|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$306.69
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$79.49 |
| Max. Negotiated Rate |
$491.50 |
| Rate for Payer: Aetna American Axle |
$199.35
|
| Rate for Payer: Aetna Commercial |
$260.69
|
| Rate for Payer: Aetna Medicare |
$158.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.99
|
| Rate for Payer: BCBS Complete |
$83.47
|
| Rate for Payer: BCBS MAPPO |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$375.10
|
| Rate for Payer: BCN Commercial |
$375.10
|
| Rate for Payer: BCN Medicare Advantage |
$151.99
|
| Rate for Payer: Cash Price |
$245.35
|
| Rate for Payer: Cash Price |
$245.35
|
| Rate for Payer: Cofinity Advantage |
$214.68
|
| Rate for Payer: Cofinity Commercial |
$263.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.99
|
| Rate for Payer: Healthscope Commercial |
$276.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.02
|
| Rate for Payer: Mclaren Medicaid |
$151.99
|
| Rate for Payer: Mclaren Medicare |
$151.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.59
|
| Rate for Payer: Meridian Medicaid |
$159.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.69
|
| Rate for Payer: Nomi Health Commercial |
$455.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.02
|
| Rate for Payer: PACE Medicare |
$144.39
|
| Rate for Payer: PACE SWMI |
$151.99
|
| Rate for Payer: PHP Commercial |
$260.69
|
| Rate for Payer: PHP Medicare Advantage |
$151.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$491.50
|
| Rate for Payer: Priority Health Medicare |
$151.99
|
| Rate for Payer: Priority Health SBD |
$193.21
|
| Rate for Payer: Priority Health Tiered Network |
$393.20
|
| Rate for Payer: Railroad Medicare Medicare |
$151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.35
|
| Rate for Payer: UHC Core |
$159.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.99
|
| Rate for Payer: UHC Exchange |
$120.53
|
| Rate for Payer: UHC Medicaid |
$79.49
|
| Rate for Payer: UHCCP Medicaid |
$79.49
|
| Rate for Payer: UMR Bronson Commercial |
$113.48
|
| Rate for Payer: VA VA |
$151.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.02
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
IP
|
$306.69
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$134.94 |
| Max. Negotiated Rate |
$276.02 |
| Rate for Payer: Aetna American Axle |
$199.35
|
| Rate for Payer: Aetna Commercial |
$260.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$199.35
|
| Rate for Payer: Cash Price |
$245.35
|
| Rate for Payer: Cofinity Advantage |
$214.68
|
| Rate for Payer: Cofinity Commercial |
$263.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.35
|
| Rate for Payer: Healthscope Commercial |
$276.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.02
|
| Rate for Payer: PHP Commercial |
$260.69
|
| Rate for Payer: Priority Health SBD |
$193.21
|
| Rate for Payer: UMR Bronson Commercial |
$134.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.02
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
IP
|
$83.31
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.66 |
| Max. Negotiated Rate |
$74.98 |
| Rate for Payer: Aetna American Axle |
$54.15
|
| Rate for Payer: Aetna Commercial |
$70.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.15
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cofinity Advantage |
$58.32
|
| Rate for Payer: Cofinity Commercial |
$71.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.65
|
| Rate for Payer: Healthscope Commercial |
$74.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.48
|
| Rate for Payer: PHP Commercial |
$70.81
|
| Rate for Payer: Priority Health SBD |
$52.49
|
| Rate for Payer: UMR Bronson Commercial |
$36.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.48
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
OP
|
$83.31
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.82 |
| Max. Negotiated Rate |
$491.50 |
| Rate for Payer: Aetna American Axle |
$54.15
|
| Rate for Payer: Aetna Commercial |
$70.81
|
| Rate for Payer: Aetna Medicare |
$158.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.99
|
| Rate for Payer: BCBS Complete |
$83.47
|
| Rate for Payer: BCBS MAPPO |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$375.10
|
| Rate for Payer: BCN Commercial |
$375.10
|
| Rate for Payer: BCN Medicare Advantage |
$151.99
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cofinity Advantage |
$58.32
|
| Rate for Payer: Cofinity Commercial |
$71.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.99
|
| Rate for Payer: Healthscope Commercial |
$74.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.48
|
| Rate for Payer: Mclaren Medicaid |
$151.99
|
| Rate for Payer: Mclaren Medicare |
$151.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.59
|
| Rate for Payer: Meridian Medicaid |
$159.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.81
|
| Rate for Payer: Nomi Health Commercial |
$455.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.48
|
| Rate for Payer: PACE Medicare |
$144.39
|
| Rate for Payer: PACE SWMI |
$151.99
|
| Rate for Payer: PHP Commercial |
$70.81
|
| Rate for Payer: PHP Medicare Advantage |
$151.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$491.50
|
| Rate for Payer: Priority Health Medicare |
$151.99
|
| Rate for Payer: Priority Health SBD |
$52.49
|
| Rate for Payer: Priority Health Tiered Network |
$393.20
|
| Rate for Payer: Railroad Medicare Medicare |
$151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.15
|
| Rate for Payer: UHC Core |
$43.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.99
|
| Rate for Payer: UHC Exchange |
$32.74
|
| Rate for Payer: UHC Medicaid |
$79.49
|
| Rate for Payer: UHCCP Medicaid |
$79.49
|
| Rate for Payer: UMR Bronson Commercial |
$30.82
|
| Rate for Payer: VA VA |
$151.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.48
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$105.72
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$39.12 |
| Max. Negotiated Rate |
$491.50 |
| Rate for Payer: Aetna American Axle |
$68.72
|
| Rate for Payer: Aetna Commercial |
$89.86
|
| Rate for Payer: Aetna Medicare |
$158.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$189.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$189.99
|
| Rate for Payer: BCBS Complete |
$83.47
|
| Rate for Payer: BCBS MAPPO |
$151.99
|
| Rate for Payer: BCBS Trust/PPO |
$375.10
|
| Rate for Payer: BCN Commercial |
$375.10
|
| Rate for Payer: BCN Medicare Advantage |
$151.99
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cofinity Advantage |
$74.00
|
| Rate for Payer: Cofinity Commercial |
$90.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$151.99
|
| Rate for Payer: Healthscope Commercial |
$95.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.29
|
| Rate for Payer: Mclaren Medicaid |
$151.99
|
| Rate for Payer: Mclaren Medicare |
$151.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$159.59
|
| Rate for Payer: Meridian Medicaid |
$159.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$174.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$167.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.86
|
| Rate for Payer: Nomi Health Commercial |
$455.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.29
|
| Rate for Payer: PACE Medicare |
$144.39
|
| Rate for Payer: PACE SWMI |
$151.99
|
| Rate for Payer: PHP Commercial |
$89.86
|
| Rate for Payer: PHP Medicare Advantage |
$151.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$79.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$491.50
|
| Rate for Payer: Priority Health Medicare |
$151.99
|
| Rate for Payer: Priority Health SBD |
$66.60
|
| Rate for Payer: Priority Health Tiered Network |
$393.20
|
| Rate for Payer: Railroad Medicare Medicare |
$151.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.72
|
| Rate for Payer: UHC Core |
$55.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$151.99
|
| Rate for Payer: UHC Exchange |
$41.55
|
| Rate for Payer: UHC Medicaid |
$79.49
|
| Rate for Payer: UHCCP Medicaid |
$79.49
|
| Rate for Payer: UMR Bronson Commercial |
$39.12
|
| Rate for Payer: VA VA |
$151.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.29
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$105.72
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$46.52 |
| Max. Negotiated Rate |
$95.15 |
| Rate for Payer: Aetna American Axle |
$68.72
|
| Rate for Payer: Aetna Commercial |
$89.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.72
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cofinity Advantage |
$74.00
|
| Rate for Payer: Cofinity Commercial |
$90.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.58
|
| Rate for Payer: Healthscope Commercial |
$95.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.29
|
| Rate for Payer: PHP Commercial |
$89.86
|
| Rate for Payer: Priority Health SBD |
$66.60
|
| Rate for Payer: UMR Bronson Commercial |
$46.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.29
|
|
|
HC BLOOD TYPING RH
|
Facility
|
OP
|
$22.72
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna American Axle |
$14.77
|
| Rate for Payer: Aetna Commercial |
$19.31
|
| Rate for Payer: Aetna Medicare |
$3.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.74
|
| Rate for Payer: BCBS Complete |
$1.64
|
| Rate for Payer: BCBS MAPPO |
$2.99
|
| Rate for Payer: BCBS Trust/PPO |
$3.45
|
| Rate for Payer: BCN Commercial |
$3.45
|
| Rate for Payer: BCN Medicare Advantage |
$2.99
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cofinity Advantage |
$15.90
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.99
|
| Rate for Payer: Healthscope Commercial |
$20.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.04
|
| Rate for Payer: Mclaren Medicaid |
$2.99
|
| Rate for Payer: Mclaren Medicare |
$2.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.14
|
| Rate for Payer: Meridian Medicaid |
$3.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Nomi Health Commercial |
$8.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.04
|
| Rate for Payer: PACE Medicare |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.99
|
| Rate for Payer: PHP Commercial |
$19.31
|
| Rate for Payer: PHP Medicare Advantage |
$2.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$120.34
|
| Rate for Payer: Priority Health Medicare |
$2.99
|
| Rate for Payer: Priority Health SBD |
$14.31
|
| Rate for Payer: Priority Health Tiered Network |
$96.27
|
| Rate for Payer: Railroad Medicare Medicare |
$2.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.49
|
| Rate for Payer: UHC Core |
$4.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.99
|
| Rate for Payer: UHC Exchange |
$4.49
|
| Rate for Payer: UHC Medicaid |
$1.56
|
| Rate for Payer: UHCCP Medicaid |
$1.56
|
| Rate for Payer: UMR Bronson Commercial |
$8.41
|
| Rate for Payer: VA VA |
$2.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.04
|
|
|
HC BLOOD TYPING RH
|
Facility
|
IP
|
$22.72
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$20.45 |
| Rate for Payer: Aetna American Axle |
$14.77
|
| Rate for Payer: Aetna Commercial |
$19.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.77
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cofinity Advantage |
$15.90
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Healthscope Commercial |
$20.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.04
|
| Rate for Payer: PHP Commercial |
$19.31
|
| Rate for Payer: Priority Health SBD |
$14.31
|
| Rate for Payer: UMR Bronson Commercial |
$10.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.04
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,560.60
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$96.83 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna American Axle |
$1,014.39
|
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: Aetna Medicare |
$192.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.44
|
| Rate for Payer: BCBS Complete |
$101.68
|
| Rate for Payer: BCBS MAPPO |
$185.15
|
| Rate for Payer: BCBS Trust/PPO |
$595.51
|
| Rate for Payer: BCN Commercial |
$595.51
|
| Rate for Payer: BCN Medicare Advantage |
$185.15
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Advantage |
$1,092.42
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.15
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,092.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Mclaren Medicaid |
$185.15
|
| Rate for Payer: Mclaren Medicare |
$185.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.41
|
| Rate for Payer: Meridian Medicaid |
$194.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$555.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.45
|
| Rate for Payer: PACE Medicare |
$175.89
|
| Rate for Payer: PACE SWMI |
$185.15
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: PHP Medicare Advantage |
$185.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$598.75
|
| Rate for Payer: Priority Health Medicare |
$185.15
|
| Rate for Payer: Priority Health SBD |
$983.18
|
| Rate for Payer: Priority Health Tiered Network |
$479.00
|
| Rate for Payer: Railroad Medicare Medicare |
$185.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,014.39
|
| Rate for Payer: UHC Core |
$813.07
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$185.15
|
| Rate for Payer: UHC Exchange |
$613.32
|
| Rate for Payer: UHC Medicaid |
$96.83
|
| Rate for Payer: UHCCP Medicaid |
$96.83
|
| Rate for Payer: UMR Bronson Commercial |
$577.42
|
| Rate for Payer: VA VA |
$185.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,560.60
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$686.66 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna American Axle |
$1,014.39
|
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.39
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Advantage |
$1,092.42
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,092.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.45
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: Priority Health SBD |
$983.18
|
| Rate for Payer: UMR Bronson Commercial |
$686.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$157.30
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.21 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna American Axle |
$102.25
|
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.25
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Advantage |
$110.11
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: Priority Health SBD |
$99.10
|
| Rate for Payer: UMR Bronson Commercial |
$69.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.97
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$157.30
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna American Axle |
$102.25
|
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna Medicare |
$40.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: BCBS Complete |
$21.56
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$45.39
|
| Rate for Payer: BCN Commercial |
$45.39
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Advantage |
$110.11
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.97
|
| Rate for Payer: Mclaren Medicaid |
$39.26
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$41.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$58.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.26
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health SBD |
$99.10
|
| Rate for Payer: Priority Health Tiered Network |
$31.41
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.89
|
| Rate for Payer: UHC Core |
$58.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.26
|
| Rate for Payer: UHC Exchange |
$58.89
|
| Rate for Payer: UHC Medicaid |
$20.53
|
| Rate for Payer: UHCCP Medicaid |
$20.53
|
| Rate for Payer: UMR Bronson Commercial |
$58.20
|
| Rate for Payer: VA VA |
$39.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.97
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,076.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$913.50 |
| Max. Negotiated Rate |
$1,868.53 |
| Rate for Payer: Aetna American Axle |
$1,349.49
|
| Rate for Payer: Aetna Commercial |
$1,764.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.49
|
| Rate for Payer: Cash Price |
$1,660.91
|
| Rate for Payer: Cofinity Advantage |
$1,453.30
|
| Rate for Payer: Cofinity Commercial |
$1,785.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.91
|
| Rate for Payer: Healthscope Commercial |
$1,868.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,453.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,557.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.11
|
| Rate for Payer: PHP Commercial |
$1,764.72
|
| Rate for Payer: Priority Health SBD |
$1,307.97
|
| Rate for Payer: UMR Bronson Commercial |
$913.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,557.11
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,076.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$768.17 |
| Max. Negotiated Rate |
$1,868.53 |
| Rate for Payer: Aetna American Axle |
$1,349.49
|
| Rate for Payer: Aetna Commercial |
$1,764.72
|
| Rate for Payer: Aetna Medicare |
$1,038.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,349.49
|
| Rate for Payer: BCBS Complete |
$830.46
|
| Rate for Payer: Cash Price |
$1,660.91
|
| Rate for Payer: Cofinity Advantage |
$1,453.30
|
| Rate for Payer: Cofinity Commercial |
$1,785.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.91
|
| Rate for Payer: Healthscope Commercial |
$1,868.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,453.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,557.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,660.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.11
|
| Rate for Payer: PHP Commercial |
$1,764.72
|
| Rate for Payer: Priority Health SBD |
$1,307.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,349.49
|
| Rate for Payer: UHC Core |
$1,081.67
|
| Rate for Payer: UHC Exchange |
$815.92
|
| Rate for Payer: UMR Bronson Commercial |
$768.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,557.11
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,211.27
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$972.96 |
| Max. Negotiated Rate |
$1,990.14 |
| Rate for Payer: Aetna American Axle |
$1,437.33
|
| Rate for Payer: Aetna Commercial |
$1,879.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,437.33
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cofinity Advantage |
$1,547.89
|
| Rate for Payer: Cofinity Commercial |
$1,901.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,769.02
|
| Rate for Payer: Healthscope Commercial |
$1,990.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,547.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,658.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,879.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.45
|
| Rate for Payer: PHP Commercial |
$1,879.58
|
| Rate for Payer: Priority Health SBD |
$1,393.10
|
| Rate for Payer: UMR Bronson Commercial |
$972.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,658.45
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,211.27
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$818.17 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$1,437.33
|
| Rate for Payer: Aetna Commercial |
$1,879.58
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,437.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.89
|
| Rate for Payer: BCN Commercial |
$2,031.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cofinity Advantage |
$1,547.89
|
| Rate for Payer: Cofinity Commercial |
$1,901.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,769.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,990.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,547.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,658.45
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,879.58
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.45
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,879.58
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,393.10
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$818.17
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,658.45
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,105.96
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$779.21 |
| Max. Negotiated Rate |
$5,321.93 |
| Rate for Payer: Aetna American Axle |
$1,368.87
|
| Rate for Payer: Aetna Commercial |
$1,790.07
|
| Rate for Payer: Aetna Medicare |
$1,711.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,057.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,057.07
|
| Rate for Payer: BCBS Complete |
$903.80
|
| Rate for Payer: BCBS MAPPO |
$1,645.66
|
| Rate for Payer: BCBS Trust/PPO |
$2,031.89
|
| Rate for Payer: BCN Commercial |
$2,031.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,645.66
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cofinity Advantage |
$1,474.17
|
| Rate for Payer: Cofinity Commercial |
$1,811.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,645.66
|
| Rate for Payer: Healthscope Commercial |
$1,895.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,474.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,579.47
|
| Rate for Payer: Mclaren Medicaid |
$1,645.66
|
| Rate for Payer: Mclaren Medicare |
$1,645.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,727.94
|
| Rate for Payer: Meridian Medicaid |
$1,727.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,892.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,810.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.07
|
| Rate for Payer: Nomi Health Commercial |
$4,936.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,579.47
|
| Rate for Payer: PACE Medicare |
$1,563.38
|
| Rate for Payer: PACE SWMI |
$1,645.66
|
| Rate for Payer: PHP Commercial |
$1,790.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,645.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$860.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,321.93
|
| Rate for Payer: Priority Health Medicare |
$1,645.66
|
| Rate for Payer: Priority Health SBD |
$1,326.75
|
| Rate for Payer: Priority Health Tiered Network |
$4,257.54
|
| Rate for Payer: Railroad Medicare Medicare |
$1,645.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,645.66
|
| Rate for Payer: UHC Medicaid |
$860.68
|
| Rate for Payer: UHCCP Medicaid |
$860.68
|
| Rate for Payer: UMR Bronson Commercial |
$779.21
|
| Rate for Payer: VA VA |
$1,645.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,579.47
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,105.96
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$926.62 |
| Max. Negotiated Rate |
$1,895.36 |
| Rate for Payer: Aetna American Axle |
$1,368.87
|
| Rate for Payer: Aetna Commercial |
$1,790.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,368.87
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cofinity Advantage |
$1,474.17
|
| Rate for Payer: Cofinity Commercial |
$1,811.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.77
|
| Rate for Payer: Healthscope Commercial |
$1,895.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,474.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,579.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,579.47
|
| Rate for Payer: PHP Commercial |
$1,790.07
|
| Rate for Payer: Priority Health SBD |
$1,326.75
|
| Rate for Payer: UMR Bronson Commercial |
$926.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,579.47
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,550.48
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$943.68 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$1,657.81
|
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,500.30
|
| Rate for Payer: BCN Commercial |
$3,500.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Advantage |
$1,785.34
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,785.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.86
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.86
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$1,606.80
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$943.68
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.86
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,550.48
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,122.21 |
| Max. Negotiated Rate |
$2,295.43 |
| Rate for Payer: Aetna American Axle |
$1,657.81
|
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.81
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Advantage |
$1,785.34
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,785.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.86
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: Priority Health SBD |
$1,606.80
|
| Rate for Payer: UMR Bronson Commercial |
$1,122.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.86
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$198.32
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$87.26 |
| Max. Negotiated Rate |
$178.49 |
| Rate for Payer: Aetna American Axle |
$128.91
|
| Rate for Payer: Aetna Commercial |
$168.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.91
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cofinity Advantage |
$138.82
|
| Rate for Payer: Cofinity Commercial |
$170.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.66
|
| Rate for Payer: Healthscope Commercial |
$178.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.74
|
| Rate for Payer: PHP Commercial |
$168.57
|
| Rate for Payer: Priority Health SBD |
$124.94
|
| Rate for Payer: UMR Bronson Commercial |
$87.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.74
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$198.32
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$73.38 |
| Max. Negotiated Rate |
$2,596.12 |
| Rate for Payer: Aetna American Axle |
$128.91
|
| Rate for Payer: Aetna Commercial |
$168.57
|
| Rate for Payer: Aetna Medicare |
$834.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,003.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,003.48
|
| Rate for Payer: BCBS Complete |
$440.89
|
| Rate for Payer: BCBS MAPPO |
$802.78
|
| Rate for Payer: BCBS Trust/PPO |
$128.07
|
| Rate for Payer: BCN Commercial |
$128.07
|
| Rate for Payer: BCN Medicare Advantage |
$802.78
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cofinity Advantage |
$138.82
|
| Rate for Payer: Cofinity Commercial |
$170.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.78
|
| Rate for Payer: Healthscope Commercial |
$178.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.74
|
| Rate for Payer: Mclaren Medicaid |
$802.78
|
| Rate for Payer: Mclaren Medicare |
$802.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.92
|
| Rate for Payer: Meridian Medicaid |
$842.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$923.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$883.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Nomi Health Commercial |
$2,408.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.74
|
| Rate for Payer: PACE Medicare |
$762.64
|
| Rate for Payer: PACE SWMI |
$802.78
|
| Rate for Payer: PHP Commercial |
$168.57
|
| Rate for Payer: PHP Medicare Advantage |
$802.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$419.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,596.12
|
| Rate for Payer: Priority Health Medicare |
$802.78
|
| Rate for Payer: Priority Health SBD |
$124.94
|
| Rate for Payer: Priority Health Tiered Network |
$2,076.90
|
| Rate for Payer: Railroad Medicare Medicare |
$802.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,225.35
|
| Rate for Payer: UHC Core |
$1,225.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$802.78
|
| Rate for Payer: UHC Exchange |
$1,225.35
|
| Rate for Payer: UHC Medicaid |
$419.85
|
| Rate for Payer: UHCCP Medicaid |
$419.85
|
| Rate for Payer: UMR Bronson Commercial |
$73.38
|
| Rate for Payer: VA VA |
$802.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.74
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$151.13
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$66.50 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna American Axle |
$98.23
|
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.23
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Advantage |
$105.79
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: Priority Health SBD |
$95.21
|
| Rate for Payer: UMR Bronson Commercial |
$66.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.35
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$151.13
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.92 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna American Axle |
$98.23
|
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: Aetna Medicare |
$75.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.23
|
| Rate for Payer: BCBS Complete |
$60.45
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Advantage |
$105.79
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: Priority Health SBD |
$95.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.23
|
| Rate for Payer: UHC Core |
$78.74
|
| Rate for Payer: UHC Exchange |
$59.39
|
| Rate for Payer: UMR Bronson Commercial |
$55.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.35
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
OP
|
$49.78
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.42 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna American Axle |
$32.36
|
| Rate for Payer: Aetna Commercial |
$42.31
|
| Rate for Payer: Aetna Medicare |
$24.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.36
|
| Rate for Payer: BCBS Complete |
$19.91
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cofinity Advantage |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.82
|
| Rate for Payer: Healthscope Commercial |
$44.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.34
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: Priority Health SBD |
$31.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.36
|
| Rate for Payer: UHC Core |
$25.94
|
| Rate for Payer: UHC Exchange |
$19.56
|
| Rate for Payer: UMR Bronson Commercial |
$18.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.34
|
|
