.92
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$135.04 |
| Max. Negotiated Rate |
$276.23 |
| Rate for Payer: Aetna American Axle |
$199.50
|
| Rate for Payer: Aetna Commercial |
$260.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.50
|
| Rate for Payer: Cash Price |
$245.54
|
| Rate for Payer: Cofinity Advantage |
$214.84
|
| Rate for Payer: Cofinity Commercial |
$263.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.54
|
| Rate for Payer: Healthscope Commercial |
$276.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.19
|
| Rate for Payer: PHP Commercial |
$260.88
|
| Rate for Payer: Priority Health SBD |
$193.36
|
| Rate for Payer: UMR Bronson Commercial |
$135.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.19
|
|
|
HC ADALIMUMAB, S
|
Facility
|
OP
|
$306.92
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$276.23 |
| Rate for Payer: Aetna American Axle |
$199.50
|
| Rate for Payer: Aetna Commercial |
$260.88
|
| Rate for Payer: Aetna Medicare |
$40.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.21
|
| Rate for Payer: BCBS Complete |
$21.18
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCBS Trust/PPO |
$44.59
|
| Rate for Payer: BCN Commercial |
$44.59
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$245.54
|
| Rate for Payer: Cash Price |
$245.54
|
| Rate for Payer: Cofinity Advantage |
$214.84
|
| Rate for Payer: Cofinity Commercial |
$263.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$276.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.19
|
| Rate for Payer: Mclaren Medicaid |
$38.57
|
| Rate for Payer: Mclaren Medicare |
$38.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: Meridian Medicaid |
$40.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.88
|
| Rate for Payer: Nomi Health Commercial |
$57.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.19
|
| Rate for Payer: PACE Medicare |
$36.64
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Commercial |
$260.88
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.57
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health SBD |
$193.36
|
| Rate for Payer: Priority Health Tiered Network |
$30.86
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.86
|
| Rate for Payer: UHC Core |
$57.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.57
|
| Rate for Payer: UHC Exchange |
$57.86
|
| Rate for Payer: UHC Medicaid |
$20.17
|
| Rate for Payer: UHCCP Medicaid |
$20.17
|
| Rate for Payer: UMR Bronson Commercial |
$113.56
|
| Rate for Payer: VA VA |
$38.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.19
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
OP
|
$163.97
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$147.57 |
| Rate for Payer: Aetna American Axle |
$106.58
|
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$35.68
|
| Rate for Payer: BCN Commercial |
$35.68
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cofinity Advantage |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$141.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$147.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.98
|
| Rate for Payer: Mclaren Medicaid |
$30.86
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$32.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.37
|
| Rate for Payer: Nomi Health Commercial |
$46.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.98
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$139.37
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.86
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health SBD |
$103.30
|
| Rate for Payer: Priority Health Tiered Network |
$24.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.29
|
| Rate for Payer: UHC Core |
$46.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.86
|
| Rate for Payer: UHC Exchange |
$46.29
|
| Rate for Payer: UHC Medicaid |
$16.14
|
| Rate for Payer: UHCCP Medicaid |
$16.14
|
| Rate for Payer: UMR Bronson Commercial |
$60.67
|
| Rate for Payer: VA VA |
$30.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.98
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
IP
|
$163.97
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$72.15 |
| Max. Negotiated Rate |
$147.57 |
| Rate for Payer: Aetna American Axle |
$106.58
|
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.58
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cofinity Advantage |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$141.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.18
|
| Rate for Payer: Healthscope Commercial |
$147.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.98
|
| Rate for Payer: PHP Commercial |
$139.37
|
| Rate for Payer: Priority Health SBD |
$103.30
|
| Rate for Payer: UMR Bronson Commercial |
$72.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.98
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
IP
|
$184.15
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$81.03 |
| Max. Negotiated Rate |
$165.74 |
| Rate for Payer: Aetna American Axle |
$119.70
|
| Rate for Payer: Aetna Commercial |
$156.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.70
|
| Rate for Payer: Cash Price |
$147.32
|
| Rate for Payer: Cofinity Advantage |
$128.91
|
| Rate for Payer: Cofinity Commercial |
$158.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.32
|
| Rate for Payer: Healthscope Commercial |
$165.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.11
|
| Rate for Payer: PHP Commercial |
$156.53
|
| Rate for Payer: Priority Health SBD |
$116.01
|
| Rate for Payer: UMR Bronson Commercial |
$81.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.11
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
OP
|
$184.15
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$165.74 |
| Rate for Payer: Aetna American Axle |
$119.70
|
| Rate for Payer: Aetna Commercial |
$156.53
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$119.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$147.32
|
| Rate for Payer: Cash Price |
$147.32
|
| Rate for Payer: Cofinity Advantage |
$128.91
|
| Rate for Payer: Cofinity Commercial |
$158.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$165.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.11
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.53
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.11
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$156.53
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$116.01
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$68.14
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.11
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
OP
|
$154.94
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$139.45 |
| Rate for Payer: Aetna American Axle |
$100.71
|
| Rate for Payer: Aetna Commercial |
$131.70
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$14.87
|
| Rate for Payer: BCN Commercial |
$14.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$123.95
|
| Rate for Payer: Cash Price |
$123.95
|
| Rate for Payer: Cofinity Advantage |
$108.46
|
| Rate for Payer: Cofinity Commercial |
$133.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$139.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.20
|
| Rate for Payer: Mclaren Medicaid |
$12.87
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$13.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.70
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.20
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$131.70
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.87
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health SBD |
$97.61
|
| Rate for Payer: Priority Health Tiered Network |
$10.30
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.31
|
| Rate for Payer: UHC Core |
$19.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.31
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: UMR Bronson Commercial |
$57.33
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.20
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
IP
|
$154.94
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$68.17 |
| Max. Negotiated Rate |
$139.45 |
| Rate for Payer: Aetna American Axle |
$100.71
|
| Rate for Payer: Aetna Commercial |
$131.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.71
|
| Rate for Payer: Cash Price |
$123.95
|
| Rate for Payer: Cofinity Advantage |
$108.46
|
| Rate for Payer: Cofinity Commercial |
$133.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.95
|
| Rate for Payer: Healthscope Commercial |
$139.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.20
|
| Rate for Payer: PHP Commercial |
$131.70
|
| Rate for Payer: Priority Health SBD |
$97.61
|
| Rate for Payer: UMR Bronson Commercial |
$68.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.20
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
IP
|
$163.97
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$72.15 |
| Max. Negotiated Rate |
$147.57 |
| Rate for Payer: Aetna American Axle |
$106.58
|
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.58
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cofinity Advantage |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$141.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.18
|
| Rate for Payer: Healthscope Commercial |
$147.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.98
|
| Rate for Payer: PHP Commercial |
$139.37
|
| Rate for Payer: Priority Health SBD |
$103.30
|
| Rate for Payer: UMR Bronson Commercial |
$72.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.98
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
OP
|
$163.97
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$147.57 |
| Rate for Payer: Aetna American Axle |
$106.58
|
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: BCBS Complete |
$16.95
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$35.68
|
| Rate for Payer: BCN Commercial |
$35.68
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cofinity Advantage |
$114.78
|
| Rate for Payer: Cofinity Commercial |
$141.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$147.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.98
|
| Rate for Payer: Mclaren Medicaid |
$30.86
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$32.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$33.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.37
|
| Rate for Payer: Nomi Health Commercial |
$46.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.98
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$139.37
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$30.86
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health SBD |
$103.30
|
| Rate for Payer: Priority Health Tiered Network |
$24.69
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.29
|
| Rate for Payer: UHC Core |
$46.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$30.86
|
| Rate for Payer: UHC Exchange |
$46.29
|
| Rate for Payer: UHC Medicaid |
$16.14
|
| Rate for Payer: UHCCP Medicaid |
$16.14
|
| Rate for Payer: UMR Bronson Commercial |
$60.67
|
| Rate for Payer: VA VA |
$30.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.98
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
IP
|
$9.04
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.98 |
| Max. Negotiated Rate |
$8.14 |
| Rate for Payer: Aetna American Axle |
$5.88
|
| Rate for Payer: Aetna Commercial |
$7.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.88
|
| Rate for Payer: Cash Price |
$7.23
|
| Rate for Payer: Cofinity Advantage |
$6.33
|
| Rate for Payer: Cofinity Commercial |
$7.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.23
|
| Rate for Payer: Healthscope Commercial |
$8.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.78
|
| Rate for Payer: PHP Commercial |
$7.68
|
| Rate for Payer: Priority Health SBD |
$5.70
|
| Rate for Payer: UMR Bronson Commercial |
$3.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.78
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
OP
|
$9.04
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.34 |
| Max. Negotiated Rate |
$8.14 |
| Rate for Payer: Aetna American Axle |
$5.88
|
| Rate for Payer: Aetna Commercial |
$7.68
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.88
|
| Rate for Payer: BCBS Complete |
$3.62
|
| Rate for Payer: Cash Price |
$7.23
|
| Rate for Payer: Cofinity Advantage |
$6.33
|
| Rate for Payer: Cofinity Commercial |
$7.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.23
|
| Rate for Payer: Healthscope Commercial |
$8.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.78
|
| Rate for Payer: PHP Commercial |
$7.68
|
| Rate for Payer: Priority Health SBD |
$5.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.88
|
| Rate for Payer: UHC Core |
$4.71
|
| Rate for Payer: UHC Exchange |
$3.55
|
| Rate for Payer: UMR Bronson Commercial |
$3.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.78
|
|
|
HC ADAPTER PERFUSION STERILE
|
Facility
|
OP
|
$93.64
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$46.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: BCBS Complete |
$37.46
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Advantage |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.87
|
| Rate for Payer: UHC Core |
$48.79
|
| Rate for Payer: UHC Exchange |
$36.80
|
| Rate for Payer: UMR Bronson Commercial |
$34.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC ADAPTER PERFUSION STERILE
|
Facility
|
IP
|
$93.64
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Advantage |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: UMR Bronson Commercial |
$41.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC ADAPTOR PERFUSION
|
Facility
|
IP
|
$12.48
|
|
| Hospital Charge Code |
27000264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.49 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna American Axle |
$8.11
|
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.11
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Advantage |
$8.74
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: Priority Health SBD |
$7.86
|
| Rate for Payer: UMR Bronson Commercial |
$5.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC ADAPTOR PERFUSION
|
Facility
|
OP
|
$12.48
|
|
| Hospital Charge Code |
27000264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna American Axle |
$8.11
|
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare |
$6.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.11
|
| Rate for Payer: BCBS Complete |
$4.99
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Advantage |
$8.74
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: Priority Health SBD |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.11
|
| Rate for Payer: UHC Core |
$6.50
|
| Rate for Payer: UHC Exchange |
$4.90
|
| Rate for Payer: UMR Bronson Commercial |
$4.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
