|
HC ADD.AFIB ABL AFTER PVI
|
Facility
|
IP
|
$8,902.00
|
|
|
Service Code
|
CPT 93657
|
| Hospital Charge Code |
48100095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,916.88 |
| Max. Negotiated Rate |
$8,011.80 |
| Rate for Payer: Aetna American Axle |
$5,786.30
|
| Rate for Payer: Aetna Commercial |
$7,566.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,786.30
|
| Rate for Payer: Cash Price |
$7,121.60
|
| Rate for Payer: Cofinity Commercial |
$6,231.40
|
| Rate for Payer: Cofinity Commercial |
$7,655.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,231.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,121.60
|
| Rate for Payer: Healthscope Commercial |
$8,011.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,231.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,676.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,566.70
|
| Rate for Payer: PHP Commercial |
$7,566.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,786.30
|
| Rate for Payer: Priority Health SBD |
$5,608.26
|
| Rate for Payer: UMR Bronson Commercial |
$3,916.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,676.50
|
|
|
HC ADD.AFIB ABL AFTER PVI
|
Facility
|
OP
|
$8,902.00
|
|
|
Service Code
|
CPT 93657
|
| Hospital Charge Code |
48100095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,293.74 |
| Max. Negotiated Rate |
$8,011.80 |
| Rate for Payer: Aetna American Axle |
$5,786.30
|
| Rate for Payer: Aetna Commercial |
$7,566.70
|
| Rate for Payer: Aetna Medicare |
$4,451.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,786.30
|
| Rate for Payer: BCBS Complete |
$3,560.80
|
| Rate for Payer: Cash Price |
$7,121.60
|
| Rate for Payer: Cofinity Commercial |
$6,231.40
|
| Rate for Payer: Cofinity Commercial |
$7,655.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,231.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,121.60
|
| Rate for Payer: Healthscope Commercial |
$8,011.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,231.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,676.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,566.70
|
| Rate for Payer: PHP Commercial |
$7,566.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,786.30
|
| Rate for Payer: Priority Health SBD |
$5,608.26
|
| Rate for Payer: UMR Bronson Commercial |
$3,293.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,676.50
|
|
|
HC ADDL DOSE TC99M NON HEU
|
Facility
|
OP
|
$54.62
|
|
|
Service Code
|
HCPCS Q9969
|
| Hospital Charge Code |
34300036
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$5.36 |
| Max. Negotiated Rate |
$49.16 |
| Rate for Payer: Aetna American Axle |
$35.50
|
| Rate for Payer: Aetna Commercial |
$46.43
|
| Rate for Payer: Aetna Medicare |
$10.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.50
|
| Rate for Payer: BCBS Complete |
$5.63
|
| Rate for Payer: BCBS MAPPO |
$10.00
|
| Rate for Payer: BCN Medicare Advantage |
$10.00
|
| Rate for Payer: Cash Price |
$43.70
|
| Rate for Payer: Cash Price |
$43.70
|
| Rate for Payer: Cofinity Commercial |
$46.97
|
| Rate for Payer: Cofinity Commercial |
$38.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.00
|
| Rate for Payer: Healthscope Commercial |
$49.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.97
|
| Rate for Payer: Mclaren Medicaid |
$5.36
|
| Rate for Payer: Mclaren Medicare |
$10.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.50
|
| Rate for Payer: Meridian Medicaid |
$5.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.43
|
| Rate for Payer: PACE Medicare |
$9.50
|
| Rate for Payer: PACE SWMI |
$10.00
|
| Rate for Payer: PHP Commercial |
$46.43
|
| Rate for Payer: PHP Medicare Advantage |
$10.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.00
|
| Rate for Payer: Priority Health SBD |
$34.41
|
| Rate for Payer: Railroad Medicare Medicare |
$10.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.00
|
| Rate for Payer: UHC Exchange |
$19.11
|
| Rate for Payer: UHC Medicare Advantage |
$10.00
|
| Rate for Payer: UHCCP Medicaid |
$5.36
|
| Rate for Payer: UMR Bronson Commercial |
$20.21
|
| Rate for Payer: VA VA |
$10.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.97
|
|
|
HC ADDL DOSE TC99M NON HEU
|
Facility
|
IP
|
$54.62
|
|
|
Service Code
|
HCPCS Q9969
|
| Hospital Charge Code |
34300036
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$24.03 |
| Max. Negotiated Rate |
$49.16 |
| Rate for Payer: Aetna American Axle |
$35.50
|
| Rate for Payer: Aetna Commercial |
$46.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.50
|
| Rate for Payer: Cash Price |
$43.70
|
| Rate for Payer: Cofinity Commercial |
$38.23
|
| Rate for Payer: Cofinity Commercial |
$46.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.70
|
| Rate for Payer: Healthscope Commercial |
$49.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.43
|
| Rate for Payer: PHP Commercial |
$46.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.50
|
| Rate for Payer: Priority Health SBD |
$34.41
|
| Rate for Payer: UMR Bronson Commercial |
$24.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.97
|
|
|
HC ADENOVIRUS ANTIBODY
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200219
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: UMR Bronson Commercial |
$45.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC ADENOVIRUS ANTIBODY
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200219
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$24.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$38.49
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC ADENOVIRUS PCR
|
Facility
|
OP
|
$103.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600279
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$66.95
|
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Cofinity Commercial |
$72.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.25
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$64.89
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$38.11
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.25
|
|
|
HC ADENOVIRUS PCR
|
Facility
|
IP
|
$103.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600279
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.32 |
| Max. Negotiated Rate |
$92.70 |
| Rate for Payer: Aetna American Axle |
$66.95
|
| Rate for Payer: Aetna Commercial |
$87.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.95
|
| Rate for Payer: Cash Price |
$82.40
|
| Rate for Payer: Cofinity Commercial |
$72.10
|
| Rate for Payer: Cofinity Commercial |
$88.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.40
|
| Rate for Payer: Healthscope Commercial |
$92.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.55
|
| Rate for Payer: PHP Commercial |
$87.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.95
|
| Rate for Payer: Priority Health SBD |
$64.89
|
| Rate for Payer: UMR Bronson Commercial |
$45.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.25
|
|
|
HC ADHESIVE RELEASER 50 ML
|
Facility
|
OP
|
$26.60
|
|
|
Service Code
|
HCPCS A4455
|
| Hospital Charge Code |
27000626
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.84 |
| Max. Negotiated Rate |
$23.94 |
| Rate for Payer: Aetna American Axle |
$17.29
|
| Rate for Payer: Aetna Commercial |
$22.61
|
| Rate for Payer: Aetna Medicare |
$13.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.29
|
| Rate for Payer: BCBS Complete |
$10.64
|
| Rate for Payer: Cash Price |
$21.28
|
| Rate for Payer: Cofinity Commercial |
$18.62
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.28
|
| Rate for Payer: Healthscope Commercial |
$23.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.61
|
| Rate for Payer: PHP Commercial |
$22.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.29
|
| Rate for Payer: Priority Health SBD |
$16.76
|
| Rate for Payer: UMR Bronson Commercial |
$9.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.95
|
|
|
HC ADHESIVE RELEASER 50 ML
|
Facility
|
IP
|
$26.60
|
|
|
Service Code
|
HCPCS A4455
|
| Hospital Charge Code |
27000626
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.70 |
| Max. Negotiated Rate |
$23.94 |
| Rate for Payer: Aetna American Axle |
$17.29
|
| Rate for Payer: Aetna Commercial |
$22.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.29
|
| Rate for Payer: Cash Price |
$21.28
|
| Rate for Payer: Cofinity Commercial |
$18.62
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.28
|
| Rate for Payer: Healthscope Commercial |
$23.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.61
|
| Rate for Payer: PHP Commercial |
$22.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.29
|
| Rate for Payer: Priority Health SBD |
$16.76
|
| Rate for Payer: UMR Bronson Commercial |
$11.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.95
|
|
|
HC ADL TRAINING EA 15 MIN
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
42000030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$44.86 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna American Axle |
$66.27
|
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$71.37
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: UMR Bronson Commercial |
$44.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC ADL TRAINING EA 15 MIN
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
42000030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$37.73 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$66.27
|
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$50.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: BCBS Complete |
$40.78
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Cofinity Commercial |
$71.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$37.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC ADMIN INTRAPULMONARY SURFACTANT
|
Facility
|
IP
|
$585.48
|
|
|
Service Code
|
CPT 94610
|
| Hospital Charge Code |
46000034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$257.61 |
| Max. Negotiated Rate |
$526.93 |
| Rate for Payer: Aetna American Axle |
$380.56
|
| Rate for Payer: Aetna Commercial |
$497.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.56
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$409.84
|
| Rate for Payer: Cofinity Commercial |
$503.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$409.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.38
|
| Rate for Payer: Healthscope Commercial |
$526.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.66
|
| Rate for Payer: PHP Commercial |
$497.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.56
|
| Rate for Payer: Priority Health SBD |
$368.85
|
| Rate for Payer: UMR Bronson Commercial |
$257.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.11
|
|
|
HC ADMIN INTRAPULMONARY SURFACTANT
|
Facility
|
OP
|
$585.48
|
|
|
Service Code
|
CPT 94610
|
| Hospital Charge Code |
46000034
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$106.32 |
| Max. Negotiated Rate |
$558.36 |
| Rate for Payer: Aetna American Axle |
$380.56
|
| Rate for Payer: Aetna Commercial |
$497.66
|
| Rate for Payer: Aetna Medicare |
$206.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$380.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$247.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$247.95
|
| Rate for Payer: BCBS Complete |
$111.64
|
| Rate for Payer: BCBS MAPPO |
$198.36
|
| Rate for Payer: BCN Medicare Advantage |
$198.36
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cash Price |
$468.38
|
| Rate for Payer: Cofinity Commercial |
$409.84
|
| Rate for Payer: Cofinity Commercial |
$503.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$409.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$468.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.36
|
| Rate for Payer: Healthscope Commercial |
$526.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$409.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$439.11
|
| Rate for Payer: Mclaren Medicaid |
$106.32
|
| Rate for Payer: Mclaren Medicare |
$198.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$208.28
|
| Rate for Payer: Meridian Medicaid |
$111.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$228.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$497.66
|
| Rate for Payer: PACE Medicare |
$188.44
|
| Rate for Payer: PACE SWMI |
$198.36
|
| Rate for Payer: PHP Commercial |
$497.66
|
| Rate for Payer: PHP Medicare Advantage |
$198.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$106.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$380.56
|
| Rate for Payer: Priority Health Medicare |
$198.36
|
| Rate for Payer: Priority Health SBD |
$368.85
|
| Rate for Payer: Railroad Medicare Medicare |
$198.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.36
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$198.36
|
| Rate for Payer: UHC Exchange |
$379.09
|
| Rate for Payer: UHC Medicare Advantage |
$198.36
|
| Rate for Payer: UHCCP Medicaid |
$106.32
|
| Rate for Payer: UMR Bronson Commercial |
$216.63
|
| Rate for Payer: VA VA |
$198.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$439.11
|
|
|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
OP
|
$84.70
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$31.34 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna American Axle |
$55.05
|
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: BCBS Complete |
$33.88
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Cofinity Commercial |
$59.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.05
|
| Rate for Payer: Priority Health SBD |
$53.36
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UMR Bronson Commercial |
$31.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.52
|
|
|
HC ADMIN RSV MONOC ANTB IM INJ
|
Facility
|
IP
|
$84.70
|
|
|
Service Code
|
CPT 96381
|
| Hospital Charge Code |
77100066
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$37.27 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna American Axle |
$55.05
|
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$59.29
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.05
|
| Rate for Payer: Priority Health SBD |
$53.36
|
| Rate for Payer: UMR Bronson Commercial |
$37.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.52
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
OP
|
$84.70
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$31.34 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna American Axle |
$55.05
|
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare |
$42.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: BCBS Complete |
$33.88
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Cofinity Commercial |
$59.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.05
|
| Rate for Payer: Priority Health SBD |
$53.36
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UMR Bronson Commercial |
$31.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.52
|
|
|
HC ADMIN RSV MONOC ANTB IM W/COUNSELING
|
Facility
|
IP
|
$84.70
|
|
|
Service Code
|
CPT 96380
|
| Hospital Charge Code |
77100065
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$37.27 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna American Axle |
$55.05
|
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$59.29
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.05
|
| Rate for Payer: Priority Health SBD |
$53.36
|
| Rate for Payer: UMR Bronson Commercial |
$37.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.52
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
OP
|
$534.77
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$1,236.75 |
| Rate for Payer: Aetna American Axle |
$347.60
|
| Rate for Payer: Aetna Commercial |
$454.55
|
| Rate for Payer: Aetna Medicare |
$456.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.20
|
| Rate for Payer: BCBS Complete |
$247.27
|
| Rate for Payer: BCBS MAPPO |
$439.36
|
| Rate for Payer: BCN Medicare Advantage |
$439.36
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$374.34
|
| Rate for Payer: Cofinity Commercial |
$459.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.36
|
| Rate for Payer: Healthscope Commercial |
$481.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.08
|
| Rate for Payer: Mclaren Medicaid |
$235.50
|
| Rate for Payer: Mclaren Medicare |
$439.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.33
|
| Rate for Payer: Meridian Medicaid |
$247.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: PACE Medicare |
$417.39
|
| Rate for Payer: PACE SWMI |
$439.36
|
| Rate for Payer: PHP Commercial |
$454.55
|
| Rate for Payer: PHP Medicare Advantage |
$439.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: Priority Health Medicare |
$439.36
|
| Rate for Payer: Priority Health SBD |
$336.91
|
| Rate for Payer: Railroad Medicare Medicare |
$439.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,236.75
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.36
|
| Rate for Payer: UHC Exchange |
$839.66
|
| Rate for Payer: UHC Medicare Advantage |
$439.36
|
| Rate for Payer: UHCCP Medicaid |
$235.50
|
| Rate for Payer: UMR Bronson Commercial |
$197.86
|
| Rate for Payer: VA VA |
$439.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.08
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 1ST DOSE
|
Facility
|
IP
|
$534.77
|
|
|
Service Code
|
HCPCS M0249
|
| Hospital Charge Code |
77100044
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$235.30 |
| Max. Negotiated Rate |
$481.29 |
| Rate for Payer: Aetna American Axle |
$347.60
|
| Rate for Payer: Aetna Commercial |
$454.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.60
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$374.34
|
| Rate for Payer: Cofinity Commercial |
$459.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Healthscope Commercial |
$481.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: PHP Commercial |
$454.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: Priority Health SBD |
$336.91
|
| Rate for Payer: UMR Bronson Commercial |
$235.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.08
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
OP
|
$534.77
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$47.00 |
| Max. Negotiated Rate |
$1,236.75 |
| Rate for Payer: Aetna American Axle |
$347.60
|
| Rate for Payer: Aetna Commercial |
$454.55
|
| Rate for Payer: Aetna Medicare |
$456.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$549.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$549.20
|
| Rate for Payer: BCBS Complete |
$247.27
|
| Rate for Payer: BCBS MAPPO |
$439.36
|
| Rate for Payer: BCN Medicare Advantage |
$439.36
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$374.34
|
| Rate for Payer: Cofinity Commercial |
$459.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$439.36
|
| Rate for Payer: Healthscope Commercial |
$481.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.08
|
| Rate for Payer: Mclaren Medicaid |
$235.50
|
| Rate for Payer: Mclaren Medicare |
$439.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$461.33
|
| Rate for Payer: Meridian Medicaid |
$247.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$505.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: PACE Medicare |
$417.39
|
| Rate for Payer: PACE SWMI |
$439.36
|
| Rate for Payer: PHP Commercial |
$454.55
|
| Rate for Payer: PHP Medicare Advantage |
$439.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: Priority Health Medicare |
$439.36
|
| Rate for Payer: Priority Health SBD |
$336.91
|
| Rate for Payer: Railroad Medicare Medicare |
$439.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,236.75
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$439.36
|
| Rate for Payer: UHC Exchange |
$839.66
|
| Rate for Payer: UHC Medicare Advantage |
$439.36
|
| Rate for Payer: UHCCP Medicaid |
$235.50
|
| Rate for Payer: UMR Bronson Commercial |
$197.86
|
| Rate for Payer: VA VA |
$439.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.08
|
|
|
HC ADMIN TOCILIZUMAB COVID 19 2ND DOSE
|
Facility
|
IP
|
$534.77
|
|
|
Service Code
|
HCPCS M0250
|
| Hospital Charge Code |
77100045
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$235.30 |
| Max. Negotiated Rate |
$481.29 |
| Rate for Payer: Aetna American Axle |
$347.60
|
| Rate for Payer: Aetna Commercial |
$454.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$347.60
|
| Rate for Payer: Cash Price |
$427.82
|
| Rate for Payer: Cofinity Commercial |
$374.34
|
| Rate for Payer: Cofinity Commercial |
$459.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$427.82
|
| Rate for Payer: Healthscope Commercial |
$481.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$454.55
|
| Rate for Payer: PHP Commercial |
$454.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.60
|
| Rate for Payer: Priority Health SBD |
$336.91
|
| Rate for Payer: UMR Bronson Commercial |
$235.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.08
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
OP
|
$84.70
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$21.70 |
| Max. Negotiated Rate |
$113.98 |
| Rate for Payer: Aetna American Axle |
$55.05
|
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna Medicare |
$42.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.61
|
| Rate for Payer: BCBS Complete |
$22.79
|
| Rate for Payer: BCBS MAPPO |
$40.49
|
| Rate for Payer: BCN Medicare Advantage |
$40.49
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$59.29
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.49
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.52
|
| Rate for Payer: Mclaren Medicaid |
$21.70
|
| Rate for Payer: Mclaren Medicare |
$40.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.51
|
| Rate for Payer: Meridian Medicaid |
$22.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: PACE Medicare |
$38.47
|
| Rate for Payer: PACE SWMI |
$40.49
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: PHP Medicare Advantage |
$40.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.05
|
| Rate for Payer: Priority Health Medicare |
$40.49
|
| Rate for Payer: Priority Health SBD |
$53.36
|
| Rate for Payer: Railroad Medicare Medicare |
$40.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.98
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.49
|
| Rate for Payer: UHC Exchange |
$77.38
|
| Rate for Payer: UHC Medicare Advantage |
$40.49
|
| Rate for Payer: UHCCP Medicaid |
$21.70
|
| Rate for Payer: UMR Bronson Commercial |
$31.34
|
| Rate for Payer: VA VA |
$40.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.52
|
|
|
HC ADMN SARSCOV2 VACC 1 DOSE
|
Facility
|
IP
|
$84.70
|
|
|
Service Code
|
CPT 90480
|
| Hospital Charge Code |
77100064
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$37.27 |
| Max. Negotiated Rate |
$76.23 |
| Rate for Payer: Aetna American Axle |
$55.05
|
| Rate for Payer: Aetna Commercial |
$72.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.05
|
| Rate for Payer: Cash Price |
$67.76
|
| Rate for Payer: Cofinity Commercial |
$59.29
|
| Rate for Payer: Cofinity Commercial |
$72.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.76
|
| Rate for Payer: Healthscope Commercial |
$76.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.00
|
| Rate for Payer: PHP Commercial |
$72.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.05
|
| Rate for Payer: Priority Health SBD |
$53.36
|
| Rate for Payer: UMR Bronson Commercial |
$37.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.52
|
|
|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$63.84 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna American Axle |
$94.30
|
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$63.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
