|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
IP
|
$92.21
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$40.57 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna American Axle |
$59.94
|
| Rate for Payer: Aetna Commercial |
$78.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.94
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$64.55
|
| Rate for Payer: Cofinity Commercial |
$79.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Healthscope Commercial |
$82.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: PHP Commercial |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health SBD |
$58.09
|
| Rate for Payer: UMR Bronson Commercial |
$40.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
IP
|
$262.96
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$115.70 |
| Max. Negotiated Rate |
$236.66 |
| Rate for Payer: Aetna American Axle |
$170.92
|
| Rate for Payer: Aetna Commercial |
$223.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.92
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cofinity Commercial |
$184.07
|
| Rate for Payer: Cofinity Commercial |
$226.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$184.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.37
|
| Rate for Payer: Healthscope Commercial |
$236.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.52
|
| Rate for Payer: PHP Commercial |
$223.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.92
|
| Rate for Payer: Priority Health SBD |
$165.66
|
| Rate for Payer: UMR Bronson Commercial |
$115.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.22
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
OP
|
$262.96
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$72.82 |
| Max. Negotiated Rate |
$382.43 |
| Rate for Payer: Aetna American Axle |
$170.92
|
| Rate for Payer: Aetna Commercial |
$223.52
|
| Rate for Payer: Aetna Medicare |
$141.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.82
|
| Rate for Payer: BCBS Complete |
$76.46
|
| Rate for Payer: BCBS MAPPO |
$135.86
|
| Rate for Payer: BCN Medicare Advantage |
$135.86
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cofinity Commercial |
$226.15
|
| Rate for Payer: Cofinity Commercial |
$184.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$184.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.86
|
| Rate for Payer: Healthscope Commercial |
$236.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$184.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.22
|
| Rate for Payer: Mclaren Medicaid |
$72.82
|
| Rate for Payer: Mclaren Medicare |
$135.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$142.65
|
| Rate for Payer: Meridian Medicaid |
$76.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$156.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.52
|
| Rate for Payer: PACE Medicare |
$129.07
|
| Rate for Payer: PACE SWMI |
$135.86
|
| Rate for Payer: PHP Commercial |
$223.52
|
| Rate for Payer: PHP Medicare Advantage |
$135.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.92
|
| Rate for Payer: Priority Health Medicare |
$135.86
|
| Rate for Payer: Priority Health SBD |
$165.66
|
| Rate for Payer: Railroad Medicare Medicare |
$135.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.86
|
| Rate for Payer: UHC Exchange |
$259.64
|
| Rate for Payer: UHC Medicare Advantage |
$135.86
|
| Rate for Payer: UHCCP Medicaid |
$72.82
|
| Rate for Payer: UMR Bronson Commercial |
$97.30
|
| Rate for Payer: VA VA |
$135.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.22
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$54.83 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna American Axle |
$96.32
|
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna Medicare |
$74.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.32
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$103.73
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$103.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.32
|
| Rate for Payer: Priority Health SBD |
$93.36
|
| Rate for Payer: UMR Bronson Commercial |
$54.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna American Axle |
$96.32
|
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.32
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$103.73
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$103.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.32
|
| Rate for Payer: Priority Health SBD |
$93.36
|
| Rate for Payer: UMR Bronson Commercial |
$65.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTROMERE AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC CENTROMERE AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$50.47 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$34.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$92.46 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna American Axle |
$162.44
|
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna Medicare |
$124.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: BCBS Complete |
$99.96
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: UMR Bronson Commercial |
$92.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.43
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$109.96 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna American Axle |
$162.44
|
| Rate for Payer: Aetna Commercial |
$212.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.44
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$174.93
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$174.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: PHP Commercial |
$212.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health SBD |
$157.44
|
| Rate for Payer: UMR Bronson Commercial |
$109.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.43
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
OP
|
$4,135.96
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,530.31 |
| Max. Negotiated Rate |
$3,722.36 |
| Rate for Payer: Aetna American Axle |
$2,688.37
|
| Rate for Payer: Aetna Commercial |
$3,515.57
|
| Rate for Payer: Aetna Medicare |
$2,067.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,688.37
|
| Rate for Payer: BCBS Complete |
$1,654.38
|
| Rate for Payer: Cash Price |
$3,308.77
|
| Rate for Payer: Cofinity Commercial |
$2,895.17
|
| Rate for Payer: Cofinity Commercial |
$3,556.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,895.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,308.77
|
| Rate for Payer: Healthscope Commercial |
$3,722.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,895.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,101.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,515.57
|
| Rate for Payer: PHP Commercial |
$3,515.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,688.37
|
| Rate for Payer: Priority Health SBD |
$2,605.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,530.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,101.97
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
IP
|
$4,135.96
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,819.82 |
| Max. Negotiated Rate |
$3,722.36 |
| Rate for Payer: Aetna American Axle |
$2,688.37
|
| Rate for Payer: Aetna Commercial |
$3,515.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,688.37
|
| Rate for Payer: Cash Price |
$3,308.77
|
| Rate for Payer: Cofinity Commercial |
$2,895.17
|
| Rate for Payer: Cofinity Commercial |
$3,556.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,895.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,308.77
|
| Rate for Payer: Healthscope Commercial |
$3,722.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,895.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,101.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,515.57
|
| Rate for Payer: PHP Commercial |
$3,515.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,688.37
|
| Rate for Payer: Priority Health SBD |
$2,605.65
|
| Rate for Payer: UMR Bronson Commercial |
$1,819.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,101.97
|
|
|
HC CERETEC PER DOSE
|
Facility
|
OP
|
$2,060.99
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$430.05 |
| Max. Negotiated Rate |
$2,258.51 |
| Rate for Payer: Aetna American Axle |
$1,339.64
|
| Rate for Payer: Aetna Commercial |
$1,751.84
|
| Rate for Payer: Aetna Medicare |
$834.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,339.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,002.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,002.92
|
| Rate for Payer: BCBS Complete |
$451.56
|
| Rate for Payer: BCBS MAPPO |
$802.34
|
| Rate for Payer: BCN Medicare Advantage |
$802.34
|
| Rate for Payer: Cash Price |
$1,648.79
|
| Rate for Payer: Cash Price |
$1,648.79
|
| Rate for Payer: Cofinity Commercial |
$1,772.45
|
| Rate for Payer: Cofinity Commercial |
$1,442.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,442.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,648.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$802.34
|
| Rate for Payer: Healthscope Commercial |
$1,854.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,442.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,545.74
|
| Rate for Payer: Mclaren Medicaid |
$430.05
|
| Rate for Payer: Mclaren Medicare |
$802.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$842.46
|
| Rate for Payer: Meridian Medicaid |
$451.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$922.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,751.84
|
| Rate for Payer: PACE Medicare |
$762.22
|
| Rate for Payer: PACE SWMI |
$802.34
|
| Rate for Payer: PHP Commercial |
$1,751.84
|
| Rate for Payer: PHP Medicare Advantage |
$802.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$430.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.64
|
| Rate for Payer: Priority Health Medicare |
$802.34
|
| Rate for Payer: Priority Health SBD |
$1,298.42
|
| Rate for Payer: Railroad Medicare Medicare |
$802.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,258.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$802.34
|
| Rate for Payer: UHC Exchange |
$1,533.35
|
| Rate for Payer: UHC Medicare Advantage |
$802.34
|
| Rate for Payer: UHCCP Medicaid |
$430.05
|
| Rate for Payer: UMR Bronson Commercial |
$762.57
|
| Rate for Payer: VA VA |
$802.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,545.74
|
|
|
HC CERETEC PER DOSE
|
Facility
|
IP
|
$2,060.99
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$906.84 |
| Max. Negotiated Rate |
$1,854.89 |
| Rate for Payer: Aetna American Axle |
$1,339.64
|
| Rate for Payer: Aetna Commercial |
$1,751.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,339.64
|
| Rate for Payer: Cash Price |
$1,648.79
|
| Rate for Payer: Cofinity Commercial |
$1,442.69
|
| Rate for Payer: Cofinity Commercial |
$1,772.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,442.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,648.79
|
| Rate for Payer: Healthscope Commercial |
$1,854.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,442.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,545.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,751.84
|
| Rate for Payer: PHP Commercial |
$1,751.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.64
|
| Rate for Payer: Priority Health SBD |
$1,298.42
|
| Rate for Payer: UMR Bronson Commercial |
$906.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,545.74
|
|
|
HC CERTOLIZUMAB
|
Facility
|
OP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna American Axle |
$108.07
|
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Cofinity Commercial |
$116.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.69
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$104.74
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$33.00
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: UMR Bronson Commercial |
$61.52
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.69
|
|
|
HC CERTOLIZUMAB
|
Facility
|
IP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.15 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna American Axle |
$108.07
|
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.07
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$116.38
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health SBD |
$104.74
|
| Rate for Payer: UMR Bronson Commercial |
$73.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.69
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
OP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna American Axle |
$84.86
|
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$82.25
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$35.62
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: UMR Bronson Commercial |
$48.31
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
IP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$57.45 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna American Axle |
$84.86
|
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Cofinity Commercial |
$91.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health SBD |
$82.25
|
| Rate for Payer: UMR Bronson Commercial |
$57.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC CERULOPLASMIN
|
Facility
|
OP
|
$42.66
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna American Axle |
$27.73
|
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna Medicare |
$11.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.43
|
| Rate for Payer: BCBS Complete |
$6.04
|
| Rate for Payer: BCBS MAPPO |
$10.74
|
| Rate for Payer: BCN Medicare Advantage |
$10.74
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Cofinity Commercial |
$29.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.74
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Mclaren Medicaid |
$5.76
|
| Rate for Payer: Mclaren Medicare |
$10.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.28
|
| Rate for Payer: Meridian Medicaid |
$6.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: PACE Medicare |
$10.20
|
| Rate for Payer: PACE SWMI |
$10.74
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: PHP Medicare Advantage |
$10.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health Medicare |
$10.74
|
| Rate for Payer: Priority Health SBD |
$26.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.74
|
| Rate for Payer: UHC Exchange |
$20.53
|
| Rate for Payer: UHC Medicare Advantage |
$10.74
|
| Rate for Payer: UHCCP Medicaid |
$5.76
|
| Rate for Payer: UMR Bronson Commercial |
$15.78
|
| Rate for Payer: VA VA |
$10.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC CERULOPLASMIN
|
Facility
|
IP
|
$42.66
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.77 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna American Axle |
$27.73
|
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.73
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$29.86
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health SBD |
$26.88
|
| Rate for Payer: UMR Bronson Commercial |
$18.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC CERVILENZ
|
Facility
|
IP
|
$170.69
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$75.10 |
| Max. Negotiated Rate |
$153.62 |
| Rate for Payer: Aetna American Axle |
$110.95
|
| Rate for Payer: Aetna Commercial |
$145.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.95
|
| Rate for Payer: Cash Price |
$136.55
|
| Rate for Payer: Cofinity Commercial |
$119.48
|
| Rate for Payer: Cofinity Commercial |
$146.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.55
|
| Rate for Payer: Healthscope Commercial |
$153.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.09
|
| Rate for Payer: PHP Commercial |
$145.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.95
|
| Rate for Payer: Priority Health SBD |
$107.53
|
| Rate for Payer: UMR Bronson Commercial |
$75.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.02
|
|
|
HC CERVILENZ
|
Facility
|
OP
|
$170.69
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$63.16 |
| Max. Negotiated Rate |
$153.62 |
| Rate for Payer: Aetna American Axle |
$110.95
|
| Rate for Payer: Aetna Commercial |
$145.09
|
| Rate for Payer: Aetna Medicare |
$85.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.95
|
| Rate for Payer: BCBS Complete |
$68.28
|
| Rate for Payer: Cash Price |
$136.55
|
| Rate for Payer: Cofinity Commercial |
$119.48
|
| Rate for Payer: Cofinity Commercial |
$146.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.55
|
| Rate for Payer: Healthscope Commercial |
$153.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.09
|
| Rate for Payer: PHP Commercial |
$145.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.95
|
| Rate for Payer: Priority Health SBD |
$107.53
|
| Rate for Payer: UMR Bronson Commercial |
$63.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.02
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
IP
|
$140.78
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$61.94 |
| Max. Negotiated Rate |
$126.70 |
| Rate for Payer: Aetna American Axle |
$91.51
|
| Rate for Payer: Aetna Commercial |
$119.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.51
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cofinity Commercial |
$121.07
|
| Rate for Payer: Cofinity Commercial |
$98.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.62
|
| Rate for Payer: Healthscope Commercial |
$126.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.66
|
| Rate for Payer: PHP Commercial |
$119.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.51
|
| Rate for Payer: Priority Health SBD |
$88.69
|
| Rate for Payer: UMR Bronson Commercial |
$61.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.58
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
OP
|
$140.78
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$48.35 |
| Max. Negotiated Rate |
$253.93 |
| Rate for Payer: Aetna American Axle |
$91.51
|
| Rate for Payer: Aetna Commercial |
$119.66
|
| Rate for Payer: Aetna Medicare |
$93.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.76
|
| Rate for Payer: BCBS Complete |
$50.77
|
| Rate for Payer: BCBS MAPPO |
$90.21
|
| Rate for Payer: BCN Medicare Advantage |
$90.21
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cofinity Commercial |
$98.55
|
| Rate for Payer: Cofinity Commercial |
$121.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.21
|
| Rate for Payer: Healthscope Commercial |
$126.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.58
|
| Rate for Payer: Mclaren Medicaid |
$48.35
|
| Rate for Payer: Mclaren Medicare |
$90.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.72
|
| Rate for Payer: Meridian Medicaid |
$50.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.66
|
| Rate for Payer: PACE Medicare |
$85.70
|
| Rate for Payer: PACE SWMI |
$90.21
|
| Rate for Payer: PHP Commercial |
$119.66
|
| Rate for Payer: PHP Medicare Advantage |
$90.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.51
|
| Rate for Payer: Priority Health Medicare |
$90.21
|
| Rate for Payer: Priority Health SBD |
$88.69
|
| Rate for Payer: Railroad Medicare Medicare |
$90.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$253.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.21
|
| Rate for Payer: UHC Exchange |
$172.40
|
| Rate for Payer: UHC Medicare Advantage |
$90.21
|
| Rate for Payer: UHCCP Medicaid |
$48.35
|
| Rate for Payer: UMR Bronson Commercial |
$52.09
|
| Rate for Payer: VA VA |
$90.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.58
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
OP
|
$777.71
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$287.75 |
| Max. Negotiated Rate |
$832.00 |
| Rate for Payer: Aetna American Axle |
$505.51
|
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna Medicare |
$388.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.51
|
| Rate for Payer: BCBS Complete |
$311.08
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Cofinity Commercial |
$544.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health SBD |
$489.96
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UMR Bronson Commercial |
$287.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
IP
|
$777.71
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$342.19 |
| Max. Negotiated Rate |
$699.94 |
| Rate for Payer: Aetna American Axle |
$505.51
|
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$505.51
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$544.40
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$544.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$544.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health SBD |
$489.96
|
| Rate for Payer: UMR Bronson Commercial |
$342.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
