|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
OP
|
$46.43
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$17.18 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$30.18
|
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: Aetna Medicare |
$143.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.86
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$32.50
|
| Rate for Payer: Cofinity Commercial |
$39.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$41.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.82
|
| Rate for Payer: Mclaren Medicaid |
$74.12
|
| Rate for Payer: Mclaren Medicare |
$138.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.20
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.47
|
| Rate for Payer: PACE Medicare |
$131.38
|
| Rate for Payer: PACE SWMI |
$138.29
|
| Rate for Payer: PHP Commercial |
$39.47
|
| Rate for Payer: PHP Medicare Advantage |
$138.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.18
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health SBD |
$29.25
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.27
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.29
|
| Rate for Payer: UHC Exchange |
$264.29
|
| Rate for Payer: UHC Medicare Advantage |
$138.29
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
| Rate for Payer: UMR Bronson Commercial |
$17.18
|
| Rate for Payer: VA VA |
$138.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.82
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
IP
|
$46.43
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$20.43 |
| Max. Negotiated Rate |
$41.79 |
| Rate for Payer: Aetna American Axle |
$30.18
|
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.18
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$32.50
|
| Rate for Payer: Cofinity Commercial |
$39.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.14
|
| Rate for Payer: Healthscope Commercial |
$41.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.47
|
| Rate for Payer: PHP Commercial |
$39.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.18
|
| Rate for Payer: Priority Health SBD |
$29.25
|
| Rate for Payer: UMR Bronson Commercial |
$20.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.82
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
IP
|
$358.58
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$157.78 |
| Max. Negotiated Rate |
$322.72 |
| Rate for Payer: Aetna American Axle |
$233.08
|
| Rate for Payer: Aetna Commercial |
$304.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.08
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cofinity Commercial |
$251.01
|
| Rate for Payer: Cofinity Commercial |
$308.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.86
|
| Rate for Payer: Healthscope Commercial |
$322.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.79
|
| Rate for Payer: PHP Commercial |
$304.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.08
|
| Rate for Payer: Priority Health SBD |
$225.91
|
| Rate for Payer: UMR Bronson Commercial |
$157.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.94
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
OP
|
$358.58
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$233.08
|
| Rate for Payer: Aetna Commercial |
$304.79
|
| Rate for Payer: Aetna Medicare |
$143.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.86
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cofinity Commercial |
$251.01
|
| Rate for Payer: Cofinity Commercial |
$308.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$322.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.94
|
| Rate for Payer: Mclaren Medicaid |
$74.12
|
| Rate for Payer: Mclaren Medicare |
$138.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.20
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.79
|
| Rate for Payer: PACE Medicare |
$131.38
|
| Rate for Payer: PACE SWMI |
$138.29
|
| Rate for Payer: PHP Commercial |
$304.79
|
| Rate for Payer: PHP Medicare Advantage |
$138.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.08
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health SBD |
$225.91
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.27
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.29
|
| Rate for Payer: UHC Exchange |
$264.29
|
| Rate for Payer: UHC Medicare Advantage |
$138.29
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
| Rate for Payer: UMR Bronson Commercial |
$132.67
|
| Rate for Payer: VA VA |
$138.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.94
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
IP
|
$300.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$132.30 |
| Max. Negotiated Rate |
$270.61 |
| Rate for Payer: Aetna American Axle |
$195.44
|
| Rate for Payer: Aetna Commercial |
$255.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.44
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cofinity Commercial |
$210.48
|
| Rate for Payer: Cofinity Commercial |
$258.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.54
|
| Rate for Payer: Healthscope Commercial |
$270.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.58
|
| Rate for Payer: PHP Commercial |
$255.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.44
|
| Rate for Payer: Priority Health SBD |
$189.43
|
| Rate for Payer: UMR Bronson Commercial |
$132.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.51
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$300.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$74.12 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$195.44
|
| Rate for Payer: Aetna Commercial |
$255.58
|
| Rate for Payer: Aetna Medicare |
$143.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.86
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cofinity Commercial |
$210.48
|
| Rate for Payer: Cofinity Commercial |
$258.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$270.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.51
|
| Rate for Payer: Mclaren Medicaid |
$74.12
|
| Rate for Payer: Mclaren Medicare |
$138.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.20
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.58
|
| Rate for Payer: PACE Medicare |
$131.38
|
| Rate for Payer: PACE SWMI |
$138.29
|
| Rate for Payer: PHP Commercial |
$255.58
|
| Rate for Payer: PHP Medicare Advantage |
$138.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.44
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health SBD |
$189.43
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.27
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.29
|
| Rate for Payer: UHC Exchange |
$264.29
|
| Rate for Payer: UHC Medicare Advantage |
$138.29
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
| Rate for Payer: UMR Bronson Commercial |
$111.25
|
| Rate for Payer: VA VA |
$138.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.51
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
IP
|
$81.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$35.94 |
| Max. Negotiated Rate |
$73.51 |
| Rate for Payer: Aetna American Axle |
$53.09
|
| Rate for Payer: Aetna Commercial |
$69.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.09
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$57.18
|
| Rate for Payer: Cofinity Commercial |
$70.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$73.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.43
|
| Rate for Payer: PHP Commercial |
$69.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.09
|
| Rate for Payer: Priority Health SBD |
$51.46
|
| Rate for Payer: UMR Bronson Commercial |
$35.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.26
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
OP
|
$81.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.22 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$53.09
|
| Rate for Payer: Aetna Commercial |
$69.43
|
| Rate for Payer: Aetna Medicare |
$143.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.86
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$57.18
|
| Rate for Payer: Cofinity Commercial |
$70.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$73.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.26
|
| Rate for Payer: Mclaren Medicaid |
$74.12
|
| Rate for Payer: Mclaren Medicare |
$138.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.20
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.43
|
| Rate for Payer: PACE Medicare |
$131.38
|
| Rate for Payer: PACE SWMI |
$138.29
|
| Rate for Payer: PHP Commercial |
$69.43
|
| Rate for Payer: PHP Medicare Advantage |
$138.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.09
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health SBD |
$51.46
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.27
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.29
|
| Rate for Payer: UHC Exchange |
$264.29
|
| Rate for Payer: UHC Medicare Advantage |
$138.29
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
| Rate for Payer: UMR Bronson Commercial |
$30.22
|
| Rate for Payer: VA VA |
$138.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.26
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$103.65
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$45.61 |
| Max. Negotiated Rate |
$93.28 |
| Rate for Payer: Aetna American Axle |
$67.37
|
| Rate for Payer: Aetna Commercial |
$88.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.37
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cofinity Commercial |
$72.56
|
| Rate for Payer: Cofinity Commercial |
$89.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.92
|
| Rate for Payer: Healthscope Commercial |
$93.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.10
|
| Rate for Payer: PHP Commercial |
$88.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.37
|
| Rate for Payer: Priority Health SBD |
$65.30
|
| Rate for Payer: UMR Bronson Commercial |
$45.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.74
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$103.65
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$38.35 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$67.37
|
| Rate for Payer: Aetna Commercial |
$88.10
|
| Rate for Payer: Aetna Medicare |
$143.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.86
|
| Rate for Payer: BCBS Complete |
$77.83
|
| Rate for Payer: BCBS MAPPO |
$138.29
|
| Rate for Payer: BCN Medicare Advantage |
$138.29
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cofinity Commercial |
$72.56
|
| Rate for Payer: Cofinity Commercial |
$89.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.29
|
| Rate for Payer: Healthscope Commercial |
$93.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.74
|
| Rate for Payer: Mclaren Medicaid |
$74.12
|
| Rate for Payer: Mclaren Medicare |
$138.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.20
|
| Rate for Payer: Meridian Medicaid |
$77.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.10
|
| Rate for Payer: PACE Medicare |
$131.38
|
| Rate for Payer: PACE SWMI |
$138.29
|
| Rate for Payer: PHP Commercial |
$88.10
|
| Rate for Payer: PHP Medicare Advantage |
$138.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.37
|
| Rate for Payer: Priority Health Medicare |
$138.29
|
| Rate for Payer: Priority Health SBD |
$65.30
|
| Rate for Payer: Railroad Medicare Medicare |
$138.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$389.27
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.29
|
| Rate for Payer: UHC Exchange |
$264.29
|
| Rate for Payer: UHC Medicare Advantage |
$138.29
|
| Rate for Payer: UHCCP Medicaid |
$74.12
|
| Rate for Payer: UMR Bronson Commercial |
$38.35
|
| Rate for Payer: VA VA |
$138.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.74
|
|
|
HC BLOOD TYPING RH
|
Facility
|
IP
|
$22.27
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.80 |
| Max. Negotiated Rate |
$20.04 |
| Rate for Payer: Aetna American Axle |
$14.48
|
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.48
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$15.59
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Healthscope Commercial |
$20.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: PHP Commercial |
$18.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: Priority Health SBD |
$14.03
|
| Rate for Payer: UMR Bronson Commercial |
$9.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.70
|
|
|
HC BLOOD TYPING RH
|
Facility
|
OP
|
$22.27
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$20.04 |
| Rate for Payer: Aetna American Axle |
$14.48
|
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: Aetna Medicare |
$3.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.74
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$2.99
|
| Rate for Payer: BCN Medicare Advantage |
$2.99
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Cofinity Commercial |
$15.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.99
|
| Rate for Payer: Healthscope Commercial |
$20.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.70
|
| Rate for Payer: Mclaren Medicaid |
$1.60
|
| Rate for Payer: Mclaren Medicare |
$2.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.14
|
| Rate for Payer: Meridian Medicaid |
$1.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: PACE Medicare |
$2.84
|
| Rate for Payer: PACE SWMI |
$2.99
|
| Rate for Payer: PHP Commercial |
$18.93
|
| Rate for Payer: PHP Medicare Advantage |
$2.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: Priority Health Medicare |
$2.99
|
| Rate for Payer: Priority Health SBD |
$14.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.42
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.99
|
| Rate for Payer: UHC Exchange |
$5.71
|
| Rate for Payer: UHC Medicare Advantage |
$2.99
|
| Rate for Payer: UHCCP Medicaid |
$1.60
|
| Rate for Payer: UMR Bronson Commercial |
$8.24
|
| Rate for Payer: VA VA |
$2.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.70
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$117.68 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$228.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$274.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$274.45
|
| Rate for Payer: BCBS Complete |
$123.57
|
| Rate for Payer: BCBS MAPPO |
$219.56
|
| Rate for Payer: BCN Medicare Advantage |
$219.56
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$219.56
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Mclaren Medicaid |
$117.68
|
| Rate for Payer: Mclaren Medicare |
$219.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$230.54
|
| Rate for Payer: Meridian Medicaid |
$123.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: PACE Medicare |
$208.58
|
| Rate for Payer: PACE SWMI |
$219.56
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$219.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health Medicare |
$219.56
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: Railroad Medicare Medicare |
$219.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$618.04
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$219.56
|
| Rate for Payer: UHC Exchange |
$419.60
|
| Rate for Payer: UHC Medicare Advantage |
$219.56
|
| Rate for Payer: UHCCP Medicaid |
$117.68
|
| Rate for Payer: UMR Bronson Commercial |
$566.10
|
| Rate for Payer: VA VA |
$219.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$673.20 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: UMR Bronson Commercial |
$673.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.86 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Aetna American Axle |
$100.24
|
| Rate for Payer: Aetna Commercial |
$131.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.24
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$107.95
|
| Rate for Payer: Cofinity Commercial |
$132.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health SBD |
$97.16
|
| Rate for Payer: UMR Bronson Commercial |
$67.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.67
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.04 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Aetna American Axle |
$100.24
|
| Rate for Payer: Aetna Commercial |
$131.09
|
| Rate for Payer: Aetna Medicare |
$40.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: BCBS Complete |
$22.10
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$132.63
|
| Rate for Payer: Cofinity Commercial |
$107.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.67
|
| Rate for Payer: Mclaren Medicaid |
$21.04
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$22.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health SBD |
$97.16
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$110.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.26
|
| Rate for Payer: UHC Exchange |
$75.03
|
| Rate for Payer: UHC Medicare Advantage |
$39.26
|
| Rate for Payer: UHCCP Medicaid |
$21.04
|
| Rate for Payer: UMR Bronson Commercial |
$57.06
|
| Rate for Payer: VA VA |
$39.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.67
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$753.11 |
| Max. Negotiated Rate |
$1,831.89 |
| Rate for Payer: Aetna American Axle |
$1,323.03
|
| Rate for Payer: Aetna Commercial |
$1,730.12
|
| Rate for Payer: Aetna Medicare |
$1,017.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,323.03
|
| Rate for Payer: BCBS Complete |
$814.17
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,750.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,424.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$1,831.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,424.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,526.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: PHP Commercial |
$1,730.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health SBD |
$1,282.32
|
| Rate for Payer: UMR Bronson Commercial |
$753.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,526.57
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$895.59 |
| Max. Negotiated Rate |
$1,831.89 |
| Rate for Payer: Aetna American Axle |
$1,323.03
|
| Rate for Payer: Aetna Commercial |
$1,730.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,323.03
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,424.80
|
| Rate for Payer: Cofinity Commercial |
$1,750.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,424.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$1,831.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,424.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,526.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: PHP Commercial |
$1,730.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health SBD |
$1,282.32
|
| Rate for Payer: UMR Bronson Commercial |
$895.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,526.57
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$953.88 |
| Max. Negotiated Rate |
$1,951.12 |
| Rate for Payer: Aetna American Axle |
$1,409.14
|
| Rate for Payer: Aetna Commercial |
$1,842.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.14
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$1,517.54
|
| Rate for Payer: Cofinity Commercial |
$1,864.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,517.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Healthscope Commercial |
$1,951.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,517.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,625.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: PHP Commercial |
$1,842.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: Priority Health SBD |
$1,365.78
|
| Rate for Payer: UMR Bronson Commercial |
$953.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,625.93
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$802.13 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,409.14
|
| Rate for Payer: Aetna Commercial |
$1,842.72
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,409.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$1,864.40
|
| Rate for Payer: Cofinity Commercial |
$1,517.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,517.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,951.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,517.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,625.93
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,842.72
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,365.78
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$802.13
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,625.93
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$763.93 |
| Max. Negotiated Rate |
$4,448.08 |
| Rate for Payer: Aetna American Axle |
$1,342.04
|
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: Aetna Medicare |
$1,643.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,975.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,975.24
|
| Rate for Payer: BCBS Complete |
$889.33
|
| Rate for Payer: BCBS MAPPO |
$1,580.19
|
| Rate for Payer: BCN Medicare Advantage |
$1,580.19
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,775.62
|
| Rate for Payer: Cofinity Commercial |
$1,445.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,445.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,580.19
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,445.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.50
|
| Rate for Payer: Mclaren Medicaid |
$846.98
|
| Rate for Payer: Mclaren Medicare |
$1,580.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,659.20
|
| Rate for Payer: Meridian Medicaid |
$889.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,817.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: PACE Medicare |
$1,501.18
|
| Rate for Payer: PACE SWMI |
$1,580.19
|
| Rate for Payer: PHP Commercial |
$1,754.97
|
| Rate for Payer: PHP Medicare Advantage |
$1,580.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$846.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: Priority Health Medicare |
$1,580.19
|
| Rate for Payer: Priority Health SBD |
$1,300.74
|
| Rate for Payer: Railroad Medicare Medicare |
$1,580.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,448.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,580.19
|
| Rate for Payer: UHC Exchange |
$3,019.90
|
| Rate for Payer: UHC Medicare Advantage |
$1,580.19
|
| Rate for Payer: UHCCP Medicaid |
$846.98
|
| Rate for Payer: UMR Bronson Commercial |
$763.93
|
| Rate for Payer: VA VA |
$1,580.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.50
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$908.45 |
| Max. Negotiated Rate |
$1,858.20 |
| Rate for Payer: Aetna American Axle |
$1,342.04
|
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,342.04
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,445.27
|
| Rate for Payer: Cofinity Commercial |
$1,775.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,445.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,445.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: PHP Commercial |
$1,754.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: Priority Health SBD |
$1,300.74
|
| Rate for Payer: UMR Bronson Commercial |
$908.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.50
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$898.74 |
| Max. Negotiated Rate |
$7,857.23 |
| Rate for Payer: Aetna American Axle |
$1,578.87
|
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: Aetna Medicare |
$2,902.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,489.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,489.12
|
| Rate for Payer: BCBS Complete |
$1,570.94
|
| Rate for Payer: BCBS MAPPO |
$2,791.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,791.30
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Cofinity Commercial |
$1,700.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,700.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,791.30
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,700.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,821.77
|
| Rate for Payer: Mclaren Medicaid |
$1,496.14
|
| Rate for Payer: Mclaren Medicare |
$2,791.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,930.86
|
| Rate for Payer: Meridian Medicaid |
$1,570.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,209.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: PACE Medicare |
$2,651.74
|
| Rate for Payer: PACE SWMI |
$2,791.30
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: PHP Medicare Advantage |
$2,791.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,496.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health Medicare |
$2,791.30
|
| Rate for Payer: Priority Health SBD |
$1,530.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,791.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,857.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,791.30
|
| Rate for Payer: UHC Exchange |
$5,334.45
|
| Rate for Payer: UHC Medicare Advantage |
$2,791.30
|
| Rate for Payer: UHCCP Medicaid |
$1,496.14
|
| Rate for Payer: UMR Bronson Commercial |
$898.74
|
| Rate for Payer: VA VA |
$2,791.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,821.77
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,068.77 |
| Max. Negotiated Rate |
$2,186.13 |
| Rate for Payer: Aetna American Axle |
$1,578.87
|
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,578.87
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$1,700.32
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,700.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,700.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health SBD |
$1,530.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,068.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,821.77
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$73.80 |
| Max. Negotiated Rate |
$150.96 |
| Rate for Payer: Aetna American Axle |
$109.02
|
| Rate for Payer: Aetna Commercial |
$142.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.02
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$117.41
|
| Rate for Payer: Cofinity Commercial |
$144.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: PHP Commercial |
$142.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health SBD |
$105.67
|
| Rate for Payer: UMR Bronson Commercial |
$73.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.80
|
|
