|
HC HIAA SEROTONIN URINE
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 83497
|
| Hospital Charge Code |
30100248
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.30 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna American Axle |
$28.51
|
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.51
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$37.28
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.70
|
| Rate for Payer: Priority Health SBD |
$27.63
|
| Rate for Payer: UMR Bronson Commercial |
$19.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC HIB PRP-OMP VACC 3 DOSE IM
|
Facility
|
IP
|
$41.34
|
|
|
Service Code
|
CPT 90647
|
| Hospital Charge Code |
63600180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$18.19 |
| Max. Negotiated Rate |
$37.21 |
| Rate for Payer: Aetna American Axle |
$26.87
|
| Rate for Payer: Aetna Commercial |
$35.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.87
|
| Rate for Payer: Cash Price |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$35.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.07
|
| Rate for Payer: Healthscope Commercial |
$37.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.14
|
| Rate for Payer: PHP Commercial |
$35.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.94
|
| Rate for Payer: Priority Health SBD |
$26.04
|
| Rate for Payer: UMR Bronson Commercial |
$18.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.00
|
|
|
HC HIB PRP-OMP VACC 3 DOSE IM
|
Facility
|
OP
|
$41.34
|
|
|
Service Code
|
CPT 90647
|
| Hospital Charge Code |
63600180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.30 |
| Max. Negotiated Rate |
$89.95 |
| Rate for Payer: Aetna American Axle |
$26.87
|
| Rate for Payer: Aetna Commercial |
$35.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.87
|
| Rate for Payer: BCBS Complete |
$16.54
|
| Rate for Payer: BCBS Trust/PPO |
$89.95
|
| Rate for Payer: Cash Price |
$33.07
|
| Rate for Payer: Cash Price |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$28.94
|
| Rate for Payer: Cofinity Commercial |
$35.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.07
|
| Rate for Payer: Healthscope Commercial |
$37.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.14
|
| Rate for Payer: PHP Commercial |
$35.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.94
|
| Rate for Payer: Priority Health SBD |
$26.04
|
| Rate for Payer: UMR Bronson Commercial |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.00
|
|
|
HC HIGH FLOW JET VENT
|
Facility
|
OP
|
$1,023.00
|
|
| Hospital Charge Code |
27000699
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$378.51 |
| Max. Negotiated Rate |
$920.70 |
| Rate for Payer: Aetna American Axle |
$664.95
|
| Rate for Payer: Aetna Commercial |
$869.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.95
|
| Rate for Payer: BCBS Complete |
$409.20
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cofinity Commercial |
$716.10
|
| Rate for Payer: Cofinity Commercial |
$879.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$818.40
|
| Rate for Payer: Healthscope Commercial |
$920.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$716.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$767.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$869.55
|
| Rate for Payer: PHP Commercial |
$869.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health SBD |
$644.49
|
| Rate for Payer: UMR Bronson Commercial |
$378.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$767.25
|
|
|
HC HIGH FLOW JET VENT
|
Facility
|
IP
|
$1,023.00
|
|
| Hospital Charge Code |
27000699
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$450.12 |
| Max. Negotiated Rate |
$920.70 |
| Rate for Payer: Aetna American Axle |
$664.95
|
| Rate for Payer: Aetna Commercial |
$869.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$664.95
|
| Rate for Payer: Cash Price |
$818.40
|
| Rate for Payer: Cofinity Commercial |
$716.10
|
| Rate for Payer: Cofinity Commercial |
$879.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$818.40
|
| Rate for Payer: Healthscope Commercial |
$920.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$716.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$767.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$869.55
|
| Rate for Payer: PHP Commercial |
$869.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$716.10
|
| Rate for Payer: Priority Health SBD |
$644.49
|
| Rate for Payer: UMR Bronson Commercial |
$450.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$767.25
|
|
|
HC HIGH FLOW OXYGEN THERAPY
|
Facility
|
IP
|
$213.13
|
|
| Hospital Charge Code |
27000632
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$93.78 |
| Max. Negotiated Rate |
$191.82 |
| Rate for Payer: Aetna American Axle |
$138.53
|
| Rate for Payer: Aetna Commercial |
$181.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.53
|
| Rate for Payer: Cash Price |
$170.50
|
| Rate for Payer: Cofinity Commercial |
$149.19
|
| Rate for Payer: Cofinity Commercial |
$183.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.50
|
| Rate for Payer: Healthscope Commercial |
$191.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.16
|
| Rate for Payer: PHP Commercial |
$181.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.19
|
| Rate for Payer: Priority Health SBD |
$134.27
|
| Rate for Payer: UMR Bronson Commercial |
$93.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.85
|
|
|
HC HIGH FLOW OXYGEN THERAPY
|
Facility
|
OP
|
$213.13
|
|
| Hospital Charge Code |
27000632
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.86 |
| Max. Negotiated Rate |
$191.82 |
| Rate for Payer: Aetna American Axle |
$138.53
|
| Rate for Payer: Aetna Commercial |
$181.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.53
|
| Rate for Payer: BCBS Complete |
$85.25
|
| Rate for Payer: Cash Price |
$170.50
|
| Rate for Payer: Cofinity Commercial |
$149.19
|
| Rate for Payer: Cofinity Commercial |
$183.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.50
|
| Rate for Payer: Healthscope Commercial |
$191.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.16
|
| Rate for Payer: PHP Commercial |
$181.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.19
|
| Rate for Payer: Priority Health SBD |
$134.27
|
| Rate for Payer: UMR Bronson Commercial |
$78.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.85
|
|
|
HC HINGE EXTENSION/FLEX WRIST/F
|
Facility
|
IP
|
$1,511.64
|
|
|
Service Code
|
HCPCS L3900
|
| Hospital Charge Code |
27400048
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$665.12 |
| Max. Negotiated Rate |
$1,360.48 |
| Rate for Payer: Aetna American Axle |
$982.57
|
| Rate for Payer: Aetna Commercial |
$1,284.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.57
|
| Rate for Payer: Cash Price |
$1,209.31
|
| Rate for Payer: Cofinity Commercial |
$1,058.15
|
| Rate for Payer: Cofinity Commercial |
$1,300.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,209.31
|
| Rate for Payer: Healthscope Commercial |
$1,360.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,058.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,133.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,284.89
|
| Rate for Payer: PHP Commercial |
$1,284.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.15
|
| Rate for Payer: Priority Health SBD |
$952.33
|
| Rate for Payer: UMR Bronson Commercial |
$665.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,133.73
|
|
|
HC HINGE EXTENSION/FLEX WRIST/F
|
Facility
|
OP
|
$1,511.64
|
|
|
Service Code
|
HCPCS L3900
|
| Hospital Charge Code |
27400048
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$559.31 |
| Max. Negotiated Rate |
$5,362.49 |
| Rate for Payer: Aetna American Axle |
$982.57
|
| Rate for Payer: Aetna Commercial |
$1,284.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$982.57
|
| Rate for Payer: BCBS Complete |
$604.66
|
| Rate for Payer: BCBS Trust/PPO |
$5,362.49
|
| Rate for Payer: Cash Price |
$1,209.31
|
| Rate for Payer: Cash Price |
$1,209.31
|
| Rate for Payer: Cofinity Commercial |
$1,058.15
|
| Rate for Payer: Cofinity Commercial |
$1,300.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,209.31
|
| Rate for Payer: Healthscope Commercial |
$1,360.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,058.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,133.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,284.89
|
| Rate for Payer: PHP Commercial |
$1,284.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,058.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,734.69
|
| Rate for Payer: Priority Health Narrow Network |
$1,387.75
|
| Rate for Payer: Priority Health SBD |
$952.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,228.88
|
| Rate for Payer: UHC Exchange |
$1,857.40
|
| Rate for Payer: UMR Bronson Commercial |
$559.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,133.73
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS
|
Facility
|
IP
|
$383.75
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
32000312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$168.85 |
| Max. Negotiated Rate |
$345.38 |
| Rate for Payer: Aetna American Axle |
$249.44
|
| Rate for Payer: Aetna Commercial |
$326.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.44
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cofinity Commercial |
$268.62
|
| Rate for Payer: Cofinity Commercial |
$330.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.00
|
| Rate for Payer: Healthscope Commercial |
$345.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.19
|
| Rate for Payer: PHP Commercial |
$326.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.62
|
| Rate for Payer: Priority Health SBD |
$241.76
|
| Rate for Payer: UMR Bronson Commercial |
$168.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.81
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 2 VIEWS
|
Facility
|
OP
|
$383.75
|
|
|
Service Code
|
CPT 73521
|
| Hospital Charge Code |
32000312
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$345.38 |
| Rate for Payer: Aetna American Axle |
$249.44
|
| Rate for Payer: Aetna Commercial |
$326.19
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$58.28
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cofinity Commercial |
$330.02
|
| Rate for Payer: Cofinity Commercial |
$268.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$345.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.81
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.19
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$326.19
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$241.76
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.66
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$40.60
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$141.99
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.81
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
IP
|
$472.31
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$207.82 |
| Max. Negotiated Rate |
$425.08 |
| Rate for Payer: Aetna American Axle |
$307.00
|
| Rate for Payer: Aetna Commercial |
$401.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.00
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$406.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.85
|
| Rate for Payer: Healthscope Commercial |
$425.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.46
|
| Rate for Payer: PHP Commercial |
$401.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.62
|
| Rate for Payer: Priority Health SBD |
$297.56
|
| Rate for Payer: UMR Bronson Commercial |
$207.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.23
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED 3 TO 4 VIEWS
|
Facility
|
OP
|
$472.31
|
|
|
Service Code
|
CPT 73522
|
| Hospital Charge Code |
32000313
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.05 |
| Max. Negotiated Rate |
$425.08 |
| Rate for Payer: Aetna American Axle |
$307.00
|
| Rate for Payer: Aetna Commercial |
$401.46
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$307.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$75.39
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cash Price |
$377.85
|
| Rate for Payer: Cofinity Commercial |
$330.62
|
| Rate for Payer: Cofinity Commercial |
$406.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$377.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$425.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$330.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$354.23
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$401.46
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$401.46
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$330.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$297.56
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.36
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$53.05
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$174.75
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$354.23
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
IP
|
$531.36
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$233.80 |
| Max. Negotiated Rate |
$478.22 |
| Rate for Payer: Aetna American Axle |
$345.38
|
| Rate for Payer: Aetna Commercial |
$451.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.38
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cofinity Commercial |
$371.95
|
| Rate for Payer: Cofinity Commercial |
$456.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.09
|
| Rate for Payer: Healthscope Commercial |
$478.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.66
|
| Rate for Payer: PHP Commercial |
$451.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.95
|
| Rate for Payer: Priority Health SBD |
$334.76
|
| Rate for Payer: UMR Bronson Commercial |
$233.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.52
|
|
|
HC HIPS BIL WITH PELVIS IF PERFORMED MIN 5 VIEWS
|
Facility
|
OP
|
$531.36
|
|
|
Service Code
|
CPT 73523
|
| Hospital Charge Code |
32000314
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$478.22 |
| Rate for Payer: Aetna American Axle |
$345.38
|
| Rate for Payer: Aetna Commercial |
$451.66
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$89.32
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cash Price |
$425.09
|
| Rate for Payer: Cofinity Commercial |
$371.95
|
| Rate for Payer: Cofinity Commercial |
$456.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$478.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.52
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$451.66
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$451.66
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$334.76
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.99
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$60.90
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$196.60
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.52
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
IP
|
$147.59
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$64.94 |
| Max. Negotiated Rate |
$132.83 |
| Rate for Payer: Aetna American Axle |
$95.93
|
| Rate for Payer: Aetna Commercial |
$125.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.93
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$103.31
|
| Rate for Payer: Cofinity Commercial |
$126.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Healthscope Commercial |
$132.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PHP Commercial |
$125.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health SBD |
$92.98
|
| Rate for Payer: UMR Bronson Commercial |
$64.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.69
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 1 VIEW
|
Facility
|
OP
|
$147.59
|
|
|
Service Code
|
CPT 73501
|
| Hospital Charge Code |
32000309
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$32.42 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$95.93
|
| Rate for Payer: Aetna Commercial |
$125.45
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$45.61
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cash Price |
$118.07
|
| Rate for Payer: Cofinity Commercial |
$103.31
|
| Rate for Payer: Cofinity Commercial |
$126.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$132.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.69
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.45
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$125.45
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$92.98
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.66
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$32.42
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$54.61
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.69
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
OP
|
$295.20
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$265.68 |
| Rate for Payer: Aetna American Axle |
$191.88
|
| Rate for Payer: Aetna Commercial |
$250.92
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$69.04
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cofinity Commercial |
$206.64
|
| Rate for Payer: Cofinity Commercial |
$253.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$265.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$206.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.40
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.92
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$250.92
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$185.98
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.50
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$46.82
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$109.22
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.40
|
|
|
HC HIP UNI W PELVIS IF PERFORMED 2 OR 3 VIEWS
|
Facility
|
IP
|
$295.20
|
|
|
Service Code
|
CPT 73502
|
| Hospital Charge Code |
32000310
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$129.89 |
| Max. Negotiated Rate |
$265.68 |
| Rate for Payer: Aetna American Axle |
$191.88
|
| Rate for Payer: Aetna Commercial |
$250.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$191.88
|
| Rate for Payer: Cash Price |
$236.16
|
| Rate for Payer: Cofinity Commercial |
$206.64
|
| Rate for Payer: Cofinity Commercial |
$253.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$236.16
|
| Rate for Payer: Healthscope Commercial |
$265.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$206.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$221.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$250.92
|
| Rate for Payer: PHP Commercial |
$250.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$206.64
|
| Rate for Payer: Priority Health SBD |
$185.98
|
| Rate for Payer: UMR Bronson Commercial |
$129.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$221.40
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
IP
|
$383.75
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$168.85 |
| Max. Negotiated Rate |
$345.38 |
| Rate for Payer: Aetna American Axle |
$249.44
|
| Rate for Payer: Aetna Commercial |
$326.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.44
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cofinity Commercial |
$268.62
|
| Rate for Payer: Cofinity Commercial |
$330.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.00
|
| Rate for Payer: Healthscope Commercial |
$345.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.19
|
| Rate for Payer: PHP Commercial |
$326.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.62
|
| Rate for Payer: Priority Health SBD |
$241.76
|
| Rate for Payer: UMR Bronson Commercial |
$168.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.81
|
|
|
HC HIP UNI W PELVIS IF PERFORMED MIN 4 VIEWS
|
Facility
|
OP
|
$383.75
|
|
|
Service Code
|
CPT 73503
|
| Hospital Charge Code |
32000311
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$53.45 |
| Max. Negotiated Rate |
$345.38 |
| Rate for Payer: Aetna American Axle |
$249.44
|
| Rate for Payer: Aetna Commercial |
$326.19
|
| Rate for Payer: Aetna Medicare |
$101.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$249.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$122.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$122.15
|
| Rate for Payer: BCBS Complete |
$56.13
|
| Rate for Payer: BCBS MAPPO |
$97.72
|
| Rate for Payer: BCBS Trust/PPO |
$88.05
|
| Rate for Payer: BCN Medicare Advantage |
$97.72
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cash Price |
$307.00
|
| Rate for Payer: Cofinity Commercial |
$330.02
|
| Rate for Payer: Cofinity Commercial |
$268.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.72
|
| Rate for Payer: Healthscope Commercial |
$345.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$268.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$287.81
|
| Rate for Payer: Mclaren Medicaid |
$53.45
|
| Rate for Payer: Mclaren Medicare |
$97.72
|
| Rate for Payer: Meridian Medicaid |
$56.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$102.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$326.19
|
| Rate for Payer: PACE Medicare |
$92.83
|
| Rate for Payer: PACE SWMI |
$97.72
|
| Rate for Payer: PHP Commercial |
$326.19
|
| Rate for Payer: PHP Medicare Advantage |
$97.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$268.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$307.65
|
| Rate for Payer: Priority Health Medicare |
$97.72
|
| Rate for Payer: Priority Health Narrow Network |
$246.12
|
| Rate for Payer: Priority Health SBD |
$241.76
|
| Rate for Payer: Railroad Medicare Medicare |
$97.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.83
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.72
|
| Rate for Payer: UHC Exchange |
$58.94
|
| Rate for Payer: UHC Medicare Advantage |
$100.65
|
| Rate for Payer: UMR Bronson Commercial |
$141.99
|
| Rate for Payer: VA VA |
$97.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$287.81
|
|
|
HC HIS LEAD
|
Facility
|
OP
|
$1,413.72
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$523.08 |
| Max. Negotiated Rate |
$1,272.35 |
| Rate for Payer: Aetna American Axle |
$918.92
|
| Rate for Payer: Aetna Commercial |
$1,201.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.92
|
| Rate for Payer: BCBS Complete |
$565.49
|
| Rate for Payer: Cash Price |
$1,130.98
|
| Rate for Payer: Cofinity Commercial |
$1,215.80
|
| Rate for Payer: Cofinity Commercial |
$989.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.98
|
| Rate for Payer: Healthscope Commercial |
$1,272.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$989.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,060.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,201.66
|
| Rate for Payer: PHP Commercial |
$1,201.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$989.60
|
| Rate for Payer: Priority Health SBD |
$890.64
|
| Rate for Payer: UMR Bronson Commercial |
$523.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,060.29
|
|
|
HC HIS LEAD
|
Facility
|
IP
|
$1,413.72
|
|
|
Service Code
|
HCPCS C1898
|
| Hospital Charge Code |
27800121
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$622.04 |
| Max. Negotiated Rate |
$1,272.35 |
| Rate for Payer: Aetna American Axle |
$918.92
|
| Rate for Payer: Aetna Commercial |
$1,201.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$918.92
|
| Rate for Payer: Cash Price |
$1,130.98
|
| Rate for Payer: Cofinity Commercial |
$1,215.80
|
| Rate for Payer: Cofinity Commercial |
$989.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.98
|
| Rate for Payer: Healthscope Commercial |
$1,272.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$989.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,060.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,201.66
|
| Rate for Payer: PHP Commercial |
$1,201.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$989.60
|
| Rate for Payer: Priority Health SBD |
$890.64
|
| Rate for Payer: UMR Bronson Commercial |
$622.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,060.29
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC HISTONE AUTOANTIBODIES, S
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100601
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| 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 |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$10.37
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$6.31
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Medicaid |
$6.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.82
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$12.66
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.84
|
| Rate for Payer: UHC Core |
$19.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$11.53
|
| Rate for Payer: UHC Medicare Advantage |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
