|
HC CREATININE CLEARANCE
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 82575
|
| Hospital Charge Code |
30100182
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna American Axle |
$50.99
|
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$9.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.82
|
| Rate for Payer: BCBS Complete |
$5.20
|
| Rate for Payer: BCBS MAPPO |
$9.46
|
| Rate for Payer: BCBS Trust/PPO |
$10.94
|
| Rate for Payer: BCN Commercial |
$10.94
|
| Rate for Payer: BCN Medicare Advantage |
$9.46
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.46
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Mclaren Medicaid |
$9.46
|
| Rate for Payer: Mclaren Medicare |
$9.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.93
|
| Rate for Payer: Meridian Medicaid |
$9.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$14.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Medicare |
$8.99
|
| Rate for Payer: PACE SWMI |
$9.46
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$9.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.46
|
| Rate for Payer: Priority Health Medicare |
$9.46
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: Priority Health Tiered Network |
$7.57
|
| Rate for Payer: Railroad Medicare Medicare |
$9.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.19
|
| Rate for Payer: UHC Core |
$14.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.46
|
| Rate for Payer: UHC Exchange |
$14.19
|
| Rate for Payer: UHC Medicaid |
$4.95
|
| Rate for Payer: UHCCP Medicaid |
$4.95
|
| Rate for Payer: UMR Bronson Commercial |
$29.03
|
| Rate for Payer: VA VA |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC CREATININE SERUM
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: BCBS Complete |
$2.81
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.12
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$5.12
|
| Rate for Payer: Mclaren Medicare |
$5.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.38
|
| Rate for Payer: Meridian Medicaid |
$5.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.86
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.12
|
| Rate for Payer: Priority Health Medicare |
$5.12
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$4.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.68
|
| Rate for Payer: UHC Core |
$7.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.12
|
| Rate for Payer: UHC Exchange |
$7.68
|
| Rate for Payer: UHC Medicaid |
$2.68
|
| Rate for Payer: UHCCP Medicaid |
$2.68
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: VA VA |
$5.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CREATININE SERUM
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100180
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC CREATININE URINE/OTHER SOURCE
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100181
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$6.00
|
| Rate for Payer: BCN Commercial |
$6.00
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.18
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$4.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.77
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC CREATININE, WHOLE BLOOD
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100761
|
|
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 Advantage |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| 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: Opus (Opus Packaging Group) HMA |
$15.61
|
| Rate for Payer: PHP Commercial |
$17.69
|
| 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 CREATININE, WHOLE BLOOD
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 82565
|
| Hospital Charge Code |
30100761
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.68 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.40
|
| Rate for Payer: BCBS Complete |
$2.81
|
| Rate for Payer: BCBS MAPPO |
$5.12
|
| Rate for Payer: BCN Medicare Advantage |
$5.12
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Advantage |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.12
|
| 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 |
$5.12
|
| Rate for Payer: Mclaren Medicare |
$5.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.38
|
| Rate for Payer: Meridian Medicaid |
$5.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$7.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.61
|
| Rate for Payer: PACE Medicare |
$4.86
|
| Rate for Payer: PACE SWMI |
$5.12
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.12
|
| Rate for Payer: Priority Health Medicare |
$5.12
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Priority Health Tiered Network |
$4.10
|
| Rate for Payer: Railroad Medicare Medicare |
$5.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.68
|
| Rate for Payer: UHC Core |
$7.68
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.12
|
| Rate for Payer: UHC Exchange |
$7.68
|
| Rate for Payer: UHC Medicaid |
$2.68
|
| Rate for Payer: UHCCP Medicaid |
$2.68
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$5.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
OP
|
$40.79
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$15.09 |
| Max. Negotiated Rate |
$36.71 |
| Rate for Payer: Aetna American Axle |
$26.51
|
| Rate for Payer: Aetna Commercial |
$34.67
|
| Rate for Payer: Aetna Medicare |
$20.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.51
|
| Rate for Payer: BCBS Complete |
$16.32
|
| Rate for Payer: Cash Price |
$32.63
|
| Rate for Payer: Cofinity Advantage |
$28.55
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.63
|
| Rate for Payer: Healthscope Commercial |
$36.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.59
|
| Rate for Payer: PHP Commercial |
$34.67
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.51
|
| Rate for Payer: UHC Core |
$21.25
|
| Rate for Payer: UHC Exchange |
$16.03
|
| Rate for Payer: UMR Bronson Commercial |
$15.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.59
|
|
|
HC CRITIC AID 6.5 OZ
|
Facility
|
IP
|
$40.79
|
|
| Hospital Charge Code |
27100008
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$36.71 |
| Rate for Payer: Aetna American Axle |
$26.51
|
| Rate for Payer: Aetna Commercial |
$34.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.51
|
| Rate for Payer: Cash Price |
$32.63
|
| Rate for Payer: Cofinity Advantage |
$28.55
|
| Rate for Payer: Cofinity Commercial |
$35.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.63
|
| Rate for Payer: Healthscope Commercial |
$36.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.59
|
| Rate for Payer: PHP Commercial |
$34.67
|
| 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 |
$30.59
|
|
|
HC CRITICAL CARE R&B
|
Facility
|
IP
|
$6,464.21
|
|
| Hospital Charge Code |
20000001
|
|
Hospital Revenue Code
|
200
|
| Min. Negotiated Rate |
$2,844.25 |
| Max. Negotiated Rate |
$5,817.79 |
| Rate for Payer: Aetna American Axle |
$4,201.74
|
| Rate for Payer: Aetna Commercial |
$5,494.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,201.74
|
| Rate for Payer: Cash Price |
$5,171.37
|
| Rate for Payer: Cofinity Advantage |
$4,524.95
|
| Rate for Payer: Cofinity Commercial |
$5,559.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,171.37
|
| Rate for Payer: Healthscope Commercial |
$5,817.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,524.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,848.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,494.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,848.16
|
| Rate for Payer: PHP Commercial |
$5,494.58
|
| Rate for Payer: Priority Health SBD |
$4,072.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,844.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,848.16
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
IP
|
$163.34
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.87 |
| Max. Negotiated Rate |
$147.01 |
| Rate for Payer: Aetna American Axle |
$106.17
|
| Rate for Payer: Aetna Commercial |
$138.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.17
|
| Rate for Payer: Cash Price |
$130.67
|
| Rate for Payer: Cofinity Advantage |
$114.34
|
| Rate for Payer: Cofinity Commercial |
$140.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.67
|
| Rate for Payer: Healthscope Commercial |
$147.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.50
|
| Rate for Payer: PHP Commercial |
$138.84
|
| Rate for Payer: Priority Health SBD |
$102.90
|
| Rate for Payer: UMR Bronson Commercial |
$71.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.50
|
|
|
HC CRMP 5 IGG WB
|
Facility
|
OP
|
$163.34
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100640
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.28 |
| Max. Negotiated Rate |
$147.01 |
| Rate for Payer: Aetna American Axle |
$106.17
|
| Rate for Payer: Aetna Commercial |
$138.84
|
| Rate for Payer: Aetna Medicare |
$30.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.51
|
| Rate for Payer: BCBS Complete |
$16.04
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCBS Trust/PPO |
$25.34
|
| Rate for Payer: BCN Commercial |
$25.34
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$130.67
|
| Rate for Payer: Cash Price |
$130.67
|
| Rate for Payer: Cofinity Advantage |
$114.34
|
| Rate for Payer: Cofinity Commercial |
$140.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$147.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.50
|
| Rate for Payer: Mclaren Medicaid |
$29.21
|
| Rate for Payer: Mclaren Medicare |
$29.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Meridian Medicaid |
$30.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.84
|
| Rate for Payer: Nomi Health Commercial |
$43.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.50
|
| Rate for Payer: PACE Medicare |
$27.75
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Commercial |
$138.84
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health SBD |
$102.90
|
| Rate for Payer: Priority Health Tiered Network |
$23.37
|
| Rate for Payer: Railroad Medicare Medicare |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.82
|
| Rate for Payer: UHC Core |
$43.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.21
|
| Rate for Payer: UHC Exchange |
$43.82
|
| Rate for Payer: UHC Medicaid |
$15.28
|
| Rate for Payer: UHCCP Medicaid |
$15.28
|
| Rate for Payer: UMR Bronson Commercial |
$60.44
|
| Rate for Payer: VA VA |
$29.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.50
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
IP
|
$161.26
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$70.95 |
| Max. Negotiated Rate |
$145.13 |
| Rate for Payer: Aetna American Axle |
$104.82
|
| Rate for Payer: Aetna Commercial |
$137.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.82
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Advantage |
$112.88
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Healthscope Commercial |
$145.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: Priority Health SBD |
$101.59
|
| Rate for Payer: UMR Bronson Commercial |
$70.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.94
|
|
|
HC CRMP 5 IGG WESTERN BLOT
|
Facility
|
OP
|
$161.26
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200180
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$145.13 |
| Rate for Payer: Aetna American Axle |
$104.82
|
| Rate for Payer: Aetna Commercial |
$137.07
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cash Price |
$129.01
|
| Rate for Payer: Cofinity Advantage |
$112.88
|
| Rate for Payer: Cofinity Commercial |
$138.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$145.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.94
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.07
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.94
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$137.07
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$101.59
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$59.67
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.94
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
OP
|
$188.31
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.25 |
| Max. Negotiated Rate |
$548.99 |
| Rate for Payer: Aetna American Axle |
$122.40
|
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna Medicare |
$176.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$20.25
|
| Rate for Payer: BCN Commercial |
$20.25
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$150.65
|
| Rate for Payer: Cash Price |
$150.65
|
| Rate for Payer: Cofinity Advantage |
$131.82
|
| Rate for Payer: Cofinity Commercial |
$161.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$169.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.23
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.06
|
| Rate for Payer: Nomi Health Commercial |
$509.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.23
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$160.06
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$548.99
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health SBD |
$118.64
|
| Rate for Payer: Priority Health Tiered Network |
$439.19
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.04
|
| Rate for Payer: UHC Core |
$257.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$257.04
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: UMR Bronson Commercial |
$69.67
|
| Rate for Payer: VA VA |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.23
|
|
|
HC CROSSMATCH COOMBS
|
Facility
|
IP
|
$188.31
|
|
|
Service Code
|
CPT 86922
|
| Hospital Charge Code |
30200352
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$82.86 |
| Max. Negotiated Rate |
$169.48 |
| Rate for Payer: Aetna American Axle |
$122.40
|
| Rate for Payer: Aetna Commercial |
$160.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.40
|
| Rate for Payer: Cash Price |
$150.65
|
| Rate for Payer: Cofinity Advantage |
$131.82
|
| Rate for Payer: Cofinity Commercial |
$161.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.65
|
| Rate for Payer: Healthscope Commercial |
$169.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$141.23
|
| Rate for Payer: PHP Commercial |
$160.06
|
| Rate for Payer: Priority Health SBD |
$118.64
|
| Rate for Payer: UMR Bronson Commercial |
$82.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.23
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$548.99 |
| Rate for Payer: Aetna American Axle |
$41.39
|
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$176.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$6.94
|
| Rate for Payer: BCN Commercial |
$6.94
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$509.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$548.99
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: Priority Health Tiered Network |
$439.19
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.04
|
| Rate for Payer: UHC Core |
$257.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$257.04
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: UMR Bronson Commercial |
$23.56
|
| Rate for Payer: VA VA |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC CROSSMATCH ELECTRONIC
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 86923
|
| Hospital Charge Code |
30200380
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna American Axle |
$41.39
|
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: UMR Bronson Commercial |
$28.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
OP
|
$93.71
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$548.99 |
| Rate for Payer: Aetna American Axle |
$60.91
|
| Rate for Payer: Aetna Commercial |
$79.65
|
| Rate for Payer: Aetna Medicare |
$176.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$6.94
|
| Rate for Payer: BCN Commercial |
$6.94
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$74.97
|
| Rate for Payer: Cash Price |
$74.97
|
| Rate for Payer: Cofinity Advantage |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$80.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$84.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.28
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.65
|
| Rate for Payer: Nomi Health Commercial |
$509.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.28
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$79.65
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$548.99
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health SBD |
$59.04
|
| Rate for Payer: Priority Health Tiered Network |
$439.19
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.04
|
| Rate for Payer: UHC Core |
$257.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$257.04
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: UMR Bronson Commercial |
$34.67
|
| Rate for Payer: VA VA |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.28
|
|
|
HC CROSSMATCH IMMED SPIN
|
Facility
|
IP
|
$93.71
|
|
|
Service Code
|
CPT 86920
|
| Hospital Charge Code |
30200351
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.23 |
| Max. Negotiated Rate |
$84.34 |
| Rate for Payer: Aetna American Axle |
$60.91
|
| Rate for Payer: Aetna Commercial |
$79.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.91
|
| Rate for Payer: Cash Price |
$74.97
|
| Rate for Payer: Cofinity Advantage |
$65.60
|
| Rate for Payer: Cofinity Commercial |
$80.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.97
|
| Rate for Payer: Healthscope Commercial |
$84.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.28
|
| Rate for Payer: PHP Commercial |
$79.65
|
| Rate for Payer: Priority Health SBD |
$59.04
|
| Rate for Payer: UMR Bronson Commercial |
$41.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.28
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
OP
|
$237.73
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$548.99 |
| Rate for Payer: Aetna American Axle |
$154.52
|
| Rate for Payer: Aetna Commercial |
$202.07
|
| Rate for Payer: Aetna Medicare |
$176.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$6.94
|
| Rate for Payer: BCN Commercial |
$6.94
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$190.18
|
| Rate for Payer: Cash Price |
$190.18
|
| Rate for Payer: Cofinity Advantage |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$204.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$213.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.30
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.07
|
| Rate for Payer: Nomi Health Commercial |
$509.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.30
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$202.07
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$548.99
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health SBD |
$149.77
|
| Rate for Payer: Priority Health Tiered Network |
$439.19
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.04
|
| Rate for Payer: UHC Core |
$257.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$257.04
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: UMR Bronson Commercial |
$87.96
|
| Rate for Payer: VA VA |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.30
|
|
|
HC CROSSMATCH PREWARM
|
Facility
|
IP
|
$237.73
|
|
|
Service Code
|
CPT 86921
|
| Hospital Charge Code |
30200491
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$104.60 |
| Max. Negotiated Rate |
$213.96 |
| Rate for Payer: Aetna American Axle |
$154.52
|
| Rate for Payer: Aetna Commercial |
$202.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$154.52
|
| Rate for Payer: Cash Price |
$190.18
|
| Rate for Payer: Cofinity Advantage |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$204.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.18
|
| Rate for Payer: Healthscope Commercial |
$213.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$166.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.30
|
| Rate for Payer: PHP Commercial |
$202.07
|
| Rate for Payer: Priority Health SBD |
$149.77
|
| Rate for Payer: UMR Bronson Commercial |
$104.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.30
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.77 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna American Axle |
$61.13
|
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna Medicare |
$13.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.19
|
| Rate for Payer: BCBS Complete |
$7.11
|
| Rate for Payer: BCBS MAPPO |
$12.95
|
| Rate for Payer: BCBS Trust/PPO |
$14.97
|
| Rate for Payer: BCN Commercial |
$14.97
|
| Rate for Payer: BCN Medicare Advantage |
$12.95
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Advantage |
$65.83
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Mclaren Medicaid |
$12.95
|
| Rate for Payer: Mclaren Medicare |
$12.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.60
|
| Rate for Payer: Meridian Medicaid |
$13.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$19.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PACE Medicare |
$12.30
|
| Rate for Payer: PACE SWMI |
$12.95
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: PHP Medicare Advantage |
$12.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.95
|
| Rate for Payer: Priority Health Medicare |
$12.95
|
| Rate for Payer: Priority Health SBD |
$59.25
|
| Rate for Payer: Priority Health Tiered Network |
$10.36
|
| Rate for Payer: Railroad Medicare Medicare |
$12.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.43
|
| Rate for Payer: UHC Core |
$19.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.95
|
| Rate for Payer: UHC Exchange |
$19.43
|
| Rate for Payer: UHC Medicaid |
$6.77
|
| Rate for Payer: UHCCP Medicaid |
$6.77
|
| Rate for Payer: UMR Bronson Commercial |
$34.80
|
| Rate for Payer: VA VA |
$12.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC CRP HIGH SENSITIVITY CARDIAC RISK
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 86141
|
| Hospital Charge Code |
30200138
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna American Axle |
$61.13
|
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.13
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Advantage |
$65.83
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: Priority Health SBD |
$59.25
|
| Rate for Payer: UMR Bronson Commercial |
$41.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC CRP-SF
|
Facility
|
OP
|
$30.57
|
|
|
Service Code
|
CPT 86140
|
| Hospital Charge Code |
30200407
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$27.51 |
| Rate for Payer: Aetna American Axle |
$19.87
|
| Rate for Payer: Aetna Commercial |
$25.98
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$6.00
|
| Rate for Payer: BCN Commercial |
$6.00
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$24.46
|
| Rate for Payer: Cash Price |
$24.46
|
| Rate for Payer: Cofinity Advantage |
$21.40
|
| Rate for Payer: Cofinity Commercial |
$26.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$27.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.93
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.98
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.93
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$25.98
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.18
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$19.26
|
| Rate for Payer: Priority Health Tiered Network |
$4.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.77
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.31
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.93
|
|
