|
HC APPLY SPLINT/CAST COMPLEX
|
Facility
|
OP
|
$335.44
|
|
| Hospital Charge Code |
45000027
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$124.11 |
| Max. Negotiated Rate |
$301.90 |
| Rate for Payer: Aetna American Axle |
$218.04
|
| Rate for Payer: Aetna Commercial |
$285.12
|
| Rate for Payer: Aetna Medicare |
$167.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.04
|
| Rate for Payer: BCBS Complete |
$134.18
|
| Rate for Payer: Cash Price |
$268.35
|
| Rate for Payer: Cash Price |
$268.35
|
| Rate for Payer: Cofinity Advantage |
$234.81
|
| Rate for Payer: Cofinity Commercial |
$288.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.35
|
| Rate for Payer: Healthscope Commercial |
$301.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$234.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.58
|
| Rate for Payer: PHP Commercial |
$285.12
|
| Rate for Payer: Priority Health SBD |
$211.33
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$124.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.58
|
|
|
HC APPLY SPLINT/CAST COMPLEX
|
Facility
|
IP
|
$335.44
|
|
| Hospital Charge Code |
45000027
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$147.59 |
| Max. Negotiated Rate |
$301.90 |
| Rate for Payer: Aetna American Axle |
$218.04
|
| Rate for Payer: Aetna Commercial |
$285.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.04
|
| Rate for Payer: Cash Price |
$268.35
|
| Rate for Payer: Cofinity Advantage |
$234.81
|
| Rate for Payer: Cofinity Commercial |
$288.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$268.35
|
| Rate for Payer: Healthscope Commercial |
$301.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$234.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$251.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$285.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$251.58
|
| Rate for Payer: PHP Commercial |
$285.12
|
| Rate for Payer: Priority Health SBD |
$211.33
|
| Rate for Payer: UMR Bronson Commercial |
$147.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$251.58
|
|
|
HC APPLY SPLINT/CAST SIMPLE
|
Facility
|
IP
|
$200.95
|
|
| Hospital Charge Code |
45000028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$88.42 |
| Max. Negotiated Rate |
$180.85 |
| Rate for Payer: Aetna American Axle |
$130.62
|
| Rate for Payer: Aetna Commercial |
$170.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.62
|
| Rate for Payer: Cash Price |
$160.76
|
| Rate for Payer: Cofinity Advantage |
$140.66
|
| Rate for Payer: Cofinity Commercial |
$172.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.76
|
| Rate for Payer: Healthscope Commercial |
$180.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.71
|
| Rate for Payer: PHP Commercial |
$170.81
|
| Rate for Payer: Priority Health SBD |
$126.60
|
| Rate for Payer: UMR Bronson Commercial |
$88.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.71
|
|
|
HC APPLY SPLINT/CAST SIMPLE
|
Facility
|
OP
|
$200.95
|
|
| Hospital Charge Code |
45000028
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$74.35 |
| Max. Negotiated Rate |
$180.85 |
| Rate for Payer: Aetna American Axle |
$130.62
|
| Rate for Payer: Aetna Commercial |
$170.81
|
| Rate for Payer: Aetna Medicare |
$100.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.62
|
| Rate for Payer: BCBS Complete |
$80.38
|
| Rate for Payer: Cash Price |
$160.76
|
| Rate for Payer: Cash Price |
$160.76
|
| Rate for Payer: Cofinity Advantage |
$140.66
|
| Rate for Payer: Cofinity Commercial |
$172.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.76
|
| Rate for Payer: Healthscope Commercial |
$180.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$160.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$150.71
|
| Rate for Payer: PHP Commercial |
$170.81
|
| Rate for Payer: Priority Health SBD |
$126.60
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$74.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.71
|
|
|
HC APT DOWNEY TEST
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 83033
|
| Hospital Charge Code |
30100237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.18 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna American Axle |
$61.13
|
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna Medicare |
$8.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.00
|
| Rate for Payer: BCBS Complete |
$4.39
|
| Rate for Payer: BCBS MAPPO |
$8.00
|
| Rate for Payer: BCBS Trust/PPO |
$9.25
|
| Rate for Payer: BCN Commercial |
$9.25
|
| Rate for Payer: BCN Medicare Advantage |
$8.00
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Advantage |
$65.83
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.00
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Mclaren Medicaid |
$8.00
|
| Rate for Payer: Mclaren Medicare |
$8.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.40
|
| Rate for Payer: Meridian Medicaid |
$8.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$12.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PACE Medicare |
$7.60
|
| Rate for Payer: PACE SWMI |
$8.00
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: PHP Medicare Advantage |
$8.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.00
|
| Rate for Payer: Priority Health Medicare |
$8.00
|
| Rate for Payer: Priority Health SBD |
$59.25
|
| Rate for Payer: Priority Health Tiered Network |
$6.40
|
| Rate for Payer: Railroad Medicare Medicare |
$8.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.00
|
| Rate for Payer: UHC Core |
$12.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.00
|
| Rate for Payer: UHC Exchange |
$12.00
|
| Rate for Payer: UHC Medicaid |
$4.18
|
| Rate for Payer: UHCCP Medicaid |
$4.18
|
| Rate for Payer: UMR Bronson Commercial |
$34.80
|
| Rate for Payer: VA VA |
$8.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC APT DOWNEY TEST
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 83033
|
| Hospital Charge Code |
30100237
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna American Axle |
$61.13
|
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.13
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Advantage |
$65.83
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: Priority Health SBD |
$59.25
|
| Rate for Payer: UMR Bronson Commercial |
$41.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC APTT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
| Rate for Payer: BCBS Complete |
$3.30
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCBS Trust/PPO |
$6.95
|
| Rate for Payer: BCN Commercial |
$6.95
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$6.01
|
| Rate for Payer: Mclaren Medicare |
$6.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: Meridian Medicaid |
$6.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$9.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.01
|
| Rate for Payer: Priority Health Medicare |
$6.01
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$4.81
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.02
|
| Rate for Payer: UHC Core |
$9.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.01
|
| Rate for Payer: UHC Exchange |
$9.02
|
| Rate for Payer: UHC Medicaid |
$3.14
|
| Rate for Payer: UHCCP Medicaid |
$3.14
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$6.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC APTT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC APTT MIXING STUDY
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$44.86 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna American Axle |
$66.27
|
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Advantage |
$71.37
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: UMR Bronson Commercial |
$44.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC APTT MIXING STUDY
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna American Axle |
$66.27
|
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.55
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$7.48
|
| Rate for Payer: BCN Commercial |
$7.48
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Advantage |
$71.37
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Mclaren Medicaid |
$6.47
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: Meridian Medicaid |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$9.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.47
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: Priority Health Tiered Network |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.71
|
| Rate for Payer: UHC Core |
$9.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.47
|
| Rate for Payer: UHC Exchange |
$9.71
|
| Rate for Payer: UHC Medicaid |
$3.38
|
| Rate for Payer: UHCCP Medicaid |
$3.38
|
| Rate for Payer: UMR Bronson Commercial |
$37.73
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC AQUATIC THERAPY EA 15 MIN
|
Facility
|
OP
|
$95.51
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
42000022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$26.40 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$62.08
|
| Rate for Payer: Aetna Commercial |
$81.18
|
| Rate for Payer: Aetna Medicare |
$47.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.08
|
| Rate for Payer: BCBS Complete |
$38.20
|
| Rate for Payer: BCBS Trust/PPO |
$34.16
|
| Rate for Payer: BCN Commercial |
$34.16
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cofinity Advantage |
$66.86
|
| Rate for Payer: Cofinity Commercial |
$82.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.41
|
| Rate for Payer: Healthscope Commercial |
$85.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.18
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.63
|
| Rate for Payer: PHP Commercial |
$81.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$33.00
|
| Rate for Payer: Priority Health SBD |
$60.17
|
| Rate for Payer: Priority Health Tiered Network |
$26.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.08
|
| Rate for Payer: UHC Core |
$49.76
|
| Rate for Payer: UHC Exchange |
$37.54
|
| Rate for Payer: UMR Bronson Commercial |
$35.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.63
|
|
|
HC AQUATIC THERAPY EA 15 MIN
|
Facility
|
IP
|
$95.51
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
42000022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$42.02 |
| Max. Negotiated Rate |
$85.96 |
| Rate for Payer: Aetna American Axle |
$62.08
|
| Rate for Payer: Aetna Commercial |
$81.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.08
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cofinity Advantage |
$66.86
|
| Rate for Payer: Cofinity Commercial |
$82.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.41
|
| Rate for Payer: Healthscope Commercial |
$85.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.63
|
| Rate for Payer: PHP Commercial |
$81.18
|
| Rate for Payer: Priority Health SBD |
$60.17
|
| Rate for Payer: UMR Bronson Commercial |
$42.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.63
|
|
|
HC ARBOVIRUS CALIF CMPT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200388
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$13.19
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.19
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$10.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.79
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.19
|
| Rate for Payer: UHC Exchange |
$19.79
|
| Rate for Payer: UHC Medicaid |
$6.90
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS CALIF CMPT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200388
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS E EQUINE CMPT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200389
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS E EQUINE CMPT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200389
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$13.19
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.19
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$10.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.79
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.19
|
| Rate for Payer: UHC Exchange |
$19.79
|
| Rate for Payer: UHC Medicaid |
$6.90
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS IGG/IGM PNL, CSF
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200387
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS IGG/IGM PNL, CSF
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200387
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$13.19
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.19
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$10.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.79
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.19
|
| Rate for Payer: UHC Exchange |
$19.79
|
| Rate for Payer: UHC Medicaid |
$6.90
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$13.19
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.19
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$10.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.79
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.19
|
| Rate for Payer: UHC Exchange |
$19.79
|
| Rate for Payer: UHC Medicaid |
$6.90
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$13.19
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.19
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$10.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.79
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.19
|
| Rate for Payer: UHC Exchange |
$19.79
|
| Rate for Payer: UHC Medicaid |
$6.90
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
IP
|
$2,632.46
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,158.28 |
| Max. Negotiated Rate |
$2,369.21 |
| Rate for Payer: Aetna American Axle |
$1,711.10
|
| Rate for Payer: Aetna Commercial |
$2,237.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,711.10
|
| Rate for Payer: Cash Price |
$2,105.97
|
| Rate for Payer: Cofinity Advantage |
$1,842.72
|
| Rate for Payer: Cofinity Commercial |
$2,263.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.97
|
| Rate for Payer: Healthscope Commercial |
$2,369.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,842.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,974.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,974.35
|
| Rate for Payer: PHP Commercial |
$2,237.59
|
| Rate for Payer: Priority Health SBD |
$1,658.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,158.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,974.35
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
OP
|
$2,632.46
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$974.01 |
| Max. Negotiated Rate |
$2,369.21 |
| Rate for Payer: Aetna American Axle |
$1,711.10
|
| Rate for Payer: Aetna Commercial |
$2,237.59
|
| Rate for Payer: Aetna Medicare |
$1,316.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,711.10
|
| Rate for Payer: BCBS Complete |
$1,052.98
|
| Rate for Payer: Cash Price |
$2,105.97
|
| Rate for Payer: Cofinity Advantage |
$1,842.72
|
| Rate for Payer: Cofinity Commercial |
$2,263.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.97
|
| Rate for Payer: Healthscope Commercial |
$2,369.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,842.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,974.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,105.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,974.35
|
| Rate for Payer: PHP Commercial |
$2,237.59
|
| Rate for Payer: Priority Health SBD |
$1,658.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,711.10
|
| Rate for Payer: UHC Core |
$1,371.51
|
| Rate for Payer: UHC Exchange |
$1,034.56
|
| Rate for Payer: UMR Bronson Commercial |
$974.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,974.35
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
IP
|
$1,140.74
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$501.93 |
| Max. Negotiated Rate |
$1,026.67 |
| Rate for Payer: Aetna American Axle |
$741.48
|
| Rate for Payer: Aetna Commercial |
$969.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$741.48
|
| Rate for Payer: Cash Price |
$912.59
|
| Rate for Payer: Cofinity Advantage |
$798.52
|
| Rate for Payer: Cofinity Commercial |
$981.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$912.59
|
| Rate for Payer: Healthscope Commercial |
$1,026.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$798.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$855.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$969.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$855.55
|
| Rate for Payer: PHP Commercial |
$969.63
|
| Rate for Payer: Priority Health SBD |
$718.67
|
| Rate for Payer: UMR Bronson Commercial |
$501.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$855.55
|
|
