|
HC CHLAMYDIA ANTIBODIES IGM
|
Facility
|
OP
|
$22.70
|
|
|
Service Code
|
CPT 86632
|
| Hospital Charge Code |
30200242
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$38.04 |
| Rate for Payer: Aetna American Axle |
$14.76
|
| Rate for Payer: Aetna Commercial |
$19.30
|
| Rate for Payer: Aetna Medicare |
$13.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.85
|
| Rate for Payer: BCBS Complete |
$6.96
|
| Rate for Payer: BCBS MAPPO |
$12.68
|
| Rate for Payer: BCBS Trust/PPO |
$14.66
|
| Rate for Payer: BCN Commercial |
$14.66
|
| Rate for Payer: BCN Medicare Advantage |
$12.68
|
| Rate for Payer: Cash Price |
$18.16
|
| Rate for Payer: Cash Price |
$18.16
|
| Rate for Payer: Cofinity Advantage |
$15.89
|
| Rate for Payer: Cofinity Commercial |
$19.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.68
|
| Rate for Payer: Healthscope Commercial |
$20.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.02
|
| Rate for Payer: Mclaren Medicaid |
$12.68
|
| Rate for Payer: Mclaren Medicare |
$12.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.31
|
| Rate for Payer: Meridian Medicaid |
$13.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.30
|
| Rate for Payer: Nomi Health Commercial |
$38.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.02
|
| Rate for Payer: PACE Medicare |
$12.05
|
| Rate for Payer: PACE SWMI |
$12.68
|
| Rate for Payer: PHP Commercial |
$19.30
|
| Rate for Payer: PHP Medicare Advantage |
$12.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.68
|
| Rate for Payer: Priority Health Medicare |
$12.68
|
| Rate for Payer: Priority Health SBD |
$14.30
|
| Rate for Payer: Priority Health Tiered Network |
$10.14
|
| Rate for Payer: Railroad Medicare Medicare |
$12.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.02
|
| Rate for Payer: UHC Core |
$19.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.68
|
| Rate for Payer: UHC Exchange |
$19.02
|
| Rate for Payer: UHC Medicaid |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$6.63
|
| Rate for Payer: UMR Bronson Commercial |
$8.40
|
| Rate for Payer: VA VA |
$12.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.02
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE
|
Facility
|
OP
|
$83.23
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
30600088
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna American Axle |
$54.10
|
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna Medicare |
$20.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.50
|
| Rate for Payer: BCBS Complete |
$10.76
|
| Rate for Payer: BCBS MAPPO |
$19.60
|
| Rate for Payer: BCBS Trust/PPO |
$22.66
|
| Rate for Payer: BCN Commercial |
$22.66
|
| Rate for Payer: BCN Medicare Advantage |
$19.60
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Advantage |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.60
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$19.60
|
| Rate for Payer: Mclaren Medicare |
$19.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.58
|
| Rate for Payer: Meridian Medicaid |
$20.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$29.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PACE Medicare |
$18.62
|
| Rate for Payer: PACE SWMI |
$19.60
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: PHP Medicare Advantage |
$19.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.60
|
| Rate for Payer: Priority Health Medicare |
$19.60
|
| Rate for Payer: Priority Health SBD |
$52.43
|
| Rate for Payer: Priority Health Tiered Network |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$19.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.40
|
| Rate for Payer: UHC Core |
$29.40
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.60
|
| Rate for Payer: UHC Exchange |
$29.40
|
| Rate for Payer: UHC Medicaid |
$10.25
|
| Rate for Payer: UHCCP Medicaid |
$10.25
|
| Rate for Payer: UMR Bronson Commercial |
$30.80
|
| Rate for Payer: VA VA |
$19.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE
|
Facility
|
IP
|
$83.23
|
|
|
Service Code
|
CPT 87110
|
| Hospital Charge Code |
30600088
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.62 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna American Axle |
$54.10
|
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.10
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Advantage |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: Priority Health SBD |
$52.43
|
| Rate for Payer: UMR Bronson Commercial |
$36.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE REF LAB
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 87140
|
| Hospital Charge Code |
30600090
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.73 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: UMR Bronson Commercial |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC CHLAMYDIA PNEUMONIAE CULTURE REF LAB
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 87140
|
| Hospital Charge Code |
30600090
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.96
|
| Rate for Payer: BCBS Complete |
$3.06
|
| Rate for Payer: BCBS MAPPO |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$6.44
|
| Rate for Payer: BCN Commercial |
$6.44
|
| Rate for Payer: BCN Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$5.57
|
| Rate for Payer: Mclaren Medicare |
$5.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: Meridian Medicaid |
$5.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$8.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Medicare |
$5.29
|
| Rate for Payer: PACE SWMI |
$5.57
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$5.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.57
|
| Rate for Payer: Priority Health Medicare |
$5.57
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Priority Health Tiered Network |
$4.46
|
| Rate for Payer: Railroad Medicare Medicare |
$5.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.36
|
| Rate for Payer: UHC Core |
$8.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.57
|
| Rate for Payer: UHC Exchange |
$8.36
|
| Rate for Payer: UHC Medicaid |
$2.91
|
| Rate for Payer: UHCCP Medicaid |
$2.91
|
| Rate for Payer: UMR Bronson Commercial |
$11.55
|
| Rate for Payer: VA VA |
$5.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC CHLORAMPHENICOL LEVEL
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82415
|
| Hospital Charge Code |
30100151
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC CHLORAMPHENICOL LEVEL
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82415
|
| Hospital Charge Code |
30100151
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.63 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$13.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.84
|
| Rate for Payer: BCBS Complete |
$6.96
|
| Rate for Payer: BCBS MAPPO |
$12.67
|
| Rate for Payer: BCBS Trust/PPO |
$14.64
|
| Rate for Payer: BCN Commercial |
$14.64
|
| Rate for Payer: BCN Medicare Advantage |
$12.67
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.67
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$12.67
|
| Rate for Payer: Mclaren Medicare |
$12.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.30
|
| Rate for Payer: Meridian Medicaid |
$13.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$19.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$12.04
|
| Rate for Payer: PACE SWMI |
$12.67
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$12.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.67
|
| Rate for Payer: Priority Health Medicare |
$12.67
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Priority Health Tiered Network |
$10.14
|
| Rate for Payer: Railroad Medicare Medicare |
$12.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.01
|
| Rate for Payer: UHC Core |
$19.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.67
|
| Rate for Payer: UHC Exchange |
$19.01
|
| Rate for Payer: UHC Medicaid |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$6.63
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$12.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna American Axle |
$14.07
|
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Advantage |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health SBD |
$13.63
|
| Rate for Payer: UMR Bronson Commercial |
$9.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
IP
|
$21.64
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.52 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna American Axle |
$14.07
|
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Advantage |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: Priority Health SBD |
$13.63
|
| Rate for Payer: UMR Bronson Commercial |
$9.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
OP
|
$21.64
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100554
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna American Axle |
$14.07
|
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$5.78
|
| Rate for Payer: BCN Commercial |
$5.78
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Advantage |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Mclaren Medicaid |
$5.00
|
| Rate for Payer: Mclaren Medicare |
$5.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: Meridian Medicaid |
$5.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$7.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PACE Medicare |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.00
|
| Rate for Payer: Priority Health Medicare |
$5.00
|
| Rate for Payer: Priority Health SBD |
$13.63
|
| Rate for Payer: Priority Health Tiered Network |
$4.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.50
|
| Rate for Payer: UHC Core |
$7.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.00
|
| Rate for Payer: UHC Exchange |
$7.50
|
| Rate for Payer: UHC Medicaid |
$2.62
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: UMR Bronson Commercial |
$8.01
|
| Rate for Payer: VA VA |
$5.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC CHLORIDE OTHER SOURCE
|
Facility
|
OP
|
$21.64
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100513
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$19.48 |
| Rate for Payer: Aetna American Axle |
$14.07
|
| Rate for Payer: Aetna Commercial |
$18.39
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$5.78
|
| Rate for Payer: BCN Commercial |
$5.78
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cash Price |
$17.31
|
| Rate for Payer: Cofinity Advantage |
$15.15
|
| Rate for Payer: Cofinity Commercial |
$18.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$19.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.23
|
| Rate for Payer: Mclaren Medicaid |
$5.00
|
| Rate for Payer: Mclaren Medicare |
$5.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: Meridian Medicaid |
$5.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.39
|
| Rate for Payer: Nomi Health Commercial |
$7.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.23
|
| Rate for Payer: PACE Medicare |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$18.39
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.00
|
| Rate for Payer: Priority Health Medicare |
$5.00
|
| Rate for Payer: Priority Health SBD |
$13.63
|
| Rate for Payer: Priority Health Tiered Network |
$4.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.50
|
| Rate for Payer: UHC Core |
$7.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.00
|
| Rate for Payer: UHC Exchange |
$7.50
|
| Rate for Payer: UHC Medicaid |
$2.62
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: UMR Bronson Commercial |
$8.01
|
| Rate for Payer: VA VA |
$5.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.23
|
|
|
HC CHLORIDE SERUM
|
Facility
|
IP
|
$22.07
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.71 |
| Max. Negotiated Rate |
$19.86 |
| Rate for Payer: Aetna American Axle |
$14.35
|
| Rate for Payer: Aetna Commercial |
$18.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.35
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Advantage |
$15.45
|
| Rate for Payer: Cofinity Commercial |
$18.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Healthscope Commercial |
$19.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: PHP Commercial |
$18.76
|
| Rate for Payer: Priority Health SBD |
$13.90
|
| Rate for Payer: UMR Bronson Commercial |
$9.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.55
|
|
|
HC CHLORIDE SERUM
|
Facility
|
OP
|
$22.07
|
|
|
Service Code
|
CPT 82435
|
| Hospital Charge Code |
30100152
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$19.86 |
| Rate for Payer: Aetna American Axle |
$14.35
|
| Rate for Payer: Aetna Commercial |
$18.76
|
| Rate for Payer: Aetna Medicare |
$4.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.75
|
| Rate for Payer: BCBS Complete |
$2.53
|
| Rate for Payer: BCBS MAPPO |
$4.60
|
| Rate for Payer: BCN Medicare Advantage |
$4.60
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cash Price |
$17.66
|
| Rate for Payer: Cofinity Advantage |
$15.45
|
| Rate for Payer: Cofinity Commercial |
$18.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.60
|
| Rate for Payer: Healthscope Commercial |
$19.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.55
|
| Rate for Payer: Mclaren Medicaid |
$4.60
|
| Rate for Payer: Mclaren Medicare |
$4.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.83
|
| Rate for Payer: Meridian Medicaid |
$4.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.76
|
| Rate for Payer: Nomi Health Commercial |
$6.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$16.55
|
| Rate for Payer: PACE Medicare |
$4.37
|
| Rate for Payer: PACE SWMI |
$4.60
|
| Rate for Payer: PHP Commercial |
$18.76
|
| Rate for Payer: PHP Medicare Advantage |
$4.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.60
|
| Rate for Payer: Priority Health Medicare |
$4.60
|
| Rate for Payer: Priority Health SBD |
$13.90
|
| Rate for Payer: Priority Health Tiered Network |
$3.68
|
| Rate for Payer: Railroad Medicare Medicare |
$4.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.90
|
| Rate for Payer: UHC Core |
$6.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.60
|
| Rate for Payer: UHC Exchange |
$6.90
|
| Rate for Payer: UHC Medicaid |
$2.41
|
| Rate for Payer: UHCCP Medicaid |
$2.41
|
| Rate for Payer: UMR Bronson Commercial |
$8.17
|
| Rate for Payer: VA VA |
$4.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.55
|
|
|
HC CHLORIDE URINE
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
30100153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC CHLORIDE URINE
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 82436
|
| Hospital Charge Code |
30100153
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.01 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$5.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.19
|
| Rate for Payer: BCBS Complete |
$3.16
|
| Rate for Payer: BCBS MAPPO |
$5.75
|
| Rate for Payer: BCBS Trust/PPO |
$6.64
|
| Rate for Payer: BCN Commercial |
$6.64
|
| Rate for Payer: BCN Medicare Advantage |
$5.75
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.75
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$5.75
|
| Rate for Payer: Mclaren Medicare |
$5.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.04
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.61
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$8.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$5.46
|
| Rate for Payer: PACE SWMI |
$5.75
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.75
|
| Rate for Payer: Priority Health Medicare |
$5.75
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$4.60
|
| Rate for Payer: Railroad Medicare Medicare |
$5.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.63
|
| Rate for Payer: UHC Core |
$8.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.75
|
| Rate for Payer: UHC Exchange |
$8.63
|
| Rate for Payer: UHC Medicaid |
$3.01
|
| Rate for Payer: UHCCP Medicaid |
$3.01
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$5.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC CHLOROZINE BATH
|
Facility
|
OP
|
$4.57
|
|
| Hospital Charge Code |
27000094
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.69 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna American Axle |
$2.97
|
| Rate for Payer: Aetna Commercial |
$3.88
|
| Rate for Payer: Aetna Medicare |
$2.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.97
|
| Rate for Payer: BCBS Complete |
$1.83
|
| Rate for Payer: Cash Price |
$3.66
|
| Rate for Payer: Cofinity Advantage |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.66
|
| Rate for Payer: Healthscope Commercial |
$4.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.43
|
| Rate for Payer: PHP Commercial |
$3.88
|
| Rate for Payer: Priority Health SBD |
$2.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.97
|
| Rate for Payer: UHC Core |
$2.38
|
| Rate for Payer: UHC Exchange |
$1.80
|
| Rate for Payer: UMR Bronson Commercial |
$1.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.43
|
|
|
HC CHLOROZINE BATH
|
Facility
|
IP
|
$4.57
|
|
| Hospital Charge Code |
27000094
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.01 |
| Max. Negotiated Rate |
$4.11 |
| Rate for Payer: Aetna American Axle |
$2.97
|
| Rate for Payer: Aetna Commercial |
$3.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.97
|
| Rate for Payer: Cash Price |
$3.66
|
| Rate for Payer: Cofinity Advantage |
$3.20
|
| Rate for Payer: Cofinity Commercial |
$3.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.66
|
| Rate for Payer: Healthscope Commercial |
$4.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.43
|
| Rate for Payer: PHP Commercial |
$3.88
|
| Rate for Payer: Priority Health SBD |
$2.88
|
| Rate for Payer: UMR Bronson Commercial |
$2.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.43
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE EXISTING ACCESS
|
Facility
|
IP
|
$600.96
|
|
|
Service Code
|
CPT 47531
|
| Hospital Charge Code |
36100488
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$264.42 |
| Max. Negotiated Rate |
$540.86 |
| Rate for Payer: Aetna American Axle |
$390.62
|
| Rate for Payer: Aetna Commercial |
$510.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.62
|
| Rate for Payer: Cash Price |
$480.77
|
| Rate for Payer: Cofinity Advantage |
$420.67
|
| Rate for Payer: Cofinity Commercial |
$516.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.77
|
| Rate for Payer: Healthscope Commercial |
$540.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.72
|
| Rate for Payer: PHP Commercial |
$510.82
|
| Rate for Payer: Priority Health SBD |
$378.60
|
| Rate for Payer: UMR Bronson Commercial |
$264.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.72
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE EXISTING ACCESS
|
Facility
|
OP
|
$600.96
|
|
|
Service Code
|
CPT 47531
|
| Hospital Charge Code |
36100488
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$222.36 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna American Axle |
$390.62
|
| Rate for Payer: Aetna Commercial |
$510.82
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$390.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,033.85
|
| Rate for Payer: BCN Commercial |
$1,033.85
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$480.77
|
| Rate for Payer: Cash Price |
$480.77
|
| Rate for Payer: Cash Price |
$480.77
|
| Rate for Payer: Cofinity Advantage |
$420.67
|
| Rate for Payer: Cofinity Commercial |
$516.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$540.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$420.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.72
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.82
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$450.72
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$510.82
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$378.60
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: UMR Bronson Commercial |
$222.36
|
| Rate for Payer: VA VA |
$3,567.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.72
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE NEW ACCESS
|
Facility
|
OP
|
$3,756.70
|
|
|
Service Code
|
CPT 47532
|
| Hospital Charge Code |
36100489
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,389.98 |
| Max. Negotiated Rate |
$11,537.07 |
| Rate for Payer: Aetna American Axle |
$2,441.86
|
| Rate for Payer: Aetna Commercial |
$3,193.20
|
| Rate for Payer: Aetna Medicare |
$3,710.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,441.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,459.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,459.41
|
| Rate for Payer: BCBS Complete |
$1,959.29
|
| Rate for Payer: BCBS MAPPO |
$3,567.53
|
| Rate for Payer: BCBS Trust/PPO |
$3,230.13
|
| Rate for Payer: BCN Commercial |
$3,230.13
|
| Rate for Payer: BCN Medicare Advantage |
$3,567.53
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Advantage |
$2,629.69
|
| Rate for Payer: Cofinity Commercial |
$3,230.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,567.53
|
| Rate for Payer: Healthscope Commercial |
$3,381.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,629.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,817.53
|
| Rate for Payer: Mclaren Medicaid |
$3,567.53
|
| Rate for Payer: Mclaren Medicare |
$3,567.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,745.91
|
| Rate for Payer: Meridian Medicaid |
$3,745.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,102.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,924.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Nomi Health Commercial |
$10,702.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PACE Medicare |
$3,389.15
|
| Rate for Payer: PACE SWMI |
$3,567.53
|
| Rate for Payer: PHP Commercial |
$3,193.20
|
| Rate for Payer: PHP Medicare Advantage |
$3,567.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,865.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11,537.07
|
| Rate for Payer: Priority Health Medicare |
$3,567.53
|
| Rate for Payer: Priority Health SBD |
$2,366.72
|
| Rate for Payer: Priority Health Tiered Network |
$9,229.66
|
| Rate for Payer: Railroad Medicare Medicare |
$3,567.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,567.53
|
| Rate for Payer: UHC Medicaid |
$1,865.82
|
| Rate for Payer: UHCCP Medicaid |
$1,865.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,389.98
|
| Rate for Payer: VA VA |
$3,567.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,817.53
|
|
|
HC CHOLANGIOGRAPHY INJ INCLD GUIDE NEW ACCESS
|
Facility
|
IP
|
$3,756.70
|
|
|
Service Code
|
CPT 47532
|
| Hospital Charge Code |
36100489
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,652.95 |
| Max. Negotiated Rate |
$3,381.03 |
| Rate for Payer: Aetna American Axle |
$2,441.86
|
| Rate for Payer: Aetna Commercial |
$3,193.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,441.86
|
| Rate for Payer: Cash Price |
$3,005.36
|
| Rate for Payer: Cofinity Advantage |
$2,629.69
|
| Rate for Payer: Cofinity Commercial |
$3,230.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,005.36
|
| Rate for Payer: Healthscope Commercial |
$3,381.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,629.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,817.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,193.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,817.53
|
| Rate for Payer: PHP Commercial |
$3,193.20
|
| Rate for Payer: Priority Health SBD |
$2,366.72
|
| Rate for Payer: UMR Bronson Commercial |
$1,652.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,817.53
|
|
|
HC CHOLESTEROL
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100155
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CHOLESTEROL
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100155
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.44
|
| Rate for Payer: BCBS Complete |
$2.39
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$4.35
|
| Rate for Payer: Mclaren Medicare |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Meridian Medicaid |
$4.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.13
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.35
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$3.48
|
| Rate for Payer: Railroad Medicare Medicare |
$4.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.53
|
| Rate for Payer: UHC Core |
$6.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.35
|
| Rate for Payer: UHC Exchange |
$6.53
|
| Rate for Payer: UHC Medicaid |
$2.28
|
| Rate for Payer: UHCCP Medicaid |
$2.28
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: VA VA |
$4.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CHOLESTEROL, TOTAL LMPP
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100688
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC CHOLESTEROL, TOTAL LMPP
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 82465
|
| Hospital Charge Code |
30100688
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.28 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$4.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.44
|
| Rate for Payer: BCBS Complete |
$2.39
|
| Rate for Payer: BCBS MAPPO |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.35
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Mclaren Medicaid |
$4.35
|
| Rate for Payer: Mclaren Medicare |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.57
|
| Rate for Payer: Meridian Medicaid |
$4.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PACE Medicare |
$4.13
|
| Rate for Payer: PACE SWMI |
$4.35
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: PHP Medicare Advantage |
$4.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.35
|
| Rate for Payer: Priority Health Medicare |
$4.35
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: Priority Health Tiered Network |
$3.48
|
| Rate for Payer: Railroad Medicare Medicare |
$4.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.53
|
| Rate for Payer: UHC Core |
$6.53
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.35
|
| Rate for Payer: UHC Exchange |
$6.53
|
| Rate for Payer: UHC Medicaid |
$2.28
|
| Rate for Payer: UHCCP Medicaid |
$2.28
|
| Rate for Payer: UMR Bronson Commercial |
$5.89
|
| Rate for Payer: VA VA |
$4.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
