|
HC CELIAC ASSOCIATED HLA DQ TYPING CMPT
|
Facility
|
OP
|
$218.80
|
|
|
Service Code
|
CPT 81376
|
| Hospital Charge Code |
31000105
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.92 |
| Max. Negotiated Rate |
$366.66 |
| Rate for Payer: Aetna American Axle |
$142.22
|
| Rate for Payer: Aetna Commercial |
$185.98
|
| Rate for Payer: Aetna Medicare |
$127.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.78
|
| Rate for Payer: BCBS Complete |
$67.12
|
| Rate for Payer: BCBS MAPPO |
$122.22
|
| Rate for Payer: BCBS Trust/PPO |
$141.29
|
| Rate for Payer: BCN Commercial |
$141.29
|
| Rate for Payer: BCN Medicare Advantage |
$122.22
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cash Price |
$175.04
|
| Rate for Payer: Cofinity Advantage |
$153.16
|
| Rate for Payer: Cofinity Commercial |
$188.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.22
|
| Rate for Payer: Healthscope Commercial |
$196.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.10
|
| Rate for Payer: Mclaren Medicaid |
$122.22
|
| Rate for Payer: Mclaren Medicare |
$122.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.33
|
| Rate for Payer: Meridian Medicaid |
$128.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$134.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.98
|
| Rate for Payer: Nomi Health Commercial |
$366.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$164.10
|
| Rate for Payer: PACE Medicare |
$116.11
|
| Rate for Payer: PACE SWMI |
$122.22
|
| Rate for Payer: PHP Commercial |
$185.98
|
| Rate for Payer: PHP Medicare Advantage |
$122.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$63.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$122.22
|
| Rate for Payer: Priority Health Medicare |
$122.22
|
| Rate for Payer: Priority Health SBD |
$137.84
|
| Rate for Payer: Priority Health Tiered Network |
$97.78
|
| Rate for Payer: Railroad Medicare Medicare |
$122.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.33
|
| Rate for Payer: UHC Core |
$183.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$122.22
|
| Rate for Payer: UHC Exchange |
$183.33
|
| Rate for Payer: UHC Medicaid |
$63.92
|
| Rate for Payer: UHCCP Medicaid |
$63.92
|
| Rate for Payer: UMR Bronson Commercial |
$80.96
|
| Rate for Payer: VA VA |
$122.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.10
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna American Axle |
$18.84
|
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| 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 |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| 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 |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$18.26
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: UMR Bronson Commercial |
$10.72
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC CELIAC DISEASE CASCADE
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200005
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna American Axle |
$18.84
|
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health SBD |
$18.26
|
| Rate for Payer: UMR Bronson Commercial |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna American Axle |
$18.84
|
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| 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 |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| 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 |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$18.26
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: UMR Bronson Commercial |
$10.72
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC CELIAC DISEASE CASCADE CMPT
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200006
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna American Axle |
$18.84
|
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health SBD |
$18.26
|
| Rate for Payer: UMR Bronson Commercial |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
IP
|
$1,235.50
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$543.62 |
| Max. Negotiated Rate |
$1,111.95 |
| Rate for Payer: Aetna American Axle |
$803.08
|
| Rate for Payer: Aetna Commercial |
$1,050.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.08
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cofinity Advantage |
$864.85
|
| Rate for Payer: Cofinity Commercial |
$1,062.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.40
|
| Rate for Payer: Healthscope Commercial |
$1,111.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$864.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$926.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.62
|
| Rate for Payer: PHP Commercial |
$1,050.17
|
| Rate for Payer: Priority Health SBD |
$778.37
|
| Rate for Payer: UMR Bronson Commercial |
$543.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$926.62
|
|
|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,235.50
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$457.13 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$803.08
|
| Rate for Payer: Aetna Commercial |
$1,050.17
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$803.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,410.23
|
| Rate for Payer: BCN Commercial |
$1,410.23
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cash Price |
$988.40
|
| Rate for Payer: Cofinity Advantage |
$864.85
|
| Rate for Payer: Cofinity Commercial |
$1,062.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$988.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,111.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$864.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$926.62
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,050.17
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$926.62
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,050.17
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$778.37
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UMR Bronson Commercial |
$457.13
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$926.62
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
IP
|
$174.79
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$76.91 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna American Axle |
$113.61
|
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.61
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Advantage |
$122.35
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.09
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: Priority Health SBD |
$110.12
|
| Rate for Payer: UMR Bronson Commercial |
$76.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.09
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$174.79
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.52 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna American Axle |
$113.61
|
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: Aetna Medicare |
$12.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.57
|
| Rate for Payer: BCBS Complete |
$6.84
|
| Rate for Payer: BCBS MAPPO |
$12.46
|
| Rate for Payer: BCBS Trust/PPO |
$14.41
|
| Rate for Payer: BCN Commercial |
$14.41
|
| Rate for Payer: BCN Medicare Advantage |
$12.46
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Advantage |
$122.35
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.46
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$122.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.09
|
| Rate for Payer: Mclaren Medicaid |
$12.46
|
| Rate for Payer: Mclaren Medicare |
$12.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.08
|
| Rate for Payer: Meridian Medicaid |
$13.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$18.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.09
|
| Rate for Payer: PACE Medicare |
$11.84
|
| Rate for Payer: PACE SWMI |
$12.46
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: PHP Medicare Advantage |
$12.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.46
|
| Rate for Payer: Priority Health Medicare |
$12.46
|
| Rate for Payer: Priority Health SBD |
$110.12
|
| Rate for Payer: Priority Health Tiered Network |
$9.97
|
| Rate for Payer: Railroad Medicare Medicare |
$12.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.69
|
| Rate for Payer: UHC Core |
$18.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.46
|
| Rate for Payer: UHC Exchange |
$18.69
|
| Rate for Payer: UHC Medicaid |
$6.52
|
| Rate for Payer: UHCCP Medicaid |
$6.52
|
| Rate for Payer: UMR Bronson Commercial |
$64.67
|
| Rate for Payer: VA VA |
$12.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.09
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.93 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna American Axle |
$61.13
|
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna Medicare |
$5.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.00
|
| Rate for Payer: BCBS Complete |
$3.08
|
| Rate for Payer: BCBS MAPPO |
$5.60
|
| Rate for Payer: BCBS Trust/PPO |
$6.47
|
| Rate for Payer: BCN Commercial |
$6.47
|
| Rate for Payer: BCN Medicare Advantage |
$5.60
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Advantage |
$65.83
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.60
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Mclaren Medicaid |
$5.60
|
| Rate for Payer: Mclaren Medicare |
$5.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.88
|
| Rate for Payer: Meridian Medicaid |
$5.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$8.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PACE Medicare |
$5.32
|
| Rate for Payer: PACE SWMI |
$5.60
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: PHP Medicare Advantage |
$5.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.60
|
| Rate for Payer: Priority Health Medicare |
$5.60
|
| Rate for Payer: Priority Health SBD |
$59.25
|
| Rate for Payer: Priority Health Tiered Network |
$4.48
|
| Rate for Payer: Railroad Medicare Medicare |
$5.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.40
|
| Rate for Payer: UHC Core |
$8.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.60
|
| Rate for Payer: UHC Exchange |
$8.40
|
| Rate for Payer: UHC Medicaid |
$2.93
|
| Rate for Payer: UHCCP Medicaid |
$2.93
|
| Rate for Payer: UMR Bronson Commercial |
$34.80
|
| Rate for Payer: VA VA |
$5.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna American Axle |
$61.13
|
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.13
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Advantage |
$65.83
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: Priority Health SBD |
$59.25
|
| Rate for Payer: UMR Bronson Commercial |
$41.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
IP
|
$268.22
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$118.02 |
| Max. Negotiated Rate |
$241.40 |
| Rate for Payer: Aetna American Axle |
$174.34
|
| Rate for Payer: Aetna Commercial |
$227.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.34
|
| Rate for Payer: Cash Price |
$214.58
|
| Rate for Payer: Cofinity Advantage |
$187.75
|
| Rate for Payer: Cofinity Commercial |
$230.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.58
|
| Rate for Payer: Healthscope Commercial |
$241.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.16
|
| Rate for Payer: PHP Commercial |
$227.99
|
| Rate for Payer: Priority Health SBD |
$168.98
|
| Rate for Payer: UMR Bronson Commercial |
$118.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.16
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
OP
|
$268.22
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$71.05 |
| Max. Negotiated Rate |
$241.40 |
| Rate for Payer: Aetna American Axle |
$174.34
|
| Rate for Payer: Aetna Commercial |
$227.99
|
| Rate for Payer: Aetna Medicare |
$141.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.82
|
| Rate for Payer: BCBS Complete |
$74.61
|
| Rate for Payer: BCBS MAPPO |
$135.86
|
| Rate for Payer: BCN Medicare Advantage |
$135.86
|
| Rate for Payer: Cash Price |
$214.58
|
| Rate for Payer: Cash Price |
$214.58
|
| Rate for Payer: Cofinity Advantage |
$187.75
|
| Rate for Payer: Cofinity Commercial |
$230.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$241.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.16
|
| Rate for Payer: Mclaren Medicaid |
$135.86
|
| Rate for Payer: Mclaren Medicare |
$135.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.65
|
| Rate for Payer: Meridian Medicaid |
$142.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$149.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.99
|
| Rate for Payer: Nomi Health Commercial |
$203.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.16
|
| Rate for Payer: PACE Medicare |
$129.07
|
| Rate for Payer: PACE SWMI |
$135.86
|
| Rate for Payer: PHP Commercial |
$227.99
|
| Rate for Payer: PHP Medicare Advantage |
$135.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$71.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$135.86
|
| Rate for Payer: Priority Health Medicare |
$135.86
|
| Rate for Payer: Priority Health SBD |
$168.98
|
| Rate for Payer: Priority Health Tiered Network |
$108.69
|
| Rate for Payer: Railroad Medicare Medicare |
$135.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.79
|
| Rate for Payer: UHC Core |
$203.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$135.86
|
| Rate for Payer: UHC Exchange |
$203.79
|
| Rate for Payer: UHC Medicaid |
$71.05
|
| Rate for Payer: UHCCP Medicaid |
$71.05
|
| Rate for Payer: UMR Bronson Commercial |
$99.24
|
| Rate for Payer: VA VA |
$135.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.16
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna American Axle |
$96.32
|
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna Medicare |
$74.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.32
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: BCBS Trust/PPO |
$47.11
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$47.11
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Advantage |
$103.73
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.14
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health SBD |
$93.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.32
|
| Rate for Payer: UHC Core |
$77.21
|
| Rate for Payer: UHC Exchange |
$58.24
|
| Rate for Payer: UMR Bronson Commercial |
$54.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna American Axle |
$96.32
|
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.32
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Advantage |
$103.73
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.14
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health SBD |
$93.36
|
| Rate for Payer: UMR Bronson Commercial |
$65.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRIFUGAL HEAD
|
Facility
|
IP
|
$414.48
|
|
| Hospital Charge Code |
27006714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$182.37 |
| Max. Negotiated Rate |
$373.03 |
| Rate for Payer: Aetna American Axle |
$269.41
|
| Rate for Payer: Aetna Commercial |
$352.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.41
|
| Rate for Payer: Cash Price |
$331.58
|
| Rate for Payer: Cofinity Advantage |
$290.14
|
| Rate for Payer: Cofinity Commercial |
$356.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.58
|
| Rate for Payer: Healthscope Commercial |
$373.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.86
|
| Rate for Payer: PHP Commercial |
$352.31
|
| Rate for Payer: Priority Health SBD |
$261.12
|
| Rate for Payer: UMR Bronson Commercial |
$182.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.86
|
|
|
HC CENTRIFUGAL HEAD
|
Facility
|
OP
|
$414.48
|
|
| Hospital Charge Code |
27006714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$153.36 |
| Max. Negotiated Rate |
$373.03 |
| Rate for Payer: Aetna American Axle |
$269.41
|
| Rate for Payer: Aetna Commercial |
$352.31
|
| Rate for Payer: Aetna Medicare |
$207.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$269.41
|
| Rate for Payer: BCBS Complete |
$165.79
|
| Rate for Payer: Cash Price |
$331.58
|
| Rate for Payer: Cofinity Advantage |
$290.14
|
| Rate for Payer: Cofinity Commercial |
$356.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.58
|
| Rate for Payer: Healthscope Commercial |
$373.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$290.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$331.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.86
|
| Rate for Payer: PHP Commercial |
$352.31
|
| Rate for Payer: Priority Health SBD |
$261.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.41
|
| Rate for Payer: UHC Core |
$215.94
|
| Rate for Payer: UHC Exchange |
$162.89
|
| Rate for Payer: UMR Bronson Commercial |
$153.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.86
|
|
|
HC CENTROMERE AB
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna American Axle |
$23.32
|
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$20.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Advantage |
$25.11
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$22.60
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$13.27
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC CENTROMERE AB
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.78 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna American Axle |
$23.32
|
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.32
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Advantage |
$25.11
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health SBD |
$22.60
|
| Rate for Payer: UMR Bronson Commercial |
$15.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$112.16 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna American Axle |
$165.69
|
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: UMR Bronson Commercial |
$112.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$94.31 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna American Axle |
$165.69
|
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$127.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: BCBS Complete |
$101.96
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$203.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$127.45
|
| Rate for Payer: UHC Core |
$127.45
|
| Rate for Payer: UHC Exchange |
$127.45
|
| Rate for Payer: UMR Bronson Commercial |
$94.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
IP
|
$4,218.68
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,856.22 |
| Max. Negotiated Rate |
$3,796.81 |
| Rate for Payer: Aetna American Axle |
$2,742.14
|
| Rate for Payer: Aetna Commercial |
$3,585.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,742.14
|
| Rate for Payer: Cash Price |
$3,374.94
|
| Rate for Payer: Cofinity Advantage |
$2,953.08
|
| Rate for Payer: Cofinity Commercial |
$3,628.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,374.94
|
| Rate for Payer: Healthscope Commercial |
$3,796.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,953.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,164.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,585.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,164.01
|
| Rate for Payer: PHP Commercial |
$3,585.88
|
| Rate for Payer: Priority Health SBD |
$2,657.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,856.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,164.01
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
OP
|
$4,218.68
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,560.91 |
| Max. Negotiated Rate |
$3,796.81 |
| Rate for Payer: Aetna American Axle |
$2,742.14
|
| Rate for Payer: Aetna Commercial |
$3,585.88
|
| Rate for Payer: Aetna Medicare |
$2,109.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,742.14
|
| Rate for Payer: BCBS Complete |
$1,687.47
|
| Rate for Payer: Cash Price |
$3,374.94
|
| Rate for Payer: Cofinity Advantage |
$2,953.08
|
| Rate for Payer: Cofinity Commercial |
$3,628.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,374.94
|
| Rate for Payer: Healthscope Commercial |
$3,796.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,953.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,164.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,374.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,585.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,164.01
|
| Rate for Payer: PHP Commercial |
$3,585.88
|
| Rate for Payer: Priority Health SBD |
$2,657.77
|
| Rate for Payer: UMR Bronson Commercial |
$1,560.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,164.01
|
|
|
HC CERETEC PER DOSE
|
Facility
|
IP
|
$2,102.21
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$924.97 |
| Max. Negotiated Rate |
$1,891.99 |
| Rate for Payer: Aetna American Axle |
$1,366.44
|
| Rate for Payer: Aetna Commercial |
$1,786.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,366.44
|
| Rate for Payer: Cash Price |
$1,681.77
|
| Rate for Payer: Cofinity Advantage |
$1,471.55
|
| Rate for Payer: Cofinity Commercial |
$1,807.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,681.77
|
| Rate for Payer: Healthscope Commercial |
$1,891.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,471.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,576.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,786.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,576.66
|
| Rate for Payer: PHP Commercial |
$1,786.88
|
| Rate for Payer: Priority Health SBD |
$1,324.39
|
| Rate for Payer: UMR Bronson Commercial |
$924.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,576.66
|
|
|
HC CERETEC PER DOSE
|
Facility
|
OP
|
$2,102.21
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$777.82 |
| Max. Negotiated Rate |
$2,925.96 |
| Rate for Payer: Aetna American Axle |
$1,366.44
|
| Rate for Payer: Aetna Commercial |
$1,786.88
|
| Rate for Payer: Aetna Medicare |
$1,051.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,366.44
|
| Rate for Payer: BCBS Complete |
$840.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,236.65
|
| Rate for Payer: BCN Commercial |
$1,236.65
|
| Rate for Payer: Cash Price |
$1,681.77
|
| Rate for Payer: Cash Price |
$1,681.77
|
| Rate for Payer: Cofinity Advantage |
$1,471.55
|
| Rate for Payer: Cofinity Commercial |
$1,807.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,681.77
|
| Rate for Payer: Healthscope Commercial |
$1,891.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,471.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,576.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,681.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,786.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,576.66
|
| Rate for Payer: PHP Commercial |
$1,786.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,925.96
|
| Rate for Payer: Priority Health SBD |
$1,324.39
|
| Rate for Payer: Priority Health Tiered Network |
$2,340.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,530.72
|
| Rate for Payer: UHC Core |
$1,530.72
|
| Rate for Payer: UHC Exchange |
$1,530.72
|
| Rate for Payer: UMR Bronson Commercial |
$777.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,576.66
|
|
