|
HC ENCEPHALOPATHY EVAL, SERUM
|
Facility
|
IP
|
$213.50
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30100721
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$93.94 |
| Max. Negotiated Rate |
$192.15 |
| Rate for Payer: Aetna American Axle |
$138.78
|
| Rate for Payer: Aetna Commercial |
$181.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.78
|
| Rate for Payer: Cash Price |
$170.80
|
| Rate for Payer: Cofinity Advantage |
$149.45
|
| Rate for Payer: Cofinity Commercial |
$183.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.80
|
| Rate for Payer: Healthscope Commercial |
$192.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$181.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$160.12
|
| Rate for Payer: PHP Commercial |
$181.47
|
| Rate for Payer: Priority Health SBD |
$134.50
|
| Rate for Payer: UMR Bronson Commercial |
$93.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.12
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
OP
|
$158.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.33 |
| Max. Negotiated Rate |
$142.33 |
| Rate for Payer: Aetna American Axle |
$102.79
|
| Rate for Payer: Aetna Commercial |
$134.42
|
| Rate for Payer: Aetna Medicare |
$24.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: BCBS Complete |
$12.94
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCBS Trust/PPO |
$27.25
|
| Rate for Payer: BCN Commercial |
$27.25
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$126.51
|
| Rate for Payer: Cash Price |
$126.51
|
| Rate for Payer: Cofinity Advantage |
$110.70
|
| Rate for Payer: Cofinity Commercial |
$136.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$142.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.61
|
| Rate for Payer: Mclaren Medicaid |
$23.57
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$24.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.42
|
| Rate for Payer: Nomi Health Commercial |
$35.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.61
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$134.42
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23.57
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health SBD |
$99.63
|
| Rate for Payer: Priority Health Tiered Network |
$18.86
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.36
|
| Rate for Payer: UHC Core |
$35.36
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$23.57
|
| Rate for Payer: UHC Exchange |
$35.36
|
| Rate for Payer: UHC Medicaid |
$12.33
|
| Rate for Payer: UHCCP Medicaid |
$12.33
|
| Rate for Payer: UMR Bronson Commercial |
$58.51
|
| Rate for Payer: VA VA |
$23.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.61
|
|
|
HC ENCEPH AUTOIMMUNE EVAL
|
Facility
|
IP
|
$158.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200468
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$69.58 |
| Max. Negotiated Rate |
$142.33 |
| Rate for Payer: Aetna American Axle |
$102.79
|
| Rate for Payer: Aetna Commercial |
$134.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.79
|
| Rate for Payer: Cash Price |
$126.51
|
| Rate for Payer: Cofinity Advantage |
$110.70
|
| Rate for Payer: Cofinity Commercial |
$136.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.51
|
| Rate for Payer: Healthscope Commercial |
$142.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$118.61
|
| Rate for Payer: PHP Commercial |
$134.42
|
| Rate for Payer: Priority Health SBD |
$99.63
|
| Rate for Payer: UMR Bronson Commercial |
$69.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.61
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
IP
|
$76.41
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.62 |
| Max. Negotiated Rate |
$68.77 |
| Rate for Payer: Aetna American Axle |
$49.67
|
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.67
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cofinity Advantage |
$53.49
|
| Rate for Payer: Cofinity Commercial |
$65.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.13
|
| Rate for Payer: Healthscope Commercial |
$68.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.31
|
| Rate for Payer: PHP Commercial |
$64.95
|
| Rate for Payer: Priority Health SBD |
$48.14
|
| Rate for Payer: UMR Bronson Commercial |
$33.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.31
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT
|
Facility
|
OP
|
$76.41
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200469
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$68.77 |
| Rate for Payer: Aetna American Axle |
$49.67
|
| Rate for Payer: Aetna Commercial |
$64.95
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cash Price |
$61.13
|
| Rate for Payer: Cofinity Advantage |
$53.49
|
| Rate for Payer: Cofinity Commercial |
$65.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$68.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.31
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.95
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$57.31
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$64.95
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$48.14
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$28.27
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.31
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.28 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$30.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.51
|
| Rate for Payer: BCBS Complete |
$16.04
|
| Rate for Payer: BCBS MAPPO |
$29.21
|
| Rate for Payer: BCBS Trust/PPO |
$25.34
|
| Rate for Payer: BCN Commercial |
$25.34
|
| Rate for Payer: BCN Medicare Advantage |
$29.21
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Advantage |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.21
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$29.21
|
| Rate for Payer: Mclaren Medicare |
$29.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.67
|
| Rate for Payer: Meridian Medicaid |
$30.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$43.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PACE Medicare |
$27.75
|
| Rate for Payer: PACE SWMI |
$29.21
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$29.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$29.21
|
| Rate for Payer: Priority Health Medicare |
$29.21
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: Priority Health Tiered Network |
$23.37
|
| Rate for Payer: Railroad Medicare Medicare |
$29.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.82
|
| Rate for Payer: UHC Core |
$43.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$29.21
|
| Rate for Payer: UHC Exchange |
$43.82
|
| Rate for Payer: UHC Medicaid |
$15.28
|
| Rate for Payer: UHCCP Medicaid |
$15.28
|
| Rate for Payer: UMR Bronson Commercial |
$40.42
|
| Rate for Payer: VA VA |
$29.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC ENCEPH AUTOIMMUNE EVAL CMPT 2
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 84182
|
| Hospital Charge Code |
30100717
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.07 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Advantage |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: UMR Bronson Commercial |
$48.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC ENDO BIOPSY
|
Facility
|
OP
|
$293.24
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$108.50 |
| Max. Negotiated Rate |
$263.92 |
| Rate for Payer: Aetna American Axle |
$190.61
|
| Rate for Payer: Aetna Commercial |
$249.25
|
| Rate for Payer: Aetna Medicare |
$146.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.61
|
| Rate for Payer: BCBS Complete |
$117.30
|
| Rate for Payer: Cash Price |
$234.59
|
| Rate for Payer: Cofinity Advantage |
$205.27
|
| Rate for Payer: Cofinity Commercial |
$252.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.59
|
| Rate for Payer: Healthscope Commercial |
$263.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.93
|
| Rate for Payer: PHP Commercial |
$249.25
|
| Rate for Payer: Priority Health SBD |
$184.74
|
| Rate for Payer: UMR Bronson Commercial |
$108.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.93
|
|
|
HC ENDO BIOPSY
|
Facility
|
IP
|
$293.24
|
|
| Hospital Charge Code |
36000092
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$129.03 |
| Max. Negotiated Rate |
$263.92 |
| Rate for Payer: Aetna American Axle |
$190.61
|
| Rate for Payer: Aetna Commercial |
$249.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.61
|
| Rate for Payer: Cash Price |
$234.59
|
| Rate for Payer: Cofinity Advantage |
$205.27
|
| Rate for Payer: Cofinity Commercial |
$252.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.59
|
| Rate for Payer: Healthscope Commercial |
$263.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$219.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$219.93
|
| Rate for Payer: PHP Commercial |
$249.25
|
| Rate for Payer: Priority Health SBD |
$184.74
|
| Rate for Payer: UMR Bronson Commercial |
$129.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$219.93
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
IP
|
$689.79
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$303.51 |
| Max. Negotiated Rate |
$620.81 |
| Rate for Payer: Aetna American Axle |
$448.36
|
| Rate for Payer: Aetna Commercial |
$586.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.36
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cofinity Advantage |
$482.85
|
| Rate for Payer: Cofinity Commercial |
$593.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.83
|
| Rate for Payer: Healthscope Commercial |
$620.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$482.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.34
|
| Rate for Payer: PHP Commercial |
$586.32
|
| Rate for Payer: Priority Health SBD |
$434.57
|
| Rate for Payer: UMR Bronson Commercial |
$303.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.34
|
|
|
HC ENDOCERVICAL CURETTAGE
|
Facility
|
OP
|
$689.79
|
|
|
Service Code
|
CPT 57505
|
| Hospital Charge Code |
76100071
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.60 |
| Max. Negotiated Rate |
$2,967.88 |
| Rate for Payer: Aetna American Axle |
$448.36
|
| Rate for Payer: Aetna Commercial |
$586.32
|
| Rate for Payer: Aetna Medicare |
$954.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$448.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,147.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,147.17
|
| Rate for Payer: BCBS Complete |
$504.02
|
| Rate for Payer: BCBS MAPPO |
$917.74
|
| Rate for Payer: BCBS Trust/PPO |
$953.20
|
| Rate for Payer: BCCCP Commercial |
$145.60
|
| Rate for Payer: BCN Commercial |
$953.20
|
| Rate for Payer: BCN Medicare Advantage |
$917.74
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cash Price |
$551.83
|
| Rate for Payer: Cofinity Advantage |
$482.85
|
| Rate for Payer: Cofinity Commercial |
$593.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$551.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$917.74
|
| Rate for Payer: Healthscope Commercial |
$620.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$482.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$517.34
|
| Rate for Payer: Mclaren Medicaid |
$917.74
|
| Rate for Payer: Mclaren Medicare |
$917.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$963.63
|
| Rate for Payer: Meridian Medicaid |
$963.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,055.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,009.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$586.32
|
| Rate for Payer: Nomi Health Commercial |
$2,753.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$517.34
|
| Rate for Payer: PACE Medicare |
$871.85
|
| Rate for Payer: PACE SWMI |
$917.74
|
| Rate for Payer: PHP Commercial |
$586.32
|
| Rate for Payer: PHP Medicare Advantage |
$917.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$479.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,967.88
|
| Rate for Payer: Priority Health Medicare |
$917.74
|
| Rate for Payer: Priority Health SBD |
$434.57
|
| Rate for Payer: Priority Health Tiered Network |
$2,374.30
|
| Rate for Payer: Railroad Medicare Medicare |
$917.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$448.36
|
| Rate for Payer: UHC Core |
$359.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$917.74
|
| Rate for Payer: UHC Exchange |
$271.09
|
| Rate for Payer: UHC Medicaid |
$479.98
|
| Rate for Payer: UHCCP Medicaid |
$479.98
|
| Rate for Payer: UMR Bronson Commercial |
$255.22
|
| Rate for Payer: VA VA |
$917.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$517.34
|
|
|
HC ENDO CLIPPING
|
Facility
|
OP
|
$329.81
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$122.03 |
| Max. Negotiated Rate |
$296.83 |
| Rate for Payer: Aetna American Axle |
$214.38
|
| Rate for Payer: Aetna Commercial |
$280.34
|
| Rate for Payer: Aetna Medicare |
$164.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.38
|
| Rate for Payer: BCBS Complete |
$131.92
|
| Rate for Payer: Cash Price |
$263.85
|
| Rate for Payer: Cofinity Advantage |
$230.87
|
| Rate for Payer: Cofinity Commercial |
$283.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.85
|
| Rate for Payer: Healthscope Commercial |
$296.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$263.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$247.36
|
| Rate for Payer: PHP Commercial |
$280.34
|
| Rate for Payer: Priority Health SBD |
$207.78
|
| Rate for Payer: UMR Bronson Commercial |
$122.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.36
|
|
|
HC ENDO CLIPPING
|
Facility
|
IP
|
$329.81
|
|
| Hospital Charge Code |
36000117
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$145.12 |
| Max. Negotiated Rate |
$296.83 |
| Rate for Payer: Aetna American Axle |
$214.38
|
| Rate for Payer: Aetna Commercial |
$280.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.38
|
| Rate for Payer: Cash Price |
$263.85
|
| Rate for Payer: Cofinity Advantage |
$230.87
|
| Rate for Payer: Cofinity Commercial |
$283.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.85
|
| Rate for Payer: Healthscope Commercial |
$296.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$247.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$280.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$247.36
|
| Rate for Payer: PHP Commercial |
$280.34
|
| Rate for Payer: Priority Health SBD |
$207.78
|
| Rate for Payer: UMR Bronson Commercial |
$145.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$247.36
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
IP
|
$1,841.57
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$810.29 |
| Max. Negotiated Rate |
$1,657.41 |
| Rate for Payer: Aetna American Axle |
$1,197.02
|
| Rate for Payer: Aetna Commercial |
$1,565.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,197.02
|
| Rate for Payer: Cash Price |
$1,473.26
|
| Rate for Payer: Cofinity Advantage |
$1,289.10
|
| Rate for Payer: Cofinity Commercial |
$1,583.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,473.26
|
| Rate for Payer: Healthscope Commercial |
$1,657.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,289.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,381.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,565.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,381.18
|
| Rate for Payer: PHP Commercial |
$1,565.33
|
| Rate for Payer: Priority Health SBD |
$1,160.19
|
| Rate for Payer: UMR Bronson Commercial |
$810.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,381.18
|
|
|
HC ENDO CYTOLOGY/BRUSHING
|
Facility
|
OP
|
$1,841.57
|
|
| Hospital Charge Code |
36000012
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$681.38 |
| Max. Negotiated Rate |
$1,657.41 |
| Rate for Payer: Aetna American Axle |
$1,197.02
|
| Rate for Payer: Aetna Commercial |
$1,565.33
|
| Rate for Payer: Aetna Medicare |
$920.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,197.02
|
| Rate for Payer: BCBS Complete |
$736.63
|
| Rate for Payer: Cash Price |
$1,473.26
|
| Rate for Payer: Cofinity Advantage |
$1,289.10
|
| Rate for Payer: Cofinity Commercial |
$1,583.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,473.26
|
| Rate for Payer: Healthscope Commercial |
$1,657.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,289.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,381.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,473.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,565.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,381.18
|
| Rate for Payer: PHP Commercial |
$1,565.33
|
| Rate for Payer: Priority Health SBD |
$1,160.19
|
| Rate for Payer: UMR Bronson Commercial |
$681.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,381.18
|
|
|
HC ENDO DILATATION
|
Facility
|
OP
|
$1,357.00
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$502.09 |
| Max. Negotiated Rate |
$1,221.30 |
| Rate for Payer: Aetna American Axle |
$882.05
|
| Rate for Payer: Aetna Commercial |
$1,153.45
|
| Rate for Payer: Aetna Medicare |
$678.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.05
|
| Rate for Payer: BCBS Complete |
$542.80
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Advantage |
$949.90
|
| Rate for Payer: Cofinity Commercial |
$1,167.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,085.60
|
| Rate for Payer: Healthscope Commercial |
$1,221.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$949.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,017.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,085.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,153.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,017.75
|
| Rate for Payer: PHP Commercial |
$1,153.45
|
| Rate for Payer: Priority Health SBD |
$854.91
|
| Rate for Payer: UMR Bronson Commercial |
$502.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,017.75
|
|
|
HC ENDO DILATATION
|
Facility
|
IP
|
$1,357.00
|
|
| Hospital Charge Code |
36000115
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$597.08 |
| Max. Negotiated Rate |
$1,221.30 |
| Rate for Payer: Aetna American Axle |
$882.05
|
| Rate for Payer: Aetna Commercial |
$1,153.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$882.05
|
| Rate for Payer: Cash Price |
$1,085.60
|
| Rate for Payer: Cofinity Advantage |
$949.90
|
| Rate for Payer: Cofinity Commercial |
$1,167.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,085.60
|
| Rate for Payer: Healthscope Commercial |
$1,221.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$949.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,017.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,153.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,017.75
|
| Rate for Payer: PHP Commercial |
$1,153.45
|
| Rate for Payer: Priority Health SBD |
$854.91
|
| Rate for Payer: UMR Bronson Commercial |
$597.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,017.75
|
|
|
HC ENDO FINE NEEDLE ASP/BIOPSY
|
Facility
|
IP
|
$1,096.02
|
|
| Hospital Charge Code |
36000103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$482.25 |
| Max. Negotiated Rate |
$986.42 |
| Rate for Payer: Aetna American Axle |
$712.41
|
| Rate for Payer: Aetna Commercial |
$931.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.41
|
| Rate for Payer: Cash Price |
$876.82
|
| Rate for Payer: Cofinity Advantage |
$767.21
|
| Rate for Payer: Cofinity Commercial |
$942.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$876.82
|
| Rate for Payer: Healthscope Commercial |
$986.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$767.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$931.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$822.01
|
| Rate for Payer: PHP Commercial |
$931.62
|
| Rate for Payer: Priority Health SBD |
$690.49
|
| Rate for Payer: UMR Bronson Commercial |
$482.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.01
|
|
|
HC ENDO FINE NEEDLE ASP/BIOPSY
|
Facility
|
OP
|
$1,096.02
|
|
| Hospital Charge Code |
36000103
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$405.53 |
| Max. Negotiated Rate |
$986.42 |
| Rate for Payer: Aetna American Axle |
$712.41
|
| Rate for Payer: Aetna Commercial |
$931.62
|
| Rate for Payer: Aetna Medicare |
$548.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$712.41
|
| Rate for Payer: BCBS Complete |
$438.41
|
| Rate for Payer: Cash Price |
$876.82
|
| Rate for Payer: Cofinity Advantage |
$767.21
|
| Rate for Payer: Cofinity Commercial |
$942.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$876.82
|
| Rate for Payer: Healthscope Commercial |
$986.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$767.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$822.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$876.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$931.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$822.01
|
| Rate for Payer: PHP Commercial |
$931.62
|
| Rate for Payer: Priority Health SBD |
$690.49
|
| Rate for Payer: UMR Bronson Commercial |
$405.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$822.01
|
|
|
HC ENDOFORM 2X2
|
Facility
|
IP
|
$39.80
|
|
| Hospital Charge Code |
27000459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.51 |
| Max. Negotiated Rate |
$35.82 |
| Rate for Payer: Aetna American Axle |
$25.87
|
| Rate for Payer: Aetna Commercial |
$33.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.87
|
| Rate for Payer: Cash Price |
$31.84
|
| Rate for Payer: Cofinity Advantage |
$27.86
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.84
|
| Rate for Payer: Healthscope Commercial |
$35.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.85
|
| Rate for Payer: PHP Commercial |
$33.83
|
| Rate for Payer: Priority Health SBD |
$25.07
|
| Rate for Payer: UMR Bronson Commercial |
$17.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.85
|
|
|
HC ENDOFORM 2X2
|
Facility
|
OP
|
$39.80
|
|
| Hospital Charge Code |
27000459
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.73 |
| Max. Negotiated Rate |
$35.82 |
| Rate for Payer: Aetna American Axle |
$25.87
|
| Rate for Payer: Aetna Commercial |
$33.83
|
| Rate for Payer: Aetna Medicare |
$19.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.87
|
| Rate for Payer: BCBS Complete |
$15.92
|
| Rate for Payer: Cash Price |
$31.84
|
| Rate for Payer: Cofinity Advantage |
$27.86
|
| Rate for Payer: Cofinity Commercial |
$34.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.84
|
| Rate for Payer: Healthscope Commercial |
$35.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.85
|
| Rate for Payer: PHP Commercial |
$33.83
|
| Rate for Payer: Priority Health SBD |
$25.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.87
|
| Rate for Payer: UHC Core |
$20.74
|
| Rate for Payer: UHC Exchange |
$15.64
|
| Rate for Payer: UMR Bronson Commercial |
$14.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.85
|
|
|
HC ENDOFORM 4X4
|
Facility
|
IP
|
$138.43
|
|
| Hospital Charge Code |
27000460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.91 |
| Max. Negotiated Rate |
$124.59 |
| Rate for Payer: Aetna American Axle |
$89.98
|
| Rate for Payer: Aetna Commercial |
$117.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.98
|
| Rate for Payer: Cash Price |
$110.74
|
| Rate for Payer: Cofinity Advantage |
$96.90
|
| Rate for Payer: Cofinity Commercial |
$119.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.74
|
| Rate for Payer: Healthscope Commercial |
$124.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.82
|
| Rate for Payer: PHP Commercial |
$117.67
|
| Rate for Payer: Priority Health SBD |
$87.21
|
| Rate for Payer: UMR Bronson Commercial |
$60.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.82
|
|
|
HC ENDOFORM 4X4
|
Facility
|
OP
|
$138.43
|
|
| Hospital Charge Code |
27000460
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$51.22 |
| Max. Negotiated Rate |
$124.59 |
| Rate for Payer: Aetna American Axle |
$89.98
|
| Rate for Payer: Aetna Commercial |
$117.67
|
| Rate for Payer: Aetna Medicare |
$69.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.98
|
| Rate for Payer: BCBS Complete |
$55.37
|
| Rate for Payer: Cash Price |
$110.74
|
| Rate for Payer: Cofinity Advantage |
$96.90
|
| Rate for Payer: Cofinity Commercial |
$119.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.74
|
| Rate for Payer: Healthscope Commercial |
$124.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$103.82
|
| Rate for Payer: PHP Commercial |
$117.67
|
| Rate for Payer: Priority Health SBD |
$87.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.98
|
| Rate for Payer: UHC Core |
$72.12
|
| Rate for Payer: UHC Exchange |
$54.40
|
| Rate for Payer: UMR Bronson Commercial |
$51.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.82
|
|
|
HC ENDO HEMOSTASIS
|
Facility
|
OP
|
$127.97
|
|
| Hospital Charge Code |
36000116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$47.35 |
| Max. Negotiated Rate |
$115.17 |
| Rate for Payer: Aetna American Axle |
$83.18
|
| Rate for Payer: Aetna Commercial |
$108.77
|
| Rate for Payer: Aetna Medicare |
$63.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.18
|
| Rate for Payer: BCBS Complete |
$51.19
|
| Rate for Payer: Cash Price |
$102.38
|
| Rate for Payer: Cofinity Advantage |
$89.58
|
| Rate for Payer: Cofinity Commercial |
$110.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.38
|
| Rate for Payer: Healthscope Commercial |
$115.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.98
|
| Rate for Payer: PHP Commercial |
$108.77
|
| Rate for Payer: Priority Health SBD |
$80.62
|
| Rate for Payer: UMR Bronson Commercial |
$47.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.98
|
|
|
HC ENDO HEMOSTASIS
|
Facility
|
IP
|
$127.97
|
|
| Hospital Charge Code |
36000116
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$56.31 |
| Max. Negotiated Rate |
$115.17 |
| Rate for Payer: Aetna American Axle |
$83.18
|
| Rate for Payer: Aetna Commercial |
$108.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.18
|
| Rate for Payer: Cash Price |
$102.38
|
| Rate for Payer: Cofinity Advantage |
$89.58
|
| Rate for Payer: Cofinity Commercial |
$110.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.38
|
| Rate for Payer: Healthscope Commercial |
$115.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.98
|
| Rate for Payer: PHP Commercial |
$108.77
|
| Rate for Payer: Priority Health SBD |
$80.62
|
| Rate for Payer: UMR Bronson Commercial |
$56.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.98
|
|
