|
HC BCR / ABL FISH CMPT1
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna American Axle |
$68.30
|
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.30
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$73.56
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health SBD |
$66.20
|
| Rate for Payer: UMR Bronson Commercial |
$46.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna American Axle |
$68.30
|
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Cofinity Commercial |
$73.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$66.20
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$40.94
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: UMR Bronson Commercial |
$38.88
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
OP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$144.09 |
| Rate for Payer: Aetna American Axle |
$50.62
|
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Cofinity Commercial |
$54.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$70.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.40
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$66.19
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$49.06
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$97.83
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: UMR Bronson Commercial |
$28.81
|
| Rate for Payer: VA VA |
$51.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.40
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
IP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.26 |
| Max. Negotiated Rate |
$70.08 |
| Rate for Payer: Aetna American Axle |
$50.62
|
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.62
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$54.51
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Healthscope Commercial |
$70.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: PHP Commercial |
$66.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health SBD |
$49.06
|
| Rate for Payer: UMR Bronson Commercial |
$34.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.40
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
OP
|
$390.15
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.88 |
| Max. Negotiated Rate |
$461.53 |
| Rate for Payer: Aetna American Axle |
$253.60
|
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: Aetna Medicare |
$170.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: BCBS Complete |
$92.28
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Cofinity Commercial |
$273.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$273.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$351.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.61
|
| Rate for Payer: Mclaren Medicaid |
$87.88
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: Meridian Medicaid |
$92.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.60
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health SBD |
$245.79
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.96
|
| Rate for Payer: UHC Exchange |
$313.34
|
| Rate for Payer: UHC Medicare Advantage |
$163.96
|
| Rate for Payer: UHCCP Medicaid |
$87.88
|
| Rate for Payer: UMR Bronson Commercial |
$144.36
|
| Rate for Payer: VA VA |
$163.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.61
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
IP
|
$390.15
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$171.67 |
| Max. Negotiated Rate |
$351.13 |
| Rate for Payer: Aetna American Axle |
$253.60
|
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$253.60
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$273.11
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$273.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Healthscope Commercial |
$351.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$273.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.60
|
| Rate for Payer: Priority Health SBD |
$245.79
|
| Rate for Payer: UMR Bronson Commercial |
$171.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.61
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
IP
|
$236.92
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$104.24 |
| Max. Negotiated Rate |
$213.23 |
| Rate for Payer: Aetna American Axle |
$154.00
|
| Rate for Payer: Aetna Commercial |
$201.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.00
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cofinity Commercial |
$165.84
|
| Rate for Payer: Cofinity Commercial |
$203.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.54
|
| Rate for Payer: Healthscope Commercial |
$213.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.38
|
| Rate for Payer: PHP Commercial |
$201.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health SBD |
$149.26
|
| Rate for Payer: UMR Bronson Commercial |
$104.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.69
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
OP
|
$236.92
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$77.63 |
| Max. Negotiated Rate |
$407.71 |
| Rate for Payer: Aetna American Axle |
$154.00
|
| Rate for Payer: Aetna Commercial |
$201.38
|
| Rate for Payer: Aetna Medicare |
$150.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$181.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$181.05
|
| Rate for Payer: BCBS Complete |
$81.52
|
| Rate for Payer: BCBS MAPPO |
$144.84
|
| Rate for Payer: BCN Medicare Advantage |
$144.84
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cofinity Commercial |
$203.75
|
| Rate for Payer: Cofinity Commercial |
$165.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$144.84
|
| Rate for Payer: Healthscope Commercial |
$213.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.69
|
| Rate for Payer: Mclaren Medicaid |
$77.63
|
| Rate for Payer: Mclaren Medicare |
$144.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$152.08
|
| Rate for Payer: Meridian Medicaid |
$81.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$166.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.38
|
| Rate for Payer: PACE Medicare |
$137.60
|
| Rate for Payer: PACE SWMI |
$144.84
|
| Rate for Payer: PHP Commercial |
$201.38
|
| Rate for Payer: PHP Medicare Advantage |
$144.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health Medicare |
$144.84
|
| Rate for Payer: Priority Health SBD |
$149.26
|
| Rate for Payer: Railroad Medicare Medicare |
$144.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$407.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.84
|
| Rate for Payer: UHC Exchange |
$276.80
|
| Rate for Payer: UHC Medicare Advantage |
$144.84
|
| Rate for Payer: UHCCP Medicaid |
$77.63
|
| Rate for Payer: UMR Bronson Commercial |
$87.66
|
| Rate for Payer: VA VA |
$144.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.69
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
OP
|
$351.08
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$115.04 |
| Max. Negotiated Rate |
$604.13 |
| Rate for Payer: Aetna American Axle |
$228.20
|
| Rate for Payer: Aetna Commercial |
$298.42
|
| Rate for Payer: Aetna Medicare |
$223.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.27
|
| Rate for Payer: BCBS Complete |
$120.79
|
| Rate for Payer: BCBS MAPPO |
$214.62
|
| Rate for Payer: BCN Medicare Advantage |
$214.62
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cofinity Commercial |
$301.93
|
| Rate for Payer: Cofinity Commercial |
$245.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.62
|
| Rate for Payer: Healthscope Commercial |
$315.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.31
|
| Rate for Payer: Mclaren Medicaid |
$115.04
|
| Rate for Payer: Mclaren Medicare |
$214.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.35
|
| Rate for Payer: Meridian Medicaid |
$120.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.42
|
| Rate for Payer: PACE Medicare |
$203.89
|
| Rate for Payer: PACE SWMI |
$214.62
|
| Rate for Payer: PHP Commercial |
$298.42
|
| Rate for Payer: PHP Medicare Advantage |
$214.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$115.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.20
|
| Rate for Payer: Priority Health Medicare |
$214.62
|
| Rate for Payer: Priority Health SBD |
$221.18
|
| Rate for Payer: Railroad Medicare Medicare |
$214.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$604.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$214.62
|
| Rate for Payer: UHC Exchange |
$410.16
|
| Rate for Payer: UHC Medicare Advantage |
$214.62
|
| Rate for Payer: UHCCP Medicaid |
$115.04
|
| Rate for Payer: UMR Bronson Commercial |
$129.90
|
| Rate for Payer: VA VA |
$214.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.31
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
IP
|
$351.08
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$154.48 |
| Max. Negotiated Rate |
$315.97 |
| Rate for Payer: Aetna American Axle |
$228.20
|
| Rate for Payer: Aetna Commercial |
$298.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$228.20
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cofinity Commercial |
$245.76
|
| Rate for Payer: Cofinity Commercial |
$301.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$245.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.86
|
| Rate for Payer: Healthscope Commercial |
$315.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$245.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.42
|
| Rate for Payer: PHP Commercial |
$298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.20
|
| Rate for Payer: Priority Health SBD |
$221.18
|
| Rate for Payer: UMR Bronson Commercial |
$154.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.31
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
IP
|
$268.20
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$118.01 |
| Max. Negotiated Rate |
$241.38 |
| Rate for Payer: Aetna American Axle |
$174.33
|
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.33
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cofinity Commercial |
$187.74
|
| Rate for Payer: Cofinity Commercial |
$230.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.56
|
| Rate for Payer: Healthscope Commercial |
$241.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.97
|
| Rate for Payer: PHP Commercial |
$227.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.33
|
| Rate for Payer: Priority Health SBD |
$168.97
|
| Rate for Payer: UMR Bronson Commercial |
$118.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.15
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
OP
|
$268.20
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$87.88 |
| Max. Negotiated Rate |
$461.53 |
| Rate for Payer: Aetna American Axle |
$174.33
|
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$170.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$204.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$204.95
|
| Rate for Payer: BCBS Complete |
$92.28
|
| Rate for Payer: BCBS MAPPO |
$163.96
|
| Rate for Payer: BCN Medicare Advantage |
$163.96
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cofinity Commercial |
$230.65
|
| Rate for Payer: Cofinity Commercial |
$187.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$163.96
|
| Rate for Payer: Healthscope Commercial |
$241.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.15
|
| Rate for Payer: Mclaren Medicaid |
$87.88
|
| Rate for Payer: Mclaren Medicare |
$163.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$172.16
|
| Rate for Payer: Meridian Medicaid |
$92.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$188.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.97
|
| Rate for Payer: PACE Medicare |
$155.76
|
| Rate for Payer: PACE SWMI |
$163.96
|
| Rate for Payer: PHP Commercial |
$227.97
|
| Rate for Payer: PHP Medicare Advantage |
$163.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.33
|
| Rate for Payer: Priority Health Medicare |
$163.96
|
| Rate for Payer: Priority Health SBD |
$168.97
|
| Rate for Payer: Railroad Medicare Medicare |
$163.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$163.96
|
| Rate for Payer: UHC Exchange |
$313.34
|
| Rate for Payer: UHC Medicare Advantage |
$163.96
|
| Rate for Payer: UHCCP Medicaid |
$87.88
|
| Rate for Payer: UMR Bronson Commercial |
$99.23
|
| Rate for Payer: VA VA |
$163.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.15
|
|
|
HC BDIAL APTT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.22 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.51
|
| Rate for Payer: BCBS Complete |
$3.38
|
| Rate for Payer: BCBS MAPPO |
$6.01
|
| Rate for Payer: BCN Medicare Advantage |
$6.01
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.01
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$3.22
|
| Rate for Payer: Mclaren Medicare |
$6.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.31
|
| Rate for Payer: Meridian Medicaid |
$3.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$5.71
|
| Rate for Payer: PACE SWMI |
$6.01
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$6.01
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$6.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.01
|
| Rate for Payer: UHC Exchange |
$11.49
|
| Rate for Payer: UHC Medicare Advantage |
$6.01
|
| Rate for Payer: UHCCP Medicaid |
$3.22
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$6.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC BDIAL APTT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC BDIAL DIRM
|
Facility
|
OP
|
$40.32
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.46 |
| Max. Negotiated Rate |
$36.29 |
| Rate for Payer: Aetna American Axle |
$26.21
|
| Rate for Payer: Aetna Commercial |
$34.27
|
| Rate for Payer: Aetna Medicare |
$10.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.72
|
| Rate for Payer: BCBS Complete |
$5.73
|
| Rate for Payer: BCBS MAPPO |
$10.18
|
| Rate for Payer: BCN Medicare Advantage |
$10.18
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cofinity Commercial |
$34.68
|
| Rate for Payer: Cofinity Commercial |
$28.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.18
|
| Rate for Payer: Healthscope Commercial |
$36.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.24
|
| Rate for Payer: Mclaren Medicaid |
$5.46
|
| Rate for Payer: Mclaren Medicare |
$10.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.69
|
| Rate for Payer: Meridian Medicaid |
$5.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.27
|
| Rate for Payer: PACE Medicare |
$9.67
|
| Rate for Payer: PACE SWMI |
$10.18
|
| Rate for Payer: PHP Commercial |
$34.27
|
| Rate for Payer: PHP Medicare Advantage |
$10.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.21
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health SBD |
$25.40
|
| Rate for Payer: Railroad Medicare Medicare |
$10.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.18
|
| Rate for Payer: UHC Exchange |
$19.45
|
| Rate for Payer: UHC Medicare Advantage |
$10.18
|
| Rate for Payer: UHCCP Medicaid |
$5.46
|
| Rate for Payer: UMR Bronson Commercial |
$14.92
|
| Rate for Payer: VA VA |
$10.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.24
|
|
|
HC BDIAL DIRM
|
Facility
|
IP
|
$40.32
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$36.29 |
| Rate for Payer: Aetna American Axle |
$26.21
|
| Rate for Payer: Aetna Commercial |
$34.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.21
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cofinity Commercial |
$28.22
|
| Rate for Payer: Cofinity Commercial |
$34.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.26
|
| Rate for Payer: Healthscope Commercial |
$36.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.27
|
| Rate for Payer: PHP Commercial |
$34.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.21
|
| Rate for Payer: Priority Health SBD |
$25.40
|
| Rate for Payer: UMR Bronson Commercial |
$17.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.24
|
|
|
HC BDIAL F8A
|
Facility
|
OP
|
$66.95
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$60.26 |
| Rate for Payer: Aetna American Axle |
$43.52
|
| Rate for Payer: Aetna Commercial |
$56.91
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cofinity Commercial |
$57.58
|
| Rate for Payer: Cofinity Commercial |
$46.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$60.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.21
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.91
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$56.91
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.52
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health SBD |
$42.18
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.90
|
| Rate for Payer: UHC Exchange |
$34.21
|
| Rate for Payer: UHC Medicare Advantage |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: UMR Bronson Commercial |
$24.77
|
| Rate for Payer: VA VA |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.21
|
|
|
HC BDIAL F8A
|
Facility
|
IP
|
$66.95
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.46 |
| Max. Negotiated Rate |
$60.26 |
| Rate for Payer: Aetna American Axle |
$43.52
|
| Rate for Payer: Aetna Commercial |
$56.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.52
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cofinity Commercial |
$46.87
|
| Rate for Payer: Cofinity Commercial |
$57.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.56
|
| Rate for Payer: Healthscope Commercial |
$60.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.91
|
| Rate for Payer: PHP Commercial |
$56.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.52
|
| Rate for Payer: Priority Health SBD |
$42.18
|
| Rate for Payer: UMR Bronson Commercial |
$29.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.21
|
|
|
HC BDIAL FIBC
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.21 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna American Axle |
$22.99
|
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$10.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.15
|
| Rate for Payer: BCBS Complete |
$5.47
|
| Rate for Payer: BCBS MAPPO |
$9.72
|
| Rate for Payer: BCN Medicare Advantage |
$9.72
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.72
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Mclaren Medicaid |
$5.21
|
| Rate for Payer: Mclaren Medicare |
$9.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.21
|
| Rate for Payer: Meridian Medicaid |
$5.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: PACE Medicare |
$9.23
|
| Rate for Payer: PACE SWMI |
$9.72
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$9.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health SBD |
$22.28
|
| Rate for Payer: Railroad Medicare Medicare |
$9.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.72
|
| Rate for Payer: UHC Exchange |
$18.58
|
| Rate for Payer: UHC Medicare Advantage |
$9.72
|
| Rate for Payer: UHCCP Medicaid |
$5.21
|
| Rate for Payer: UMR Bronson Commercial |
$13.09
|
| Rate for Payer: VA VA |
$9.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC BDIAL FIBC
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.56 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna American Axle |
$22.99
|
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$24.76
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health SBD |
$22.28
|
| Rate for Payer: UMR Bronson Commercial |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC BDIAL FXIII
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.39
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$9.11
|
| Rate for Payer: BCN Medicare Advantage |
$9.11
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.11
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$4.88
|
| Rate for Payer: Mclaren Medicare |
$9.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.57
|
| Rate for Payer: Meridian Medicaid |
$5.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PACE Medicare |
$8.65
|
| Rate for Payer: PACE SWMI |
$9.11
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$9.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health Medicare |
$9.11
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$9.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.11
|
| Rate for Payer: UHC Exchange |
$17.41
|
| Rate for Payer: UHC Medicare Advantage |
$9.11
|
| Rate for Payer: UHCCP Medicaid |
$4.88
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$9.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC BDIAL FXIII
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC BDIAL PTIN
|
Facility
|
IP
|
$29.13
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.82 |
| Max. Negotiated Rate |
$26.22 |
| Rate for Payer: Aetna American Axle |
$18.93
|
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$20.39
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health SBD |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$12.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC BDIAL PTIN
|
Facility
|
OP
|
$29.13
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.30 |
| Max. Negotiated Rate |
$26.22 |
| Rate for Payer: Aetna American Axle |
$18.93
|
| Rate for Payer: Aetna Commercial |
$24.76
|
| Rate for Payer: Aetna Medicare |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cash Price |
$23.30
|
| Rate for Payer: Cofinity Commercial |
$25.05
|
| Rate for Payer: Cofinity Commercial |
$20.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$26.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.85
|
| Rate for Payer: Mclaren Medicaid |
$2.30
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.76
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$24.76
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.93
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health SBD |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.29
|
| Rate for Payer: UHC Exchange |
$8.20
|
| Rate for Payer: UHC Medicare Advantage |
$4.29
|
| Rate for Payer: UHCCP Medicaid |
$2.30
|
| Rate for Payer: UMR Bronson Commercial |
$10.78
|
| Rate for Payer: VA VA |
$4.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.85
|
|
|
HC BDIAL SFM
|
Facility
|
IP
|
$249.98
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$109.99 |
| Max. Negotiated Rate |
$224.98 |
| Rate for Payer: Aetna American Axle |
$162.49
|
| Rate for Payer: Aetna Commercial |
$212.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.49
|
| Rate for Payer: Cash Price |
$199.98
|
| Rate for Payer: Cofinity Commercial |
$174.99
|
| Rate for Payer: Cofinity Commercial |
$214.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.98
|
| Rate for Payer: Healthscope Commercial |
$224.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.48
|
| Rate for Payer: PHP Commercial |
$212.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.49
|
| Rate for Payer: Priority Health SBD |
$157.49
|
| Rate for Payer: UMR Bronson Commercial |
$109.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.49
|
|
