|
HC CA 125
|
Facility
|
IP
|
$148.88
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.51 |
| Max. Negotiated Rate |
$133.99 |
| Rate for Payer: Aetna American Axle |
$96.77
|
| Rate for Payer: Aetna Commercial |
$126.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.77
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cofinity Advantage |
$104.22
|
| Rate for Payer: Cofinity Commercial |
$128.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.10
|
| Rate for Payer: Healthscope Commercial |
$133.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.66
|
| Rate for Payer: PHP Commercial |
$126.55
|
| Rate for Payer: Priority Health SBD |
$93.79
|
| Rate for Payer: UMR Bronson Commercial |
$65.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.66
|
|
|
HC CADMIUM LEVEL
|
Facility
|
OP
|
$49.61
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.36 |
| Max. Negotiated Rate |
$44.65 |
| Rate for Payer: Aetna American Axle |
$32.25
|
| Rate for Payer: Aetna Commercial |
$42.17
|
| Rate for Payer: Aetna Medicare |
$24.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.25
|
| 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 |
$12.98
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCBS Trust/PPO |
$27.33
|
| Rate for Payer: BCN Commercial |
$27.33
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$39.69
|
| Rate for Payer: Cash Price |
$39.69
|
| Rate for Payer: Cofinity Advantage |
$34.73
|
| Rate for Payer: Cofinity Commercial |
$42.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$44.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.21
|
| Rate for Payer: Mclaren Medicaid |
$23.64
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: Meridian Medicaid |
$24.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.17
|
| Rate for Payer: Nomi Health Commercial |
$35.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.21
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$42.17
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.64
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health SBD |
$31.25
|
| Rate for Payer: Priority Health Tiered Network |
$18.91
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.46
|
| Rate for Payer: UHC Core |
$35.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.64
|
| Rate for Payer: UHC Exchange |
$35.46
|
| Rate for Payer: UHC Medicaid |
$12.36
|
| Rate for Payer: UHCCP Medicaid |
$12.36
|
| Rate for Payer: UMR Bronson Commercial |
$18.36
|
| Rate for Payer: VA VA |
$23.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.21
|
|
|
HC CADMIUM LEVEL
|
Facility
|
IP
|
$49.61
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.83 |
| Max. Negotiated Rate |
$44.65 |
| Rate for Payer: Aetna American Axle |
$32.25
|
| Rate for Payer: Aetna Commercial |
$42.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.25
|
| Rate for Payer: Cash Price |
$39.69
|
| Rate for Payer: Cofinity Advantage |
$34.73
|
| Rate for Payer: Cofinity Commercial |
$42.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.69
|
| Rate for Payer: Healthscope Commercial |
$44.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.21
|
| Rate for Payer: PHP Commercial |
$42.17
|
| Rate for Payer: Priority Health SBD |
$31.25
|
| Rate for Payer: UMR Bronson Commercial |
$21.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.21
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
OP
|
$119.92
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$107.93 |
| Rate for Payer: Aetna American Axle |
$77.95
|
| Rate for Payer: Aetna Commercial |
$101.93
|
| Rate for Payer: Aetna Medicare |
$40.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.21
|
| Rate for Payer: BCBS Complete |
$21.18
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCBS Trust/PPO |
$44.59
|
| Rate for Payer: BCN Commercial |
$44.59
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$95.94
|
| Rate for Payer: Cash Price |
$95.94
|
| Rate for Payer: Cofinity Advantage |
$83.94
|
| Rate for Payer: Cofinity Commercial |
$103.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$107.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.94
|
| Rate for Payer: Mclaren Medicaid |
$38.57
|
| Rate for Payer: Mclaren Medicare |
$38.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: Meridian Medicaid |
$40.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.93
|
| Rate for Payer: Nomi Health Commercial |
$57.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.94
|
| Rate for Payer: PACE Medicare |
$36.64
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Commercial |
$101.93
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$38.57
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health SBD |
$75.55
|
| Rate for Payer: Priority Health Tiered Network |
$30.86
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.86
|
| Rate for Payer: UHC Core |
$57.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$38.57
|
| Rate for Payer: UHC Exchange |
$57.86
|
| Rate for Payer: UHC Medicaid |
$20.17
|
| Rate for Payer: UHCCP Medicaid |
$20.17
|
| Rate for Payer: UMR Bronson Commercial |
$44.37
|
| Rate for Payer: VA VA |
$38.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.94
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
IP
|
$119.92
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.76 |
| Max. Negotiated Rate |
$107.93 |
| Rate for Payer: Aetna American Axle |
$77.95
|
| Rate for Payer: Aetna Commercial |
$101.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.95
|
| Rate for Payer: Cash Price |
$95.94
|
| Rate for Payer: Cofinity Advantage |
$83.94
|
| Rate for Payer: Cofinity Commercial |
$103.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.94
|
| Rate for Payer: Healthscope Commercial |
$107.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.94
|
| Rate for Payer: PHP Commercial |
$101.93
|
| Rate for Payer: Priority Health SBD |
$75.55
|
| Rate for Payer: UMR Bronson Commercial |
$52.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.94
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
IP
|
$70.04
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.82 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna American Axle |
$45.53
|
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.53
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Advantage |
$49.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: Priority Health SBD |
$44.13
|
| Rate for Payer: UMR Bronson Commercial |
$30.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
OP
|
$70.04
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna American Axle |
$45.53
|
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna Medicare |
$27.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.49
|
| Rate for Payer: BCBS Complete |
$14.71
|
| Rate for Payer: BCBS MAPPO |
$26.79
|
| Rate for Payer: BCBS Trust/PPO |
$30.96
|
| Rate for Payer: BCN Commercial |
$30.96
|
| Rate for Payer: BCN Medicare Advantage |
$26.79
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Advantage |
$49.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.79
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Mclaren Medicaid |
$26.79
|
| Rate for Payer: Mclaren Medicare |
$26.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.13
|
| Rate for Payer: Meridian Medicaid |
$28.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$40.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PACE Medicare |
$25.45
|
| Rate for Payer: PACE SWMI |
$26.79
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: PHP Medicare Advantage |
$26.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.79
|
| Rate for Payer: Priority Health Medicare |
$26.79
|
| Rate for Payer: Priority Health SBD |
$44.13
|
| Rate for Payer: Priority Health Tiered Network |
$21.43
|
| Rate for Payer: Railroad Medicare Medicare |
$26.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.19
|
| Rate for Payer: UHC Core |
$40.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.79
|
| Rate for Payer: UHC Exchange |
$40.19
|
| Rate for Payer: UHC Medicaid |
$14.01
|
| Rate for Payer: UHCCP Medicaid |
$14.01
|
| Rate for Payer: UMR Bronson Commercial |
$25.91
|
| Rate for Payer: VA VA |
$26.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
IP
|
$27.42
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.06 |
| Max. Negotiated Rate |
$24.68 |
| Rate for Payer: Aetna American Axle |
$17.82
|
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.82
|
| Rate for Payer: Cash Price |
$21.94
|
| Rate for Payer: Cofinity Advantage |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$23.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.94
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.57
|
| Rate for Payer: PHP Commercial |
$23.31
|
| Rate for Payer: Priority Health SBD |
$17.27
|
| Rate for Payer: UMR Bronson Commercial |
$12.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.57
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
OP
|
$27.42
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.15 |
| Max. Negotiated Rate |
$24.68 |
| Rate for Payer: Aetna American Axle |
$17.82
|
| Rate for Payer: Aetna Commercial |
$23.31
|
| Rate for Payer: Aetna Medicare |
$13.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.82
|
| Rate for Payer: BCBS Complete |
$10.97
|
| Rate for Payer: Cash Price |
$21.94
|
| Rate for Payer: Cofinity Advantage |
$19.19
|
| Rate for Payer: Cofinity Commercial |
$23.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.94
|
| Rate for Payer: Healthscope Commercial |
$24.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.57
|
| Rate for Payer: PHP Commercial |
$23.31
|
| Rate for Payer: Priority Health SBD |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.82
|
| Rate for Payer: UHC Core |
$14.29
|
| Rate for Payer: UHC Exchange |
$10.78
|
| Rate for Payer: UMR Bronson Commercial |
$10.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.57
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
OP
|
$19.26
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.13 |
| Max. Negotiated Rate |
$17.33 |
| Rate for Payer: Aetna American Axle |
$12.52
|
| Rate for Payer: Aetna Commercial |
$16.37
|
| Rate for Payer: Aetna Medicare |
$9.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.52
|
| Rate for Payer: BCBS Complete |
$7.70
|
| Rate for Payer: Cash Price |
$15.41
|
| Rate for Payer: Cofinity Advantage |
$13.48
|
| Rate for Payer: Cofinity Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.41
|
| Rate for Payer: Healthscope Commercial |
$17.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.45
|
| Rate for Payer: PHP Commercial |
$16.37
|
| Rate for Payer: Priority Health SBD |
$12.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.52
|
| Rate for Payer: UHC Core |
$10.03
|
| Rate for Payer: UHC Exchange |
$7.57
|
| Rate for Payer: UMR Bronson Commercial |
$7.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.45
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
IP
|
$19.26
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.47 |
| Max. Negotiated Rate |
$17.33 |
| Rate for Payer: Aetna American Axle |
$12.52
|
| Rate for Payer: Aetna Commercial |
$16.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.52
|
| Rate for Payer: Cash Price |
$15.41
|
| Rate for Payer: Cofinity Advantage |
$13.48
|
| Rate for Payer: Cofinity Commercial |
$16.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.41
|
| Rate for Payer: Healthscope Commercial |
$17.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.45
|
| Rate for Payer: PHP Commercial |
$16.37
|
| Rate for Payer: Priority Health SBD |
$12.13
|
| Rate for Payer: UMR Bronson Commercial |
$8.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.45
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.70 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.45
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.16
|
| Rate for Payer: BCN Medicare Advantage |
$5.16
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.16
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$5.16
|
| Rate for Payer: Mclaren Medicare |
$5.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.42
|
| Rate for Payer: Meridian Medicaid |
$5.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$7.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.90
|
| Rate for Payer: PACE SWMI |
$5.16
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.16
|
| Rate for Payer: Priority Health Medicare |
$5.16
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$4.13
|
| Rate for Payer: Railroad Medicare Medicare |
$5.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.74
|
| Rate for Payer: UHC Core |
$7.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.16
|
| Rate for Payer: UHC Exchange |
$7.74
|
| Rate for Payer: UHC Medicaid |
$2.70
|
| Rate for Payer: UHCCP Medicaid |
$2.70
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: VA VA |
$5.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CALCIUM URINE
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna American Axle |
$35.71
|
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Advantage |
$38.46
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: Priority Health SBD |
$34.61
|
| Rate for Payer: UMR Bronson Commercial |
$24.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC CALCIUM URINE
|
Facility
|
OP
|
$54.94
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna American Axle |
$35.71
|
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna Medicare |
$6.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.54
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$6.03
|
| Rate for Payer: BCBS Trust/PPO |
$6.97
|
| Rate for Payer: BCN Commercial |
$6.97
|
| Rate for Payer: BCN Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Advantage |
$38.46
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.03
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Mclaren Medicare |
$6.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.33
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Nomi Health Commercial |
$9.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PACE Medicare |
$5.73
|
| Rate for Payer: PACE SWMI |
$6.03
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: PHP Medicare Advantage |
$6.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.03
|
| Rate for Payer: Priority Health Medicare |
$6.03
|
| Rate for Payer: Priority Health SBD |
$34.61
|
| Rate for Payer: Priority Health Tiered Network |
$4.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.05
|
| Rate for Payer: UHC Core |
$9.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.03
|
| Rate for Payer: UHC Exchange |
$9.05
|
| Rate for Payer: UHC Medicaid |
$3.15
|
| Rate for Payer: UHCCP Medicaid |
$3.15
|
| Rate for Payer: UMR Bronson Commercial |
$20.33
|
| Rate for Payer: VA VA |
$6.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
|
HC CALCULI
|
Facility
|
IP
|
$43.51
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.14 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna American Axle |
$28.28
|
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.28
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Advantage |
$30.46
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: Priority Health SBD |
$27.41
|
| Rate for Payer: UMR Bronson Commercial |
$19.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC CALCULI
|
Facility
|
OP
|
$43.51
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna American Axle |
$28.28
|
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$14.92
|
| Rate for Payer: BCN Commercial |
$14.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Advantage |
$30.46
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Mclaren Medicaid |
$12.90
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$19.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.90
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health SBD |
$27.41
|
| Rate for Payer: Priority Health Tiered Network |
$10.32
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.35
|
| Rate for Payer: UHC Core |
$19.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.90
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicaid |
$6.75
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$16.10
|
| Rate for Payer: VA VA |
$12.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$29.77 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna American Axle |
$307.27
|
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$29.77
|
| Rate for Payer: BCN Commercial |
$29.77
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.27
|
| Rate for Payer: UHC Core |
$246.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$185.78
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$174.91
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
IP
|
$472.72
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna American Axle |
$307.27
|
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: UMR Bronson Commercial |
$208.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
OP
|
$472.72
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$52.77 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna American Axle |
$307.27
|
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$52.77
|
| Rate for Payer: BCN Commercial |
$52.77
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$307.27
|
| Rate for Payer: UHC Core |
$246.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Exchange |
$185.78
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: UMR Bronson Commercial |
$174.91
|
| Rate for Payer: VA VA |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
IP
|
$472.72
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$208.00 |
| Max. Negotiated Rate |
$425.45 |
| Rate for Payer: Aetna American Axle |
$307.27
|
| Rate for Payer: Aetna Commercial |
$401.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.27
|
| Rate for Payer: Cash Price |
$378.18
|
| Rate for Payer: Cofinity Advantage |
$330.90
|
| Rate for Payer: Cofinity Commercial |
$406.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$378.18
|
| Rate for Payer: Healthscope Commercial |
$425.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$401.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$354.54
|
| Rate for Payer: PHP Commercial |
$401.81
|
| Rate for Payer: Priority Health SBD |
$297.81
|
| Rate for Payer: UMR Bronson Commercial |
$208.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.54
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
OP
|
$241.37
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$217.23 |
| Rate for Payer: Aetna American Axle |
$156.89
|
| Rate for Payer: Aetna Commercial |
$205.16
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$22.69
|
| Rate for Payer: BCN Commercial |
$22.69
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cofinity Advantage |
$168.96
|
| Rate for Payer: Cofinity Commercial |
$207.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$217.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.03
|
| Rate for Payer: Mclaren Medicaid |
$19.63
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: Meridian Medicaid |
$20.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.16
|
| Rate for Payer: Nomi Health Commercial |
$29.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.03
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$205.16
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.63
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health SBD |
$152.06
|
| Rate for Payer: Priority Health Tiered Network |
$15.70
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.45
|
| Rate for Payer: UHC Core |
$29.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.63
|
| Rate for Payer: UHC Exchange |
$29.45
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: UMR Bronson Commercial |
$89.31
|
| Rate for Payer: VA VA |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.03
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
IP
|
$241.37
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$106.20 |
| Max. Negotiated Rate |
$217.23 |
| Rate for Payer: Aetna American Axle |
$156.89
|
| Rate for Payer: Aetna Commercial |
$205.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.89
|
| Rate for Payer: Cash Price |
$193.10
|
| Rate for Payer: Cofinity Advantage |
$168.96
|
| Rate for Payer: Cofinity Commercial |
$207.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$193.10
|
| Rate for Payer: Healthscope Commercial |
$217.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$181.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$205.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$181.03
|
| Rate for Payer: PHP Commercial |
$205.16
|
| Rate for Payer: Priority Health SBD |
$152.06
|
| Rate for Payer: UMR Bronson Commercial |
$106.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$181.03
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$22.69
|
| Rate for Payer: BCN Commercial |
$22.69
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$19.63
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: Meridian Medicaid |
$20.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$29.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.63
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Priority Health Tiered Network |
$15.70
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.45
|
| Rate for Payer: UHC Core |
$29.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.63
|
| Rate for Payer: UHC Exchange |
$29.45
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
