|
HC ADMU OBSERVATION PER HOUR
|
Facility
|
OP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200020
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$53.68 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$94.30
|
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna Medicare |
$72.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: BCBS Complete |
$58.03
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| 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: Meridian Medicaid |
$1,000.00
|
| 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: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$53.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
OP
|
$63.18
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.70 |
| Max. Negotiated Rate |
$108.71 |
| Rate for Payer: Aetna American Axle |
$41.07
|
| Rate for Payer: Aetna Commercial |
$53.70
|
| Rate for Payer: Aetna Medicare |
$40.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.27
|
| Rate for Payer: BCBS Complete |
$21.74
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$54.33
|
| Rate for Payer: Cofinity Commercial |
$44.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$56.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.38
|
| Rate for Payer: Mclaren Medicaid |
$20.70
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$21.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.70
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$53.70
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.07
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health SBD |
$39.80
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$108.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.62
|
| Rate for Payer: UHC Exchange |
$73.81
|
| Rate for Payer: UHC Medicare Advantage |
$38.62
|
| Rate for Payer: UHCCP Medicaid |
$20.70
|
| Rate for Payer: UMR Bronson Commercial |
$23.38
|
| Rate for Payer: VA VA |
$38.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.38
|
|
|
HC ADRENOCORTICOTROPIC HORMONE
|
Facility
|
IP
|
$63.18
|
|
|
Service Code
|
CPT 82024
|
| Hospital Charge Code |
30100071
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.80 |
| Max. Negotiated Rate |
$56.86 |
| Rate for Payer: Aetna American Axle |
$41.07
|
| Rate for Payer: Aetna Commercial |
$53.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.07
|
| Rate for Payer: Cash Price |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$44.23
|
| Rate for Payer: Cofinity Commercial |
$54.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.54
|
| Rate for Payer: Healthscope Commercial |
$56.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.70
|
| Rate for Payer: PHP Commercial |
$53.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.07
|
| Rate for Payer: Priority Health SBD |
$39.80
|
| Rate for Payer: UMR Bronson Commercial |
$27.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.38
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
OP
|
$15.30
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.16 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.95
|
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.22
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.47
|
| Rate for Payer: Mclaren Medicaid |
$1.16
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Medicaid |
$1.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$13.01
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.95
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.17
|
| Rate for Payer: UHC Exchange |
$4.15
|
| Rate for Payer: UHC Medicare Advantage |
$2.17
|
| Rate for Payer: UHCCP Medicaid |
$1.16
|
| Rate for Payer: UMR Bronson Commercial |
$5.66
|
| Rate for Payer: VA VA |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.47
|
|
|
HC ADULTERANT SURVEY URINE
|
Facility
|
IP
|
$15.30
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700010
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$6.73 |
| Max. Negotiated Rate |
$13.77 |
| Rate for Payer: Aetna American Axle |
$9.95
|
| Rate for Payer: Aetna Commercial |
$13.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.95
|
| Rate for Payer: Cash Price |
$12.24
|
| Rate for Payer: Cofinity Commercial |
$10.71
|
| Rate for Payer: Cofinity Commercial |
$13.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.24
|
| Rate for Payer: Healthscope Commercial |
$13.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.01
|
| Rate for Payer: PHP Commercial |
$13.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.95
|
| Rate for Payer: Priority Health SBD |
$9.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.47
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.65 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna American Axle |
$21.64
|
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.64
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health SBD |
$20.97
|
| Rate for Payer: UMR Bronson Commercial |
$14.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC ADVANCE CARE PLANNING EA ADDL 30 MIN
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 99498
|
| Hospital Charge Code |
51000091
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.32 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna American Axle |
$21.64
|
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna Medicare |
$16.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.64
|
| Rate for Payer: BCBS Complete |
$13.32
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health SBD |
$20.97
|
| Rate for Payer: UMR Bronson Commercial |
$12.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
OP
|
$33.29
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$12.32 |
| Max. Negotiated Rate |
$253.93 |
| Rate for Payer: Aetna American Axle |
$21.64
|
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna Medicare |
$93.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.76
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$90.21
|
| Rate for Payer: BCN Medicare Advantage |
$90.21
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Cofinity Commercial |
$23.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.21
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Mclaren Medicare |
$90.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.72
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: PACE Medicare |
$85.70
|
| Rate for Payer: PACE SWMI |
$90.21
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: PHP Medicare Advantage |
$90.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health Medicare |
$90.21
|
| Rate for Payer: Priority Health SBD |
$20.97
|
| Rate for Payer: Railroad Medicare Medicare |
$90.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.21
|
| Rate for Payer: UHC Exchange |
$172.40
|
| Rate for Payer: UHC Medicare Advantage |
$90.21
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
| Rate for Payer: UMR Bronson Commercial |
$12.32
|
| Rate for Payer: VA VA |
$90.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC ADVANCE CARE PLANNING FIRST 30 MIN
|
Facility
|
IP
|
$33.29
|
|
|
Service Code
|
CPT 99497
|
| Hospital Charge Code |
51000090
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.65 |
| Max. Negotiated Rate |
$29.96 |
| Rate for Payer: Aetna American Axle |
$21.64
|
| Rate for Payer: Aetna Commercial |
$28.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.64
|
| Rate for Payer: Cash Price |
$26.63
|
| Rate for Payer: Cofinity Commercial |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$28.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.63
|
| Rate for Payer: Healthscope Commercial |
$29.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.30
|
| Rate for Payer: PHP Commercial |
$28.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.64
|
| Rate for Payer: Priority Health SBD |
$20.97
|
| Rate for Payer: UMR Bronson Commercial |
$14.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.97
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
OP
|
$161.16
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$59.63 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna American Axle |
$104.75
|
| Rate for Payer: Aetna Commercial |
$136.99
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$112.81
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$145.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.87
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.99
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$136.99
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.75
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$101.53
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$580.40
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: UMR Bronson Commercial |
$59.63
|
| Rate for Payer: VA VA |
$303.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.87
|
|
|
HC AEP HEARING STATUS DETER BROADBAND STIMULI I&R
|
Facility
|
IP
|
$161.16
|
|
|
Service Code
|
CPT 92651
|
| Hospital Charge Code |
76100497
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$70.91 |
| Max. Negotiated Rate |
$145.04 |
| Rate for Payer: Aetna American Axle |
$104.75
|
| Rate for Payer: Aetna Commercial |
$136.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.75
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$112.81
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Healthscope Commercial |
$145.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.99
|
| Rate for Payer: PHP Commercial |
$136.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.75
|
| Rate for Payer: Priority Health SBD |
$101.53
|
| Rate for Payer: UMR Bronson Commercial |
$70.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.87
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
OP
|
$286.62
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$106.05 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna American Axle |
$186.30
|
| Rate for Payer: Aetna Commercial |
$243.63
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$200.63
|
| Rate for Payer: Cofinity Commercial |
$246.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$200.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$257.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.97
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$243.63
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$180.57
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$580.40
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: UMR Bronson Commercial |
$106.05
|
| Rate for Payer: VA VA |
$303.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.97
|
|
|
HC AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R
|
Facility
|
IP
|
$286.62
|
|
|
Service Code
|
CPT 92652
|
| Hospital Charge Code |
47100401
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$126.11 |
| Max. Negotiated Rate |
$257.96 |
| Rate for Payer: Aetna American Axle |
$186.30
|
| Rate for Payer: Aetna Commercial |
$243.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.30
|
| Rate for Payer: Cash Price |
$229.30
|
| Rate for Payer: Cofinity Commercial |
$200.63
|
| Rate for Payer: Cofinity Commercial |
$246.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$200.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.30
|
| Rate for Payer: Healthscope Commercial |
$257.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.63
|
| Rate for Payer: PHP Commercial |
$243.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.30
|
| Rate for Payer: Priority Health SBD |
$180.57
|
| Rate for Payer: UMR Bronson Commercial |
$126.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.97
|
|
|
HC AEROBIKA
|
Facility
|
OP
|
$150.27
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$55.60 |
| Max. Negotiated Rate |
$135.24 |
| Rate for Payer: Aetna American Axle |
$97.68
|
| Rate for Payer: Aetna Commercial |
$127.73
|
| Rate for Payer: Aetna Medicare |
$75.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.68
|
| Rate for Payer: BCBS Complete |
$60.11
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$105.19
|
| Rate for Payer: Cofinity Commercial |
$129.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$135.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.73
|
| Rate for Payer: PHP Commercial |
$127.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.68
|
| Rate for Payer: Priority Health SBD |
$94.67
|
| Rate for Payer: UMR Bronson Commercial |
$55.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.70
|
|
|
HC AEROBIKA
|
Facility
|
IP
|
$150.27
|
|
| Hospital Charge Code |
27000612
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$66.12 |
| Max. Negotiated Rate |
$135.24 |
| Rate for Payer: Aetna American Axle |
$97.68
|
| Rate for Payer: Aetna Commercial |
$127.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.68
|
| Rate for Payer: Cash Price |
$120.22
|
| Rate for Payer: Cofinity Commercial |
$105.19
|
| Rate for Payer: Cofinity Commercial |
$129.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$105.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.22
|
| Rate for Payer: Healthscope Commercial |
$135.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.73
|
| Rate for Payer: PHP Commercial |
$127.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.68
|
| Rate for Payer: Priority Health SBD |
$94.67
|
| Rate for Payer: UMR Bronson Commercial |
$66.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.70
|
|
|
HC AERONEB SUPPLY
|
Facility
|
OP
|
$167.21
|
|
| Hospital Charge Code |
27000465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$61.87 |
| Max. Negotiated Rate |
$150.49 |
| Rate for Payer: Aetna American Axle |
$108.69
|
| Rate for Payer: Aetna Commercial |
$142.13
|
| Rate for Payer: Aetna Medicare |
$83.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.69
|
| Rate for Payer: BCBS Complete |
$66.88
|
| Rate for Payer: Cash Price |
$133.77
|
| Rate for Payer: Cofinity Commercial |
$117.05
|
| Rate for Payer: Cofinity Commercial |
$143.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.77
|
| Rate for Payer: Healthscope Commercial |
$150.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.13
|
| Rate for Payer: PHP Commercial |
$142.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.69
|
| Rate for Payer: Priority Health SBD |
$105.34
|
| Rate for Payer: UMR Bronson Commercial |
$61.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.41
|
|
|
HC AERONEB SUPPLY
|
Facility
|
IP
|
$167.21
|
|
| Hospital Charge Code |
27000465
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.57 |
| Max. Negotiated Rate |
$150.49 |
| Rate for Payer: Aetna American Axle |
$108.69
|
| Rate for Payer: Aetna Commercial |
$142.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.69
|
| Rate for Payer: Cash Price |
$133.77
|
| Rate for Payer: Cofinity Commercial |
$117.05
|
| Rate for Payer: Cofinity Commercial |
$143.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.77
|
| Rate for Payer: Healthscope Commercial |
$150.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.13
|
| Rate for Payer: PHP Commercial |
$142.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.69
|
| Rate for Payer: Priority Health SBD |
$105.34
|
| Rate for Payer: UMR Bronson Commercial |
$73.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.41
|
|
|
HC AEROSOLIZED MEDICATION
|
Facility
|
OP
|
$149.67
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$55.38 |
| Max. Negotiated Rate |
$558.36 |
| Rate for Payer: Aetna American Axle |
$97.29
|
| Rate for Payer: Aetna Commercial |
$127.22
|
| Rate for Payer: Aetna Medicare |
$206.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.29
|
| 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 |
$119.74
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cofinity Commercial |
$104.77
|
| Rate for Payer: Cofinity Commercial |
$128.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$198.36
|
| Rate for Payer: Healthscope Commercial |
$134.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.25
|
| 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 |
$127.22
|
| Rate for Payer: PACE Medicare |
$188.44
|
| Rate for Payer: PACE SWMI |
$198.36
|
| Rate for Payer: PHP Commercial |
$127.22
|
| 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 |
$97.29
|
| Rate for Payer: Priority Health Medicare |
$198.36
|
| Rate for Payer: Priority Health SBD |
$94.29
|
| 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 |
$55.38
|
| Rate for Payer: VA VA |
$198.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.25
|
|
|
HC AEROSOLIZED MEDICATION
|
Facility
|
IP
|
$149.67
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000012
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$65.85 |
| Max. Negotiated Rate |
$134.70 |
| Rate for Payer: Aetna American Axle |
$97.29
|
| Rate for Payer: Aetna Commercial |
$127.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.29
|
| Rate for Payer: Cash Price |
$119.74
|
| Rate for Payer: Cofinity Commercial |
$104.77
|
| Rate for Payer: Cofinity Commercial |
$128.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$104.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.74
|
| Rate for Payer: Healthscope Commercial |
$134.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.22
|
| Rate for Payer: PHP Commercial |
$127.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$97.29
|
| Rate for Payer: Priority Health SBD |
$94.29
|
| Rate for Payer: UMR Bronson Commercial |
$65.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.25
|
|
|
HC AFB CULTURE
|
Facility
|
IP
|
$91.19
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
30600089
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$40.12 |
| Max. Negotiated Rate |
$82.07 |
| Rate for Payer: Aetna American Axle |
$59.27
|
| Rate for Payer: Aetna Commercial |
$77.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.27
|
| Rate for Payer: Cash Price |
$72.95
|
| Rate for Payer: Cofinity Commercial |
$63.83
|
| Rate for Payer: Cofinity Commercial |
$78.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.95
|
| Rate for Payer: Healthscope Commercial |
$82.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.51
|
| Rate for Payer: PHP Commercial |
$77.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.27
|
| Rate for Payer: Priority Health SBD |
$57.45
|
| Rate for Payer: UMR Bronson Commercial |
$40.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.39
|
|
|
HC AFB CULTURE
|
Facility
|
OP
|
$91.19
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
30600089
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$82.07 |
| Rate for Payer: Aetna American Axle |
$59.27
|
| Rate for Payer: Aetna Commercial |
$77.51
|
| Rate for Payer: Aetna Medicare |
$11.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.50
|
| Rate for Payer: BCBS Complete |
$6.08
|
| Rate for Payer: BCBS MAPPO |
$10.80
|
| Rate for Payer: BCN Medicare Advantage |
$10.80
|
| Rate for Payer: Cash Price |
$72.95
|
| Rate for Payer: Cash Price |
$72.95
|
| Rate for Payer: Cofinity Commercial |
$78.42
|
| Rate for Payer: Cofinity Commercial |
$63.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$63.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.80
|
| Rate for Payer: Healthscope Commercial |
$82.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.39
|
| Rate for Payer: Mclaren Medicaid |
$5.79
|
| Rate for Payer: Mclaren Medicare |
$10.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.34
|
| Rate for Payer: Meridian Medicaid |
$6.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.51
|
| Rate for Payer: PACE Medicare |
$10.26
|
| Rate for Payer: PACE SWMI |
$10.80
|
| Rate for Payer: PHP Commercial |
$77.51
|
| Rate for Payer: PHP Medicare Advantage |
$10.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.27
|
| Rate for Payer: Priority Health Medicare |
$10.80
|
| Rate for Payer: Priority Health SBD |
$57.45
|
| Rate for Payer: Railroad Medicare Medicare |
$10.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.80
|
| Rate for Payer: UHC Exchange |
$20.64
|
| Rate for Payer: UHC Medicare Advantage |
$10.80
|
| Rate for Payer: UHCCP Medicaid |
$5.79
|
| Rate for Payer: UMR Bronson Commercial |
$33.74
|
| Rate for Payer: VA VA |
$10.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.39
|
|
|
HC AFB SMEAR
|
Facility
|
IP
|
$58.65
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
30600105
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.81 |
| Max. Negotiated Rate |
$52.78 |
| Rate for Payer: Aetna American Axle |
$38.12
|
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.12
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: PHP Commercial |
$49.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health SBD |
$36.95
|
| Rate for Payer: UMR Bronson Commercial |
$25.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
HC AFB SMEAR
|
Facility
|
OP
|
$58.65
|
|
|
Service Code
|
CPT 87206
|
| Hospital Charge Code |
30600105
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.89 |
| Max. Negotiated Rate |
$52.78 |
| Rate for Payer: Aetna American Axle |
$38.12
|
| Rate for Payer: Aetna Commercial |
$49.85
|
| Rate for Payer: Aetna Medicare |
$5.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.74
|
| Rate for Payer: BCBS Complete |
$3.03
|
| Rate for Payer: BCBS MAPPO |
$5.39
|
| Rate for Payer: BCN Medicare Advantage |
$5.39
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cash Price |
$46.92
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Cofinity Commercial |
$41.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.39
|
| Rate for Payer: Healthscope Commercial |
$52.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.99
|
| Rate for Payer: Mclaren Medicaid |
$2.89
|
| Rate for Payer: Mclaren Medicare |
$5.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.66
|
| Rate for Payer: Meridian Medicaid |
$3.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.85
|
| Rate for Payer: PACE Medicare |
$5.12
|
| Rate for Payer: PACE SWMI |
$5.39
|
| Rate for Payer: PHP Commercial |
$49.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.12
|
| Rate for Payer: Priority Health Medicare |
$5.39
|
| Rate for Payer: Priority Health SBD |
$36.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.39
|
| Rate for Payer: UHC Exchange |
$10.30
|
| Rate for Payer: UHC Medicare Advantage |
$5.39
|
| Rate for Payer: UHCCP Medicaid |
$2.89
|
| Rate for Payer: UMR Bronson Commercial |
$21.70
|
| Rate for Payer: VA VA |
$5.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.99
|
|
|
HC AFFINITY 1.5 X 1.5 PER SQ CM
|
Facility
|
IP
|
$721.00
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600124
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$317.24 |
| Max. Negotiated Rate |
$648.90 |
| Rate for Payer: Aetna American Axle |
$468.65
|
| Rate for Payer: Aetna Commercial |
$612.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.65
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cofinity Commercial |
$504.70
|
| Rate for Payer: Cofinity Commercial |
$620.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$504.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.80
|
| Rate for Payer: Healthscope Commercial |
$648.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.85
|
| Rate for Payer: PHP Commercial |
$612.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.65
|
| Rate for Payer: Priority Health SBD |
$454.23
|
| Rate for Payer: UMR Bronson Commercial |
$317.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.75
|
|
|
HC AFFINITY 1.5 X 1.5 PER SQ CM
|
Facility
|
OP
|
$721.00
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600124
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$266.77 |
| Max. Negotiated Rate |
$648.90 |
| Rate for Payer: Aetna American Axle |
$468.65
|
| Rate for Payer: Aetna Commercial |
$612.85
|
| Rate for Payer: Aetna Medicare |
$360.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$468.65
|
| Rate for Payer: BCBS Complete |
$288.40
|
| Rate for Payer: Cash Price |
$576.80
|
| Rate for Payer: Cofinity Commercial |
$504.70
|
| Rate for Payer: Cofinity Commercial |
$620.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$504.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$576.80
|
| Rate for Payer: Healthscope Commercial |
$648.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$504.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$540.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$612.85
|
| Rate for Payer: PHP Commercial |
$612.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$468.65
|
| Rate for Payer: Priority Health SBD |
$454.23
|
| Rate for Payer: UMR Bronson Commercial |
$266.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$540.75
|
|
