|
HC CYTO DNA PROBE
|
Facility
|
OP
|
$133.17
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000031
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna American Axle |
$86.56
|
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$93.22
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$93.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.56
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$83.90
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$40.94
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: UMR Bronson Commercial |
$49.27
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna American Axle |
$68.98
|
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Cofinity Commercial |
$74.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$40.94
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: UMR Bronson Commercial |
$39.26
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC CYTO DNA PROBE CMPT
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000032
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.69 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna American Axle |
$68.98
|
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Commercial |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.98
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: UMR Bronson Commercial |
$46.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
OP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$241.43 |
| Rate for Payer: Aetna American Axle |
$174.37
|
| Rate for Payer: Aetna Commercial |
$228.02
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$230.70
|
| Rate for Payer: Cofinity Commercial |
$187.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.19
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$228.02
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$169.00
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$40.94
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: UMR Bronson Commercial |
$99.26
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.19
|
|
|
HC CYTOGENETICS DNA PROBE
|
Facility
|
IP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000128
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$118.03 |
| Max. Negotiated Rate |
$241.43 |
| Rate for Payer: Aetna American Axle |
$174.37
|
| Rate for Payer: Aetna Commercial |
$228.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$174.37
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$187.78
|
| Rate for Payer: Cofinity Commercial |
$230.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$187.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$187.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: PHP Commercial |
$228.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health SBD |
$169.00
|
| Rate for Payer: UMR Bronson Commercial |
$118.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.19
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
IP
|
$242.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$106.81 |
| Max. Negotiated Rate |
$218.48 |
| Rate for Payer: Aetna American Axle |
$157.79
|
| Rate for Payer: Aetna Commercial |
$206.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.79
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cofinity Commercial |
$169.93
|
| Rate for Payer: Cofinity Commercial |
$208.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$169.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.21
|
| Rate for Payer: Healthscope Commercial |
$218.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.35
|
| Rate for Payer: PHP Commercial |
$206.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.79
|
| Rate for Payer: Priority Health SBD |
$152.94
|
| Rate for Payer: UMR Bronson Commercial |
$106.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.07
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
OP
|
$242.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$218.48 |
| Rate for Payer: Aetna American Axle |
$157.79
|
| Rate for Payer: Aetna Commercial |
$206.35
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$157.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cofinity Commercial |
$208.77
|
| Rate for Payer: Cofinity Commercial |
$169.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$169.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$218.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$169.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.07
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.35
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$206.35
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.79
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$152.94
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$40.94
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: UMR Bronson Commercial |
$89.82
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.07
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| 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 |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$111.89
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$49.23 |
| Max. Negotiated Rate |
$100.70 |
| Rate for Payer: Aetna American Axle |
$72.73
|
| Rate for Payer: Aetna Commercial |
$95.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.73
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cofinity Commercial |
$78.32
|
| Rate for Payer: Cofinity Commercial |
$96.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.51
|
| Rate for Payer: Healthscope Commercial |
$100.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.11
|
| Rate for Payer: PHP Commercial |
$95.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.73
|
| Rate for Payer: Priority Health SBD |
$70.49
|
| Rate for Payer: UMR Bronson Commercial |
$49.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.92
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$111.89
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$100.70 |
| Rate for Payer: Aetna American Axle |
$72.73
|
| Rate for Payer: Aetna Commercial |
$95.11
|
| Rate for Payer: Aetna Medicare |
$20.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.45
|
| Rate for Payer: BCBS Complete |
$11.01
|
| Rate for Payer: BCBS MAPPO |
$19.56
|
| Rate for Payer: BCN Medicare Advantage |
$19.56
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cofinity Commercial |
$96.23
|
| Rate for Payer: Cofinity Commercial |
$78.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$100.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.92
|
| Rate for Payer: Mclaren Medicaid |
$10.48
|
| Rate for Payer: Mclaren Medicare |
$19.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.54
|
| Rate for Payer: Meridian Medicaid |
$11.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.11
|
| Rate for Payer: PACE Medicare |
$18.58
|
| Rate for Payer: PACE SWMI |
$19.56
|
| Rate for Payer: PHP Commercial |
$95.11
|
| Rate for Payer: PHP Medicare Advantage |
$19.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.73
|
| Rate for Payer: Priority Health Medicare |
$19.56
|
| Rate for Payer: Priority Health SBD |
$70.49
|
| Rate for Payer: Railroad Medicare Medicare |
$19.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.56
|
| Rate for Payer: UHC Exchange |
$37.38
|
| Rate for Payer: UHC Medicare Advantage |
$19.56
|
| Rate for Payer: UHCCP Medicaid |
$10.48
|
| Rate for Payer: UMR Bronson Commercial |
$41.40
|
| Rate for Payer: VA VA |
$19.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.92
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$40.51 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$27.50
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$47.43 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$32.20
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$134.42
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.93 |
| Max. Negotiated Rate |
$146.68 |
| Rate for Payer: Aetna American Axle |
$87.37
|
| Rate for Payer: Aetna Commercial |
$114.26
|
| Rate for Payer: Aetna Medicare |
$54.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.14
|
| Rate for Payer: BCBS Complete |
$29.33
|
| Rate for Payer: BCBS MAPPO |
$52.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.11
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cofinity Commercial |
$94.09
|
| Rate for Payer: Cofinity Commercial |
$115.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$94.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.11
|
| Rate for Payer: Healthscope Commercial |
$120.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.81
|
| Rate for Payer: Mclaren Medicaid |
$27.93
|
| Rate for Payer: Mclaren Medicare |
$52.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.72
|
| Rate for Payer: Meridian Medicaid |
$29.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.26
|
| Rate for Payer: PACE Medicare |
$49.50
|
| Rate for Payer: PACE SWMI |
$52.11
|
| Rate for Payer: PHP Commercial |
$114.26
|
| Rate for Payer: PHP Medicare Advantage |
$52.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.37
|
| Rate for Payer: Priority Health Medicare |
$52.11
|
| Rate for Payer: Priority Health SBD |
$84.68
|
| Rate for Payer: Railroad Medicare Medicare |
$52.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.11
|
| Rate for Payer: UHC Exchange |
$99.59
|
| Rate for Payer: UHC Medicare Advantage |
$52.11
|
| Rate for Payer: UHCCP Medicaid |
$27.93
|
| Rate for Payer: UMR Bronson Commercial |
$49.74
|
| Rate for Payer: VA VA |
$52.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.81
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$134.42
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$59.14 |
| Max. Negotiated Rate |
$120.98 |
| Rate for Payer: Aetna American Axle |
$87.37
|
| Rate for Payer: Aetna Commercial |
$114.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.37
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cofinity Commercial |
$115.60
|
| Rate for Payer: Cofinity Commercial |
$94.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$94.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.54
|
| Rate for Payer: Healthscope Commercial |
$120.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.26
|
| Rate for Payer: PHP Commercial |
$114.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.37
|
| Rate for Payer: Priority Health SBD |
$84.68
|
| Rate for Payer: UMR Bronson Commercial |
$59.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.81
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
OP
|
$102.41
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$92.17 |
| Rate for Payer: Aetna American Axle |
$66.57
|
| Rate for Payer: Aetna Commercial |
$87.05
|
| Rate for Payer: Aetna Medicare |
$24.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$13.44
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cofinity Commercial |
$88.07
|
| Rate for Payer: Cofinity Commercial |
$71.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$92.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.81
|
| Rate for Payer: Mclaren Medicaid |
$12.80
|
| Rate for Payer: Mclaren Medicare |
$23.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$13.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.05
|
| Rate for Payer: PACE Medicare |
$22.69
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$87.05
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.57
|
| Rate for Payer: Priority Health Medicare |
$23.88
|
| Rate for Payer: Priority Health SBD |
$64.52
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.88
|
| Rate for Payer: UHC Exchange |
$45.64
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$12.80
|
| Rate for Payer: UMR Bronson Commercial |
$37.89
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.81
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
IP
|
$102.41
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$45.06 |
| Max. Negotiated Rate |
$92.17 |
| Rate for Payer: Aetna American Axle |
$66.57
|
| Rate for Payer: Aetna Commercial |
$87.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.57
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cofinity Commercial |
$71.69
|
| Rate for Payer: Cofinity Commercial |
$88.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.93
|
| Rate for Payer: Healthscope Commercial |
$92.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.05
|
| Rate for Payer: PHP Commercial |
$87.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.57
|
| Rate for Payer: Priority Health SBD |
$64.52
|
| Rate for Payer: UMR Bronson Commercial |
$45.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.81
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna American Axle |
$48.40
|
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.40
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health SBD |
$46.91
|
| Rate for Payer: UMR Bronson Commercial |
$32.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna American Axle |
$48.40
|
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.40
|
| 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 |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| 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 |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$46.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$27.55
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC DAMAGED WATCH PAT DEVICE
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna American Axle |
$65.00
|
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$70.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health SBD |
$63.00
|
| Rate for Payer: UMR Bronson Commercial |
$44.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC DAMAGED WATCH PAT DEVICE
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna American Axle |
$65.00
|
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$50.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: BCBS Complete |
$40.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$70.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health SBD |
$63.00
|
| Rate for Payer: UMR Bronson Commercial |
$37.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
IP
|
$798.66
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$351.41 |
| Max. Negotiated Rate |
$718.79 |
| Rate for Payer: Aetna American Axle |
$519.13
|
| Rate for Payer: Aetna Commercial |
$678.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.13
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cofinity Commercial |
$559.06
|
| Rate for Payer: Cofinity Commercial |
$686.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$559.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.93
|
| Rate for Payer: Healthscope Commercial |
$718.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$559.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$599.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.86
|
| Rate for Payer: PHP Commercial |
$678.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.13
|
| Rate for Payer: Priority Health SBD |
$503.16
|
| Rate for Payer: UMR Bronson Commercial |
$351.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$599.00
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
OP
|
$798.66
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$295.50 |
| Max. Negotiated Rate |
$1,920.94 |
| Rate for Payer: Aetna American Axle |
$519.13
|
| Rate for Payer: Aetna Commercial |
$678.86
|
| Rate for Payer: Aetna Medicare |
$709.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$519.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$853.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$853.02
|
| Rate for Payer: BCBS Complete |
$384.07
|
| Rate for Payer: BCBS MAPPO |
$682.42
|
| Rate for Payer: BCN Medicare Advantage |
$682.42
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cofinity Commercial |
$686.85
|
| Rate for Payer: Cofinity Commercial |
$559.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$559.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.42
|
| Rate for Payer: Healthscope Commercial |
$718.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$559.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$599.00
|
| Rate for Payer: Mclaren Medicaid |
$365.78
|
| Rate for Payer: Mclaren Medicare |
$682.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.54
|
| Rate for Payer: Meridian Medicaid |
$384.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$784.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.86
|
| Rate for Payer: PACE Medicare |
$648.30
|
| Rate for Payer: PACE SWMI |
$682.42
|
| Rate for Payer: PHP Commercial |
$678.86
|
| Rate for Payer: PHP Medicare Advantage |
$682.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$365.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.13
|
| Rate for Payer: Priority Health Medicare |
$682.42
|
| Rate for Payer: Priority Health SBD |
$503.16
|
| Rate for Payer: Railroad Medicare Medicare |
$682.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,920.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$682.42
|
| Rate for Payer: UHC Exchange |
$1,304.17
|
| Rate for Payer: UHC Medicare Advantage |
$682.42
|
| Rate for Payer: UHCCP Medicaid |
$365.78
|
| Rate for Payer: UMR Bronson Commercial |
$295.50
|
| Rate for Payer: VA VA |
$682.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$599.00
|
|
