|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
IP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.08 |
| Max. Negotiated Rate |
$102.44 |
| Rate for Payer: Aetna American Axle |
$73.98
|
| Rate for Payer: Aetna Commercial |
$96.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.98
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$79.67
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health SBD |
$71.71
|
| Rate for Payer: UMR Bronson Commercial |
$50.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.36
|
|
|
HC ANTIGEN TYPE UNIT BMH
|
Facility
|
OP
|
$113.82
|
|
|
Service Code
|
CPT 86902
|
| Hospital Charge Code |
30200349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.11 |
| Max. Negotiated Rate |
$1,107.72 |
| Rate for Payer: Aetna American Axle |
$73.98
|
| Rate for Payer: Aetna Commercial |
$96.75
|
| Rate for Payer: Aetna Medicare |
$366.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$6.11
|
| Rate for Payer: BCN Commercial |
$6.11
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cash Price |
$91.06
|
| Rate for Payer: Cofinity Commercial |
$97.89
|
| Rate for Payer: Cofinity Commercial |
$79.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$102.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.36
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.75
|
| Rate for Payer: Nomi Health Commercial |
$1,057.35
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$96.75
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.72
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$886.18
|
| Rate for Payer: Priority Health SBD |
$71.71
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$188.91
|
| Rate for Payer: UMR Bronson Commercial |
$42.11
|
| Rate for Payer: VA VA |
$352.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.36
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.18 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: UMR Bronson Commercial |
$25.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.92
|
|
|
HC ANTI-GLOMULER BASEMENT MEMBER
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100259
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$16.64
|
| Rate for Payer: BCN Commercial |
$16.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.92
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$25.90
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$13.82
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: UMR Bronson Commercial |
$21.17
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.92
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
IP
|
$37.45
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.48 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna American Axle |
$24.34
|
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$26.22
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: UMR Bronson Commercial |
$16.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC ANTIMITOCHONDRIAL AB
|
Facility
|
OP
|
$37.45
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100250
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna American Axle |
$24.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$11.11
|
| Rate for Payer: BCN Commercial |
$11.11
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Cofinity Commercial |
$26.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.87
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$9.50
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$11.53
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$13.86
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
IP
|
$123.42
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.30 |
| Max. Negotiated Rate |
$111.08 |
| Rate for Payer: Aetna American Axle |
$80.22
|
| Rate for Payer: Aetna Commercial |
$104.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.22
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cofinity Commercial |
$106.14
|
| Rate for Payer: Cofinity Commercial |
$86.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.74
|
| Rate for Payer: Healthscope Commercial |
$111.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.91
|
| Rate for Payer: PHP Commercial |
$104.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.22
|
| Rate for Payer: Priority Health SBD |
$77.75
|
| Rate for Payer: UMR Bronson Commercial |
$54.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.56
|
|
|
HC ANTIMULLERIAN HORMONE
|
Facility
|
OP
|
$123.42
|
|
|
Service Code
|
CPT 82166
|
| Hospital Charge Code |
30100625
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.70 |
| Max. Negotiated Rate |
$3,946.21 |
| Rate for Payer: Aetna American Axle |
$80.22
|
| Rate for Payer: Aetna Commercial |
$104.91
|
| Rate for Payer: Aetna Medicare |
$40.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.28
|
| Rate for Payer: BCBS Complete |
$21.74
|
| Rate for Payer: BCBS MAPPO |
$38.62
|
| Rate for Payer: BCBS Trust/PPO |
$37.21
|
| Rate for Payer: BCN Commercial |
$37.21
|
| Rate for Payer: BCN Medicare Advantage |
$38.62
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cash Price |
$98.74
|
| Rate for Payer: Cofinity Commercial |
$86.39
|
| Rate for Payer: Cofinity Commercial |
$106.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.62
|
| Rate for Payer: Healthscope Commercial |
$111.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.56
|
| Rate for Payer: Mclaren Medicaid |
$20.70
|
| Rate for Payer: Mclaren Medicare |
$38.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.55
|
| Rate for Payer: Meridian Medicaid |
$21.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.91
|
| Rate for Payer: Nomi Health Commercial |
$57.93
|
| Rate for Payer: PACE Medicare |
$36.69
|
| Rate for Payer: PACE SWMI |
$38.62
|
| Rate for Payer: PHP Commercial |
$104.91
|
| Rate for Payer: PHP Medicare Advantage |
$38.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.62
|
| Rate for Payer: Priority Health Medicare |
$38.62
|
| Rate for Payer: Priority Health Narrow Network |
$30.90
|
| Rate for Payer: Priority Health SBD |
$77.75
|
| Rate for Payer: Railroad Medicare Medicare |
$38.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.34
|
| Rate for Payer: UHC Core |
$3,946.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.62
|
| Rate for Payer: UHC Exchange |
$38.62
|
| Rate for Payer: UHC Medicare Advantage |
$38.62
|
| Rate for Payer: UHCCP Medicaid |
$20.70
|
| Rate for Payer: UMR Bronson Commercial |
$45.67
|
| Rate for Payer: VA VA |
$38.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.56
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
IP
|
$72.10
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$64.89 |
| Rate for Payer: Aetna American Axle |
$46.86
|
| Rate for Payer: Aetna Commercial |
$61.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.86
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$62.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Healthscope Commercial |
$64.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: PHP Commercial |
$61.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.86
|
| Rate for Payer: Priority Health SBD |
$45.42
|
| Rate for Payer: UMR Bronson Commercial |
$31.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.08
|
|
|
HC ANTINUCLEAR AB SCREEN CMPT
|
Facility
|
OP
|
$72.10
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200159
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$64.89 |
| Rate for Payer: Aetna American Axle |
$46.86
|
| Rate for Payer: Aetna Commercial |
$61.28
|
| Rate for Payer: Aetna Medicare |
$14.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.18
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$13.24
|
| Rate for Payer: BCN Commercial |
$13.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$62.01
|
| Rate for Payer: Cofinity Commercial |
$50.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$64.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.08
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Mclaren Medicare |
$13.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.43
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$20.61
|
| Rate for Payer: PACE Medicare |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$61.28
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.74
|
| Rate for Payer: Priority Health Medicare |
$13.74
|
| Rate for Payer: Priority Health Narrow Network |
$10.99
|
| Rate for Payer: Priority Health SBD |
$45.42
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.74
|
| Rate for Payer: UHC Exchange |
$13.74
|
| Rate for Payer: UHC Medicare Advantage |
$13.74
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: UMR Bronson Commercial |
$26.68
|
| Rate for Payer: VA VA |
$13.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.08
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
OP
|
$72.10
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$64.89 |
| Rate for Payer: Aetna American Axle |
$46.86
|
| Rate for Payer: Aetna Commercial |
$61.28
|
| Rate for Payer: Aetna Medicare |
$12.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$11.65
|
| Rate for Payer: BCN Commercial |
$11.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$62.01
|
| Rate for Payer: Cofinity Commercial |
$50.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$64.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.08
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: Nomi Health Commercial |
$18.14
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$61.28
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.44
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$9.95
|
| Rate for Payer: Priority Health SBD |
$45.42
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.09
|
| Rate for Payer: UHC Exchange |
$12.09
|
| Rate for Payer: UHC Medicare Advantage |
$12.09
|
| Rate for Payer: UHCCP Medicaid |
$6.48
|
| Rate for Payer: UMR Bronson Commercial |
$26.68
|
| Rate for Payer: VA VA |
$12.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.08
|
|
|
HC ANTINUCLEAR AB SCREEN & DSDNA
|
Facility
|
IP
|
$72.10
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200135
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$64.89 |
| Rate for Payer: Aetna American Axle |
$46.86
|
| Rate for Payer: Aetna Commercial |
$61.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.86
|
| Rate for Payer: Cash Price |
$57.68
|
| Rate for Payer: Cofinity Commercial |
$50.47
|
| Rate for Payer: Cofinity Commercial |
$62.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$50.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.68
|
| Rate for Payer: Healthscope Commercial |
$64.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.28
|
| Rate for Payer: PHP Commercial |
$61.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.86
|
| Rate for Payer: Priority Health SBD |
$45.42
|
| Rate for Payer: UMR Bronson Commercial |
$31.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.08
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC ANTINUCLEAR ANTIBODIES
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 86038
|
| Hospital Charge Code |
30200134
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.11
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$12.09
|
| Rate for Payer: BCBS Trust/PPO |
$11.65
|
| Rate for Payer: BCN Commercial |
$11.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.09
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.09
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$12.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.69
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$18.14
|
| Rate for Payer: PACE Medicare |
$11.49
|
| Rate for Payer: PACE SWMI |
$12.09
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$12.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.44
|
| Rate for Payer: Priority Health Medicare |
$12.09
|
| Rate for Payer: Priority Health Narrow Network |
$9.95
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: Railroad Medicare Medicare |
$12.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.09
|
| Rate for Payer: UHC Exchange |
$12.09
|
| Rate for Payer: UHC Medicare Advantage |
$12.09
|
| Rate for Payer: UHCCP Medicaid |
$6.48
|
| Rate for Payer: UMR Bronson Commercial |
$17.32
|
| Rate for Payer: VA VA |
$12.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.98 |
| 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 |
$11.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.95
|
| Rate for Payer: BCBS Complete |
$6.28
|
| Rate for Payer: BCBS MAPPO |
$11.16
|
| Rate for Payer: BCBS Trust/PPO |
$10.75
|
| Rate for Payer: BCN Commercial |
$10.75
|
| Rate for Payer: BCN Medicare Advantage |
$11.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.16
|
| 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 |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$5.98
|
| Rate for Payer: Mclaren Medicare |
$11.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.72
|
| Rate for Payer: Meridian Medicaid |
$6.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$16.74
|
| Rate for Payer: PACE Medicare |
$10.60
|
| Rate for Payer: PACE SWMI |
$11.16
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$11.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.48
|
| Rate for Payer: Priority Health Medicare |
$11.16
|
| Rate for Payer: Priority Health Narrow Network |
$9.18
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.16
|
| Rate for Payer: UHC Exchange |
$11.16
|
| Rate for Payer: UHC Medicare Advantage |
$11.16
|
| Rate for Payer: UHCCP Medicaid |
$5.98
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$11.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC ANTINUCLEAR ANTIBODIES TITER
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86039
|
| Hospital Charge Code |
30200378
|
|
Hospital Revenue Code
|
302
|
| 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 Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| 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 |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| 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 |
$31.22
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC ANTI SMOOTH MUSCLE AB
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 86015
|
| Hospital Charge Code |
30200177
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| 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 |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$11.61
|
| Rate for Payer: BCN Commercial |
$11.61
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$18.08
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$9.64
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: UMR Bronson Commercial |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.91 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$7.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.12
|
| Rate for Payer: BCBS Complete |
$4.11
|
| Rate for Payer: BCBS MAPPO |
$7.30
|
| Rate for Payer: BCBS Trust/PPO |
$7.04
|
| Rate for Payer: BCN Commercial |
$7.04
|
| Rate for Payer: BCN Medicare Advantage |
$7.30
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.30
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Mclaren Medicaid |
$3.91
|
| Rate for Payer: Mclaren Medicare |
$7.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.66
|
| Rate for Payer: Meridian Medicaid |
$4.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$10.95
|
| Rate for Payer: PACE Medicare |
$6.94
|
| Rate for Payer: PACE SWMI |
$7.30
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$7.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.51
|
| Rate for Payer: Priority Health Medicare |
$7.30
|
| Rate for Payer: Priority Health Narrow Network |
$6.01
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: Railroad Medicare Medicare |
$7.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.30
|
| Rate for Payer: UHC Exchange |
$7.30
|
| Rate for Payer: UHC Medicare Advantage |
$7.30
|
| Rate for Payer: UHCCP Medicaid |
$3.91
|
| Rate for Payer: UMR Bronson Commercial |
$25.66
|
| Rate for Payer: VA VA |
$7.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC ANTI THROMBIN III
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$21.97 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: UMR Bronson Commercial |
$21.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.46
|
|
|
HC ANTI THROMBIN III
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$12.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.81
|
| Rate for Payer: BCBS Complete |
$6.67
|
| Rate for Payer: BCBS MAPPO |
$11.85
|
| Rate for Payer: BCBS Trust/PPO |
$11.42
|
| Rate for Payer: BCN Commercial |
$11.42
|
| Rate for Payer: BCN Medicare Advantage |
$11.85
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.85
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$6.35
|
| Rate for Payer: Mclaren Medicare |
$11.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$6.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$17.78
|
| Rate for Payer: PACE Medicare |
$11.26
|
| Rate for Payer: PACE SWMI |
$11.85
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$11.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.20
|
| Rate for Payer: Priority Health Medicare |
$11.85
|
| Rate for Payer: Priority Health Narrow Network |
$9.76
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Railroad Medicare Medicare |
$11.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.85
|
| Rate for Payer: UHC Exchange |
$11.85
|
| Rate for Payer: UHC Medicare Advantage |
$11.85
|
| Rate for Payer: UHCCP Medicaid |
$6.35
|
| Rate for Payer: UMR Bronson Commercial |
$18.48
|
| Rate for Payer: VA VA |
$11.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.46
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$11.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.51
|
| Rate for Payer: BCBS Complete |
$6.08
|
| Rate for Payer: BCBS MAPPO |
$10.81
|
| Rate for Payer: BCBS Trust/PPO |
$10.42
|
| Rate for Payer: BCN Commercial |
$10.42
|
| Rate for Payer: BCN Medicare Advantage |
$10.81
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.81
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$5.79
|
| Rate for Payer: Mclaren Medicare |
$10.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.35
|
| Rate for Payer: Meridian Medicaid |
$6.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.02
|
| Rate for Payer: Nomi Health Commercial |
$16.22
|
| Rate for Payer: PACE Medicare |
$10.27
|
| Rate for Payer: PACE SWMI |
$10.81
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$10.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.12
|
| Rate for Payer: Priority Health Medicare |
$10.81
|
| Rate for Payer: Priority Health Narrow Network |
$8.90
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$10.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.81
|
| Rate for Payer: UHC Exchange |
$10.81
|
| Rate for Payer: UHC Medicare Advantage |
$10.81
|
| Rate for Payer: UHCCP Medicaid |
$5.79
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: VA VA |
$10.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
