|
HC ADMIN DEVELOPMENTAL TEST FIRST HOUR
|
Facility
|
IP
|
$483.00
|
|
|
Service Code
|
CPT 96112
|
| Hospital Charge Code |
51000131
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$212.52 |
| Max. Negotiated Rate |
$434.70 |
| Rate for Payer: Aetna American Axle |
$313.95
|
| Rate for Payer: Aetna Commercial |
$410.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$313.95
|
| Rate for Payer: Cash Price |
$386.40
|
| Rate for Payer: Cofinity Advantage |
$338.10
|
| Rate for Payer: Cofinity Commercial |
$415.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$386.40
|
| Rate for Payer: Healthscope Commercial |
$434.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$338.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$362.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$410.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$362.25
|
| Rate for Payer: PHP Commercial |
$410.55
|
| Rate for Payer: Priority Health SBD |
$304.29
|
| Rate for Payer: UMR Bronson Commercial |
$212.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$362.25
|
|
|
HC ADMIN INTRAPULMONARY SURFACTANT
|
Facility
|
OP
|
$597.19
|
|
|
Service Code
|
CPT 94610
|
| Hospital Charge Code |
46000034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$59.18 |
| Max. Negotiated Rate |
$705.61 |
| Rate for Payer: Aetna American Axle |
$388.17
|
| Rate for Payer: Aetna Commercial |
$507.61
|
| Rate for Payer: Aetna Medicare |
$226.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.74
|
| Rate for Payer: BCBS Complete |
$119.83
|
| Rate for Payer: BCBS MAPPO |
$218.19
|
| Rate for Payer: BCBS Trust/PPO |
$59.18
|
| Rate for Payer: BCN Commercial |
$59.18
|
| Rate for Payer: BCN Medicare Advantage |
$218.19
|
| Rate for Payer: Cash Price |
$477.75
|
| Rate for Payer: Cash Price |
$477.75
|
| Rate for Payer: Cofinity Advantage |
$418.03
|
| Rate for Payer: Cofinity Commercial |
$513.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.19
|
| Rate for Payer: Healthscope Commercial |
$537.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$418.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.89
|
| Rate for Payer: Mclaren Medicaid |
$218.19
|
| Rate for Payer: Mclaren Medicare |
$218.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$229.10
|
| Rate for Payer: Meridian Medicaid |
$229.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$240.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.61
|
| Rate for Payer: Nomi Health Commercial |
$654.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.89
|
| Rate for Payer: PACE Medicare |
$207.28
|
| Rate for Payer: PACE SWMI |
$218.19
|
| Rate for Payer: PHP Commercial |
$507.61
|
| Rate for Payer: PHP Medicare Advantage |
$218.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$705.61
|
| Rate for Payer: Priority Health Medicare |
$218.19
|
| Rate for Payer: Priority Health SBD |
$376.23
|
| Rate for Payer: Priority Health Tiered Network |
$564.49
|
| Rate for Payer: Railroad Medicare Medicare |
$218.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$388.17
|
| Rate for Payer: UHC Core |
$311.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$218.19
|
| Rate for Payer: UHC Exchange |
$234.70
|
| Rate for Payer: UHC Medicaid |
$114.11
|
| Rate for Payer: UHCCP Medicaid |
$114.11
|
| Rate for Payer: UMR Bronson Commercial |
$220.96
|
| Rate for Payer: VA VA |
$218.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.89
|
|
|
HC ADMIN INTRAPULMONARY SURFACTANT
|
Facility
|
IP
|
$597.19
|
|
|
Service Code
|
CPT 94610
|
| Hospital Charge Code |
46000034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$262.76 |
| Max. Negotiated Rate |
$537.47 |
| Rate for Payer: Aetna American Axle |
$388.17
|
| Rate for Payer: Aetna Commercial |
$507.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$388.17
|
| Rate for Payer: Cash Price |
$477.75
|
| Rate for Payer: Cofinity Advantage |
$418.03
|
| Rate for Payer: Cofinity Commercial |
$513.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$477.75
|
| Rate for Payer: Healthscope Commercial |
$537.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$418.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$447.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$507.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$447.89
|
| Rate for Payer: PHP Commercial |
$507.61
|
| Rate for Payer: Priority Health SBD |
$376.23
|
| Rate for Payer: UMR Bronson Commercial |
$262.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$447.89
|
|
|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
IP
|
$101.64
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$44.72 |
| Max. Negotiated Rate |
$91.48 |
| Rate for Payer: Aetna American Axle |
$66.07
|
| Rate for Payer: Aetna Commercial |
$86.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.07
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cofinity Advantage |
$71.15
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.31
|
| Rate for Payer: Healthscope Commercial |
$91.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.23
|
| Rate for Payer: PHP Commercial |
$86.39
|
| Rate for Payer: Priority Health SBD |
$64.03
|
| Rate for Payer: UMR Bronson Commercial |
$44.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.23
|
|
|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
OP
|
$101.64
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$37.61 |
| Max. Negotiated Rate |
$92.14 |
| Rate for Payer: Aetna American Axle |
$66.07
|
| Rate for Payer: Aetna Commercial |
$86.39
|
| Rate for Payer: Aetna Medicare |
$50.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.07
|
| Rate for Payer: BCBS Complete |
$40.66
|
| Rate for Payer: BCBS Trust/PPO |
$92.14
|
| Rate for Payer: BCN Commercial |
$92.14
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cofinity Advantage |
$71.15
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.31
|
| Rate for Payer: Healthscope Commercial |
$91.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.23
|
| Rate for Payer: PHP Commercial |
$86.39
|
| Rate for Payer: Priority Health SBD |
$64.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.07
|
| Rate for Payer: UHC Core |
$52.95
|
| Rate for Payer: UHC Exchange |
$39.94
|
| Rate for Payer: UMR Bronson Commercial |
$37.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.23
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
IP
|
$101.64
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$44.72 |
| Max. Negotiated Rate |
$91.48 |
| Rate for Payer: Aetna American Axle |
$66.07
|
| Rate for Payer: Aetna Commercial |
$86.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.07
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cofinity Advantage |
$71.15
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.31
|
| Rate for Payer: Healthscope Commercial |
$91.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.23
|
| Rate for Payer: PHP Commercial |
$86.39
|
| Rate for Payer: Priority Health SBD |
$64.03
|
| Rate for Payer: UMR Bronson Commercial |
$44.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.23
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
OP
|
$101.64
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$37.61 |
| Max. Negotiated Rate |
$92.14 |
| Rate for Payer: Aetna American Axle |
$66.07
|
| Rate for Payer: Aetna Commercial |
$86.39
|
| Rate for Payer: Aetna Medicare |
$50.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.07
|
| Rate for Payer: BCBS Complete |
$40.66
|
| Rate for Payer: BCBS Trust/PPO |
$92.14
|
| Rate for Payer: BCN Commercial |
$92.14
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cofinity Advantage |
$71.15
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.31
|
| Rate for Payer: Healthscope Commercial |
$91.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.23
|
| Rate for Payer: PHP Commercial |
$86.39
|
| Rate for Payer: Priority Health SBD |
$64.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.07
|
| Rate for Payer: UHC Core |
$52.95
|
| Rate for Payer: UHC Exchange |
$39.94
|
| Rate for Payer: UMR Bronson Commercial |
$37.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.23
|
|
|
HC ADMIN SARSCOV2 VACC EACH ADDL COMPONENT
|
Facility
|
IP
|
$33.66
|
|
|
Service Code
|
CPT 90481
|
| Hospital Charge Code |
77100067
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$14.81 |
| Max. Negotiated Rate |
$30.29 |
| Rate for Payer: Aetna American Axle |
$21.88
|
| Rate for Payer: Aetna Commercial |
$28.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.88
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Advantage |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$28.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Healthscope Commercial |
$30.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.25
|
| Rate for Payer: PHP Commercial |
$28.61
|
| Rate for Payer: Priority Health SBD |
$21.21
|
| Rate for Payer: UMR Bronson Commercial |
$14.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.25
|
|
|
HC ADMIN SARSCOV2 VACC EACH ADDL COMPONENT
|
Facility
|
OP
|
$33.66
|
|
|
Service Code
|
CPT 90481
|
| Hospital Charge Code |
77100067
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.45 |
| Max. Negotiated Rate |
$30.29 |
| Rate for Payer: Aetna American Axle |
$21.88
|
| Rate for Payer: Aetna Commercial |
$28.61
|
| Rate for Payer: Aetna Medicare |
$16.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.88
|
| Rate for Payer: BCBS Complete |
$13.46
|
| Rate for Payer: Cash Price |
$26.93
|
| Rate for Payer: Cofinity Advantage |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$28.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.93
|
| Rate for Payer: Healthscope Commercial |
$30.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.25
|
| Rate for Payer: PHP Commercial |
$28.61
|
| Rate for Payer: Priority Health SBD |
$21.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.88
|
| Rate for Payer: UHC Core |
$17.54
|
| Rate for Payer: UHC Exchange |
$13.23
|
| Rate for Payer: UMR Bronson Commercial |
$12.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.25
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
OP
|
$545.47
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$201.82 |
| Max. Negotiated Rate |
$1,318.08 |
| Rate for Payer: Aetna American Axle |
$354.56
|
| Rate for Payer: Aetna Commercial |
$463.65
|
| Rate for Payer: Aetna Medicare |
$456.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.20
|
| Rate for Payer: BCBS Complete |
$241.30
|
| Rate for Payer: BCBS MAPPO |
$439.36
|
| Rate for Payer: BCN Medicare Advantage |
$439.36
|
| Rate for Payer: Cash Price |
$436.38
|
| Rate for Payer: Cash Price |
$436.38
|
| Rate for Payer: Cofinity Advantage |
$381.83
|
| Rate for Payer: Cofinity Commercial |
$469.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.36
|
| Rate for Payer: Healthscope Commercial |
$490.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.10
|
| Rate for Payer: Mclaren Medicaid |
$439.36
|
| Rate for Payer: Mclaren Medicare |
$439.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.33
|
| Rate for Payer: Meridian Medicaid |
$461.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$483.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.65
|
| Rate for Payer: Nomi Health Commercial |
$1,318.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.10
|
| Rate for Payer: PACE Medicare |
$417.39
|
| Rate for Payer: PACE SWMI |
$439.36
|
| Rate for Payer: PHP Commercial |
$463.65
|
| Rate for Payer: PHP Medicare Advantage |
$439.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$450.50
|
| Rate for Payer: Priority Health Medicare |
$439.36
|
| Rate for Payer: Priority Health SBD |
$343.65
|
| Rate for Payer: Priority Health Tiered Network |
$360.40
|
| Rate for Payer: Railroad Medicare Medicare |
$439.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.56
|
| Rate for Payer: UHC Core |
$284.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$439.36
|
| Rate for Payer: UHC Exchange |
$214.37
|
| Rate for Payer: UHC Medicaid |
$229.79
|
| Rate for Payer: UHCCP Medicaid |
$229.79
|
| Rate for Payer: UMR Bronson Commercial |
$201.82
|
| Rate for Payer: VA VA |
$439.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.10
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
IP
|
$545.47
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$240.01 |
| Max. Negotiated Rate |
$490.92 |
| Rate for Payer: Aetna American Axle |
$354.56
|
| Rate for Payer: Aetna Commercial |
$463.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.56
|
| Rate for Payer: Cash Price |
$436.38
|
| Rate for Payer: Cofinity Advantage |
$381.83
|
| Rate for Payer: Cofinity Commercial |
$469.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.38
|
| Rate for Payer: Healthscope Commercial |
$490.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.10
|
| Rate for Payer: PHP Commercial |
$463.65
|
| Rate for Payer: Priority Health SBD |
$343.65
|
| Rate for Payer: UMR Bronson Commercial |
$240.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.10
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
IP
|
$545.47
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$240.01 |
| Max. Negotiated Rate |
$490.92 |
| Rate for Payer: Aetna American Axle |
$354.56
|
| Rate for Payer: Aetna Commercial |
$463.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.56
|
| Rate for Payer: Cash Price |
$436.38
|
| Rate for Payer: Cofinity Advantage |
$381.83
|
| Rate for Payer: Cofinity Commercial |
$469.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.38
|
| Rate for Payer: Healthscope Commercial |
$490.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.10
|
| Rate for Payer: PHP Commercial |
$463.65
|
| Rate for Payer: Priority Health SBD |
$343.65
|
| Rate for Payer: UMR Bronson Commercial |
$240.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.10
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
OP
|
$545.47
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$201.82 |
| Max. Negotiated Rate |
$1,318.08 |
| Rate for Payer: Aetna American Axle |
$354.56
|
| Rate for Payer: Aetna Commercial |
$463.65
|
| Rate for Payer: Aetna Medicare |
$456.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$354.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.20
|
| Rate for Payer: BCBS Complete |
$241.30
|
| Rate for Payer: BCBS MAPPO |
$439.36
|
| Rate for Payer: BCN Medicare Advantage |
$439.36
|
| Rate for Payer: Cash Price |
$436.38
|
| Rate for Payer: Cash Price |
$436.38
|
| Rate for Payer: Cofinity Advantage |
$381.83
|
| Rate for Payer: Cofinity Commercial |
$469.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.36
|
| Rate for Payer: Healthscope Commercial |
$490.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$381.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.10
|
| Rate for Payer: Mclaren Medicaid |
$439.36
|
| Rate for Payer: Mclaren Medicare |
$439.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.33
|
| Rate for Payer: Meridian Medicaid |
$461.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$483.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$463.65
|
| Rate for Payer: Nomi Health Commercial |
$1,318.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.10
|
| Rate for Payer: PACE Medicare |
$417.39
|
| Rate for Payer: PACE SWMI |
$439.36
|
| Rate for Payer: PHP Commercial |
$463.65
|
| Rate for Payer: PHP Medicare Advantage |
$439.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$229.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$450.50
|
| Rate for Payer: Priority Health Medicare |
$439.36
|
| Rate for Payer: Priority Health SBD |
$343.65
|
| Rate for Payer: Priority Health Tiered Network |
$360.40
|
| Rate for Payer: Railroad Medicare Medicare |
$439.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.56
|
| Rate for Payer: UHC Core |
$284.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$439.36
|
| Rate for Payer: UHC Exchange |
$214.37
|
| Rate for Payer: UHC Medicaid |
$229.79
|
| Rate for Payer: UHCCP Medicaid |
$229.79
|
| Rate for Payer: UMR Bronson Commercial |
$201.82
|
| Rate for Payer: VA VA |
$439.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.10
|
|
|
HC ADMN SARSCOV2 VACC FIRST OR ONLY COMPONENT
|
Facility
|
OP
|
$101.64
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$21.18 |
| Max. Negotiated Rate |
$130.95 |
| Rate for Payer: Aetna American Axle |
$66.07
|
| Rate for Payer: Aetna Commercial |
$86.39
|
| Rate for Payer: Aetna Medicare |
$42.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.61
|
| Rate for Payer: BCBS Complete |
$22.24
|
| Rate for Payer: BCBS MAPPO |
$40.49
|
| Rate for Payer: BCBS Trust/PPO |
$92.14
|
| Rate for Payer: BCN Commercial |
$92.14
|
| Rate for Payer: BCN Medicare Advantage |
$40.49
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cofinity Advantage |
$71.15
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.49
|
| Rate for Payer: Healthscope Commercial |
$91.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.23
|
| Rate for Payer: Mclaren Medicaid |
$40.49
|
| Rate for Payer: Mclaren Medicare |
$40.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.51
|
| Rate for Payer: Meridian Medicaid |
$42.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.39
|
| Rate for Payer: Nomi Health Commercial |
$121.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.23
|
| Rate for Payer: PACE Medicare |
$38.47
|
| Rate for Payer: PACE SWMI |
$40.49
|
| Rate for Payer: PHP Commercial |
$86.39
|
| Rate for Payer: PHP Medicare Advantage |
$40.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$130.95
|
| Rate for Payer: Priority Health Medicare |
$40.49
|
| Rate for Payer: Priority Health SBD |
$64.03
|
| Rate for Payer: Priority Health Tiered Network |
$104.76
|
| Rate for Payer: Railroad Medicare Medicare |
$40.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.07
|
| Rate for Payer: UHC Core |
$52.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$40.49
|
| Rate for Payer: UHC Exchange |
$39.94
|
| Rate for Payer: UHC Medicaid |
$21.18
|
| Rate for Payer: UHCCP Medicaid |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$37.61
|
| Rate for Payer: VA VA |
$40.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.23
|
|
|
HC ADMN SARSCOV2 VACC FIRST OR ONLY COMPONENT
|
Facility
|
IP
|
$101.64
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$44.72 |
| Max. Negotiated Rate |
$91.48 |
| Rate for Payer: Aetna American Axle |
$66.07
|
| Rate for Payer: Aetna Commercial |
$86.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.07
|
| Rate for Payer: Cash Price |
$81.31
|
| Rate for Payer: Cofinity Advantage |
$71.15
|
| Rate for Payer: Cofinity Commercial |
$87.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.31
|
| Rate for Payer: Healthscope Commercial |
$91.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.23
|
| Rate for Payer: PHP Commercial |
$86.39
|
| Rate for Payer: Priority Health SBD |
$64.03
|
| Rate for Payer: UMR Bronson Commercial |
$44.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.23
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$70.40 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna American Axle |
$104.00
|
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Advantage |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health SBD |
$100.80
|
| Rate for Payer: UMR Bronson Commercial |
$70.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$1,608.00 |
| Rate for Payer: Aetna American Axle |
$104.00
|
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$80.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.00
|
| Rate for Payer: BCBS Complete |
$64.00
|
| Rate for Payer: BCBS Trust/PPO |
$107.13
|
| Rate for Payer: BCN Commercial |
$107.13
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Advantage |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health SBD |
$100.80
|
| Rate for Payer: UHC Medicaid |
$1,608.00
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: UMR Bronson Commercial |
$59.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
IP
|
$69.15
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$62.23 |
| Rate for Payer: Aetna American Axle |
$44.95
|
| Rate for Payer: Aetna Commercial |
$58.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.95
|
| Rate for Payer: Cash Price |
$55.32
|
| Rate for Payer: Cofinity Advantage |
$48.41
|
| Rate for Payer: Cofinity Commercial |
$59.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.32
|
| Rate for Payer: Healthscope Commercial |
$62.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.86
|
| Rate for Payer: PHP Commercial |
$58.78
|
| Rate for Payer: Priority Health SBD |
$43.56
|
| Rate for Payer: UMR Bronson Commercial |
$30.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.86
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
OP
|
$69.15
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$62.23 |
| Rate for Payer: Aetna American Axle |
$44.95
|
| Rate for Payer: Aetna Commercial |
$58.78
|
| Rate for Payer: Aetna Medicare |
$40.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.27
|
| Rate for Payer: BCBS Complete |
$21.21
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$44.65
|
| Rate for Payer: BCN Commercial |
$44.65
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$55.32
|
| Rate for Payer: Cash Price |
$55.32
|
| Rate for Payer: Cofinity Advantage |
$48.41
|
| Rate for Payer: Cofinity Commercial |
$59.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$62.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.86
|
| Rate for Payer: Mclaren Medicaid |
$38.62
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$40.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.78
|
| Rate for Payer: Nomi Health Commercial |
$57.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.86
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$58.78
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.62
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health SBD |
$43.56
|
| Rate for Payer: Priority Health Tiered Network |
$30.90
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.93
|
| Rate for Payer: UHC Core |
$57.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.62
|
| Rate for Payer: UHC Exchange |
$57.93
|
| Rate for Payer: UHC Medicaid |
$20.20
|
| Rate for Payer: UHCCP Medicaid |
$20.20
|
| Rate for Payer: UMR Bronson Commercial |
$25.59
|
| Rate for Payer: VA VA |
$38.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.86
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
OP
|
$15.61
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.19
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$2.51
|
| Rate for Payer: BCN Commercial |
$2.51
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Advantage |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Mclaren Medicaid |
$2.17
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Medicaid |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Nomi Health Commercial |
$3.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.71
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.17
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: Priority Health Tiered Network |
$1.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.26
|
| Rate for Payer: UHC Core |
$3.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.17
|
| Rate for Payer: UHC Exchange |
$3.26
|
| Rate for Payer: UHC Medicaid |
$1.13
|
| Rate for Payer: UHCCP Medicaid |
$1.13
|
| Rate for Payer: UMR Bronson Commercial |
$5.78
|
| Rate for Payer: VA VA |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
IP
|
$15.61
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.87 |
| Max. Negotiated Rate |
$14.05 |
| Rate for Payer: Aetna American Axle |
$10.15
|
| Rate for Payer: Aetna Commercial |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.15
|
| Rate for Payer: Cash Price |
$12.49
|
| Rate for Payer: Cofinity Advantage |
$10.93
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.49
|
| Rate for Payer: Healthscope Commercial |
$14.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.71
|
| Rate for Payer: PHP Commercial |
$13.27
|
| Rate for Payer: Priority Health SBD |
$9.83
|
| Rate for Payer: UMR Bronson Commercial |
$6.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.71
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Aetna American Axle |
$22.07
|
| Rate for Payer: Aetna Commercial |
$28.87
|
| Rate for Payer: Aetna Medicare |
$16.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.07
|
| Rate for Payer: BCBS Complete |
$13.58
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Advantage |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$30.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.87
|
| Rate for Payer: Priority Health SBD |
$21.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.07
|
| Rate for Payer: UHC Core |
$17.69
|
| Rate for Payer: UHC Exchange |
$13.35
|
| Rate for Payer: UMR Bronson Commercial |
$12.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.47
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
IP
|
$33.96
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Aetna American Axle |
$22.07
|
| Rate for Payer: Aetna Commercial |
$28.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.07
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Advantage |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$30.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.87
|
| Rate for Payer: Priority Health SBD |
$21.39
|
| Rate for Payer: UMR Bronson Commercial |
$14.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.47
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
OP
|
$33.96
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$327.36 |
| Rate for Payer: Aetna American Axle |
$22.07
|
| Rate for Payer: Aetna Commercial |
$28.87
|
| Rate for Payer: Aetna Medicare |
$105.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Advantage |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$30.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.47
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$106.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Nomi Health Commercial |
$303.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$28.87
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.36
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health SBD |
$21.39
|
| Rate for Payer: Priority Health Tiered Network |
$261.89
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.07
|
| Rate for Payer: UHC Core |
$17.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$13.35
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: UMR Bronson Commercial |
$12.57
|
| Rate for Payer: VA VA |
$101.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.47
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
IP
|
$33.96
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.94 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Aetna American Axle |
$22.07
|
| Rate for Payer: Aetna Commercial |
$28.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.07
|
| Rate for Payer: Cash Price |
$27.17
|
| Rate for Payer: Cofinity Advantage |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$29.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.17
|
| Rate for Payer: Healthscope Commercial |
$30.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.47
|
| Rate for Payer: PHP Commercial |
$28.87
|
| Rate for Payer: Priority Health SBD |
$21.39
|
| Rate for Payer: UMR Bronson Commercial |
$14.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.47
|
|
