|
HC CX ID BY PCR AMPLIFIED, PSAR
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600239
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$25.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, S.AUREUS
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600229
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$25.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, S.AUREUS
|
Facility
|
OP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600229
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| 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: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| 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 |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.86
|
| 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 |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.27
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, SERRATIA
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600246
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$25.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, SERRATIA
|
Facility
|
OP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600246
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| 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: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| 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 |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.86
|
| 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 |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.27
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, SPNE
|
Facility
|
OP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600233
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| 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: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| 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 |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.86
|
| 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 |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.27
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, SPNE
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600233
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$25.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, STAPH
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600228
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$25.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, STAPH
|
Facility
|
OP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600228
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| 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: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| 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 |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.86
|
| 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 |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.27
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, STREP
|
Facility
|
OP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600232
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| 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: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| 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 |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.86
|
| 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 |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.27
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, STREP
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600232
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$25.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
IP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.29 |
| Max. Negotiated Rate |
$51.73 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.86
|
| Rate for Payer: PHP Commercial |
$48.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.36
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: UMR Bronson Commercial |
$25.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CX ID BY PCR AMPLIFIED, VAN AB
|
Facility
|
OP
|
$57.48
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600253
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.36
|
| Rate for Payer: Aetna Commercial |
$48.86
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.36
|
| 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: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cash Price |
$45.98
|
| Rate for Payer: Cofinity Commercial |
$49.43
|
| Rate for Payer: Cofinity Commercial |
$40.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.11
|
| 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 |
$48.86
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.86
|
| 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 |
$37.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$36.21
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.27
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.11
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.69
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UMR Bronson Commercial |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC CYCLIC CITRULLINATED PEPTIDE A
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 86200
|
| Hospital Charge Code |
30200155
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.94 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$13.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.19
|
| Rate for Payer: BCBS Complete |
$7.29
|
| Rate for Payer: BCBS MAPPO |
$12.95
|
| Rate for Payer: BCBS Trust/PPO |
$12.47
|
| Rate for Payer: BCN Commercial |
$12.47
|
| Rate for Payer: BCN Medicare Advantage |
$12.95
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Cofinity Commercial |
$22.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.95
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$6.94
|
| Rate for Payer: Mclaren Medicare |
$12.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.60
|
| Rate for Payer: Meridian Medicaid |
$7.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$19.42
|
| Rate for Payer: PACE Medicare |
$12.30
|
| Rate for Payer: PACE SWMI |
$12.95
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$12.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.32
|
| Rate for Payer: Priority Health Medicare |
$12.95
|
| Rate for Payer: Priority Health Narrow Network |
$10.66
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: Railroad Medicare Medicare |
$12.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.95
|
| Rate for Payer: UHC Exchange |
$12.95
|
| Rate for Payer: UHC Medicare Advantage |
$12.95
|
| Rate for Payer: UHCCP Medicaid |
$6.94
|
| Rate for Payer: UMR Bronson Commercial |
$11.78
|
| Rate for Payer: VA VA |
$12.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
IP
|
$18.73
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Aetna American Axle |
$12.17
|
| Rate for Payer: Aetna Commercial |
$15.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.17
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$13.11
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$16.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: PHP Commercial |
$15.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.17
|
| Rate for Payer: Priority Health SBD |
$11.80
|
| Rate for Payer: UMR Bronson Commercial |
$8.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.05
|
|
|
HC CYCLOSPORA DETECTION
|
Facility
|
OP
|
$18.73
|
|
|
Service Code
|
CPT 87015
|
| Hospital Charge Code |
30600071
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.58 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Aetna American Axle |
$12.17
|
| Rate for Payer: Aetna Commercial |
$15.92
|
| Rate for Payer: Aetna Medicare |
$6.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.35
|
| Rate for Payer: BCBS Complete |
$3.76
|
| Rate for Payer: BCBS MAPPO |
$6.68
|
| Rate for Payer: BCBS Trust/PPO |
$6.44
|
| Rate for Payer: BCN Commercial |
$6.44
|
| Rate for Payer: BCN Medicare Advantage |
$6.68
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Cofinity Commercial |
$13.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.68
|
| Rate for Payer: Healthscope Commercial |
$16.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.05
|
| Rate for Payer: Mclaren Medicaid |
$3.58
|
| Rate for Payer: Mclaren Medicare |
$6.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.01
|
| Rate for Payer: Meridian Medicaid |
$3.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Nomi Health Commercial |
$10.02
|
| Rate for Payer: PACE Medicare |
$6.35
|
| Rate for Payer: PACE SWMI |
$6.68
|
| Rate for Payer: PHP Commercial |
$15.92
|
| Rate for Payer: PHP Medicare Advantage |
$6.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.17
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.68
|
| Rate for Payer: Priority Health Medicare |
$6.68
|
| Rate for Payer: Priority Health Narrow Network |
$5.34
|
| Rate for Payer: Priority Health SBD |
$11.80
|
| Rate for Payer: Railroad Medicare Medicare |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.68
|
| Rate for Payer: UHC Exchange |
$6.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.68
|
| Rate for Payer: UHCCP Medicaid |
$3.58
|
| Rate for Payer: UMR Bronson Commercial |
$6.93
|
| Rate for Payer: VA VA |
$6.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.05
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$6.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.49
|
| Rate for Payer: BCBS Complete |
$3.37
|
| Rate for Payer: BCBS MAPPO |
$5.99
|
| Rate for Payer: BCBS Trust/PPO |
$4.32
|
| Rate for Payer: BCN Commercial |
$4.32
|
| Rate for Payer: BCN Medicare Advantage |
$5.99
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.99
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Mclaren Medicaid |
$3.21
|
| Rate for Payer: Mclaren Medicare |
$5.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.29
|
| Rate for Payer: Meridian Medicaid |
$3.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$8.98
|
| Rate for Payer: PACE Medicare |
$5.69
|
| Rate for Payer: PACE SWMI |
$5.99
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$5.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.17
|
| Rate for Payer: Priority Health Medicare |
$5.99
|
| Rate for Payer: Priority Health Narrow Network |
$4.94
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: Railroad Medicare Medicare |
$5.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.99
|
| Rate for Payer: UHC Exchange |
$5.99
|
| Rate for Payer: UHC Medicare Advantage |
$5.99
|
| Rate for Payer: UHCCP Medicaid |
$3.21
|
| Rate for Payer: UMR Bronson Commercial |
$17.74
|
| Rate for Payer: VA VA |
$5.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC CYCLOSPORA DETECTION CMPT
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 87207
|
| Hospital Charge Code |
30600108
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: UMR Bronson Commercial |
$21.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC CYCLOSPORINE
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| 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 |
$31.22
|
| 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 |
$31.22
|
|
|
HC CYCLOSPORINE
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80158
|
| Hospital Charge Code |
30100025
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.67 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$18.77
|
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.56
|
| Rate for Payer: BCBS Complete |
$10.16
|
| Rate for Payer: BCBS MAPPO |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.39
|
| Rate for Payer: BCN Commercial |
$17.39
|
| Rate for Payer: BCN Medicare Advantage |
$18.05
|
| 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 |
$18.05
|
| 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 |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$9.67
|
| Rate for Payer: Mclaren Medicare |
$18.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.95
|
| Rate for Payer: Meridian Medicaid |
$10.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$27.08
|
| Rate for Payer: PACE Medicare |
$17.15
|
| Rate for Payer: PACE SWMI |
$18.05
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$18.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.05
|
| Rate for Payer: Priority Health Medicare |
$18.05
|
| Rate for Payer: Priority Health Narrow Network |
$14.44
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$18.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.05
|
| Rate for Payer: UHC Exchange |
$18.05
|
| Rate for Payer: UHC Medicare Advantage |
$18.05
|
| Rate for Payer: UHCCP Medicaid |
$9.67
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$18.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: UMR Bronson Commercial |
$29.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100559
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$19.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.15
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.52
|
| Rate for Payer: BCBS Trust/PPO |
$17.84
|
| Rate for Payer: BCN Commercial |
$17.84
|
| Rate for Payer: BCN Medicare Advantage |
$18.52
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Mclaren Medicare |
$18.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.45
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$27.78
|
| Rate for Payer: PACE Medicare |
$17.59
|
| Rate for Payer: PACE SWMI |
$18.52
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$18.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.52
|
| Rate for Payer: Priority Health Medicare |
$18.52
|
| Rate for Payer: Priority Health Narrow Network |
$14.82
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$18.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.22
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.52
|
| Rate for Payer: UHC Exchange |
$18.52
|
| Rate for Payer: UHC Medicare Advantage |
$18.52
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: UMR Bronson Commercial |
$24.53
|
| Rate for Payer: VA VA |
$18.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR, SERUM
|
Facility
|
IP
|
$67.79
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.83 |
| Max. Negotiated Rate |
$61.01 |
| Rate for Payer: Aetna American Axle |
$44.06
|
| Rate for Payer: Aetna Commercial |
$57.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.06
|
| Rate for Payer: Cash Price |
$54.23
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Cofinity Commercial |
$58.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.23
|
| Rate for Payer: Healthscope Commercial |
$61.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.62
|
| Rate for Payer: PHP Commercial |
$57.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.06
|
| Rate for Payer: Priority Health SBD |
$42.71
|
| Rate for Payer: UMR Bronson Commercial |
$29.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.84
|
|
|
HC CYSTATIN C WITH ESTIMATED GFR, SERUM
|
Facility
|
OP
|
$67.79
|
|
|
Service Code
|
CPT 82610
|
| Hospital Charge Code |
30100747
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$61.01 |
| Rate for Payer: BCN Commercial |
$17.84
|
| Rate for Payer: BCN Medicare Advantage |
$18.52
|
| Rate for Payer: Cash Price |
$54.23
|
| Rate for Payer: Cash Price |
$54.23
|
| Rate for Payer: Cofinity Commercial |
$58.30
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.45
|
| Rate for Payer: Aetna American Axle |
$44.06
|
| Rate for Payer: Aetna Commercial |
$57.62
|
| Rate for Payer: Aetna Medicare |
$19.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.15
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$18.52
|
| Rate for Payer: BCBS Trust/PPO |
$17.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.52
|
| Rate for Payer: Healthscope Commercial |
$61.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.84
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Mclaren Medicare |
$18.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.45
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.62
|
| Rate for Payer: Nomi Health Commercial |
$27.78
|
| Rate for Payer: PACE Medicare |
$17.59
|
| Rate for Payer: PACE SWMI |
$18.52
|
| Rate for Payer: PHP Commercial |
$57.62
|
| Rate for Payer: PHP Medicare Advantage |
$18.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.52
|
| Rate for Payer: Priority Health Medicare |
$18.52
|
| Rate for Payer: Priority Health Narrow Network |
$14.82
|
| Rate for Payer: Priority Health SBD |
$42.71
|
| Rate for Payer: Railroad Medicare Medicare |
$18.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.22
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.52
|
| Rate for Payer: UHC Exchange |
$18.52
|
| Rate for Payer: UHC Medicare Advantage |
$18.52
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: UMR Bronson Commercial |
$25.08
|
| Rate for Payer: VA VA |
$18.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.84
|
|
