|
HC FRAGILEX ANALYSIS
|
Facility
|
IP
|
$430.00
|
|
|
Service Code
|
CPT 81243
|
| Hospital Charge Code |
31000099
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$189.20 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Aetna American Axle |
$279.50
|
| Rate for Payer: Aetna Commercial |
$365.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.50
|
| Rate for Payer: Cash Price |
$344.00
|
| Rate for Payer: Cofinity Commercial |
$301.00
|
| Rate for Payer: Cofinity Commercial |
$369.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$344.00
|
| Rate for Payer: Healthscope Commercial |
$387.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$301.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$365.50
|
| Rate for Payer: PHP Commercial |
$365.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.00
|
| Rate for Payer: Priority Health SBD |
$270.90
|
| Rate for Payer: UMR Bronson Commercial |
$189.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.50
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
OP
|
$252.00
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$24.55 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna American Axle |
$163.80
|
| Rate for Payer: Aetna Commercial |
$214.20
|
| Rate for Payer: Aetna Medicare |
$46.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.11
|
| Rate for Payer: BCBS Complete |
$25.78
|
| Rate for Payer: BCBS MAPPO |
$44.89
|
| Rate for Payer: BCBS Trust/PPO |
$40.37
|
| Rate for Payer: BCN Medicare Advantage |
$44.89
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$216.72
|
| Rate for Payer: Cofinity Commercial |
$176.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.89
|
| Rate for Payer: Healthscope Commercial |
$226.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.00
|
| Rate for Payer: Mclaren Medicaid |
$24.55
|
| Rate for Payer: Mclaren Medicare |
$44.89
|
| Rate for Payer: Meridian Medicaid |
$25.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$47.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$214.20
|
| Rate for Payer: PACE Medicare |
$42.65
|
| Rate for Payer: PACE SWMI |
$44.89
|
| Rate for Payer: PHP Commercial |
$214.20
|
| Rate for Payer: PHP Medicare Advantage |
$44.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$100.09
|
| Rate for Payer: Priority Health Medicare |
$44.89
|
| Rate for Payer: Priority Health Narrow Network |
$80.07
|
| Rate for Payer: Priority Health SBD |
$158.76
|
| Rate for Payer: Railroad Medicare Medicare |
$44.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.87
|
| Rate for Payer: UHC Core |
$53.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$44.89
|
| Rate for Payer: UHC Exchange |
$44.89
|
| Rate for Payer: UHC Medicare Advantage |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$93.24
|
| Rate for Payer: VA VA |
$44.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.00
|
|
|
HC FRAGILE X FOLLOW UP
|
Facility
|
IP
|
$252.00
|
|
|
Service Code
|
CPT 81244
|
| Hospital Charge Code |
30000113
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$110.88 |
| Max. Negotiated Rate |
$226.80 |
| Rate for Payer: Aetna American Axle |
$163.80
|
| Rate for Payer: Aetna Commercial |
$214.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.80
|
| Rate for Payer: Cash Price |
$201.60
|
| Rate for Payer: Cofinity Commercial |
$176.40
|
| Rate for Payer: Cofinity Commercial |
$216.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$201.60
|
| Rate for Payer: Healthscope Commercial |
$226.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$176.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$189.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$214.20
|
| Rate for Payer: PHP Commercial |
$214.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.40
|
| Rate for Payer: Priority Health SBD |
$158.76
|
| Rate for Payer: UMR Bronson Commercial |
$110.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$189.00
|
|
|
HC FREE FATTY ACIDS
|
Facility
|
IP
|
$61.00
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna American Axle |
$39.65
|
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.65
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$42.70
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health SBD |
$38.43
|
| Rate for Payer: UMR Bronson Commercial |
$26.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.75
|
|
|
HC FREE FATTY ACIDS
|
Facility
|
OP
|
$61.00
|
|
|
Service Code
|
CPT 82725
|
| Hospital Charge Code |
30100201
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$54.90 |
| Rate for Payer: Aetna American Axle |
$39.65
|
| Rate for Payer: Aetna Commercial |
$51.85
|
| Rate for Payer: Aetna Medicare |
$19.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.46
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$18.77
|
| Rate for Payer: BCBS Trust/PPO |
$16.88
|
| Rate for Payer: BCN Medicare Advantage |
$18.77
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cash Price |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$42.70
|
| Rate for Payer: Cofinity Commercial |
$52.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$54.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.75
|
| Rate for Payer: Mclaren Medicaid |
$10.27
|
| Rate for Payer: Mclaren Medicare |
$18.77
|
| Rate for Payer: Meridian Medicaid |
$10.78
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.85
|
| Rate for Payer: PACE Medicare |
$17.83
|
| Rate for Payer: PACE SWMI |
$18.77
|
| Rate for Payer: PHP Commercial |
$51.85
|
| Rate for Payer: PHP Medicare Advantage |
$18.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.26
|
| Rate for Payer: Priority Health Medicare |
$18.77
|
| Rate for Payer: Priority Health Narrow Network |
$14.61
|
| Rate for Payer: Priority Health SBD |
$38.43
|
| Rate for Payer: Railroad Medicare Medicare |
$18.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.52
|
| Rate for Payer: UHC Core |
$21.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.77
|
| Rate for Payer: UHC Exchange |
$18.77
|
| Rate for Payer: UHC Medicare Advantage |
$19.33
|
| Rate for Payer: UMR Bronson Commercial |
$22.57
|
| Rate for Payer: VA VA |
$18.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.75
|
|
|
HC FREE PLASMA HEMOGLOBIN
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
30100240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.00 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna American Axle |
$42.25
|
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna Medicare |
$7.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.14
|
| Rate for Payer: BCBS Complete |
$4.20
|
| Rate for Payer: BCBS MAPPO |
$7.31
|
| Rate for Payer: BCBS Trust/PPO |
$6.57
|
| Rate for Payer: BCN Medicare Advantage |
$7.31
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$45.50
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.31
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Mclaren Medicaid |
$4.00
|
| Rate for Payer: Mclaren Medicare |
$7.31
|
| Rate for Payer: Meridian Medicaid |
$4.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Medicare |
$6.94
|
| Rate for Payer: PACE SWMI |
$7.31
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: PHP Medicare Advantage |
$7.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.65
|
| Rate for Payer: Priority Health Medicare |
$7.31
|
| Rate for Payer: Priority Health Narrow Network |
$4.52
|
| Rate for Payer: Priority Health SBD |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$7.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.77
|
| Rate for Payer: UHC Core |
$12.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.31
|
| Rate for Payer: UHC Exchange |
$7.31
|
| Rate for Payer: UHC Medicare Advantage |
$7.53
|
| Rate for Payer: UMR Bronson Commercial |
$24.05
|
| Rate for Payer: VA VA |
$7.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC FREE PLASMA HEMOGLOBIN
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 83051
|
| Hospital Charge Code |
30100240
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna American Axle |
$42.25
|
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.25
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$45.50
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health SBD |
$40.95
|
| Rate for Payer: UMR Bronson Commercial |
$28.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC FRENOTOMY
|
Facility
|
OP
|
$1,952.71
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
36100471
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$109.04 |
| Max. Negotiated Rate |
$4,267.42 |
| Rate for Payer: Aetna American Axle |
$1,269.26
|
| Rate for Payer: Aetna Commercial |
$1,659.80
|
| Rate for Payer: Aetna Medicare |
$1,409.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,269.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,694.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,694.48
|
| Rate for Payer: BCBS Complete |
$778.65
|
| Rate for Payer: BCBS MAPPO |
$1,355.58
|
| Rate for Payer: BCBS Trust/PPO |
$942.03
|
| Rate for Payer: BCN Medicare Advantage |
$1,355.58
|
| Rate for Payer: Cash Price |
$1,562.17
|
| Rate for Payer: Cash Price |
$1,562.17
|
| Rate for Payer: Cofinity Commercial |
$1,679.33
|
| Rate for Payer: Cofinity Commercial |
$1,366.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,562.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,355.58
|
| Rate for Payer: Healthscope Commercial |
$1,757.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,366.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,464.53
|
| Rate for Payer: Mclaren Medicaid |
$741.50
|
| Rate for Payer: Mclaren Medicare |
$1,355.58
|
| Rate for Payer: Meridian Medicaid |
$778.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,423.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,558.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,659.80
|
| Rate for Payer: PACE Medicare |
$1,287.80
|
| Rate for Payer: PACE SWMI |
$1,355.58
|
| Rate for Payer: PHP Commercial |
$1,659.80
|
| Rate for Payer: PHP Medicare Advantage |
$1,355.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$741.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,267.42
|
| Rate for Payer: Priority Health Medicare |
$1,355.58
|
| Rate for Payer: Priority Health Narrow Network |
$3,413.94
|
| Rate for Payer: Priority Health SBD |
$1,230.21
|
| Rate for Payer: Railroad Medicare Medicare |
$1,355.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,355.58
|
| Rate for Payer: UHC Exchange |
$109.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,396.25
|
| Rate for Payer: UMR Bronson Commercial |
$722.50
|
| Rate for Payer: VA VA |
$1,355.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,464.53
|
|
|
HC FRENOTOMY
|
Facility
|
IP
|
$1,952.71
|
|
|
Service Code
|
CPT 41010
|
| Hospital Charge Code |
36100471
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$859.19 |
| Max. Negotiated Rate |
$1,757.44 |
| Rate for Payer: Aetna American Axle |
$1,269.26
|
| Rate for Payer: Aetna Commercial |
$1,659.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,269.26
|
| Rate for Payer: Cash Price |
$1,562.17
|
| Rate for Payer: Cofinity Commercial |
$1,366.90
|
| Rate for Payer: Cofinity Commercial |
$1,679.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,562.17
|
| Rate for Payer: Healthscope Commercial |
$1,757.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,366.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,464.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,659.80
|
| Rate for Payer: PHP Commercial |
$1,659.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,366.90
|
| Rate for Payer: Priority Health SBD |
$1,230.21
|
| Rate for Payer: UMR Bronson Commercial |
$859.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,464.53
|
|
|
HC FRESH FROZEN PLASMA
|
Facility
|
IP
|
$357.89
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000051
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$157.47 |
| Max. Negotiated Rate |
$322.10 |
| Rate for Payer: Aetna American Axle |
$232.63
|
| Rate for Payer: Aetna Commercial |
$304.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.63
|
| Rate for Payer: Cash Price |
$286.31
|
| Rate for Payer: Cofinity Commercial |
$250.52
|
| Rate for Payer: Cofinity Commercial |
$307.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.31
|
| Rate for Payer: Healthscope Commercial |
$322.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.21
|
| Rate for Payer: PHP Commercial |
$304.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.52
|
| Rate for Payer: Priority Health SBD |
$225.47
|
| Rate for Payer: UMR Bronson Commercial |
$157.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.42
|
|
|
HC FRESH FROZEN PLASMA
|
Facility
|
OP
|
$357.89
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000051
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$232.63
|
| Rate for Payer: Aetna Commercial |
$304.21
|
| Rate for Payer: Aetna Medicare |
$77.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$232.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$286.31
|
| Rate for Payer: Cash Price |
$286.31
|
| Rate for Payer: Cash Price |
$286.31
|
| Rate for Payer: Cofinity Commercial |
$250.52
|
| Rate for Payer: Cofinity Commercial |
$307.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$322.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$250.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.42
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$304.21
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$304.21
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.84
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$187.87
|
| Rate for Payer: Priority Health SBD |
$225.47
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.60
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: UMR Bronson Commercial |
$132.42
|
| Rate for Payer: VA VA |
$74.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.42
|
|
|
HC FRESH FROZEN PLASMA 2X
|
Facility
|
OP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000052
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$170.85
|
| Rate for Payer: Aetna Commercial |
$223.42
|
| Rate for Payer: Aetna Medicare |
$77.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$236.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.14
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$223.42
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.84
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$187.87
|
| Rate for Payer: Priority Health SBD |
$165.60
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.60
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: UMR Bronson Commercial |
$97.25
|
| Rate for Payer: VA VA |
$74.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.14
|
|
|
HC FRESH FROZEN PLASMA 2X
|
Facility
|
IP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000052
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$115.65 |
| Max. Negotiated Rate |
$236.56 |
| Rate for Payer: Aetna American Axle |
$170.85
|
| Rate for Payer: Aetna Commercial |
$223.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.85
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$184.00
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Healthscope Commercial |
$236.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: PHP Commercial |
$223.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: Priority Health SBD |
$165.60
|
| Rate for Payer: UMR Bronson Commercial |
$115.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.14
|
|
|
HC FRESH FROZEN PLASMA 2X CMPT
|
Facility
|
OP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000050
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$170.85
|
| Rate for Payer: Aetna Commercial |
$223.42
|
| Rate for Payer: Aetna Medicare |
$77.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Cofinity Commercial |
$184.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$236.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.14
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$223.42
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.84
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$187.87
|
| Rate for Payer: Priority Health SBD |
$165.60
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.60
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: UMR Bronson Commercial |
$97.25
|
| Rate for Payer: VA VA |
$74.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.14
|
|
|
HC FRESH FROZEN PLASMA 2X CMPT
|
Facility
|
IP
|
$262.85
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000050
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$115.65 |
| Max. Negotiated Rate |
$236.56 |
| Rate for Payer: Aetna American Axle |
$170.85
|
| Rate for Payer: Aetna Commercial |
$223.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.85
|
| Rate for Payer: Cash Price |
$210.28
|
| Rate for Payer: Cofinity Commercial |
$226.05
|
| Rate for Payer: Cofinity Commercial |
$184.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.28
|
| Rate for Payer: Healthscope Commercial |
$236.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.42
|
| Rate for Payer: PHP Commercial |
$223.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.00
|
| Rate for Payer: Priority Health SBD |
$165.60
|
| Rate for Payer: UMR Bronson Commercial |
$115.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.14
|
|
|
HC FRESH FROZEN PLASMA 3X
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000053
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$147.72
|
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna Medicare |
$77.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.84
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$187.87
|
| Rate for Payer: Priority Health SBD |
$143.17
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.60
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: UMR Bronson Commercial |
$84.09
|
| Rate for Payer: VA VA |
$74.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000053
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$99.99 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna American Axle |
$147.72
|
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health SBD |
$143.17
|
| Rate for Payer: UMR Bronson Commercial |
$99.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT1
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000054
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$147.72
|
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna Medicare |
$77.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.84
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$187.87
|
| Rate for Payer: Priority Health SBD |
$143.17
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.60
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: UMR Bronson Commercial |
$84.09
|
| Rate for Payer: VA VA |
$74.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT1
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000054
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$99.99 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna American Axle |
$147.72
|
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health SBD |
$143.17
|
| Rate for Payer: UMR Bronson Commercial |
$99.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
IP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$99.99 |
| Max. Negotiated Rate |
$204.53 |
| Rate for Payer: Aetna American Axle |
$147.72
|
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health SBD |
$143.17
|
| Rate for Payer: UMR Bronson Commercial |
$99.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
OP
|
$227.26
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.81 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$147.72
|
| Rate for Payer: Aetna Commercial |
$193.17
|
| Rate for Payer: Aetna Medicare |
$77.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$147.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cash Price |
$181.81
|
| Rate for Payer: Cofinity Commercial |
$159.08
|
| Rate for Payer: Cofinity Commercial |
$195.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$181.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$204.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$159.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$170.44
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$193.17
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$193.17
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.84
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$187.87
|
| Rate for Payer: Priority Health SBD |
$143.17
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.60
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: UMR Bronson Commercial |
$84.09
|
| Rate for Payer: VA VA |
$74.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$170.44
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
IP
|
$94.70
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$41.67 |
| Max. Negotiated Rate |
$85.23 |
| Rate for Payer: Aetna American Axle |
$61.56
|
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.56
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cofinity Commercial |
$66.29
|
| Rate for Payer: Cofinity Commercial |
$81.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.76
|
| Rate for Payer: Healthscope Commercial |
$85.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.50
|
| Rate for Payer: PHP Commercial |
$80.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.29
|
| Rate for Payer: Priority Health SBD |
$59.66
|
| Rate for Payer: UMR Bronson Commercial |
$41.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.02
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
OP
|
$94.70
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$35.04 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$61.56
|
| Rate for Payer: Aetna Commercial |
$80.50
|
| Rate for Payer: Aetna Medicare |
$77.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.25
|
| Rate for Payer: BCBS Complete |
$42.85
|
| Rate for Payer: BCBS MAPPO |
$74.60
|
| Rate for Payer: BCBS Trust/PPO |
$271.09
|
| Rate for Payer: BCN Medicare Advantage |
$74.60
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cash Price |
$75.76
|
| Rate for Payer: Cofinity Commercial |
$81.44
|
| Rate for Payer: Cofinity Commercial |
$66.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.60
|
| Rate for Payer: Healthscope Commercial |
$85.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.02
|
| Rate for Payer: Mclaren Medicaid |
$40.81
|
| Rate for Payer: Mclaren Medicare |
$74.60
|
| Rate for Payer: Meridian Medicaid |
$42.85
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$78.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.50
|
| Rate for Payer: PACE Medicare |
$70.87
|
| Rate for Payer: PACE SWMI |
$74.60
|
| Rate for Payer: PHP Commercial |
$80.50
|
| Rate for Payer: PHP Medicare Advantage |
$74.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$234.84
|
| Rate for Payer: Priority Health Medicare |
$74.60
|
| Rate for Payer: Priority Health Narrow Network |
$187.87
|
| Rate for Payer: Priority Health SBD |
$59.66
|
| Rate for Payer: Railroad Medicare Medicare |
$74.60
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$74.60
|
| Rate for Payer: UHC Medicare Advantage |
$76.84
|
| Rate for Payer: UMR Bronson Commercial |
$35.04
|
| Rate for Payer: VA VA |
$74.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.02
|
|
|
HC FROZEN SECTION
|
Facility
|
IP
|
$124.54
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$54.80 |
| Max. Negotiated Rate |
$112.09 |
| Rate for Payer: Aetna American Axle |
$80.95
|
| Rate for Payer: Aetna Commercial |
$105.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.95
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$87.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.86
|
| Rate for Payer: PHP Commercial |
$105.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.18
|
| Rate for Payer: Priority Health SBD |
$78.46
|
| Rate for Payer: UMR Bronson Commercial |
$54.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.40
|
|
|
HC FROZEN SECTION
|
Facility
|
OP
|
$124.54
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$477.95 |
| Rate for Payer: Aetna American Axle |
$80.95
|
| Rate for Payer: Aetna Commercial |
$105.86
|
| Rate for Payer: Aetna Medicare |
$157.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.95
|
| 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 |
$58.44
|
| Rate for Payer: BCCCP Commercial |
$102.87
|
| Rate for Payer: BCN Medicare Advantage |
$151.82
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cash Price |
$99.63
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$87.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.82
|
| Rate for Payer: Healthscope Commercial |
$112.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$87.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.40
|
| 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 |
$105.86
|
| Rate for Payer: PACE Medicare |
$144.23
|
| Rate for Payer: PACE SWMI |
$151.82
|
| Rate for Payer: PHP Commercial |
$105.86
|
| 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 |
$87.18
|
| 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 |
$78.46
|
| Rate for Payer: Railroad Medicare Medicare |
$151.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.13
|
| Rate for Payer: UHC Core |
$28.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$151.82
|
| Rate for Payer: UHC Exchange |
$99.21
|
| Rate for Payer: UHC Medicare Advantage |
$156.37
|
| Rate for Payer: UMR Bronson Commercial |
$46.08
|
| Rate for Payer: VA VA |
$151.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.40
|
|
