|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
OP
|
$463.45
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$481.80 |
| Rate for Payer: Aetna American Axle |
$301.24
|
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$27.02
|
| Rate for Payer: BCN Commercial |
$27.02
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$324.42
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$291.97
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.13
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$21.03
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: UMR Bronson Commercial |
$171.48
|
| Rate for Payer: VA VA |
$153.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC CALORIC VESTIBULAR BILATERAL MONOTHERMAL
|
Facility
|
IP
|
$463.45
|
|
|
Service Code
|
HCPCS 92538
|
| Hospital Charge Code |
47100007
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$203.92 |
| Max. Negotiated Rate |
$417.10 |
| Rate for Payer: Aetna American Axle |
$301.24
|
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.24
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$324.42
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health SBD |
$291.97
|
| Rate for Payer: UMR Bronson Commercial |
$203.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
OP
|
$463.45
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$37.42 |
| Max. Negotiated Rate |
$481.80 |
| Rate for Payer: Aetna American Axle |
$301.24
|
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$48.00
|
| Rate for Payer: BCN Commercial |
$48.00
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$324.42
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$291.97
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.16
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$37.42
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: UMR Bronson Commercial |
$171.48
|
| Rate for Payer: VA VA |
$153.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC CALORIC VESTIBULAR TEST BILAT BITHERMAL
|
Facility
|
IP
|
$463.45
|
|
|
Service Code
|
HCPCS 92537
|
| Hospital Charge Code |
47100006
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$203.92 |
| Max. Negotiated Rate |
$417.10 |
| Rate for Payer: Aetna American Axle |
$301.24
|
| Rate for Payer: Aetna Commercial |
$393.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.24
|
| Rate for Payer: Cash Price |
$370.76
|
| Rate for Payer: Cofinity Commercial |
$324.42
|
| Rate for Payer: Cofinity Commercial |
$398.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$370.76
|
| Rate for Payer: Healthscope Commercial |
$417.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$347.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$393.93
|
| Rate for Payer: PHP Commercial |
$393.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.24
|
| Rate for Payer: Priority Health SBD |
$291.97
|
| Rate for Payer: UMR Bronson Commercial |
$203.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$347.59
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
OP
|
$236.64
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.52 |
| Max. Negotiated Rate |
$212.98 |
| Rate for Payer: Aetna American Axle |
$153.82
|
| Rate for Payer: Aetna Commercial |
$201.14
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$11.05
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$18.91
|
| Rate for Payer: BCN Commercial |
$18.91
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$189.31
|
| Rate for Payer: Cash Price |
$189.31
|
| Rate for Payer: Cofinity Commercial |
$203.51
|
| Rate for Payer: Cofinity Commercial |
$165.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$212.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.48
|
| Rate for Payer: Mclaren Medicaid |
$10.52
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: Meridian Medicaid |
$11.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.14
|
| Rate for Payer: Nomi Health Commercial |
$29.44
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$201.14
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.63
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health Narrow Network |
$15.70
|
| Rate for Payer: Priority Health SBD |
$149.08
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.63
|
| Rate for Payer: UHC Exchange |
$19.63
|
| Rate for Payer: UHC Medicare Advantage |
$19.63
|
| Rate for Payer: UHCCP Medicaid |
$10.52
|
| Rate for Payer: UMR Bronson Commercial |
$87.56
|
| Rate for Payer: VA VA |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.48
|
|
|
HC CALPROTECTIN FECAL
|
Facility
|
IP
|
$236.64
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100638
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$104.12 |
| Max. Negotiated Rate |
$212.98 |
| Rate for Payer: Aetna American Axle |
$153.82
|
| Rate for Payer: Aetna Commercial |
$201.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.82
|
| Rate for Payer: Cash Price |
$189.31
|
| Rate for Payer: Cofinity Commercial |
$165.65
|
| Rate for Payer: Cofinity Commercial |
$203.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.31
|
| Rate for Payer: Healthscope Commercial |
$212.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.14
|
| Rate for Payer: PHP Commercial |
$201.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.82
|
| Rate for Payer: Priority Health SBD |
$149.08
|
| Rate for Payer: UMR Bronson Commercial |
$104.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.48
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: UMR Bronson Commercial |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CALPROTECTIN, FECES
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 83993
|
| Hospital Charge Code |
30100741
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.52 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$20.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.54
|
| Rate for Payer: BCBS Complete |
$11.05
|
| Rate for Payer: BCBS MAPPO |
$19.63
|
| Rate for Payer: BCBS Trust/PPO |
$18.91
|
| Rate for Payer: BCN Commercial |
$18.91
|
| Rate for Payer: BCN Medicare Advantage |
$19.63
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.63
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$10.52
|
| Rate for Payer: Mclaren Medicare |
$19.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.61
|
| Rate for Payer: Meridian Medicaid |
$11.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.68
|
| Rate for Payer: Nomi Health Commercial |
$29.44
|
| Rate for Payer: PACE Medicare |
$18.65
|
| Rate for Payer: PACE SWMI |
$19.63
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$19.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.63
|
| Rate for Payer: Priority Health Medicare |
$19.63
|
| Rate for Payer: Priority Health Narrow Network |
$15.70
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$19.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.63
|
| Rate for Payer: UHC Exchange |
$19.63
|
| Rate for Payer: UHC Medicare Advantage |
$19.63
|
| Rate for Payer: UHCCP Medicaid |
$10.52
|
| Rate for Payer: UMR Bronson Commercial |
$15.10
|
| Rate for Payer: VA VA |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
IP
|
$673.24
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$296.23 |
| Max. Negotiated Rate |
$605.92 |
| Rate for Payer: Aetna American Axle |
$437.61
|
| Rate for Payer: Aetna Commercial |
$572.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.61
|
| Rate for Payer: Cash Price |
$538.59
|
| Rate for Payer: Cofinity Commercial |
$471.27
|
| Rate for Payer: Cofinity Commercial |
$578.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.59
|
| Rate for Payer: Healthscope Commercial |
$605.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.25
|
| Rate for Payer: PHP Commercial |
$572.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.61
|
| Rate for Payer: Priority Health SBD |
$424.14
|
| Rate for Payer: UMR Bronson Commercial |
$296.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.93
|
|
|
HC CALR, GENE MUTATION, EXON 9, REFLEX
|
Facility
|
OP
|
$673.24
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000108
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$65.19 |
| Max. Negotiated Rate |
$605.92 |
| Rate for Payer: Aetna American Axle |
$437.61
|
| Rate for Payer: Aetna Commercial |
$572.25
|
| Rate for Payer: Aetna Medicare |
$126.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$437.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.04
|
| Rate for Payer: BCBS Complete |
$68.45
|
| Rate for Payer: BCBS MAPPO |
$121.63
|
| Rate for Payer: BCBS Trust/PPO |
$117.18
|
| Rate for Payer: BCN Commercial |
$117.18
|
| Rate for Payer: BCN Medicare Advantage |
$121.63
|
| Rate for Payer: Cash Price |
$538.59
|
| Rate for Payer: Cash Price |
$538.59
|
| Rate for Payer: Cofinity Commercial |
$578.99
|
| Rate for Payer: Cofinity Commercial |
$471.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$471.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$538.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.63
|
| Rate for Payer: Healthscope Commercial |
$605.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$471.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$504.93
|
| Rate for Payer: Mclaren Medicaid |
$65.19
|
| Rate for Payer: Mclaren Medicare |
$121.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$127.71
|
| Rate for Payer: Meridian Medicaid |
$68.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$139.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$572.25
|
| Rate for Payer: Nomi Health Commercial |
$364.89
|
| Rate for Payer: PACE Medicare |
$115.55
|
| Rate for Payer: PACE SWMI |
$121.63
|
| Rate for Payer: PHP Commercial |
$572.25
|
| Rate for Payer: PHP Medicare Advantage |
$121.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$437.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$125.13
|
| Rate for Payer: Priority Health Medicare |
$121.63
|
| Rate for Payer: Priority Health Narrow Network |
$100.10
|
| Rate for Payer: Priority Health SBD |
$424.14
|
| Rate for Payer: Railroad Medicare Medicare |
$121.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$145.96
|
| Rate for Payer: UHC Core |
$113.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.63
|
| Rate for Payer: UHC Exchange |
$121.63
|
| Rate for Payer: UHC Medicare Advantage |
$121.63
|
| Rate for Payer: UHCCP Medicaid |
$65.19
|
| Rate for Payer: UMR Bronson Commercial |
$249.10
|
| Rate for Payer: VA VA |
$121.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$504.93
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
OP
|
$131.61
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.13 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$85.55
|
| Rate for Payer: Aetna Commercial |
$111.87
|
| Rate for Payer: Aetna Medicare |
$65.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.55
|
| Rate for Payer: BCBS Complete |
$52.64
|
| Rate for Payer: BCBS Trust/PPO |
$51.23
|
| Rate for Payer: BCN Commercial |
$51.23
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cofinity Commercial |
$113.18
|
| Rate for Payer: Cofinity Commercial |
$92.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.29
|
| Rate for Payer: Healthscope Commercial |
$118.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.87
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$111.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58.91
|
| Rate for Payer: Priority Health Narrow Network |
$47.13
|
| Rate for Payer: Priority Health SBD |
$82.91
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$48.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.71
|
|
|
HC CANALITH REPOSITIONING
|
Facility
|
IP
|
$131.61
|
|
|
Service Code
|
CPT 95992
|
| Hospital Charge Code |
42000008
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$57.91 |
| Max. Negotiated Rate |
$118.45 |
| Rate for Payer: Aetna American Axle |
$85.55
|
| Rate for Payer: Aetna Commercial |
$111.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.55
|
| Rate for Payer: Cash Price |
$105.29
|
| Rate for Payer: Cofinity Commercial |
$113.18
|
| Rate for Payer: Cofinity Commercial |
$92.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.29
|
| Rate for Payer: Healthscope Commercial |
$118.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.87
|
| Rate for Payer: PHP Commercial |
$111.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.55
|
| Rate for Payer: Priority Health SBD |
$82.91
|
| Rate for Payer: UMR Bronson Commercial |
$57.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.71
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna American Axle |
$31.78
|
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.78
|
| 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 |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.68
|
| 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 |
$41.56
|
| 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 |
$41.56
|
| 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 |
$31.78
|
| 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 |
$30.81
|
| 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 |
$18.09
|
| Rate for Payer: VA VA |
$20.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.68
|
|
|
HC CANCER ANTIGEN 15-3
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200182
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.52 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna American Axle |
$31.78
|
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.78
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health SBD |
$30.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.68
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| 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 |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$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 |
$38.91
|
| 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 |
$38.91
|
| 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 |
$29.76
|
| 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 |
$28.84
|
| 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 |
$16.94
|
| Rate for Payer: VA VA |
$20.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC CANCER ANTIGEN 19-9
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 86301
|
| Hospital Charge Code |
30200184
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: UMR Bronson Commercial |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
OP
|
$41.20
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.15 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna American Axle |
$26.78
|
| Rate for Payer: Aetna Commercial |
$35.02
|
| Rate for Payer: Aetna Medicare |
$21.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.78
|
| 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 |
$32.96
|
| Rate for Payer: Cash Price |
$32.96
|
| Rate for Payer: Cofinity Commercial |
$35.43
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$37.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.90
|
| 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 |
$35.02
|
| 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 |
$35.02
|
| 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 |
$26.78
|
| 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 |
$25.96
|
| 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 |
$15.24
|
| Rate for Payer: VA VA |
$20.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.90
|
|
|
HC CANCER ANTIGEN 2729
|
Facility
|
IP
|
$41.20
|
|
|
Service Code
|
CPT 86300
|
| Hospital Charge Code |
30200183
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.13 |
| Max. Negotiated Rate |
$37.08 |
| Rate for Payer: Aetna American Axle |
$26.78
|
| Rate for Payer: Aetna Commercial |
$35.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.78
|
| Rate for Payer: Cash Price |
$32.96
|
| Rate for Payer: Cofinity Commercial |
$28.84
|
| Rate for Payer: Cofinity Commercial |
$35.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$28.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.96
|
| Rate for Payer: Healthscope Commercial |
$37.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.02
|
| Rate for Payer: PHP Commercial |
$35.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.78
|
| Rate for Payer: Priority Health SBD |
$25.96
|
| Rate for Payer: UMR Bronson Commercial |
$18.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.90
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CANDIDA ALBICANS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200077
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC CANNABINOID URIN
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$91.49 |
| Rate for Payer: Aetna American Axle |
$66.08
|
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health SBD |
$64.05
|
| Rate for Payer: UMR Bronson Commercial |
$44.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.24
|
|
|
HC CANNABINOID URIN
|
Facility
|
OP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000125
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$93.21 |
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna American Axle |
$66.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$59.88
|
| Rate for Payer: BCN Commercial |
$59.88
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.24
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$49.71
|
| Rate for Payer: Priority Health SBD |
$64.05
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$37.61
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.24
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
IP
|
$884.34
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$389.11 |
| Max. Negotiated Rate |
$795.91 |
| Rate for Payer: Cofinity Commercial |
$619.04
|
| Rate for Payer: Cofinity Commercial |
$760.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$619.04
|
| Rate for Payer: Aetna American Axle |
$574.82
|
| Rate for Payer: Aetna Commercial |
$751.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.82
|
| Rate for Payer: Cash Price |
$707.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.47
|
| Rate for Payer: Healthscope Commercial |
$795.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$619.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.69
|
| Rate for Payer: PHP Commercial |
$751.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.82
|
| Rate for Payer: Priority Health SBD |
$557.13
|
| Rate for Payer: UMR Bronson Commercial |
$389.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.26
|
|
|
HC CANN/INTRO FEM ART 17,19,21 FR
|
Facility
|
OP
|
$884.34
|
|
| Hospital Charge Code |
27000274
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$327.21 |
| Max. Negotiated Rate |
$795.91 |
| Rate for Payer: Aetna American Axle |
$574.82
|
| Rate for Payer: Aetna Commercial |
$751.69
|
| Rate for Payer: Aetna Medicare |
$442.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$574.82
|
| Rate for Payer: BCBS Complete |
$353.74
|
| Rate for Payer: Cash Price |
$707.47
|
| Rate for Payer: Cofinity Commercial |
$619.04
|
| Rate for Payer: Cofinity Commercial |
$760.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$619.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$707.47
|
| Rate for Payer: Healthscope Commercial |
$795.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$619.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$663.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$751.69
|
| Rate for Payer: PHP Commercial |
$751.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$574.82
|
| Rate for Payer: Priority Health SBD |
$557.13
|
| Rate for Payer: UMR Bronson Commercial |
$327.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$663.26
|
|
|
HC CANN RT ANG BALLOON 4-6MM
|
Facility
|
OP
|
$302.94
|
|
| Hospital Charge Code |
27000446
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$112.09 |
| Max. Negotiated Rate |
$272.65 |
| Rate for Payer: Aetna American Axle |
$196.91
|
| Rate for Payer: Aetna Commercial |
$257.50
|
| Rate for Payer: Aetna Medicare |
$151.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.91
|
| Rate for Payer: BCBS Complete |
$121.18
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$212.06
|
| Rate for Payer: Cofinity Commercial |
$260.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$212.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.35
|
| Rate for Payer: Healthscope Commercial |
$272.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.50
|
| Rate for Payer: PHP Commercial |
$257.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.91
|
| Rate for Payer: Priority Health SBD |
$190.85
|
| Rate for Payer: UMR Bronson Commercial |
$112.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.20
|
|
