|
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: BCBS Trust/PPO |
$5.19
|
| Rate for Payer: BCN Commercial |
$5.19
|
| 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 |
$41.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.06
|
| 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 |
$41.06
|
| 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: Nomi Health Commercial |
$8.08
|
| 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 HMO/PPO/Tiered Network |
$5.54
|
| Rate for Payer: Priority Health Medicare |
$5.39
|
| Rate for Payer: Priority Health Narrow Network |
$4.43
|
| Rate for Payer: Priority Health SBD |
$36.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.39
|
| Rate for Payer: UHC Exchange |
$5.39
|
| 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 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 |
$41.06
|
| Rate for Payer: Cofinity Commercial |
$50.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.06
|
| 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 |
$41.06
|
| 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 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 |
$1,111.53 |
| 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: BCBS Trust/PPO |
$1,111.53
|
| Rate for Payer: BCN Commercial |
$1,111.53
|
| Rate for Payer: Cash Price |
$576.80
|
| 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
|
|
|
HC AFFINITY 2.5 X 2.5 PER SQ CM
|
Facility
|
IP
|
$434.79
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600125
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$191.31 |
| Max. Negotiated Rate |
$391.31 |
| Rate for Payer: Aetna American Axle |
$282.61
|
| Rate for Payer: Aetna Commercial |
$369.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.61
|
| Rate for Payer: Cash Price |
$347.83
|
| Rate for Payer: Cofinity Commercial |
$304.35
|
| Rate for Payer: Cofinity Commercial |
$373.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$304.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.83
|
| Rate for Payer: Healthscope Commercial |
$391.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$304.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$326.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.57
|
| Rate for Payer: PHP Commercial |
$369.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.61
|
| Rate for Payer: Priority Health SBD |
$273.92
|
| Rate for Payer: UMR Bronson Commercial |
$191.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$326.09
|
|
|
HC AFFINITY 2.5 X 2.5 PER SQ CM
|
Facility
|
OP
|
$434.79
|
|
|
Service Code
|
HCPCS Q4159
|
| Hospital Charge Code |
63600125
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$160.87 |
| Max. Negotiated Rate |
$1,111.53 |
| Rate for Payer: Aetna American Axle |
$282.61
|
| Rate for Payer: Aetna Commercial |
$369.57
|
| Rate for Payer: Aetna Medicare |
$217.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$282.61
|
| Rate for Payer: BCBS Complete |
$173.92
|
| Rate for Payer: BCBS Trust/PPO |
$1,111.53
|
| Rate for Payer: BCN Commercial |
$1,111.53
|
| Rate for Payer: Cash Price |
$347.83
|
| Rate for Payer: Cash Price |
$347.83
|
| Rate for Payer: Cofinity Commercial |
$304.35
|
| Rate for Payer: Cofinity Commercial |
$373.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$304.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$347.83
|
| Rate for Payer: Healthscope Commercial |
$391.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$304.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$326.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$369.57
|
| Rate for Payer: PHP Commercial |
$369.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$282.61
|
| Rate for Payer: Priority Health SBD |
$273.92
|
| Rate for Payer: UMR Bronson Commercial |
$160.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$326.09
|
|
|
HC AFP SINGLE MARKER SCRN,MS
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna American Axle |
$31.78
|
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.78
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health SBD |
$30.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.68
|
|
|
HC AFP SINGLE MARKER SCRN,MS
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 82105
|
| Hospital Charge Code |
30100622
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.99 |
| Max. Negotiated Rate |
$722.52 |
| Rate for Payer: Aetna American Axle |
$31.78
|
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$17.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.96
|
| Rate for Payer: BCBS Complete |
$9.44
|
| Rate for Payer: BCBS MAPPO |
$16.77
|
| Rate for Payer: BCBS Trust/PPO |
$16.16
|
| Rate for Payer: BCN Commercial |
$16.16
|
| Rate for Payer: BCN Medicare Advantage |
$16.77
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.77
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.68
|
| Rate for Payer: Mclaren Medicaid |
$8.99
|
| Rate for Payer: Mclaren Medicare |
$16.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.61
|
| Rate for Payer: Meridian Medicaid |
$9.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$25.16
|
| Rate for Payer: PACE Medicare |
$15.93
|
| Rate for Payer: PACE SWMI |
$16.77
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$16.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.26
|
| Rate for Payer: Priority Health Medicare |
$16.77
|
| Rate for Payer: Priority Health Narrow Network |
$13.81
|
| Rate for Payer: Priority Health SBD |
$30.81
|
| Rate for Payer: Railroad Medicare Medicare |
$16.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.12
|
| Rate for Payer: UHC Core |
$722.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.77
|
| Rate for Payer: UHC Exchange |
$16.77
|
| Rate for Payer: UHC Medicare Advantage |
$16.77
|
| Rate for Payer: UHCCP Medicaid |
$8.99
|
| Rate for Payer: UMR Bronson Commercial |
$18.09
|
| Rate for Payer: VA VA |
$16.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.68
|
|
|
HC AFTER HOURS ACCESS
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 99050
|
| Hospital Charge Code |
98300006
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$7.55 |
| Max. Negotiated Rate |
$57.67 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: BCBS Complete |
$8.16
|
| Rate for Payer: BCBS Trust/PPO |
$57.67
|
| Rate for Payer: BCN Commercial |
$57.67
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.26
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: UMR Bronson Commercial |
$7.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC AFTER HOURS ACCESS
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 99050
|
| Hospital Charge Code |
98300006
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.26
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: UMR Bronson Commercial |
$8.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC ALBUMIN SERUM
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100072
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$2,938.27 |
| Rate for Payer: Aetna American Axle |
$25.13
|
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$5.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.19
|
| Rate for Payer: BCBS Complete |
$2.79
|
| Rate for Payer: BCBS MAPPO |
$4.95
|
| Rate for Payer: BCN Medicare Advantage |
$4.95
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.95
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$2.65
|
| Rate for Payer: Mclaren Medicare |
$4.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.20
|
| Rate for Payer: Meridian Medicaid |
$2.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$7.42
|
| Rate for Payer: PACE Medicare |
$4.70
|
| Rate for Payer: PACE SWMI |
$4.95
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$4.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.09
|
| Rate for Payer: Priority Health Medicare |
$4.95
|
| Rate for Payer: Priority Health Narrow Network |
$4.07
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$4.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.94
|
| Rate for Payer: UHC Core |
$2,938.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.95
|
| Rate for Payer: UHC Exchange |
$4.95
|
| Rate for Payer: UHC Medicare Advantage |
$4.95
|
| Rate for Payer: UHCCP Medicaid |
$2.65
|
| Rate for Payer: UMR Bronson Commercial |
$14.30
|
| Rate for Payer: VA VA |
$4.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC ALBUMIN SERUM
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100072
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna American Axle |
$25.13
|
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: UMR Bronson Commercial |
$17.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC ALBUMIN URINE OR OTHER SOURCE
|
Facility
|
IP
|
$41.30
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100663
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.17 |
| Max. Negotiated Rate |
$37.17 |
| Rate for Payer: Aetna American Axle |
$26.84
|
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.84
|
| Rate for Payer: Cash Price |
$33.04
|
| Rate for Payer: Cofinity Commercial |
$28.91
|
| Rate for Payer: Cofinity Commercial |
$35.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.04
|
| Rate for Payer: Healthscope Commercial |
$37.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.10
|
| Rate for Payer: PHP Commercial |
$35.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.84
|
| Rate for Payer: Priority Health SBD |
$26.02
|
| Rate for Payer: UMR Bronson Commercial |
$18.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.98
|
|
|
HC ALBUMIN URINE OR OTHER SOURCE
|
Facility
|
OP
|
$41.30
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100663
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.17 |
| Max. Negotiated Rate |
$962.80 |
| Rate for Payer: Aetna American Axle |
$26.84
|
| Rate for Payer: Aetna Commercial |
$35.10
|
| Rate for Payer: Aetna Medicare |
$8.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.72
|
| Rate for Payer: BCBS Complete |
$4.38
|
| Rate for Payer: BCBS MAPPO |
$7.78
|
| Rate for Payer: BCBS Trust/PPO |
$7.50
|
| Rate for Payer: BCN Commercial |
$7.50
|
| Rate for Payer: BCN Medicare Advantage |
$7.78
|
| Rate for Payer: Cash Price |
$33.04
|
| Rate for Payer: Cash Price |
$33.04
|
| Rate for Payer: Cofinity Commercial |
$35.52
|
| Rate for Payer: Cofinity Commercial |
$28.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.78
|
| Rate for Payer: Healthscope Commercial |
$37.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.98
|
| Rate for Payer: Mclaren Medicaid |
$4.17
|
| Rate for Payer: Mclaren Medicare |
$7.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.17
|
| Rate for Payer: Meridian Medicaid |
$4.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.10
|
| Rate for Payer: Nomi Health Commercial |
$11.67
|
| Rate for Payer: PACE Medicare |
$7.39
|
| Rate for Payer: PACE SWMI |
$7.78
|
| Rate for Payer: PHP Commercial |
$35.10
|
| Rate for Payer: PHP Medicare Advantage |
$7.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.78
|
| Rate for Payer: Priority Health Medicare |
$7.78
|
| Rate for Payer: Priority Health Narrow Network |
$6.22
|
| Rate for Payer: Priority Health SBD |
$26.02
|
| Rate for Payer: Railroad Medicare Medicare |
$7.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.34
|
| Rate for Payer: UHC Core |
$962.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.78
|
| Rate for Payer: UHC Exchange |
$7.78
|
| Rate for Payer: UHC Medicare Advantage |
$7.78
|
| Rate for Payer: UHCCP Medicaid |
$4.17
|
| Rate for Payer: UMR Bronson Commercial |
$15.28
|
| Rate for Payer: VA VA |
$7.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.98
|
|
|
HC ALBUTEROL, INHALATION SOLUTION, UNIT DOSE 1MG
|
Facility
|
OP
|
$6.24
|
|
|
Service Code
|
CPT J7613
|
| Hospital Charge Code |
63600110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$5.62 |
| Rate for Payer: Aetna American Axle |
$4.06
|
| Rate for Payer: Aetna Commercial |
$5.30
|
| Rate for Payer: Aetna Medicare |
$3.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.06
|
| Rate for Payer: BCBS Complete |
$2.50
|
| Rate for Payer: BCBS Trust/PPO |
$0.19
|
| Rate for Payer: BCN Commercial |
$0.19
|
| Rate for Payer: Cash Price |
$4.99
|
| Rate for Payer: Cash Price |
$4.99
|
| Rate for Payer: Cofinity Commercial |
$4.37
|
| Rate for Payer: Cofinity Commercial |
$5.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$4.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.99
|
| Rate for Payer: Healthscope Commercial |
$5.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.30
|
| Rate for Payer: PHP Commercial |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.07
|
| Rate for Payer: Priority Health Narrow Network |
$0.06
|
| Rate for Payer: Priority Health SBD |
$3.93
|
| Rate for Payer: UMR Bronson Commercial |
$2.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.68
|
|
|
HC ALBUTEROL, INHALATION SOLUTION, UNIT DOSE 1MG
|
Facility
|
IP
|
$6.24
|
|
|
Service Code
|
CPT J7613
|
| Hospital Charge Code |
63600110
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$2.75 |
| Max. Negotiated Rate |
$5.62 |
| Rate for Payer: Aetna American Axle |
$4.06
|
| Rate for Payer: Aetna Commercial |
$5.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.06
|
| Rate for Payer: Cash Price |
$4.99
|
| Rate for Payer: Cofinity Commercial |
$4.37
|
| Rate for Payer: Cofinity Commercial |
$5.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$4.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4.99
|
| Rate for Payer: Healthscope Commercial |
$5.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5.30
|
| Rate for Payer: PHP Commercial |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.06
|
| Rate for Payer: Priority Health SBD |
$3.93
|
| Rate for Payer: UMR Bronson Commercial |
$2.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.68
|
|
|
HC ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG
|
Facility
|
IP
|
$4.16
|
|
|
Service Code
|
CPT J7620
|
| Hospital Charge Code |
63600111
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.83 |
| Max. Negotiated Rate |
$3.74 |
| Rate for Payer: Aetna American Axle |
$2.70
|
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.70
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Cofinity Commercial |
$3.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.70
|
| Rate for Payer: Priority Health SBD |
$2.62
|
| Rate for Payer: UMR Bronson Commercial |
$1.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.12
|
|
|
HC ALBUTEROL, UP TO 2.5 MG AND IPRATROPIUM BROMIDE, UP TO 0.5 MG
|
Facility
|
OP
|
$4.16
|
|
|
Service Code
|
CPT J7620
|
| Hospital Charge Code |
63600111
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.15 |
| Max. Negotiated Rate |
$3.74 |
| Rate for Payer: Aetna American Axle |
$2.70
|
| Rate for Payer: Aetna Commercial |
$3.54
|
| Rate for Payer: Aetna Medicare |
$2.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.70
|
| Rate for Payer: BCBS Complete |
$1.66
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cash Price |
$3.33
|
| Rate for Payer: Cofinity Commercial |
$3.58
|
| Rate for Payer: Cofinity Commercial |
$2.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$2.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.33
|
| Rate for Payer: Healthscope Commercial |
$3.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.54
|
| Rate for Payer: PHP Commercial |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$0.19
|
| Rate for Payer: Priority Health Narrow Network |
$0.15
|
| Rate for Payer: Priority Health SBD |
$2.62
|
| Rate for Payer: UMR Bronson Commercial |
$1.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.12
|
|
|
HC ALCOHOL ETHANOL LVL.
|
Facility
|
OP
|
$125.88
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100651
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$113.29 |
| Rate for Payer: Aetna American Axle |
$81.82
|
| Rate for Payer: Aetna Commercial |
$107.00
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$59.88
|
| Rate for Payer: BCN Commercial |
$59.88
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$100.70
|
| Rate for Payer: Cash Price |
$100.70
|
| Rate for Payer: Cofinity Commercial |
$88.12
|
| Rate for Payer: Cofinity Commercial |
$108.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$88.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$113.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.41
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.00
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$107.00
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$49.71
|
| Rate for Payer: Priority Health SBD |
$79.30
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$46.58
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.41
|
|
|
HC ALCOHOL ETHANOL LVL.
|
Facility
|
IP
|
$125.88
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100651
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$55.39 |
| Max. Negotiated Rate |
$113.29 |
| Rate for Payer: Aetna American Axle |
$81.82
|
| Rate for Payer: Aetna Commercial |
$107.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.82
|
| Rate for Payer: Cash Price |
$100.70
|
| Rate for Payer: Cofinity Commercial |
$108.26
|
| Rate for Payer: Cofinity Commercial |
$88.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$88.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.70
|
| Rate for Payer: Healthscope Commercial |
$113.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.00
|
| Rate for Payer: PHP Commercial |
$107.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.82
|
| Rate for Payer: Priority Health SBD |
$79.30
|
| Rate for Payer: UMR Bronson Commercial |
$55.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.41
|
|
|
HC ALCOHOL ETHANOL LVL REFLEX
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100617
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.53 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$33.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: BCBS Complete |
$26.52
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: UMR Bronson Commercial |
$24.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC ALCOHOL ETHANOL LVL REFLEX
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100617
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: UMR Bronson Commercial |
$29.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC ALDER IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200071
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ALDER IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200071
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ALDOLASE
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 82085
|
| Hospital Charge Code |
30100079
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.30 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna American Axle |
$28.51
|
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.51
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: Priority Health SBD |
$27.63
|
| Rate for Payer: UMR Bronson Commercial |
$19.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
