|
HC AUD VESTIBULAR EVAL BASIC
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
CPT 92540
|
| Hospital Charge Code |
47100005
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna American Axle |
$307.27
|
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$122.58
|
| Rate for Payer: BCN Commercial |
$122.58
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.27
|
| Rate for Payer: UHC Core |
$246.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$185.78
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$174.91
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC AUTOIMMUNE DIABETES CMPT
|
Facility
|
IP
|
$44.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200522
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna American Axle |
$28.60
|
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.60
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Advantage |
$30.80
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: Priority Health SBD |
$27.72
|
| Rate for Payer: UMR Bronson Commercial |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC AUTOIMMUNE DIABETES CMPT
|
Facility
|
OP
|
$44.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200522
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Aetna American Axle |
$28.60
|
| Rate for Payer: Aetna Commercial |
$37.40
|
| Rate for Payer: Aetna Medicare |
$24.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: BCBS Complete |
$12.94
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$27.25
|
| Rate for Payer: BCN Commercial |
$27.25
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cash Price |
$35.20
|
| Rate for Payer: Cofinity Advantage |
$30.80
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$39.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.00
|
| Rate for Payer: Mclaren Medicaid |
$23.57
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$24.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.40
|
| Rate for Payer: Nomi Health Commercial |
$35.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.00
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$37.40
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.57
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health SBD |
$27.72
|
| Rate for Payer: Priority Health Tiered Network |
$18.86
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.36
|
| Rate for Payer: UHC Core |
$35.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.57
|
| Rate for Payer: UHC Exchange |
$35.36
|
| Rate for Payer: UHC Medicaid |
$12.33
|
| Rate for Payer: UHCCP Medicaid |
$12.33
|
| Rate for Payer: UMR Bronson Commercial |
$16.28
|
| Rate for Payer: VA VA |
$23.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.00
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
IP
|
$841.79
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$370.39 |
| Max. Negotiated Rate |
$757.61 |
| Rate for Payer: Aetna American Axle |
$547.16
|
| Rate for Payer: Aetna Commercial |
$715.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.16
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cofinity Advantage |
$589.25
|
| Rate for Payer: Cofinity Commercial |
$723.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.43
|
| Rate for Payer: Healthscope Commercial |
$757.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$589.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.34
|
| Rate for Payer: PHP Commercial |
$715.52
|
| Rate for Payer: Priority Health SBD |
$530.33
|
| Rate for Payer: UMR Bronson Commercial |
$370.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.34
|
|
|
HC AUTOLOGOUS UNIT
|
Facility
|
OP
|
$841.79
|
|
|
Service Code
|
HCPCS P9021
|
| Hospital Charge Code |
39000040
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$76.80 |
| Max. Negotiated Rate |
$757.61 |
| Rate for Payer: Aetna American Axle |
$547.16
|
| Rate for Payer: Aetna Commercial |
$715.52
|
| Rate for Payer: Aetna Medicare |
$152.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$547.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$183.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$183.56
|
| Rate for Payer: BCBS Complete |
$80.65
|
| Rate for Payer: BCBS MAPPO |
$146.85
|
| Rate for Payer: BCBS Trust/PPO |
$381.77
|
| Rate for Payer: BCN Commercial |
$381.77
|
| Rate for Payer: BCN Medicare Advantage |
$146.85
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cofinity Advantage |
$589.25
|
| Rate for Payer: Cofinity Commercial |
$723.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$146.85
|
| Rate for Payer: Healthscope Commercial |
$757.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$589.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.34
|
| Rate for Payer: Mclaren Medicaid |
$146.85
|
| Rate for Payer: Mclaren Medicare |
$146.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$154.19
|
| Rate for Payer: Meridian Medicaid |
$154.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$168.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$161.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.52
|
| Rate for Payer: Nomi Health Commercial |
$440.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.34
|
| Rate for Payer: PACE Medicare |
$139.51
|
| Rate for Payer: PACE SWMI |
$146.85
|
| Rate for Payer: PHP Commercial |
$715.52
|
| Rate for Payer: PHP Medicare Advantage |
$146.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$474.89
|
| Rate for Payer: Priority Health Medicare |
$146.85
|
| Rate for Payer: Priority Health SBD |
$530.33
|
| Rate for Payer: Priority Health Tiered Network |
$379.91
|
| Rate for Payer: Railroad Medicare Medicare |
$146.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$547.16
|
| Rate for Payer: UHC Core |
$438.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$146.85
|
| Rate for Payer: UHC Exchange |
$330.82
|
| Rate for Payer: UHC Medicaid |
$76.80
|
| Rate for Payer: UHCCP Medicaid |
$76.80
|
| Rate for Payer: UMR Bronson Commercial |
$311.46
|
| Rate for Payer: VA VA |
$146.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.34
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
OP
|
$185.16
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$68.51 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$120.35
|
| Rate for Payer: Aetna Commercial |
$157.39
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$185.96
|
| Rate for Payer: BCN Commercial |
$185.96
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$148.13
|
| Rate for Payer: Cash Price |
$148.13
|
| Rate for Payer: Cofinity Advantage |
$129.61
|
| Rate for Payer: Cofinity Commercial |
$159.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$166.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.87
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.39
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.87
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$157.39
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$116.65
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.35
|
| Rate for Payer: UHC Core |
$96.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$72.77
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$68.51
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.87
|
|
|
HC AUTONOMIC FUNC ADRENERGIC
|
Facility
|
IP
|
$185.16
|
|
|
Service Code
|
CPT 95922
|
| Hospital Charge Code |
92000007
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$81.47 |
| Max. Negotiated Rate |
$166.64 |
| Rate for Payer: Aetna American Axle |
$120.35
|
| Rate for Payer: Aetna Commercial |
$157.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.35
|
| Rate for Payer: Cash Price |
$148.13
|
| Rate for Payer: Cofinity Advantage |
$129.61
|
| Rate for Payer: Cofinity Commercial |
$159.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.13
|
| Rate for Payer: Healthscope Commercial |
$166.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$157.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.87
|
| Rate for Payer: PHP Commercial |
$157.39
|
| Rate for Payer: Priority Health SBD |
$116.65
|
| Rate for Payer: UMR Bronson Commercial |
$81.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.87
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
IP
|
$370.31
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$162.94 |
| Max. Negotiated Rate |
$333.28 |
| Rate for Payer: Aetna American Axle |
$240.70
|
| Rate for Payer: Aetna Commercial |
$314.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.70
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Advantage |
$259.22
|
| Rate for Payer: Cofinity Commercial |
$318.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Healthscope Commercial |
$333.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PHP Commercial |
$314.76
|
| Rate for Payer: Priority Health SBD |
$233.30
|
| Rate for Payer: UMR Bronson Commercial |
$162.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.73
|
|
|
HC AUTONOMIC FUNC CARDIO INNERVAT
|
Facility
|
OP
|
$370.31
|
|
|
Service Code
|
CPT 95921
|
| Hospital Charge Code |
92000006
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$414.63 |
| Rate for Payer: Aetna American Axle |
$240.70
|
| Rate for Payer: Aetna Commercial |
$314.76
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$181.76
|
| Rate for Payer: BCN Commercial |
$181.76
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Advantage |
$259.22
|
| Rate for Payer: Cofinity Commercial |
$318.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$333.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.73
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$314.76
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$233.30
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.70
|
| Rate for Payer: UHC Core |
$192.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$145.53
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: UMR Bronson Commercial |
$137.01
|
| Rate for Payer: VA VA |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.73
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
IP
|
$370.31
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$162.94 |
| Max. Negotiated Rate |
$333.28 |
| Rate for Payer: Aetna American Axle |
$240.70
|
| Rate for Payer: Aetna Commercial |
$314.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.70
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Advantage |
$259.22
|
| Rate for Payer: Cofinity Commercial |
$318.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Healthscope Commercial |
$333.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PHP Commercial |
$314.76
|
| Rate for Payer: Priority Health SBD |
$233.30
|
| Rate for Payer: UMR Bronson Commercial |
$162.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.73
|
|
|
HC AUTONOMIC FUNC QSART
|
Facility
|
OP
|
$370.31
|
|
|
Service Code
|
CPT 95923
|
| Hospital Charge Code |
92000008
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$69.33 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$240.70
|
| Rate for Payer: Aetna Commercial |
$314.76
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$312.78
|
| Rate for Payer: BCN Commercial |
$312.78
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cash Price |
$296.25
|
| Rate for Payer: Cofinity Advantage |
$259.22
|
| Rate for Payer: Cofinity Commercial |
$318.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$333.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$277.73
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$314.76
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$277.73
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$314.76
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$233.30
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.70
|
| Rate for Payer: UHC Core |
$192.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$145.53
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$137.01
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$277.73
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
OP
|
$529.01
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$112.52 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna American Axle |
$343.86
|
| Rate for Payer: Aetna Commercial |
$449.66
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$264.87
|
| Rate for Payer: BCN Commercial |
$264.87
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$423.21
|
| Rate for Payer: Cash Price |
$423.21
|
| Rate for Payer: Cofinity Advantage |
$370.31
|
| Rate for Payer: Cofinity Commercial |
$454.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$476.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$370.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.76
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.66
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.76
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$449.66
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$333.28
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.86
|
| Rate for Payer: UHC Core |
$275.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$207.90
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$195.73
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.76
|
|
|
HC AUTONOMIC W/O QSART
|
Facility
|
IP
|
$529.01
|
|
|
Service Code
|
CPT 95924
|
| Hospital Charge Code |
92000012
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$232.76 |
| Max. Negotiated Rate |
$476.11 |
| Rate for Payer: Aetna American Axle |
$343.86
|
| Rate for Payer: Aetna Commercial |
$449.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$343.86
|
| Rate for Payer: Cash Price |
$423.21
|
| Rate for Payer: Cofinity Advantage |
$370.31
|
| Rate for Payer: Cofinity Commercial |
$454.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.21
|
| Rate for Payer: Healthscope Commercial |
$476.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$370.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$396.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$449.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$396.76
|
| Rate for Payer: PHP Commercial |
$449.66
|
| Rate for Payer: Priority Health SBD |
$333.28
|
| Rate for Payer: UMR Bronson Commercial |
$232.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$396.76
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
IP
|
$326.34
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$143.59 |
| Max. Negotiated Rate |
$293.71 |
| Rate for Payer: Aetna American Axle |
$212.12
|
| Rate for Payer: Aetna Commercial |
$277.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.12
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cofinity Advantage |
$228.44
|
| Rate for Payer: Cofinity Commercial |
$280.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.07
|
| Rate for Payer: Healthscope Commercial |
$293.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.75
|
| Rate for Payer: PHP Commercial |
$277.39
|
| Rate for Payer: Priority Health SBD |
$205.59
|
| Rate for Payer: UMR Bronson Commercial |
$143.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.75
|
|
|
HC AVULSION OF NAIL PLATE
|
Facility
|
OP
|
$326.34
|
|
|
Service Code
|
CPT 11730
|
| Hospital Charge Code |
76100045
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$212.12
|
| Rate for Payer: Aetna Commercial |
$277.39
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$209.78
|
| Rate for Payer: BCN Commercial |
$209.78
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cash Price |
$261.07
|
| Rate for Payer: Cofinity Advantage |
$228.44
|
| Rate for Payer: Cofinity Commercial |
$280.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$293.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.75
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$277.39
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$244.75
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$277.39
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$205.59
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$212.12
|
| Rate for Payer: UHC Core |
$170.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$128.25
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$120.75
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.75
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
OP
|
$8.29
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.07 |
| Max. Negotiated Rate |
$7.46 |
| Rate for Payer: Aetna American Axle |
$5.39
|
| Rate for Payer: Aetna Commercial |
$7.05
|
| Rate for Payer: Aetna Medicare |
$4.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.39
|
| Rate for Payer: BCBS Complete |
$3.32
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cofinity Advantage |
$5.80
|
| Rate for Payer: Cofinity Commercial |
$7.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$7.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.22
|
| Rate for Payer: PHP Commercial |
$7.05
|
| Rate for Payer: Priority Health SBD |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.39
|
| Rate for Payer: UHC Core |
$4.32
|
| Rate for Payer: UHC Exchange |
$3.26
|
| Rate for Payer: UMR Bronson Commercial |
$3.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.22
|
|
|
HC BACITRACIN 1 OZ
|
Facility
|
IP
|
$8.29
|
|
| Hospital Charge Code |
27100006
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$7.46 |
| Rate for Payer: Aetna American Axle |
$5.39
|
| Rate for Payer: Aetna Commercial |
$7.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.39
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cofinity Advantage |
$5.80
|
| Rate for Payer: Cofinity Commercial |
$7.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$7.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.22
|
| Rate for Payer: PHP Commercial |
$7.05
|
| Rate for Payer: Priority Health SBD |
$5.22
|
| Rate for Payer: UMR Bronson Commercial |
$3.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.22
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
OP
|
$31.60
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$11.69 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Aetna American Axle |
$20.54
|
| Rate for Payer: Aetna Commercial |
$26.86
|
| Rate for Payer: Aetna Medicare |
$15.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.54
|
| Rate for Payer: BCBS Complete |
$12.64
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cofinity Advantage |
$22.12
|
| Rate for Payer: Cofinity Commercial |
$27.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.28
|
| Rate for Payer: Healthscope Commercial |
$28.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.70
|
| Rate for Payer: PHP Commercial |
$26.86
|
| Rate for Payer: Priority Health SBD |
$19.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.54
|
| Rate for Payer: UHC Core |
$16.46
|
| Rate for Payer: UHC Exchange |
$12.42
|
| Rate for Payer: UMR Bronson Commercial |
$11.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.70
|
|
|
HC BACITRACIN 4 OZ
|
Facility
|
IP
|
$31.60
|
|
| Hospital Charge Code |
27100007
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$13.90 |
| Max. Negotiated Rate |
$28.44 |
| Rate for Payer: Aetna American Axle |
$20.54
|
| Rate for Payer: Aetna Commercial |
$26.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.54
|
| Rate for Payer: Cash Price |
$25.28
|
| Rate for Payer: Cofinity Advantage |
$22.12
|
| Rate for Payer: Cofinity Commercial |
$27.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.28
|
| Rate for Payer: Healthscope Commercial |
$28.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.70
|
| Rate for Payer: PHP Commercial |
$26.86
|
| Rate for Payer: Priority Health SBD |
$19.91
|
| Rate for Payer: UMR Bronson Commercial |
$13.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.70
|
|
|
HC BACK SCREEN
|
Facility
|
IP
|
$53.06
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC BACK SCREEN
|
Facility
|
OP
|
$53.06
|
|
| Hospital Charge Code |
42000047
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.63 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.49
|
| Rate for Payer: UHC Core |
$27.64
|
| Rate for Payer: UHC Exchange |
$20.85
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
OP
|
$69.71
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$25.79 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$45.31
|
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$34.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.31
|
| Rate for Payer: BCBS Complete |
$27.88
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Advantage |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health SBD |
$43.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.31
|
| Rate for Payer: UHC Core |
$36.32
|
| Rate for Payer: UHC Exchange |
$27.40
|
| Rate for Payer: UMR Bronson Commercial |
$25.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC BACK SCREEN, VBISD
|
Facility
|
IP
|
$69.71
|
|
| Hospital Charge Code |
43000014
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna American Axle |
$45.31
|
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.31
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Advantage |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health SBD |
$43.92
|
| Rate for Payer: UMR Bronson Commercial |
$30.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC BACTERIAL VAGINOSIS PANEL
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 0352U
|
| Hospital Charge Code |
30600337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$57.74 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna American Axle |
$101.44
|
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$78.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: BCBS Complete |
$62.42
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Advantage |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.03
|
| Rate for Payer: UHC Core |
$78.03
|
| Rate for Payer: UHC Exchange |
$78.03
|
| Rate for Payer: UMR Bronson Commercial |
$57.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC BACTERIAL VAGINOSIS PANEL
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 0352U
|
| Hospital Charge Code |
30600337
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$68.67 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna American Axle |
$101.44
|
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Advantage |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: UMR Bronson Commercial |
$68.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
