|
HC CLSD TX PELVIC RING FX W/O MANIPULATION
|
Facility
|
IP
|
$635.11
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
76100361
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$279.45 |
| Max. Negotiated Rate |
$571.60 |
| Rate for Payer: Aetna American Axle |
$412.82
|
| Rate for Payer: Aetna Commercial |
$539.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.82
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cofinity Commercial |
$444.58
|
| Rate for Payer: Cofinity Commercial |
$546.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$444.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.09
|
| Rate for Payer: Healthscope Commercial |
$571.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$444.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.84
|
| Rate for Payer: PHP Commercial |
$539.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.82
|
| Rate for Payer: Priority Health SBD |
$400.12
|
| Rate for Payer: UMR Bronson Commercial |
$279.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
|
HC CLSD TX PELVIC RING FX W/O MANIPULATION
|
Facility
|
OP
|
$635.11
|
|
|
Service Code
|
CPT 27197
|
| Hospital Charge Code |
76100361
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$412.82
|
| Rate for Payer: Aetna Commercial |
$539.84
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$412.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$264.56
|
| Rate for Payer: BCN Commercial |
$264.56
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cash Price |
$508.09
|
| Rate for Payer: Cofinity Commercial |
$546.19
|
| Rate for Payer: Cofinity Commercial |
$444.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$444.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$508.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$571.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$444.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$476.33
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$539.84
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$539.84
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$412.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$400.12
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.39
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$127.63
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$234.99
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$476.33
|
|
|
HC CL TX GREATER HUMERAL TUBEROSITY FX W/O MAN
|
Facility
|
OP
|
$328.51
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
76100325
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.55 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$213.53
|
| Rate for Payer: Aetna Commercial |
$279.23
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$142.96
|
| Rate for Payer: BCN Commercial |
$142.96
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$262.81
|
| Rate for Payer: Cash Price |
$262.81
|
| Rate for Payer: Cash Price |
$262.81
|
| Rate for Payer: Cofinity Commercial |
$282.52
|
| Rate for Payer: Cofinity Commercial |
$229.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$229.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$295.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$229.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.38
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.23
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$279.23
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$206.96
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$280.32
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$254.84
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$121.55
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.38
|
|
|
HC CL TX GREATER HUMERAL TUBEROSITY FX W/O MAN
|
Facility
|
IP
|
$328.51
|
|
|
Service Code
|
CPT 23620
|
| Hospital Charge Code |
76100325
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$144.54 |
| Max. Negotiated Rate |
$295.66 |
| Rate for Payer: Aetna American Axle |
$213.53
|
| Rate for Payer: Aetna Commercial |
$279.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$213.53
|
| Rate for Payer: Cash Price |
$262.81
|
| Rate for Payer: Cofinity Commercial |
$229.96
|
| Rate for Payer: Cofinity Commercial |
$282.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$229.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.81
|
| Rate for Payer: Healthscope Commercial |
$295.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$229.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.23
|
| Rate for Payer: PHP Commercial |
$279.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.53
|
| Rate for Payer: Priority Health SBD |
$206.96
|
| Rate for Payer: UMR Bronson Commercial |
$144.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.38
|
|
|
HC CL TX INTERCONDYL SPI&/TUBRST FX KNE W/WO MAN
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
76100374
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$397.80
|
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$196.22
|
| Rate for Payer: BCN Commercial |
$196.22
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$483.22
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$439.29
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$226.44
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC CL TX INTERCONDYL SPI&/TUBRST FX KNE W/WO MAN
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
CPT 27538
|
| Hospital Charge Code |
76100374
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$269.28 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna American Axle |
$397.80
|
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$428.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.20
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$397.80
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: UMR Bronson Commercial |
$269.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC CL TX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Facility
|
IP
|
$665.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
76100520
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$292.60 |
| Max. Negotiated Rate |
$598.50 |
| Rate for Payer: Aetna American Axle |
$432.25
|
| Rate for Payer: Aetna Commercial |
$565.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.25
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$465.50
|
| Rate for Payer: Cofinity Commercial |
$571.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$465.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.00
|
| Rate for Payer: Healthscope Commercial |
$598.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$465.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$498.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: PHP Commercial |
$565.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health SBD |
$418.95
|
| Rate for Payer: UMR Bronson Commercial |
$292.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$498.75
|
|
|
HC CL TX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES
|
Facility
|
OP
|
$665.00
|
|
|
Service Code
|
CPT 26700
|
| Hospital Charge Code |
76100520
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$125.98 |
| Max. Negotiated Rate |
$738.70 |
| Rate for Payer: Aetna American Axle |
$432.25
|
| Rate for Payer: Aetna Commercial |
$565.25
|
| Rate for Payer: Aetna Medicare |
$244.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$293.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$293.79
|
| Rate for Payer: BCBS Complete |
$132.27
|
| Rate for Payer: BCBS MAPPO |
$235.03
|
| Rate for Payer: BCBS Trust/PPO |
$222.68
|
| Rate for Payer: BCN Commercial |
$222.68
|
| Rate for Payer: BCN Medicare Advantage |
$235.03
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cash Price |
$532.00
|
| Rate for Payer: Cofinity Commercial |
$571.90
|
| Rate for Payer: Cofinity Commercial |
$465.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$465.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.03
|
| Rate for Payer: Healthscope Commercial |
$598.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$465.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$498.75
|
| Rate for Payer: Mclaren Medicaid |
$125.98
|
| Rate for Payer: Mclaren Medicare |
$235.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$246.78
|
| Rate for Payer: Meridian Medicaid |
$132.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.25
|
| Rate for Payer: Nomi Health Commercial |
$493.56
|
| Rate for Payer: PACE Medicare |
$223.28
|
| Rate for Payer: PACE SWMI |
$235.03
|
| Rate for Payer: PHP Commercial |
$565.25
|
| Rate for Payer: PHP Medicare Advantage |
$235.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$125.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$738.70
|
| Rate for Payer: Priority Health Medicare |
$235.03
|
| Rate for Payer: Priority Health Narrow Network |
$590.96
|
| Rate for Payer: Priority Health SBD |
$418.95
|
| Rate for Payer: Railroad Medicare Medicare |
$235.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.02
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$235.03
|
| Rate for Payer: UHC Exchange |
$310.02
|
| Rate for Payer: UHC Medicare Advantage |
$235.03
|
| Rate for Payer: UHCCP Medicaid |
$125.98
|
| Rate for Payer: UMR Bronson Commercial |
$246.05
|
| Rate for Payer: VA VA |
$235.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$498.75
|
|
|
HC CMS CLINIC SUPPORT
|
Facility
|
OP
|
$141.03
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$52.18 |
| Max. Negotiated Rate |
$126.93 |
| Rate for Payer: Aetna American Axle |
$91.67
|
| Rate for Payer: Aetna Commercial |
$119.88
|
| Rate for Payer: Aetna Medicare |
$70.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.67
|
| Rate for Payer: BCBS Complete |
$56.41
|
| Rate for Payer: BCBS Trust/PPO |
$114.09
|
| Rate for Payer: BCCCP Commercial |
$87.68
|
| Rate for Payer: BCN Commercial |
$114.09
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cofinity Commercial |
$98.72
|
| Rate for Payer: Cofinity Commercial |
$121.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.82
|
| Rate for Payer: Healthscope Commercial |
$126.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.88
|
| Rate for Payer: PHP Commercial |
$119.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.67
|
| Rate for Payer: Priority Health SBD |
$88.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.42
|
| Rate for Payer: UHC Exchange |
$63.11
|
| Rate for Payer: UMR Bronson Commercial |
$52.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.77
|
|
|
HC CMS CLINIC SUPPORT
|
Facility
|
IP
|
$141.03
|
|
|
Service Code
|
CPT 99213
|
| Hospital Charge Code |
51000056
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.05 |
| Max. Negotiated Rate |
$126.93 |
| Rate for Payer: Aetna American Axle |
$91.67
|
| Rate for Payer: Aetna Commercial |
$119.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.67
|
| Rate for Payer: Cash Price |
$112.82
|
| Rate for Payer: Cofinity Commercial |
$121.29
|
| Rate for Payer: Cofinity Commercial |
$98.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$98.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.82
|
| Rate for Payer: Healthscope Commercial |
$126.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.88
|
| Rate for Payer: PHP Commercial |
$119.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.67
|
| Rate for Payer: Priority Health SBD |
$88.85
|
| Rate for Payer: UMR Bronson Commercial |
$62.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.77
|
|
|
HC CMV BY PCR CSF & BODY FLUIDS
|
Facility
|
OP
|
$89.47
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600151
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna American Axle |
$58.16
|
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| 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 |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| 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 |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$56.37
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$33.10
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC CMV BY PCR CSF & BODY FLUIDS
|
Facility
|
IP
|
$89.47
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600151
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$39.37 |
| Max. Negotiated Rate |
$80.52 |
| Rate for Payer: Aetna American Axle |
$58.16
|
| Rate for Payer: Aetna Commercial |
$76.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.16
|
| Rate for Payer: Cash Price |
$71.58
|
| Rate for Payer: Cofinity Commercial |
$62.63
|
| Rate for Payer: Cofinity Commercial |
$76.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.58
|
| Rate for Payer: Healthscope Commercial |
$80.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.05
|
| Rate for Payer: PHP Commercial |
$76.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.16
|
| Rate for Payer: Priority Health SBD |
$56.37
|
| Rate for Payer: UMR Bronson Commercial |
$39.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.10
|
|
|
HC CMV DNA PCR QUANTITATIVE
|
Facility
|
OP
|
$173.40
|
|
|
Service Code
|
CPT 87497
|
| Hospital Charge Code |
30600152
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna American Axle |
$112.71
|
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.11
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$41.27
|
| Rate for Payer: BCN Commercial |
$41.27
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$149.12
|
| Rate for Payer: Cofinity Commercial |
$121.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$121.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
| Rate for Payer: Mclaren Medicaid |
$22.96
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$24.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.39
|
| Rate for Payer: Nomi Health Commercial |
$64.26
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.07
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health Narrow Network |
$35.26
|
| Rate for Payer: Priority Health SBD |
$109.24
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$22.96
|
| Rate for Payer: UMR Bronson Commercial |
$64.16
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
|
HC CMV DNA PCR QUANTITATIVE
|
Facility
|
IP
|
$173.40
|
|
|
Service Code
|
CPT 87497
|
| Hospital Charge Code |
30600152
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$76.30 |
| Max. Negotiated Rate |
$156.06 |
| Rate for Payer: Aetna American Axle |
$112.71
|
| Rate for Payer: Aetna Commercial |
$147.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.71
|
| Rate for Payer: Cash Price |
$138.72
|
| Rate for Payer: Cofinity Commercial |
$121.38
|
| Rate for Payer: Cofinity Commercial |
$149.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$121.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.72
|
| Rate for Payer: Healthscope Commercial |
$156.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.39
|
| Rate for Payer: PHP Commercial |
$147.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$112.71
|
| Rate for Payer: Priority Health SBD |
$109.24
|
| Rate for Payer: UMR Bronson Commercial |
$76.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.05
|
|
|
HC COAGULATION INTERPRETATION
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 85390
|
| Hospital Charge Code |
30500075
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.30 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$16.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.35
|
| Rate for Payer: BCBS Complete |
$8.71
|
| Rate for Payer: BCBS MAPPO |
$15.48
|
| Rate for Payer: BCBS Trust/PPO |
$11.18
|
| Rate for Payer: BCN Commercial |
$11.18
|
| Rate for Payer: BCN Medicare Advantage |
$15.48
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.48
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$8.30
|
| Rate for Payer: Mclaren Medicare |
$15.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.25
|
| Rate for Payer: Meridian Medicaid |
$8.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$23.22
|
| Rate for Payer: PACE Medicare |
$14.71
|
| Rate for Payer: PACE SWMI |
$15.48
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$15.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.48
|
| Rate for Payer: Priority Health Medicare |
$15.48
|
| Rate for Payer: Priority Health Narrow Network |
$12.38
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$15.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.48
|
| Rate for Payer: UHC Exchange |
$15.48
|
| Rate for Payer: UHC Medicare Advantage |
$15.48
|
| Rate for Payer: UHCCP Medicaid |
$8.30
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$15.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC COAGULATION INTERPRETATION
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 85390
|
| Hospital Charge Code |
30500075
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC COAGULATION TIME ACTIVATED
|
Facility
|
IP
|
$76.63
|
|
|
Service Code
|
CPT 85347
|
| Hospital Charge Code |
30000166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.72 |
| Max. Negotiated Rate |
$68.97 |
| Rate for Payer: Aetna American Axle |
$49.81
|
| Rate for Payer: Aetna Commercial |
$65.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.81
|
| Rate for Payer: Cash Price |
$61.30
|
| Rate for Payer: Cofinity Commercial |
$53.64
|
| Rate for Payer: Cofinity Commercial |
$65.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.30
|
| Rate for Payer: Healthscope Commercial |
$68.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.14
|
| Rate for Payer: PHP Commercial |
$65.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.81
|
| Rate for Payer: Priority Health SBD |
$48.28
|
| Rate for Payer: UMR Bronson Commercial |
$33.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.47
|
|
|
HC COAGULATION TIME ACTIVATED
|
Facility
|
OP
|
$76.63
|
|
|
Service Code
|
CPT 85347
|
| Hospital Charge Code |
30000166
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$68.97 |
| Rate for Payer: Aetna American Axle |
$49.81
|
| Rate for Payer: Aetna Commercial |
$65.14
|
| Rate for Payer: Aetna Medicare |
$4.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.35
|
| Rate for Payer: BCBS Complete |
$2.41
|
| Rate for Payer: BCBS MAPPO |
$4.28
|
| Rate for Payer: BCBS Trust/PPO |
$4.12
|
| Rate for Payer: BCN Commercial |
$4.12
|
| Rate for Payer: BCN Medicare Advantage |
$4.28
|
| Rate for Payer: Cash Price |
$61.30
|
| Rate for Payer: Cash Price |
$61.30
|
| Rate for Payer: Cofinity Commercial |
$65.90
|
| Rate for Payer: Cofinity Commercial |
$53.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.28
|
| Rate for Payer: Healthscope Commercial |
$68.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.47
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.49
|
| Rate for Payer: Meridian Medicaid |
$2.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.14
|
| Rate for Payer: Nomi Health Commercial |
$6.42
|
| Rate for Payer: PACE Medicare |
$4.07
|
| Rate for Payer: PACE SWMI |
$4.28
|
| Rate for Payer: PHP Commercial |
$65.14
|
| Rate for Payer: PHP Medicare Advantage |
$4.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.38
|
| Rate for Payer: Priority Health Medicare |
$4.28
|
| Rate for Payer: Priority Health Narrow Network |
$3.50
|
| Rate for Payer: Priority Health SBD |
$48.28
|
| Rate for Payer: Railroad Medicare Medicare |
$4.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.28
|
| Rate for Payer: UHC Exchange |
$4.28
|
| Rate for Payer: UHC Medicare Advantage |
$4.28
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: UMR Bronson Commercial |
$28.35
|
| Rate for Payer: VA VA |
$4.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.47
|
|
|
HC COBALT SERUM
|
Facility
|
OP
|
$88.74
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
30100639
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.77 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: VA VA |
$21.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
| Rate for Payer: Aetna American Axle |
$57.68
|
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna Medicare |
$22.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.45
|
| Rate for Payer: BCBS Complete |
$12.36
|
| Rate for Payer: BCBS MAPPO |
$21.96
|
| Rate for Payer: BCBS Trust/PPO |
$21.16
|
| Rate for Payer: BCN Commercial |
$21.16
|
| Rate for Payer: BCN Medicare Advantage |
$21.96
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Cofinity Commercial |
$62.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.96
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Mclaren Medicaid |
$11.77
|
| Rate for Payer: Mclaren Medicare |
$21.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.06
|
| Rate for Payer: Meridian Medicaid |
$12.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: Nomi Health Commercial |
$32.94
|
| Rate for Payer: PACE Medicare |
$20.86
|
| Rate for Payer: PACE SWMI |
$21.96
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: PHP Medicare Advantage |
$21.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.60
|
| Rate for Payer: Priority Health Medicare |
$21.96
|
| Rate for Payer: Priority Health Narrow Network |
$18.08
|
| Rate for Payer: Priority Health SBD |
$55.91
|
| Rate for Payer: Railroad Medicare Medicare |
$21.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.96
|
| Rate for Payer: UHC Exchange |
$21.96
|
| Rate for Payer: UHC Medicare Advantage |
$21.96
|
| Rate for Payer: UHCCP Medicaid |
$11.77
|
| Rate for Payer: UMR Bronson Commercial |
$32.83
|
|
|
HC COBALT SERUM
|
Facility
|
IP
|
$88.74
|
|
|
Service Code
|
CPT 83018
|
| Hospital Charge Code |
30100639
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.05 |
| Max. Negotiated Rate |
$79.87 |
| Rate for Payer: Aetna American Axle |
$57.68
|
| Rate for Payer: Aetna Commercial |
$75.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.68
|
| Rate for Payer: Cash Price |
$70.99
|
| Rate for Payer: Cofinity Commercial |
$62.12
|
| Rate for Payer: Cofinity Commercial |
$76.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.99
|
| Rate for Payer: Healthscope Commercial |
$79.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.43
|
| Rate for Payer: PHP Commercial |
$75.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.68
|
| Rate for Payer: Priority Health SBD |
$55.91
|
| Rate for Payer: UMR Bronson Commercial |
$39.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.56
|
|
|
HC COCAINE CONFIRMATION URINE
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100597
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna American Axle |
$41.11
|
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: Aetna Medicare |
$31.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.11
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Cofinity Commercial |
$44.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health SBD |
$39.84
|
| Rate for Payer: UHC Core |
$30.68
|
| Rate for Payer: UMR Bronson Commercial |
$23.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC COCAINE CONFIRMATION URINE
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100597
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.83 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna American Axle |
$41.11
|
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.11
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$44.27
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health SBD |
$39.84
|
| Rate for Payer: UMR Bronson Commercial |
$27.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC COCAINE CONFIRM MECONIUM
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100573
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.68 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$58.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UHC Core |
$30.68
|
| Rate for Payer: UMR Bronson Commercial |
$43.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC COCAINE CONFIRM MECONIUM
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80353
|
| Hospital Charge Code |
30100573
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.61 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UMR Bronson Commercial |
$51.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC COCAINE URIN
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000127
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$91.49 |
| Rate for Payer: Aetna American Axle |
$66.08
|
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health SBD |
$64.05
|
| Rate for Payer: UMR Bronson Commercial |
$44.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.24
|
|
