|
HC INDIUM 111 PER 0.5 MCI
|
Facility
|
IP
|
$2,608.96
|
|
|
Service Code
|
HCPCS A9547
|
| Hospital Charge Code |
63600040
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,147.94 |
| Max. Negotiated Rate |
$2,348.06 |
| Rate for Payer: Aetna American Axle |
$1,695.82
|
| Rate for Payer: Aetna Commercial |
$2,217.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,695.82
|
| Rate for Payer: Cash Price |
$2,087.17
|
| Rate for Payer: Cofinity Commercial |
$1,826.27
|
| Rate for Payer: Cofinity Commercial |
$2,243.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,087.17
|
| Rate for Payer: Healthscope Commercial |
$2,348.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,826.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,956.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,217.62
|
| Rate for Payer: PHP Commercial |
$2,217.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,826.27
|
| Rate for Payer: Priority Health SBD |
$1,643.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,147.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,956.72
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
IP
|
$161.52
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$71.07 |
| Max. Negotiated Rate |
$145.37 |
| Rate for Payer: Aetna American Axle |
$104.99
|
| Rate for Payer: Aetna Commercial |
$137.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.99
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Commercial |
$113.06
|
| Rate for Payer: Cofinity Commercial |
$138.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Healthscope Commercial |
$145.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$137.29
|
| Rate for Payer: PHP Commercial |
$137.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.06
|
| Rate for Payer: Priority Health SBD |
$101.76
|
| Rate for Payer: UMR Bronson Commercial |
$71.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.14
|
|
|
HC INDIVIDUAL SESSION 30 MIN RD G0108
|
Facility
|
OP
|
$161.52
|
|
|
Service Code
|
HCPCS G0108
|
| Hospital Charge Code |
94200029
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$104.99
|
| Rate for Payer: Aetna Commercial |
$137.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.99
|
| Rate for Payer: BCBS Complete |
$64.61
|
| Rate for Payer: BCBS Trust/PPO |
$113.93
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Commercial |
$138.91
|
| Rate for Payer: Cofinity Commercial |
$113.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Healthscope Commercial |
$145.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$137.29
|
| Rate for Payer: PHP Commercial |
$137.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$113.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.00
|
| Rate for Payer: Priority Health Narrow Network |
$27.20
|
| Rate for Payer: Priority Health SBD |
$101.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.71
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$53.37
|
| Rate for Payer: UMR Bronson Commercial |
$59.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.14
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
OP
|
$3,679.65
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$578.66 |
| Max. Negotiated Rate |
$3,542.98 |
| Rate for Payer: Aetna American Axle |
$2,391.77
|
| Rate for Payer: Aetna Commercial |
$3,127.70
|
| Rate for Payer: Aetna Medicare |
$1,100.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,391.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,322.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,322.35
|
| Rate for Payer: BCBS Complete |
$607.65
|
| Rate for Payer: BCBS MAPPO |
$1,057.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,542.98
|
| Rate for Payer: BCN Medicare Advantage |
$1,057.88
|
| Rate for Payer: Cash Price |
$2,943.72
|
| Rate for Payer: Cash Price |
$2,943.72
|
| Rate for Payer: Cofinity Commercial |
$2,575.76
|
| Rate for Payer: Cofinity Commercial |
$3,164.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,943.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,057.88
|
| Rate for Payer: Healthscope Commercial |
$3,311.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,575.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,759.74
|
| Rate for Payer: Mclaren Medicaid |
$578.66
|
| Rate for Payer: Mclaren Medicare |
$1,057.88
|
| Rate for Payer: Meridian Medicaid |
$607.65
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,110.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,216.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,127.70
|
| Rate for Payer: PACE Medicare |
$1,004.99
|
| Rate for Payer: PACE SWMI |
$1,057.88
|
| Rate for Payer: PHP Commercial |
$3,127.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,057.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$578.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,575.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,330.26
|
| Rate for Payer: Priority Health Medicare |
$1,057.88
|
| Rate for Payer: Priority Health Narrow Network |
$2,664.21
|
| Rate for Payer: Priority Health SBD |
$2,318.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,057.88
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,057.88
|
| Rate for Payer: UHC Medicare Advantage |
$1,089.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,361.47
|
| Rate for Payer: VA VA |
$1,057.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,759.74
|
|
|
HC INDUCTION OF ARRHYTHMIA
|
Facility
|
IP
|
$3,679.65
|
|
|
Service Code
|
CPT 93618
|
| Hospital Charge Code |
48100036
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,619.05 |
| Max. Negotiated Rate |
$3,311.68 |
| Rate for Payer: Aetna American Axle |
$2,391.77
|
| Rate for Payer: Aetna Commercial |
$3,127.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,391.77
|
| Rate for Payer: Cash Price |
$2,943.72
|
| Rate for Payer: Cofinity Commercial |
$2,575.76
|
| Rate for Payer: Cofinity Commercial |
$3,164.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,943.72
|
| Rate for Payer: Healthscope Commercial |
$3,311.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,575.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,759.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,127.70
|
| Rate for Payer: PHP Commercial |
$3,127.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,575.76
|
| Rate for Payer: Priority Health SBD |
$2,318.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,619.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,759.74
|
|
|
HC INDWELLING PORT
|
Facility
|
IP
|
$1,334.80
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$587.31 |
| Max. Negotiated Rate |
$1,201.32 |
| Rate for Payer: Aetna American Axle |
$867.62
|
| Rate for Payer: Aetna Commercial |
$1,134.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.62
|
| Rate for Payer: Cash Price |
$1,067.84
|
| Rate for Payer: Cofinity Commercial |
$1,147.93
|
| Rate for Payer: Cofinity Commercial |
$934.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.84
|
| Rate for Payer: Healthscope Commercial |
$1,201.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$934.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,001.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,134.58
|
| Rate for Payer: PHP Commercial |
$1,134.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.36
|
| Rate for Payer: Priority Health SBD |
$840.92
|
| Rate for Payer: UMR Bronson Commercial |
$587.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,001.10
|
|
|
HC INDWELLING PORT
|
Facility
|
OP
|
$1,334.80
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800015
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$493.88 |
| Max. Negotiated Rate |
$1,201.32 |
| Rate for Payer: Aetna American Axle |
$867.62
|
| Rate for Payer: Aetna Commercial |
$1,134.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$867.62
|
| Rate for Payer: BCBS Complete |
$533.92
|
| Rate for Payer: Cash Price |
$1,067.84
|
| Rate for Payer: Cofinity Commercial |
$1,147.93
|
| Rate for Payer: Cofinity Commercial |
$934.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,067.84
|
| Rate for Payer: Healthscope Commercial |
$1,201.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$934.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,001.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,134.58
|
| Rate for Payer: PHP Commercial |
$1,134.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$934.36
|
| Rate for Payer: Priority Health SBD |
$840.92
|
| Rate for Payer: UMR Bronson Commercial |
$493.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,001.10
|
|
|
HC INFANT COOLING SYSTEM
|
Facility
|
OP
|
$657.75
|
|
| Hospital Charge Code |
27000644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$243.37 |
| Max. Negotiated Rate |
$591.98 |
| Rate for Payer: Aetna American Axle |
$427.54
|
| Rate for Payer: Aetna Commercial |
$559.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.54
|
| Rate for Payer: BCBS Complete |
$263.10
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cofinity Commercial |
$460.42
|
| Rate for Payer: Cofinity Commercial |
$565.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.20
|
| Rate for Payer: Healthscope Commercial |
$591.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$460.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$559.09
|
| Rate for Payer: PHP Commercial |
$559.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.42
|
| Rate for Payer: Priority Health SBD |
$414.38
|
| Rate for Payer: UMR Bronson Commercial |
$243.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.31
|
|
|
HC INFANT COOLING SYSTEM
|
Facility
|
IP
|
$657.75
|
|
| Hospital Charge Code |
27000644
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$289.41 |
| Max. Negotiated Rate |
$591.98 |
| Rate for Payer: Aetna American Axle |
$427.54
|
| Rate for Payer: Aetna Commercial |
$559.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.54
|
| Rate for Payer: Cash Price |
$526.20
|
| Rate for Payer: Cofinity Commercial |
$460.42
|
| Rate for Payer: Cofinity Commercial |
$565.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.20
|
| Rate for Payer: Healthscope Commercial |
$591.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$460.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$559.09
|
| Rate for Payer: PHP Commercial |
$559.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$460.42
|
| Rate for Payer: Priority Health SBD |
$414.38
|
| Rate for Payer: UMR Bronson Commercial |
$289.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.31
|
|
|
HC INFECT AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Facility
|
OP
|
$153.00
|
|
|
Service Code
|
CPT 87502
|
| Hospital Charge Code |
30000171
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$140.35 |
| Rate for Payer: Aetna American Axle |
$99.45
|
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna Medicare |
$99.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.75
|
| Rate for Payer: BCBS Complete |
$55.03
|
| Rate for Payer: BCBS MAPPO |
$95.80
|
| Rate for Payer: BCBS Trust/PPO |
$86.16
|
| Rate for Payer: BCN Medicare Advantage |
$95.80
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.80
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Mclaren Medicaid |
$52.40
|
| Rate for Payer: Mclaren Medicare |
$95.80
|
| Rate for Payer: Meridian Medicaid |
$55.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.05
|
| Rate for Payer: PACE Medicare |
$91.01
|
| Rate for Payer: PACE SWMI |
$95.80
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: PHP Medicare Advantage |
$95.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.73
|
| Rate for Payer: Priority Health Medicare |
$95.80
|
| Rate for Payer: Priority Health Narrow Network |
$93.38
|
| Rate for Payer: Priority Health SBD |
$96.39
|
| Rate for Payer: Railroad Medicare Medicare |
$95.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.96
|
| Rate for Payer: UHC Core |
$140.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.80
|
| Rate for Payer: UHC Exchange |
$95.80
|
| Rate for Payer: UHC Medicare Advantage |
$98.67
|
| Rate for Payer: UMR Bronson Commercial |
$56.61
|
| Rate for Payer: VA VA |
$95.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC INFECT AGENT DNA/RNA INFLUENZA 1ST 2 TYPES
|
Facility
|
IP
|
$153.00
|
|
|
Service Code
|
CPT 87502
|
| Hospital Charge Code |
30000171
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$67.32 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna American Axle |
$99.45
|
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$130.05
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$107.10
|
| Rate for Payer: Priority Health SBD |
$96.39
|
| Rate for Payer: UMR Bronson Commercial |
$67.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC INFLIXIMAB AB
|
Facility
|
IP
|
$185.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100662
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.40 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna American Axle |
$120.25
|
| Rate for Payer: Aetna Commercial |
$157.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.25
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$129.50
|
| Rate for Payer: Cofinity Commercial |
$159.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.00
|
| Rate for Payer: Healthscope Commercial |
$166.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.25
|
| Rate for Payer: PHP Commercial |
$157.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.50
|
| Rate for Payer: Priority Health SBD |
$116.55
|
| Rate for Payer: UMR Bronson Commercial |
$81.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.75
|
|
|
HC INFLIXIMAB AB
|
Facility
|
OP
|
$185.00
|
|
|
Service Code
|
CPT 82397
|
| Hospital Charge Code |
30100662
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$166.50 |
| Rate for Payer: Aetna American Axle |
$120.25
|
| Rate for Payer: Aetna Commercial |
$157.25
|
| Rate for Payer: Aetna Medicare |
$14.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.65
|
| Rate for Payer: BCBS Complete |
$8.11
|
| Rate for Payer: BCBS MAPPO |
$14.12
|
| Rate for Payer: BCBS Trust/PPO |
$12.70
|
| Rate for Payer: BCN Medicare Advantage |
$14.12
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cash Price |
$148.00
|
| Rate for Payer: Cofinity Commercial |
$159.10
|
| Rate for Payer: Cofinity Commercial |
$129.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.12
|
| Rate for Payer: Healthscope Commercial |
$166.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.75
|
| Rate for Payer: Mclaren Medicaid |
$7.72
|
| Rate for Payer: Mclaren Medicare |
$14.12
|
| Rate for Payer: Meridian Medicaid |
$8.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.25
|
| Rate for Payer: PACE Medicare |
$13.41
|
| Rate for Payer: PACE SWMI |
$14.12
|
| Rate for Payer: PHP Commercial |
$157.25
|
| Rate for Payer: PHP Medicare Advantage |
$14.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.84
|
| Rate for Payer: Priority Health Medicare |
$14.12
|
| Rate for Payer: Priority Health Narrow Network |
$9.47
|
| Rate for Payer: Priority Health SBD |
$116.55
|
| Rate for Payer: Railroad Medicare Medicare |
$14.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.94
|
| Rate for Payer: UHC Core |
$23.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.12
|
| Rate for Payer: UHC Exchange |
$14.12
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: UMR Bronson Commercial |
$68.45
|
| Rate for Payer: VA VA |
$14.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.75
|
|
|
HC INFLIXIMAB, S
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 80230
|
| Hospital Charge Code |
30100705
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$107.80 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna American Axle |
$159.25
|
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.25
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$171.50
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health SBD |
$154.35
|
| Rate for Payer: UMR Bronson Commercial |
$107.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC INFLIXIMAB, S
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 80230
|
| Hospital Charge Code |
30100705
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.10 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna American Axle |
$159.25
|
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna Medicare |
$40.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.21
|
| Rate for Payer: BCBS Complete |
$22.15
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCBS Trust/PPO |
$34.69
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$171.50
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Mclaren Medicaid |
$21.10
|
| Rate for Payer: Mclaren Medicare |
$38.57
|
| Rate for Payer: Meridian Medicaid |
$22.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PACE Medicare |
$36.64
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.57
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health Narrow Network |
$30.86
|
| Rate for Payer: Priority Health SBD |
$154.35
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.28
|
| Rate for Payer: UHC Core |
$46.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.57
|
| Rate for Payer: UHC Exchange |
$38.57
|
| Rate for Payer: UHC Medicare Advantage |
$39.73
|
| Rate for Payer: UMR Bronson Commercial |
$90.65
|
| Rate for Payer: VA VA |
$38.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC INFLUENZA A AND B PCR
|
Facility
|
OP
|
$212.70
|
|
|
Service Code
|
CPT 87631
|
| Hospital Charge Code |
30600207
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.02 |
| Max. Negotiated Rate |
$211.61 |
| Rate for Payer: Aetna American Axle |
$138.26
|
| Rate for Payer: Aetna Commercial |
$180.80
|
| Rate for Payer: Aetna Medicare |
$148.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: BCBS Complete |
$81.93
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCBS Trust/PPO |
$128.27
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$170.16
|
| Rate for Payer: Cash Price |
$170.16
|
| Rate for Payer: Cofinity Commercial |
$182.92
|
| Rate for Payer: Cofinity Commercial |
$148.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$191.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.52
|
| Rate for Payer: Mclaren Medicaid |
$78.02
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Medicaid |
$81.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.80
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$180.80
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.98
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health Narrow Network |
$140.78
|
| Rate for Payer: Priority Health SBD |
$134.00
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.16
|
| Rate for Payer: UHC Core |
$211.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.63
|
| Rate for Payer: UHC Exchange |
$142.63
|
| Rate for Payer: UHC Medicare Advantage |
$146.91
|
| Rate for Payer: UMR Bronson Commercial |
$78.70
|
| Rate for Payer: VA VA |
$142.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.52
|
|
|
HC INFLUENZA A AND B PCR
|
Facility
|
IP
|
$212.70
|
|
|
Service Code
|
CPT 87631
|
| Hospital Charge Code |
30600207
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$93.59 |
| Max. Negotiated Rate |
$191.43 |
| Rate for Payer: Aetna American Axle |
$138.26
|
| Rate for Payer: Aetna Commercial |
$180.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.26
|
| Rate for Payer: Cash Price |
$170.16
|
| Rate for Payer: Cofinity Commercial |
$148.89
|
| Rate for Payer: Cofinity Commercial |
$182.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.16
|
| Rate for Payer: Healthscope Commercial |
$191.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.80
|
| Rate for Payer: PHP Commercial |
$180.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.89
|
| Rate for Payer: Priority Health SBD |
$134.00
|
| Rate for Payer: UMR Bronson Commercial |
$93.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.52
|
|
|
HC INFLUENZA A/B DNA AMP PROBE
|
Facility
|
OP
|
$142.87
|
|
|
Service Code
|
CPT 87502
|
| Hospital Charge Code |
30600314
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$140.35 |
| Rate for Payer: Aetna American Axle |
$92.87
|
| Rate for Payer: Aetna Commercial |
$121.44
|
| Rate for Payer: Aetna Medicare |
$99.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.75
|
| Rate for Payer: BCBS Complete |
$55.03
|
| Rate for Payer: BCBS MAPPO |
$95.80
|
| Rate for Payer: BCBS Trust/PPO |
$86.16
|
| Rate for Payer: BCN Medicare Advantage |
$95.80
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cofinity Commercial |
$122.87
|
| Rate for Payer: Cofinity Commercial |
$100.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.80
|
| Rate for Payer: Healthscope Commercial |
$128.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.15
|
| Rate for Payer: Mclaren Medicaid |
$52.40
|
| Rate for Payer: Mclaren Medicare |
$95.80
|
| Rate for Payer: Meridian Medicaid |
$55.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$100.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.44
|
| Rate for Payer: PACE Medicare |
$91.01
|
| Rate for Payer: PACE SWMI |
$95.80
|
| Rate for Payer: PHP Commercial |
$121.44
|
| Rate for Payer: PHP Medicare Advantage |
$95.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$116.73
|
| Rate for Payer: Priority Health Medicare |
$95.80
|
| Rate for Payer: Priority Health Narrow Network |
$93.38
|
| Rate for Payer: Priority Health SBD |
$90.01
|
| Rate for Payer: Railroad Medicare Medicare |
$95.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.96
|
| Rate for Payer: UHC Core |
$140.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.80
|
| Rate for Payer: UHC Exchange |
$95.80
|
| Rate for Payer: UHC Medicare Advantage |
$98.67
|
| Rate for Payer: UMR Bronson Commercial |
$52.86
|
| Rate for Payer: VA VA |
$95.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.15
|
|
|
HC INFLUENZA A/B DNA AMP PROBE
|
Facility
|
IP
|
$142.87
|
|
|
Service Code
|
CPT 87502
|
| Hospital Charge Code |
30600314
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.86 |
| Max. Negotiated Rate |
$128.58 |
| Rate for Payer: Aetna American Axle |
$92.87
|
| Rate for Payer: Aetna Commercial |
$121.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.87
|
| Rate for Payer: Cash Price |
$114.30
|
| Rate for Payer: Cofinity Commercial |
$100.01
|
| Rate for Payer: Cofinity Commercial |
$122.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.30
|
| Rate for Payer: Healthscope Commercial |
$128.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$121.44
|
| Rate for Payer: PHP Commercial |
$121.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.01
|
| Rate for Payer: Priority Health SBD |
$90.01
|
| Rate for Payer: UMR Bronson Commercial |
$62.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.15
|
|
|
HC INFLUENZA AND RSV BY PCR
|
Facility
|
OP
|
$218.96
|
|
|
Service Code
|
CPT 87631
|
| Hospital Charge Code |
30600213
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$78.02 |
| Max. Negotiated Rate |
$211.61 |
| Rate for Payer: Aetna American Axle |
$142.32
|
| Rate for Payer: Aetna Commercial |
$186.12
|
| Rate for Payer: Aetna Medicare |
$148.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$178.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$178.29
|
| Rate for Payer: BCBS Complete |
$81.93
|
| Rate for Payer: BCBS MAPPO |
$142.63
|
| Rate for Payer: BCBS Trust/PPO |
$128.27
|
| Rate for Payer: BCN Medicare Advantage |
$142.63
|
| Rate for Payer: Cash Price |
$175.17
|
| Rate for Payer: Cash Price |
$175.17
|
| Rate for Payer: Cofinity Commercial |
$188.31
|
| Rate for Payer: Cofinity Commercial |
$153.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$197.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.22
|
| Rate for Payer: Mclaren Medicaid |
$78.02
|
| Rate for Payer: Mclaren Medicare |
$142.63
|
| Rate for Payer: Meridian Medicaid |
$81.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$149.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$164.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.12
|
| Rate for Payer: PACE Medicare |
$135.50
|
| Rate for Payer: PACE SWMI |
$142.63
|
| Rate for Payer: PHP Commercial |
$186.12
|
| Rate for Payer: PHP Medicare Advantage |
$142.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$175.98
|
| Rate for Payer: Priority Health Medicare |
$142.63
|
| Rate for Payer: Priority Health Narrow Network |
$140.78
|
| Rate for Payer: Priority Health SBD |
$137.94
|
| Rate for Payer: Railroad Medicare Medicare |
$142.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.16
|
| Rate for Payer: UHC Core |
$211.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$142.63
|
| Rate for Payer: UHC Exchange |
$142.63
|
| Rate for Payer: UHC Medicare Advantage |
$146.91
|
| Rate for Payer: UMR Bronson Commercial |
$81.02
|
| Rate for Payer: VA VA |
$142.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.22
|
|
|
HC INFLUENZA AND RSV BY PCR
|
Facility
|
IP
|
$218.96
|
|
|
Service Code
|
CPT 87631
|
| Hospital Charge Code |
30600213
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$96.34 |
| Max. Negotiated Rate |
$197.06 |
| Rate for Payer: Aetna American Axle |
$142.32
|
| Rate for Payer: Aetna Commercial |
$186.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$142.32
|
| Rate for Payer: Cash Price |
$175.17
|
| Rate for Payer: Cofinity Commercial |
$153.27
|
| Rate for Payer: Cofinity Commercial |
$188.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$175.17
|
| Rate for Payer: Healthscope Commercial |
$197.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$153.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$164.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$186.12
|
| Rate for Payer: PHP Commercial |
$186.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.27
|
| Rate for Payer: Priority Health SBD |
$137.94
|
| Rate for Payer: UMR Bronson Commercial |
$96.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$164.22
|
|
|
HC INFLUENZA INJECTION
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
HCPCS G0008
|
| Hospital Charge Code |
77100009
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$11.10 |
| Max. Negotiated Rate |
$132.91 |
| Rate for Payer: Aetna American Axle |
$19.50
|
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna Medicare |
$43.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.78
|
| Rate for Payer: BCBS Complete |
$24.25
|
| Rate for Payer: BCBS MAPPO |
$42.22
|
| Rate for Payer: BCBS Trust/PPO |
$80.22
|
| Rate for Payer: BCN Medicare Advantage |
$42.22
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.22
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Mclaren Medicaid |
$23.09
|
| Rate for Payer: Mclaren Medicare |
$42.22
|
| Rate for Payer: Meridian Medicaid |
$24.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$44.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PACE Medicare |
$40.11
|
| Rate for Payer: PACE SWMI |
$42.22
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: PHP Medicare Advantage |
$42.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$132.91
|
| Rate for Payer: Priority Health Medicare |
$42.22
|
| Rate for Payer: Priority Health Narrow Network |
$106.33
|
| Rate for Payer: Priority Health SBD |
$18.90
|
| Rate for Payer: Railroad Medicare Medicare |
$42.22
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.22
|
| Rate for Payer: UHC Medicare Advantage |
$43.49
|
| Rate for Payer: UMR Bronson Commercial |
$11.10
|
| Rate for Payer: VA VA |
$42.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC INFLUENZA INJECTION
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
HCPCS G0008
|
| Hospital Charge Code |
77100009
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna American Axle |
$19.50
|
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health SBD |
$18.90
|
| Rate for Payer: UMR Bronson Commercial |
$13.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PRESERVATIVE FREE IM
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 90662
|
| Hospital Charge Code |
63600073
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: UMR Bronson Commercial |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC INFLUENZA VIRUS VACCINE (IIV), SPLIT VIRUS, PRESERVATIVE FREE IM
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 90662
|
| Hospital Charge Code |
63600073
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.66 |
| Max. Negotiated Rate |
$233.50 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: BCBS Complete |
$27.74
|
| Rate for Payer: BCBS Trust/PPO |
$233.50
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.40
|
| Rate for Payer: Priority Health Narrow Network |
$58.72
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: UMR Bronson Commercial |
$25.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
