|
HC GMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$134.33
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200006
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$49.70 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$87.31
|
| Rate for Payer: Aetna Commercial |
$114.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.31
|
| Rate for Payer: BCBS Complete |
$53.73
|
| Rate for Payer: BCBS Trust/PPO |
$118.88
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cash Price |
$107.46
|
| Rate for Payer: Cofinity Commercial |
$115.52
|
| Rate for Payer: Cofinity Commercial |
$94.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.46
|
| Rate for Payer: Healthscope Commercial |
$120.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.75
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$114.18
|
| Rate for Payer: PHP Commercial |
$114.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.03
|
| Rate for Payer: Priority Health SBD |
$84.63
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$49.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.75
|
|
|
HC GOLDENROD IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200086
|
|
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 |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| 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 GOLDENROD IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200086
|
|
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
|
|
|
HC GOLD PROBE HEMOSTASIS
|
Facility
|
IP
|
$600.43
|
|
| Hospital Charge Code |
27000080
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$264.19 |
| Max. Negotiated Rate |
$540.39 |
| Rate for Payer: Aetna American Axle |
$390.28
|
| Rate for Payer: Aetna Commercial |
$510.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.28
|
| Rate for Payer: Cash Price |
$480.34
|
| Rate for Payer: Cofinity Commercial |
$420.30
|
| Rate for Payer: Cofinity Commercial |
$516.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.34
|
| Rate for Payer: Healthscope Commercial |
$540.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.37
|
| Rate for Payer: PHP Commercial |
$510.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.30
|
| Rate for Payer: Priority Health SBD |
$378.27
|
| Rate for Payer: UMR Bronson Commercial |
$264.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.32
|
|
|
HC GOLD PROBE HEMOSTASIS
|
Facility
|
OP
|
$600.43
|
|
| Hospital Charge Code |
27000080
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$222.16 |
| Max. Negotiated Rate |
$540.39 |
| Rate for Payer: Aetna American Axle |
$390.28
|
| Rate for Payer: Aetna Commercial |
$510.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.28
|
| Rate for Payer: BCBS Complete |
$240.17
|
| Rate for Payer: Cash Price |
$480.34
|
| Rate for Payer: Cofinity Commercial |
$420.30
|
| Rate for Payer: Cofinity Commercial |
$516.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.34
|
| Rate for Payer: Healthscope Commercial |
$540.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.37
|
| Rate for Payer: PHP Commercial |
$510.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.30
|
| Rate for Payer: Priority Health SBD |
$378.27
|
| Rate for Payer: UMR Bronson Commercial |
$222.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.32
|
|
|
HC GOOSE FEATHERS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200087
|
|
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 |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| 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
|
|
|
HC GOOSE FEATHERS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200087
|
|
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 |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| 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 GRAFIX PRIME 1.5 X 2 PER SQ CM
|
Facility
|
OP
|
$748.01
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600159
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$265.53 |
| Max. Negotiated Rate |
$673.21 |
| Rate for Payer: Aetna American Axle |
$486.21
|
| Rate for Payer: Aetna Commercial |
$635.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.21
|
| Rate for Payer: BCBS Complete |
$299.20
|
| Rate for Payer: BCBS Trust/PPO |
$265.53
|
| Rate for Payer: Cash Price |
$598.41
|
| Rate for Payer: Cash Price |
$598.41
|
| Rate for Payer: Cofinity Commercial |
$523.61
|
| Rate for Payer: Cofinity Commercial |
$643.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.41
|
| Rate for Payer: Healthscope Commercial |
$673.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$523.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$561.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$635.81
|
| Rate for Payer: PHP Commercial |
$635.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.61
|
| Rate for Payer: Priority Health SBD |
$471.25
|
| Rate for Payer: UMR Bronson Commercial |
$276.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$561.01
|
|
|
HC GRAFIX PRIME 1.5 X 2 PER SQ CM
|
Facility
|
IP
|
$748.01
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600159
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$329.12 |
| Max. Negotiated Rate |
$673.21 |
| Rate for Payer: Aetna American Axle |
$486.21
|
| Rate for Payer: Aetna Commercial |
$635.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.21
|
| Rate for Payer: Cash Price |
$598.41
|
| Rate for Payer: Cofinity Commercial |
$523.61
|
| Rate for Payer: Cofinity Commercial |
$643.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.41
|
| Rate for Payer: Healthscope Commercial |
$673.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$523.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$561.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$635.81
|
| Rate for Payer: PHP Commercial |
$635.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.61
|
| Rate for Payer: Priority Health SBD |
$471.25
|
| Rate for Payer: UMR Bronson Commercial |
$329.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$561.01
|
|
|
HC GRAFIX PRIME (16 MM) DISC PER SQ CM
|
Facility
|
IP
|
$757.35
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600158
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$333.23 |
| Max. Negotiated Rate |
$681.62 |
| Rate for Payer: Aetna American Axle |
$492.28
|
| Rate for Payer: Aetna Commercial |
$643.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.28
|
| Rate for Payer: Cash Price |
$605.88
|
| Rate for Payer: Cofinity Commercial |
$530.14
|
| Rate for Payer: Cofinity Commercial |
$651.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.88
|
| Rate for Payer: Healthscope Commercial |
$681.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$530.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$568.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$643.75
|
| Rate for Payer: PHP Commercial |
$643.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.14
|
| Rate for Payer: Priority Health SBD |
$477.13
|
| Rate for Payer: UMR Bronson Commercial |
$333.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$568.01
|
|
|
HC GRAFIX PRIME (16 MM) DISC PER SQ CM
|
Facility
|
OP
|
$757.35
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600158
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$265.53 |
| Max. Negotiated Rate |
$681.62 |
| Rate for Payer: Aetna American Axle |
$492.28
|
| Rate for Payer: Aetna Commercial |
$643.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$492.28
|
| Rate for Payer: BCBS Complete |
$302.94
|
| Rate for Payer: BCBS Trust/PPO |
$265.53
|
| Rate for Payer: Cash Price |
$605.88
|
| Rate for Payer: Cash Price |
$605.88
|
| Rate for Payer: Cofinity Commercial |
$530.14
|
| Rate for Payer: Cofinity Commercial |
$651.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$605.88
|
| Rate for Payer: Healthscope Commercial |
$681.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$530.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$568.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$643.75
|
| Rate for Payer: PHP Commercial |
$643.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$530.14
|
| Rate for Payer: Priority Health SBD |
$477.13
|
| Rate for Payer: UMR Bronson Commercial |
$280.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$568.01
|
|
|
HC GRAFIX PRIME 2 X 3 PER SQ CM
|
Facility
|
IP
|
$467.51
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600160
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$205.70 |
| Max. Negotiated Rate |
$420.76 |
| Rate for Payer: Aetna American Axle |
$303.88
|
| Rate for Payer: Aetna Commercial |
$397.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.88
|
| Rate for Payer: Cash Price |
$374.01
|
| Rate for Payer: Cofinity Commercial |
$327.26
|
| Rate for Payer: Cofinity Commercial |
$402.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.01
|
| Rate for Payer: Healthscope Commercial |
$420.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$327.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$350.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$397.38
|
| Rate for Payer: PHP Commercial |
$397.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$327.26
|
| Rate for Payer: Priority Health SBD |
$294.53
|
| Rate for Payer: UMR Bronson Commercial |
$205.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$350.63
|
|
|
HC GRAFIX PRIME 2 X 3 PER SQ CM
|
Facility
|
OP
|
$467.51
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600160
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$172.98 |
| Max. Negotiated Rate |
$420.76 |
| Rate for Payer: Aetna American Axle |
$303.88
|
| Rate for Payer: Aetna Commercial |
$397.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$303.88
|
| Rate for Payer: BCBS Complete |
$187.00
|
| Rate for Payer: BCBS Trust/PPO |
$265.53
|
| Rate for Payer: Cash Price |
$374.01
|
| Rate for Payer: Cash Price |
$374.01
|
| Rate for Payer: Cofinity Commercial |
$402.06
|
| Rate for Payer: Cofinity Commercial |
$327.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$374.01
|
| Rate for Payer: Healthscope Commercial |
$420.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$327.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$350.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$397.38
|
| Rate for Payer: PHP Commercial |
$397.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$327.26
|
| Rate for Payer: Priority Health SBD |
$294.53
|
| Rate for Payer: UMR Bronson Commercial |
$172.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$350.63
|
|
|
HC GRAFIX PRIME 3 X 4 PER SQ CM
|
Facility
|
IP
|
$272.53
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600161
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$119.91 |
| Max. Negotiated Rate |
$245.28 |
| Rate for Payer: Aetna American Axle |
$177.14
|
| Rate for Payer: Aetna Commercial |
$231.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.14
|
| Rate for Payer: Cash Price |
$218.02
|
| Rate for Payer: Cofinity Commercial |
$190.77
|
| Rate for Payer: Cofinity Commercial |
$234.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.02
|
| Rate for Payer: Healthscope Commercial |
$245.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.65
|
| Rate for Payer: PHP Commercial |
$231.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.77
|
| Rate for Payer: Priority Health SBD |
$171.69
|
| Rate for Payer: UMR Bronson Commercial |
$119.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.40
|
|
|
HC GRAFIX PRIME 3 X 4 PER SQ CM
|
Facility
|
OP
|
$272.53
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600161
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$100.84 |
| Max. Negotiated Rate |
$265.53 |
| Rate for Payer: Aetna American Axle |
$177.14
|
| Rate for Payer: Aetna Commercial |
$231.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.14
|
| Rate for Payer: BCBS Complete |
$109.01
|
| Rate for Payer: BCBS Trust/PPO |
$265.53
|
| Rate for Payer: Cash Price |
$218.02
|
| Rate for Payer: Cash Price |
$218.02
|
| Rate for Payer: Cofinity Commercial |
$190.77
|
| Rate for Payer: Cofinity Commercial |
$234.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.02
|
| Rate for Payer: Healthscope Commercial |
$245.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$190.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$204.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$231.65
|
| Rate for Payer: PHP Commercial |
$231.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$190.77
|
| Rate for Payer: Priority Health SBD |
$171.69
|
| Rate for Payer: UMR Bronson Commercial |
$100.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$204.40
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM FEET, HANDS, FACE
|
Facility
|
OP
|
$2,410.57
|
|
|
Service Code
|
CPT 15115
|
| Hospital Charge Code |
76100067
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$684.35 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna American Axle |
$1,566.87
|
| Rate for Payer: Aetna Commercial |
$2,048.98
|
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,566.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,336.74
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$1,928.46
|
| Rate for Payer: Cash Price |
$1,928.46
|
| Rate for Payer: Cofinity Commercial |
$1,687.40
|
| Rate for Payer: Cofinity Commercial |
$2,073.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,928.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$2,169.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,687.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,807.93
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,048.98
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$2,048.98
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,687.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Priority Health SBD |
$1,518.66
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$752.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$684.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: UMR Bronson Commercial |
$891.91
|
| Rate for Payer: VA VA |
$1,620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,807.93
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM FEET, HANDS, FACE
|
Facility
|
IP
|
$2,410.57
|
|
|
Service Code
|
CPT 15115
|
| Hospital Charge Code |
76100067
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,060.65 |
| Max. Negotiated Rate |
$2,169.51 |
| Rate for Payer: Aetna American Axle |
$1,566.87
|
| Rate for Payer: Aetna Commercial |
$2,048.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,566.87
|
| Rate for Payer: Cash Price |
$1,928.46
|
| Rate for Payer: Cofinity Commercial |
$1,687.40
|
| Rate for Payer: Cofinity Commercial |
$2,073.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,928.46
|
| Rate for Payer: Healthscope Commercial |
$2,169.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,687.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,807.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,048.98
|
| Rate for Payer: PHP Commercial |
$2,048.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,687.40
|
| Rate for Payer: Priority Health SBD |
$1,518.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,060.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,807.93
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
OP
|
$3,156.22
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$703.35 |
| Max. Negotiated Rate |
$5,102.91 |
| Rate for Payer: Aetna American Axle |
$2,051.54
|
| Rate for Payer: Aetna Commercial |
$2,682.79
|
| Rate for Payer: Aetna Medicare |
$1,685.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,051.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,026.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,026.22
|
| Rate for Payer: BCBS Complete |
$931.09
|
| Rate for Payer: BCBS MAPPO |
$1,620.98
|
| Rate for Payer: BCBS Trust/PPO |
$976.01
|
| Rate for Payer: BCN Medicare Advantage |
$1,620.98
|
| Rate for Payer: Cash Price |
$2,524.98
|
| Rate for Payer: Cash Price |
$2,524.98
|
| Rate for Payer: Cofinity Commercial |
$2,714.35
|
| Rate for Payer: Cofinity Commercial |
$2,209.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,524.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,620.98
|
| Rate for Payer: Healthscope Commercial |
$2,840.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,209.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,367.16
|
| Rate for Payer: Mclaren Medicaid |
$886.68
|
| Rate for Payer: Mclaren Medicare |
$1,620.98
|
| Rate for Payer: Meridian Medicaid |
$931.09
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,702.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,864.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,682.79
|
| Rate for Payer: PACE Medicare |
$1,539.93
|
| Rate for Payer: PACE SWMI |
$1,620.98
|
| Rate for Payer: PHP Commercial |
$2,682.79
|
| Rate for Payer: PHP Medicare Advantage |
$1,620.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$886.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,209.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,102.91
|
| Rate for Payer: Priority Health Medicare |
$1,620.98
|
| Rate for Payer: Priority Health Narrow Network |
$4,082.33
|
| Rate for Payer: Priority Health SBD |
$1,988.42
|
| Rate for Payer: Railroad Medicare Medicare |
$1,620.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$773.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,620.98
|
| Rate for Payer: UHC Exchange |
$703.35
|
| Rate for Payer: UHC Medicare Advantage |
$1,669.61
|
| Rate for Payer: UMR Bronson Commercial |
$1,167.80
|
| Rate for Payer: VA VA |
$1,620.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,367.16
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
IP
|
$3,156.22
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,388.74 |
| Max. Negotiated Rate |
$2,840.60 |
| Rate for Payer: Aetna American Axle |
$2,051.54
|
| Rate for Payer: Aetna Commercial |
$2,682.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,051.54
|
| Rate for Payer: Cash Price |
$2,524.98
|
| Rate for Payer: Cofinity Commercial |
$2,209.35
|
| Rate for Payer: Cofinity Commercial |
$2,714.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,524.98
|
| Rate for Payer: Healthscope Commercial |
$2,840.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,209.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,367.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,682.79
|
| Rate for Payer: PHP Commercial |
$2,682.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,209.35
|
| Rate for Payer: Priority Health SBD |
$1,988.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,388.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,367.16
|
|
|
HC GRAM STAIN
|
Facility
|
IP
|
$50.30
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.13 |
| Max. Negotiated Rate |
$45.27 |
| Rate for Payer: Aetna American Axle |
$32.70
|
| Rate for Payer: Aetna Commercial |
$42.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.70
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$35.21
|
| Rate for Payer: Cofinity Commercial |
$43.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.24
|
| Rate for Payer: Healthscope Commercial |
$45.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.76
|
| Rate for Payer: PHP Commercial |
$42.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.21
|
| Rate for Payer: Priority Health SBD |
$31.69
|
| Rate for Payer: UMR Bronson Commercial |
$22.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.72
|
|
|
HC GRAM STAIN
|
Facility
|
OP
|
$50.30
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$45.27 |
| Rate for Payer: Aetna American Axle |
$32.70
|
| Rate for Payer: Aetna Commercial |
$42.76
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.45
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$3.84
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cash Price |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$43.26
|
| Rate for Payer: Cofinity Commercial |
$35.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$45.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.72
|
| Rate for Payer: Mclaren Medicaid |
$2.34
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Medicaid |
$2.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.76
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$42.76
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.86
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$4.69
|
| Rate for Payer: Priority Health SBD |
$31.69
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.12
|
| Rate for Payer: UHC Core |
$7.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: UMR Bronson Commercial |
$18.61
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.72
|
|
|
HC GRANULOCYTES
|
Facility
|
IP
|
$1,888.00
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$830.72 |
| Max. Negotiated Rate |
$1,699.20 |
| Rate for Payer: Aetna American Axle |
$1,227.20
|
| Rate for Payer: Aetna Commercial |
$1,604.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,227.20
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cofinity Commercial |
$1,321.60
|
| Rate for Payer: Cofinity Commercial |
$1,623.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,510.40
|
| Rate for Payer: Healthscope Commercial |
$1,699.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,321.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,416.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,604.80
|
| Rate for Payer: PHP Commercial |
$1,604.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,321.60
|
| Rate for Payer: Priority Health SBD |
$1,189.44
|
| Rate for Payer: UMR Bronson Commercial |
$830.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,416.00
|
|
|
HC GRANULOCYTES
|
Facility
|
OP
|
$1,888.00
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$446.00 |
| Max. Negotiated Rate |
$4,816.16 |
| Rate for Payer: Aetna American Axle |
$1,227.20
|
| Rate for Payer: Aetna Commercial |
$1,604.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,227.20
|
| Rate for Payer: BCBS Complete |
$755.20
|
| Rate for Payer: BCBS Trust/PPO |
$4,816.16
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cash Price |
$1,510.40
|
| Rate for Payer: Cofinity Commercial |
$1,321.60
|
| Rate for Payer: Cofinity Commercial |
$1,623.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,510.40
|
| Rate for Payer: Healthscope Commercial |
$1,699.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,321.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,416.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,604.80
|
| Rate for Payer: PHP Commercial |
$1,604.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,321.60
|
| Rate for Payer: Priority Health SBD |
$1,189.44
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UMR Bronson Commercial |
$698.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,416.00
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
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
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
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
|
|
