|
HC EPIFIX 4 X 4.5 PER SQ CM
|
Facility
|
OP
|
$207.64
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600227
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$76.83 |
| Max. Negotiated Rate |
$481.38 |
| Rate for Payer: Aetna American Axle |
$134.97
|
| Rate for Payer: Aetna Commercial |
$176.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.97
|
| Rate for Payer: BCBS Complete |
$83.06
|
| Rate for Payer: BCBS Trust/PPO |
$481.38
|
| Rate for Payer: Cash Price |
$166.11
|
| Rate for Payer: Cash Price |
$166.11
|
| Rate for Payer: Cofinity Commercial |
$145.35
|
| Rate for Payer: Cofinity Commercial |
$178.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.11
|
| Rate for Payer: Healthscope Commercial |
$186.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$155.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.49
|
| Rate for Payer: PHP Commercial |
$176.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.35
|
| Rate for Payer: Priority Health SBD |
$130.81
|
| Rate for Payer: UMR Bronson Commercial |
$76.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$155.73
|
|
|
HC EPIFIX 4X4 PER SQ CM
|
Facility
|
OP
|
$389.01
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600134
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$143.93 |
| Max. Negotiated Rate |
$481.38 |
| Rate for Payer: Aetna American Axle |
$252.86
|
| Rate for Payer: Aetna Commercial |
$330.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.86
|
| Rate for Payer: BCBS Complete |
$155.60
|
| Rate for Payer: BCBS Trust/PPO |
$481.38
|
| Rate for Payer: Cash Price |
$311.21
|
| Rate for Payer: Cash Price |
$311.21
|
| Rate for Payer: Cofinity Commercial |
$334.55
|
| Rate for Payer: Cofinity Commercial |
$272.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.21
|
| Rate for Payer: Healthscope Commercial |
$350.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.66
|
| Rate for Payer: PHP Commercial |
$330.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.31
|
| Rate for Payer: Priority Health SBD |
$245.08
|
| Rate for Payer: UMR Bronson Commercial |
$143.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.76
|
|
|
HC EPIFIX 4X4 PER SQ CM
|
Facility
|
IP
|
$389.01
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600134
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$171.16 |
| Max. Negotiated Rate |
$350.11 |
| Rate for Payer: Aetna American Axle |
$252.86
|
| Rate for Payer: Aetna Commercial |
$330.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.86
|
| Rate for Payer: Cash Price |
$311.21
|
| Rate for Payer: Cofinity Commercial |
$272.31
|
| Rate for Payer: Cofinity Commercial |
$334.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$311.21
|
| Rate for Payer: Healthscope Commercial |
$350.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$272.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$330.66
|
| Rate for Payer: PHP Commercial |
$330.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$272.31
|
| Rate for Payer: Priority Health SBD |
$245.08
|
| Rate for Payer: UMR Bronson Commercial |
$171.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.76
|
|
|
HC EPIFIX 5X6 PER SQ CM
|
Facility
|
IP
|
$291.77
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600188
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$128.38 |
| Max. Negotiated Rate |
$262.59 |
| Rate for Payer: Aetna American Axle |
$189.65
|
| Rate for Payer: Aetna Commercial |
$248.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.65
|
| Rate for Payer: Cash Price |
$233.42
|
| Rate for Payer: Cofinity Commercial |
$204.24
|
| Rate for Payer: Cofinity Commercial |
$250.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.42
|
| Rate for Payer: Healthscope Commercial |
$262.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$248.00
|
| Rate for Payer: PHP Commercial |
$248.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.24
|
| Rate for Payer: Priority Health SBD |
$183.82
|
| Rate for Payer: UMR Bronson Commercial |
$128.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.83
|
|
|
HC EPIFIX 5X6 PER SQ CM
|
Facility
|
OP
|
$291.77
|
|
|
Service Code
|
HCPCS Q4186
|
| Hospital Charge Code |
63600188
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$107.95 |
| Max. Negotiated Rate |
$481.38 |
| Rate for Payer: Aetna American Axle |
$189.65
|
| Rate for Payer: Aetna Commercial |
$248.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$189.65
|
| Rate for Payer: BCBS Complete |
$116.71
|
| Rate for Payer: BCBS Trust/PPO |
$481.38
|
| Rate for Payer: Cash Price |
$233.42
|
| Rate for Payer: Cash Price |
$233.42
|
| Rate for Payer: Cofinity Commercial |
$250.92
|
| Rate for Payer: Cofinity Commercial |
$204.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.42
|
| Rate for Payer: Healthscope Commercial |
$262.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$204.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$248.00
|
| Rate for Payer: PHP Commercial |
$248.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.24
|
| Rate for Payer: Priority Health SBD |
$183.82
|
| Rate for Payer: UMR Bronson Commercial |
$107.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.83
|
|
|
HC EPIPEN EPINEPHRINE INJECTION .3MG
|
Facility
|
OP
|
$408.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
63600228
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$150.96 |
| Max. Negotiated Rate |
$367.20 |
| Rate for Payer: Aetna American Axle |
$265.20
|
| Rate for Payer: Aetna Commercial |
$346.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.20
|
| Rate for Payer: BCBS Complete |
$163.20
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cofinity Commercial |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$350.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.40
|
| Rate for Payer: Healthscope Commercial |
$367.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$346.80
|
| Rate for Payer: PHP Commercial |
$346.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.60
|
| Rate for Payer: Priority Health SBD |
$257.04
|
| Rate for Payer: UMR Bronson Commercial |
$150.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.00
|
|
|
HC EPIPEN EPINEPHRINE INJECTION .3MG
|
Facility
|
IP
|
$408.00
|
|
|
Service Code
|
CPT J3490
|
| Hospital Charge Code |
63600228
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$179.52 |
| Max. Negotiated Rate |
$367.20 |
| Rate for Payer: Aetna American Axle |
$265.20
|
| Rate for Payer: Aetna Commercial |
$346.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.20
|
| Rate for Payer: Cash Price |
$326.40
|
| Rate for Payer: Cofinity Commercial |
$285.60
|
| Rate for Payer: Cofinity Commercial |
$350.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.40
|
| Rate for Payer: Healthscope Commercial |
$367.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$346.80
|
| Rate for Payer: PHP Commercial |
$346.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.60
|
| Rate for Payer: Priority Health SBD |
$257.04
|
| Rate for Payer: UMR Bronson Commercial |
$179.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.00
|
|
|
HC EP LOWER EXTREMITY SOMATOSENSO
|
Facility
|
IP
|
$916.76
|
|
|
Service Code
|
CPT 95926
|
| Hospital Charge Code |
92200015
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$403.37 |
| Max. Negotiated Rate |
$825.08 |
| Rate for Payer: Aetna American Axle |
$595.89
|
| Rate for Payer: Aetna Commercial |
$779.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.89
|
| Rate for Payer: Cash Price |
$733.41
|
| Rate for Payer: Cofinity Commercial |
$788.41
|
| Rate for Payer: Cofinity Commercial |
$641.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$733.41
|
| Rate for Payer: Healthscope Commercial |
$825.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$641.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$687.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$779.25
|
| Rate for Payer: PHP Commercial |
$779.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.73
|
| Rate for Payer: Priority Health SBD |
$577.56
|
| Rate for Payer: UMR Bronson Commercial |
$403.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$687.57
|
|
|
HC EP LOWER EXTREMITY SOMATOSENSO
|
Facility
|
OP
|
$916.76
|
|
|
Service Code
|
CPT 95926
|
| Hospital Charge Code |
92200015
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$878.32 |
| Rate for Payer: Aetna American Axle |
$595.89
|
| Rate for Payer: Aetna Commercial |
$779.25
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$595.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$643.44
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$733.41
|
| Rate for Payer: Cash Price |
$733.41
|
| Rate for Payer: Cash Price |
$733.41
|
| Rate for Payer: Cofinity Commercial |
$641.73
|
| Rate for Payer: Cofinity Commercial |
$788.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$733.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$825.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$641.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$687.57
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$779.25
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$779.25
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$641.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$577.56
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$170.37
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$154.88
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$339.20
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$687.57
|
|
|
HC EP+PVI ABL
|
Facility
|
OP
|
$8,727.45
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
48100094
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$906.69 |
| Max. Negotiated Rate |
$66,459.11 |
| Rate for Payer: Aetna American Axle |
$5,672.84
|
| Rate for Payer: Aetna Commercial |
$7,418.33
|
| Rate for Payer: Aetna Medicare |
$21,955.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,672.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26,389.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26,389.02
|
| Rate for Payer: BCBS Complete |
$12,126.28
|
| Rate for Payer: BCBS MAPPO |
$21,111.22
|
| Rate for Payer: BCBS Trust/PPO |
$1,211.46
|
| Rate for Payer: BCN Medicare Advantage |
$21,111.22
|
| Rate for Payer: Cash Price |
$6,981.96
|
| Rate for Payer: Cash Price |
$6,981.96
|
| Rate for Payer: Cofinity Commercial |
$7,505.61
|
| Rate for Payer: Cofinity Commercial |
$6,109.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,981.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21,111.22
|
| Rate for Payer: Healthscope Commercial |
$7,854.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,109.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,545.59
|
| Rate for Payer: Mclaren Medicaid |
$11,547.84
|
| Rate for Payer: Mclaren Medicare |
$21,111.22
|
| Rate for Payer: Meridian Medicaid |
$12,126.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22,166.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,277.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,418.33
|
| Rate for Payer: PACE Medicare |
$20,055.66
|
| Rate for Payer: PACE SWMI |
$21,111.22
|
| Rate for Payer: PHP Commercial |
$7,418.33
|
| Rate for Payer: PHP Medicare Advantage |
$21,111.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$11,547.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,109.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66,459.11
|
| Rate for Payer: Priority Health Medicare |
$21,111.22
|
| Rate for Payer: Priority Health Narrow Network |
$53,167.29
|
| Rate for Payer: Priority Health SBD |
$5,498.29
|
| Rate for Payer: Railroad Medicare Medicare |
$21,111.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$997.36
|
| Rate for Payer: UHC Core |
$18,337.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$21,111.22
|
| Rate for Payer: UHC Exchange |
$906.69
|
| Rate for Payer: UHC Medicare Advantage |
$21,744.56
|
| Rate for Payer: UMR Bronson Commercial |
$3,229.16
|
| Rate for Payer: VA VA |
$21,111.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,545.59
|
|
|
HC EP+PVI ABL
|
Facility
|
IP
|
$8,727.45
|
|
|
Service Code
|
CPT 93656
|
| Hospital Charge Code |
48100094
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,840.08 |
| Max. Negotiated Rate |
$7,854.70 |
| Rate for Payer: Aetna American Axle |
$5,672.84
|
| Rate for Payer: Aetna Commercial |
$7,418.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,672.84
|
| Rate for Payer: Cash Price |
$6,981.96
|
| Rate for Payer: Cofinity Commercial |
$6,109.22
|
| Rate for Payer: Cofinity Commercial |
$7,505.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,981.96
|
| Rate for Payer: Healthscope Commercial |
$7,854.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,109.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,545.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,418.33
|
| Rate for Payer: PHP Commercial |
$7,418.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,109.22
|
| Rate for Payer: Priority Health SBD |
$5,498.29
|
| Rate for Payer: UMR Bronson Commercial |
$3,840.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,545.59
|
|
|
HC EPSTEIN BARR AB-IGG & IGM
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200353
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.68
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.14
|
| Rate for Payer: BCBS Trust/PPO |
$16.32
|
| Rate for Payer: BCN Medicare Advantage |
$18.14
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.14
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Medicare |
$17.23
|
| Rate for Payer: PACE SWMI |
$18.14
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$18.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$18.14
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: Railroad Medicare Medicare |
$18.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.77
|
| Rate for Payer: UHC Core |
$29.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.14
|
| Rate for Payer: UHC Exchange |
$18.14
|
| Rate for Payer: UHC Medicare Advantage |
$18.68
|
| Rate for Payer: UMR Bronson Commercial |
$13.59
|
| Rate for Payer: VA VA |
$18.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR AB-IGG & IGM
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200353
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.16 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: UMR Bronson Commercial |
$16.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR ANTIBODY
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$18.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.68
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.14
|
| Rate for Payer: BCBS Trust/PPO |
$16.32
|
| Rate for Payer: BCN Medicare Advantage |
$18.14
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.14
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Mclaren Medicare |
$18.14
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Medicare |
$17.23
|
| Rate for Payer: PACE SWMI |
$18.14
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$18.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$18.14
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: Railroad Medicare Medicare |
$18.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.77
|
| Rate for Payer: UHC Core |
$29.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.14
|
| Rate for Payer: UHC Exchange |
$18.14
|
| Rate for Payer: UHC Medicare Advantage |
$18.68
|
| Rate for Payer: UMR Bronson Commercial |
$13.59
|
| Rate for Payer: VA VA |
$18.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR ANTIBODY
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200268
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.16 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: UMR Bronson Commercial |
$16.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN-BARR ANTIBODY NUCLEAR ANTIGEN
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200267
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.16 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: UMR Bronson Commercial |
$16.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN-BARR ANTIBODY NUCLEAR ANTIGEN
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86664
|
| Hospital Charge Code |
30200267
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.36 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$15.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.11
|
| Rate for Payer: BCBS Complete |
$8.78
|
| Rate for Payer: BCBS MAPPO |
$15.29
|
| Rate for Payer: BCBS Trust/PPO |
$13.75
|
| Rate for Payer: BCN Medicare Advantage |
$15.29
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.29
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$8.36
|
| Rate for Payer: Mclaren Medicare |
$15.29
|
| Rate for Payer: Meridian Medicaid |
$8.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Medicare |
$14.53
|
| Rate for Payer: PACE SWMI |
$15.29
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$15.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$15.29
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: Railroad Medicare Medicare |
$15.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.35
|
| Rate for Payer: UHC Core |
$25.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.29
|
| Rate for Payer: UHC Exchange |
$15.29
|
| Rate for Payer: UHC Medicare Advantage |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$13.59
|
| Rate for Payer: VA VA |
$15.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR EA AG
|
Facility
|
OP
|
$36.72
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
30200365
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna Medicare |
$13.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.40
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$13.12
|
| Rate for Payer: BCBS Trust/PPO |
$11.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.12
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.12
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Mclaren Medicaid |
$7.18
|
| Rate for Payer: Mclaren Medicare |
$13.12
|
| Rate for Payer: Meridian Medicaid |
$7.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PACE Medicare |
$12.46
|
| Rate for Payer: PACE SWMI |
$13.12
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.00
|
| Rate for Payer: Priority Health Medicare |
$13.12
|
| Rate for Payer: Priority Health Narrow Network |
$14.40
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: Railroad Medicare Medicare |
$13.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.74
|
| Rate for Payer: UHC Core |
$21.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.12
|
| Rate for Payer: UHC Exchange |
$13.12
|
| Rate for Payer: UHC Medicare Advantage |
$13.51
|
| Rate for Payer: UMR Bronson Commercial |
$13.59
|
| Rate for Payer: VA VA |
$13.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR EA AG
|
Facility
|
IP
|
$36.72
|
|
|
Service Code
|
CPT 86663
|
| Hospital Charge Code |
30200365
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.16 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$23.87
|
| Rate for Payer: Aetna Commercial |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.87
|
| Rate for Payer: Cash Price |
$29.38
|
| Rate for Payer: Cofinity Commercial |
$25.70
|
| Rate for Payer: Cofinity Commercial |
$31.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.38
|
| Rate for Payer: Healthscope Commercial |
$33.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31.21
|
| Rate for Payer: PHP Commercial |
$31.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.70
|
| Rate for Payer: Priority Health SBD |
$23.13
|
| Rate for Payer: UMR Bronson Commercial |
$16.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.54
|
|
|
HC EPSTEIN BARR VIRUS BY PCR FLUID
|
Facility
|
OP
|
$119.34
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600171
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna American Axle |
$77.57
|
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$83.54
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$75.18
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC EPSTEIN BARR VIRUS BY PCR FLUID
|
Facility
|
IP
|
$119.34
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600171
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.51 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna American Axle |
$77.57
|
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.57
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Cofinity Commercial |
$83.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health SBD |
$75.18
|
| Rate for Payer: UMR Bronson Commercial |
$52.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC EPSTEIN BARR VIRUS PCR BLOOD
|
Facility
|
OP
|
$119.34
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600172
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna American Axle |
$77.57
|
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.61
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$38.53
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Cofinity Commercial |
$83.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Mclaren Medicaid |
$23.43
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Medicaid |
$24.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$75.18
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.41
|
| Rate for Payer: UHC Core |
$70.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$44.13
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC EPSTEIN BARR VIRUS PCR BLOOD
|
Facility
|
IP
|
$119.34
|
|
|
Service Code
|
CPT 87799
|
| Hospital Charge Code |
30600172
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.51 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna American Axle |
$77.57
|
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.57
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Cofinity Commercial |
$83.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$101.44
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.54
|
| Rate for Payer: Priority Health SBD |
$75.18
|
| Rate for Payer: UMR Bronson Commercial |
$52.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC EP UPPER EXTREMITY SOMATOSENSO
|
Facility
|
IP
|
$1,098.32
|
|
|
Service Code
|
CPT 95925
|
| Hospital Charge Code |
92200014
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$483.26 |
| Max. Negotiated Rate |
$988.49 |
| Rate for Payer: Aetna American Axle |
$713.91
|
| Rate for Payer: Aetna Commercial |
$933.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.91
|
| Rate for Payer: Cash Price |
$878.66
|
| Rate for Payer: Cofinity Commercial |
$768.82
|
| Rate for Payer: Cofinity Commercial |
$944.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.66
|
| Rate for Payer: Healthscope Commercial |
$988.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$768.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$933.57
|
| Rate for Payer: PHP Commercial |
$933.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.82
|
| Rate for Payer: Priority Health SBD |
$691.94
|
| Rate for Payer: UMR Bronson Commercial |
$483.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.74
|
|
|
HC EP UPPER EXTREMITY SOMATOSENSO
|
Facility
|
OP
|
$1,098.32
|
|
|
Service Code
|
CPT 95925
|
| Hospital Charge Code |
92200014
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$152.61 |
| Max. Negotiated Rate |
$988.49 |
| Rate for Payer: Aetna American Axle |
$713.91
|
| Rate for Payer: Aetna Commercial |
$933.57
|
| Rate for Payer: Aetna Medicare |
$290.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$713.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$348.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$348.75
|
| Rate for Payer: BCBS Complete |
$160.26
|
| Rate for Payer: BCBS MAPPO |
$279.00
|
| Rate for Payer: BCBS Trust/PPO |
$752.36
|
| Rate for Payer: BCN Medicare Advantage |
$279.00
|
| Rate for Payer: Cash Price |
$878.66
|
| Rate for Payer: Cash Price |
$878.66
|
| Rate for Payer: Cash Price |
$878.66
|
| Rate for Payer: Cofinity Commercial |
$944.56
|
| Rate for Payer: Cofinity Commercial |
$768.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$878.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$279.00
|
| Rate for Payer: Healthscope Commercial |
$988.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$768.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$823.74
|
| Rate for Payer: Mclaren Medicaid |
$152.61
|
| Rate for Payer: Mclaren Medicare |
$279.00
|
| Rate for Payer: Meridian Medicaid |
$160.26
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$292.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$320.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$933.57
|
| Rate for Payer: PACE Medicare |
$265.05
|
| Rate for Payer: PACE SWMI |
$279.00
|
| Rate for Payer: PHP Commercial |
$933.57
|
| Rate for Payer: PHP Medicare Advantage |
$279.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$768.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$878.32
|
| Rate for Payer: Priority Health Medicare |
$279.00
|
| Rate for Payer: Priority Health Narrow Network |
$702.66
|
| Rate for Payer: Priority Health SBD |
$691.94
|
| Rate for Payer: Railroad Medicare Medicare |
$279.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.18
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$279.00
|
| Rate for Payer: UHC Exchange |
$172.89
|
| Rate for Payer: UHC Medicare Advantage |
$287.37
|
| Rate for Payer: UMR Bronson Commercial |
$406.38
|
| Rate for Payer: VA VA |
$279.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$823.74
|
|
