|
HC FNA BX 1ST LESION FLUORO GUIDE
|
Facility
|
OP
|
$890.46
|
|
|
Service Code
|
CPT 10007
|
| Hospital Charge Code |
36100556
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$86.77 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$578.80
|
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$304.07
|
| Rate for Payer: BCCCP Commercial |
$304.04
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Cofinity Commercial |
$623.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$560.99
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.45
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$86.77
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$329.47
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
IP
|
$890.46
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$391.80 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna American Axle |
$578.80
|
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.80
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$623.32
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health SBD |
$560.99
|
| Rate for Payer: UMR Bronson Commercial |
$391.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION MR GUIDE
|
Facility
|
OP
|
$890.46
|
|
|
Service Code
|
CPT 10011
|
| Hospital Charge Code |
36100560
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$329.47 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$578.80
|
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$413.47
|
| Rate for Payer: BCCCP Commercial |
$445.03
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Cofinity Commercial |
$623.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$560.99
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$329.47
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
OP
|
$890.46
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$70.73 |
| Max. Negotiated Rate |
$1,968.76 |
| Rate for Payer: Aetna American Axle |
$578.80
|
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna Medicare |
$650.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.74
|
| Rate for Payer: BCBS Complete |
$359.22
|
| Rate for Payer: BCBS MAPPO |
$625.39
|
| Rate for Payer: BCBS Trust/PPO |
$778.18
|
| Rate for Payer: BCCCP Commercial |
$141.12
|
| Rate for Payer: BCN Medicare Advantage |
$625.39
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$623.32
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.39
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Mclaren Medicaid |
$342.09
|
| Rate for Payer: Mclaren Medicare |
$625.39
|
| Rate for Payer: Meridian Medicaid |
$359.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$656.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$719.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PACE Medicare |
$594.12
|
| Rate for Payer: PACE SWMI |
$625.39
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: PHP Medicare Advantage |
$625.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$342.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,968.76
|
| Rate for Payer: Priority Health Medicare |
$625.39
|
| Rate for Payer: Priority Health Narrow Network |
$1,575.01
|
| Rate for Payer: Priority Health SBD |
$560.99
|
| Rate for Payer: Railroad Medicare Medicare |
$625.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$625.39
|
| Rate for Payer: UHC Exchange |
$70.73
|
| Rate for Payer: UHC Medicare Advantage |
$644.15
|
| Rate for Payer: UMR Bronson Commercial |
$329.47
|
| Rate for Payer: VA VA |
$625.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX 1ST LESION US GUIDE
|
Facility
|
IP
|
$890.46
|
|
|
Service Code
|
CPT 10005
|
| Hospital Charge Code |
36100554
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$391.80 |
| Max. Negotiated Rate |
$801.41 |
| Rate for Payer: Aetna American Axle |
$578.80
|
| Rate for Payer: Aetna Commercial |
$756.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$578.80
|
| Rate for Payer: Cash Price |
$712.37
|
| Rate for Payer: Cofinity Commercial |
$623.32
|
| Rate for Payer: Cofinity Commercial |
$765.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.37
|
| Rate for Payer: Healthscope Commercial |
$801.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$623.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.89
|
| Rate for Payer: PHP Commercial |
$756.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.32
|
| Rate for Payer: Priority Health SBD |
$560.99
|
| Rate for Payer: UMR Bronson Commercial |
$391.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.84
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
OP
|
$147.90
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$54.72 |
| Max. Negotiated Rate |
$1,076.98 |
| Rate for Payer: Aetna American Axle |
$96.14
|
| Rate for Payer: Aetna Commercial |
$125.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.14
|
| Rate for Payer: BCBS Complete |
$59.16
|
| Rate for Payer: BCBS Trust/PPO |
$1,076.98
|
| Rate for Payer: BCCCP Commercial |
$245.50
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cofinity Commercial |
$103.53
|
| Rate for Payer: Cofinity Commercial |
$127.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.32
|
| Rate for Payer: Healthscope Commercial |
$133.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.72
|
| Rate for Payer: PHP Commercial |
$125.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.53
|
| Rate for Payer: Priority Health SBD |
$93.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.72
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$69.75
|
| Rate for Payer: UMR Bronson Commercial |
$54.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.92
|
|
|
HC FNA BX EACH ADDL CT GUIDE
|
Facility
|
IP
|
$147.90
|
|
|
Service Code
|
CPT 10010
|
| Hospital Charge Code |
36100559
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$65.08 |
| Max. Negotiated Rate |
$133.11 |
| Rate for Payer: Aetna American Axle |
$96.14
|
| Rate for Payer: Aetna Commercial |
$125.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.14
|
| Rate for Payer: Cash Price |
$118.32
|
| Rate for Payer: Cofinity Commercial |
$103.53
|
| Rate for Payer: Cofinity Commercial |
$127.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.32
|
| Rate for Payer: Healthscope Commercial |
$133.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.72
|
| Rate for Payer: PHP Commercial |
$125.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.53
|
| Rate for Payer: Priority Health SBD |
$93.18
|
| Rate for Payer: UMR Bronson Commercial |
$65.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.92
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
IP
|
$162.69
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$71.58 |
| Max. Negotiated Rate |
$146.42 |
| Rate for Payer: Aetna American Axle |
$105.75
|
| Rate for Payer: Aetna Commercial |
$138.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.75
|
| Rate for Payer: Cash Price |
$130.15
|
| Rate for Payer: Cofinity Commercial |
$113.88
|
| Rate for Payer: Cofinity Commercial |
$139.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.15
|
| Rate for Payer: Healthscope Commercial |
$146.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.29
|
| Rate for Payer: PHP Commercial |
$138.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.88
|
| Rate for Payer: Priority Health SBD |
$102.49
|
| Rate for Payer: UMR Bronson Commercial |
$71.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.02
|
|
|
HC FNA BX EACH ADDL FLUORO GUIDE
|
Facility
|
OP
|
$162.69
|
|
|
Service Code
|
CPT 10008
|
| Hospital Charge Code |
36100557
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$49.77 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$105.75
|
| Rate for Payer: Aetna Commercial |
$138.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.75
|
| Rate for Payer: BCBS Complete |
$65.08
|
| Rate for Payer: BCBS Trust/PPO |
$615.43
|
| Rate for Payer: BCCCP Commercial |
$149.11
|
| Rate for Payer: Cash Price |
$130.15
|
| Rate for Payer: Cash Price |
$130.15
|
| Rate for Payer: Cofinity Commercial |
$113.88
|
| Rate for Payer: Cofinity Commercial |
$139.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.15
|
| Rate for Payer: Healthscope Commercial |
$146.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.29
|
| Rate for Payer: PHP Commercial |
$138.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.88
|
| Rate for Payer: Priority Health SBD |
$102.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.75
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$49.77
|
| Rate for Payer: UMR Bronson Commercial |
$60.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.02
|
|
|
HC FNA BX EACH ADDL US GUIDE
|
Facility
|
IP
|
$195.23
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
36100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.90 |
| Max. Negotiated Rate |
$175.71 |
| Rate for Payer: Aetna American Axle |
$126.90
|
| Rate for Payer: Aetna Commercial |
$165.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.90
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$136.66
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.18
|
| Rate for Payer: Healthscope Commercial |
$175.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.95
|
| Rate for Payer: PHP Commercial |
$165.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.66
|
| Rate for Payer: Priority Health SBD |
$122.99
|
| Rate for Payer: UMR Bronson Commercial |
$85.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.42
|
|
|
HC FNA BX EACH ADDL US GUIDE
|
Facility
|
OP
|
$195.23
|
|
|
Service Code
|
CPT 10006
|
| Hospital Charge Code |
36100555
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$48.46 |
| Max. Negotiated Rate |
$582.64 |
| Rate for Payer: Aetna American Axle |
$126.90
|
| Rate for Payer: Aetna Commercial |
$165.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.90
|
| Rate for Payer: BCBS Complete |
$78.09
|
| Rate for Payer: BCBS Trust/PPO |
$582.64
|
| Rate for Payer: BCCCP Commercial |
$62.74
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cash Price |
$156.18
|
| Rate for Payer: Cofinity Commercial |
$136.66
|
| Rate for Payer: Cofinity Commercial |
$167.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$156.18
|
| Rate for Payer: Healthscope Commercial |
$175.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$136.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$146.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$165.95
|
| Rate for Payer: PHP Commercial |
$165.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.66
|
| Rate for Payer: Priority Health SBD |
$122.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.31
|
| Rate for Payer: UHC Exchange |
$48.46
|
| Rate for Payer: UMR Bronson Commercial |
$72.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$146.42
|
|
|
HC FNA IMED EVAL
|
Facility
|
OP
|
$73.24
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
31100006
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.10 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$47.61
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.78
|
| Rate for Payer: BCBS Complete |
$87.21
|
| Rate for Payer: BCBS MAPPO |
$151.82
|
| Rate for Payer: BCBS Trust/PPO |
$29.45
|
| Rate for Payer: BCCCP Commercial |
$56.11
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Cofinity Commercial |
$51.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Mclaren Medicaid |
$83.05
|
| Rate for Payer: Mclaren Medicare |
$151.82
|
| Rate for Payer: Meridian Medicaid |
$87.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$159.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.25
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$151.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$83.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$477.95
|
| Rate for Payer: Priority Health Medicare |
$151.82
|
| Rate for Payer: Priority Health Narrow Network |
$382.36
|
| Rate for Payer: Priority Health SBD |
$46.14
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.15
|
| Rate for Payer: UHC Core |
$28.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Exchange |
$54.68
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$27.10
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC FNA IMED EVAL
|
Facility
|
IP
|
$73.24
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
31100006
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$32.23 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna American Axle |
$47.61
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.61
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$51.27
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.25
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.27
|
| Rate for Payer: Priority Health SBD |
$46.14
|
| Rate for Payer: UMR Bronson Commercial |
$32.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC FNA IMMEDIATE EVAL ADDITIONAL
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
31000002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna American Axle |
$14.59
|
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.59
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health SBD |
$14.14
|
| Rate for Payer: UMR Bronson Commercial |
$9.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC FNA IMMEDIATE EVAL ADDITIONAL
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
31000002
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$8.30 |
| Max. Negotiated Rate |
$31.69 |
| Rate for Payer: Aetna American Axle |
$14.59
|
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.59
|
| Rate for Payer: BCBS Complete |
$8.98
|
| Rate for Payer: BCBS Trust/PPO |
$11.40
|
| Rate for Payer: BCCCP Commercial |
$29.59
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health SBD |
$14.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.69
|
| Rate for Payer: UHC Core |
$15.25
|
| Rate for Payer: UHC Exchange |
$28.81
|
| Rate for Payer: UMR Bronson Commercial |
$8.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC FNA INTERPRETATION & REPORT
|
Facility
|
IP
|
$217.45
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
31100007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$95.68 |
| Max. Negotiated Rate |
$195.70 |
| Rate for Payer: Aetna American Axle |
$141.34
|
| Rate for Payer: Aetna Commercial |
$184.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.34
|
| Rate for Payer: Cash Price |
$173.96
|
| Rate for Payer: Cofinity Commercial |
$152.22
|
| Rate for Payer: Cofinity Commercial |
$187.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.96
|
| Rate for Payer: Healthscope Commercial |
$195.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.83
|
| Rate for Payer: PHP Commercial |
$184.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.22
|
| Rate for Payer: Priority Health SBD |
$136.99
|
| Rate for Payer: UMR Bronson Commercial |
$95.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.09
|
|
|
HC FNA INTERPRETATION & REPORT
|
Facility
|
OP
|
$217.45
|
|
|
Service Code
|
CPT 88173
|
| Hospital Charge Code |
31100007
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$195.70 |
| Rate for Payer: Aetna American Axle |
$141.34
|
| Rate for Payer: Aetna Commercial |
$184.83
|
| Rate for Payer: Aetna Medicare |
$50.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.21
|
| Rate for Payer: BCBS Complete |
$27.67
|
| Rate for Payer: BCBS MAPPO |
$48.17
|
| Rate for Payer: BCBS Trust/PPO |
$132.08
|
| Rate for Payer: BCCCP Commercial |
$163.43
|
| Rate for Payer: BCN Medicare Advantage |
$48.17
|
| Rate for Payer: Cash Price |
$173.96
|
| Rate for Payer: Cash Price |
$173.96
|
| Rate for Payer: Cofinity Commercial |
$152.22
|
| Rate for Payer: Cofinity Commercial |
$187.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$195.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.09
|
| Rate for Payer: Mclaren Medicaid |
$26.35
|
| Rate for Payer: Mclaren Medicare |
$48.17
|
| Rate for Payer: Meridian Medicaid |
$27.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$184.83
|
| Rate for Payer: PACE Medicare |
$45.76
|
| Rate for Payer: PACE SWMI |
$48.17
|
| Rate for Payer: PHP Commercial |
$184.83
|
| Rate for Payer: PHP Medicare Advantage |
$48.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$152.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.62
|
| Rate for Payer: Priority Health Medicare |
$48.17
|
| Rate for Payer: Priority Health Narrow Network |
$121.30
|
| Rate for Payer: Priority Health SBD |
$136.99
|
| Rate for Payer: Railroad Medicare Medicare |
$48.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.82
|
| Rate for Payer: UHC Core |
$45.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.17
|
| Rate for Payer: UHC Exchange |
$164.38
|
| Rate for Payer: UHC Medicare Advantage |
$49.62
|
| Rate for Payer: UMR Bronson Commercial |
$80.46
|
| Rate for Payer: VA VA |
$48.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.09
|
|
|
HC FOLATE SERUM
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 82746
|
| Hospital Charge Code |
30100204
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.38
|
| Rate for Payer: BCBS Complete |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$14.70
|
| Rate for Payer: BCBS Trust/PPO |
$13.23
|
| Rate for Payer: BCN Medicare Advantage |
$14.70
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.70
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$8.04
|
| Rate for Payer: Mclaren Medicare |
$14.70
|
| Rate for Payer: Meridian Medicaid |
$8.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$13.96
|
| Rate for Payer: PACE SWMI |
$14.70
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$14.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.17
|
| Rate for Payer: Priority Health Medicare |
$14.70
|
| Rate for Payer: Priority Health Narrow Network |
$16.14
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$14.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.64
|
| Rate for Payer: UHC Core |
$24.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.70
|
| Rate for Payer: UHC Exchange |
$14.70
|
| Rate for Payer: UHC Medicare Advantage |
$15.14
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: VA VA |
$14.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC FOLATE SERUM
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 82746
|
| Hospital Charge Code |
30100204
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC FOLEY INSERT BY PHYSICIAN
|
Facility
|
IP
|
$490.51
|
|
| Hospital Charge Code |
45000041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$215.82 |
| Max. Negotiated Rate |
$441.46 |
| Rate for Payer: Aetna American Axle |
$318.83
|
| Rate for Payer: Aetna Commercial |
$416.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.83
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$343.36
|
| Rate for Payer: Cofinity Commercial |
$421.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Healthscope Commercial |
$441.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: PHP Commercial |
$416.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: Priority Health SBD |
$309.02
|
| Rate for Payer: UMR Bronson Commercial |
$215.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.88
|
|
|
HC FOLEY INSERT BY PHYSICIAN
|
Facility
|
OP
|
$490.51
|
|
| Hospital Charge Code |
45000041
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$181.49 |
| Max. Negotiated Rate |
$441.46 |
| Rate for Payer: Aetna American Axle |
$318.83
|
| Rate for Payer: Aetna Commercial |
$416.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.83
|
| Rate for Payer: BCBS Complete |
$196.20
|
| Rate for Payer: Cash Price |
$392.41
|
| Rate for Payer: Cofinity Commercial |
$343.36
|
| Rate for Payer: Cofinity Commercial |
$421.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.41
|
| Rate for Payer: Healthscope Commercial |
$441.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$416.93
|
| Rate for Payer: PHP Commercial |
$416.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$343.36
|
| Rate for Payer: Priority Health SBD |
$309.02
|
| Rate for Payer: UMR Bronson Commercial |
$181.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.88
|
|
|
HC FOLLICLE STIM HORMONE (FSH)
|
Facility
|
IP
|
$64.26
|
|
|
Service Code
|
CPT 83001
|
| Hospital Charge Code |
30100230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.27 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna American Axle |
$41.77
|
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.77
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: UMR Bronson Commercial |
$28.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC FOLLICLE STIM HORMONE (FSH)
|
Facility
|
OP
|
$64.26
|
|
|
Service Code
|
CPT 83001
|
| Hospital Charge Code |
30100230
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.16 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna American Axle |
$41.77
|
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: Aetna Medicare |
$19.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.22
|
| Rate for Payer: BCBS Complete |
$10.67
|
| Rate for Payer: BCBS MAPPO |
$18.58
|
| Rate for Payer: BCBS Trust/PPO |
$16.72
|
| Rate for Payer: BCN Medicare Advantage |
$18.58
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.58
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Mclaren Medicaid |
$10.16
|
| Rate for Payer: Mclaren Medicare |
$18.58
|
| Rate for Payer: Meridian Medicaid |
$10.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PACE Medicare |
$17.65
|
| Rate for Payer: PACE SWMI |
$18.58
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: PHP Medicare Advantage |
$18.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25.49
|
| Rate for Payer: Priority Health Medicare |
$18.58
|
| Rate for Payer: Priority Health Narrow Network |
$20.39
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: Railroad Medicare Medicare |
$18.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.30
|
| Rate for Payer: UHC Core |
$30.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.58
|
| Rate for Payer: UHC Exchange |
$18.58
|
| Rate for Payer: UHC Medicare Advantage |
$19.14
|
| Rate for Payer: UMR Bronson Commercial |
$23.78
|
| Rate for Payer: VA VA |
$18.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC FOOD ALLERGY PROFILE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200070
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC FOOD ALLERGY PROFILE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200070
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
