|
HC BILIARY BRUSH BIOPSY
|
Facility
|
OP
|
$4,068.04
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,505.17 |
| Max. Negotiated Rate |
$17,130.07 |
| Rate for Payer: Aetna American Axle |
$2,644.23
|
| Rate for Payer: Aetna Commercial |
$3,457.83
|
| Rate for Payer: Aetna Medicare |
$6,328.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,644.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,606.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,606.88
|
| Rate for Payer: BCBS Complete |
$3,424.92
|
| Rate for Payer: BCBS MAPPO |
$6,085.50
|
| Rate for Payer: BCN Medicare Advantage |
$6,085.50
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cofinity Commercial |
$3,498.51
|
| Rate for Payer: Cofinity Commercial |
$2,847.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,847.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,254.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,085.50
|
| Rate for Payer: Healthscope Commercial |
$3,661.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,847.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,051.03
|
| Rate for Payer: Mclaren Medicaid |
$3,261.83
|
| Rate for Payer: Mclaren Medicare |
$6,085.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,389.77
|
| Rate for Payer: Meridian Medicaid |
$3,424.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,998.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,457.83
|
| Rate for Payer: PACE Medicare |
$5,781.23
|
| Rate for Payer: PACE SWMI |
$6,085.50
|
| Rate for Payer: PHP Commercial |
$3,457.83
|
| Rate for Payer: PHP Medicare Advantage |
$6,085.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,261.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,644.23
|
| Rate for Payer: Priority Health Medicare |
$6,085.50
|
| Rate for Payer: Priority Health SBD |
$2,562.87
|
| Rate for Payer: Railroad Medicare Medicare |
$6,085.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,130.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,085.50
|
| Rate for Payer: UHC Exchange |
$11,630.00
|
| Rate for Payer: UHC Medicare Advantage |
$6,085.50
|
| Rate for Payer: UHCCP Medicaid |
$3,261.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,505.17
|
| Rate for Payer: VA VA |
$6,085.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,051.03
|
|
|
HC BILIARY BRUSH BIOPSY
|
Facility
|
IP
|
$4,068.04
|
|
|
Service Code
|
CPT 47552
|
| Hospital Charge Code |
36100207
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,789.94 |
| Max. Negotiated Rate |
$3,661.24 |
| Rate for Payer: Aetna American Axle |
$2,644.23
|
| Rate for Payer: Aetna Commercial |
$3,457.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,644.23
|
| Rate for Payer: Cash Price |
$3,254.43
|
| Rate for Payer: Cofinity Commercial |
$2,847.63
|
| Rate for Payer: Cofinity Commercial |
$3,498.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,847.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,254.43
|
| Rate for Payer: Healthscope Commercial |
$3,661.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,847.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,051.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,457.83
|
| Rate for Payer: PHP Commercial |
$3,457.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,644.23
|
| Rate for Payer: Priority Health SBD |
$2,562.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,789.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,051.03
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
IP
|
$469.09
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$206.40 |
| Max. Negotiated Rate |
$422.18 |
| Rate for Payer: Aetna American Axle |
$304.91
|
| Rate for Payer: Aetna Commercial |
$398.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.91
|
| Rate for Payer: Cash Price |
$375.27
|
| Rate for Payer: Cofinity Commercial |
$328.36
|
| Rate for Payer: Cofinity Commercial |
$403.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$328.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.27
|
| Rate for Payer: Healthscope Commercial |
$422.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$328.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.73
|
| Rate for Payer: PHP Commercial |
$398.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.91
|
| Rate for Payer: Priority Health SBD |
$295.53
|
| Rate for Payer: UMR Bronson Commercial |
$206.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.82
|
|
|
HC BILIARY DRAINAGE
|
Facility
|
OP
|
$469.09
|
|
| Hospital Charge Code |
36000010
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$173.56 |
| Max. Negotiated Rate |
$422.18 |
| Rate for Payer: Aetna American Axle |
$304.91
|
| Rate for Payer: Aetna Commercial |
$398.73
|
| Rate for Payer: Aetna Medicare |
$234.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$304.91
|
| Rate for Payer: BCBS Complete |
$187.64
|
| Rate for Payer: Cash Price |
$375.27
|
| Rate for Payer: Cofinity Commercial |
$328.36
|
| Rate for Payer: Cofinity Commercial |
$403.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$328.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$375.27
|
| Rate for Payer: Healthscope Commercial |
$422.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$328.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$351.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$398.73
|
| Rate for Payer: PHP Commercial |
$398.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$304.91
|
| Rate for Payer: Priority Health SBD |
$295.53
|
| Rate for Payer: UMR Bronson Commercial |
$173.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$351.82
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
IP
|
$1,855.62
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$816.47 |
| Max. Negotiated Rate |
$1,670.06 |
| Rate for Payer: Aetna American Axle |
$1,206.15
|
| Rate for Payer: Aetna Commercial |
$1,577.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.15
|
| Rate for Payer: Cash Price |
$1,484.50
|
| Rate for Payer: Cofinity Commercial |
$1,298.93
|
| Rate for Payer: Cofinity Commercial |
$1,595.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,298.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.50
|
| Rate for Payer: Healthscope Commercial |
$1,670.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,298.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,391.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,577.28
|
| Rate for Payer: PHP Commercial |
$1,577.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.15
|
| Rate for Payer: Priority Health SBD |
$1,169.04
|
| Rate for Payer: UMR Bronson Commercial |
$816.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,391.71
|
|
|
HC BILIARY DUCT BALLOON DILATATIO
|
Facility
|
OP
|
$1,855.62
|
|
| Hospital Charge Code |
36000011
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$686.58 |
| Max. Negotiated Rate |
$1,670.06 |
| Rate for Payer: Aetna American Axle |
$1,206.15
|
| Rate for Payer: Aetna Commercial |
$1,577.28
|
| Rate for Payer: Aetna Medicare |
$927.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,206.15
|
| Rate for Payer: BCBS Complete |
$742.25
|
| Rate for Payer: Cash Price |
$1,484.50
|
| Rate for Payer: Cofinity Commercial |
$1,298.93
|
| Rate for Payer: Cofinity Commercial |
$1,595.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,298.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,484.50
|
| Rate for Payer: Healthscope Commercial |
$1,670.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,298.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,391.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,577.28
|
| Rate for Payer: PHP Commercial |
$1,577.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,206.15
|
| Rate for Payer: Priority Health SBD |
$1,169.04
|
| Rate for Payer: UMR Bronson Commercial |
$686.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,391.71
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
IP
|
$28,810.00
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$12,676.40 |
| Max. Negotiated Rate |
$25,929.00 |
| Rate for Payer: Aetna American Axle |
$18,726.50
|
| Rate for Payer: Aetna Commercial |
$24,488.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,726.50
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cofinity Commercial |
$20,167.00
|
| Rate for Payer: Cofinity Commercial |
$24,776.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,167.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,048.00
|
| Rate for Payer: Healthscope Commercial |
$25,929.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,167.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,607.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,488.50
|
| Rate for Payer: PHP Commercial |
$24,488.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,726.50
|
| Rate for Payer: Priority Health SBD |
$18,150.30
|
| Rate for Payer: UMR Bronson Commercial |
$12,676.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,607.50
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX REMV CALCULI
|
Facility
|
OP
|
$28,810.00
|
|
|
Service Code
|
CPT 47554
|
| Hospital Charge Code |
36100633
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,442.46 |
| Max. Negotiated Rate |
$28,582.07 |
| Rate for Payer: Aetna American Axle |
$18,726.50
|
| Rate for Payer: Aetna Commercial |
$24,488.50
|
| Rate for Payer: Aetna Medicare |
$10,560.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,726.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12,692.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12,692.31
|
| Rate for Payer: BCBS Complete |
$5,714.59
|
| Rate for Payer: BCBS MAPPO |
$10,153.85
|
| Rate for Payer: BCN Medicare Advantage |
$10,153.85
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cash Price |
$23,048.00
|
| Rate for Payer: Cofinity Commercial |
$24,776.60
|
| Rate for Payer: Cofinity Commercial |
$20,167.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,167.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,048.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10,153.85
|
| Rate for Payer: Healthscope Commercial |
$25,929.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,167.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,607.50
|
| Rate for Payer: Mclaren Medicaid |
$5,442.46
|
| Rate for Payer: Mclaren Medicare |
$10,153.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10,661.54
|
| Rate for Payer: Meridian Medicaid |
$5,714.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,676.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24,488.50
|
| Rate for Payer: PACE Medicare |
$9,646.16
|
| Rate for Payer: PACE SWMI |
$10,153.85
|
| Rate for Payer: PHP Commercial |
$24,488.50
|
| Rate for Payer: PHP Medicare Advantage |
$10,153.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,442.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18,726.50
|
| Rate for Payer: Priority Health Medicare |
$10,153.85
|
| Rate for Payer: Priority Health SBD |
$18,150.30
|
| Rate for Payer: Railroad Medicare Medicare |
$10,153.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28,582.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10,153.85
|
| Rate for Payer: UHC Exchange |
$19,405.02
|
| Rate for Payer: UHC Medicare Advantage |
$10,153.85
|
| Rate for Payer: UHCCP Medicaid |
$5,442.46
|
| Rate for Payer: UMR Bronson Commercial |
$10,659.70
|
| Rate for Payer: VA VA |
$10,153.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,607.50
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
OP
|
$21,200.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,261.83 |
| Max. Negotiated Rate |
$19,080.00 |
| Rate for Payer: Aetna American Axle |
$13,780.00
|
| Rate for Payer: Aetna Commercial |
$18,020.00
|
| Rate for Payer: Aetna Medicare |
$6,328.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,780.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7,606.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7,606.88
|
| Rate for Payer: BCBS Complete |
$3,424.92
|
| Rate for Payer: BCBS MAPPO |
$6,085.50
|
| Rate for Payer: BCN Medicare Advantage |
$6,085.50
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cofinity Commercial |
$18,232.00
|
| Rate for Payer: Cofinity Commercial |
$14,840.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$14,840.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,960.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,085.50
|
| Rate for Payer: Healthscope Commercial |
$19,080.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,840.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,900.00
|
| Rate for Payer: Mclaren Medicaid |
$3,261.83
|
| Rate for Payer: Mclaren Medicare |
$6,085.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6,389.77
|
| Rate for Payer: Meridian Medicaid |
$3,424.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,998.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,020.00
|
| Rate for Payer: PACE Medicare |
$5,781.23
|
| Rate for Payer: PACE SWMI |
$6,085.50
|
| Rate for Payer: PHP Commercial |
$18,020.00
|
| Rate for Payer: PHP Medicare Advantage |
$6,085.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,261.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,780.00
|
| Rate for Payer: Priority Health Medicare |
$6,085.50
|
| Rate for Payer: Priority Health SBD |
$13,356.00
|
| Rate for Payer: Railroad Medicare Medicare |
$6,085.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,130.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$6,085.50
|
| Rate for Payer: UHC Exchange |
$11,630.00
|
| Rate for Payer: UHC Medicare Advantage |
$6,085.50
|
| Rate for Payer: UHCCP Medicaid |
$3,261.83
|
| Rate for Payer: UMR Bronson Commercial |
$7,844.00
|
| Rate for Payer: VA VA |
$6,085.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,900.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W BX SING OR MULTI
|
Facility
|
IP
|
$21,200.00
|
|
|
Service Code
|
CPT 47553
|
| Hospital Charge Code |
36100632
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$9,328.00 |
| Max. Negotiated Rate |
$19,080.00 |
| Rate for Payer: Aetna American Axle |
$13,780.00
|
| Rate for Payer: Aetna Commercial |
$18,020.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13,780.00
|
| Rate for Payer: Cash Price |
$16,960.00
|
| Rate for Payer: Cofinity Commercial |
$14,840.00
|
| Rate for Payer: Cofinity Commercial |
$18,232.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$14,840.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16,960.00
|
| Rate for Payer: Healthscope Commercial |
$19,080.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14,840.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15,900.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18,020.00
|
| Rate for Payer: PHP Commercial |
$18,020.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13,780.00
|
| Rate for Payer: Priority Health SBD |
$13,356.00
|
| Rate for Payer: UMR Bronson Commercial |
$9,328.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15,900.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
OP
|
$9,700.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,844.82 |
| Max. Negotiated Rate |
$9,688.38 |
| Rate for Payer: Aetna American Axle |
$6,305.00
|
| Rate for Payer: Aetna Commercial |
$8,245.00
|
| Rate for Payer: Aetna Medicare |
$3,579.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,305.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,302.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,302.27
|
| Rate for Payer: BCBS Complete |
$1,937.06
|
| Rate for Payer: BCBS MAPPO |
$3,441.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,441.82
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cofinity Commercial |
$8,342.00
|
| Rate for Payer: Cofinity Commercial |
$6,790.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,790.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,760.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,441.82
|
| Rate for Payer: Healthscope Commercial |
$8,730.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,790.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,275.00
|
| Rate for Payer: Mclaren Medicaid |
$1,844.82
|
| Rate for Payer: Mclaren Medicare |
$3,441.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,613.91
|
| Rate for Payer: Meridian Medicaid |
$1,937.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,958.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,245.00
|
| Rate for Payer: PACE Medicare |
$3,269.73
|
| Rate for Payer: PACE SWMI |
$3,441.82
|
| Rate for Payer: PHP Commercial |
$8,245.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,441.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,844.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,305.00
|
| Rate for Payer: Priority Health Medicare |
$3,441.82
|
| Rate for Payer: Priority Health SBD |
$6,111.00
|
| Rate for Payer: Railroad Medicare Medicare |
$3,441.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,688.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,441.82
|
| Rate for Payer: UHC Exchange |
$6,577.66
|
| Rate for Payer: UHC Medicare Advantage |
$3,441.82
|
| Rate for Payer: UHCCP Medicaid |
$1,844.82
|
| Rate for Payer: UMR Bronson Commercial |
$3,589.00
|
| Rate for Payer: VA VA |
$3,441.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,275.00
|
|
|
HC BILIARY ENDO PERC VIA T-TUBE/OTHER TRACT W DIL OF BIL STRICT WO STENT
|
Facility
|
IP
|
$9,700.00
|
|
|
Service Code
|
CPT 47555
|
| Hospital Charge Code |
36100634
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,268.00 |
| Max. Negotiated Rate |
$8,730.00 |
| Rate for Payer: Aetna American Axle |
$6,305.00
|
| Rate for Payer: Aetna Commercial |
$8,245.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,305.00
|
| Rate for Payer: Cash Price |
$7,760.00
|
| Rate for Payer: Cofinity Commercial |
$6,790.00
|
| Rate for Payer: Cofinity Commercial |
$8,342.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,790.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,760.00
|
| Rate for Payer: Healthscope Commercial |
$8,730.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,790.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,275.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,245.00
|
| Rate for Payer: PHP Commercial |
$8,245.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,305.00
|
| Rate for Payer: Priority Health SBD |
$6,111.00
|
| Rate for Payer: UMR Bronson Commercial |
$4,268.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,275.00
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: UMR Bronson Commercial |
$9.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC BILIRUBIN DIRECT
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82248
|
| Hospital Charge Code |
30100118
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Exchange |
$9.59
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UHCCP Medicaid |
$2.69
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$5.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Exchange |
$9.59
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UHCCP Medicaid |
$2.69
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$5.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC BILIRUBIN TOTAL
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82247
|
| Hospital Charge Code |
30100117
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: UMR Bronson Commercial |
$9.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
IP
|
$47.48
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.89 |
| Max. Negotiated Rate |
$42.73 |
| Rate for Payer: Aetna American Axle |
$30.86
|
| Rate for Payer: Aetna Commercial |
$40.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.86
|
| Rate for Payer: Cash Price |
$37.98
|
| Rate for Payer: Cofinity Commercial |
$33.24
|
| Rate for Payer: Cofinity Commercial |
$40.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.98
|
| Rate for Payer: Healthscope Commercial |
$42.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.36
|
| Rate for Payer: PHP Commercial |
$40.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.86
|
| Rate for Payer: Priority Health SBD |
$29.91
|
| Rate for Payer: UMR Bronson Commercial |
$20.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.61
|
|
|
HC BILIRUBIN TOTAL TRANSCUTANEOUS
|
Facility
|
OP
|
$47.48
|
|
|
Service Code
|
CPT 88720
|
| Hospital Charge Code |
30100694
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$42.73 |
| Rate for Payer: Aetna American Axle |
$30.86
|
| Rate for Payer: Aetna Commercial |
$40.36
|
| Rate for Payer: Aetna Medicare |
$5.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.28
|
| Rate for Payer: BCBS Complete |
$2.83
|
| Rate for Payer: BCBS MAPPO |
$5.02
|
| Rate for Payer: BCN Medicare Advantage |
$5.02
|
| Rate for Payer: Cash Price |
$37.98
|
| Rate for Payer: Cash Price |
$37.98
|
| Rate for Payer: Cofinity Commercial |
$40.83
|
| Rate for Payer: Cofinity Commercial |
$33.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.02
|
| Rate for Payer: Healthscope Commercial |
$42.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.61
|
| Rate for Payer: Mclaren Medicaid |
$2.69
|
| Rate for Payer: Mclaren Medicare |
$5.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.27
|
| Rate for Payer: Meridian Medicaid |
$2.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.36
|
| Rate for Payer: PACE Medicare |
$4.77
|
| Rate for Payer: PACE SWMI |
$5.02
|
| Rate for Payer: PHP Commercial |
$40.36
|
| Rate for Payer: PHP Medicare Advantage |
$5.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.86
|
| Rate for Payer: Priority Health Medicare |
$5.02
|
| Rate for Payer: Priority Health SBD |
$29.91
|
| Rate for Payer: Railroad Medicare Medicare |
$5.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.02
|
| Rate for Payer: UHC Exchange |
$9.59
|
| Rate for Payer: UHC Medicare Advantage |
$5.02
|
| Rate for Payer: UHCCP Medicaid |
$2.69
|
| Rate for Payer: UMR Bronson Commercial |
$17.57
|
| Rate for Payer: VA VA |
$5.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.61
|
|
|
HC BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
OP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$174.92 |
| Rate for Payer: Aetna American Axle |
$66.08
|
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.25
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$64.05
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$118.76
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$37.61
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.25
|
|
|
HC BILL ONLY URINE DRUG SCR8 AUTO
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000141
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$91.49 |
| Rate for Payer: Aetna American Axle |
$66.08
|
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health SBD |
$64.05
|
| Rate for Payer: UMR Bronson Commercial |
$44.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.25
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: UMR Bronson Commercial |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC BILL ONLY URINE DRUG SCR8 MAN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000135
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$24.08
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
OP
|
$101.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$174.92 |
| Rate for Payer: Aetna American Axle |
$66.27
|
| Rate for Payer: Aetna Commercial |
$86.66
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cofinity Commercial |
$87.68
|
| Rate for Payer: Cofinity Commercial |
$71.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$91.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.46
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.66
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$86.66
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$118.76
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$37.72
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.46
|
|
|
HC BILL ONLY URINE DRUG SCR AUTO
|
Facility
|
IP
|
$101.95
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000142
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.86 |
| Max. Negotiated Rate |
$91.75 |
| Rate for Payer: Aetna American Axle |
$66.27
|
| Rate for Payer: Aetna Commercial |
$86.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Cash Price |
$81.56
|
| Rate for Payer: Cofinity Commercial |
$71.36
|
| Rate for Payer: Cofinity Commercial |
$87.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.56
|
| Rate for Payer: Healthscope Commercial |
$91.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.66
|
| Rate for Payer: PHP Commercial |
$86.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.27
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: UMR Bronson Commercial |
$44.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.46
|
|
|
HC BILL ONLY URINE DRUG SCR MAN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000143
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$24.08
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
