|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$114.13
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.23 |
| Max. Negotiated Rate |
$102.72 |
| Rate for Payer: Aetna American Axle |
$74.18
|
| Rate for Payer: Aetna Commercial |
$97.01
|
| Rate for Payer: Aetna Medicare |
$20.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.45
|
| Rate for Payer: BCBS Complete |
$10.74
|
| Rate for Payer: BCBS MAPPO |
$19.56
|
| Rate for Payer: BCBS Trust/PPO |
$22.61
|
| Rate for Payer: BCN Commercial |
$22.61
|
| Rate for Payer: BCN Medicare Advantage |
$19.56
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cofinity Advantage |
$79.89
|
| Rate for Payer: Cofinity Commercial |
$98.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$102.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.60
|
| Rate for Payer: Mclaren Medicaid |
$19.56
|
| Rate for Payer: Mclaren Medicare |
$19.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.54
|
| Rate for Payer: Meridian Medicaid |
$20.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.01
|
| Rate for Payer: Nomi Health Commercial |
$29.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.60
|
| Rate for Payer: PACE Medicare |
$18.58
|
| Rate for Payer: PACE SWMI |
$19.56
|
| Rate for Payer: PHP Commercial |
$97.01
|
| Rate for Payer: PHP Medicare Advantage |
$19.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.56
|
| Rate for Payer: Priority Health Medicare |
$19.56
|
| Rate for Payer: Priority Health SBD |
$71.90
|
| Rate for Payer: Priority Health Tiered Network |
$15.65
|
| Rate for Payer: Railroad Medicare Medicare |
$19.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.34
|
| Rate for Payer: UHC Core |
$29.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.56
|
| Rate for Payer: UHC Exchange |
$29.34
|
| Rate for Payer: UHC Medicaid |
$10.23
|
| Rate for Payer: UHCCP Medicaid |
$10.23
|
| Rate for Payer: UMR Bronson Commercial |
$42.23
|
| Rate for Payer: VA VA |
$19.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.60
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$114.13
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$50.22 |
| Max. Negotiated Rate |
$102.72 |
| Rate for Payer: Aetna American Axle |
$74.18
|
| Rate for Payer: Aetna Commercial |
$97.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.18
|
| Rate for Payer: Cash Price |
$91.30
|
| Rate for Payer: Cofinity Advantage |
$79.89
|
| Rate for Payer: Cofinity Commercial |
$98.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.30
|
| Rate for Payer: Healthscope Commercial |
$102.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.60
|
| Rate for Payer: PHP Commercial |
$97.01
|
| Rate for Payer: Priority Health SBD |
$71.90
|
| Rate for Payer: UMR Bronson Commercial |
$50.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.60
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.53 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$7.90
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$16.63
|
| Rate for Payer: BCN Commercial |
$16.63
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$14.39
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$21.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.39
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$11.51
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.59
|
| Rate for Payer: UHC Core |
$21.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.39
|
| Rate for Payer: UHC Exchange |
$21.59
|
| Rate for Payer: UHC Medicaid |
$7.53
|
| Rate for Payer: UHCCP Medicaid |
$7.53
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.81 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.25
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$19.48
|
| Rate for Payer: BCN Commercial |
$19.48
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$16.85
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$17.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$25.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.85
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$13.48
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.28
|
| Rate for Payer: UHC Core |
$25.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.85
|
| Rate for Payer: UHC Exchange |
$25.28
|
| Rate for Payer: UHC Medicaid |
$8.81
|
| Rate for Payer: UHCCP Medicaid |
$8.81
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$137.11
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$60.33 |
| Max. Negotiated Rate |
$123.40 |
| Rate for Payer: Aetna American Axle |
$89.12
|
| Rate for Payer: Aetna Commercial |
$116.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.12
|
| Rate for Payer: Cash Price |
$109.69
|
| Rate for Payer: Cofinity Advantage |
$95.98
|
| Rate for Payer: Cofinity Commercial |
$117.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.69
|
| Rate for Payer: Healthscope Commercial |
$123.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.83
|
| Rate for Payer: PHP Commercial |
$116.54
|
| Rate for Payer: Priority Health SBD |
$86.38
|
| Rate for Payer: UMR Bronson Commercial |
$60.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.83
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$137.11
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$167.92 |
| Rate for Payer: Aetna American Axle |
$89.12
|
| Rate for Payer: Aetna Commercial |
$116.54
|
| Rate for Payer: Aetna Medicare |
$54.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$75.72
|
| Rate for Payer: BCN Commercial |
$75.72
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$109.69
|
| Rate for Payer: Cash Price |
$109.69
|
| Rate for Payer: Cofinity Advantage |
$95.98
|
| Rate for Payer: Cofinity Commercial |
$117.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$123.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.83
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$54.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.54
|
| Rate for Payer: Nomi Health Commercial |
$155.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.83
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$116.54
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.92
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health SBD |
$86.38
|
| Rate for Payer: Priority Health Tiered Network |
$134.34
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.15
|
| Rate for Payer: UHC Core |
$80.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.15
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: UMR Bronson Commercial |
$50.73
|
| Rate for Payer: VA VA |
$51.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.83
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
OP
|
$104.46
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.07 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: Aetna American Axle |
$67.90
|
| Rate for Payer: Aetna Commercial |
$88.79
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$107.75
|
| Rate for Payer: BCN Commercial |
$107.75
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$83.57
|
| Rate for Payer: Cash Price |
$83.57
|
| Rate for Payer: Cofinity Advantage |
$73.12
|
| Rate for Payer: Cofinity Commercial |
$89.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$94.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.34
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.79
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.34
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$88.79
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$65.81
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.74
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$36.74
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: UMR Bronson Commercial |
$38.65
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.34
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
IP
|
$104.46
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$94.01 |
| Rate for Payer: Aetna American Axle |
$67.90
|
| Rate for Payer: Aetna Commercial |
$88.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.90
|
| Rate for Payer: Cash Price |
$83.57
|
| Rate for Payer: Cofinity Advantage |
$73.12
|
| Rate for Payer: Cofinity Commercial |
$89.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.57
|
| Rate for Payer: Healthscope Commercial |
$94.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.34
|
| Rate for Payer: PHP Commercial |
$88.79
|
| Rate for Payer: Priority Health SBD |
$65.81
|
| Rate for Payer: UMR Bronson Commercial |
$45.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.34
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.64 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna American Axle |
$52.65
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Advantage |
$56.70
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health SBD |
$51.03
|
| Rate for Payer: UMR Bronson Commercial |
$35.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna American Axle |
$52.65
|
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.65
|
| 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 |
$64.80
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Advantage |
$56.70
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| 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 |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$68.85
|
| 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 |
$51.03
|
| 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 |
$29.97
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
HC DAMAGED TYPE III HOME STUDY DEVICE
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna American Axle |
$65.00
|
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Advantage |
$70.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health SBD |
$63.00
|
| Rate for Payer: UMR Bronson Commercial |
$44.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC DAMAGED TYPE III HOME STUDY DEVICE
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna American Axle |
$65.00
|
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$50.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Advantage |
$70.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health SBD |
$63.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.00
|
| Rate for Payer: UHC Core |
$52.10
|
| Rate for Payer: UHC Exchange |
$39.30
|
| Rate for Payer: UMR Bronson Commercial |
$37.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
OP
|
$814.63
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$301.41 |
| Max. Negotiated Rate |
$2,211.50 |
| Rate for Payer: Aetna American Axle |
$529.51
|
| Rate for Payer: Aetna Commercial |
$692.44
|
| Rate for Payer: Aetna Medicare |
$711.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$854.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$854.81
|
| Rate for Payer: BCBS Complete |
$375.57
|
| Rate for Payer: BCBS MAPPO |
$683.85
|
| Rate for Payer: BCN Medicare Advantage |
$683.85
|
| Rate for Payer: Cash Price |
$651.70
|
| Rate for Payer: Cash Price |
$651.70
|
| Rate for Payer: Cofinity Advantage |
$570.24
|
| Rate for Payer: Cofinity Commercial |
$700.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.85
|
| Rate for Payer: Healthscope Commercial |
$733.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$570.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.97
|
| Rate for Payer: Mclaren Medicaid |
$683.85
|
| Rate for Payer: Mclaren Medicare |
$683.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.04
|
| Rate for Payer: Meridian Medicaid |
$718.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$692.44
|
| Rate for Payer: Nomi Health Commercial |
$2,051.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.97
|
| Rate for Payer: PACE Medicare |
$649.66
|
| Rate for Payer: PACE SWMI |
$683.85
|
| Rate for Payer: PHP Commercial |
$692.44
|
| Rate for Payer: PHP Medicare Advantage |
$683.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,211.50
|
| Rate for Payer: Priority Health Medicare |
$683.85
|
| Rate for Payer: Priority Health SBD |
$513.22
|
| Rate for Payer: Priority Health Tiered Network |
$1,769.20
|
| Rate for Payer: Railroad Medicare Medicare |
$683.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$529.51
|
| Rate for Payer: UHC Core |
$424.42
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.85
|
| Rate for Payer: UHC Exchange |
$320.15
|
| Rate for Payer: UHC Medicaid |
$357.65
|
| Rate for Payer: UHCCP Medicaid |
$357.65
|
| Rate for Payer: UMR Bronson Commercial |
$301.41
|
| Rate for Payer: VA VA |
$683.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.97
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
IP
|
$814.63
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$358.44 |
| Max. Negotiated Rate |
$733.17 |
| Rate for Payer: Aetna American Axle |
$529.51
|
| Rate for Payer: Aetna Commercial |
$692.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$529.51
|
| Rate for Payer: Cash Price |
$651.70
|
| Rate for Payer: Cofinity Advantage |
$570.24
|
| Rate for Payer: Cofinity Commercial |
$700.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.70
|
| Rate for Payer: Healthscope Commercial |
$733.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$570.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$692.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.97
|
| Rate for Payer: PHP Commercial |
$692.44
|
| Rate for Payer: Priority Health SBD |
$513.22
|
| Rate for Payer: UMR Bronson Commercial |
$358.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.97
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
OP
|
$872.14
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$322.69 |
| Max. Negotiated Rate |
$2,211.50 |
| Rate for Payer: Aetna American Axle |
$566.89
|
| Rate for Payer: Aetna Commercial |
$741.32
|
| Rate for Payer: Aetna Medicare |
$711.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$854.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$854.81
|
| Rate for Payer: BCBS Complete |
$375.57
|
| Rate for Payer: BCBS MAPPO |
$683.85
|
| Rate for Payer: BCN Medicare Advantage |
$683.85
|
| Rate for Payer: Cash Price |
$697.71
|
| Rate for Payer: Cash Price |
$697.71
|
| Rate for Payer: Cofinity Advantage |
$610.50
|
| Rate for Payer: Cofinity Commercial |
$750.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.85
|
| Rate for Payer: Healthscope Commercial |
$784.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$610.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$654.11
|
| Rate for Payer: Mclaren Medicaid |
$683.85
|
| Rate for Payer: Mclaren Medicare |
$683.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.04
|
| Rate for Payer: Meridian Medicaid |
$718.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.32
|
| Rate for Payer: Nomi Health Commercial |
$2,051.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.11
|
| Rate for Payer: PACE Medicare |
$649.66
|
| Rate for Payer: PACE SWMI |
$683.85
|
| Rate for Payer: PHP Commercial |
$741.32
|
| Rate for Payer: PHP Medicare Advantage |
$683.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,211.50
|
| Rate for Payer: Priority Health Medicare |
$683.85
|
| Rate for Payer: Priority Health SBD |
$549.45
|
| Rate for Payer: Priority Health Tiered Network |
$1,769.20
|
| Rate for Payer: Railroad Medicare Medicare |
$683.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.89
|
| Rate for Payer: UHC Core |
$454.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.85
|
| Rate for Payer: UHC Exchange |
$342.75
|
| Rate for Payer: UHC Medicaid |
$357.65
|
| Rate for Payer: UHCCP Medicaid |
$357.65
|
| Rate for Payer: UMR Bronson Commercial |
$322.69
|
| Rate for Payer: VA VA |
$683.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$654.11
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
IP
|
$872.14
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$383.74 |
| Max. Negotiated Rate |
$784.93 |
| Rate for Payer: Aetna American Axle |
$566.89
|
| Rate for Payer: Aetna Commercial |
$741.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$566.89
|
| Rate for Payer: Cash Price |
$697.71
|
| Rate for Payer: Cofinity Advantage |
$610.50
|
| Rate for Payer: Cofinity Commercial |
$750.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.71
|
| Rate for Payer: Healthscope Commercial |
$784.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$610.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$654.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.11
|
| Rate for Payer: PHP Commercial |
$741.32
|
| Rate for Payer: Priority Health SBD |
$549.45
|
| Rate for Payer: UMR Bronson Commercial |
$383.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$654.11
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
OP
|
$799.09
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$295.66 |
| Max. Negotiated Rate |
$719.18 |
| Rate for Payer: Aetna American Axle |
$519.41
|
| Rate for Payer: Aetna Commercial |
$679.23
|
| Rate for Payer: Aetna Medicare |
$399.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.41
|
| Rate for Payer: BCBS Complete |
$319.64
|
| Rate for Payer: Cash Price |
$639.27
|
| Rate for Payer: Cofinity Advantage |
$559.36
|
| Rate for Payer: Cofinity Commercial |
$687.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$639.27
|
| Rate for Payer: Healthscope Commercial |
$719.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$559.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$599.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$639.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$679.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$599.32
|
| Rate for Payer: PHP Commercial |
$679.23
|
| Rate for Payer: Priority Health SBD |
$503.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.41
|
| Rate for Payer: UHC Core |
$416.33
|
| Rate for Payer: UHC Exchange |
$314.04
|
| Rate for Payer: UMR Bronson Commercial |
$295.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$599.32
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
IP
|
$799.09
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$351.60 |
| Max. Negotiated Rate |
$719.18 |
| Rate for Payer: Aetna American Axle |
$519.41
|
| Rate for Payer: Aetna Commercial |
$679.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.41
|
| Rate for Payer: Cash Price |
$639.27
|
| Rate for Payer: Cofinity Advantage |
$559.36
|
| Rate for Payer: Cofinity Commercial |
$687.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$639.27
|
| Rate for Payer: Healthscope Commercial |
$719.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$559.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$599.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$679.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$599.32
|
| Rate for Payer: PHP Commercial |
$679.23
|
| Rate for Payer: Priority Health SBD |
$503.43
|
| Rate for Payer: UMR Bronson Commercial |
$351.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$599.32
|
|
|
HC D & C
|
Facility
|
IP
|
$2,082.24
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$916.19 |
| Max. Negotiated Rate |
$1,874.02 |
| Rate for Payer: Aetna American Axle |
$1,353.46
|
| Rate for Payer: Aetna Commercial |
$1,769.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,353.46
|
| Rate for Payer: Cash Price |
$1,665.79
|
| Rate for Payer: Cofinity Advantage |
$1,457.57
|
| Rate for Payer: Cofinity Commercial |
$1,790.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.79
|
| Rate for Payer: Healthscope Commercial |
$1,874.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,457.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,561.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,769.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.68
|
| Rate for Payer: PHP Commercial |
$1,769.90
|
| Rate for Payer: Priority Health SBD |
$1,311.81
|
| Rate for Payer: UMR Bronson Commercial |
$916.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,561.68
|
|
|
HC D & C
|
Facility
|
OP
|
$2,082.24
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$1,874.02 |
| Rate for Payer: Aetna American Axle |
$1,353.46
|
| Rate for Payer: Aetna Commercial |
$1,769.90
|
| Rate for Payer: Aetna Medicare |
$1,041.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,353.46
|
| Rate for Payer: BCBS Complete |
$832.90
|
| Rate for Payer: Cash Price |
$1,665.79
|
| Rate for Payer: Cash Price |
$1,665.79
|
| Rate for Payer: Cofinity Advantage |
$1,457.57
|
| Rate for Payer: Cofinity Commercial |
$1,790.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.79
|
| Rate for Payer: Healthscope Commercial |
$1,874.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,457.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,561.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,665.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,769.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.68
|
| Rate for Payer: PHP Commercial |
$1,769.90
|
| Rate for Payer: Priority Health SBD |
$1,311.81
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$770.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,561.68
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
OP
|
$1,072.43
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$396.80 |
| Max. Negotiated Rate |
$965.19 |
| Rate for Payer: Aetna American Axle |
$697.08
|
| Rate for Payer: Aetna Commercial |
$911.57
|
| Rate for Payer: Aetna Medicare |
$536.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.08
|
| Rate for Payer: BCBS Complete |
$428.97
|
| Rate for Payer: Cash Price |
$857.94
|
| Rate for Payer: Cofinity Advantage |
$750.70
|
| Rate for Payer: Cofinity Commercial |
$922.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.94
|
| Rate for Payer: Healthscope Commercial |
$965.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$750.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$857.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.32
|
| Rate for Payer: PHP Commercial |
$911.57
|
| Rate for Payer: Priority Health SBD |
$675.63
|
| Rate for Payer: UMR Bronson Commercial |
$396.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.32
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
IP
|
$1,072.43
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$471.87 |
| Max. Negotiated Rate |
$965.19 |
| Rate for Payer: Aetna American Axle |
$697.08
|
| Rate for Payer: Aetna Commercial |
$911.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$697.08
|
| Rate for Payer: Cash Price |
$857.94
|
| Rate for Payer: Cofinity Advantage |
$750.70
|
| Rate for Payer: Cofinity Commercial |
$922.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.94
|
| Rate for Payer: Healthscope Commercial |
$965.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$750.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.32
|
| Rate for Payer: PHP Commercial |
$911.57
|
| Rate for Payer: Priority Health SBD |
$675.63
|
| Rate for Payer: UMR Bronson Commercial |
$471.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.32
|
|
