|
HC HEART CATH LT W CORONARIES
|
Facility
|
OP
|
$12,598.15
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,007.21 |
| Max. Negotiated Rate |
$11,338.34 |
| Rate for Payer: Aetna American Axle |
$8,188.80
|
| Rate for Payer: Aetna Commercial |
$10,708.43
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,188.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,786.88
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$10,078.52
|
| Rate for Payer: Cash Price |
$10,078.52
|
| Rate for Payer: Cofinity Commercial |
$8,818.70
|
| Rate for Payer: Cofinity Commercial |
$10,834.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,078.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$11,338.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,818.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,448.61
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,708.43
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$10,708.43
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,818.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$7,936.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,107.93
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$1,007.21
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$4,661.32
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,448.61
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
IP
|
$12,598.15
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,543.19 |
| Max. Negotiated Rate |
$11,338.34 |
| Rate for Payer: Aetna American Axle |
$8,188.80
|
| Rate for Payer: Aetna Commercial |
$10,708.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,188.80
|
| Rate for Payer: Cash Price |
$10,078.52
|
| Rate for Payer: Cofinity Commercial |
$10,834.41
|
| Rate for Payer: Cofinity Commercial |
$8,818.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,078.52
|
| Rate for Payer: Healthscope Commercial |
$11,338.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,818.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,448.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,708.43
|
| Rate for Payer: PHP Commercial |
$10,708.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,818.70
|
| Rate for Payer: Priority Health SBD |
$7,936.83
|
| Rate for Payer: UMR Bronson Commercial |
$5,543.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,448.61
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
OP
|
$42.25
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.63 |
| Max. Negotiated Rate |
$38.02 |
| Rate for Payer: Aetna American Axle |
$27.46
|
| Rate for Payer: Aetna Commercial |
$35.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.46
|
| Rate for Payer: BCBS Complete |
$16.90
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$29.58
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.80
|
| Rate for Payer: Healthscope Commercial |
$38.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: PHP Commercial |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: Priority Health SBD |
$26.62
|
| Rate for Payer: UMR Bronson Commercial |
$15.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.69
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
IP
|
$42.25
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.59 |
| Max. Negotiated Rate |
$38.02 |
| Rate for Payer: Aetna American Axle |
$27.46
|
| Rate for Payer: Aetna Commercial |
$35.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.46
|
| Rate for Payer: Cash Price |
$33.80
|
| Rate for Payer: Cofinity Commercial |
$29.58
|
| Rate for Payer: Cofinity Commercial |
$36.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.80
|
| Rate for Payer: Healthscope Commercial |
$38.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.91
|
| Rate for Payer: PHP Commercial |
$35.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.58
|
| Rate for Payer: Priority Health SBD |
$26.62
|
| Rate for Payer: UMR Bronson Commercial |
$18.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.69
|
|
|
HC HEART CATH PACK
|
Facility
|
OP
|
$508.22
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$188.04 |
| Max. Negotiated Rate |
$457.40 |
| Rate for Payer: Aetna American Axle |
$330.34
|
| Rate for Payer: Aetna Commercial |
$431.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.34
|
| Rate for Payer: BCBS Complete |
$203.29
|
| Rate for Payer: Cash Price |
$406.58
|
| Rate for Payer: Cofinity Commercial |
$355.75
|
| Rate for Payer: Cofinity Commercial |
$437.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.58
|
| Rate for Payer: Healthscope Commercial |
$457.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$355.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$431.99
|
| Rate for Payer: PHP Commercial |
$431.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.75
|
| Rate for Payer: Priority Health SBD |
$320.18
|
| Rate for Payer: UMR Bronson Commercial |
$188.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.16
|
|
|
HC HEART CATH PACK
|
Facility
|
IP
|
$508.22
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$223.62 |
| Max. Negotiated Rate |
$457.40 |
| Rate for Payer: Aetna American Axle |
$330.34
|
| Rate for Payer: Aetna Commercial |
$431.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.34
|
| Rate for Payer: Cash Price |
$406.58
|
| Rate for Payer: Cofinity Commercial |
$355.75
|
| Rate for Payer: Cofinity Commercial |
$437.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.58
|
| Rate for Payer: Healthscope Commercial |
$457.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$355.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$431.99
|
| Rate for Payer: PHP Commercial |
$431.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$355.75
|
| Rate for Payer: Priority Health SBD |
$320.18
|
| Rate for Payer: UMR Bronson Commercial |
$223.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.16
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
OP
|
$9,364.34
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$834.98 |
| Max. Negotiated Rate |
$9,118.19 |
| Rate for Payer: Aetna American Axle |
$6,086.82
|
| Rate for Payer: Aetna Commercial |
$7,959.69
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,086.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$3,718.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cofinity Commercial |
$6,555.04
|
| Rate for Payer: Cofinity Commercial |
$8,053.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,491.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$8,427.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,555.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,023.26
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,959.69
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$7,959.69
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,555.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$5,899.53
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$918.48
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$834.98
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$3,464.81
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,023.26
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
IP
|
$9,364.34
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,120.31 |
| Max. Negotiated Rate |
$8,427.91 |
| Rate for Payer: Aetna American Axle |
$6,086.82
|
| Rate for Payer: Aetna Commercial |
$7,959.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,086.82
|
| Rate for Payer: Cash Price |
$7,491.47
|
| Rate for Payer: Cofinity Commercial |
$6,555.04
|
| Rate for Payer: Cofinity Commercial |
$8,053.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,491.47
|
| Rate for Payer: Healthscope Commercial |
$8,427.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,555.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,023.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,959.69
|
| Rate for Payer: PHP Commercial |
$7,959.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,555.04
|
| Rate for Payer: Priority Health SBD |
$5,899.53
|
| Rate for Payer: UMR Bronson Commercial |
$4,120.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,023.26
|
|
|
HC HEART CATH WIRE
|
Facility
|
IP
|
$32.62
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.35 |
| Max. Negotiated Rate |
$29.36 |
| Rate for Payer: Aetna American Axle |
$21.20
|
| Rate for Payer: Aetna Commercial |
$27.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.20
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cofinity Commercial |
$28.05
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.10
|
| Rate for Payer: Healthscope Commercial |
$29.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.73
|
| Rate for Payer: PHP Commercial |
$27.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.83
|
| Rate for Payer: Priority Health SBD |
$20.55
|
| Rate for Payer: UMR Bronson Commercial |
$14.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.46
|
|
|
HC HEART CATH WIRE
|
Facility
|
OP
|
$32.62
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.07 |
| Max. Negotiated Rate |
$29.36 |
| Rate for Payer: Aetna American Axle |
$21.20
|
| Rate for Payer: Aetna Commercial |
$27.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.20
|
| Rate for Payer: BCBS Complete |
$13.05
|
| Rate for Payer: Cash Price |
$26.10
|
| Rate for Payer: Cofinity Commercial |
$22.83
|
| Rate for Payer: Cofinity Commercial |
$28.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.10
|
| Rate for Payer: Healthscope Commercial |
$29.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$27.73
|
| Rate for Payer: PHP Commercial |
$27.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.83
|
| Rate for Payer: Priority Health SBD |
$20.55
|
| Rate for Payer: UMR Bronson Commercial |
$12.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.46
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$31.30 |
| Rate for Payer: Aetna American Axle |
$18.93
|
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.90
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$17.06
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$20.39
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.85
|
| Rate for Payer: Mclaren Medicaid |
$10.38
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Medicaid |
$10.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.76
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.39
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.02
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$20.82
|
| Rate for Payer: Priority Health SBD |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.76
|
| Rate for Payer: UHC Core |
$31.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Exchange |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$19.54
|
| Rate for Payer: UMR Bronson Commercial |
$10.78
|
| Rate for Payer: VA VA |
$18.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.82 |
| Max. Negotiated Rate |
$26.22 |
| Rate for Payer: Aetna American Axle |
$18.93
|
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$20.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24.76
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.39
|
| Rate for Payer: Priority Health SBD |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$12.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
OP
|
$25.08
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$26.82 |
| Rate for Payer: Aetna American Axle |
$16.30
|
| Rate for Payer: Aetna Commercial |
$21.32
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS Trust/PPO |
$14.63
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$17.56
|
| Rate for Payer: Cofinity Commercial |
$21.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$22.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.81
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Mclaren Medicare |
$16.26
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.32
|
| Rate for Payer: PACE Medicare |
$15.45
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$21.32
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.97
|
| Rate for Payer: Priority Health Medicare |
$16.26
|
| Rate for Payer: Priority Health Narrow Network |
$12.78
|
| Rate for Payer: Priority Health SBD |
$15.80
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.51
|
| Rate for Payer: UHC Core |
$26.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.26
|
| Rate for Payer: UHC Exchange |
$16.26
|
| Rate for Payer: UHC Medicare Advantage |
$16.75
|
| Rate for Payer: UMR Bronson Commercial |
$9.28
|
| Rate for Payer: VA VA |
$16.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.81
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
IP
|
$25.08
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.04 |
| Max. Negotiated Rate |
$22.57 |
| Rate for Payer: Aetna American Axle |
$16.30
|
| Rate for Payer: Aetna Commercial |
$21.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.30
|
| Rate for Payer: Cash Price |
$20.06
|
| Rate for Payer: Cofinity Commercial |
$17.56
|
| Rate for Payer: Cofinity Commercial |
$21.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.06
|
| Rate for Payer: Healthscope Commercial |
$22.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.32
|
| Rate for Payer: PHP Commercial |
$21.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.56
|
| Rate for Payer: Priority Health SBD |
$15.80
|
| Rate for Payer: UMR Bronson Commercial |
$11.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.81
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
IP
|
$36.29
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.97 |
| Max. Negotiated Rate |
$32.66 |
| Rate for Payer: Aetna American Axle |
$23.59
|
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.59
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$25.40
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health SBD |
$22.86
|
| Rate for Payer: UMR Bronson Commercial |
$15.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.22
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
OP
|
$36.29
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.41 |
| Max. Negotiated Rate |
$38.17 |
| Rate for Payer: Aetna American Axle |
$23.59
|
| Rate for Payer: Aetna Commercial |
$30.85
|
| Rate for Payer: Aetna Medicare |
$24.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.55
|
| Rate for Payer: BCBS Complete |
$13.58
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCBS Trust/PPO |
$21.26
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cofinity Commercial |
$31.21
|
| Rate for Payer: Cofinity Commercial |
$25.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$32.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.22
|
| Rate for Payer: Mclaren Medicaid |
$12.93
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Medicaid |
$13.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.85
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$30.85
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.01
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow Network |
$10.41
|
| Rate for Payer: Priority Health SBD |
$22.86
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.37
|
| Rate for Payer: UHC Core |
$38.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.64
|
| Rate for Payer: UHC Exchange |
$23.64
|
| Rate for Payer: UHC Medicare Advantage |
$24.35
|
| Rate for Payer: UMR Bronson Commercial |
$13.43
|
| Rate for Payer: VA VA |
$23.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.22
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
IP
|
$19.38
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.53 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna American Axle |
$12.60
|
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.60
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$13.57
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health SBD |
$12.21
|
| Rate for Payer: UMR Bronson Commercial |
$8.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
OP
|
$19.38
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.62 |
| Max. Negotiated Rate |
$19.97 |
| Rate for Payer: Aetna American Axle |
$12.60
|
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: Aetna Medicare |
$12.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.14
|
| Rate for Payer: BCBS Complete |
$6.96
|
| Rate for Payer: BCBS MAPPO |
$12.11
|
| Rate for Payer: BCBS Trust/PPO |
$10.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.11
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$13.57
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.11
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Mclaren Medicaid |
$6.62
|
| Rate for Payer: Mclaren Medicare |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PACE Medicare |
$11.50
|
| Rate for Payer: PACE SWMI |
$12.11
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: PHP Medicare Advantage |
$12.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.61
|
| Rate for Payer: Priority Health Medicare |
$12.11
|
| Rate for Payer: Priority Health Narrow Network |
$13.29
|
| Rate for Payer: Priority Health SBD |
$12.21
|
| Rate for Payer: Railroad Medicare Medicare |
$12.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.53
|
| Rate for Payer: UHC Core |
$19.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.11
|
| Rate for Payer: UHC Exchange |
$12.11
|
| Rate for Payer: UHC Medicare Advantage |
$12.47
|
| Rate for Payer: UMR Bronson Commercial |
$7.17
|
| Rate for Payer: VA VA |
$12.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
OP
|
$30.60
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.38 |
| Max. Negotiated Rate |
$31.30 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.90
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$17.06
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Mclaren Medicaid |
$10.38
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Medicaid |
$10.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.02
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health Narrow Network |
$20.82
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.76
|
| Rate for Payer: UHC Core |
$31.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Exchange |
$18.97
|
| Rate for Payer: UHC Medicare Advantage |
$19.54
|
| Rate for Payer: UMR Bronson Commercial |
$11.32
|
| Rate for Payer: VA VA |
$18.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC HEAVY METAL SCREEN URINE
|
Facility
|
IP
|
$30.60
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100109
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.46 |
| Max. Negotiated Rate |
$27.54 |
| Rate for Payer: Aetna American Axle |
$19.89
|
| Rate for Payer: Aetna Commercial |
$26.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.89
|
| Rate for Payer: Cash Price |
$24.48
|
| Rate for Payer: Cofinity Commercial |
$21.42
|
| Rate for Payer: Cofinity Commercial |
$26.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$27.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$26.01
|
| Rate for Payer: PHP Commercial |
$26.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.42
|
| Rate for Payer: Priority Health SBD |
$19.28
|
| Rate for Payer: UMR Bronson Commercial |
$13.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.95
|
|
|
HC HEINZ BODIES
|
Facility
|
OP
|
$27.40
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$24.66 |
| Rate for Payer: Aetna American Axle |
$17.81
|
| Rate for Payer: Aetna Commercial |
$23.29
|
| Rate for Payer: Aetna Medicare |
$4.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.25
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.20
|
| Rate for Payer: BCBS Trust/PPO |
$3.78
|
| Rate for Payer: BCN Medicare Advantage |
$4.20
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.20
|
| Rate for Payer: Healthscope Commercial |
$24.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.55
|
| Rate for Payer: Mclaren Medicaid |
$2.30
|
| Rate for Payer: Mclaren Medicare |
$4.20
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.29
|
| Rate for Payer: PACE Medicare |
$3.99
|
| Rate for Payer: PACE SWMI |
$4.20
|
| Rate for Payer: PHP Commercial |
$23.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.18
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.76
|
| Rate for Payer: Priority Health Medicare |
$4.20
|
| Rate for Payer: Priority Health Narrow Network |
$4.61
|
| Rate for Payer: Priority Health SBD |
$17.26
|
| Rate for Payer: Railroad Medicare Medicare |
$4.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.04
|
| Rate for Payer: UHC Core |
$6.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.20
|
| Rate for Payer: UHC Exchange |
$4.20
|
| Rate for Payer: UHC Medicare Advantage |
$4.33
|
| Rate for Payer: UMR Bronson Commercial |
$10.14
|
| Rate for Payer: VA VA |
$4.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.55
|
|
|
HC HEINZ BODIES
|
Facility
|
IP
|
$27.40
|
|
|
Service Code
|
CPT 85441
|
| Hospital Charge Code |
30000008
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.06 |
| Max. Negotiated Rate |
$24.66 |
| Rate for Payer: Aetna American Axle |
$17.81
|
| Rate for Payer: Aetna Commercial |
$23.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.81
|
| Rate for Payer: Cash Price |
$21.92
|
| Rate for Payer: Cofinity Commercial |
$19.18
|
| Rate for Payer: Cofinity Commercial |
$23.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.92
|
| Rate for Payer: Healthscope Commercial |
$24.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.29
|
| Rate for Payer: PHP Commercial |
$23.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.18
|
| Rate for Payer: Priority Health SBD |
$17.26
|
| Rate for Payer: UMR Bronson Commercial |
$12.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.55
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$8.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.82
|
| Rate for Payer: BCBS Complete |
$4.51
|
| Rate for Payer: BCBS MAPPO |
$7.86
|
| Rate for Payer: BCBS Trust/PPO |
$7.07
|
| Rate for Payer: BCN Medicare Advantage |
$7.86
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.86
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$4.30
|
| Rate for Payer: Mclaren Medicare |
$7.86
|
| Rate for Payer: Meridian Medicaid |
$4.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$8.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PACE Medicare |
$7.47
|
| Rate for Payer: PACE SWMI |
$7.86
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$7.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.78
|
| Rate for Payer: Priority Health Medicare |
$7.86
|
| Rate for Payer: Priority Health Narrow Network |
$8.62
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$7.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.43
|
| Rate for Payer: UHC Core |
$12.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.86
|
| Rate for Payer: UHC Exchange |
$7.86
|
| Rate for Payer: UHC Medicare Advantage |
$8.10
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: VA VA |
$7.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC HELICOBACTER PYLORI DRUG ADMINISTRATION
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 83014
|
| Hospital Charge Code |
30600224
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.85
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC HELICOBACTER PYLORI IGG
|
Facility
|
IP
|
$107.60
|
|
|
Service Code
|
CPT 86677
|
| Hospital Charge Code |
30200271
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.34 |
| Max. Negotiated Rate |
$96.84 |
| Rate for Payer: Aetna American Axle |
$69.94
|
| Rate for Payer: Aetna Commercial |
$91.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.94
|
| Rate for Payer: Cash Price |
$86.08
|
| Rate for Payer: Cofinity Commercial |
$75.32
|
| Rate for Payer: Cofinity Commercial |
$92.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.08
|
| Rate for Payer: Healthscope Commercial |
$96.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.46
|
| Rate for Payer: PHP Commercial |
$91.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.32
|
| Rate for Payer: Priority Health SBD |
$67.79
|
| Rate for Payer: UMR Bronson Commercial |
$47.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.70
|
|
