|
HC BRUCELLA ANTIBODY CMPT
|
Facility
|
IP
|
$73.44
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200238
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.31 |
| Max. Negotiated Rate |
$66.10 |
| Rate for Payer: Aetna American Axle |
$47.74
|
| Rate for Payer: Aetna Commercial |
$62.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.74
|
| Rate for Payer: Cash Price |
$58.75
|
| Rate for Payer: Cofinity Commercial |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$63.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.75
|
| Rate for Payer: Healthscope Commercial |
$66.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.42
|
| Rate for Payer: PHP Commercial |
$62.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.74
|
| Rate for Payer: Priority Health SBD |
$46.27
|
| Rate for Payer: UMR Bronson Commercial |
$32.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.08
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna American Axle |
$34.48
|
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna Medicare |
$9.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$5.03
|
| Rate for Payer: BCBS MAPPO |
$8.93
|
| Rate for Payer: BCBS Trust/PPO |
$8.61
|
| Rate for Payer: BCN Commercial |
$8.61
|
| Rate for Payer: BCN Medicare Advantage |
$8.93
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.93
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Mclaren Medicaid |
$4.79
|
| Rate for Payer: Mclaren Medicare |
$8.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.38
|
| Rate for Payer: Meridian Medicaid |
$5.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: Nomi Health Commercial |
$13.40
|
| Rate for Payer: PACE Medicare |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.93
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: PHP Medicare Advantage |
$8.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.19
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow Network |
$7.35
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: Railroad Medicare Medicare |
$8.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.93
|
| Rate for Payer: UHC Exchange |
$8.93
|
| Rate for Payer: UHC Medicare Advantage |
$8.93
|
| Rate for Payer: UHCCP Medicaid |
$4.79
|
| Rate for Payer: UMR Bronson Commercial |
$19.62
|
| Rate for Payer: VA VA |
$8.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC BRUCELLA ANTIBODY CONFIRMATION
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 86622
|
| Hospital Charge Code |
30200237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.34 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna American Axle |
$34.48
|
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: UMR Bronson Commercial |
$23.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
IP
|
$29.35
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$26.42 |
| Rate for Payer: Aetna American Axle |
$19.08
|
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.08
|
| Rate for Payer: Cash Price |
$23.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Cofinity Commercial |
$25.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.48
|
| Rate for Payer: Healthscope Commercial |
$26.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.95
|
| Rate for Payer: PHP Commercial |
$24.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.08
|
| Rate for Payer: Priority Health SBD |
$18.49
|
| Rate for Payer: UMR Bronson Commercial |
$12.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.01
|
|
|
HC BUDESONIDE INHALATION SOLUTION
|
Facility
|
OP
|
$29.35
|
|
| Hospital Charge Code |
63700005
|
|
Hospital Revenue Code
|
637
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$26.42 |
| Rate for Payer: Aetna American Axle |
$19.08
|
| Rate for Payer: Aetna Commercial |
$24.95
|
| Rate for Payer: Aetna Medicare |
$14.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.08
|
| Rate for Payer: BCBS Complete |
$11.74
|
| Rate for Payer: Cash Price |
$23.48
|
| Rate for Payer: Cofinity Commercial |
$20.54
|
| Rate for Payer: Cofinity Commercial |
$25.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$20.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.48
|
| Rate for Payer: Healthscope Commercial |
$26.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.95
|
| Rate for Payer: PHP Commercial |
$24.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.08
|
| Rate for Payer: Priority Health SBD |
$18.49
|
| Rate for Payer: UMR Bronson Commercial |
$10.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.01
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
IP
|
$4,021.38
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,769.41 |
| Max. Negotiated Rate |
$3,619.24 |
| Rate for Payer: Aetna American Axle |
$2,613.90
|
| Rate for Payer: Aetna Commercial |
$3,418.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,613.90
|
| Rate for Payer: Cash Price |
$3,217.10
|
| Rate for Payer: Cofinity Commercial |
$2,814.97
|
| Rate for Payer: Cofinity Commercial |
$3,458.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,814.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,217.10
|
| Rate for Payer: Healthscope Commercial |
$3,619.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,814.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,016.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,418.17
|
| Rate for Payer: PHP Commercial |
$3,418.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,613.90
|
| Rate for Payer: Priority Health SBD |
$2,533.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,769.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,016.04
|
|
|
HC BUNDLE OF HIS RECORDING
|
Facility
|
OP
|
$4,021.38
|
|
|
Service Code
|
CPT 93600
|
| Hospital Charge Code |
48100029
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,487.91 |
| Max. Negotiated Rate |
$23,367.06 |
| Rate for Payer: Aetna American Axle |
$2,613.90
|
| Rate for Payer: Aetna Commercial |
$3,418.17
|
| Rate for Payer: Aetna Medicare |
$7,732.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,613.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,293.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,293.34
|
| Rate for Payer: BCBS Complete |
$4,184.23
|
| Rate for Payer: BCBS MAPPO |
$7,434.67
|
| Rate for Payer: BCBS Trust/PPO |
$18,830.78
|
| Rate for Payer: BCN Commercial |
$18,830.78
|
| Rate for Payer: BCN Medicare Advantage |
$7,434.67
|
| Rate for Payer: Cash Price |
$3,217.10
|
| Rate for Payer: Cash Price |
$3,217.10
|
| Rate for Payer: Cash Price |
$3,217.10
|
| Rate for Payer: Cofinity Commercial |
$3,458.39
|
| Rate for Payer: Cofinity Commercial |
$2,814.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,814.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,217.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,434.67
|
| Rate for Payer: Healthscope Commercial |
$3,619.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,814.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,016.04
|
| Rate for Payer: Mclaren Medicaid |
$3,984.98
|
| Rate for Payer: Mclaren Medicare |
$7,434.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,806.40
|
| Rate for Payer: Meridian Medicaid |
$4,184.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,549.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,418.17
|
| Rate for Payer: Nomi Health Commercial |
$15,612.81
|
| Rate for Payer: PACE Medicare |
$7,062.94
|
| Rate for Payer: PACE SWMI |
$7,434.67
|
| Rate for Payer: PHP Commercial |
$3,418.17
|
| Rate for Payer: PHP Medicare Advantage |
$7,434.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,984.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,613.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23,367.06
|
| Rate for Payer: Priority Health Medicare |
$7,434.67
|
| Rate for Payer: Priority Health Narrow Network |
$18,693.65
|
| Rate for Payer: Priority Health SBD |
$2,533.47
|
| Rate for Payer: Railroad Medicare Medicare |
$7,434.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20,927.85
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$7,434.67
|
| Rate for Payer: UHC Exchange |
$14,208.40
|
| Rate for Payer: UHC Medicare Advantage |
$7,434.67
|
| Rate for Payer: UHCCP Medicaid |
$3,984.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,487.91
|
| Rate for Payer: VA VA |
$7,434.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,016.04
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
OP
|
$1.51
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$1.36 |
| Rate for Payer: Aetna American Axle |
$0.98
|
| Rate for Payer: Aetna Commercial |
$1.28
|
| Rate for Payer: Aetna Medicare |
$0.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.98
|
| Rate for Payer: BCBS Complete |
$0.60
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$1.21
|
| Rate for Payer: Cash Price |
$1.21
|
| Rate for Payer: Cofinity Commercial |
$1.06
|
| Rate for Payer: Cofinity Commercial |
$1.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.21
|
| Rate for Payer: Healthscope Commercial |
$1.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.28
|
| Rate for Payer: PHP Commercial |
$1.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.98
|
| Rate for Payer: Priority Health SBD |
$0.95
|
| Rate for Payer: UMR Bronson Commercial |
$0.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.13
|
|
|
HC BUPIVACAINE 0.5 MG
|
Facility
|
IP
|
$1.51
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
25000016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.66 |
| Max. Negotiated Rate |
$1.36 |
| Rate for Payer: Aetna American Axle |
$0.98
|
| Rate for Payer: Aetna Commercial |
$1.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.98
|
| Rate for Payer: Cash Price |
$1.21
|
| Rate for Payer: Cofinity Commercial |
$1.06
|
| Rate for Payer: Cofinity Commercial |
$1.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.21
|
| Rate for Payer: Healthscope Commercial |
$1.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.28
|
| Rate for Payer: PHP Commercial |
$1.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.98
|
| Rate for Payer: Priority Health SBD |
$0.95
|
| Rate for Payer: UMR Bronson Commercial |
$0.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.13
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
OP
|
$177.48
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.62 |
| Max. Negotiated Rate |
$159.73 |
| Rate for Payer: Aetna American Axle |
$115.36
|
| Rate for Payer: Aetna Commercial |
$150.86
|
| Rate for Payer: Aetna Medicare |
$88.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.36
|
| Rate for Payer: BCBS Complete |
$70.99
|
| Rate for Payer: Cash Price |
$141.98
|
| Rate for Payer: Cash Price |
$141.98
|
| Rate for Payer: Cofinity Commercial |
$152.63
|
| Rate for Payer: Cofinity Commercial |
$124.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$124.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.98
|
| Rate for Payer: Healthscope Commercial |
$159.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.86
|
| Rate for Payer: PHP Commercial |
$150.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.36
|
| Rate for Payer: Priority Health SBD |
$111.81
|
| Rate for Payer: UHC Core |
$25.62
|
| Rate for Payer: UMR Bronson Commercial |
$65.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.11
|
|
|
HC BUPRENORPHINE & MET QUANT, UR
|
Facility
|
IP
|
$177.48
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30100598
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.09 |
| Max. Negotiated Rate |
$159.73 |
| Rate for Payer: Aetna American Axle |
$115.36
|
| Rate for Payer: Aetna Commercial |
$150.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.36
|
| Rate for Payer: Cash Price |
$141.98
|
| Rate for Payer: Cofinity Commercial |
$124.24
|
| Rate for Payer: Cofinity Commercial |
$152.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$124.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.98
|
| Rate for Payer: Healthscope Commercial |
$159.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.86
|
| Rate for Payer: PHP Commercial |
$150.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.36
|
| Rate for Payer: Priority Health SBD |
$111.81
|
| Rate for Payer: UMR Bronson Commercial |
$78.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.11
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC BUPRENORPHINE SCRN URN
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000116
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| 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: BCBS Trust/PPO |
$12.14
|
| Rate for Payer: BCN Commercial |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| 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 |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$35.38
|
| 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 |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$10.08
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$12.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC BURN CARE LARGE
|
Facility
|
IP
|
$691.65
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$304.33 |
| Max. Negotiated Rate |
$622.48 |
| Rate for Payer: Aetna American Axle |
$449.57
|
| Rate for Payer: Aetna Commercial |
$587.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.57
|
| Rate for Payer: Cash Price |
$553.32
|
| Rate for Payer: Cofinity Commercial |
$484.16
|
| Rate for Payer: Cofinity Commercial |
$594.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$484.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.32
|
| Rate for Payer: Healthscope Commercial |
$622.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.90
|
| Rate for Payer: PHP Commercial |
$587.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.57
|
| Rate for Payer: Priority Health SBD |
$435.74
|
| Rate for Payer: UMR Bronson Commercial |
$304.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC BURN CARE LARGE
|
Facility
|
OP
|
$691.65
|
|
|
Service Code
|
CPT 16030
|
| Hospital Charge Code |
36100007
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$127.49 |
| Max. Negotiated Rate |
$1,230.33 |
| Rate for Payer: Aetna American Axle |
$449.57
|
| Rate for Payer: Aetna Commercial |
$587.90
|
| Rate for Payer: Aetna Medicare |
$407.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$449.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.31
|
| Rate for Payer: BCBS Complete |
$220.31
|
| Rate for Payer: BCBS MAPPO |
$391.45
|
| Rate for Payer: BCBS Trust/PPO |
$246.29
|
| Rate for Payer: BCN Commercial |
$246.29
|
| Rate for Payer: BCN Medicare Advantage |
$391.45
|
| Rate for Payer: Cash Price |
$553.32
|
| Rate for Payer: Cash Price |
$553.32
|
| Rate for Payer: Cash Price |
$553.32
|
| Rate for Payer: Cofinity Commercial |
$594.82
|
| Rate for Payer: Cofinity Commercial |
$484.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$484.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$553.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.45
|
| Rate for Payer: Healthscope Commercial |
$622.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$518.74
|
| Rate for Payer: Mclaren Medicaid |
$209.82
|
| Rate for Payer: Mclaren Medicare |
$391.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.02
|
| Rate for Payer: Meridian Medicaid |
$220.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$587.90
|
| Rate for Payer: Nomi Health Commercial |
$822.04
|
| Rate for Payer: PACE Medicare |
$371.88
|
| Rate for Payer: PACE SWMI |
$391.45
|
| Rate for Payer: PHP Commercial |
$587.90
|
| Rate for Payer: PHP Medicare Advantage |
$391.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$449.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,230.33
|
| Rate for Payer: Priority Health Medicare |
$391.45
|
| Rate for Payer: Priority Health Narrow Network |
$984.26
|
| Rate for Payer: Priority Health SBD |
$435.74
|
| Rate for Payer: Railroad Medicare Medicare |
$391.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.24
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.45
|
| Rate for Payer: UHC Exchange |
$127.49
|
| Rate for Payer: UHC Medicare Advantage |
$391.45
|
| Rate for Payer: UHCCP Medicaid |
$209.82
|
| Rate for Payer: UMR Bronson Commercial |
$255.91
|
| Rate for Payer: VA VA |
$391.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$518.74
|
|
|
HC BURN CARE MEDIUM
|
Facility
|
OP
|
$531.94
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
36100006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$104.35 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$345.76
|
| Rate for Payer: Aetna Commercial |
$452.15
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$202.54
|
| Rate for Payer: BCN Commercial |
$202.54
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$425.55
|
| Rate for Payer: Cash Price |
$425.55
|
| Rate for Payer: Cash Price |
$425.55
|
| Rate for Payer: Cofinity Commercial |
$457.47
|
| Rate for Payer: Cofinity Commercial |
$372.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$372.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$478.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$372.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.96
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.15
|
| Rate for Payer: Nomi Health Commercial |
$408.83
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$452.15
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$335.12
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.91
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$107.19
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: UMR Bronson Commercial |
$196.82
|
| Rate for Payer: VA VA |
$194.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.96
|
|
|
HC BURN CARE MEDIUM
|
Facility
|
IP
|
$531.94
|
|
|
Service Code
|
CPT 16025
|
| Hospital Charge Code |
36100006
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$234.05 |
| Max. Negotiated Rate |
$478.75 |
| Rate for Payer: Aetna American Axle |
$345.76
|
| Rate for Payer: Aetna Commercial |
$452.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$345.76
|
| Rate for Payer: Cash Price |
$425.55
|
| Rate for Payer: Cofinity Commercial |
$372.36
|
| Rate for Payer: Cofinity Commercial |
$457.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$372.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$425.55
|
| Rate for Payer: Healthscope Commercial |
$478.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$372.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$398.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$452.15
|
| Rate for Payer: PHP Commercial |
$452.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$345.76
|
| Rate for Payer: Priority Health SBD |
$335.12
|
| Rate for Payer: UMR Bronson Commercial |
$234.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$398.96
|
|
|
HC BURN CARE SMALL
|
Facility
|
IP
|
$365.20
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
36100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$160.69 |
| Max. Negotiated Rate |
$328.68 |
| Rate for Payer: Aetna American Axle |
$237.38
|
| Rate for Payer: Aetna Commercial |
$310.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.38
|
| Rate for Payer: Cash Price |
$292.16
|
| Rate for Payer: Cofinity Commercial |
$255.64
|
| Rate for Payer: Cofinity Commercial |
$314.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$255.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.16
|
| Rate for Payer: Healthscope Commercial |
$328.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.42
|
| Rate for Payer: PHP Commercial |
$310.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.38
|
| Rate for Payer: Priority Health SBD |
$230.08
|
| Rate for Payer: UMR Bronson Commercial |
$160.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.90
|
|
|
HC BURN CARE SMALL
|
Facility
|
OP
|
$365.20
|
|
|
Service Code
|
CPT 16020
|
| Hospital Charge Code |
36100005
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$53.21 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$237.38
|
| Rate for Payer: Aetna Commercial |
$310.42
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$237.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$202.54
|
| Rate for Payer: BCN Commercial |
$202.54
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$292.16
|
| Rate for Payer: Cash Price |
$292.16
|
| Rate for Payer: Cash Price |
$292.16
|
| Rate for Payer: Cofinity Commercial |
$255.64
|
| Rate for Payer: Cofinity Commercial |
$314.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$255.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$328.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$255.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.90
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.42
|
| Rate for Payer: Nomi Health Commercial |
$584.04
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$310.42
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$230.08
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.53
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$53.21
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: UMR Bronson Commercial |
$135.12
|
| Rate for Payer: VA VA |
$194.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.90
|
|
|
HC BURN R&B
|
Facility
|
IP
|
$7,438.86
|
|
| Hospital Charge Code |
20700001
|
|
Hospital Revenue Code
|
207
|
| Min. Negotiated Rate |
$3,273.10 |
| Max. Negotiated Rate |
$6,694.97 |
| Rate for Payer: Aetna American Axle |
$4,835.26
|
| Rate for Payer: Aetna Commercial |
$6,323.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,835.26
|
| Rate for Payer: Cash Price |
$5,951.09
|
| Rate for Payer: Cofinity Commercial |
$5,207.20
|
| Rate for Payer: Cofinity Commercial |
$6,397.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,207.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,951.09
|
| Rate for Payer: Healthscope Commercial |
$6,694.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,207.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,579.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,323.03
|
| Rate for Payer: PHP Commercial |
$6,323.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,835.26
|
| Rate for Payer: Priority Health SBD |
$4,686.48
|
| Rate for Payer: UMR Bronson Commercial |
$3,273.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,579.14
|
|
|
HC BX VULVA PERINEUM ADDL LESION
|
Facility
|
OP
|
$223.87
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
76100202
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$28.33 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$145.52
|
| Rate for Payer: Aetna Commercial |
$190.29
|
| Rate for Payer: Aetna Medicare |
$111.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.52
|
| Rate for Payer: BCBS Complete |
$89.55
|
| Rate for Payer: BCBS Trust/PPO |
$397.45
|
| Rate for Payer: BCN Commercial |
$397.45
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cofinity Commercial |
$192.53
|
| Rate for Payer: Cofinity Commercial |
$156.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.10
|
| Rate for Payer: Healthscope Commercial |
$201.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.29
|
| Rate for Payer: PHP Commercial |
$190.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.52
|
| Rate for Payer: Priority Health SBD |
$141.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.16
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$28.33
|
| Rate for Payer: UMR Bronson Commercial |
$82.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.90
|
|
|
HC BX VULVA PERINEUM ADDL LESION
|
Facility
|
IP
|
$223.87
|
|
|
Service Code
|
CPT 56606
|
| Hospital Charge Code |
76100202
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$98.50 |
| Max. Negotiated Rate |
$201.48 |
| Rate for Payer: Aetna American Axle |
$145.52
|
| Rate for Payer: Aetna Commercial |
$190.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$145.52
|
| Rate for Payer: Cash Price |
$179.10
|
| Rate for Payer: Cofinity Commercial |
$156.71
|
| Rate for Payer: Cofinity Commercial |
$192.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$156.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.10
|
| Rate for Payer: Healthscope Commercial |
$201.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.29
|
| Rate for Payer: PHP Commercial |
$190.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.52
|
| Rate for Payer: Priority Health SBD |
$141.04
|
| Rate for Payer: UMR Bronson Commercial |
$98.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.90
|
|
|
HC C1 ESTERASE INHIBITOR FUNCTION
|
Facility
|
IP
|
$75.95
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200153
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.42 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna American Axle |
$49.37
|
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.37
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$53.16
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health SBD |
$47.85
|
| Rate for Payer: UMR Bronson Commercial |
$33.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
|
HC C1 ESTERASE INHIBITOR FUNCTION
|
Facility
|
OP
|
$75.95
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200153
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$68.36 |
| Rate for Payer: Aetna American Axle |
$49.37
|
| Rate for Payer: Aetna Commercial |
$64.56
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.00
|
| Rate for Payer: BCBS Complete |
$6.75
|
| Rate for Payer: BCBS MAPPO |
$12.00
|
| Rate for Payer: BCBS Trust/PPO |
$11.56
|
| Rate for Payer: BCN Commercial |
$11.56
|
| Rate for Payer: BCN Medicare Advantage |
$12.00
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cash Price |
$60.76
|
| Rate for Payer: Cofinity Commercial |
$65.32
|
| Rate for Payer: Cofinity Commercial |
$53.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$68.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.96
|
| Rate for Payer: Mclaren Medicaid |
$6.43
|
| Rate for Payer: Mclaren Medicare |
$12.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.60
|
| Rate for Payer: Meridian Medicaid |
$6.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.56
|
| Rate for Payer: Nomi Health Commercial |
$18.00
|
| Rate for Payer: PACE Medicare |
$11.40
|
| Rate for Payer: PACE SWMI |
$12.00
|
| Rate for Payer: PHP Commercial |
$64.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.00
|
| Rate for Payer: Priority Health Medicare |
$12.00
|
| Rate for Payer: Priority Health Narrow Network |
$9.60
|
| Rate for Payer: Priority Health SBD |
$47.85
|
| Rate for Payer: Railroad Medicare Medicare |
$12.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.00
|
| Rate for Payer: UHC Exchange |
$12.00
|
| Rate for Payer: UHC Medicare Advantage |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$6.43
|
| Rate for Payer: UMR Bronson Commercial |
$28.10
|
| Rate for Payer: VA VA |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.96
|
|
|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
OP
|
$74.51
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$67.06 |
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Aetna American Axle |
$48.43
|
| Rate for Payer: Aetna Commercial |
$63.33
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$16.64
|
| Rate for Payer: BCN Commercial |
$16.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$59.61
|
| Rate for Payer: Cash Price |
$59.61
|
| Rate for Payer: Cofinity Commercial |
$64.08
|
| Rate for Payer: Cofinity Commercial |
$52.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$67.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.88
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: Nomi Health Commercial |
$25.90
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$63.33
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$13.82
|
| Rate for Payer: Priority Health SBD |
$46.94
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: UMR Bronson Commercial |
$27.57
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.88
|
|
