|
HC AMNIOCENTESIS
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 59001
|
| Hospital Charge Code |
76100006
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna American Axle |
$541.37
|
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$541.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$238.33
|
| Rate for Payer: BCN Commercial |
$238.33
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Advantage |
$583.01
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$583.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.65
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$524.71
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$541.37
|
| Rate for Payer: UHC Core |
$433.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$327.32
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: UMR Bronson Commercial |
$308.16
|
| Rate for Payer: VA VA |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.65
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
36100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$165.16 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$953.20
|
| Rate for Payer: BCN Commercial |
$953.20
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$290.15
|
| Rate for Payer: UHC Core |
$232.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Exchange |
$175.43
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: UMR Bronson Commercial |
$165.16
|
| Rate for Payer: VA VA |
$917.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC AMNIOCENTESIS DIAGNOSTIC
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 59000
|
| Hospital Charge Code |
36100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$196.41 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: UMR Bronson Commercial |
$196.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC AMNIOINFUSION
|
Facility
|
OP
|
$586.12
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
76100007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna American Axle |
$380.98
|
| Rate for Payer: Aetna Commercial |
$498.20
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$375.97
|
| Rate for Payer: BCN Commercial |
$375.97
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$468.90
|
| Rate for Payer: Cash Price |
$468.90
|
| Rate for Payer: Cash Price |
$468.90
|
| Rate for Payer: Cofinity Advantage |
$410.28
|
| Rate for Payer: Cofinity Commercial |
$504.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$527.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$410.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.59
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.20
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.59
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$498.20
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$369.26
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.98
|
| Rate for Payer: UHC Core |
$305.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Exchange |
$230.35
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: UMR Bronson Commercial |
$216.86
|
| Rate for Payer: VA VA |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.59
|
|
|
HC AMNIOINFUSION
|
Facility
|
IP
|
$586.12
|
|
|
Service Code
|
CPT 59070
|
| Hospital Charge Code |
76100007
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$257.89 |
| Max. Negotiated Rate |
$527.51 |
| Rate for Payer: Aetna American Axle |
$380.98
|
| Rate for Payer: Aetna Commercial |
$498.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.98
|
| Rate for Payer: Cash Price |
$468.90
|
| Rate for Payer: Cofinity Advantage |
$410.28
|
| Rate for Payer: Cofinity Commercial |
$504.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.90
|
| Rate for Payer: Healthscope Commercial |
$527.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$410.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$498.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$439.59
|
| Rate for Payer: PHP Commercial |
$498.20
|
| Rate for Payer: Priority Health SBD |
$369.26
|
| Rate for Payer: UMR Bronson Commercial |
$257.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.59
|
|
|
HC AMNIOTIC FLUID DELTA OD
|
Facility
|
OP
|
$71.89
|
|
|
Service Code
|
CPT 82143
|
| Hospital Charge Code |
30100095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$64.70 |
| Rate for Payer: Aetna American Axle |
$46.73
|
| Rate for Payer: Aetna Commercial |
$61.11
|
| Rate for Payer: Aetna Medicare |
$9.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.69
|
| Rate for Payer: BCBS Complete |
$5.14
|
| Rate for Payer: BCBS MAPPO |
$9.35
|
| Rate for Payer: BCBS Trust/PPO |
$10.80
|
| Rate for Payer: BCN Commercial |
$10.80
|
| Rate for Payer: BCN Medicare Advantage |
$9.35
|
| Rate for Payer: Cash Price |
$57.51
|
| Rate for Payer: Cash Price |
$57.51
|
| Rate for Payer: Cofinity Advantage |
$50.32
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.35
|
| Rate for Payer: Healthscope Commercial |
$64.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.92
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Mclaren Medicare |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.82
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.11
|
| Rate for Payer: Nomi Health Commercial |
$14.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.92
|
| Rate for Payer: PACE Medicare |
$8.88
|
| Rate for Payer: PACE SWMI |
$9.35
|
| Rate for Payer: PHP Commercial |
$61.11
|
| Rate for Payer: PHP Medicare Advantage |
$9.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.35
|
| Rate for Payer: Priority Health Medicare |
$9.35
|
| Rate for Payer: Priority Health SBD |
$45.29
|
| Rate for Payer: Priority Health Tiered Network |
$7.48
|
| Rate for Payer: Railroad Medicare Medicare |
$9.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.03
|
| Rate for Payer: UHC Core |
$14.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.35
|
| Rate for Payer: UHC Exchange |
$14.03
|
| Rate for Payer: UHC Medicaid |
$4.89
|
| Rate for Payer: UHCCP Medicaid |
$4.89
|
| Rate for Payer: UMR Bronson Commercial |
$26.60
|
| Rate for Payer: VA VA |
$9.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.92
|
|
|
HC AMNIOTIC FLUID DELTA OD
|
Facility
|
IP
|
$71.89
|
|
|
Service Code
|
CPT 82143
|
| Hospital Charge Code |
30100095
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.63 |
| Max. Negotiated Rate |
$64.70 |
| Rate for Payer: Aetna American Axle |
$46.73
|
| Rate for Payer: Aetna Commercial |
$61.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.73
|
| Rate for Payer: Cash Price |
$57.51
|
| Rate for Payer: Cofinity Advantage |
$50.32
|
| Rate for Payer: Cofinity Commercial |
$61.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.51
|
| Rate for Payer: Healthscope Commercial |
$64.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.92
|
| Rate for Payer: PHP Commercial |
$61.11
|
| Rate for Payer: Priority Health SBD |
$45.29
|
| Rate for Payer: UMR Bronson Commercial |
$31.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.92
|
|
|
HC AMNISURE ROM
|
Facility
|
OP
|
$211.71
|
|
|
Service Code
|
CPT 84112
|
| Hospital Charge Code |
30000009
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$51.31 |
| Max. Negotiated Rate |
$190.54 |
| Rate for Payer: Aetna American Axle |
$137.61
|
| Rate for Payer: Aetna Commercial |
$179.95
|
| Rate for Payer: Aetna Medicare |
$102.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.64
|
| Rate for Payer: BCBS Complete |
$53.88
|
| Rate for Payer: BCBS MAPPO |
$98.11
|
| Rate for Payer: BCBS Trust/PPO |
$113.41
|
| Rate for Payer: BCN Commercial |
$113.41
|
| Rate for Payer: BCN Medicare Advantage |
$98.11
|
| Rate for Payer: Cash Price |
$169.37
|
| Rate for Payer: Cash Price |
$169.37
|
| Rate for Payer: Cofinity Advantage |
$148.20
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.11
|
| Rate for Payer: Healthscope Commercial |
$190.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.78
|
| Rate for Payer: Mclaren Medicaid |
$98.11
|
| Rate for Payer: Mclaren Medicare |
$98.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.02
|
| Rate for Payer: Meridian Medicaid |
$103.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$107.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.95
|
| Rate for Payer: Nomi Health Commercial |
$147.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.78
|
| Rate for Payer: PACE Medicare |
$93.20
|
| Rate for Payer: PACE SWMI |
$98.11
|
| Rate for Payer: PHP Commercial |
$179.95
|
| Rate for Payer: PHP Medicare Advantage |
$98.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$98.11
|
| Rate for Payer: Priority Health Medicare |
$98.11
|
| Rate for Payer: Priority Health SBD |
$133.38
|
| Rate for Payer: Priority Health Tiered Network |
$78.49
|
| Rate for Payer: Railroad Medicare Medicare |
$98.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.17
|
| Rate for Payer: UHC Core |
$147.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$98.11
|
| Rate for Payer: UHC Exchange |
$147.17
|
| Rate for Payer: UHC Medicaid |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$51.31
|
| Rate for Payer: UMR Bronson Commercial |
$78.33
|
| Rate for Payer: VA VA |
$98.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.78
|
|
|
HC AMNISURE ROM
|
Facility
|
IP
|
$211.71
|
|
|
Service Code
|
CPT 84112
|
| Hospital Charge Code |
30000009
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$93.15 |
| Max. Negotiated Rate |
$190.54 |
| Rate for Payer: Aetna American Axle |
$137.61
|
| Rate for Payer: Aetna Commercial |
$179.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.61
|
| Rate for Payer: Cash Price |
$169.37
|
| Rate for Payer: Cofinity Advantage |
$148.20
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.37
|
| Rate for Payer: Healthscope Commercial |
$190.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.78
|
| Rate for Payer: PHP Commercial |
$179.95
|
| Rate for Payer: Priority Health SBD |
$133.38
|
| Rate for Payer: UMR Bronson Commercial |
$93.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.78
|
|
|
HC AMPA-R AB CBA, SERUM
|
Facility
|
IP
|
$520.20
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200416
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$228.89 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna American Axle |
$338.13
|
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Advantage |
$364.14
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$442.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.15
|
| Rate for Payer: PHP Commercial |
$442.17
|
| Rate for Payer: Priority Health SBD |
$327.73
|
| Rate for Payer: UMR Bronson Commercial |
$228.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.15
|
|
|
HC AMPA-R AB CBA, SERUM
|
Facility
|
OP
|
$520.20
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200416
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$468.18 |
| Rate for Payer: Aetna American Axle |
$338.13
|
| Rate for Payer: Aetna Commercial |
$442.17
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.13
|
| 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 |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cash Price |
$416.16
|
| Rate for Payer: Cofinity Advantage |
$364.14
|
| Rate for Payer: Cofinity Commercial |
$447.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$468.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.15
|
| 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 |
$442.17
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$390.15
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$442.17
|
| 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 |
$327.73
|
| 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 |
$192.47
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.15
|
|
|
HC AMPA-R AB IF TITER ASSAY, S
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200417
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| 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 |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Advantage |
$83.75
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| 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 |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$101.70
|
| 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 |
$75.38
|
| 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 |
$44.27
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC AMPA-R AB IF TITER ASSAY, S
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200417
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Advantage |
$83.75
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: UMR Bronson Commercial |
$52.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC AMP FINGER/THUMB W DIRECT CLOSURE
|
Facility
|
IP
|
$4,957.82
|
|
|
Service Code
|
CPT 26951
|
| Hospital Charge Code |
45000090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,181.44 |
| Max. Negotiated Rate |
$4,462.04 |
| Rate for Payer: Aetna American Axle |
$3,222.58
|
| Rate for Payer: Aetna Commercial |
$4,214.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,222.58
|
| Rate for Payer: Cash Price |
$3,966.26
|
| Rate for Payer: Cofinity Advantage |
$3,470.47
|
| Rate for Payer: Cofinity Commercial |
$4,263.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,966.26
|
| Rate for Payer: Healthscope Commercial |
$4,462.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,470.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,718.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,214.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,718.36
|
| Rate for Payer: PHP Commercial |
$4,214.15
|
| Rate for Payer: Priority Health SBD |
$3,123.43
|
| Rate for Payer: UMR Bronson Commercial |
$2,181.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,718.36
|
|
|
HC AMP FINGER/THUMB W DIRECT CLOSURE
|
Facility
|
OP
|
$4,957.82
|
|
|
Service Code
|
CPT 26951
|
| Hospital Charge Code |
45000090
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna American Axle |
$3,222.58
|
| Rate for Payer: Aetna Commercial |
$4,214.15
|
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,222.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$3,187.10
|
| Rate for Payer: BCN Commercial |
$3,187.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$3,966.26
|
| Rate for Payer: Cash Price |
$3,966.26
|
| Rate for Payer: Cash Price |
$3,966.26
|
| Rate for Payer: Cofinity Advantage |
$3,470.47
|
| Rate for Payer: Cofinity Commercial |
$4,263.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,966.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$4,462.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,470.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,718.36
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,214.15
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,718.36
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$4,214.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health SBD |
$3,123.43
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,834.39
|
| Rate for Payer: VA VA |
$3,260.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,718.36
|
|
|
HC AMP FINGER/THUMB W FLAP
|
Facility
|
OP
|
$4,751.30
|
|
|
Service Code
|
CPT 26952
|
| Hospital Charge Code |
45000091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$10,543.31 |
| Rate for Payer: Aetna American Axle |
$3,088.34
|
| Rate for Payer: Aetna Commercial |
$4,038.61
|
| Rate for Payer: Aetna Medicare |
$3,390.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,088.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,075.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,075.29
|
| Rate for Payer: BCBS Complete |
$1,790.52
|
| Rate for Payer: BCBS MAPPO |
$3,260.23
|
| Rate for Payer: BCBS Trust/PPO |
$2,293.43
|
| Rate for Payer: BCN Commercial |
$2,293.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,260.23
|
| Rate for Payer: Cash Price |
$3,801.04
|
| Rate for Payer: Cash Price |
$3,801.04
|
| Rate for Payer: Cash Price |
$3,801.04
|
| Rate for Payer: Cofinity Advantage |
$3,325.91
|
| Rate for Payer: Cofinity Commercial |
$4,086.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,801.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,260.23
|
| Rate for Payer: Healthscope Commercial |
$4,276.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,325.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,563.47
|
| Rate for Payer: Mclaren Medicaid |
$3,260.23
|
| Rate for Payer: Mclaren Medicare |
$3,260.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,423.24
|
| Rate for Payer: Meridian Medicaid |
$3,423.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,749.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,586.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,038.61
|
| Rate for Payer: Nomi Health Commercial |
$9,780.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,563.47
|
| Rate for Payer: PACE Medicare |
$3,097.22
|
| Rate for Payer: PACE SWMI |
$3,260.23
|
| Rate for Payer: PHP Commercial |
$4,038.61
|
| Rate for Payer: PHP Medicare Advantage |
$3,260.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,705.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,543.31
|
| Rate for Payer: Priority Health Medicare |
$3,260.23
|
| Rate for Payer: Priority Health SBD |
$2,993.32
|
| Rate for Payer: Priority Health Tiered Network |
$8,434.65
|
| Rate for Payer: Railroad Medicare Medicare |
$3,260.23
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,260.23
|
| Rate for Payer: UHC Medicaid |
$1,705.10
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,757.98
|
| Rate for Payer: VA VA |
$3,260.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,563.47
|
|
|
HC AMP FINGER/THUMB W FLAP
|
Facility
|
IP
|
$4,751.30
|
|
|
Service Code
|
CPT 26952
|
| Hospital Charge Code |
45000091
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,090.57 |
| Max. Negotiated Rate |
$4,276.17 |
| Rate for Payer: Aetna American Axle |
$3,088.34
|
| Rate for Payer: Aetna Commercial |
$4,038.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,088.34
|
| Rate for Payer: Cash Price |
$3,801.04
|
| Rate for Payer: Cofinity Advantage |
$3,325.91
|
| Rate for Payer: Cofinity Commercial |
$4,086.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,801.04
|
| Rate for Payer: Healthscope Commercial |
$4,276.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,325.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,563.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,038.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,563.47
|
| Rate for Payer: PHP Commercial |
$4,038.61
|
| Rate for Payer: Priority Health SBD |
$2,993.32
|
| Rate for Payer: UMR Bronson Commercial |
$2,090.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,563.47
|
|
|
HC AMPHETAMINES 3 OR 4
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 80325
|
| Hospital Charge Code |
30000173
|
|
Hospital Revenue Code
|
300
|
| 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 AMPHETAMINES 3 OR 4
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 80325
|
| Hospital Charge Code |
30000173
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$14.24 |
| 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 |
$19.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: BCBS Complete |
$15.40
|
| 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: MI Amish Medical Board Commercial |
$30.79
|
| 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 |
$14.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC AMPHETAMINE URIN
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000139
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna American Axle |
$72.31
|
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.84
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Advantage |
$77.88
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$70.09
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: UMR Bronson Commercial |
$41.16
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC AMPHETAMINE URIN
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000139
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$48.95 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna American Axle |
$72.31
|
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.31
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Advantage |
$77.88
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health SBD |
$70.09
|
| Rate for Payer: UMR Bronson Commercial |
$48.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC AMPHETAMINE URN CMPT
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 80359
|
| Hospital Charge Code |
30100570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna American Axle |
$20.96
|
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: BCBS Complete |
$12.90
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Advantage |
$22.57
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC AMPHETAMINE URN CMPT
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 80359
|
| Hospital Charge Code |
30100570
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna American Axle |
$20.96
|
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Advantage |
$22.57
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: UMR Bronson Commercial |
$14.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC AMPHIPHYSIN WESTERN BLOT
|
Facility
|
OP
|
$296.51
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100677
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.28 |
| Max. Negotiated Rate |
$266.86 |
| Rate for Payer: Aetna American Axle |
$192.73
|
| Rate for Payer: Aetna Commercial |
$252.03
|
| Rate for Payer: Aetna Medicare |
$30.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.51
|
| Rate for Payer: BCBS Complete |
$16.04
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCBS Trust/PPO |
$25.34
|
| Rate for Payer: BCN Commercial |
$25.34
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$237.21
|
| Rate for Payer: Cash Price |
$237.21
|
| Rate for Payer: Cofinity Advantage |
$207.56
|
| Rate for Payer: Cofinity Commercial |
$255.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$266.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.38
|
| Rate for Payer: Mclaren Medicaid |
$29.21
|
| Rate for Payer: Mclaren Medicare |
$29.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Meridian Medicaid |
$30.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.03
|
| Rate for Payer: Nomi Health Commercial |
$43.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.38
|
| Rate for Payer: PACE Medicare |
$27.75
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Commercial |
$252.03
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health SBD |
$186.80
|
| Rate for Payer: Priority Health Tiered Network |
$23.37
|
| Rate for Payer: Railroad Medicare Medicare |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.82
|
| Rate for Payer: UHC Core |
$43.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.21
|
| Rate for Payer: UHC Exchange |
$43.82
|
| Rate for Payer: UHC Medicaid |
$15.28
|
| Rate for Payer: UHCCP Medicaid |
$15.28
|
| Rate for Payer: UMR Bronson Commercial |
$109.71
|
| Rate for Payer: VA VA |
$29.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.38
|
|
|
HC AMPHIPHYSIN WESTERN BLOT
|
Facility
|
IP
|
$296.51
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100677
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$130.46 |
| Max. Negotiated Rate |
$266.86 |
| Rate for Payer: Aetna American Axle |
$192.73
|
| Rate for Payer: Aetna Commercial |
$252.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$192.73
|
| Rate for Payer: Cash Price |
$237.21
|
| Rate for Payer: Cofinity Advantage |
$207.56
|
| Rate for Payer: Cofinity Commercial |
$255.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.21
|
| Rate for Payer: Healthscope Commercial |
$266.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$207.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.38
|
| Rate for Payer: PHP Commercial |
$252.03
|
| Rate for Payer: Priority Health SBD |
$186.80
|
| Rate for Payer: UMR Bronson Commercial |
$130.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.38
|
|
