|
HC LP (A) CHOLESTEROL LMPP
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 83700
|
| Hospital Charge Code |
30100636
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna American Axle |
$15.25
|
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| 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: 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: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.94
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.42
|
| Rate for Payer: Priority Health SBD |
$14.78
|
| Rate for Payer: UMR Bronson Commercial |
$10.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.60
|
|
|
HC LTC ROOM AND BOARD
|
Facility
|
IP
|
$377.40
|
|
| Hospital Charge Code |
11000003
|
|
Hospital Revenue Code
|
110
|
| Min. Negotiated Rate |
$166.06 |
| Max. Negotiated Rate |
$339.66 |
| Rate for Payer: Aetna American Axle |
$245.31
|
| Rate for Payer: Aetna Commercial |
$320.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$245.31
|
| Rate for Payer: Cash Price |
$301.92
|
| Rate for Payer: Cofinity Commercial |
$264.18
|
| Rate for Payer: Cofinity Commercial |
$324.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$301.92
|
| Rate for Payer: Healthscope Commercial |
$339.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$264.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$283.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$320.79
|
| Rate for Payer: PHP Commercial |
$320.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$264.18
|
| Rate for Payer: Priority Health SBD |
$237.76
|
| Rate for Payer: UMR Bronson Commercial |
$166.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$283.05
|
|
|
HC LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
OP
|
$12,115.61
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,326.14 |
| Max. Negotiated Rate |
$10,904.05 |
| Rate for Payer: Aetna American Axle |
$7,875.15
|
| Rate for Payer: Aetna Commercial |
$10,298.27
|
| Rate for Payer: Aetna Medicare |
$3,012.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,875.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,620.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,620.58
|
| Rate for Payer: BCBS Complete |
$1,663.73
|
| Rate for Payer: BCBS MAPPO |
$2,896.46
|
| Rate for Payer: BCBS Trust/PPO |
$4,867.64
|
| Rate for Payer: BCN Medicare Advantage |
$2,896.46
|
| Rate for Payer: Cash Price |
$9,692.49
|
| Rate for Payer: Cash Price |
$9,692.49
|
| Rate for Payer: Cofinity Commercial |
$8,480.93
|
| Rate for Payer: Cofinity Commercial |
$10,419.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,692.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,896.46
|
| Rate for Payer: Healthscope Commercial |
$10,904.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,480.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,086.71
|
| Rate for Payer: Mclaren Medicaid |
$1,584.36
|
| Rate for Payer: Mclaren Medicare |
$2,896.46
|
| Rate for Payer: Meridian Medicaid |
$1,663.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,041.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,330.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,298.27
|
| Rate for Payer: PACE Medicare |
$2,751.64
|
| Rate for Payer: PACE SWMI |
$2,896.46
|
| Rate for Payer: PHP Commercial |
$10,298.27
|
| Rate for Payer: PHP Medicare Advantage |
$2,896.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,584.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,480.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,118.19
|
| Rate for Payer: Priority Health Medicare |
$2,896.46
|
| Rate for Payer: Priority Health Narrow Network |
$7,294.55
|
| Rate for Payer: Priority Health SBD |
$7,632.83
|
| Rate for Payer: Railroad Medicare Medicare |
$2,896.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,458.75
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,896.46
|
| Rate for Payer: UHC Exchange |
$1,326.14
|
| Rate for Payer: UHC Medicare Advantage |
$2,983.35
|
| Rate for Payer: UMR Bronson Commercial |
$4,482.78
|
| Rate for Payer: VA VA |
$2,896.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,086.71
|
|
|
HC LT/RT/C'S/CABG'S W INTERVENTION
|
Facility
|
IP
|
$12,115.61
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100051
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,330.87 |
| Max. Negotiated Rate |
$10,904.05 |
| Rate for Payer: Aetna American Axle |
$7,875.15
|
| Rate for Payer: Aetna Commercial |
$10,298.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,875.15
|
| Rate for Payer: Cash Price |
$9,692.49
|
| Rate for Payer: Cofinity Commercial |
$10,419.42
|
| Rate for Payer: Cofinity Commercial |
$8,480.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,692.49
|
| Rate for Payer: Healthscope Commercial |
$10,904.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,480.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,086.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,298.27
|
| Rate for Payer: PHP Commercial |
$10,298.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,480.93
|
| Rate for Payer: Priority Health SBD |
$7,632.83
|
| Rate for Payer: UMR Bronson Commercial |
$5,330.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,086.71
|
|
|
HC LUMASON PER ML
|
Facility
|
IP
|
$77.94
|
|
|
Service Code
|
HCPCS Q9950
|
| Hospital Charge Code |
63600066
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.29 |
| Max. Negotiated Rate |
$70.15 |
| Rate for Payer: Aetna American Axle |
$50.66
|
| Rate for Payer: Aetna Commercial |
$66.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.66
|
| Rate for Payer: Cash Price |
$62.35
|
| Rate for Payer: Cofinity Commercial |
$54.56
|
| Rate for Payer: Cofinity Commercial |
$67.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.35
|
| Rate for Payer: Healthscope Commercial |
$70.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.25
|
| Rate for Payer: PHP Commercial |
$66.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.56
|
| Rate for Payer: Priority Health SBD |
$49.10
|
| Rate for Payer: UMR Bronson Commercial |
$34.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.46
|
|
|
HC LUMASON PER ML
|
Facility
|
OP
|
$77.94
|
|
|
Service Code
|
HCPCS Q9950
|
| Hospital Charge Code |
63600066
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$70.15 |
| Rate for Payer: Aetna American Axle |
$50.66
|
| Rate for Payer: Aetna Commercial |
$66.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.66
|
| Rate for Payer: BCBS Complete |
$31.18
|
| Rate for Payer: BCBS Trust/PPO |
$23.20
|
| Rate for Payer: Cash Price |
$62.35
|
| Rate for Payer: Cash Price |
$62.35
|
| Rate for Payer: Cofinity Commercial |
$54.56
|
| Rate for Payer: Cofinity Commercial |
$67.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.35
|
| Rate for Payer: Healthscope Commercial |
$70.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$66.25
|
| Rate for Payer: PHP Commercial |
$66.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.56
|
| Rate for Payer: Priority Health SBD |
$49.10
|
| Rate for Payer: UMR Bronson Commercial |
$28.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.46
|
|
|
HC LUMBAR PUNCTURE
|
Facility
|
OP
|
$748.54
|
|
| Hospital Charge Code |
45000046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$276.96 |
| Max. Negotiated Rate |
$673.69 |
| Rate for Payer: Aetna American Axle |
$486.55
|
| Rate for Payer: Aetna Commercial |
$636.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.55
|
| Rate for Payer: BCBS Complete |
$299.42
|
| Rate for Payer: Cash Price |
$598.83
|
| Rate for Payer: Cofinity Commercial |
$523.98
|
| Rate for Payer: Cofinity Commercial |
$643.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.83
|
| Rate for Payer: Healthscope Commercial |
$673.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$523.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$561.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$636.26
|
| Rate for Payer: PHP Commercial |
$636.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.98
|
| Rate for Payer: Priority Health SBD |
$471.58
|
| Rate for Payer: UMR Bronson Commercial |
$276.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$561.40
|
|
|
HC LUMBAR PUNCTURE
|
Facility
|
IP
|
$748.54
|
|
| Hospital Charge Code |
45000046
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$329.36 |
| Max. Negotiated Rate |
$673.69 |
| Rate for Payer: Aetna American Axle |
$486.55
|
| Rate for Payer: Aetna Commercial |
$636.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$486.55
|
| Rate for Payer: Cash Price |
$598.83
|
| Rate for Payer: Cofinity Commercial |
$523.98
|
| Rate for Payer: Cofinity Commercial |
$643.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$598.83
|
| Rate for Payer: Healthscope Commercial |
$673.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$523.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$561.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$636.26
|
| Rate for Payer: PHP Commercial |
$636.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$523.98
|
| Rate for Payer: Priority Health SBD |
$471.58
|
| Rate for Payer: UMR Bronson Commercial |
$329.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$561.40
|
|
|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$898.41
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.21 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$583.97
|
| Rate for Payer: Aetna American Axle |
$554.86
|
| Rate for Payer: Aetna Commercial |
$725.59
|
| Rate for Payer: Aetna Commercial |
$763.65
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$907.07
|
| Rate for Payer: BCBS Trust/PPO |
$907.07
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$682.90
|
| Rate for Payer: Cash Price |
$682.90
|
| Rate for Payer: Cash Price |
$718.73
|
| Rate for Payer: Cash Price |
$718.73
|
| Rate for Payer: Cofinity Commercial |
$734.12
|
| Rate for Payer: Cofinity Commercial |
$772.63
|
| Rate for Payer: Cofinity Commercial |
$628.89
|
| Rate for Payer: Cofinity Commercial |
$597.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$718.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$768.27
|
| Rate for Payer: Healthscope Commercial |
$808.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$628.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$597.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$640.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.81
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$763.65
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$725.59
|
| Rate for Payer: PHP Commercial |
$763.65
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$537.79
|
| Rate for Payer: Priority Health SBD |
$566.00
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$62.21
|
| Rate for Payer: UHC Exchange |
$62.21
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$332.41
|
| Rate for Payer: UMR Bronson Commercial |
$315.84
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$640.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.81
|
|
|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
IP
|
$898.41
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$395.30 |
| Max. Negotiated Rate |
$808.57 |
| Rate for Payer: Aetna American Axle |
$583.97
|
| Rate for Payer: Aetna American Axle |
$554.86
|
| Rate for Payer: Aetna Commercial |
$763.65
|
| Rate for Payer: Aetna Commercial |
$725.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$583.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$554.86
|
| Rate for Payer: Cash Price |
$718.73
|
| Rate for Payer: Cash Price |
$682.90
|
| Rate for Payer: Cofinity Commercial |
$772.63
|
| Rate for Payer: Cofinity Commercial |
$597.54
|
| Rate for Payer: Cofinity Commercial |
$734.12
|
| Rate for Payer: Cofinity Commercial |
$628.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$718.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.90
|
| Rate for Payer: Healthscope Commercial |
$808.57
|
| Rate for Payer: Healthscope Commercial |
$768.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$597.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$628.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$640.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$673.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$725.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$763.65
|
| Rate for Payer: PHP Commercial |
$725.59
|
| Rate for Payer: PHP Commercial |
$763.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$597.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$628.89
|
| Rate for Payer: Priority Health SBD |
$537.79
|
| Rate for Payer: Priority Health SBD |
$566.00
|
| Rate for Payer: UMR Bronson Commercial |
$395.30
|
| Rate for Payer: UMR Bronson Commercial |
$375.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$673.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$640.22
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$755.88
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$332.59 |
| Max. Negotiated Rate |
$680.29 |
| Rate for Payer: Aetna American Axle |
$491.32
|
| Rate for Payer: Aetna Commercial |
$642.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.32
|
| Rate for Payer: Cash Price |
$604.70
|
| Rate for Payer: Cofinity Commercial |
$529.12
|
| Rate for Payer: Cofinity Commercial |
$650.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.70
|
| Rate for Payer: Healthscope Commercial |
$680.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$529.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$566.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$642.50
|
| Rate for Payer: PHP Commercial |
$642.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.12
|
| Rate for Payer: Priority Health SBD |
$476.20
|
| Rate for Payer: UMR Bronson Commercial |
$332.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$566.91
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$755.88
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.05 |
| Max. Negotiated Rate |
$1,935.09 |
| Rate for Payer: Aetna American Axle |
$491.32
|
| Rate for Payer: Aetna Commercial |
$642.50
|
| Rate for Payer: Aetna Medicare |
$639.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$768.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$768.38
|
| Rate for Payer: BCBS Complete |
$353.08
|
| Rate for Payer: BCBS MAPPO |
$614.70
|
| Rate for Payer: BCBS Trust/PPO |
$407.02
|
| Rate for Payer: BCN Medicare Advantage |
$614.70
|
| Rate for Payer: Cash Price |
$604.70
|
| Rate for Payer: Cash Price |
$604.70
|
| Rate for Payer: Cofinity Commercial |
$650.06
|
| Rate for Payer: Cofinity Commercial |
$529.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$614.70
|
| Rate for Payer: Healthscope Commercial |
$680.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$529.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$566.91
|
| Rate for Payer: Mclaren Medicaid |
$336.24
|
| Rate for Payer: Mclaren Medicare |
$614.70
|
| Rate for Payer: Meridian Medicaid |
$353.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$645.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$706.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$642.50
|
| Rate for Payer: PACE Medicare |
$583.96
|
| Rate for Payer: PACE SWMI |
$614.70
|
| Rate for Payer: PHP Commercial |
$642.50
|
| Rate for Payer: PHP Medicare Advantage |
$614.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$336.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$529.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,935.09
|
| Rate for Payer: Priority Health Medicare |
$614.70
|
| Rate for Payer: Priority Health Narrow Network |
$1,548.07
|
| Rate for Payer: Priority Health SBD |
$476.20
|
| Rate for Payer: Railroad Medicare Medicare |
$614.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$614.70
|
| Rate for Payer: UHC Exchange |
$90.05
|
| Rate for Payer: UHC Medicare Advantage |
$633.14
|
| Rate for Payer: UMR Bronson Commercial |
$279.68
|
| Rate for Payer: VA VA |
$614.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$566.91
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
IP
|
$2,066.60
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$909.30 |
| Max. Negotiated Rate |
$1,859.94 |
| Rate for Payer: Aetna American Axle |
$1,343.29
|
| Rate for Payer: Aetna Commercial |
$1,756.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,343.29
|
| Rate for Payer: Cash Price |
$1,653.28
|
| Rate for Payer: Cofinity Commercial |
$1,446.62
|
| Rate for Payer: Cofinity Commercial |
$1,777.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,653.28
|
| Rate for Payer: Healthscope Commercial |
$1,859.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,446.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,549.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,756.61
|
| Rate for Payer: PHP Commercial |
$1,756.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.62
|
| Rate for Payer: Priority Health SBD |
$1,301.96
|
| Rate for Payer: UMR Bronson Commercial |
$909.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,549.95
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
OP
|
$2,066.60
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$146.04 |
| Max. Negotiated Rate |
$4,536.73 |
| Rate for Payer: Aetna American Axle |
$1,343.29
|
| Rate for Payer: Aetna Commercial |
$1,756.61
|
| Rate for Payer: Aetna Medicare |
$1,498.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,343.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,801.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,801.41
|
| Rate for Payer: BCBS Complete |
$827.79
|
| Rate for Payer: BCBS MAPPO |
$1,441.13
|
| Rate for Payer: BCBS Trust/PPO |
$962.40
|
| Rate for Payer: BCN Medicare Advantage |
$1,441.13
|
| Rate for Payer: Cash Price |
$1,653.28
|
| Rate for Payer: Cash Price |
$1,653.28
|
| Rate for Payer: Cofinity Commercial |
$1,777.28
|
| Rate for Payer: Cofinity Commercial |
$1,446.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,653.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,441.13
|
| Rate for Payer: Healthscope Commercial |
$1,859.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,446.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,549.95
|
| Rate for Payer: Mclaren Medicaid |
$788.30
|
| Rate for Payer: Mclaren Medicare |
$1,441.13
|
| Rate for Payer: Meridian Medicaid |
$827.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,513.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,657.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,756.61
|
| Rate for Payer: PACE Medicare |
$1,369.07
|
| Rate for Payer: PACE SWMI |
$1,441.13
|
| Rate for Payer: PHP Commercial |
$1,756.61
|
| Rate for Payer: PHP Medicare Advantage |
$1,441.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$788.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,446.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,536.73
|
| Rate for Payer: Priority Health Medicare |
$1,441.13
|
| Rate for Payer: Priority Health Narrow Network |
$3,629.38
|
| Rate for Payer: Priority Health SBD |
$1,301.96
|
| Rate for Payer: Railroad Medicare Medicare |
$1,441.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.64
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,441.13
|
| Rate for Payer: UHC Exchange |
$146.04
|
| Rate for Payer: UHC Medicare Advantage |
$1,484.36
|
| Rate for Payer: UMR Bronson Commercial |
$764.64
|
| Rate for Payer: VA VA |
$1,441.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,549.95
|
|
|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.26 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna American Axle |
$104.00
|
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna Medicare |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: BCBS Complete |
$10.33
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Cofinity Commercial |
$112.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Mclaren Medicaid |
$9.84
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Medicaid |
$10.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.00
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.83
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health Narrow Network |
$6.26
|
| Rate for Payer: Priority Health SBD |
$100.80
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.58
|
| Rate for Payer: UHC Core |
$29.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.98
|
| Rate for Payer: UHC Exchange |
$17.98
|
| Rate for Payer: UHC Medicare Advantage |
$18.52
|
| Rate for Payer: UMR Bronson Commercial |
$59.20
|
| Rate for Payer: VA VA |
$17.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$70.40 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Aetna American Axle |
$104.00
|
| Rate for Payer: Aetna Commercial |
$136.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.00
|
| Rate for Payer: Cash Price |
$128.00
|
| Rate for Payer: Cofinity Commercial |
$112.00
|
| Rate for Payer: Cofinity Commercial |
$137.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.00
|
| Rate for Payer: Healthscope Commercial |
$144.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$136.00
|
| Rate for Payer: PHP Commercial |
$136.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.00
|
| Rate for Payer: Priority Health SBD |
$100.80
|
| Rate for Payer: UMR Bronson Commercial |
$70.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.00
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
OP
|
$305.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$274.50 |
| Rate for Payer: Aetna American Axle |
$198.25
|
| Rate for Payer: Aetna Commercial |
$259.25
|
| Rate for Payer: Aetna Medicare |
$50.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.21
|
| Rate for Payer: BCBS Complete |
$27.67
|
| Rate for Payer: BCBS MAPPO |
$48.17
|
| Rate for Payer: BCBS Trust/PPO |
$59.99
|
| Rate for Payer: BCCCP Commercial |
$71.93
|
| Rate for Payer: BCN Medicare Advantage |
$48.17
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$213.50
|
| Rate for Payer: Cofinity Commercial |
$262.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$274.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.75
|
| Rate for Payer: Mclaren Medicaid |
$26.35
|
| Rate for Payer: Mclaren Medicare |
$48.17
|
| Rate for Payer: Meridian Medicaid |
$27.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$259.25
|
| Rate for Payer: PACE Medicare |
$45.76
|
| Rate for Payer: PACE SWMI |
$48.17
|
| Rate for Payer: PHP Commercial |
$259.25
|
| Rate for Payer: PHP Medicare Advantage |
$48.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.62
|
| Rate for Payer: Priority Health Medicare |
$48.17
|
| Rate for Payer: Priority Health Narrow Network |
$121.30
|
| Rate for Payer: Priority Health SBD |
$192.15
|
| Rate for Payer: Railroad Medicare Medicare |
$48.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.44
|
| Rate for Payer: UHC Core |
$45.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.17
|
| Rate for Payer: UHC Exchange |
$70.40
|
| Rate for Payer: UHC Medicare Advantage |
$49.62
|
| Rate for Payer: UMR Bronson Commercial |
$112.85
|
| Rate for Payer: VA VA |
$48.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.75
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
IP
|
$305.00
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$134.20 |
| Max. Negotiated Rate |
$274.50 |
| Rate for Payer: Aetna American Axle |
$198.25
|
| Rate for Payer: Aetna Commercial |
$259.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.25
|
| Rate for Payer: Cash Price |
$244.00
|
| Rate for Payer: Cofinity Commercial |
$213.50
|
| Rate for Payer: Cofinity Commercial |
$262.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$244.00
|
| Rate for Payer: Healthscope Commercial |
$274.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$259.25
|
| Rate for Payer: PHP Commercial |
$259.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.50
|
| Rate for Payer: Priority Health SBD |
$192.15
|
| Rate for Payer: UMR Bronson Commercial |
$134.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.75
|
|
|
HC LVAD INSERTION
|
Facility
|
OP
|
$3,160.43
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$345.45 |
| Max. Negotiated Rate |
$2,844.39 |
| Rate for Payer: Aetna American Axle |
$2,054.28
|
| Rate for Payer: Aetna Commercial |
$2,686.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,054.28
|
| Rate for Payer: BCBS Complete |
$1,264.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,495.00
|
| Rate for Payer: Cash Price |
$2,528.34
|
| Rate for Payer: Cash Price |
$2,528.34
|
| Rate for Payer: Cofinity Commercial |
$2,717.97
|
| Rate for Payer: Cofinity Commercial |
$2,212.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$2,844.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,212.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,370.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,686.37
|
| Rate for Payer: PHP Commercial |
$2,686.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,212.30
|
| Rate for Payer: Priority Health SBD |
$1,991.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$380.00
|
| Rate for Payer: UHC Core |
$1,879.00
|
| Rate for Payer: UHC Exchange |
$345.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,169.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,370.32
|
|
|
HC LVAD INSERTION
|
Facility
|
IP
|
$3,160.43
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,390.59 |
| Max. Negotiated Rate |
$2,844.39 |
| Rate for Payer: Aetna American Axle |
$2,054.28
|
| Rate for Payer: Aetna Commercial |
$2,686.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,054.28
|
| Rate for Payer: Cash Price |
$2,528.34
|
| Rate for Payer: Cofinity Commercial |
$2,212.30
|
| Rate for Payer: Cofinity Commercial |
$2,717.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,528.34
|
| Rate for Payer: Healthscope Commercial |
$2,844.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,212.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,370.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,686.37
|
| Rate for Payer: PHP Commercial |
$2,686.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,212.30
|
| Rate for Payer: Priority Health SBD |
$1,991.07
|
| Rate for Payer: UMR Bronson Commercial |
$1,390.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,370.32
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
OP
|
$2,777.25
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$343.17 |
| Max. Negotiated Rate |
$2,499.52 |
| Rate for Payer: Aetna American Axle |
$1,805.21
|
| Rate for Payer: Aetna Commercial |
$2,360.66
|
| Rate for Payer: Aetna Medicare |
$652.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$784.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$784.21
|
| Rate for Payer: BCBS Complete |
$360.36
|
| Rate for Payer: BCBS MAPPO |
$627.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,024.15
|
| Rate for Payer: BCN Medicare Advantage |
$627.37
|
| Rate for Payer: Cash Price |
$2,221.80
|
| Rate for Payer: Cash Price |
$2,221.80
|
| Rate for Payer: Cash Price |
$2,221.80
|
| Rate for Payer: Cofinity Commercial |
$2,388.44
|
| Rate for Payer: Cofinity Commercial |
$1,944.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.37
|
| Rate for Payer: Healthscope Commercial |
$2,499.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,944.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.94
|
| Rate for Payer: Mclaren Medicaid |
$343.17
|
| Rate for Payer: Mclaren Medicare |
$627.37
|
| Rate for Payer: Meridian Medicaid |
$360.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$658.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,360.66
|
| Rate for Payer: PACE Medicare |
$596.00
|
| Rate for Payer: PACE SWMI |
$627.37
|
| Rate for Payer: PHP Commercial |
$2,360.66
|
| Rate for Payer: PHP Medicare Advantage |
$627.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,944.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,975.00
|
| Rate for Payer: Priority Health Medicare |
$627.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,580.00
|
| Rate for Payer: Priority Health SBD |
$1,749.67
|
| Rate for Payer: Railroad Medicare Medicare |
$627.37
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.37
|
| Rate for Payer: UHC Medicare Advantage |
$646.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,027.58
|
| Rate for Payer: VA VA |
$627.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.94
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
IP
|
$2,777.25
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,221.99 |
| Max. Negotiated Rate |
$2,499.52 |
| Rate for Payer: Aetna American Axle |
$1,805.21
|
| Rate for Payer: Aetna Commercial |
$2,360.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,805.21
|
| Rate for Payer: Cash Price |
$2,221.80
|
| Rate for Payer: Cofinity Commercial |
$1,944.08
|
| Rate for Payer: Cofinity Commercial |
$2,388.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,221.80
|
| Rate for Payer: Healthscope Commercial |
$2,499.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,944.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,082.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,360.66
|
| Rate for Payer: PHP Commercial |
$2,360.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,944.08
|
| Rate for Payer: Priority Health SBD |
$1,749.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,221.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,082.94
|
|
|
HC LVDS PLT PHER LEUKO RED
|
Facility
|
IP
|
$2,156.91
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000087
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$949.04 |
| Max. Negotiated Rate |
$1,941.22 |
| Rate for Payer: Aetna American Axle |
$1,401.99
|
| Rate for Payer: Aetna Commercial |
$1,833.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,401.99
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cofinity Commercial |
$1,509.84
|
| Rate for Payer: Cofinity Commercial |
$1,854.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.53
|
| Rate for Payer: Healthscope Commercial |
$1,941.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,509.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,617.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,833.37
|
| Rate for Payer: PHP Commercial |
$1,833.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.84
|
| Rate for Payer: Priority Health SBD |
$1,358.85
|
| Rate for Payer: UMR Bronson Commercial |
$949.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,617.68
|
|
|
HC LVDS PLT PHER LEUKO RED
|
Facility
|
OP
|
$2,156.91
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000087
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$1,941.22 |
| Rate for Payer: Aetna American Axle |
$1,401.99
|
| Rate for Payer: Aetna Commercial |
$1,833.37
|
| Rate for Payer: Aetna Medicare |
$458.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,401.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$550.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$550.81
|
| Rate for Payer: BCBS Complete |
$253.11
|
| Rate for Payer: BCBS MAPPO |
$440.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,540.37
|
| Rate for Payer: BCN Medicare Advantage |
$440.65
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cash Price |
$1,725.53
|
| Rate for Payer: Cofinity Commercial |
$1,509.84
|
| Rate for Payer: Cofinity Commercial |
$1,854.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,725.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.65
|
| Rate for Payer: Healthscope Commercial |
$1,941.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,509.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,617.68
|
| Rate for Payer: Mclaren Medicaid |
$241.04
|
| Rate for Payer: Mclaren Medicare |
$440.65
|
| Rate for Payer: Meridian Medicaid |
$253.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$506.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,833.37
|
| Rate for Payer: PACE Medicare |
$418.62
|
| Rate for Payer: PACE SWMI |
$440.65
|
| Rate for Payer: PHP Commercial |
$1,833.37
|
| Rate for Payer: PHP Medicare Advantage |
$440.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,509.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,387.19
|
| Rate for Payer: Priority Health Medicare |
$440.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.75
|
| Rate for Payer: Priority Health SBD |
$1,358.85
|
| Rate for Payer: Railroad Medicare Medicare |
$440.65
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.65
|
| Rate for Payer: UHC Medicare Advantage |
$453.87
|
| Rate for Payer: UMR Bronson Commercial |
$798.06
|
| Rate for Payer: VA VA |
$440.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,617.68
|
|
|
HC LV LEAD PLACEMENT
|
Facility
|
OP
|
$8,832.18
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
36100070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$442.37 |
| Max. Negotiated Rate |
$18,337.00 |
| Rate for Payer: Aetna American Axle |
$5,740.92
|
| Rate for Payer: Aetna Commercial |
$7,507.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,740.92
|
| Rate for Payer: BCBS Complete |
$3,532.87
|
| Rate for Payer: BCBS Trust/PPO |
$17,491.00
|
| Rate for Payer: Cash Price |
$7,065.74
|
| Rate for Payer: Cash Price |
$7,065.74
|
| Rate for Payer: Cofinity Commercial |
$6,182.53
|
| Rate for Payer: Cofinity Commercial |
$7,595.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,065.74
|
| Rate for Payer: Healthscope Commercial |
$7,948.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,182.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,624.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,507.35
|
| Rate for Payer: PHP Commercial |
$7,507.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,182.53
|
| Rate for Payer: Priority Health SBD |
$5,564.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.61
|
| Rate for Payer: UHC Core |
$18,337.00
|
| Rate for Payer: UHC Exchange |
$442.37
|
| Rate for Payer: UMR Bronson Commercial |
$3,267.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,624.14
|
|
