|
HC DRUG SCREEN 10 URINE
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000134
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna American Axle |
$68.98
|
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.84
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: UMR Bronson Commercial |
$39.26
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC DRUG SCREEN COLLECT-OUTSIDE SVC
|
Facility
|
IP
|
$24.97
|
|
|
Service Code
|
CPT 99000
|
| Hospital Charge Code |
98300005
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna American Axle |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: UMR Bronson Commercial |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC DRUG SCREEN COLLECT-OUTSIDE SVC
|
Facility
|
OP
|
$24.97
|
|
|
Service Code
|
CPT 99000
|
| Hospital Charge Code |
98300005
|
|
Hospital Revenue Code
|
983
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna American Axle |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: BCBS Complete |
$9.99
|
| Rate for Payer: BCBS Trust/PPO |
$15.64
|
| Rate for Payer: BCN Commercial |
$15.64
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC DRUG SCREEN QUAL EA PROC
|
Facility
|
IP
|
$49.19
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100652
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.64 |
| Max. Negotiated Rate |
$44.27 |
| Rate for Payer: Aetna American Axle |
$31.97
|
| Rate for Payer: Aetna Commercial |
$41.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.97
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cofinity Advantage |
$34.43
|
| Rate for Payer: Cofinity Commercial |
$42.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.35
|
| Rate for Payer: Healthscope Commercial |
$44.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.89
|
| Rate for Payer: PHP Commercial |
$41.81
|
| Rate for Payer: Priority Health SBD |
$30.99
|
| Rate for Payer: UMR Bronson Commercial |
$21.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.89
|
|
|
HC DRUG SCREEN QUAL EA PROC
|
Facility
|
OP
|
$49.19
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100652
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$44.27 |
| Rate for Payer: Aetna American Axle |
$31.97
|
| Rate for Payer: Aetna Commercial |
$41.81
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$14.57
|
| Rate for Payer: BCN Commercial |
$14.57
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cofinity Advantage |
$34.43
|
| Rate for Payer: Cofinity Commercial |
$42.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$44.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.89
|
| Rate for Payer: Mclaren Medicaid |
$12.60
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.81
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.89
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$41.81
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$30.99
|
| Rate for Payer: Priority Health Tiered Network |
$10.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.90
|
| Rate for Payer: UHC Core |
$18.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicaid |
$6.59
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: UMR Bronson Commercial |
$18.20
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.89
|
|
|
HC DRUG SCREEN QUANTALCOHOLS
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100732
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.87 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: BCBS Complete |
$31.21
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC DRUG SCREEN QUANTALCOHOLS
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100732
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC DSDNA AB WITH REFLEX, IGG, S
|
Facility
|
IP
|
$40.30
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200505
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.73 |
| Max. Negotiated Rate |
$36.27 |
| Rate for Payer: Aetna American Axle |
$26.20
|
| Rate for Payer: Aetna Commercial |
$34.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.20
|
| Rate for Payer: Cash Price |
$32.24
|
| Rate for Payer: Cofinity Advantage |
$28.21
|
| Rate for Payer: Cofinity Commercial |
$34.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.24
|
| Rate for Payer: Healthscope Commercial |
$36.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.23
|
| Rate for Payer: PHP Commercial |
$34.26
|
| Rate for Payer: Priority Health SBD |
$25.39
|
| Rate for Payer: UMR Bronson Commercial |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.23
|
|
|
HC DSDNA AB WITH REFLEX, IGG, S
|
Facility
|
OP
|
$40.30
|
|
|
Service Code
|
CPT 86225
|
| Hospital Charge Code |
30200505
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$36.27 |
| Rate for Payer: Aetna American Axle |
$26.20
|
| Rate for Payer: Aetna Commercial |
$34.26
|
| Rate for Payer: Aetna Medicare |
$14.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.18
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$13.74
|
| Rate for Payer: BCBS Trust/PPO |
$15.89
|
| Rate for Payer: BCN Commercial |
$15.89
|
| Rate for Payer: BCN Medicare Advantage |
$13.74
|
| Rate for Payer: Cash Price |
$32.24
|
| Rate for Payer: Cash Price |
$32.24
|
| Rate for Payer: Cofinity Advantage |
$28.21
|
| Rate for Payer: Cofinity Commercial |
$34.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.74
|
| Rate for Payer: Healthscope Commercial |
$36.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.23
|
| Rate for Payer: Mclaren Medicaid |
$13.74
|
| Rate for Payer: Mclaren Medicare |
$13.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.43
|
| Rate for Payer: Meridian Medicaid |
$14.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.26
|
| Rate for Payer: Nomi Health Commercial |
$20.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.23
|
| Rate for Payer: PACE Medicare |
$13.05
|
| Rate for Payer: PACE SWMI |
$13.74
|
| Rate for Payer: PHP Commercial |
$34.26
|
| Rate for Payer: PHP Medicare Advantage |
$13.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.74
|
| Rate for Payer: Priority Health Medicare |
$13.74
|
| Rate for Payer: Priority Health SBD |
$25.39
|
| Rate for Payer: Priority Health Tiered Network |
$10.99
|
| Rate for Payer: Railroad Medicare Medicare |
$13.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.61
|
| Rate for Payer: UHC Core |
$20.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.74
|
| Rate for Payer: UHC Exchange |
$20.61
|
| Rate for Payer: UHC Medicaid |
$7.19
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: UMR Bronson Commercial |
$14.91
|
| Rate for Payer: VA VA |
$13.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.23
|
|
|
HC DSMA TC 99M PER STUDY
|
Facility
|
OP
|
$396.48
|
|
|
Service Code
|
HCPCS A9551
|
| Hospital Charge Code |
34300004
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$146.70 |
| Max. Negotiated Rate |
$2,081.41 |
| Rate for Payer: Aetna American Axle |
$257.71
|
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna Medicare |
$686.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$824.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$824.91
|
| Rate for Payer: BCBS Complete |
$362.43
|
| Rate for Payer: BCBS MAPPO |
$659.93
|
| Rate for Payer: BCBS Trust/PPO |
$241.20
|
| Rate for Payer: BCN Commercial |
$241.20
|
| Rate for Payer: BCN Medicare Advantage |
$659.93
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$659.93
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Mclaren Medicaid |
$659.93
|
| Rate for Payer: Mclaren Medicare |
$659.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$692.93
|
| Rate for Payer: Meridian Medicaid |
$692.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$758.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$725.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Nomi Health Commercial |
$1,979.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PACE Medicare |
$626.93
|
| Rate for Payer: PACE SWMI |
$659.93
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: PHP Medicare Advantage |
$659.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$345.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,081.41
|
| Rate for Payer: Priority Health Medicare |
$659.93
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: Priority Health Tiered Network |
$1,665.13
|
| Rate for Payer: Railroad Medicare Medicare |
$659.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,088.88
|
| Rate for Payer: UHC Core |
$1,088.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$659.93
|
| Rate for Payer: UHC Exchange |
$1,088.88
|
| Rate for Payer: UHC Medicaid |
$345.14
|
| Rate for Payer: UHCCP Medicaid |
$345.14
|
| Rate for Payer: UMR Bronson Commercial |
$146.70
|
| Rate for Payer: VA VA |
$659.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC DSMA TC 99M PER STUDY
|
Facility
|
IP
|
$396.48
|
|
|
Service Code
|
HCPCS A9551
|
| Hospital Charge Code |
34300004
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$174.45 |
| Max. Negotiated Rate |
$356.83 |
| Rate for Payer: Aetna American Axle |
$257.71
|
| Rate for Payer: Aetna Commercial |
$337.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$257.71
|
| Rate for Payer: Cash Price |
$317.18
|
| Rate for Payer: Cofinity Advantage |
$277.54
|
| Rate for Payer: Cofinity Commercial |
$340.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$317.18
|
| Rate for Payer: Healthscope Commercial |
$356.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$277.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$297.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$337.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$297.36
|
| Rate for Payer: PHP Commercial |
$337.01
|
| Rate for Payer: Priority Health SBD |
$249.78
|
| Rate for Payer: UMR Bronson Commercial |
$174.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$297.36
|
|
|
HC DTAP HEPB IPV VACCINE INTRAMUSCULAR
|
Facility
|
IP
|
$179.71
|
|
|
Service Code
|
CPT 90723
|
| Hospital Charge Code |
63600137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$79.07 |
| Max. Negotiated Rate |
$161.74 |
| Rate for Payer: Aetna American Axle |
$116.81
|
| Rate for Payer: Aetna Commercial |
$152.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.81
|
| Rate for Payer: Cash Price |
$143.77
|
| Rate for Payer: Cofinity Advantage |
$125.80
|
| Rate for Payer: Cofinity Commercial |
$154.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.77
|
| Rate for Payer: Healthscope Commercial |
$161.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.78
|
| Rate for Payer: PHP Commercial |
$152.75
|
| Rate for Payer: Priority Health SBD |
$113.22
|
| Rate for Payer: UMR Bronson Commercial |
$79.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.78
|
|
|
HC DTAP HEPB IPV VACCINE INTRAMUSCULAR
|
Facility
|
OP
|
$179.71
|
|
|
Service Code
|
CPT 90723
|
| Hospital Charge Code |
63600137
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.49 |
| Max. Negotiated Rate |
$329.78 |
| Rate for Payer: Aetna American Axle |
$116.81
|
| Rate for Payer: Aetna Commercial |
$152.75
|
| Rate for Payer: Aetna Medicare |
$89.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$116.81
|
| Rate for Payer: BCBS Complete |
$71.88
|
| Rate for Payer: BCBS Trust/PPO |
$329.78
|
| Rate for Payer: BCN Commercial |
$329.78
|
| Rate for Payer: Cash Price |
$143.77
|
| Rate for Payer: Cash Price |
$143.77
|
| Rate for Payer: Cofinity Advantage |
$125.80
|
| Rate for Payer: Cofinity Commercial |
$154.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$143.77
|
| Rate for Payer: Healthscope Commercial |
$161.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$125.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$134.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$152.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$134.78
|
| Rate for Payer: PHP Commercial |
$152.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$117.41
|
| Rate for Payer: Priority Health SBD |
$113.22
|
| Rate for Payer: Priority Health Tiered Network |
$93.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.96
|
| Rate for Payer: UHC Core |
$218.96
|
| Rate for Payer: UHC Exchange |
$218.96
|
| Rate for Payer: UMR Bronson Commercial |
$66.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$134.78
|
|
|
HC DTAP-IPV VACCINE 4-6 YEARS IM
|
Facility
|
OP
|
$78.20
|
|
|
Service Code
|
CPT 90696
|
| Hospital Charge Code |
63600120
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.93 |
| Max. Negotiated Rate |
$199.93 |
| Rate for Payer: Aetna American Axle |
$50.83
|
| Rate for Payer: Aetna Commercial |
$66.47
|
| Rate for Payer: Aetna Medicare |
$39.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.83
|
| Rate for Payer: BCBS Complete |
$31.28
|
| Rate for Payer: BCBS Trust/PPO |
$199.93
|
| Rate for Payer: BCN Commercial |
$199.93
|
| Rate for Payer: Cash Price |
$62.56
|
| Rate for Payer: Cash Price |
$62.56
|
| Rate for Payer: Cofinity Advantage |
$54.74
|
| Rate for Payer: Cofinity Commercial |
$67.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.56
|
| Rate for Payer: Healthscope Commercial |
$70.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.65
|
| Rate for Payer: PHP Commercial |
$66.47
|
| Rate for Payer: Priority Health SBD |
$49.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.84
|
| Rate for Payer: UHC Core |
$129.84
|
| Rate for Payer: UHC Exchange |
$129.84
|
| Rate for Payer: UMR Bronson Commercial |
$28.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.65
|
|
|
HC DTAP-IPV VACCINE 4-6 YEARS IM
|
Facility
|
IP
|
$78.20
|
|
|
Service Code
|
CPT 90696
|
| Hospital Charge Code |
63600120
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.41 |
| Max. Negotiated Rate |
$70.38 |
| Rate for Payer: Aetna American Axle |
$50.83
|
| Rate for Payer: Aetna Commercial |
$66.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.83
|
| Rate for Payer: Cash Price |
$62.56
|
| Rate for Payer: Cofinity Advantage |
$54.74
|
| Rate for Payer: Cofinity Commercial |
$67.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.56
|
| Rate for Payer: Healthscope Commercial |
$70.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.65
|
| Rate for Payer: PHP Commercial |
$66.47
|
| Rate for Payer: Priority Health SBD |
$49.27
|
| Rate for Payer: UMR Bronson Commercial |
$34.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.65
|
|
|
HC DTAP-IVP-HIB-HEPB INTRAMUSCULAR
|
Facility
|
IP
|
$169.79
|
|
|
Service Code
|
CPT 90697
|
| Hospital Charge Code |
63600207
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.71 |
| Max. Negotiated Rate |
$152.81 |
| Rate for Payer: Aetna American Axle |
$110.36
|
| Rate for Payer: Aetna Commercial |
$144.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.36
|
| Rate for Payer: Cash Price |
$135.83
|
| Rate for Payer: Cofinity Advantage |
$118.85
|
| Rate for Payer: Cofinity Commercial |
$146.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.83
|
| Rate for Payer: Healthscope Commercial |
$152.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.34
|
| Rate for Payer: PHP Commercial |
$144.32
|
| Rate for Payer: Priority Health SBD |
$106.97
|
| Rate for Payer: UMR Bronson Commercial |
$74.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.34
|
|
|
HC DTAP-IVP-HIB-HEPB INTRAMUSCULAR
|
Facility
|
OP
|
$169.79
|
|
|
Service Code
|
CPT 90697
|
| Hospital Charge Code |
63600207
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$62.82 |
| Max. Negotiated Rate |
$532.64 |
| Rate for Payer: Aetna American Axle |
$110.36
|
| Rate for Payer: Aetna Commercial |
$144.32
|
| Rate for Payer: Aetna Medicare |
$84.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$110.36
|
| Rate for Payer: BCBS Complete |
$67.92
|
| Rate for Payer: BCBS Trust/PPO |
$532.64
|
| Rate for Payer: BCN Commercial |
$532.64
|
| Rate for Payer: Cash Price |
$135.83
|
| Rate for Payer: Cash Price |
$135.83
|
| Rate for Payer: Cofinity Advantage |
$118.85
|
| Rate for Payer: Cofinity Commercial |
$146.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.83
|
| Rate for Payer: Healthscope Commercial |
$152.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.34
|
| Rate for Payer: PHP Commercial |
$144.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$177.69
|
| Rate for Payer: Priority Health SBD |
$106.97
|
| Rate for Payer: Priority Health Tiered Network |
$142.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.88
|
| Rate for Payer: UHC Core |
$329.88
|
| Rate for Payer: UHC Exchange |
$329.88
|
| Rate for Payer: UMR Bronson Commercial |
$62.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.34
|
|
|
HC DTPA PER STUDY
|
Facility
|
IP
|
$446.00
|
|
|
Service Code
|
HCPCS A9539
|
| Hospital Charge Code |
34300005
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$196.24 |
| Max. Negotiated Rate |
$401.40 |
| Rate for Payer: Aetna American Axle |
$289.90
|
| Rate for Payer: Aetna Commercial |
$379.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.90
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Advantage |
$312.20
|
| Rate for Payer: Cofinity Commercial |
$383.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.80
|
| Rate for Payer: Healthscope Commercial |
$401.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.50
|
| Rate for Payer: PHP Commercial |
$379.10
|
| Rate for Payer: Priority Health SBD |
$280.98
|
| Rate for Payer: UMR Bronson Commercial |
$196.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.50
|
|
|
HC DTPA PER STUDY
|
Facility
|
OP
|
$446.00
|
|
|
Service Code
|
HCPCS A9539
|
| Hospital Charge Code |
34300005
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$47.39 |
| Max. Negotiated Rate |
$401.40 |
| Rate for Payer: Aetna American Axle |
$289.90
|
| Rate for Payer: Aetna Commercial |
$379.10
|
| Rate for Payer: Aetna Medicare |
$223.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$289.90
|
| Rate for Payer: BCBS Complete |
$178.40
|
| Rate for Payer: BCBS Trust/PPO |
$88.27
|
| Rate for Payer: BCN Commercial |
$88.27
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cash Price |
$356.80
|
| Rate for Payer: Cofinity Advantage |
$312.20
|
| Rate for Payer: Cofinity Commercial |
$383.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$356.80
|
| Rate for Payer: Healthscope Commercial |
$401.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$356.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.50
|
| Rate for Payer: PHP Commercial |
$379.10
|
| Rate for Payer: Priority Health SBD |
$280.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.39
|
| Rate for Payer: UHC Core |
$47.39
|
| Rate for Payer: UHC Exchange |
$47.39
|
| Rate for Payer: UMR Bronson Commercial |
$165.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.50
|
|
|
HC DUAL LEAD INSERTION
|
Facility
|
IP
|
$12,964.56
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
36100066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,704.41 |
| Max. Negotiated Rate |
$11,668.10 |
| Rate for Payer: Aetna American Axle |
$8,426.96
|
| Rate for Payer: Aetna Commercial |
$11,019.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,426.96
|
| Rate for Payer: Cash Price |
$10,371.65
|
| Rate for Payer: Cofinity Advantage |
$9,075.19
|
| Rate for Payer: Cofinity Commercial |
$11,149.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,371.65
|
| Rate for Payer: Healthscope Commercial |
$11,668.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,075.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,723.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,019.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,723.42
|
| Rate for Payer: PHP Commercial |
$11,019.88
|
| Rate for Payer: Priority Health SBD |
$8,167.67
|
| Rate for Payer: UMR Bronson Commercial |
$5,704.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,723.42
|
|
|
HC DUAL LEAD INSERTION
|
Facility
|
OP
|
$12,964.56
|
|
|
Service Code
|
CPT 33217
|
| Hospital Charge Code |
36100066
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,312.46 |
| Max. Negotiated Rate |
$26,665.62 |
| Rate for Payer: Aetna American Axle |
$8,426.96
|
| Rate for Payer: Aetna Commercial |
$11,019.88
|
| Rate for Payer: Aetna Medicare |
$8,575.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,426.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,307.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,307.04
|
| Rate for Payer: BCBS Complete |
$4,528.50
|
| Rate for Payer: BCBS MAPPO |
$8,245.63
|
| Rate for Payer: BCBS Trust/PPO |
$10,278.37
|
| Rate for Payer: BCN Commercial |
$10,278.37
|
| Rate for Payer: BCN Medicare Advantage |
$8,245.63
|
| Rate for Payer: Cash Price |
$10,371.65
|
| Rate for Payer: Cash Price |
$10,371.65
|
| Rate for Payer: Cash Price |
$10,371.65
|
| Rate for Payer: Cofinity Advantage |
$9,075.19
|
| Rate for Payer: Cofinity Commercial |
$11,149.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,371.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,245.63
|
| Rate for Payer: Healthscope Commercial |
$11,668.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,075.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,723.42
|
| Rate for Payer: Mclaren Medicaid |
$8,245.63
|
| Rate for Payer: Mclaren Medicare |
$8,245.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,657.91
|
| Rate for Payer: Meridian Medicaid |
$8,657.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,482.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$9,070.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,019.88
|
| Rate for Payer: Nomi Health Commercial |
$24,736.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,723.42
|
| Rate for Payer: PACE Medicare |
$7,833.35
|
| Rate for Payer: PACE SWMI |
$8,245.63
|
| Rate for Payer: PHP Commercial |
$11,019.88
|
| Rate for Payer: PHP Medicare Advantage |
$8,245.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,312.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26,665.62
|
| Rate for Payer: Priority Health Medicare |
$8,245.63
|
| Rate for Payer: Priority Health SBD |
$8,167.67
|
| Rate for Payer: Priority Health Tiered Network |
$21,332.50
|
| Rate for Payer: Railroad Medicare Medicare |
$8,245.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8,245.63
|
| Rate for Payer: UHC Medicaid |
$4,312.46
|
| Rate for Payer: UHCCP Medicaid |
$4,312.46
|
| Rate for Payer: UMR Bronson Commercial |
$4,796.89
|
| Rate for Payer: VA VA |
$8,245.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,723.42
|
|
|
HC DUCK FEATHERS IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200083
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC DUCK FEATHERS IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200083
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC DUODENOSCOPY/COLONOSCOPY
|
Facility
|
IP
|
$4,487.77
|
|
| Hospital Charge Code |
36000033
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,974.62 |
| Max. Negotiated Rate |
$4,038.99 |
| Rate for Payer: Aetna American Axle |
$2,917.05
|
| Rate for Payer: Aetna Commercial |
$3,814.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,917.05
|
| Rate for Payer: Cash Price |
$3,590.22
|
| Rate for Payer: Cofinity Advantage |
$3,141.44
|
| Rate for Payer: Cofinity Commercial |
$3,859.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,590.22
|
| Rate for Payer: Healthscope Commercial |
$4,038.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,141.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,365.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,814.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,365.83
|
| Rate for Payer: PHP Commercial |
$3,814.60
|
| Rate for Payer: Priority Health SBD |
$2,827.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,974.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,365.83
|
|
|
HC DUODENOSCOPY/COLONOSCOPY
|
Facility
|
OP
|
$4,487.77
|
|
| Hospital Charge Code |
36000033
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,660.47 |
| Max. Negotiated Rate |
$4,038.99 |
| Rate for Payer: Aetna American Axle |
$2,917.05
|
| Rate for Payer: Aetna Commercial |
$3,814.60
|
| Rate for Payer: Aetna Medicare |
$2,243.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,917.05
|
| Rate for Payer: BCBS Complete |
$1,795.11
|
| Rate for Payer: Cash Price |
$3,590.22
|
| Rate for Payer: Cofinity Advantage |
$3,141.44
|
| Rate for Payer: Cofinity Commercial |
$3,859.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,590.22
|
| Rate for Payer: Healthscope Commercial |
$4,038.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,141.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,365.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,590.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,814.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,365.83
|
| Rate for Payer: PHP Commercial |
$3,814.60
|
| Rate for Payer: Priority Health SBD |
$2,827.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,660.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,365.83
|
|
