|
HC C1 ESTERASE INHIBITOR QUANTITATIVE
|
Facility
|
IP
|
$74.51
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$67.06 |
| Rate for Payer: Aetna American Axle |
$48.43
|
| Rate for Payer: Aetna Commercial |
$63.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.43
|
| Rate for Payer: Cash Price |
$59.61
|
| Rate for Payer: Cofinity Commercial |
$52.16
|
| Rate for Payer: Cofinity Commercial |
$64.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.61
|
| 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: Multiplan/Beech St/PHCS Commercial |
$63.33
|
| Rate for Payer: PHP Commercial |
$63.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.43
|
| Rate for Payer: Priority Health SBD |
$46.94
|
| Rate for Payer: UMR Bronson Commercial |
$32.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.88
|
|
|
HC C1Q BINDING
|
Facility
|
IP
|
$113.22
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.82 |
| Max. Negotiated Rate |
$101.90 |
| Rate for Payer: Aetna American Axle |
$73.59
|
| Rate for Payer: Aetna Commercial |
$96.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.59
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cofinity Commercial |
$79.25
|
| Rate for Payer: Cofinity Commercial |
$97.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.58
|
| Rate for Payer: Healthscope Commercial |
$101.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.24
|
| Rate for Payer: PHP Commercial |
$96.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.59
|
| Rate for Payer: Priority Health SBD |
$71.33
|
| Rate for Payer: UMR Bronson Commercial |
$49.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.92
|
|
|
HC C1Q BINDING
|
Facility
|
OP
|
$113.22
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200193
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.06 |
| Max. Negotiated Rate |
$101.90 |
| Rate for Payer: Aetna American Axle |
$73.59
|
| Rate for Payer: Aetna Commercial |
$96.24
|
| Rate for Payer: Aetna Medicare |
$25.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.46
|
| Rate for Payer: BCBS Complete |
$13.72
|
| Rate for Payer: BCBS MAPPO |
$24.37
|
| Rate for Payer: BCBS Trust/PPO |
$23.48
|
| Rate for Payer: BCN Commercial |
$23.48
|
| Rate for Payer: BCN Medicare Advantage |
$24.37
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cofinity Commercial |
$97.37
|
| Rate for Payer: Cofinity Commercial |
$79.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$101.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.92
|
| Rate for Payer: Mclaren Medicaid |
$13.06
|
| Rate for Payer: Mclaren Medicare |
$24.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.59
|
| Rate for Payer: Meridian Medicaid |
$13.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.24
|
| Rate for Payer: Nomi Health Commercial |
$36.56
|
| Rate for Payer: PACE Medicare |
$23.15
|
| Rate for Payer: PACE SWMI |
$24.37
|
| Rate for Payer: PHP Commercial |
$96.24
|
| Rate for Payer: PHP Medicare Advantage |
$24.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.37
|
| Rate for Payer: Priority Health Medicare |
$24.37
|
| Rate for Payer: Priority Health Narrow Network |
$19.50
|
| Rate for Payer: Priority Health SBD |
$71.33
|
| Rate for Payer: Railroad Medicare Medicare |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.37
|
| Rate for Payer: UHC Exchange |
$24.37
|
| Rate for Payer: UHC Medicare Advantage |
$24.37
|
| Rate for Payer: UHCCP Medicaid |
$13.06
|
| Rate for Payer: UMR Bronson Commercial |
$41.89
|
| Rate for Payer: VA VA |
$24.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.92
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna American Axle |
$44.64
|
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.64
|
| 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 |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| 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 |
$58.37
|
| 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 |
$58.37
|
| 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 |
$44.64
|
| 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 |
$43.26
|
| 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 |
$25.41
|
| Rate for Payer: VA VA |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC C1Q COMPL COMPONENT, S
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 86160
|
| Hospital Charge Code |
30200409
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.21 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna American Axle |
$44.64
|
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.64
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health SBD |
$43.26
|
| Rate for Payer: UMR Bronson Commercial |
$30.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC C2 COMPLEMENT, FUNCTIONAL, S
|
Facility
|
OP
|
$76.13
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200483
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.43 |
| Max. Negotiated Rate |
$68.52 |
| Rate for Payer: Aetna American Axle |
$49.48
|
| Rate for Payer: Aetna Commercial |
$64.71
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.48
|
| 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 |
$60.90
|
| Rate for Payer: Cash Price |
$60.90
|
| Rate for Payer: Cofinity Commercial |
$65.47
|
| Rate for Payer: Cofinity Commercial |
$53.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$68.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.10
|
| 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 |
$64.71
|
| 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 |
$64.71
|
| 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 |
$49.48
|
| 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 |
$47.96
|
| 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 |
$28.17
|
| Rate for Payer: VA VA |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.10
|
|
|
HC C2 COMPLEMENT, FUNCTIONAL, S
|
Facility
|
IP
|
$76.13
|
|
|
Service Code
|
CPT 86161
|
| Hospital Charge Code |
30200483
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.50 |
| Max. Negotiated Rate |
$68.52 |
| Rate for Payer: Aetna American Axle |
$49.48
|
| Rate for Payer: Aetna Commercial |
$64.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.48
|
| Rate for Payer: Cash Price |
$60.90
|
| Rate for Payer: Cofinity Commercial |
$53.29
|
| Rate for Payer: Cofinity Commercial |
$65.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.90
|
| Rate for Payer: Healthscope Commercial |
$68.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.71
|
| Rate for Payer: PHP Commercial |
$64.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.48
|
| Rate for Payer: Priority Health SBD |
$47.96
|
| Rate for Payer: UMR Bronson Commercial |
$33.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.10
|
|
|
HC CA 125
|
Facility
|
IP
|
$145.96
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$64.22 |
| Max. Negotiated Rate |
$131.36 |
| Rate for Payer: Aetna American Axle |
$94.87
|
| Rate for Payer: Aetna Commercial |
$124.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.87
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$102.17
|
| Rate for Payer: Cofinity Commercial |
$125.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Healthscope Commercial |
$131.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: PHP Commercial |
$124.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health SBD |
$91.95
|
| Rate for Payer: UMR Bronson Commercial |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.47
|
|
|
HC CA 125
|
Facility
|
OP
|
$145.96
|
|
|
Service Code
|
CPT 86304
|
| Hospital Charge Code |
30200185
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$131.36 |
| Rate for Payer: Aetna American Axle |
$94.87
|
| Rate for Payer: Aetna Commercial |
$124.07
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.01
|
| Rate for Payer: BCBS Complete |
$11.71
|
| Rate for Payer: BCBS MAPPO |
$20.81
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCN Commercial |
$20.05
|
| Rate for Payer: BCN Medicare Advantage |
$20.81
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$125.53
|
| Rate for Payer: Cofinity Commercial |
$102.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$102.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$131.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.47
|
| Rate for Payer: Mclaren Medicaid |
$11.15
|
| Rate for Payer: Mclaren Medicare |
$20.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.85
|
| Rate for Payer: Meridian Medicaid |
$11.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: Nomi Health Commercial |
$31.22
|
| Rate for Payer: PACE Medicare |
$19.77
|
| Rate for Payer: PACE SWMI |
$20.81
|
| Rate for Payer: PHP Commercial |
$124.07
|
| Rate for Payer: PHP Medicare Advantage |
$20.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.41
|
| Rate for Payer: Priority Health Medicare |
$20.81
|
| Rate for Payer: Priority Health Narrow Network |
$17.13
|
| Rate for Payer: Priority Health SBD |
$91.95
|
| Rate for Payer: Railroad Medicare Medicare |
$20.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.81
|
| Rate for Payer: UHC Exchange |
$20.81
|
| Rate for Payer: UHC Medicare Advantage |
$20.81
|
| Rate for Payer: UHCCP Medicaid |
$11.15
|
| Rate for Payer: UMR Bronson Commercial |
$54.01
|
| Rate for Payer: VA VA |
$20.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.47
|
|
|
HC CADMIUM LEVEL
|
Facility
|
OP
|
$48.64
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$315.59 |
| Rate for Payer: Aetna American Axle |
$31.62
|
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna Medicare |
$24.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.55
|
| Rate for Payer: BCBS Complete |
$13.30
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCBS Trust/PPO |
$22.78
|
| Rate for Payer: BCN Commercial |
$22.78
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$43.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.48
|
| Rate for Payer: Mclaren Medicaid |
$12.67
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: Meridian Medicaid |
$13.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.34
|
| Rate for Payer: Nomi Health Commercial |
$35.46
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.64
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow Network |
$18.91
|
| Rate for Payer: Priority Health SBD |
$30.64
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.37
|
| Rate for Payer: UHC Core |
$315.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.64
|
| Rate for Payer: UHC Exchange |
$23.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.64
|
| Rate for Payer: UHCCP Medicaid |
$12.67
|
| Rate for Payer: UMR Bronson Commercial |
$18.00
|
| Rate for Payer: VA VA |
$23.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.48
|
|
|
HC CADMIUM LEVEL
|
Facility
|
IP
|
$48.64
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100124
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.40 |
| Max. Negotiated Rate |
$43.78 |
| Rate for Payer: Aetna American Axle |
$31.62
|
| Rate for Payer: Aetna Commercial |
$41.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.62
|
| Rate for Payer: Cash Price |
$38.91
|
| Rate for Payer: Cofinity Commercial |
$34.05
|
| Rate for Payer: Cofinity Commercial |
$41.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.91
|
| Rate for Payer: Healthscope Commercial |
$43.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.34
|
| Rate for Payer: PHP Commercial |
$41.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.62
|
| Rate for Payer: Priority Health SBD |
$30.64
|
| Rate for Payer: UMR Bronson Commercial |
$21.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.48
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
OP
|
$117.57
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.67 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Mclaren Medicare |
$38.57
|
| Rate for Payer: Aetna American Axle |
$76.42
|
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna Medicare |
$40.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.21
|
| Rate for Payer: BCBS Complete |
$21.71
|
| Rate for Payer: BCBS MAPPO |
$38.57
|
| Rate for Payer: BCBS Trust/PPO |
$37.16
|
| Rate for Payer: BCN Commercial |
$37.16
|
| Rate for Payer: BCN Medicare Advantage |
$38.57
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.57
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Mclaren Medicaid |
$20.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.50
|
| Rate for Payer: Meridian Medicaid |
$21.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$57.86
|
| Rate for Payer: PACE Medicare |
$36.64
|
| Rate for Payer: PACE SWMI |
$38.57
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: PHP Medicare Advantage |
$38.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.57
|
| Rate for Payer: Priority Health Medicare |
$38.57
|
| Rate for Payer: Priority Health Narrow Network |
$30.86
|
| Rate for Payer: Priority Health SBD |
$74.07
|
| Rate for Payer: Railroad Medicare Medicare |
$38.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.57
|
| Rate for Payer: UHC Exchange |
$38.57
|
| Rate for Payer: UHC Medicare Advantage |
$38.57
|
| Rate for Payer: UHCCP Medicaid |
$20.67
|
| Rate for Payer: UMR Bronson Commercial |
$43.50
|
| Rate for Payer: VA VA |
$38.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC CAFFEINE LEVEL
|
Facility
|
IP
|
$117.57
|
|
|
Service Code
|
CPT 80155
|
| Hospital Charge Code |
30100063
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.73 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna American Axle |
$76.42
|
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.42
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Cofinity Commercial |
$82.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.42
|
| Rate for Payer: Priority Health SBD |
$74.07
|
| Rate for Payer: UMR Bronson Commercial |
$51.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.36 |
| Max. Negotiated Rate |
$4,647.60 |
| Rate for Payer: Aetna American Axle |
$44.64
|
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$27.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.49
|
| Rate for Payer: BCBS Complete |
$15.08
|
| Rate for Payer: BCBS MAPPO |
$26.79
|
| Rate for Payer: BCBS Trust/PPO |
$25.81
|
| Rate for Payer: BCN Commercial |
$25.81
|
| Rate for Payer: BCN Medicare Advantage |
$26.79
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.79
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$14.36
|
| Rate for Payer: Mclaren Medicare |
$26.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.13
|
| Rate for Payer: Meridian Medicaid |
$15.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$40.18
|
| Rate for Payer: PACE Medicare |
$25.45
|
| Rate for Payer: PACE SWMI |
$26.79
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$26.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.56
|
| Rate for Payer: Priority Health Medicare |
$26.79
|
| Rate for Payer: Priority Health Narrow Network |
$22.05
|
| Rate for Payer: Priority Health SBD |
$43.26
|
| Rate for Payer: Railroad Medicare Medicare |
$26.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.15
|
| Rate for Payer: UHC Core |
$4,647.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.79
|
| Rate for Payer: UHC Exchange |
$26.79
|
| Rate for Payer: UHC Medicare Advantage |
$26.79
|
| Rate for Payer: UHCCP Medicaid |
$14.36
|
| Rate for Payer: UMR Bronson Commercial |
$25.41
|
| Rate for Payer: VA VA |
$26.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC CALCITONIN LEVEL
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 82308
|
| Hospital Charge Code |
30100128
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.21 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna American Axle |
$44.64
|
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.64
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health SBD |
$43.26
|
| Rate for Payer: UMR Bronson Commercial |
$30.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
OP
|
$26.88
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.95 |
| Max. Negotiated Rate |
$24.19 |
| Rate for Payer: Aetna American Axle |
$17.47
|
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.47
|
| Rate for Payer: BCBS Complete |
$10.75
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$18.82
|
| Rate for Payer: Cofinity Commercial |
$23.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Healthscope Commercial |
$24.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.85
|
| Rate for Payer: PHP Commercial |
$22.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health SBD |
$16.93
|
| Rate for Payer: UMR Bronson Commercial |
$9.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.16
|
|
|
HC CALCIUM ALGINATE AG 4X4
|
Facility
|
IP
|
$26.88
|
|
| Hospital Charge Code |
27000461
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.83 |
| Max. Negotiated Rate |
$24.19 |
| Rate for Payer: Aetna American Axle |
$17.47
|
| Rate for Payer: Aetna Commercial |
$22.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.47
|
| Rate for Payer: Cash Price |
$21.50
|
| Rate for Payer: Cofinity Commercial |
$18.82
|
| Rate for Payer: Cofinity Commercial |
$23.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.50
|
| Rate for Payer: Healthscope Commercial |
$24.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.85
|
| Rate for Payer: PHP Commercial |
$22.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.47
|
| Rate for Payer: Priority Health SBD |
$16.93
|
| Rate for Payer: UMR Bronson Commercial |
$11.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.16
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
IP
|
$18.88
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$16.99 |
| Rate for Payer: Aetna American Axle |
$12.27
|
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.27
|
| Rate for Payer: Cash Price |
$15.10
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.10
|
| Rate for Payer: Healthscope Commercial |
$16.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.05
|
| Rate for Payer: PHP Commercial |
$16.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.27
|
| Rate for Payer: Priority Health SBD |
$11.89
|
| Rate for Payer: UMR Bronson Commercial |
$8.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.16
|
|
|
HC CALCIUM ALGINATE AG ROPE
|
Facility
|
OP
|
$18.88
|
|
| Hospital Charge Code |
27000462
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$16.99 |
| Rate for Payer: Aetna American Axle |
$12.27
|
| Rate for Payer: Aetna Commercial |
$16.05
|
| Rate for Payer: Aetna Medicare |
$9.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.27
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: Cash Price |
$15.10
|
| Rate for Payer: Cofinity Commercial |
$13.22
|
| Rate for Payer: Cofinity Commercial |
$16.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.10
|
| Rate for Payer: Healthscope Commercial |
$16.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.05
|
| Rate for Payer: PHP Commercial |
$16.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.27
|
| Rate for Payer: Priority Health SBD |
$11.89
|
| Rate for Payer: UMR Bronson Commercial |
$6.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.16
|
|
|
HC CALCIUM LEVEL, TOTAL
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
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 CALCIUM LEVEL, TOTAL
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82310
|
| Hospital Charge Code |
30100129
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.77 |
| Max. Negotiated Rate |
$4,099.01 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.45
|
| Rate for Payer: BCBS Complete |
$2.90
|
| Rate for Payer: BCBS MAPPO |
$5.16
|
| Rate for Payer: BCN Medicare Advantage |
$5.16
|
| 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 |
$5.16
|
| 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 |
$2.77
|
| Rate for Payer: Mclaren Medicare |
$5.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.42
|
| Rate for Payer: Meridian Medicaid |
$2.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$7.74
|
| Rate for Payer: PACE Medicare |
$4.90
|
| Rate for Payer: PACE SWMI |
$5.16
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.16
|
| Rate for Payer: Priority Health Medicare |
$5.16
|
| Rate for Payer: Priority Health Narrow Network |
$4.13
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$5.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.19
|
| Rate for Payer: UHC Core |
$4,099.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.16
|
| Rate for Payer: UHC Exchange |
$5.16
|
| Rate for Payer: UHC Medicare Advantage |
$5.16
|
| Rate for Payer: UHCCP Medicaid |
$2.77
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$5.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC CALCIUM URINE
|
Facility
|
OP
|
$53.86
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$4,647.60 |
| Rate for Payer: UHC Dual Complete DSNP |
$6.03
|
| Rate for Payer: UHC Exchange |
$6.03
|
| Rate for Payer: UHC Medicare Advantage |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$3.23
|
| Rate for Payer: UMR Bronson Commercial |
$19.93
|
| Rate for Payer: VA VA |
$6.03
|
| Rate for Payer: Aetna American Axle |
$35.01
|
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna Medicare |
$6.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.54
|
| Rate for Payer: BCBS Complete |
$3.39
|
| Rate for Payer: BCBS MAPPO |
$6.03
|
| Rate for Payer: BCBS Trust/PPO |
$5.81
|
| Rate for Payer: BCN Commercial |
$5.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.03
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.03
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Mclaren Medicaid |
$3.23
|
| Rate for Payer: Mclaren Medicare |
$6.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.33
|
| Rate for Payer: Meridian Medicaid |
$3.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: Nomi Health Commercial |
$9.04
|
| Rate for Payer: PACE Medicare |
$5.73
|
| Rate for Payer: PACE SWMI |
$6.03
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: PHP Medicare Advantage |
$6.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.03
|
| Rate for Payer: Priority Health Medicare |
$6.03
|
| Rate for Payer: Priority Health Narrow Network |
$4.82
|
| Rate for Payer: Priority Health SBD |
$33.93
|
| Rate for Payer: Railroad Medicare Medicare |
$6.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.24
|
| Rate for Payer: UHC Core |
$4,647.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC CALCIUM URINE
|
Facility
|
IP
|
$53.86
|
|
|
Service Code
|
CPT 82340
|
| Hospital Charge Code |
30100131
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.70 |
| Max. Negotiated Rate |
$48.47 |
| Rate for Payer: Aetna American Axle |
$35.01
|
| Rate for Payer: Aetna Commercial |
$45.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.01
|
| Rate for Payer: Cash Price |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$37.70
|
| Rate for Payer: Cofinity Commercial |
$46.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.09
|
| Rate for Payer: Healthscope Commercial |
$48.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.78
|
| Rate for Payer: PHP Commercial |
$45.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.01
|
| Rate for Payer: Priority Health SBD |
$33.93
|
| Rate for Payer: UMR Bronson Commercial |
$23.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.40
|
|
|
HC CALCULI
|
Facility
|
OP
|
$42.66
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.91 |
| Max. Negotiated Rate |
$610.64 |
| Rate for Payer: Aetna American Axle |
$27.73
|
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: BCBS Complete |
$7.26
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$12.43
|
| Rate for Payer: BCN Commercial |
$12.43
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Cofinity Commercial |
$29.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Mclaren Medicaid |
$6.91
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$7.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$19.35
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.27
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health Narrow Network |
$10.62
|
| Rate for Payer: Priority Health SBD |
$26.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.48
|
| Rate for Payer: UHC Core |
$610.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.90
|
| Rate for Payer: UHC Exchange |
$12.90
|
| Rate for Payer: UHC Medicare Advantage |
$12.90
|
| Rate for Payer: UHCCP Medicaid |
$6.91
|
| Rate for Payer: UMR Bronson Commercial |
$15.78
|
| Rate for Payer: VA VA |
$12.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC CALCULI
|
Facility
|
IP
|
$42.66
|
|
|
Service Code
|
CPT 82365
|
| Hospital Charge Code |
30100132
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna American Axle |
$27.73
|
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.73
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$29.86
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health SBD |
$26.88
|
| Rate for Payer: UMR Bronson Commercial |
$18.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
