|
HC MICROVENTION LVIS
|
Facility
|
OP
|
$11,245.50
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27200303
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,160.84 |
| Max. Negotiated Rate |
$10,120.95 |
| Rate for Payer: Aetna American Axle |
$7,309.58
|
| Rate for Payer: Aetna Commercial |
$9,558.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,309.58
|
| Rate for Payer: BCBS Complete |
$4,498.20
|
| Rate for Payer: Cash Price |
$8,996.40
|
| Rate for Payer: Cofinity Commercial |
$7,871.85
|
| Rate for Payer: Cofinity Commercial |
$9,671.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,996.40
|
| Rate for Payer: Healthscope Commercial |
$10,120.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,871.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,434.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,558.68
|
| Rate for Payer: PHP Commercial |
$9,558.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,871.85
|
| Rate for Payer: Priority Health SBD |
$7,084.66
|
| Rate for Payer: UMR Bronson Commercial |
$4,160.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,434.12
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$186.06
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$81.87 |
| Max. Negotiated Rate |
$167.45 |
| Rate for Payer: Aetna American Axle |
$120.94
|
| Rate for Payer: Aetna Commercial |
$158.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.94
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Cofinity Commercial |
$130.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.85
|
| Rate for Payer: Healthscope Commercial |
$167.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.15
|
| Rate for Payer: PHP Commercial |
$158.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.24
|
| Rate for Payer: Priority Health SBD |
$117.22
|
| Rate for Payer: UMR Bronson Commercial |
$81.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.54
|
|
|
HC MICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$186.06
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200005
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$68.84 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$120.94
|
| Rate for Payer: Aetna Commercial |
$158.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.94
|
| Rate for Payer: BCBS Complete |
$74.42
|
| Rate for Payer: BCBS Trust/PPO |
$118.88
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Cofinity Commercial |
$130.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.85
|
| Rate for Payer: Healthscope Commercial |
$167.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.54
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.15
|
| Rate for Payer: PHP Commercial |
$158.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.24
|
| Rate for Payer: Priority Health SBD |
$117.22
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$68.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.54
|
|
|
HC MILK IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
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 MILK IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200047
|
|
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 MINI BAL PROCEDURE
|
Facility
|
OP
|
$303.20
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$75.95 |
| Max. Negotiated Rate |
$461.26 |
| Rate for Payer: Aetna American Axle |
$197.08
|
| Rate for Payer: Aetna Commercial |
$257.72
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$461.26
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$242.56
|
| Rate for Payer: Cash Price |
$242.56
|
| Rate for Payer: Cash Price |
$242.56
|
| Rate for Payer: Cofinity Commercial |
$260.75
|
| Rate for Payer: Cofinity Commercial |
$212.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$272.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.40
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.72
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$257.72
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$349.67
|
| Rate for Payer: Priority Health SBD |
$191.02
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$112.18
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.40
|
|
|
HC MINI BAL PROCEDURE
|
Facility
|
IP
|
$303.20
|
|
|
Service Code
|
CPT 94799
|
| Hospital Charge Code |
41000014
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$133.41 |
| Max. Negotiated Rate |
$272.88 |
| Rate for Payer: Aetna American Axle |
$197.08
|
| Rate for Payer: Aetna Commercial |
$257.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$197.08
|
| Rate for Payer: Cash Price |
$242.56
|
| Rate for Payer: Cofinity Commercial |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$260.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.56
|
| Rate for Payer: Healthscope Commercial |
$272.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$257.72
|
| Rate for Payer: PHP Commercial |
$257.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$212.24
|
| Rate for Payer: Priority Health SBD |
$191.02
|
| Rate for Payer: UMR Bronson Commercial |
$133.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.40
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
OP
|
$30.00
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna American Axle |
$19.50
|
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna Medicare |
$6.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.30
|
| Rate for Payer: BCBS Complete |
$3.81
|
| Rate for Payer: BCBS MAPPO |
$6.64
|
| Rate for Payer: BCBS Trust/PPO |
$5.97
|
| Rate for Payer: BCN Medicare Advantage |
$6.64
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.64
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Mclaren Medicaid |
$3.63
|
| Rate for Payer: Mclaren Medicare |
$6.64
|
| Rate for Payer: Meridian Medicaid |
$3.81
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PACE Medicare |
$6.31
|
| Rate for Payer: PACE SWMI |
$6.64
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: PHP Medicare Advantage |
$6.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.11
|
| Rate for Payer: Priority Health Medicare |
$6.64
|
| Rate for Payer: Priority Health Narrow Network |
$7.29
|
| Rate for Payer: Priority Health SBD |
$18.90
|
| Rate for Payer: Railroad Medicare Medicare |
$6.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.97
|
| Rate for Payer: UHC Core |
$10.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.64
|
| Rate for Payer: UHC Exchange |
$6.64
|
| Rate for Payer: UHC Medicare Advantage |
$6.84
|
| Rate for Payer: UMR Bronson Commercial |
$11.10
|
| Rate for Payer: VA VA |
$6.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC MINIMUM BACTERICIDAL CONCENTRA
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
CPT 87188
|
| Hospital Charge Code |
30600103
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Aetna American Axle |
$19.50
|
| Rate for Payer: Aetna Commercial |
$25.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.50
|
| Rate for Payer: Cash Price |
$24.00
|
| Rate for Payer: Cofinity Commercial |
$21.00
|
| Rate for Payer: Cofinity Commercial |
$25.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.00
|
| Rate for Payer: Healthscope Commercial |
$27.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$25.50
|
| Rate for Payer: PHP Commercial |
$25.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.00
|
| Rate for Payer: Priority Health SBD |
$18.90
|
| Rate for Payer: UMR Bronson Commercial |
$13.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.50
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC MINIMUM LETHAL CONCENTRATION (MLC)
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 87187
|
| Hospital Charge Code |
30600102
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$50.21 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$41.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.21
|
| Rate for Payer: BCBS Complete |
$23.07
|
| Rate for Payer: BCBS MAPPO |
$40.17
|
| Rate for Payer: BCBS Trust/PPO |
$36.13
|
| Rate for Payer: BCN Medicare Advantage |
$40.17
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.17
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$21.97
|
| Rate for Payer: Mclaren Medicare |
$40.17
|
| Rate for Payer: Meridian Medicaid |
$23.07
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$38.16
|
| Rate for Payer: PACE SWMI |
$40.17
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$40.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.22
|
| Rate for Payer: Priority Health Medicare |
$40.17
|
| Rate for Payer: Priority Health Narrow Network |
$11.38
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Railroad Medicare Medicare |
$40.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.20
|
| Rate for Payer: UHC Core |
$17.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.17
|
| Rate for Payer: UHC Exchange |
$40.17
|
| Rate for Payer: UHC Medicare Advantage |
$41.38
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: VA VA |
$40.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
IP
|
$521.12
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$229.29 |
| Max. Negotiated Rate |
$469.01 |
| Rate for Payer: Aetna American Axle |
$338.73
|
| Rate for Payer: Aetna Commercial |
$442.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.73
|
| Rate for Payer: Cash Price |
$416.90
|
| Rate for Payer: Cofinity Commercial |
$364.78
|
| Rate for Payer: Cofinity Commercial |
$448.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.90
|
| Rate for Payer: Healthscope Commercial |
$469.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$442.95
|
| Rate for Payer: PHP Commercial |
$442.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.78
|
| Rate for Payer: Priority Health SBD |
$328.31
|
| Rate for Payer: UMR Bronson Commercial |
$229.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.84
|
|
|
HC MINOR PROCEDURE WO SEDATION
|
Facility
|
OP
|
$521.12
|
|
| Hospital Charge Code |
36000076
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$192.81 |
| Max. Negotiated Rate |
$469.01 |
| Rate for Payer: Aetna American Axle |
$338.73
|
| Rate for Payer: Aetna Commercial |
$442.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$338.73
|
| Rate for Payer: BCBS Complete |
$208.45
|
| Rate for Payer: Cash Price |
$416.90
|
| Rate for Payer: Cofinity Commercial |
$364.78
|
| Rate for Payer: Cofinity Commercial |
$448.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$416.90
|
| Rate for Payer: Healthscope Commercial |
$469.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$364.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$390.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$442.95
|
| Rate for Payer: PHP Commercial |
$442.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$364.78
|
| Rate for Payer: Priority Health SBD |
$328.31
|
| Rate for Payer: UMR Bronson Commercial |
$192.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$390.84
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
IP
|
$603.84
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$265.69 |
| Max. Negotiated Rate |
$543.46 |
| Rate for Payer: Aetna American Axle |
$392.50
|
| Rate for Payer: Aetna Commercial |
$513.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.50
|
| Rate for Payer: Cash Price |
$483.07
|
| Rate for Payer: Cofinity Commercial |
$422.69
|
| Rate for Payer: Cofinity Commercial |
$519.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$483.07
|
| Rate for Payer: Healthscope Commercial |
$543.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$422.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$513.26
|
| Rate for Payer: PHP Commercial |
$513.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.69
|
| Rate for Payer: Priority Health SBD |
$380.42
|
| Rate for Payer: UMR Bronson Commercial |
$265.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.88
|
|
|
HC MINOR PROCEDURE W SEDATION
|
Facility
|
OP
|
$603.84
|
|
| Hospital Charge Code |
36000075
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$223.42 |
| Max. Negotiated Rate |
$543.46 |
| Rate for Payer: Aetna American Axle |
$392.50
|
| Rate for Payer: Aetna Commercial |
$513.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$392.50
|
| Rate for Payer: BCBS Complete |
$241.54
|
| Rate for Payer: Cash Price |
$483.07
|
| Rate for Payer: Cofinity Commercial |
$422.69
|
| Rate for Payer: Cofinity Commercial |
$519.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$483.07
|
| Rate for Payer: Healthscope Commercial |
$543.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$422.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$452.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$513.26
|
| Rate for Payer: PHP Commercial |
$513.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$422.69
|
| Rate for Payer: Priority Health SBD |
$380.42
|
| Rate for Payer: UMR Bronson Commercial |
$223.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$452.88
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
IP
|
$115.22
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.70 |
| Max. Negotiated Rate |
$103.70 |
| Rate for Payer: Aetna American Axle |
$74.89
|
| Rate for Payer: Aetna Commercial |
$97.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.89
|
| Rate for Payer: Cash Price |
$92.18
|
| Rate for Payer: Cofinity Commercial |
$80.65
|
| Rate for Payer: Cofinity Commercial |
$99.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.18
|
| Rate for Payer: Healthscope Commercial |
$103.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.94
|
| Rate for Payer: PHP Commercial |
$97.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.65
|
| Rate for Payer: Priority Health SBD |
$72.59
|
| Rate for Payer: UMR Bronson Commercial |
$50.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.42
|
|
|
HC MITOTANE (LYSODREN)
|
Facility
|
OP
|
$115.22
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$103.70 |
| Rate for Payer: Aetna American Axle |
$74.89
|
| Rate for Payer: Aetna Commercial |
$97.94
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.71
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$16.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$92.18
|
| Rate for Payer: Cash Price |
$92.18
|
| Rate for Payer: Cofinity Commercial |
$99.09
|
| Rate for Payer: Cofinity Commercial |
$80.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$103.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.42
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Medicaid |
$10.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$97.94
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$97.94
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.65
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$72.59
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.37
|
| Rate for Payer: UHC Core |
$22.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$19.20
|
| Rate for Payer: UMR Bronson Commercial |
$42.63
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.42
|
|
|
HC MMR VACCINE
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 90707
|
| Hospital Charge Code |
63600027
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$39.63 |
| Max. Negotiated Rate |
$280.12 |
| Rate for Payer: Aetna American Axle |
$69.62
|
| Rate for Payer: Aetna Commercial |
$91.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.62
|
| Rate for Payer: BCBS Complete |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$280.12
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.04
|
| Rate for Payer: PHP Commercial |
$91.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.97
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$39.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.32
|
|
|
HC MMR VACCINE
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 90707
|
| Hospital Charge Code |
63600027
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.62
|
| Rate for Payer: Aetna Commercial |
$91.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.62
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.04
|
| Rate for Payer: PHP Commercial |
$91.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.97
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.32
|
|
|
HC MNT GROUP 2ND REFERRAL 30 MIN
|
Facility
|
IP
|
$50.59
|
|
|
Service Code
|
HCPCS G0271
|
| Hospital Charge Code |
94200009
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$22.26 |
| Max. Negotiated Rate |
$45.53 |
| Rate for Payer: Aetna American Axle |
$32.88
|
| Rate for Payer: Aetna Commercial |
$43.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.88
|
| Rate for Payer: Cash Price |
$40.47
|
| Rate for Payer: Cofinity Commercial |
$35.41
|
| Rate for Payer: Cofinity Commercial |
$43.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.47
|
| Rate for Payer: Healthscope Commercial |
$45.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.00
|
| Rate for Payer: PHP Commercial |
$43.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.41
|
| Rate for Payer: Priority Health SBD |
$31.87
|
| Rate for Payer: UMR Bronson Commercial |
$22.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.94
|
|
|
HC MNT GROUP 2ND REFERRAL 30 MIN
|
Facility
|
OP
|
$50.59
|
|
|
Service Code
|
HCPCS G0271
|
| Hospital Charge Code |
94200009
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$5.16 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$32.88
|
| Rate for Payer: Aetna Commercial |
$43.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.88
|
| Rate for Payer: BCBS Complete |
$20.24
|
| Rate for Payer: BCBS Trust/PPO |
$40.22
|
| Rate for Payer: Cash Price |
$40.47
|
| Rate for Payer: Cash Price |
$40.47
|
| Rate for Payer: Cash Price |
$40.47
|
| Rate for Payer: Cofinity Commercial |
$43.51
|
| Rate for Payer: Cofinity Commercial |
$35.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.47
|
| Rate for Payer: Healthscope Commercial |
$45.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.00
|
| Rate for Payer: PHP Commercial |
$43.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.45
|
| Rate for Payer: Priority Health Narrow Network |
$5.16
|
| Rate for Payer: Priority Health SBD |
$31.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.57
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$15.06
|
| Rate for Payer: UMR Bronson Commercial |
$18.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.94
|
|
|
HC MNT GROUP 30 MIN
|
Facility
|
OP
|
$59.34
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
94200004
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$38.57
|
| Rate for Payer: Aetna Commercial |
$50.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.57
|
| Rate for Payer: BCBS Complete |
$23.74
|
| Rate for Payer: BCBS Trust/PPO |
$40.22
|
| Rate for Payer: Cash Price |
$47.47
|
| Rate for Payer: Cash Price |
$47.47
|
| Rate for Payer: Cash Price |
$47.47
|
| Rate for Payer: Cofinity Commercial |
$41.54
|
| Rate for Payer: Cofinity Commercial |
$51.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.47
|
| Rate for Payer: Healthscope Commercial |
$53.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.44
|
| Rate for Payer: PHP Commercial |
$50.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.00
|
| Rate for Payer: Priority Health Narrow Network |
$12.00
|
| Rate for Payer: Priority Health SBD |
$37.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.57
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$15.06
|
| Rate for Payer: UMR Bronson Commercial |
$21.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.50
|
|
|
HC MNT GROUP 30 MIN
|
Facility
|
IP
|
$59.34
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
94200004
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$26.11 |
| Max. Negotiated Rate |
$53.41 |
| Rate for Payer: Aetna American Axle |
$38.57
|
| Rate for Payer: Aetna Commercial |
$50.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.57
|
| Rate for Payer: Cash Price |
$47.47
|
| Rate for Payer: Cofinity Commercial |
$41.54
|
| Rate for Payer: Cofinity Commercial |
$51.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.47
|
| Rate for Payer: Healthscope Commercial |
$53.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$50.44
|
| Rate for Payer: PHP Commercial |
$50.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.54
|
| Rate for Payer: Priority Health SBD |
$37.38
|
| Rate for Payer: UMR Bronson Commercial |
$26.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.50
|
|
|
HC MNT INITIAL 15 MIN
|
Facility
|
IP
|
$135.94
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
94200002
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$59.81 |
| Max. Negotiated Rate |
$122.35 |
| Rate for Payer: Aetna American Axle |
$88.36
|
| Rate for Payer: Aetna Commercial |
$115.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.36
|
| Rate for Payer: Cash Price |
$108.75
|
| Rate for Payer: Cofinity Commercial |
$116.91
|
| Rate for Payer: Cofinity Commercial |
$95.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.75
|
| Rate for Payer: Healthscope Commercial |
$122.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.55
|
| Rate for Payer: PHP Commercial |
$115.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.16
|
| Rate for Payer: Priority Health SBD |
$85.64
|
| Rate for Payer: UMR Bronson Commercial |
$59.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.96
|
|
|
HC MNT INITIAL 15 MIN
|
Facility
|
OP
|
$135.94
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
94200002
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$27.20 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$88.36
|
| Rate for Payer: Aetna Commercial |
$115.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.36
|
| Rate for Payer: BCBS Complete |
$54.38
|
| Rate for Payer: BCBS Trust/PPO |
$92.17
|
| Rate for Payer: Cash Price |
$108.75
|
| Rate for Payer: Cash Price |
$108.75
|
| Rate for Payer: Cash Price |
$108.75
|
| Rate for Payer: Cofinity Commercial |
$95.16
|
| Rate for Payer: Cofinity Commercial |
$116.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.75
|
| Rate for Payer: Healthscope Commercial |
$122.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.55
|
| Rate for Payer: PHP Commercial |
$115.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34.00
|
| Rate for Payer: Priority Health Narrow Network |
$27.20
|
| Rate for Payer: Priority Health SBD |
$85.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.22
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$31.11
|
| Rate for Payer: UMR Bronson Commercial |
$50.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.96
|
|
