|
HC HEPATITIS C RNA PCR DETECT & QUANT
|
Facility
|
OP
|
$149.94
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600295
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$134.95 |
| Rate for Payer: Aetna American Axle |
$97.46
|
| Rate for Payer: Aetna Commercial |
$127.45
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.61
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$38.53
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$119.95
|
| Rate for Payer: Cash Price |
$119.95
|
| Rate for Payer: Cofinity Commercial |
$104.96
|
| Rate for Payer: Cofinity Commercial |
$128.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$134.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.46
|
| Rate for Payer: Mclaren Medicaid |
$23.43
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Medicaid |
$24.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.45
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$127.45
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.76
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health Narrow Network |
$47.01
|
| Rate for Payer: Priority Health SBD |
$94.46
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.41
|
| Rate for Payer: UHC Core |
$70.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$44.13
|
| Rate for Payer: UMR Bronson Commercial |
$55.48
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.46
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANTIFICATION
|
Facility
|
OP
|
$149.94
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$134.95 |
| Rate for Payer: Aetna American Axle |
$97.46
|
| Rate for Payer: Aetna Commercial |
$127.45
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.61
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$38.53
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$119.95
|
| Rate for Payer: Cash Price |
$119.95
|
| Rate for Payer: Cofinity Commercial |
$104.96
|
| Rate for Payer: Cofinity Commercial |
$128.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$134.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.46
|
| Rate for Payer: Mclaren Medicaid |
$23.43
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Medicaid |
$24.61
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.45
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$127.45
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.76
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health Narrow Network |
$47.01
|
| Rate for Payer: Priority Health SBD |
$94.46
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.41
|
| Rate for Payer: UHC Core |
$70.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$44.13
|
| Rate for Payer: UMR Bronson Commercial |
$55.48
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.46
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANTIFICATION
|
Facility
|
IP
|
$149.94
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.97 |
| Max. Negotiated Rate |
$134.95 |
| Rate for Payer: Aetna American Axle |
$97.46
|
| Rate for Payer: Aetna Commercial |
$127.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.46
|
| Rate for Payer: Cash Price |
$119.95
|
| Rate for Payer: Cofinity Commercial |
$128.95
|
| Rate for Payer: Cofinity Commercial |
$104.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.95
|
| Rate for Payer: Healthscope Commercial |
$134.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.45
|
| Rate for Payer: PHP Commercial |
$127.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.96
|
| Rate for Payer: Priority Health SBD |
$94.46
|
| Rate for Payer: UMR Bronson Commercial |
$65.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.46
|
|
|
HC HEPATITS B VACCINE (HEPB), PEDIATRIC/ADOLESCENT, 3 DOSE IM
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
63600086
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna American Axle |
$23.20
|
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health SBD |
$22.49
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC HEPATITS B VACCINE (HEPB), PEDIATRIC/ADOLESCENT, 3 DOSE IM
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
63600086
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.21 |
| Max. Negotiated Rate |
$98.42 |
| Rate for Payer: Aetna American Axle |
$23.20
|
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: BCBS Complete |
$14.28
|
| Rate for Payer: BCBS Trust/PPO |
$98.42
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Cofinity Commercial |
$24.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.77
|
| Rate for Payer: Priority Health Narrow Network |
$24.62
|
| Rate for Payer: Priority Health SBD |
$22.49
|
| Rate for Payer: UMR Bronson Commercial |
$13.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC HEP B ADMINISTRATION
|
Facility
|
IP
|
$33.50
|
|
|
Service Code
|
HCPCS G0010
|
| Hospital Charge Code |
77100008
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$14.74 |
| Max. Negotiated Rate |
$30.15 |
| Rate for Payer: Aetna American Axle |
$21.78
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.78
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.48
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.45
|
| Rate for Payer: Priority Health SBD |
$21.10
|
| Rate for Payer: UMR Bronson Commercial |
$14.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
HC HEP B ADMINISTRATION
|
Facility
|
OP
|
$33.50
|
|
|
Service Code
|
HCPCS G0010
|
| Hospital Charge Code |
77100008
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.40 |
| Max. Negotiated Rate |
$132.91 |
| Rate for Payer: Aetna American Axle |
$21.78
|
| Rate for Payer: Aetna Commercial |
$28.48
|
| Rate for Payer: Aetna Medicare |
$43.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.78
|
| Rate for Payer: BCBS Complete |
$24.25
|
| Rate for Payer: BCBS MAPPO |
$42.22
|
| Rate for Payer: BCBS Trust/PPO |
$80.22
|
| Rate for Payer: BCN Medicare Advantage |
$42.22
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cash Price |
$26.80
|
| Rate for Payer: Cofinity Commercial |
$28.81
|
| Rate for Payer: Cofinity Commercial |
$23.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.22
|
| Rate for Payer: Healthscope Commercial |
$30.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.12
|
| Rate for Payer: Mclaren Medicaid |
$23.09
|
| Rate for Payer: Mclaren Medicare |
$42.22
|
| Rate for Payer: Meridian Medicaid |
$24.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$28.48
|
| Rate for Payer: PACE Medicare |
$40.11
|
| Rate for Payer: PACE SWMI |
$42.22
|
| Rate for Payer: PHP Commercial |
$28.48
|
| Rate for Payer: PHP Medicare Advantage |
$42.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.45
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.91
|
| Rate for Payer: Priority Health Medicare |
$42.22
|
| Rate for Payer: Priority Health Narrow Network |
$106.33
|
| Rate for Payer: Priority Health SBD |
$21.10
|
| Rate for Payer: Railroad Medicare Medicare |
$42.22
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.22
|
| Rate for Payer: UHC Medicare Advantage |
$43.49
|
| Rate for Payer: UMR Bronson Commercial |
$12.40
|
| Rate for Payer: VA VA |
$42.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.12
|
|
|
HC HEP B CORE AB TOTAL.
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200293
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna American Axle |
$63.70
|
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.84
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$68.60
|
| Rate for Payer: Cofinity Commercial |
$84.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$88.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.50
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.30
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$83.30
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.53
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$13.22
|
| Rate for Payer: Priority Health SBD |
$61.74
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Core |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: UMR Bronson Commercial |
$36.26
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.50
|
|
|
HC HEP B CORE AB TOTAL.
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200293
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.12 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Aetna American Axle |
$63.70
|
| Rate for Payer: Aetna Commercial |
$83.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.70
|
| Rate for Payer: Cash Price |
$78.40
|
| Rate for Payer: Cofinity Commercial |
$68.60
|
| Rate for Payer: Cofinity Commercial |
$84.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.40
|
| Rate for Payer: Healthscope Commercial |
$88.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.30
|
| Rate for Payer: PHP Commercial |
$83.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.60
|
| Rate for Payer: Priority Health SBD |
$61.74
|
| Rate for Payer: UMR Bronson Commercial |
$43.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.50
|
|
|
HC HEP B SURFACE ANTIGEN CONFIRMATION
|
Facility
|
OP
|
$45.03
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600140
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.65 |
| Max. Negotiated Rate |
$40.53 |
| Rate for Payer: Aetna American Axle |
$29.27
|
| Rate for Payer: Aetna Commercial |
$38.28
|
| Rate for Payer: Aetna Medicare |
$10.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.91
|
| Rate for Payer: BCBS Complete |
$5.93
|
| Rate for Payer: BCBS MAPPO |
$10.33
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCN Medicare Advantage |
$10.33
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cofinity Commercial |
$38.73
|
| Rate for Payer: Cofinity Commercial |
$31.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.33
|
| Rate for Payer: Healthscope Commercial |
$40.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.77
|
| Rate for Payer: Mclaren Medicaid |
$5.65
|
| Rate for Payer: Mclaren Medicare |
$10.33
|
| Rate for Payer: Meridian Medicaid |
$5.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.28
|
| Rate for Payer: PACE Medicare |
$9.81
|
| Rate for Payer: PACE SWMI |
$10.33
|
| Rate for Payer: PHP Commercial |
$38.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.17
|
| Rate for Payer: Priority Health Medicare |
$10.33
|
| Rate for Payer: Priority Health Narrow Network |
$11.34
|
| Rate for Payer: Priority Health SBD |
$28.37
|
| Rate for Payer: Railroad Medicare Medicare |
$10.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.40
|
| Rate for Payer: UHC Core |
$17.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.33
|
| Rate for Payer: UHC Exchange |
$10.33
|
| Rate for Payer: UHC Medicare Advantage |
$10.64
|
| Rate for Payer: UMR Bronson Commercial |
$16.66
|
| Rate for Payer: VA VA |
$10.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.77
|
|
|
HC HEP B SURFACE ANTIGEN CONFIRMATION
|
Facility
|
IP
|
$45.03
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600140
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.81 |
| Max. Negotiated Rate |
$40.53 |
| Rate for Payer: Aetna American Axle |
$29.27
|
| Rate for Payer: Aetna Commercial |
$38.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.27
|
| Rate for Payer: Cash Price |
$36.02
|
| Rate for Payer: Cofinity Commercial |
$31.52
|
| Rate for Payer: Cofinity Commercial |
$38.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.02
|
| Rate for Payer: Healthscope Commercial |
$40.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.28
|
| Rate for Payer: PHP Commercial |
$38.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.52
|
| Rate for Payer: Priority Health SBD |
$28.37
|
| Rate for Payer: UMR Bronson Commercial |
$19.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.77
|
|
|
HC HEP B VACC 2 DOSE ADULT IM
|
Facility
|
OP
|
$326.40
|
|
|
Service Code
|
CPT 90739
|
| Hospital Charge Code |
63600181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$120.77 |
| Max. Negotiated Rate |
$527.74 |
| Rate for Payer: Aetna American Axle |
$212.16
|
| Rate for Payer: Aetna Commercial |
$277.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.16
|
| Rate for Payer: BCBS Complete |
$130.56
|
| Rate for Payer: BCBS Trust/PPO |
$527.74
|
| Rate for Payer: Cash Price |
$261.12
|
| Rate for Payer: Cash Price |
$261.12
|
| Rate for Payer: Cofinity Commercial |
$228.48
|
| Rate for Payer: Cofinity Commercial |
$280.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.12
|
| Rate for Payer: Healthscope Commercial |
$293.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$277.44
|
| Rate for Payer: PHP Commercial |
$277.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$160.28
|
| Rate for Payer: Priority Health Narrow Network |
$128.22
|
| Rate for Payer: Priority Health SBD |
$205.63
|
| Rate for Payer: UMR Bronson Commercial |
$120.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.80
|
|
|
HC HEP B VACC 2 DOSE ADULT IM
|
Facility
|
IP
|
$326.40
|
|
|
Service Code
|
CPT 90739
|
| Hospital Charge Code |
63600181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$143.62 |
| Max. Negotiated Rate |
$293.76 |
| Rate for Payer: Aetna American Axle |
$212.16
|
| Rate for Payer: Aetna Commercial |
$277.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$212.16
|
| Rate for Payer: Cash Price |
$261.12
|
| Rate for Payer: Cofinity Commercial |
$228.48
|
| Rate for Payer: Cofinity Commercial |
$280.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$261.12
|
| Rate for Payer: Healthscope Commercial |
$293.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$228.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$244.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$277.44
|
| Rate for Payer: PHP Commercial |
$277.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.48
|
| Rate for Payer: Priority Health SBD |
$205.63
|
| Rate for Payer: UMR Bronson Commercial |
$143.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$244.80
|
|
|
HC HEP C GENO SUBTYPES
|
Facility
|
IP
|
$406.67
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600256
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$178.93 |
| Max. Negotiated Rate |
$366.00 |
| Rate for Payer: Aetna American Axle |
$264.34
|
| Rate for Payer: Aetna Commercial |
$345.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.34
|
| Rate for Payer: Cash Price |
$325.34
|
| Rate for Payer: Cofinity Commercial |
$284.67
|
| Rate for Payer: Cofinity Commercial |
$349.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.34
|
| Rate for Payer: Healthscope Commercial |
$366.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.67
|
| Rate for Payer: PHP Commercial |
$345.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.67
|
| Rate for Payer: Priority Health SBD |
$256.20
|
| Rate for Payer: UMR Bronson Commercial |
$178.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.00
|
|
|
HC HEP C GENO SUBTYPES
|
Facility
|
OP
|
$406.67
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600256
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$140.83 |
| Max. Negotiated Rate |
$424.66 |
| Rate for Payer: Aetna American Axle |
$264.34
|
| Rate for Payer: Aetna Commercial |
$345.67
|
| Rate for Payer: Aetna Medicare |
$267.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$264.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$321.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$321.81
|
| Rate for Payer: BCBS Complete |
$147.88
|
| Rate for Payer: BCBS MAPPO |
$257.45
|
| Rate for Payer: BCBS Trust/PPO |
$231.53
|
| Rate for Payer: BCN Medicare Advantage |
$257.45
|
| Rate for Payer: Cash Price |
$325.34
|
| Rate for Payer: Cash Price |
$325.34
|
| Rate for Payer: Cofinity Commercial |
$349.74
|
| Rate for Payer: Cofinity Commercial |
$284.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$325.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.45
|
| Rate for Payer: Healthscope Commercial |
$366.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$284.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.00
|
| Rate for Payer: Mclaren Medicaid |
$140.83
|
| Rate for Payer: Mclaren Medicare |
$257.45
|
| Rate for Payer: Meridian Medicaid |
$147.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$345.67
|
| Rate for Payer: PACE Medicare |
$244.58
|
| Rate for Payer: PACE SWMI |
$257.45
|
| Rate for Payer: PHP Commercial |
$345.67
|
| Rate for Payer: PHP Medicare Advantage |
$257.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$353.15
|
| Rate for Payer: Priority Health Medicare |
$257.45
|
| Rate for Payer: Priority Health Narrow Network |
$282.52
|
| Rate for Payer: Priority Health SBD |
$256.20
|
| Rate for Payer: Railroad Medicare Medicare |
$257.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.94
|
| Rate for Payer: UHC Core |
$424.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.45
|
| Rate for Payer: UHC Exchange |
$257.45
|
| Rate for Payer: UHC Medicare Advantage |
$265.17
|
| Rate for Payer: UMR Bronson Commercial |
$150.47
|
| Rate for Payer: VA VA |
$257.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.00
|
|
|
HC HER2 DUAL ISH
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000065
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$134.64 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna American Axle |
$198.90
|
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health SBD |
$192.78
|
| Rate for Payer: UMR Bronson Commercial |
$134.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC HER2 DUAL ISH
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000065
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.54 |
| Max. Negotiated Rate |
$1,005.81 |
| Rate for Payer: Aetna American Axle |
$198.90
|
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna Medicare |
$332.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.39
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$319.51
|
| Rate for Payer: BCBS Trust/PPO |
$143.95
|
| Rate for Payer: BCCCP Commercial |
$143.46
|
| Rate for Payer: BCN Medicare Advantage |
$319.51
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.51
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$319.51
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: PACE Medicare |
$303.53
|
| Rate for Payer: PACE SWMI |
$319.51
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: PHP Medicare Advantage |
$319.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,005.81
|
| Rate for Payer: Priority Health Medicare |
$319.51
|
| Rate for Payer: Priority Health Narrow Network |
$804.65
|
| Rate for Payer: Priority Health SBD |
$192.78
|
| Rate for Payer: Railroad Medicare Medicare |
$319.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.92
|
| Rate for Payer: UHC Core |
$72.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.51
|
| Rate for Payer: UHC Exchange |
$145.38
|
| Rate for Payer: UHC Medicare Advantage |
$329.10
|
| Rate for Payer: UMR Bronson Commercial |
$113.22
|
| Rate for Payer: VA VA |
$319.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC HER2 DUAL ISH CMPT
|
Facility
|
IP
|
$306.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000066
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$134.64 |
| Max. Negotiated Rate |
$275.40 |
| Rate for Payer: Aetna American Axle |
$198.90
|
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health SBD |
$192.78
|
| Rate for Payer: UMR Bronson Commercial |
$134.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC HER2 DUAL ISH CMPT
|
Facility
|
OP
|
$306.00
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000066
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$72.54 |
| Max. Negotiated Rate |
$1,005.81 |
| Rate for Payer: Aetna American Axle |
$198.90
|
| Rate for Payer: Aetna Commercial |
$260.10
|
| Rate for Payer: Aetna Medicare |
$332.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.39
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$319.51
|
| Rate for Payer: BCBS Trust/PPO |
$143.95
|
| Rate for Payer: BCCCP Commercial |
$143.46
|
| Rate for Payer: BCN Medicare Advantage |
$319.51
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cofinity Commercial |
$214.20
|
| Rate for Payer: Cofinity Commercial |
$263.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.51
|
| Rate for Payer: Healthscope Commercial |
$275.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$214.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$229.50
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$319.51
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$260.10
|
| Rate for Payer: PACE Medicare |
$303.53
|
| Rate for Payer: PACE SWMI |
$319.51
|
| Rate for Payer: PHP Commercial |
$260.10
|
| Rate for Payer: PHP Medicare Advantage |
$319.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,005.81
|
| Rate for Payer: Priority Health Medicare |
$319.51
|
| Rate for Payer: Priority Health Narrow Network |
$804.65
|
| Rate for Payer: Priority Health SBD |
$192.78
|
| Rate for Payer: Railroad Medicare Medicare |
$319.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159.92
|
| Rate for Payer: UHC Core |
$72.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.51
|
| Rate for Payer: UHC Exchange |
$145.38
|
| Rate for Payer: UHC Medicare Advantage |
$329.10
|
| Rate for Payer: UMR Bronson Commercial |
$113.22
|
| Rate for Payer: VA VA |
$319.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$229.50
|
|
|
HC HER-2 NEU QUANTITATIVE
|
Facility
|
OP
|
$244.00
|
|
|
Service Code
|
CPT 83950
|
| Hospital Charge Code |
30100382
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.23 |
| Max. Negotiated Rate |
$219.60 |
| Rate for Payer: Aetna American Axle |
$158.60
|
| Rate for Payer: Aetna Commercial |
$207.40
|
| Rate for Payer: Aetna Medicare |
$66.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.51
|
| Rate for Payer: BCBS Complete |
$37.00
|
| Rate for Payer: BCBS MAPPO |
$64.41
|
| Rate for Payer: BCBS Trust/PPO |
$57.93
|
| Rate for Payer: BCN Medicare Advantage |
$64.41
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$170.80
|
| Rate for Payer: Cofinity Commercial |
$209.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.41
|
| Rate for Payer: Healthscope Commercial |
$219.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.00
|
| Rate for Payer: Mclaren Medicaid |
$35.23
|
| Rate for Payer: Mclaren Medicare |
$64.41
|
| Rate for Payer: Meridian Medicaid |
$37.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.40
|
| Rate for Payer: PACE Medicare |
$61.19
|
| Rate for Payer: PACE SWMI |
$64.41
|
| Rate for Payer: PHP Commercial |
$207.40
|
| Rate for Payer: PHP Medicare Advantage |
$64.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$88.36
|
| Rate for Payer: Priority Health Medicare |
$64.41
|
| Rate for Payer: Priority Health Narrow Network |
$70.69
|
| Rate for Payer: Priority Health SBD |
$153.72
|
| Rate for Payer: Railroad Medicare Medicare |
$64.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.29
|
| Rate for Payer: UHC Core |
$106.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.41
|
| Rate for Payer: UHC Exchange |
$64.41
|
| Rate for Payer: UHC Medicare Advantage |
$66.34
|
| Rate for Payer: UMR Bronson Commercial |
$90.28
|
| Rate for Payer: VA VA |
$64.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.00
|
|
|
HC HER-2 NEU QUANTITATIVE
|
Facility
|
IP
|
$244.00
|
|
|
Service Code
|
CPT 83950
|
| Hospital Charge Code |
30100382
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$107.36 |
| Max. Negotiated Rate |
$219.60 |
| Rate for Payer: Aetna American Axle |
$158.60
|
| Rate for Payer: Aetna Commercial |
$207.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.60
|
| Rate for Payer: Cash Price |
$195.20
|
| Rate for Payer: Cofinity Commercial |
$170.80
|
| Rate for Payer: Cofinity Commercial |
$209.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.20
|
| Rate for Payer: Healthscope Commercial |
$219.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$170.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.40
|
| Rate for Payer: PHP Commercial |
$207.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.80
|
| Rate for Payer: Priority Health SBD |
$153.72
|
| Rate for Payer: UMR Bronson Commercial |
$107.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.00
|
|
|
HC HERPES PCR
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600211
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UMR Bronson Commercial |
$31.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC HERPES PCR
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600211
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$26.42
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC HERPES PCR COMPONENT
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600212
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UMR Bronson Commercial |
$31.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC HERPES PCR COMPONENT
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600212
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$60.69
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$26.42
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
