|
HC DUODENOSCOPY (EGD)
|
Facility
|
IP
|
$2,237.45
|
|
| Hospital Charge Code |
36000029
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$984.48 |
| Max. Negotiated Rate |
$2,013.70 |
| Rate for Payer: Aetna American Axle |
$1,454.34
|
| Rate for Payer: Aetna Commercial |
$1,901.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,454.34
|
| Rate for Payer: Cash Price |
$1,789.96
|
| Rate for Payer: Cofinity Advantage |
$1,566.21
|
| Rate for Payer: Cofinity Commercial |
$1,924.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,789.96
|
| Rate for Payer: Healthscope Commercial |
$2,013.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,566.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,678.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,901.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,678.09
|
| Rate for Payer: PHP Commercial |
$1,901.83
|
| Rate for Payer: Priority Health SBD |
$1,409.59
|
| Rate for Payer: UMR Bronson Commercial |
$984.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,678.09
|
|
|
HC DUODENOSCOPY (EGD)
|
Facility
|
OP
|
$2,237.45
|
|
| Hospital Charge Code |
36000029
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$827.86 |
| Max. Negotiated Rate |
$2,013.70 |
| Rate for Payer: Aetna American Axle |
$1,454.34
|
| Rate for Payer: Aetna Commercial |
$1,901.83
|
| Rate for Payer: Aetna Medicare |
$1,118.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,454.34
|
| Rate for Payer: BCBS Complete |
$894.98
|
| Rate for Payer: Cash Price |
$1,789.96
|
| Rate for Payer: Cofinity Advantage |
$1,566.21
|
| Rate for Payer: Cofinity Commercial |
$1,924.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,789.96
|
| Rate for Payer: Healthscope Commercial |
$2,013.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,566.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,678.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,789.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,901.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,678.09
|
| Rate for Payer: PHP Commercial |
$1,901.83
|
| Rate for Payer: Priority Health SBD |
$1,409.59
|
| Rate for Payer: UMR Bronson Commercial |
$827.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,678.09
|
|
|
HC DUODENUM/FLEX SIGMOID
|
Facility
|
OP
|
$3,971.88
|
|
| Hospital Charge Code |
36000034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,469.60 |
| Max. Negotiated Rate |
$3,574.69 |
| Rate for Payer: Aetna American Axle |
$2,581.72
|
| Rate for Payer: Aetna Commercial |
$3,376.10
|
| Rate for Payer: Aetna Medicare |
$1,985.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,581.72
|
| Rate for Payer: BCBS Complete |
$1,588.75
|
| Rate for Payer: Cash Price |
$3,177.50
|
| Rate for Payer: Cofinity Advantage |
$2,780.32
|
| Rate for Payer: Cofinity Commercial |
$3,415.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$3,574.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,780.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,978.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,177.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,376.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,978.91
|
| Rate for Payer: PHP Commercial |
$3,376.10
|
| Rate for Payer: Priority Health SBD |
$2,502.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,469.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,978.91
|
|
|
HC DUODENUM/FLEX SIGMOID
|
Facility
|
IP
|
$3,971.88
|
|
| Hospital Charge Code |
36000034
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,747.63 |
| Max. Negotiated Rate |
$3,574.69 |
| Rate for Payer: Aetna American Axle |
$2,581.72
|
| Rate for Payer: Aetna Commercial |
$3,376.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,581.72
|
| Rate for Payer: Cash Price |
$3,177.50
|
| Rate for Payer: Cofinity Advantage |
$2,780.32
|
| Rate for Payer: Cofinity Commercial |
$3,415.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$3,574.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,780.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,978.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,376.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,978.91
|
| Rate for Payer: PHP Commercial |
$3,376.10
|
| Rate for Payer: Priority Health SBD |
$2,502.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,747.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,978.91
|
|
|
HC DUODERM CGF 4X4
|
Facility
|
OP
|
$48.68
|
|
| Hospital Charge Code |
27100010
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$18.01 |
| Max. Negotiated Rate |
$43.81 |
| Rate for Payer: Aetna American Axle |
$31.64
|
| Rate for Payer: Aetna Commercial |
$41.38
|
| Rate for Payer: Aetna Medicare |
$24.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.64
|
| Rate for Payer: BCBS Complete |
$19.47
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cofinity Advantage |
$34.08
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Healthscope Commercial |
$43.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.51
|
| Rate for Payer: PHP Commercial |
$41.38
|
| Rate for Payer: Priority Health SBD |
$30.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.64
|
| Rate for Payer: UHC Core |
$25.36
|
| Rate for Payer: UHC Exchange |
$19.13
|
| Rate for Payer: UMR Bronson Commercial |
$18.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.51
|
|
|
HC DUODERM CGF 4X4
|
Facility
|
IP
|
$48.68
|
|
| Hospital Charge Code |
27100010
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$43.81 |
| Rate for Payer: Aetna American Axle |
$31.64
|
| Rate for Payer: Aetna Commercial |
$41.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.64
|
| Rate for Payer: Cash Price |
$38.94
|
| Rate for Payer: Cofinity Advantage |
$34.08
|
| Rate for Payer: Cofinity Commercial |
$41.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.94
|
| Rate for Payer: Healthscope Commercial |
$43.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.51
|
| Rate for Payer: PHP Commercial |
$41.38
|
| Rate for Payer: Priority Health SBD |
$30.67
|
| Rate for Payer: UMR Bronson Commercial |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.51
|
|
|
HC DUODERM CGF 6X6
|
Facility
|
IP
|
$77.11
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$33.93 |
| Max. Negotiated Rate |
$69.40 |
| Rate for Payer: Aetna American Axle |
$50.12
|
| Rate for Payer: Aetna Commercial |
$65.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.12
|
| Rate for Payer: Cash Price |
$61.69
|
| Rate for Payer: Cofinity Advantage |
$53.98
|
| Rate for Payer: Cofinity Commercial |
$66.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.69
|
| Rate for Payer: Healthscope Commercial |
$69.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.83
|
| Rate for Payer: PHP Commercial |
$65.54
|
| Rate for Payer: Priority Health SBD |
$48.58
|
| Rate for Payer: UMR Bronson Commercial |
$33.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.83
|
|
|
HC DUODERM CGF 6X6
|
Facility
|
OP
|
$77.11
|
|
| Hospital Charge Code |
27100011
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$28.53 |
| Max. Negotiated Rate |
$69.40 |
| Rate for Payer: Aetna American Axle |
$50.12
|
| Rate for Payer: Aetna Commercial |
$65.54
|
| Rate for Payer: Aetna Medicare |
$38.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.12
|
| Rate for Payer: BCBS Complete |
$30.84
|
| Rate for Payer: Cash Price |
$61.69
|
| Rate for Payer: Cofinity Advantage |
$53.98
|
| Rate for Payer: Cofinity Commercial |
$66.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.69
|
| Rate for Payer: Healthscope Commercial |
$69.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.83
|
| Rate for Payer: PHP Commercial |
$65.54
|
| Rate for Payer: Priority Health SBD |
$48.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.12
|
| Rate for Payer: UHC Core |
$40.17
|
| Rate for Payer: UHC Exchange |
$30.30
|
| Rate for Payer: UMR Bronson Commercial |
$28.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.83
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
OP
|
$107.64
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$39.83 |
| Max. Negotiated Rate |
$96.88 |
| Rate for Payer: Aetna American Axle |
$69.97
|
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: Aetna Medicare |
$53.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.97
|
| Rate for Payer: BCBS Complete |
$43.06
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Advantage |
$75.35
|
| Rate for Payer: Cofinity Commercial |
$92.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Healthscope Commercial |
$96.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.73
|
| Rate for Payer: PHP Commercial |
$91.49
|
| Rate for Payer: Priority Health SBD |
$67.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.97
|
| Rate for Payer: UHC Core |
$56.08
|
| Rate for Payer: UHC Exchange |
$42.30
|
| Rate for Payer: UMR Bronson Commercial |
$39.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.73
|
|
|
HC DUODERM CGF 8X8
|
Facility
|
IP
|
$107.64
|
|
| Hospital Charge Code |
27100012
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$47.36 |
| Max. Negotiated Rate |
$96.88 |
| Rate for Payer: Aetna American Axle |
$69.97
|
| Rate for Payer: Aetna Commercial |
$91.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.97
|
| Rate for Payer: Cash Price |
$86.11
|
| Rate for Payer: Cofinity Advantage |
$75.35
|
| Rate for Payer: Cofinity Commercial |
$92.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.11
|
| Rate for Payer: Healthscope Commercial |
$96.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.73
|
| Rate for Payer: PHP Commercial |
$91.49
|
| Rate for Payer: Priority Health SBD |
$67.81
|
| Rate for Payer: UMR Bronson Commercial |
$47.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.73
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
IP
|
$663.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$291.82 |
| Max. Negotiated Rate |
$596.90 |
| Rate for Payer: Aetna American Axle |
$431.09
|
| Rate for Payer: Aetna Commercial |
$563.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.09
|
| Rate for Payer: Cash Price |
$530.58
|
| Rate for Payer: Cofinity Advantage |
$464.25
|
| Rate for Payer: Cofinity Commercial |
$570.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.58
|
| Rate for Payer: Healthscope Commercial |
$596.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$464.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.42
|
| Rate for Payer: PHP Commercial |
$563.74
|
| Rate for Payer: Priority Health SBD |
$417.83
|
| Rate for Payer: UMR Bronson Commercial |
$291.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.42
|
|
|
HC DUOGLIDE CATHETER
|
Facility
|
OP
|
$663.22
|
|
|
Service Code
|
HCPCS C1752
|
| Hospital Charge Code |
27200176
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$245.39 |
| Max. Negotiated Rate |
$596.90 |
| Rate for Payer: Aetna American Axle |
$431.09
|
| Rate for Payer: Aetna Commercial |
$563.74
|
| Rate for Payer: Aetna Medicare |
$331.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$431.09
|
| Rate for Payer: BCBS Complete |
$265.29
|
| Rate for Payer: Cash Price |
$530.58
|
| Rate for Payer: Cofinity Advantage |
$464.25
|
| Rate for Payer: Cofinity Commercial |
$570.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$530.58
|
| Rate for Payer: Healthscope Commercial |
$596.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$464.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$497.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$530.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$563.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$497.42
|
| Rate for Payer: PHP Commercial |
$563.74
|
| Rate for Payer: Priority Health SBD |
$417.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.09
|
| Rate for Payer: UHC Core |
$345.54
|
| Rate for Payer: UHC Exchange |
$260.65
|
| Rate for Payer: UMR Bronson Commercial |
$245.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$497.42
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
OP
|
$986.77
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$888.09 |
| Rate for Payer: Aetna American Axle |
$641.40
|
| Rate for Payer: Aetna Commercial |
$838.75
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$515.65
|
| Rate for Payer: BCN Commercial |
$515.65
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$789.42
|
| Rate for Payer: Cash Price |
$789.42
|
| Rate for Payer: Cofinity Advantage |
$690.74
|
| Rate for Payer: Cofinity Commercial |
$848.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$888.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$690.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$740.08
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.75
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$740.08
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$838.75
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$621.67
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$641.40
|
| Rate for Payer: UHC Core |
$514.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$387.80
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$365.10
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$740.08
|
|
|
HC DUPLX HEMODIALYSIS ACCESS
|
Facility
|
IP
|
$986.77
|
|
|
Service Code
|
CPT 93990
|
| Hospital Charge Code |
92100017
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$434.18 |
| Max. Negotiated Rate |
$888.09 |
| Rate for Payer: Aetna American Axle |
$641.40
|
| Rate for Payer: Aetna Commercial |
$838.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$641.40
|
| Rate for Payer: Cash Price |
$789.42
|
| Rate for Payer: Cofinity Advantage |
$690.74
|
| Rate for Payer: Cofinity Commercial |
$848.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$789.42
|
| Rate for Payer: Healthscope Commercial |
$888.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$690.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$740.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$838.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$740.08
|
| Rate for Payer: PHP Commercial |
$838.75
|
| Rate for Payer: Priority Health SBD |
$621.67
|
| Rate for Payer: UMR Bronson Commercial |
$434.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$740.08
|
|
|
HC DUST MITE DF IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
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 DUST MITE DF IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200039
|
|
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 DUST MITE DP IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
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 DUST MITE DP IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200040
|
|
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 DXA BONE DENSITY W FX ASSESS
|
Facility
|
OP
|
$798.52
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$718.67 |
| Rate for Payer: Aetna American Axle |
$519.04
|
| Rate for Payer: Aetna Commercial |
$678.74
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$98.50
|
| Rate for Payer: BCN Commercial |
$98.50
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$638.82
|
| Rate for Payer: Cash Price |
$638.82
|
| Rate for Payer: Cofinity Advantage |
$558.96
|
| Rate for Payer: Cofinity Commercial |
$686.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$718.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$558.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$598.89
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.74
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$598.89
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$678.74
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$503.07
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.04
|
| Rate for Payer: UHC Core |
$416.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$313.82
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$295.45
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$598.89
|
|
|
HC DXA BONE DENSITY W FX ASSESS
|
Facility
|
IP
|
$798.52
|
|
|
Service Code
|
CPT 77085
|
| Hospital Charge Code |
32000304
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$351.35 |
| Max. Negotiated Rate |
$718.67 |
| Rate for Payer: Aetna American Axle |
$519.04
|
| Rate for Payer: Aetna Commercial |
$678.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.04
|
| Rate for Payer: Cash Price |
$638.82
|
| Rate for Payer: Cofinity Advantage |
$558.96
|
| Rate for Payer: Cofinity Commercial |
$686.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.82
|
| Rate for Payer: Healthscope Commercial |
$718.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$558.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$598.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$598.89
|
| Rate for Payer: PHP Commercial |
$678.74
|
| Rate for Payer: Priority Health SBD |
$503.07
|
| Rate for Payer: UMR Bronson Commercial |
$351.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$598.89
|
|
|
HC E72 MOUSE URINE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
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 E72 MOUSE URINE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200452
|
|
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 EAKIN SEAL 2"
|
Facility
|
OP
|
$12.79
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$11.51 |
| Rate for Payer: Aetna American Axle |
$8.31
|
| Rate for Payer: Aetna Commercial |
$10.87
|
| Rate for Payer: Aetna Medicare |
$6.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.31
|
| Rate for Payer: BCBS Complete |
$5.12
|
| Rate for Payer: Cash Price |
$10.23
|
| Rate for Payer: Cofinity Advantage |
$8.95
|
| Rate for Payer: Cofinity Commercial |
$11.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.23
|
| Rate for Payer: Healthscope Commercial |
$11.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.59
|
| Rate for Payer: PHP Commercial |
$10.87
|
| Rate for Payer: Priority Health SBD |
$8.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.31
|
| Rate for Payer: UHC Core |
$6.66
|
| Rate for Payer: UHC Exchange |
$5.03
|
| Rate for Payer: UMR Bronson Commercial |
$4.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.59
|
|
|
HC EAKIN SEAL 2"
|
Facility
|
IP
|
$12.79
|
|
| Hospital Charge Code |
27100013
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$5.63 |
| Max. Negotiated Rate |
$11.51 |
| Rate for Payer: Aetna American Axle |
$8.31
|
| Rate for Payer: Aetna Commercial |
$10.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8.31
|
| Rate for Payer: Cash Price |
$10.23
|
| Rate for Payer: Cofinity Advantage |
$8.95
|
| Rate for Payer: Cofinity Commercial |
$11.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10.23
|
| Rate for Payer: Healthscope Commercial |
$11.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.59
|
| Rate for Payer: PHP Commercial |
$10.87
|
| Rate for Payer: Priority Health SBD |
$8.06
|
| Rate for Payer: UMR Bronson Commercial |
$5.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.59
|
|
|
HC EBV ANTIBODY PANEL CMPT
|
Facility
|
IP
|
$32.48
|
|
|
Service Code
|
CPT 86665
|
| Hospital Charge Code |
30200508
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.29 |
| Max. Negotiated Rate |
$29.23 |
| Rate for Payer: Aetna American Axle |
$21.11
|
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.11
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Advantage |
$22.74
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.36
|
| Rate for Payer: PHP Commercial |
$27.61
|
| Rate for Payer: Priority Health SBD |
$20.46
|
| Rate for Payer: UMR Bronson Commercial |
$14.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.36
|
|
