|
HC CT UPPER EXTREMITY WO CON
|
Facility
|
IP
|
$1,239.49
|
|
|
Service Code
|
CPT 73200
|
| Hospital Charge Code |
35200013
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$545.38 |
| Max. Negotiated Rate |
$1,115.54 |
| Rate for Payer: Aetna American Axle |
$805.67
|
| Rate for Payer: Aetna Commercial |
$1,053.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$805.67
|
| Rate for Payer: Cash Price |
$991.59
|
| Rate for Payer: Cofinity Advantage |
$867.64
|
| Rate for Payer: Cofinity Commercial |
$1,065.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$991.59
|
| Rate for Payer: Healthscope Commercial |
$1,115.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$867.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$929.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,053.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$929.62
|
| Rate for Payer: PHP Commercial |
$1,053.57
|
| Rate for Payer: Priority Health SBD |
$780.88
|
| Rate for Payer: UMR Bronson Commercial |
$545.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$929.62
|
|
|
HC CT UPPER EXTREMITY WO W CON
|
Facility
|
IP
|
$1,724.67
|
|
|
Service Code
|
CPT 73202
|
| Hospital Charge Code |
35200015
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$758.85 |
| Max. Negotiated Rate |
$1,552.20 |
| Rate for Payer: Aetna American Axle |
$1,121.04
|
| Rate for Payer: Aetna Commercial |
$1,465.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.04
|
| Rate for Payer: Cash Price |
$1,379.74
|
| Rate for Payer: Cofinity Advantage |
$1,207.27
|
| Rate for Payer: Cofinity Commercial |
$1,483.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.74
|
| Rate for Payer: Healthscope Commercial |
$1,552.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,207.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,293.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,293.50
|
| Rate for Payer: PHP Commercial |
$1,465.97
|
| Rate for Payer: Priority Health SBD |
$1,086.54
|
| Rate for Payer: UMR Bronson Commercial |
$758.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,293.50
|
|
|
HC CT UPPER EXTREMITY WO W CON
|
Facility
|
OP
|
$1,724.67
|
|
|
Service Code
|
CPT 73202
|
| Hospital Charge Code |
35200015
|
|
Hospital Revenue Code
|
352
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,552.20 |
| Rate for Payer: Aetna American Axle |
$1,121.04
|
| Rate for Payer: Aetna Commercial |
$1,465.97
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,121.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$475.31
|
| Rate for Payer: BCN Commercial |
$475.31
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,379.74
|
| Rate for Payer: Cash Price |
$1,379.74
|
| Rate for Payer: Cofinity Advantage |
$1,207.27
|
| Rate for Payer: Cofinity Commercial |
$1,483.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,379.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,552.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,207.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,293.50
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,465.97
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,293.50
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$1,465.97
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$1,086.54
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,121.04
|
| Rate for Payer: UHC Core |
$898.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$677.80
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$638.13
|
| Rate for Payer: VA VA |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,293.50
|
|
|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
OP
|
$1,034.26
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$124.34 |
| Max. Negotiated Rate |
$930.83 |
| Rate for Payer: Aetna American Axle |
$672.27
|
| Rate for Payer: Aetna Commercial |
$879.12
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$827.41
|
| Rate for Payer: Cash Price |
$827.41
|
| Rate for Payer: Cofinity Advantage |
$723.98
|
| Rate for Payer: Cofinity Commercial |
$889.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$930.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$723.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.70
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$879.12
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.70
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$879.12
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$651.58
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$672.27
|
| Rate for Payer: UHC Core |
$538.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Exchange |
$406.46
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$382.68
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.70
|
|
|
HC CT VIRTUAL COLONOSCOPY SCREENING
|
Facility
|
IP
|
$1,034.26
|
|
|
Service Code
|
CPT 74263
|
| Hospital Charge Code |
35000014
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$455.07 |
| Max. Negotiated Rate |
$930.83 |
| Rate for Payer: Aetna American Axle |
$672.27
|
| Rate for Payer: Aetna Commercial |
$879.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.27
|
| Rate for Payer: Cash Price |
$827.41
|
| Rate for Payer: Cofinity Advantage |
$723.98
|
| Rate for Payer: Cofinity Commercial |
$889.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.41
|
| Rate for Payer: Healthscope Commercial |
$930.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$723.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$879.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$775.70
|
| Rate for Payer: PHP Commercial |
$879.12
|
| Rate for Payer: Priority Health SBD |
$651.58
|
| Rate for Payer: UMR Bronson Commercial |
$455.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.70
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
IP
|
$1,312.26
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$577.39 |
| Max. Negotiated Rate |
$1,181.03 |
| Rate for Payer: Aetna American Axle |
$852.97
|
| Rate for Payer: Aetna Commercial |
$1,115.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.97
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Advantage |
$918.58
|
| Rate for Payer: Cofinity Commercial |
$1,128.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Healthscope Commercial |
$1,181.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$918.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$984.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: PHP Commercial |
$1,115.42
|
| Rate for Payer: Priority Health SBD |
$826.72
|
| Rate for Payer: UMR Bronson Commercial |
$577.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$984.20
|
|
|
HC CT VIRTUAL COLON W CON DIAG
|
Facility
|
OP
|
$1,312.26
|
|
|
Service Code
|
CPT 74262
|
| Hospital Charge Code |
35000013
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$91.40 |
| Max. Negotiated Rate |
$1,181.03 |
| Rate for Payer: Aetna American Axle |
$852.97
|
| Rate for Payer: Aetna Commercial |
$1,115.42
|
| Rate for Payer: Aetna Medicare |
$181.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.46
|
| Rate for Payer: BCBS Complete |
$95.98
|
| Rate for Payer: BCBS MAPPO |
$174.77
|
| Rate for Payer: BCBS Trust/PPO |
$862.76
|
| Rate for Payer: BCN Commercial |
$862.76
|
| Rate for Payer: BCN Medicare Advantage |
$174.77
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Advantage |
$918.58
|
| Rate for Payer: Cofinity Commercial |
$1,128.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.77
|
| Rate for Payer: Healthscope Commercial |
$1,181.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$918.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$984.20
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$174.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.51
|
| Rate for Payer: Meridian Medicaid |
$183.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Nomi Health Commercial |
$524.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: PACE Medicare |
$166.03
|
| Rate for Payer: PACE SWMI |
$174.77
|
| Rate for Payer: PHP Commercial |
$1,115.42
|
| Rate for Payer: PHP Medicare Advantage |
$174.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$565.19
|
| Rate for Payer: Priority Health Medicare |
$174.77
|
| Rate for Payer: Priority Health SBD |
$826.72
|
| Rate for Payer: Priority Health Tiered Network |
$452.15
|
| Rate for Payer: Railroad Medicare Medicare |
$174.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.97
|
| Rate for Payer: UHC Core |
$683.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$174.77
|
| Rate for Payer: UHC Exchange |
$515.72
|
| Rate for Payer: UHC Medicaid |
$91.40
|
| Rate for Payer: UHCCP Medicaid |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$485.54
|
| Rate for Payer: VA VA |
$174.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$984.20
|
|
|
HC CT VIRTUAL COLON WO CON DIAG
|
Facility
|
IP
|
$1,312.26
|
|
|
Service Code
|
CPT 74261
|
| Hospital Charge Code |
35000012
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$577.39 |
| Max. Negotiated Rate |
$1,181.03 |
| Rate for Payer: Aetna American Axle |
$852.97
|
| Rate for Payer: Aetna Commercial |
$1,115.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.97
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Advantage |
$918.58
|
| Rate for Payer: Cofinity Commercial |
$1,128.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Healthscope Commercial |
$1,181.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$918.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$984.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: PHP Commercial |
$1,115.42
|
| Rate for Payer: Priority Health SBD |
$826.72
|
| Rate for Payer: UMR Bronson Commercial |
$577.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$984.20
|
|
|
HC CT VIRTUAL COLON WO CON DIAG
|
Facility
|
OP
|
$1,312.26
|
|
|
Service Code
|
CPT 74261
|
| Hospital Charge Code |
35000012
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$1,181.03 |
| Rate for Payer: Aetna American Axle |
$852.97
|
| Rate for Payer: Aetna Commercial |
$1,115.42
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$852.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$747.02
|
| Rate for Payer: BCN Commercial |
$747.02
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cash Price |
$1,049.81
|
| Rate for Payer: Cofinity Advantage |
$918.58
|
| Rate for Payer: Cofinity Commercial |
$1,128.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,049.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$1,181.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$918.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$984.20
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,115.42
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$984.20
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$1,115.42
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$826.72
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$852.97
|
| Rate for Payer: UHC Core |
$683.69
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$515.72
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$485.54
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$984.20
|
|
|
HC CTX BETA CROSSLAPS, S
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
30100768
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Advantage |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.42
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CTX BETA CROSSLAPS, S
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 82523
|
| Hospital Charge Code |
30100768
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$19.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.35
|
| Rate for Payer: BCBS Complete |
$10.26
|
| Rate for Payer: BCBS MAPPO |
$18.68
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$18.68
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Advantage |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$18.68
|
| Rate for Payer: Mclaren Medicare |
$18.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.61
|
| Rate for Payer: Meridian Medicaid |
$19.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.02
|
| Rate for Payer: Nomi Health Commercial |
$28.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.42
|
| Rate for Payer: PACE Medicare |
$17.75
|
| Rate for Payer: PACE SWMI |
$18.68
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$18.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.68
|
| Rate for Payer: Priority Health Medicare |
$18.68
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Priority Health Tiered Network |
$14.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.02
|
| Rate for Payer: UHC Core |
$28.02
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.68
|
| Rate for Payer: UHC Exchange |
$28.02
|
| Rate for Payer: UHC Medicaid |
$9.77
|
| Rate for Payer: UHCCP Medicaid |
$9.77
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: VA VA |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CT Z ABSCESS S T NECK THORAX
|
Facility
|
OP
|
$2,698.29
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
36100319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$998.37 |
| Max. Negotiated Rate |
$9,359.82 |
| Rate for Payer: Aetna American Axle |
$1,753.89
|
| Rate for Payer: Aetna Commercial |
$2,293.55
|
| Rate for Payer: Aetna Medicare |
$3,010.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,753.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,617.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,617.84
|
| Rate for Payer: BCBS Complete |
$1,589.53
|
| Rate for Payer: BCBS MAPPO |
$2,894.27
|
| Rate for Payer: BCBS Trust/PPO |
$3,500.30
|
| Rate for Payer: BCN Commercial |
$3,500.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,894.27
|
| Rate for Payer: Cash Price |
$2,158.63
|
| Rate for Payer: Cash Price |
$2,158.63
|
| Rate for Payer: Cash Price |
$2,158.63
|
| Rate for Payer: Cofinity Advantage |
$1,888.80
|
| Rate for Payer: Cofinity Commercial |
$2,320.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,158.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,894.27
|
| Rate for Payer: Healthscope Commercial |
$2,428.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,888.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,023.72
|
| Rate for Payer: Mclaren Medicaid |
$2,894.27
|
| Rate for Payer: Mclaren Medicare |
$2,894.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,038.98
|
| Rate for Payer: Meridian Medicaid |
$3,038.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,328.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,293.55
|
| Rate for Payer: Nomi Health Commercial |
$8,682.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,023.72
|
| Rate for Payer: PACE Medicare |
$2,749.56
|
| Rate for Payer: PACE SWMI |
$2,894.27
|
| Rate for Payer: PHP Commercial |
$2,293.55
|
| Rate for Payer: PHP Medicare Advantage |
$2,894.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,513.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,359.82
|
| Rate for Payer: Priority Health Medicare |
$2,894.27
|
| Rate for Payer: Priority Health SBD |
$1,699.92
|
| Rate for Payer: Priority Health Tiered Network |
$7,487.86
|
| Rate for Payer: Railroad Medicare Medicare |
$2,894.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,894.27
|
| Rate for Payer: UHC Medicaid |
$1,513.70
|
| Rate for Payer: UHCCP Medicaid |
$1,513.70
|
| Rate for Payer: UMR Bronson Commercial |
$998.37
|
| Rate for Payer: VA VA |
$2,894.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,023.72
|
|
|
HC CT Z ABSCESS S T NECK THORAX
|
Facility
|
IP
|
$2,698.29
|
|
|
Service Code
|
CPT 21501
|
| Hospital Charge Code |
36100319
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,187.25 |
| Max. Negotiated Rate |
$2,428.46 |
| Rate for Payer: Aetna American Axle |
$1,753.89
|
| Rate for Payer: Aetna Commercial |
$2,293.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,753.89
|
| Rate for Payer: Cash Price |
$2,158.63
|
| Rate for Payer: Cofinity Advantage |
$1,888.80
|
| Rate for Payer: Cofinity Commercial |
$2,320.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,158.63
|
| Rate for Payer: Healthscope Commercial |
$2,428.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,888.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,023.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,293.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,023.72
|
| Rate for Payer: PHP Commercial |
$2,293.55
|
| Rate for Payer: Priority Health SBD |
$1,699.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,187.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,023.72
|
|
|
HC CULTURE ADDITIONAL ID
|
Facility
|
OP
|
$53.39
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
30600078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$48.05 |
| Rate for Payer: Aetna American Axle |
$34.70
|
| Rate for Payer: Aetna Commercial |
$45.38
|
| Rate for Payer: Aetna Medicare |
$8.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.10
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: BCBS MAPPO |
$8.08
|
| Rate for Payer: BCBS Trust/PPO |
$9.34
|
| Rate for Payer: BCN Commercial |
$9.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.08
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cofinity Advantage |
$37.37
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.08
|
| Rate for Payer: Healthscope Commercial |
$48.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.04
|
| Rate for Payer: Mclaren Medicaid |
$8.08
|
| Rate for Payer: Mclaren Medicare |
$8.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.48
|
| Rate for Payer: Meridian Medicaid |
$8.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.38
|
| Rate for Payer: Nomi Health Commercial |
$12.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.04
|
| Rate for Payer: PACE Medicare |
$7.68
|
| Rate for Payer: PACE SWMI |
$8.08
|
| Rate for Payer: PHP Commercial |
$45.38
|
| Rate for Payer: PHP Medicare Advantage |
$8.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.08
|
| Rate for Payer: Priority Health Medicare |
$8.08
|
| Rate for Payer: Priority Health SBD |
$33.64
|
| Rate for Payer: Priority Health Tiered Network |
$6.46
|
| Rate for Payer: Railroad Medicare Medicare |
$8.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.12
|
| Rate for Payer: UHC Core |
$12.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.08
|
| Rate for Payer: UHC Exchange |
$12.12
|
| Rate for Payer: UHC Medicaid |
$4.23
|
| Rate for Payer: UHCCP Medicaid |
$4.23
|
| Rate for Payer: UMR Bronson Commercial |
$19.75
|
| Rate for Payer: VA VA |
$8.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.04
|
|
|
HC CULTURE ADDITIONAL ID
|
Facility
|
IP
|
$53.39
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
30600078
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.49 |
| Max. Negotiated Rate |
$48.05 |
| Rate for Payer: Aetna American Axle |
$34.70
|
| Rate for Payer: Aetna Commercial |
$45.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.70
|
| Rate for Payer: Cash Price |
$42.71
|
| Rate for Payer: Cofinity Advantage |
$37.37
|
| Rate for Payer: Cofinity Commercial |
$45.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.71
|
| Rate for Payer: Healthscope Commercial |
$48.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.04
|
| Rate for Payer: PHP Commercial |
$45.38
|
| Rate for Payer: Priority Health SBD |
$33.64
|
| Rate for Payer: UMR Bronson Commercial |
$23.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.04
|
|
|
HC CULTURE ENTERIC PATH STOOL
|
Facility
|
IP
|
$42.49
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600323
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.70 |
| Max. Negotiated Rate |
$38.24 |
| Rate for Payer: Aetna American Axle |
$27.62
|
| Rate for Payer: Aetna Commercial |
$36.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.62
|
| Rate for Payer: Cash Price |
$33.99
|
| Rate for Payer: Cofinity Advantage |
$29.74
|
| Rate for Payer: Cofinity Commercial |
$36.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.99
|
| Rate for Payer: Healthscope Commercial |
$38.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.87
|
| Rate for Payer: PHP Commercial |
$36.12
|
| Rate for Payer: Priority Health SBD |
$26.77
|
| Rate for Payer: UMR Bronson Commercial |
$18.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.87
|
|
|
HC CULTURE ENTERIC PATH STOOL
|
Facility
|
OP
|
$42.49
|
|
|
Service Code
|
CPT 87045
|
| Hospital Charge Code |
30600323
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$38.24 |
| Rate for Payer: Aetna American Axle |
$27.62
|
| Rate for Payer: Aetna Commercial |
$36.12
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$10.91
|
| Rate for Payer: BCN Commercial |
$10.91
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$33.99
|
| Rate for Payer: Cash Price |
$33.99
|
| Rate for Payer: Cofinity Advantage |
$29.74
|
| Rate for Payer: Cofinity Commercial |
$36.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$38.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.87
|
| Rate for Payer: Mclaren Medicaid |
$9.44
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$9.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.12
|
| Rate for Payer: Nomi Health Commercial |
$14.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.87
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$36.12
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.44
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health SBD |
$26.77
|
| Rate for Payer: Priority Health Tiered Network |
$7.55
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.16
|
| Rate for Payer: UHC Core |
$14.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.44
|
| Rate for Payer: UHC Exchange |
$14.16
|
| Rate for Payer: UHC Medicaid |
$4.94
|
| Rate for Payer: UHCCP Medicaid |
$4.94
|
| Rate for Payer: UMR Bronson Commercial |
$15.72
|
| Rate for Payer: VA VA |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.87
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
OP
|
$15.96
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$14.36 |
| Rate for Payer: Aetna American Axle |
$10.37
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna Medicare |
$9.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.80
|
| Rate for Payer: BCBS Complete |
$5.18
|
| Rate for Payer: BCBS MAPPO |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$10.91
|
| Rate for Payer: BCN Commercial |
$10.91
|
| Rate for Payer: BCN Medicare Advantage |
$9.44
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Cofinity Advantage |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.44
|
| Rate for Payer: Healthscope Commercial |
$14.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.97
|
| Rate for Payer: Mclaren Medicaid |
$9.44
|
| Rate for Payer: Mclaren Medicare |
$9.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.91
|
| Rate for Payer: Meridian Medicaid |
$9.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Nomi Health Commercial |
$14.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.97
|
| Rate for Payer: PACE Medicare |
$8.97
|
| Rate for Payer: PACE SWMI |
$9.44
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: PHP Medicare Advantage |
$9.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.44
|
| Rate for Payer: Priority Health Medicare |
$9.44
|
| Rate for Payer: Priority Health SBD |
$10.05
|
| Rate for Payer: Priority Health Tiered Network |
$7.55
|
| Rate for Payer: Railroad Medicare Medicare |
$9.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.16
|
| Rate for Payer: UHC Core |
$14.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.44
|
| Rate for Payer: UHC Exchange |
$14.16
|
| Rate for Payer: UHC Medicaid |
$4.94
|
| Rate for Payer: UHCCP Medicaid |
$4.94
|
| Rate for Payer: UMR Bronson Commercial |
$5.91
|
| Rate for Payer: VA VA |
$9.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.97
|
|
|
HC CULTURE ENTERIC PATH STOOL CMPT
|
Facility
|
IP
|
$15.96
|
|
|
Service Code
|
CPT 87046
|
| Hospital Charge Code |
30600324
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$14.36 |
| Rate for Payer: Aetna American Axle |
$10.37
|
| Rate for Payer: Aetna Commercial |
$13.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.37
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Cofinity Advantage |
$11.17
|
| Rate for Payer: Cofinity Commercial |
$13.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.77
|
| Rate for Payer: Healthscope Commercial |
$14.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.97
|
| Rate for Payer: PHP Commercial |
$13.57
|
| Rate for Payer: Priority Health SBD |
$10.05
|
| Rate for Payer: UMR Bronson Commercial |
$7.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.97
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna American Axle |
$53.42
|
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna Medicare |
$8.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.51
|
| Rate for Payer: BCBS Complete |
$4.62
|
| Rate for Payer: BCBS MAPPO |
$8.41
|
| Rate for Payer: BCBS Trust/PPO |
$9.73
|
| Rate for Payer: BCN Commercial |
$9.73
|
| Rate for Payer: BCN Medicare Advantage |
$8.41
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Advantage |
$57.53
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.41
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Mclaren Medicaid |
$8.41
|
| Rate for Payer: Mclaren Medicare |
$8.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.83
|
| Rate for Payer: Meridian Medicaid |
$8.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$12.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PACE Medicare |
$7.99
|
| Rate for Payer: PACE SWMI |
$8.41
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: PHP Medicare Advantage |
$8.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.41
|
| Rate for Payer: Priority Health Medicare |
$8.41
|
| Rate for Payer: Priority Health SBD |
$51.78
|
| Rate for Payer: Priority Health Tiered Network |
$6.73
|
| Rate for Payer: Railroad Medicare Medicare |
$8.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.62
|
| Rate for Payer: UHC Core |
$12.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.41
|
| Rate for Payer: UHC Exchange |
$12.62
|
| Rate for Payer: UHC Medicaid |
$4.40
|
| Rate for Payer: UHCCP Medicaid |
$4.40
|
| Rate for Payer: UMR Bronson Commercial |
$30.41
|
| Rate for Payer: VA VA |
$8.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC CULTURE FUNGAL OTHER SOURCE
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
30600083
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.16 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna American Axle |
$53.42
|
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.42
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Advantage |
$57.53
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: Priority Health SBD |
$51.78
|
| Rate for Payer: UMR Bronson Commercial |
$36.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
IP
|
$82.19
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.16 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna American Axle |
$53.42
|
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.42
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Advantage |
$57.53
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: Priority Health SBD |
$51.78
|
| Rate for Payer: UMR Bronson Commercial |
$36.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC CULTURE FUNGAL SKIN, HAIR, NAIL
|
Facility
|
OP
|
$82.19
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
30600082
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.03 |
| Max. Negotiated Rate |
$73.97 |
| Rate for Payer: Aetna American Axle |
$53.42
|
| Rate for Payer: Aetna Commercial |
$69.86
|
| Rate for Payer: Aetna Medicare |
$8.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.64
|
| Rate for Payer: BCBS Complete |
$4.23
|
| Rate for Payer: BCBS MAPPO |
$7.71
|
| Rate for Payer: BCBS Trust/PPO |
$8.91
|
| Rate for Payer: BCN Commercial |
$8.91
|
| Rate for Payer: BCN Medicare Advantage |
$7.71
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cash Price |
$65.75
|
| Rate for Payer: Cofinity Advantage |
$57.53
|
| Rate for Payer: Cofinity Commercial |
$70.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.71
|
| Rate for Payer: Healthscope Commercial |
$73.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.64
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$7.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.10
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.86
|
| Rate for Payer: Nomi Health Commercial |
$11.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$61.64
|
| Rate for Payer: PACE Medicare |
$7.32
|
| Rate for Payer: PACE SWMI |
$7.71
|
| Rate for Payer: PHP Commercial |
$69.86
|
| Rate for Payer: PHP Medicare Advantage |
$7.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.71
|
| Rate for Payer: Priority Health Medicare |
$7.71
|
| Rate for Payer: Priority Health SBD |
$51.78
|
| Rate for Payer: Priority Health Tiered Network |
$6.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.57
|
| Rate for Payer: UHC Core |
$11.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.71
|
| Rate for Payer: UHC Exchange |
$11.57
|
| Rate for Payer: UHC Medicaid |
$4.03
|
| Rate for Payer: UHCCP Medicaid |
$4.03
|
| Rate for Payer: UMR Bronson Commercial |
$30.41
|
| Rate for Payer: VA VA |
$7.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.64
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
IP
|
$636.72
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$280.16 |
| Max. Negotiated Rate |
$573.05 |
| Rate for Payer: Aetna American Axle |
$413.87
|
| Rate for Payer: Aetna Commercial |
$541.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.87
|
| Rate for Payer: Cash Price |
$509.38
|
| Rate for Payer: Cofinity Advantage |
$445.70
|
| Rate for Payer: Cofinity Commercial |
$547.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.38
|
| Rate for Payer: Healthscope Commercial |
$573.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$445.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$541.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.54
|
| Rate for Payer: PHP Commercial |
$541.21
|
| Rate for Payer: Priority Health SBD |
$401.13
|
| Rate for Payer: UMR Bronson Commercial |
$280.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.54
|
|
|
HC CULTURE ID BLOOD PATHOGEN BY NUCLEIC ACID
|
Facility
|
OP
|
$636.72
|
|
|
Service Code
|
CPT 87154
|
| Hospital Charge Code |
30600329
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$114.05 |
| Max. Negotiated Rate |
$573.05 |
| Rate for Payer: Aetna American Axle |
$413.87
|
| Rate for Payer: Aetna Commercial |
$541.21
|
| Rate for Payer: Aetna Medicare |
$226.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$413.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.57
|
| Rate for Payer: BCBS Complete |
$119.76
|
| Rate for Payer: BCBS MAPPO |
$218.06
|
| Rate for Payer: BCBS Trust/PPO |
$252.08
|
| Rate for Payer: BCN Commercial |
$252.08
|
| Rate for Payer: BCN Medicare Advantage |
$218.06
|
| Rate for Payer: Cash Price |
$509.38
|
| Rate for Payer: Cash Price |
$509.38
|
| Rate for Payer: Cofinity Advantage |
$445.70
|
| Rate for Payer: Cofinity Commercial |
$547.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$509.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.06
|
| Rate for Payer: Healthscope Commercial |
$573.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$445.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$477.54
|
| Rate for Payer: Mclaren Medicaid |
$218.06
|
| Rate for Payer: Mclaren Medicare |
$218.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.96
|
| Rate for Payer: Meridian Medicaid |
$228.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$541.21
|
| Rate for Payer: Nomi Health Commercial |
$327.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$477.54
|
| Rate for Payer: PACE Medicare |
$207.16
|
| Rate for Payer: PACE SWMI |
$218.06
|
| Rate for Payer: PHP Commercial |
$541.21
|
| Rate for Payer: PHP Medicare Advantage |
$218.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$114.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$218.06
|
| Rate for Payer: Priority Health Medicare |
$218.06
|
| Rate for Payer: Priority Health SBD |
$401.13
|
| Rate for Payer: Priority Health Tiered Network |
$174.45
|
| Rate for Payer: Railroad Medicare Medicare |
$218.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$327.09
|
| Rate for Payer: UHC Core |
$327.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$218.06
|
| Rate for Payer: UHC Exchange |
$327.09
|
| Rate for Payer: UHC Medicaid |
$114.05
|
| Rate for Payer: UHCCP Medicaid |
$114.05
|
| Rate for Payer: UMR Bronson Commercial |
$235.59
|
| Rate for Payer: VA VA |
$218.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$477.54
|
|
