|
HC MAYOCOMPLETE MYELOID NEOPLASMS, NGS
|
Facility
|
OP
|
$1,925.00
|
|
|
Service Code
|
CPT 81450
|
| Hospital Charge Code |
31000084
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$107.80 |
| Max. Negotiated Rate |
$1,732.50 |
| Rate for Payer: Aetna American Axle |
$1,251.25
|
| Rate for Payer: Aetna Commercial |
$1,636.25
|
| Rate for Payer: Aetna Medicare |
$789.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$949.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$949.41
|
| Rate for Payer: BCBS Complete |
$436.27
|
| Rate for Payer: BCBS MAPPO |
$759.53
|
| Rate for Payer: BCBS Trust/PPO |
$910.75
|
| Rate for Payer: BCN Medicare Advantage |
$759.53
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cash Price |
$1,540.00
|
| Rate for Payer: Cofinity Commercial |
$1,655.50
|
| Rate for Payer: Cofinity Commercial |
$1,347.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$759.53
|
| Rate for Payer: Healthscope Commercial |
$1,732.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,347.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,443.75
|
| Rate for Payer: Mclaren Medicaid |
$415.46
|
| Rate for Payer: Mclaren Medicare |
$759.53
|
| Rate for Payer: Meridian Medicaid |
$436.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$797.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$873.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,636.25
|
| Rate for Payer: PACE Medicare |
$721.55
|
| Rate for Payer: PACE SWMI |
$759.53
|
| Rate for Payer: PHP Commercial |
$1,636.25
|
| Rate for Payer: PHP Medicare Advantage |
$759.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$415.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,347.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$652.94
|
| Rate for Payer: Priority Health Medicare |
$759.53
|
| Rate for Payer: Priority Health Narrow Network |
$522.35
|
| Rate for Payer: Priority Health SBD |
$1,212.75
|
| Rate for Payer: Railroad Medicare Medicare |
$759.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$911.44
|
| Rate for Payer: UHC Core |
$107.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$759.53
|
| Rate for Payer: UHC Exchange |
$759.53
|
| Rate for Payer: UHC Medicare Advantage |
$782.32
|
| Rate for Payer: UMR Bronson Commercial |
$712.25
|
| Rate for Payer: VA VA |
$759.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,443.75
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
IP
|
$10.57
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.65 |
| Max. Negotiated Rate |
$9.51 |
| Rate for Payer: Aetna American Axle |
$6.87
|
| Rate for Payer: Aetna Commercial |
$8.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.87
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cofinity Commercial |
$7.40
|
| Rate for Payer: Cofinity Commercial |
$9.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.46
|
| Rate for Payer: Healthscope Commercial |
$9.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.98
|
| Rate for Payer: PHP Commercial |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.40
|
| Rate for Payer: Priority Health SBD |
$6.66
|
| Rate for Payer: UMR Bronson Commercial |
$4.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.93
|
|
|
HC MAYO CREATININE, URINE CMPT
|
Facility
|
OP
|
$10.57
|
|
|
Service Code
|
CPT 82570
|
| Hospital Charge Code |
30100734
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.83 |
| Max. Negotiated Rate |
$9.51 |
| Rate for Payer: Aetna American Axle |
$6.87
|
| Rate for Payer: Aetna Commercial |
$8.98
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.48
|
| Rate for Payer: BCBS Complete |
$2.98
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCBS Trust/PPO |
$4.66
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cash Price |
$8.46
|
| Rate for Payer: Cofinity Commercial |
$9.09
|
| Rate for Payer: Cofinity Commercial |
$7.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$9.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.93
|
| Rate for Payer: Mclaren Medicaid |
$2.83
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Medicaid |
$2.98
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8.98
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$8.98
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.37
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health Narrow Network |
$5.10
|
| Rate for Payer: Priority Health SBD |
$6.66
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.22
|
| Rate for Payer: UHC Core |
$8.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$5.18
|
| Rate for Payer: UHC Medicare Advantage |
$5.34
|
| Rate for Payer: UMR Bronson Commercial |
$3.91
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.93
|
|
|
HC MDI TREATMENT
|
Facility
|
IP
|
$146.74
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$64.57 |
| Max. Negotiated Rate |
$132.07 |
| Rate for Payer: Aetna American Axle |
$95.38
|
| Rate for Payer: Aetna Commercial |
$124.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.38
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$102.72
|
| Rate for Payer: Cofinity Commercial |
$126.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.39
|
| Rate for Payer: Healthscope Commercial |
$132.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.73
|
| Rate for Payer: PHP Commercial |
$124.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.72
|
| Rate for Payer: Priority Health SBD |
$92.45
|
| Rate for Payer: UMR Bronson Commercial |
$64.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.06
|
|
|
HC MDI TREATMENT
|
Facility
|
OP
|
$146.74
|
|
|
Service Code
|
CPT 94640
|
| Hospital Charge Code |
41000004
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$7.86 |
| Max. Negotiated Rate |
$596.84 |
| Rate for Payer: Aetna American Axle |
$95.38
|
| Rate for Payer: Aetna Commercial |
$124.73
|
| Rate for Payer: Aetna Medicare |
$197.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$43.58
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cash Price |
$117.39
|
| Rate for Payer: Cofinity Commercial |
$126.20
|
| Rate for Payer: Cofinity Commercial |
$102.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$132.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.06
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$124.73
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$124.73
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.84
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$477.47
|
| Rate for Payer: Priority Health SBD |
$92.45
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.65
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.59
|
| Rate for Payer: UHC Exchange |
$7.86
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: UMR Bronson Commercial |
$54.29
|
| Rate for Payer: VA VA |
$189.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.06
|
|
|
HC MEADOW FESCUE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
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 MEADOW FESCUE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200092
|
|
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 MEASLES (RUBEOLA) IGM
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.99 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna American Axle |
$32.49
|
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health SBD |
$31.49
|
| Rate for Payer: UMR Bronson Commercial |
$21.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC MEASLES (RUBEOLA) IGM
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200398
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna American Axle |
$32.49
|
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
| Rate for Payer: BCBS Complete |
$7.40
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$11.58
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$7.05
|
| Rate for Payer: Mclaren Medicare |
$12.88
|
| Rate for Payer: Meridian Medicaid |
$7.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.48
|
| Rate for Payer: PACE Medicare |
$12.24
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.67
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow Network |
$14.14
|
| Rate for Payer: Priority Health SBD |
$31.49
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.46
|
| Rate for Payer: UHC Core |
$21.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.88
|
| Rate for Payer: UHC Exchange |
$12.88
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UMR Bronson Commercial |
$18.49
|
| Rate for Payer: VA VA |
$12.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
IP
|
$1,537.29
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$676.41 |
| Max. Negotiated Rate |
$1,383.56 |
| Rate for Payer: Aetna American Axle |
$999.24
|
| Rate for Payer: Aetna Commercial |
$1,306.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.24
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,076.10
|
| Rate for Payer: Cofinity Commercial |
$1,322.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Healthscope Commercial |
$1,383.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,076.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: PHP Commercial |
$1,306.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health SBD |
$968.49
|
| Rate for Payer: UMR Bronson Commercial |
$676.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.97
|
|
|
HC MECHANICAL REMOVAL OBSTRC CVD
|
Facility
|
OP
|
$1,537.29
|
|
|
Service Code
|
CPT 36596
|
| Hospital Charge Code |
36100143
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$43.55 |
| Max. Negotiated Rate |
$4,481.48 |
| Rate for Payer: Aetna American Axle |
$999.24
|
| Rate for Payer: Aetna Commercial |
$1,306.70
|
| Rate for Payer: Aetna Medicare |
$1,480.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$999.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,779.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,779.46
|
| Rate for Payer: BCBS Complete |
$817.70
|
| Rate for Payer: BCBS MAPPO |
$1,423.57
|
| Rate for Payer: BCBS Trust/PPO |
$775.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,423.57
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cash Price |
$1,229.83
|
| Rate for Payer: Cofinity Commercial |
$1,322.07
|
| Rate for Payer: Cofinity Commercial |
$1,076.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,229.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,423.57
|
| Rate for Payer: Healthscope Commercial |
$1,383.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,076.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,152.97
|
| Rate for Payer: Mclaren Medicaid |
$778.69
|
| Rate for Payer: Mclaren Medicare |
$1,423.57
|
| Rate for Payer: Meridian Medicaid |
$817.70
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,494.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,637.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,306.70
|
| Rate for Payer: PACE Medicare |
$1,352.39
|
| Rate for Payer: PACE SWMI |
$1,423.57
|
| Rate for Payer: PHP Commercial |
$1,306.70
|
| Rate for Payer: PHP Medicare Advantage |
$1,423.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$778.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,076.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,481.48
|
| Rate for Payer: Priority Health Medicare |
$1,423.57
|
| Rate for Payer: Priority Health Narrow Network |
$3,585.18
|
| Rate for Payer: Priority Health SBD |
$968.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,423.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.90
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,423.57
|
| Rate for Payer: UHC Exchange |
$43.55
|
| Rate for Payer: UHC Medicare Advantage |
$1,466.28
|
| Rate for Payer: UMR Bronson Commercial |
$568.80
|
| Rate for Payer: VA VA |
$1,423.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,152.97
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
OP
|
$2,904.48
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$173.22 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$1,887.91
|
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$572.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,033.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$190.54
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$173.22
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,074.66
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTION
|
Facility
|
IP
|
$2,904.48
|
|
|
Service Code
|
CPT 36595
|
| Hospital Charge Code |
36100142
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,277.97 |
| Max. Negotiated Rate |
$2,614.03 |
| Rate for Payer: Aetna American Axle |
$1,887.91
|
| Rate for Payer: Aetna Commercial |
$2,468.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,887.91
|
| Rate for Payer: Cash Price |
$2,323.58
|
| Rate for Payer: Cofinity Commercial |
$2,033.14
|
| Rate for Payer: Cofinity Commercial |
$2,497.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,323.58
|
| Rate for Payer: Healthscope Commercial |
$2,614.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,033.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,178.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,468.81
|
| Rate for Payer: PHP Commercial |
$2,468.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,033.14
|
| Rate for Payer: Priority Health SBD |
$1,829.82
|
| Rate for Payer: UMR Bronson Commercial |
$1,277.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,178.36
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
OP
|
$314.32
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$20.30 |
| Max. Negotiated Rate |
$596.84 |
| Rate for Payer: Aetna American Axle |
$204.31
|
| Rate for Payer: Aetna Commercial |
$267.17
|
| Rate for Payer: Aetna Medicare |
$197.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.99
|
| Rate for Payer: BCBS Complete |
$108.90
|
| Rate for Payer: BCBS MAPPO |
$189.59
|
| Rate for Payer: BCBS Trust/PPO |
$144.34
|
| Rate for Payer: BCN Medicare Advantage |
$189.59
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cofinity Commercial |
$220.02
|
| Rate for Payer: Cofinity Commercial |
$270.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.59
|
| Rate for Payer: Healthscope Commercial |
$282.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.74
|
| Rate for Payer: Mclaren Medicaid |
$103.71
|
| Rate for Payer: Mclaren Medicare |
$189.59
|
| Rate for Payer: Meridian Medicaid |
$108.90
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$199.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.17
|
| Rate for Payer: PACE Medicare |
$180.11
|
| Rate for Payer: PACE SWMI |
$189.59
|
| Rate for Payer: PHP Commercial |
$267.17
|
| Rate for Payer: PHP Medicare Advantage |
$189.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$596.84
|
| Rate for Payer: Priority Health Medicare |
$189.59
|
| Rate for Payer: Priority Health Narrow Network |
$477.47
|
| Rate for Payer: Priority Health SBD |
$198.02
|
| Rate for Payer: Railroad Medicare Medicare |
$189.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.33
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.59
|
| Rate for Payer: UHC Exchange |
$20.30
|
| Rate for Payer: UHC Medicare Advantage |
$195.28
|
| Rate for Payer: UMR Bronson Commercial |
$116.30
|
| Rate for Payer: VA VA |
$189.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.74
|
|
|
HC MECH CHEST WALL OSCILLATION
|
Facility
|
IP
|
$314.32
|
|
|
Service Code
|
CPT 94669
|
| Hospital Charge Code |
41000043
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$138.30 |
| Max. Negotiated Rate |
$282.89 |
| Rate for Payer: Aetna American Axle |
$204.31
|
| Rate for Payer: Aetna Commercial |
$267.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.31
|
| Rate for Payer: Cash Price |
$251.46
|
| Rate for Payer: Cofinity Commercial |
$220.02
|
| Rate for Payer: Cofinity Commercial |
$270.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$251.46
|
| Rate for Payer: Healthscope Commercial |
$282.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$235.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$267.17
|
| Rate for Payer: PHP Commercial |
$267.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.02
|
| Rate for Payer: Priority Health SBD |
$198.02
|
| Rate for Payer: UMR Bronson Commercial |
$138.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$235.74
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
IP
|
$1,477.22
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$649.98 |
| Max. Negotiated Rate |
$1,329.50 |
| Rate for Payer: Aetna American Axle |
$960.19
|
| Rate for Payer: Aetna Commercial |
$1,255.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.19
|
| Rate for Payer: Cash Price |
$1,181.78
|
| Rate for Payer: Cofinity Commercial |
$1,034.05
|
| Rate for Payer: Cofinity Commercial |
$1,270.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,181.78
|
| Rate for Payer: Healthscope Commercial |
$1,329.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,034.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,107.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,255.64
|
| Rate for Payer: PHP Commercial |
$1,255.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.05
|
| Rate for Payer: Priority Health SBD |
$930.65
|
| Rate for Payer: UMR Bronson Commercial |
$649.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,107.92
|
|
|
HC MECH VENT INITIAL DAY
|
Facility
|
OP
|
$1,477.22
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000002
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$88.41 |
| Max. Negotiated Rate |
$1,753.55 |
| Rate for Payer: Aetna American Axle |
$960.19
|
| Rate for Payer: Aetna Commercial |
$1,255.64
|
| Rate for Payer: Aetna Medicare |
$579.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$960.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.29
|
| Rate for Payer: BCBS Complete |
$319.96
|
| Rate for Payer: BCBS MAPPO |
$557.03
|
| Rate for Payer: BCBS Trust/PPO |
$90.49
|
| Rate for Payer: BCN Medicare Advantage |
$557.03
|
| Rate for Payer: Cash Price |
$1,181.78
|
| Rate for Payer: Cash Price |
$1,181.78
|
| Rate for Payer: Cash Price |
$1,181.78
|
| Rate for Payer: Cofinity Commercial |
$1,270.41
|
| Rate for Payer: Cofinity Commercial |
$1,034.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,181.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.03
|
| Rate for Payer: Healthscope Commercial |
$1,329.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,034.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,107.92
|
| Rate for Payer: Mclaren Medicaid |
$304.70
|
| Rate for Payer: Mclaren Medicare |
$557.03
|
| Rate for Payer: Meridian Medicaid |
$319.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$584.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,255.64
|
| Rate for Payer: PACE Medicare |
$529.18
|
| Rate for Payer: PACE SWMI |
$557.03
|
| Rate for Payer: PHP Commercial |
$1,255.64
|
| Rate for Payer: PHP Medicare Advantage |
$557.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,034.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,753.55
|
| Rate for Payer: Priority Health Medicare |
$557.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.84
|
| Rate for Payer: Priority Health SBD |
$930.65
|
| Rate for Payer: Railroad Medicare Medicare |
$557.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.25
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.03
|
| Rate for Payer: UHC Exchange |
$88.41
|
| Rate for Payer: UHC Medicare Advantage |
$573.74
|
| Rate for Payer: UMR Bronson Commercial |
$546.57
|
| Rate for Payer: VA VA |
$557.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,107.92
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
IP
|
$1,286.86
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$566.22 |
| Max. Negotiated Rate |
$1,158.17 |
| Rate for Payer: Aetna American Axle |
$836.46
|
| Rate for Payer: Aetna Commercial |
$1,093.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.46
|
| Rate for Payer: Cash Price |
$1,029.49
|
| Rate for Payer: Cofinity Commercial |
$1,106.70
|
| Rate for Payer: Cofinity Commercial |
$900.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.49
|
| Rate for Payer: Healthscope Commercial |
$1,158.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$900.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$965.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,093.83
|
| Rate for Payer: PHP Commercial |
$1,093.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.80
|
| Rate for Payer: Priority Health SBD |
$810.72
|
| Rate for Payer: UMR Bronson Commercial |
$566.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$965.14
|
|
|
HC MECH VENT SUBS DAYS
|
Facility
|
OP
|
$1,286.86
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000003
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$62.21 |
| Max. Negotiated Rate |
$1,753.55 |
| Rate for Payer: Aetna American Axle |
$836.46
|
| Rate for Payer: Aetna Commercial |
$1,093.83
|
| Rate for Payer: Aetna Medicare |
$579.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$836.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$696.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$696.29
|
| Rate for Payer: BCBS Complete |
$319.96
|
| Rate for Payer: BCBS MAPPO |
$557.03
|
| Rate for Payer: BCBS Trust/PPO |
$68.70
|
| Rate for Payer: BCN Medicare Advantage |
$557.03
|
| Rate for Payer: Cash Price |
$1,029.49
|
| Rate for Payer: Cash Price |
$1,029.49
|
| Rate for Payer: Cash Price |
$1,029.49
|
| Rate for Payer: Cofinity Commercial |
$900.80
|
| Rate for Payer: Cofinity Commercial |
$1,106.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,029.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$557.03
|
| Rate for Payer: Healthscope Commercial |
$1,158.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$900.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$965.14
|
| Rate for Payer: Mclaren Medicaid |
$304.70
|
| Rate for Payer: Mclaren Medicare |
$557.03
|
| Rate for Payer: Meridian Medicaid |
$319.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$584.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$640.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,093.83
|
| Rate for Payer: PACE Medicare |
$529.18
|
| Rate for Payer: PACE SWMI |
$557.03
|
| Rate for Payer: PHP Commercial |
$1,093.83
|
| Rate for Payer: PHP Medicare Advantage |
$557.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$304.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$900.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,753.55
|
| Rate for Payer: Priority Health Medicare |
$557.03
|
| Rate for Payer: Priority Health Narrow Network |
$1,402.84
|
| Rate for Payer: Priority Health SBD |
$810.72
|
| Rate for Payer: Railroad Medicare Medicare |
$557.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.43
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$557.03
|
| Rate for Payer: UHC Exchange |
$62.21
|
| Rate for Payer: UHC Medicare Advantage |
$573.74
|
| Rate for Payer: UMR Bronson Commercial |
$476.14
|
| Rate for Payer: VA VA |
$557.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$965.14
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna American Axle |
$74.75
|
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$80.50
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health SBD |
$72.45
|
| Rate for Payer: UMR Bronson Commercial |
$50.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30000099
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$25.38 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna American Axle |
$74.75
|
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.75
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Cofinity Commercial |
$80.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health SBD |
$72.45
|
| Rate for Payer: UHC Core |
$25.38
|
| Rate for Payer: UMR Bronson Commercial |
$42.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna American Axle |
$74.75
|
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$80.50
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health SBD |
$72.45
|
| Rate for Payer: UMR Bronson Commercial |
$50.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM BENZODIAZAPINE CONFIRMATION
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80346
|
| Hospital Charge Code |
30000102
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.33 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna American Axle |
$74.75
|
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.75
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Cofinity Commercial |
$80.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health SBD |
$72.45
|
| Rate for Payer: UHC Core |
$32.33
|
| Rate for Payer: UMR Bronson Commercial |
$42.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$50.60 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna American Axle |
$74.75
|
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.75
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$80.50
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health SBD |
$72.45
|
| Rate for Payer: UMR Bronson Commercial |
$50.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
|
HC MECONIUM BUPRENORPHINE CONFIRMATION
|
Facility
|
OP
|
$115.00
|
|
|
Service Code
|
CPT 80348
|
| Hospital Charge Code |
30000100
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$19.44 |
| Max. Negotiated Rate |
$103.50 |
| Rate for Payer: Aetna American Axle |
$74.75
|
| Rate for Payer: Aetna Commercial |
$97.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.75
|
| Rate for Payer: BCBS Complete |
$46.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cash Price |
$92.00
|
| Rate for Payer: Cofinity Commercial |
$98.90
|
| Rate for Payer: Cofinity Commercial |
$80.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.00
|
| Rate for Payer: Healthscope Commercial |
$103.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.75
|
| Rate for Payer: PHP Commercial |
$97.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.50
|
| Rate for Payer: Priority Health SBD |
$72.45
|
| Rate for Payer: UHC Core |
$19.44
|
| Rate for Payer: UMR Bronson Commercial |
$42.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.25
|
|
