|
HC LIVER BIOPSY
|
Facility
|
IP
|
$1,449.99
|
|
| Hospital Charge Code |
36000073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$638.00 |
| Max. Negotiated Rate |
$1,304.99 |
| Rate for Payer: Aetna American Axle |
$942.49
|
| Rate for Payer: Aetna Commercial |
$1,232.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.49
|
| Rate for Payer: Cash Price |
$1,159.99
|
| Rate for Payer: Cofinity Commercial |
$1,014.99
|
| Rate for Payer: Cofinity Commercial |
$1,246.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.99
|
| Rate for Payer: Healthscope Commercial |
$1,304.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,014.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,087.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,232.49
|
| Rate for Payer: PHP Commercial |
$1,232.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.99
|
| Rate for Payer: Priority Health SBD |
$913.49
|
| Rate for Payer: UMR Bronson Commercial |
$638.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,087.49
|
|
|
HC LIVER BIOPSY
|
Facility
|
OP
|
$1,449.99
|
|
| Hospital Charge Code |
36000073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$536.50 |
| Max. Negotiated Rate |
$1,304.99 |
| Rate for Payer: Aetna American Axle |
$942.49
|
| Rate for Payer: Aetna Commercial |
$1,232.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$942.49
|
| Rate for Payer: BCBS Complete |
$580.00
|
| Rate for Payer: Cash Price |
$1,159.99
|
| Rate for Payer: Cofinity Commercial |
$1,014.99
|
| Rate for Payer: Cofinity Commercial |
$1,246.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,159.99
|
| Rate for Payer: Healthscope Commercial |
$1,304.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,014.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,087.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,232.49
|
| Rate for Payer: PHP Commercial |
$1,232.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.99
|
| Rate for Payer: Priority Health SBD |
$913.49
|
| Rate for Payer: UMR Bronson Commercial |
$536.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,087.49
|
|
|
HC LIVER KIDNEY MICROSOME ANTIBODY
|
Facility
|
IP
|
$55.49
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200208
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.42 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna American Axle |
$36.07
|
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.07
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cofinity Commercial |
$38.84
|
| Rate for Payer: Cofinity Commercial |
$47.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.39
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.17
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.84
|
| Rate for Payer: Priority Health SBD |
$34.96
|
| Rate for Payer: UMR Bronson Commercial |
$24.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.62
|
|
|
HC LIVER KIDNEY MICROSOME ANTIBODY
|
Facility
|
OP
|
$55.49
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200208
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.96 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna American Axle |
$36.07
|
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna Medicare |
$15.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.19
|
| Rate for Payer: BCBS Complete |
$8.36
|
| Rate for Payer: BCBS MAPPO |
$14.55
|
| Rate for Payer: BCBS Trust/PPO |
$13.08
|
| Rate for Payer: BCN Medicare Advantage |
$14.55
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cofinity Commercial |
$47.72
|
| Rate for Payer: Cofinity Commercial |
$38.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.55
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.62
|
| Rate for Payer: Mclaren Medicaid |
$7.96
|
| Rate for Payer: Mclaren Medicare |
$14.55
|
| Rate for Payer: Meridian Medicaid |
$8.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.17
|
| Rate for Payer: PACE Medicare |
$13.82
|
| Rate for Payer: PACE SWMI |
$14.55
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: PHP Medicare Advantage |
$14.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.96
|
| Rate for Payer: Priority Health Medicare |
$14.55
|
| Rate for Payer: Priority Health Narrow Network |
$15.97
|
| Rate for Payer: Priority Health SBD |
$34.96
|
| Rate for Payer: Railroad Medicare Medicare |
$14.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.46
|
| Rate for Payer: UHC Core |
$23.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.55
|
| Rate for Payer: UHC Exchange |
$14.55
|
| Rate for Payer: UHC Medicare Advantage |
$14.99
|
| Rate for Payer: UMR Bronson Commercial |
$20.53
|
| Rate for Payer: VA VA |
$14.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.62
|
|
|
HC LOBSTER IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200045
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC LOBSTER IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200045
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC LOCAL ANES ADDL 15 MIN
|
Facility
|
OP
|
$94.48
|
|
| Hospital Charge Code |
37000009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$34.96 |
| Max. Negotiated Rate |
$85.03 |
| Rate for Payer: Aetna American Axle |
$61.41
|
| Rate for Payer: Aetna Commercial |
$80.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.41
|
| Rate for Payer: BCBS Complete |
$37.79
|
| Rate for Payer: Cash Price |
$75.58
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Commercial |
$81.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.58
|
| Rate for Payer: Healthscope Commercial |
$85.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.31
|
| Rate for Payer: PHP Commercial |
$80.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.14
|
| Rate for Payer: Priority Health SBD |
$59.52
|
| Rate for Payer: UMR Bronson Commercial |
$34.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.86
|
|
|
HC LOCAL ANES ADDL 15 MIN
|
Facility
|
IP
|
$94.48
|
|
| Hospital Charge Code |
37000009
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$85.03 |
| Rate for Payer: Aetna American Axle |
$61.41
|
| Rate for Payer: Aetna Commercial |
$80.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.41
|
| Rate for Payer: Cash Price |
$75.58
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Commercial |
$81.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.58
|
| Rate for Payer: Healthscope Commercial |
$85.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$80.31
|
| Rate for Payer: PHP Commercial |
$80.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.14
|
| Rate for Payer: Priority Health SBD |
$59.52
|
| Rate for Payer: UMR Bronson Commercial |
$41.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.86
|
|
|
HC LOCAL ANES INIT 30 MIN
|
Facility
|
OP
|
$342.78
|
|
| Hospital Charge Code |
37000010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$126.83 |
| Max. Negotiated Rate |
$308.50 |
| Rate for Payer: Aetna American Axle |
$222.81
|
| Rate for Payer: Aetna Commercial |
$291.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.81
|
| Rate for Payer: BCBS Complete |
$137.11
|
| Rate for Payer: Cash Price |
$274.22
|
| Rate for Payer: Cofinity Commercial |
$239.95
|
| Rate for Payer: Cofinity Commercial |
$294.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.22
|
| Rate for Payer: Healthscope Commercial |
$308.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$239.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$291.36
|
| Rate for Payer: PHP Commercial |
$291.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.95
|
| Rate for Payer: Priority Health SBD |
$215.95
|
| Rate for Payer: UMR Bronson Commercial |
$126.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.08
|
|
|
HC LOCAL ANES INIT 30 MIN
|
Facility
|
IP
|
$342.78
|
|
| Hospital Charge Code |
37000010
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$150.82 |
| Max. Negotiated Rate |
$308.50 |
| Rate for Payer: Aetna American Axle |
$222.81
|
| Rate for Payer: Aetna Commercial |
$291.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$222.81
|
| Rate for Payer: Cash Price |
$274.22
|
| Rate for Payer: Cofinity Commercial |
$239.95
|
| Rate for Payer: Cofinity Commercial |
$294.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.22
|
| Rate for Payer: Healthscope Commercial |
$308.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$239.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$257.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$291.36
|
| Rate for Payer: PHP Commercial |
$291.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$239.95
|
| Rate for Payer: Priority Health SBD |
$215.95
|
| Rate for Payer: UMR Bronson Commercial |
$150.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$257.08
|
|
|
HC LOCALIZATION CLIP
|
Facility
|
IP
|
$202.77
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$89.22 |
| Max. Negotiated Rate |
$182.49 |
| Rate for Payer: Aetna American Axle |
$131.80
|
| Rate for Payer: Aetna Commercial |
$172.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.80
|
| Rate for Payer: Cash Price |
$162.22
|
| Rate for Payer: Cofinity Commercial |
$141.94
|
| Rate for Payer: Cofinity Commercial |
$174.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.22
|
| Rate for Payer: Healthscope Commercial |
$182.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.35
|
| Rate for Payer: PHP Commercial |
$172.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.94
|
| Rate for Payer: Priority Health SBD |
$127.75
|
| Rate for Payer: UMR Bronson Commercial |
$89.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.08
|
|
|
HC LOCALIZATION CLIP
|
Facility
|
OP
|
$202.77
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800040
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$75.02 |
| Max. Negotiated Rate |
$182.49 |
| Rate for Payer: Aetna American Axle |
$131.80
|
| Rate for Payer: Aetna Commercial |
$172.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$131.80
|
| Rate for Payer: BCBS Complete |
$81.11
|
| Rate for Payer: Cash Price |
$162.22
|
| Rate for Payer: Cofinity Commercial |
$141.94
|
| Rate for Payer: Cofinity Commercial |
$174.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$162.22
|
| Rate for Payer: Healthscope Commercial |
$182.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$141.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$172.35
|
| Rate for Payer: PHP Commercial |
$172.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.94
|
| Rate for Payer: Priority Health SBD |
$127.75
|
| Rate for Payer: UMR Bronson Commercial |
$75.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.08
|
|
|
HC LOCALIZATION DEVICE LEVEL 1
|
Facility
|
OP
|
$144.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$53.28 |
| Max. Negotiated Rate |
$129.60 |
| Rate for Payer: Aetna American Axle |
$93.60
|
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.60
|
| Rate for Payer: BCBS Complete |
$57.60
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$123.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.20
|
| Rate for Payer: Healthscope Commercial |
$129.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$122.40
|
| Rate for Payer: PHP Commercial |
$122.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.80
|
| Rate for Payer: Priority Health SBD |
$90.72
|
| Rate for Payer: UMR Bronson Commercial |
$53.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.00
|
|
|
HC LOCALIZATION DEVICE LEVEL 1
|
Facility
|
IP
|
$144.00
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800350
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$63.36 |
| Max. Negotiated Rate |
$129.60 |
| Rate for Payer: Aetna American Axle |
$93.60
|
| Rate for Payer: Aetna Commercial |
$122.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.60
|
| Rate for Payer: Cash Price |
$115.20
|
| Rate for Payer: Cofinity Commercial |
$100.80
|
| Rate for Payer: Cofinity Commercial |
$123.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$115.20
|
| Rate for Payer: Healthscope Commercial |
$129.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$122.40
|
| Rate for Payer: PHP Commercial |
$122.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.80
|
| Rate for Payer: Priority Health SBD |
$90.72
|
| Rate for Payer: UMR Bronson Commercial |
$63.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.00
|
|
|
HC LOC INFIL W/CS 15 MIN
|
Facility
|
IP
|
$141.54
|
|
| Hospital Charge Code |
37000007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$62.28 |
| Max. Negotiated Rate |
$127.39 |
| Rate for Payer: Aetna American Axle |
$92.00
|
| Rate for Payer: Aetna Commercial |
$120.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.00
|
| Rate for Payer: Cash Price |
$113.23
|
| Rate for Payer: Cofinity Commercial |
$121.72
|
| Rate for Payer: Cofinity Commercial |
$99.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.23
|
| Rate for Payer: Healthscope Commercial |
$127.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$120.31
|
| Rate for Payer: PHP Commercial |
$120.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.08
|
| Rate for Payer: Priority Health SBD |
$89.17
|
| Rate for Payer: UMR Bronson Commercial |
$62.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.16
|
|
|
HC LOC INFIL W/CS 15 MIN
|
Facility
|
OP
|
$141.54
|
|
| Hospital Charge Code |
37000007
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$52.37 |
| Max. Negotiated Rate |
$127.39 |
| Rate for Payer: Aetna American Axle |
$92.00
|
| Rate for Payer: Aetna Commercial |
$120.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$92.00
|
| Rate for Payer: BCBS Complete |
$56.62
|
| Rate for Payer: Cash Price |
$113.23
|
| Rate for Payer: Cofinity Commercial |
$121.72
|
| Rate for Payer: Cofinity Commercial |
$99.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$113.23
|
| Rate for Payer: Healthscope Commercial |
$127.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$99.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$106.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$120.31
|
| Rate for Payer: PHP Commercial |
$120.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.08
|
| Rate for Payer: Priority Health SBD |
$89.17
|
| Rate for Payer: UMR Bronson Commercial |
$52.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$106.16
|
|
|
HC LOC INFIL W/CS 30 MIN
|
Facility
|
OP
|
$707.43
|
|
| Hospital Charge Code |
37000008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$261.75 |
| Max. Negotiated Rate |
$636.69 |
| Rate for Payer: Aetna American Axle |
$459.83
|
| Rate for Payer: Aetna Commercial |
$601.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.83
|
| Rate for Payer: BCBS Complete |
$282.97
|
| Rate for Payer: Cash Price |
$565.94
|
| Rate for Payer: Cofinity Commercial |
$495.20
|
| Rate for Payer: Cofinity Commercial |
$608.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.94
|
| Rate for Payer: Healthscope Commercial |
$636.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$495.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$601.32
|
| Rate for Payer: PHP Commercial |
$601.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.20
|
| Rate for Payer: Priority Health SBD |
$445.68
|
| Rate for Payer: UMR Bronson Commercial |
$261.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.57
|
|
|
HC LOC INFIL W/CS 30 MIN
|
Facility
|
IP
|
$707.43
|
|
| Hospital Charge Code |
37000008
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$311.27 |
| Max. Negotiated Rate |
$636.69 |
| Rate for Payer: Aetna American Axle |
$459.83
|
| Rate for Payer: Aetna Commercial |
$601.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.83
|
| Rate for Payer: Cash Price |
$565.94
|
| Rate for Payer: Cofinity Commercial |
$495.20
|
| Rate for Payer: Cofinity Commercial |
$608.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.94
|
| Rate for Payer: Healthscope Commercial |
$636.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$495.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$601.32
|
| Rate for Payer: PHP Commercial |
$601.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$495.20
|
| Rate for Payer: Priority Health SBD |
$445.68
|
| Rate for Payer: UMR Bronson Commercial |
$311.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.57
|
|
|
HC LOCM 100-199 MG/ML IODINE/ML1
|
Facility
|
IP
|
$3.68
|
|
|
Service Code
|
HCPCS Q9965
|
| Hospital Charge Code |
25500002
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$1.62 |
| Max. Negotiated Rate |
$3.31 |
| Rate for Payer: Aetna American Axle |
$2.39
|
| Rate for Payer: Aetna Commercial |
$3.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.39
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cofinity Commercial |
$2.58
|
| Rate for Payer: Cofinity Commercial |
$3.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Healthscope Commercial |
$3.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.13
|
| Rate for Payer: PHP Commercial |
$3.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.58
|
| Rate for Payer: Priority Health SBD |
$2.32
|
| Rate for Payer: UMR Bronson Commercial |
$1.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.76
|
|
|
HC LOCM 100-199 MG/ML IODINE/ML1
|
Facility
|
OP
|
$3.68
|
|
|
Service Code
|
HCPCS Q9965
|
| Hospital Charge Code |
25500002
|
|
Hospital Revenue Code
|
255
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$3.31 |
| Rate for Payer: Aetna American Axle |
$2.39
|
| Rate for Payer: Aetna Commercial |
$3.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.39
|
| Rate for Payer: BCBS Complete |
$1.47
|
| Rate for Payer: BCBS Trust/PPO |
$1.59
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cash Price |
$2.94
|
| Rate for Payer: Cofinity Commercial |
$2.58
|
| Rate for Payer: Cofinity Commercial |
$3.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.94
|
| Rate for Payer: Healthscope Commercial |
$3.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3.13
|
| Rate for Payer: PHP Commercial |
$3.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.58
|
| Rate for Payer: Priority Health SBD |
$2.32
|
| Rate for Payer: UMR Bronson Commercial |
$1.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.76
|
|
|
HC LOOP AV 3/8 INCH OR 1/2 INCH
|
Facility
|
IP
|
$211.80
|
|
| Hospital Charge Code |
27000444
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$93.19 |
| Max. Negotiated Rate |
$190.62 |
| Rate for Payer: Aetna American Axle |
$137.67
|
| Rate for Payer: Aetna Commercial |
$180.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.67
|
| Rate for Payer: Cash Price |
$169.44
|
| Rate for Payer: Cofinity Commercial |
$148.26
|
| Rate for Payer: Cofinity Commercial |
$182.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.44
|
| Rate for Payer: Healthscope Commercial |
$190.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.03
|
| Rate for Payer: PHP Commercial |
$180.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.26
|
| Rate for Payer: Priority Health SBD |
$133.43
|
| Rate for Payer: UMR Bronson Commercial |
$93.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.85
|
|
|
HC LOOP AV 3/8 INCH OR 1/2 INCH
|
Facility
|
OP
|
$211.80
|
|
| Hospital Charge Code |
27000444
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$78.37 |
| Max. Negotiated Rate |
$190.62 |
| Rate for Payer: Aetna American Axle |
$137.67
|
| Rate for Payer: Aetna Commercial |
$180.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.67
|
| Rate for Payer: BCBS Complete |
$84.72
|
| Rate for Payer: Cash Price |
$169.44
|
| Rate for Payer: Cofinity Commercial |
$148.26
|
| Rate for Payer: Cofinity Commercial |
$182.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.44
|
| Rate for Payer: Healthscope Commercial |
$190.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$180.03
|
| Rate for Payer: PHP Commercial |
$180.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$148.26
|
| Rate for Payer: Priority Health SBD |
$133.43
|
| Rate for Payer: UMR Bronson Commercial |
$78.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.85
|
|
|
HC LOW-LEVEL LASER THERAPY
|
Facility
|
IP
|
$90.00
|
|
|
Service Code
|
CPT 0552T
|
| Hospital Charge Code |
43000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.60 |
| Max. Negotiated Rate |
$81.00 |
| Rate for Payer: Aetna American Axle |
$58.50
|
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.50
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Cofinity Commercial |
$63.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health SBD |
$56.70
|
| Rate for Payer: UMR Bronson Commercial |
$39.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC LOW-LEVEL LASER THERAPY
|
Facility
|
OP
|
$90.00
|
|
|
Service Code
|
CPT 0552T
|
| Hospital Charge Code |
43000024
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$33.30 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$58.50
|
| Rate for Payer: Aetna Commercial |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.50
|
| Rate for Payer: BCBS Complete |
$36.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cash Price |
$72.00
|
| Rate for Payer: Cofinity Commercial |
$63.00
|
| Rate for Payer: Cofinity Commercial |
$77.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.00
|
| Rate for Payer: Healthscope Commercial |
$81.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.50
|
| Rate for Payer: PHP Commercial |
$76.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.00
|
| Rate for Payer: Priority Health SBD |
$56.70
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$33.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.50
|
|
|
HC LP (A) CHOLESTEROL LMPP
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 83700
|
| Hospital Charge Code |
30100636
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna American Axle |
$15.25
|
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna Medicare |
$11.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.08
|
| Rate for Payer: BCBS Complete |
$6.47
|
| Rate for Payer: BCBS MAPPO |
$11.26
|
| Rate for Payer: BCBS Trust/PPO |
$10.13
|
| Rate for Payer: BCN Medicare Advantage |
$11.26
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$16.42
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.26
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.60
|
| Rate for Payer: Mclaren Medicaid |
$6.16
|
| Rate for Payer: Mclaren Medicare |
$11.26
|
| Rate for Payer: Meridian Medicaid |
$6.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PACE Medicare |
$10.70
|
| Rate for Payer: PACE SWMI |
$11.26
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: PHP Medicare Advantage |
$11.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.44
|
| Rate for Payer: Priority Health Medicare |
$11.26
|
| Rate for Payer: Priority Health Narrow Network |
$12.35
|
| Rate for Payer: Priority Health SBD |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$11.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.51
|
| Rate for Payer: UHC Core |
$18.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.26
|
| Rate for Payer: UHC Exchange |
$11.26
|
| Rate for Payer: UHC Medicare Advantage |
$11.60
|
| Rate for Payer: UMR Bronson Commercial |
$8.68
|
| Rate for Payer: VA VA |
$11.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
