|
HC MSMART BM CMPT2
|
Facility
|
OP
|
$167.43
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$1,005.81 |
| Rate for Payer: Aetna American Axle |
$108.83
|
| Rate for Payer: Aetna Commercial |
$142.32
|
| Rate for Payer: Aetna Medicare |
$332.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$399.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$399.39
|
| Rate for Payer: BCBS Complete |
$183.53
|
| Rate for Payer: BCBS MAPPO |
$319.51
|
| Rate for Payer: BCBS Trust/PPO |
$105.47
|
| Rate for Payer: BCN Medicare Advantage |
$319.51
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cofinity Commercial |
$143.99
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$319.51
|
| Rate for Payer: Healthscope Commercial |
$150.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.57
|
| Rate for Payer: Mclaren Medicaid |
$174.77
|
| Rate for Payer: Mclaren Medicare |
$319.51
|
| Rate for Payer: Meridian Medicaid |
$183.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$335.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$367.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.32
|
| Rate for Payer: PACE Medicare |
$303.53
|
| Rate for Payer: PACE SWMI |
$319.51
|
| Rate for Payer: PHP Commercial |
$142.32
|
| Rate for Payer: PHP Medicare Advantage |
$319.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,005.81
|
| Rate for Payer: Priority Health Medicare |
$319.51
|
| Rate for Payer: Priority Health Narrow Network |
$804.65
|
| Rate for Payer: Priority Health SBD |
$105.48
|
| Rate for Payer: Railroad Medicare Medicare |
$319.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.28
|
| Rate for Payer: UHC Core |
$28.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$319.51
|
| Rate for Payer: UHC Exchange |
$76.62
|
| Rate for Payer: UHC Medicare Advantage |
$329.10
|
| Rate for Payer: UMR Bronson Commercial |
$61.95
|
| Rate for Payer: VA VA |
$319.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.57
|
|
|
HC MSMART BM CMPT2
|
Facility
|
IP
|
$167.43
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$73.67 |
| Max. Negotiated Rate |
$150.69 |
| Rate for Payer: Aetna American Axle |
$108.83
|
| Rate for Payer: Aetna Commercial |
$142.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.83
|
| Rate for Payer: Cash Price |
$133.94
|
| Rate for Payer: Cofinity Commercial |
$117.20
|
| Rate for Payer: Cofinity Commercial |
$143.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.94
|
| Rate for Payer: Healthscope Commercial |
$150.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.32
|
| Rate for Payer: PHP Commercial |
$142.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.20
|
| Rate for Payer: Priority Health SBD |
$105.48
|
| Rate for Payer: UMR Bronson Commercial |
$73.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.57
|
|
|
HC MSMART BM CMPT3
|
Facility
|
IP
|
$173.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$76.12 |
| Max. Negotiated Rate |
$155.70 |
| Rate for Payer: Aetna American Axle |
$112.45
|
| Rate for Payer: Aetna Commercial |
$147.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.45
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$121.10
|
| Rate for Payer: Cofinity Commercial |
$148.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.40
|
| Rate for Payer: Healthscope Commercial |
$155.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.05
|
| Rate for Payer: PHP Commercial |
$147.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.10
|
| Rate for Payer: Priority Health SBD |
$108.99
|
| Rate for Payer: UMR Bronson Commercial |
$76.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.75
|
|
|
HC MSMART BM CMPT3
|
Facility
|
OP
|
$173.00
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.25 |
| Max. Negotiated Rate |
$155.70 |
| Rate for Payer: Aetna American Axle |
$112.45
|
| Rate for Payer: Aetna Commercial |
$147.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$112.45
|
| Rate for Payer: BCBS Complete |
$69.20
|
| Rate for Payer: BCBS Trust/PPO |
$33.73
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cash Price |
$138.40
|
| Rate for Payer: Cofinity Commercial |
$121.10
|
| Rate for Payer: Cofinity Commercial |
$148.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.40
|
| Rate for Payer: Healthscope Commercial |
$155.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.05
|
| Rate for Payer: PHP Commercial |
$147.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.10
|
| Rate for Payer: Priority Health SBD |
$108.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.58
|
| Rate for Payer: UHC Core |
$15.25
|
| Rate for Payer: UHC Exchange |
$23.25
|
| Rate for Payer: UMR Bronson Commercial |
$64.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.75
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
OP
|
$63.99
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna American Axle |
$41.59
|
| Rate for Payer: Aetna Commercial |
$54.39
|
| Rate for Payer: Aetna Medicare |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.10
|
| Rate for Payer: BCBS Complete |
$23.94
|
| Rate for Payer: BCBS MAPPO |
$41.68
|
| Rate for Payer: BCBS Trust/PPO |
$37.48
|
| Rate for Payer: BCN Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$51.19
|
| Rate for Payer: Cash Price |
$51.19
|
| Rate for Payer: Cofinity Commercial |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$55.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.68
|
| Rate for Payer: Healthscope Commercial |
$57.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.99
|
| Rate for Payer: Mclaren Medicaid |
$22.80
|
| Rate for Payer: Mclaren Medicare |
$41.68
|
| Rate for Payer: Meridian Medicaid |
$23.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.39
|
| Rate for Payer: PACE Medicare |
$39.60
|
| Rate for Payer: PACE SWMI |
$41.68
|
| Rate for Payer: PHP Commercial |
$54.39
|
| Rate for Payer: PHP Medicare Advantage |
$41.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Priority Health SBD |
$40.31
|
| Rate for Payer: Railroad Medicare Medicare |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.02
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.68
|
| Rate for Payer: UHC Exchange |
$41.68
|
| Rate for Payer: UHC Medicare Advantage |
$42.93
|
| Rate for Payer: UMR Bronson Commercial |
$23.68
|
| Rate for Payer: VA VA |
$41.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.99
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
IP
|
$63.99
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.16 |
| Max. Negotiated Rate |
$57.59 |
| Rate for Payer: Aetna American Axle |
$41.59
|
| Rate for Payer: Aetna Commercial |
$54.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.59
|
| Rate for Payer: Cash Price |
$51.19
|
| Rate for Payer: Cofinity Commercial |
$44.79
|
| Rate for Payer: Cofinity Commercial |
$55.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$57.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.39
|
| Rate for Payer: PHP Commercial |
$54.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.79
|
| Rate for Payer: Priority Health SBD |
$40.31
|
| Rate for Payer: UMR Bronson Commercial |
$28.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.99
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
IP
|
$53.50
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.54 |
| Max. Negotiated Rate |
$48.15 |
| Rate for Payer: Aetna American Axle |
$34.78
|
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.78
|
| Rate for Payer: Cash Price |
$42.80
|
| Rate for Payer: Cofinity Commercial |
$37.45
|
| Rate for Payer: Cofinity Commercial |
$46.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.80
|
| Rate for Payer: Healthscope Commercial |
$48.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
| Rate for Payer: PHP Commercial |
$45.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.45
|
| Rate for Payer: Priority Health SBD |
$33.70
|
| Rate for Payer: UMR Bronson Commercial |
$23.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.12
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
OP
|
$53.50
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna American Axle |
$34.78
|
| Rate for Payer: Aetna Commercial |
$45.48
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.80
|
| Rate for Payer: Cash Price |
$42.80
|
| Rate for Payer: Cofinity Commercial |
$46.01
|
| Rate for Payer: Cofinity Commercial |
$37.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$48.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.12
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.48
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$45.48
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.45
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$33.70
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$19.80
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.12
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
IP
|
$497.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$218.68 |
| Max. Negotiated Rate |
$447.30 |
| Rate for Payer: Aetna American Axle |
$323.05
|
| Rate for Payer: Aetna Commercial |
$422.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.05
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$347.90
|
| Rate for Payer: Cofinity Commercial |
$427.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.60
|
| Rate for Payer: Healthscope Commercial |
$447.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$372.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$422.45
|
| Rate for Payer: PHP Commercial |
$422.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.90
|
| Rate for Payer: Priority Health SBD |
$313.11
|
| Rate for Payer: UMR Bronson Commercial |
$218.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$372.75
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
OP
|
$497.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.74 |
| Max. Negotiated Rate |
$447.30 |
| Rate for Payer: Aetna American Axle |
$323.05
|
| Rate for Payer: Aetna Commercial |
$422.45
|
| Rate for Payer: Aetna Medicare |
$67.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.68
|
| Rate for Payer: BCBS Complete |
$37.53
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cash Price |
$397.60
|
| Rate for Payer: Cofinity Commercial |
$347.90
|
| Rate for Payer: Cofinity Commercial |
$427.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$397.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$447.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$347.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$372.75
|
| Rate for Payer: Mclaren Medicaid |
$35.74
|
| Rate for Payer: Mclaren Medicare |
$65.34
|
| Rate for Payer: Meridian Medicaid |
$37.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$422.45
|
| Rate for Payer: PACE Medicare |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$422.45
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$347.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.88
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$47.90
|
| Rate for Payer: Priority Health SBD |
$313.11
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.41
|
| Rate for Payer: UHC Core |
$71.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.34
|
| Rate for Payer: UHC Exchange |
$65.34
|
| Rate for Payer: UHC Medicare Advantage |
$67.30
|
| Rate for Payer: UMR Bronson Commercial |
$183.89
|
| Rate for Payer: VA VA |
$65.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$372.75
|
|
|
HC MTHFR MUTATION
|
Facility
|
OP
|
$375.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.74 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna American Axle |
$243.75
|
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: Aetna Medicare |
$67.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.68
|
| Rate for Payer: BCBS Complete |
$37.53
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$262.50
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Mclaren Medicaid |
$35.74
|
| Rate for Payer: Mclaren Medicare |
$65.34
|
| Rate for Payer: Meridian Medicaid |
$37.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PACE Medicare |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$59.88
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$47.90
|
| Rate for Payer: Priority Health SBD |
$236.25
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.41
|
| Rate for Payer: UHC Core |
$71.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.34
|
| Rate for Payer: UHC Exchange |
$65.34
|
| Rate for Payer: UHC Medicare Advantage |
$67.30
|
| Rate for Payer: UMR Bronson Commercial |
$138.75
|
| Rate for Payer: VA VA |
$65.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
HC MTHFR MUTATION
|
Facility
|
IP
|
$375.00
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$165.00 |
| Max. Negotiated Rate |
$337.50 |
| Rate for Payer: Aetna American Axle |
$243.75
|
| Rate for Payer: Aetna Commercial |
$318.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.75
|
| Rate for Payer: Cash Price |
$300.00
|
| Rate for Payer: Cofinity Commercial |
$262.50
|
| Rate for Payer: Cofinity Commercial |
$322.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.00
|
| Rate for Payer: Healthscope Commercial |
$337.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$318.75
|
| Rate for Payer: PHP Commercial |
$318.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$262.50
|
| Rate for Payer: Priority Health SBD |
$236.25
|
| Rate for Payer: UMR Bronson Commercial |
$165.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.25
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
OP
|
$194.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.80 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Aetna American Axle |
$126.10
|
| Rate for Payer: Aetna Commercial |
$164.90
|
| Rate for Payer: Aetna Medicare |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.10
|
| Rate for Payer: BCBS Complete |
$23.94
|
| Rate for Payer: BCBS MAPPO |
$41.68
|
| Rate for Payer: BCBS Trust/PPO |
$37.48
|
| Rate for Payer: BCN Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$135.80
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.68
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.50
|
| Rate for Payer: Mclaren Medicaid |
$22.80
|
| Rate for Payer: Mclaren Medicare |
$41.68
|
| Rate for Payer: Meridian Medicaid |
$23.94
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.90
|
| Rate for Payer: PACE Medicare |
$39.60
|
| Rate for Payer: PACE SWMI |
$41.68
|
| Rate for Payer: PHP Commercial |
$164.90
|
| Rate for Payer: PHP Medicare Advantage |
$41.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Priority Health SBD |
$122.22
|
| Rate for Payer: Railroad Medicare Medicare |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.02
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.68
|
| Rate for Payer: UHC Exchange |
$41.68
|
| Rate for Payer: UHC Medicare Advantage |
$42.93
|
| Rate for Payer: UMR Bronson Commercial |
$71.78
|
| Rate for Payer: VA VA |
$41.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.50
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
IP
|
$194.00
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$85.36 |
| Max. Negotiated Rate |
$174.60 |
| Rate for Payer: Aetna American Axle |
$126.10
|
| Rate for Payer: Aetna Commercial |
$164.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$126.10
|
| Rate for Payer: Cash Price |
$155.20
|
| Rate for Payer: Cofinity Commercial |
$135.80
|
| Rate for Payer: Cofinity Commercial |
$166.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$155.20
|
| Rate for Payer: Healthscope Commercial |
$174.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$145.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$164.90
|
| Rate for Payer: PHP Commercial |
$164.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$135.80
|
| Rate for Payer: Priority Health SBD |
$122.22
|
| Rate for Payer: UMR Bronson Commercial |
$85.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$145.50
|
|
|
HC MUCORE RACEMOSUS IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
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 MUCORE RACEMOSUS IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
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 MUGWORT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
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 |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| 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 MUGWORT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200094
|
|
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 MULBERRY IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
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 MULBERRY IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200095
|
|
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 |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| 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 MULTIHANCE PER ML
|
Facility
|
OP
|
$6.55
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.21 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Aetna American Axle |
$4.26
|
| Rate for Payer: Aetna Commercial |
$5.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.26
|
| Rate for Payer: BCBS Complete |
$2.62
|
| Rate for Payer: BCBS Trust/PPO |
$2.21
|
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Cofinity Commercial |
$4.58
|
| Rate for Payer: Cofinity Commercial |
$5.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.24
|
| Rate for Payer: Healthscope Commercial |
$5.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.57
|
| Rate for Payer: PHP Commercial |
$5.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.58
|
| Rate for Payer: Priority Health SBD |
$4.13
|
| Rate for Payer: UMR Bronson Commercial |
$2.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.91
|
|
|
HC MULTIHANCE PER ML
|
Facility
|
IP
|
$6.55
|
|
|
Service Code
|
HCPCS A9577
|
| Hospital Charge Code |
63600016
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Aetna American Axle |
$4.26
|
| Rate for Payer: Aetna Commercial |
$5.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4.26
|
| Rate for Payer: Cash Price |
$5.24
|
| Rate for Payer: Cofinity Commercial |
$4.58
|
| Rate for Payer: Cofinity Commercial |
$5.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5.24
|
| Rate for Payer: Healthscope Commercial |
$5.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5.57
|
| Rate for Payer: PHP Commercial |
$5.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4.58
|
| Rate for Payer: Priority Health SBD |
$4.13
|
| Rate for Payer: UMR Bronson Commercial |
$2.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4.91
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$629.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$276.76 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Aetna American Axle |
$408.85
|
| Rate for Payer: Aetna Commercial |
$534.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.85
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cofinity Commercial |
$540.94
|
| Rate for Payer: Cofinity Commercial |
$440.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.20
|
| Rate for Payer: Healthscope Commercial |
$566.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$440.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$534.65
|
| Rate for Payer: PHP Commercial |
$534.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.30
|
| Rate for Payer: Priority Health SBD |
$396.27
|
| Rate for Payer: UMR Bronson Commercial |
$276.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.75
|
|
|
HC MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$629.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100020
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$25.87 |
| Max. Negotiated Rate |
$566.10 |
| Rate for Payer: Aetna American Axle |
$408.85
|
| Rate for Payer: Aetna Commercial |
$534.65
|
| Rate for Payer: Aetna Medicare |
$145.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$408.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
| Rate for Payer: BCBS Complete |
$80.45
|
| Rate for Payer: BCBS MAPPO |
$140.06
|
| Rate for Payer: BCBS Trust/PPO |
$145.99
|
| Rate for Payer: BCN Medicare Advantage |
$140.06
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cash Price |
$503.20
|
| Rate for Payer: Cofinity Commercial |
$540.94
|
| Rate for Payer: Cofinity Commercial |
$440.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$503.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
| Rate for Payer: Healthscope Commercial |
$566.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$440.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.75
|
| Rate for Payer: Mclaren Medicaid |
$76.61
|
| Rate for Payer: Mclaren Medicare |
$140.06
|
| Rate for Payer: Meridian Medicaid |
$80.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$534.65
|
| Rate for Payer: PACE Medicare |
$133.06
|
| Rate for Payer: PACE SWMI |
$140.06
|
| Rate for Payer: PHP Commercial |
$534.65
|
| Rate for Payer: PHP Medicare Advantage |
$140.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$440.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
| Rate for Payer: Priority Health Medicare |
$140.06
|
| Rate for Payer: Priority Health Narrow Network |
$352.74
|
| Rate for Payer: Priority Health SBD |
$396.27
|
| Rate for Payer: Railroad Medicare Medicare |
$140.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
| Rate for Payer: UHC Exchange |
$25.87
|
| Rate for Payer: UHC Medicare Advantage |
$144.26
|
| Rate for Payer: UMR Bronson Commercial |
$232.73
|
| Rate for Payer: VA VA |
$140.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.75
|
|
|
HC MULTILEAF COLLIMATOR
|
Facility
|
IP
|
$1,234.00
|
|
|
Service Code
|
CPT 77338
|
| Hospital Charge Code |
33300016
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$542.96 |
| Max. Negotiated Rate |
$1,110.60 |
| Rate for Payer: Aetna American Axle |
$802.10
|
| Rate for Payer: Aetna American Axle |
$543.66
|
| Rate for Payer: Aetna Commercial |
$1,048.90
|
| Rate for Payer: Aetna Commercial |
$710.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$543.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$802.10
|
| Rate for Payer: Cash Price |
$669.12
|
| Rate for Payer: Cash Price |
$987.20
|
| Rate for Payer: Cofinity Commercial |
$719.30
|
| Rate for Payer: Cofinity Commercial |
$863.80
|
| Rate for Payer: Cofinity Commercial |
$1,061.24
|
| Rate for Payer: Cofinity Commercial |
$585.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$987.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$669.12
|
| Rate for Payer: Healthscope Commercial |
$752.76
|
| Rate for Payer: Healthscope Commercial |
$1,110.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$585.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$863.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$627.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$925.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$710.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,048.90
|
| Rate for Payer: PHP Commercial |
$710.94
|
| Rate for Payer: PHP Commercial |
$1,048.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$585.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$863.80
|
| Rate for Payer: Priority Health SBD |
$526.93
|
| Rate for Payer: Priority Health SBD |
$777.42
|
| Rate for Payer: UMR Bronson Commercial |
$542.96
|
| Rate for Payer: UMR Bronson Commercial |
$368.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$627.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$925.50
|
|
