|
HC EXTERNAL PACER
|
Facility
|
OP
|
$587.96
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
48000001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$2,129.73 |
| Rate for Payer: Aetna American Axle |
$382.17
|
| Rate for Payer: Aetna Commercial |
$499.77
|
| Rate for Payer: Aetna Medicare |
$684.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$823.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$823.21
|
| Rate for Payer: BCBS Complete |
$361.69
|
| Rate for Payer: BCBS MAPPO |
$658.57
|
| Rate for Payer: BCBS Trust/PPO |
$1.40
|
| Rate for Payer: BCN Commercial |
$1.40
|
| Rate for Payer: BCN Medicare Advantage |
$658.57
|
| Rate for Payer: Cash Price |
$470.37
|
| Rate for Payer: Cash Price |
$470.37
|
| Rate for Payer: Cofinity Advantage |
$411.57
|
| Rate for Payer: Cofinity Commercial |
$505.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.57
|
| Rate for Payer: Healthscope Commercial |
$529.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$411.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$440.97
|
| Rate for Payer: Mclaren Medicaid |
$658.57
|
| Rate for Payer: Mclaren Medicare |
$658.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.50
|
| Rate for Payer: Meridian Medicaid |
$691.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$757.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$724.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.77
|
| Rate for Payer: Nomi Health Commercial |
$1,975.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.97
|
| Rate for Payer: PACE Medicare |
$625.64
|
| Rate for Payer: PACE SWMI |
$658.57
|
| Rate for Payer: PHP Commercial |
$499.77
|
| Rate for Payer: PHP Medicare Advantage |
$658.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$344.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,129.73
|
| Rate for Payer: Priority Health Medicare |
$658.57
|
| Rate for Payer: Priority Health SBD |
$370.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,703.78
|
| Rate for Payer: Railroad Medicare Medicare |
$658.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$382.17
|
| Rate for Payer: UHC Core |
$306.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$658.57
|
| Rate for Payer: UHC Exchange |
$231.07
|
| Rate for Payer: UHC Medicaid |
$344.43
|
| Rate for Payer: UHCCP Medicaid |
$344.43
|
| Rate for Payer: UMR Bronson Commercial |
$217.55
|
| Rate for Payer: VA VA |
$658.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$440.97
|
|
|
HC EXTERNAL PACER
|
Facility
|
IP
|
$587.96
|
|
|
Service Code
|
CPT 92953
|
| Hospital Charge Code |
48000001
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$258.70 |
| Max. Negotiated Rate |
$529.16 |
| Rate for Payer: Aetna American Axle |
$382.17
|
| Rate for Payer: Aetna Commercial |
$499.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$382.17
|
| Rate for Payer: Cash Price |
$470.37
|
| Rate for Payer: Cofinity Advantage |
$411.57
|
| Rate for Payer: Cofinity Commercial |
$505.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$470.37
|
| Rate for Payer: Healthscope Commercial |
$529.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$411.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$440.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$499.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$440.97
|
| Rate for Payer: PHP Commercial |
$499.77
|
| Rate for Payer: Priority Health SBD |
$370.41
|
| Rate for Payer: UMR Bronson Commercial |
$258.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$440.97
|
|
|
HC EXTERNAL VERSION
|
Facility
|
IP
|
$2,895.09
|
|
|
Service Code
|
CPT 59412
|
| Hospital Charge Code |
36100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,273.84 |
| Max. Negotiated Rate |
$2,605.58 |
| Rate for Payer: Aetna American Axle |
$1,881.81
|
| Rate for Payer: Aetna Commercial |
$2,460.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,881.81
|
| Rate for Payer: Cash Price |
$2,316.07
|
| Rate for Payer: Cofinity Advantage |
$2,026.56
|
| Rate for Payer: Cofinity Commercial |
$2,489.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,316.07
|
| Rate for Payer: Healthscope Commercial |
$2,605.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,026.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,171.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,460.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,171.32
|
| Rate for Payer: PHP Commercial |
$2,460.83
|
| Rate for Payer: Priority Health SBD |
$1,823.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,273.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,171.32
|
|
|
HC EXTERNAL VERSION
|
Facility
|
OP
|
$2,895.09
|
|
|
Service Code
|
CPT 59412
|
| Hospital Charge Code |
36100121
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$977.38 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$1,881.81
|
| Rate for Payer: Aetna Commercial |
$2,460.83
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,881.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$977.38
|
| Rate for Payer: BCN Commercial |
$977.38
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$2,316.07
|
| Rate for Payer: Cash Price |
$2,316.07
|
| Rate for Payer: Cash Price |
$2,316.07
|
| Rate for Payer: Cofinity Advantage |
$2,026.56
|
| Rate for Payer: Cofinity Commercial |
$2,489.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,316.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$2,605.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,026.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,171.32
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,460.83
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,171.32
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$2,460.83
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$1,823.91
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,881.81
|
| Rate for Payer: UHC Core |
$1,508.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$1,137.77
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,071.18
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,171.32
|
|
|
HC EXTRACTION
|
Facility
|
OP
|
$278.14
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
76100282
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$102.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$180.79
|
| Rate for Payer: Aetna Commercial |
$236.42
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$102.55
|
| Rate for Payer: BCN Commercial |
$102.55
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$222.51
|
| Rate for Payer: Cash Price |
$222.51
|
| Rate for Payer: Cash Price |
$222.51
|
| Rate for Payer: Cofinity Advantage |
$194.70
|
| Rate for Payer: Cofinity Commercial |
$239.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$250.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.60
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.42
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.60
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$236.42
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$175.23
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$180.79
|
| Rate for Payer: UHC Core |
$144.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$109.31
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$102.91
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.60
|
|
|
HC EXTRACTION
|
Facility
|
IP
|
$278.14
|
|
|
Service Code
|
CPT 10040
|
| Hospital Charge Code |
76100282
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$122.38 |
| Max. Negotiated Rate |
$250.33 |
| Rate for Payer: Aetna American Axle |
$180.79
|
| Rate for Payer: Aetna Commercial |
$236.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.79
|
| Rate for Payer: Cash Price |
$222.51
|
| Rate for Payer: Cofinity Advantage |
$194.70
|
| Rate for Payer: Cofinity Commercial |
$239.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.51
|
| Rate for Payer: Healthscope Commercial |
$250.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$208.60
|
| Rate for Payer: PHP Commercial |
$236.42
|
| Rate for Payer: Priority Health SBD |
$175.23
|
| Rate for Payer: UMR Bronson Commercial |
$122.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.60
|
|
|
HC EXTRAORAL INC AND DRAIN ABSC, CYST, HEMATOMA FLOOR OF MOUTH SUBLING
|
Facility
|
OP
|
$398.50
|
|
|
Service Code
|
CPT 41015
|
| Hospital Charge Code |
76100137
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$147.44 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna American Axle |
$259.02
|
| Rate for Payer: Aetna Commercial |
$338.73
|
| Rate for Payer: Aetna Medicare |
$558.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$450.05
|
| Rate for Payer: BCN Commercial |
$450.05
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Cofinity Advantage |
$278.95
|
| Rate for Payer: Cofinity Commercial |
$342.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$358.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$278.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.88
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$564.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.73
|
| Rate for Payer: Nomi Health Commercial |
$1,612.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.88
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$338.73
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,737.88
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health SBD |
$251.06
|
| Rate for Payer: Priority Health Tiered Network |
$1,390.30
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$259.02
|
| Rate for Payer: UHC Core |
$207.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$156.61
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: UMR Bronson Commercial |
$147.44
|
| Rate for Payer: VA VA |
$537.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.88
|
|
|
HC EXTRAORAL INC AND DRAIN ABSC, CYST, HEMATOMA FLOOR OF MOUTH SUBLING
|
Facility
|
IP
|
$398.50
|
|
|
Service Code
|
CPT 41015
|
| Hospital Charge Code |
76100137
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$175.34 |
| Max. Negotiated Rate |
$358.65 |
| Rate for Payer: Aetna American Axle |
$259.02
|
| Rate for Payer: Aetna Commercial |
$338.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$259.02
|
| Rate for Payer: Cash Price |
$318.80
|
| Rate for Payer: Cofinity Advantage |
$278.95
|
| Rate for Payer: Cofinity Commercial |
$342.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.80
|
| Rate for Payer: Healthscope Commercial |
$358.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$278.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.88
|
| Rate for Payer: PHP Commercial |
$338.73
|
| Rate for Payer: Priority Health SBD |
$251.06
|
| Rate for Payer: UMR Bronson Commercial |
$175.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.88
|
|
|
HC EXTRA VASCULAR ICD
|
Facility
|
OP
|
$26,875.00
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$9,943.75 |
| Max. Negotiated Rate |
$24,187.50 |
| Rate for Payer: Aetna American Axle |
$17,468.75
|
| Rate for Payer: Aetna Commercial |
$22,843.75
|
| Rate for Payer: Aetna Medicare |
$13,437.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,468.75
|
| Rate for Payer: BCBS Complete |
$10,750.00
|
| Rate for Payer: Cash Price |
$21,500.00
|
| Rate for Payer: Cofinity Advantage |
$18,812.50
|
| Rate for Payer: Cofinity Commercial |
$23,112.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,500.00
|
| Rate for Payer: Healthscope Commercial |
$24,187.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,812.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,156.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,500.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,843.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,156.25
|
| Rate for Payer: PHP Commercial |
$22,843.75
|
| Rate for Payer: Priority Health SBD |
$16,931.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17,468.75
|
| Rate for Payer: UHC Core |
$14,001.88
|
| Rate for Payer: UHC Exchange |
$10,561.88
|
| Rate for Payer: UMR Bronson Commercial |
$9,943.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,156.25
|
|
|
HC EXTRA VASCULAR ICD
|
Facility
|
IP
|
$26,875.00
|
|
|
Service Code
|
HCPCS C1722
|
| Hospital Charge Code |
27800160
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$11,825.00 |
| Max. Negotiated Rate |
$24,187.50 |
| Rate for Payer: Aetna American Axle |
$17,468.75
|
| Rate for Payer: Aetna Commercial |
$22,843.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,468.75
|
| Rate for Payer: Cash Price |
$21,500.00
|
| Rate for Payer: Cofinity Advantage |
$18,812.50
|
| Rate for Payer: Cofinity Commercial |
$23,112.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,500.00
|
| Rate for Payer: Healthscope Commercial |
$24,187.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,812.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,156.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,843.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,156.25
|
| Rate for Payer: PHP Commercial |
$22,843.75
|
| Rate for Payer: Priority Health SBD |
$16,931.25
|
| Rate for Payer: UMR Bronson Commercial |
$11,825.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,156.25
|
|
|
HC EXTRA VASCULAR LEAD
|
Facility
|
IP
|
$8,085.00
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,557.40 |
| Max. Negotiated Rate |
$7,276.50 |
| Rate for Payer: Aetna American Axle |
$5,255.25
|
| Rate for Payer: Aetna Commercial |
$6,872.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,255.25
|
| Rate for Payer: Cash Price |
$6,468.00
|
| Rate for Payer: Cofinity Advantage |
$5,659.50
|
| Rate for Payer: Cofinity Commercial |
$6,953.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,468.00
|
| Rate for Payer: Healthscope Commercial |
$7,276.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,659.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,063.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,872.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,063.75
|
| Rate for Payer: PHP Commercial |
$6,872.25
|
| Rate for Payer: Priority Health SBD |
$5,093.55
|
| Rate for Payer: UMR Bronson Commercial |
$3,557.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,063.75
|
|
|
HC EXTRA VASCULAR LEAD
|
Facility
|
OP
|
$8,085.00
|
|
|
Service Code
|
HCPCS C1896
|
| Hospital Charge Code |
27800161
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,991.45 |
| Max. Negotiated Rate |
$7,276.50 |
| Rate for Payer: Aetna American Axle |
$5,255.25
|
| Rate for Payer: Aetna Commercial |
$6,872.25
|
| Rate for Payer: Aetna Medicare |
$4,042.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,255.25
|
| Rate for Payer: BCBS Complete |
$3,234.00
|
| Rate for Payer: Cash Price |
$6,468.00
|
| Rate for Payer: Cofinity Advantage |
$5,659.50
|
| Rate for Payer: Cofinity Commercial |
$6,953.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,468.00
|
| Rate for Payer: Healthscope Commercial |
$7,276.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,659.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,063.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,468.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,872.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,063.75
|
| Rate for Payer: PHP Commercial |
$6,872.25
|
| Rate for Payer: Priority Health SBD |
$5,093.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,255.25
|
| Rate for Payer: UHC Core |
$4,212.28
|
| Rate for Payer: UHC Exchange |
$3,177.41
|
| Rate for Payer: UMR Bronson Commercial |
$2,991.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,063.75
|
|
|
HC EXTRA VASCULAR STERNAL TUNNELING TOOL
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
27200398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$660.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna American Axle |
$975.00
|
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Advantage |
$1,050.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: Priority Health SBD |
$945.00
|
| Rate for Payer: UMR Bronson Commercial |
$660.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC EXTRA VASCULAR STERNAL TUNNELING TOOL
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
27200398
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$555.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna American Axle |
$975.00
|
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna Medicare |
$750.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.00
|
| Rate for Payer: BCBS Complete |
$600.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Advantage |
$1,050.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,200.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: Priority Health SBD |
$945.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$975.00
|
| Rate for Payer: UHC Core |
$781.50
|
| Rate for Payer: UHC Exchange |
$589.50
|
| Rate for Payer: UMR Bronson Commercial |
$555.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC EXTRA VASCULAR TRANSVERSE TUNNELING TOOL
|
Facility
|
OP
|
$1,500.00
|
|
| Hospital Charge Code |
27200399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$555.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna American Axle |
$975.00
|
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna Medicare |
$750.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.00
|
| Rate for Payer: BCBS Complete |
$600.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Advantage |
$1,050.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,200.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: Priority Health SBD |
$945.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$975.00
|
| Rate for Payer: UHC Core |
$781.50
|
| Rate for Payer: UHC Exchange |
$589.50
|
| Rate for Payer: UMR Bronson Commercial |
$555.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC EXTRA VASCULAR TRANSVERSE TUNNELING TOOL
|
Facility
|
IP
|
$1,500.00
|
|
| Hospital Charge Code |
27200399
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$660.00 |
| Max. Negotiated Rate |
$1,350.00 |
| Rate for Payer: Aetna American Axle |
$975.00
|
| Rate for Payer: Aetna Commercial |
$1,275.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$975.00
|
| Rate for Payer: Cash Price |
$1,200.00
|
| Rate for Payer: Cofinity Advantage |
$1,050.00
|
| Rate for Payer: Cofinity Commercial |
$1,290.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.00
|
| Rate for Payer: Healthscope Commercial |
$1,350.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,275.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,125.00
|
| Rate for Payer: PHP Commercial |
$1,275.00
|
| Rate for Payer: Priority Health SBD |
$945.00
|
| Rate for Payer: UMR Bronson Commercial |
$660.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.00
|
|
|
HC EZPAP SUPPLY
|
Facility
|
OP
|
$130.55
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.30 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna American Axle |
$84.86
|
| Rate for Payer: Aetna Commercial |
$110.97
|
| Rate for Payer: Aetna Medicare |
$65.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: BCBS Complete |
$52.22
|
| Rate for Payer: Cash Price |
$104.44
|
| Rate for Payer: Cofinity Advantage |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$112.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.44
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.91
|
| Rate for Payer: PHP Commercial |
$110.97
|
| Rate for Payer: Priority Health SBD |
$82.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.86
|
| Rate for Payer: UHC Core |
$68.02
|
| Rate for Payer: UHC Exchange |
$51.31
|
| Rate for Payer: UMR Bronson Commercial |
$48.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.91
|
|
|
HC EZPAP SUPPLY
|
Facility
|
IP
|
$130.55
|
|
| Hospital Charge Code |
27000072
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$57.44 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna American Axle |
$84.86
|
| Rate for Payer: Aetna Commercial |
$110.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.86
|
| Rate for Payer: Cash Price |
$104.44
|
| Rate for Payer: Cofinity Advantage |
$91.39
|
| Rate for Payer: Cofinity Commercial |
$112.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.44
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.91
|
| Rate for Payer: PHP Commercial |
$110.97
|
| Rate for Payer: Priority Health SBD |
$82.25
|
| Rate for Payer: UMR Bronson Commercial |
$57.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.91
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
IP
|
$494.43
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$217.55 |
| Max. Negotiated Rate |
$444.99 |
| Rate for Payer: Aetna American Axle |
$321.38
|
| Rate for Payer: Aetna Commercial |
$420.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.38
|
| Rate for Payer: Cash Price |
$395.54
|
| Rate for Payer: Cofinity Advantage |
$346.10
|
| Rate for Payer: Cofinity Commercial |
$425.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.54
|
| Rate for Payer: Healthscope Commercial |
$444.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.82
|
| Rate for Payer: PHP Commercial |
$420.27
|
| Rate for Payer: Priority Health SBD |
$311.49
|
| Rate for Payer: UMR Bronson Commercial |
$217.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.82
|
|
|
HC F-18 SODIUM FLUORIDE <=30MCI
|
Facility
|
OP
|
$494.43
|
|
|
Service Code
|
HCPCS A9580
|
| Hospital Charge Code |
34300028
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$182.94 |
| Max. Negotiated Rate |
$864.67 |
| Rate for Payer: Aetna American Axle |
$321.38
|
| Rate for Payer: Aetna Commercial |
$420.27
|
| Rate for Payer: Aetna Medicare |
$247.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$321.38
|
| Rate for Payer: BCBS Complete |
$197.77
|
| Rate for Payer: BCBS Trust/PPO |
$864.67
|
| Rate for Payer: BCN Commercial |
$864.67
|
| Rate for Payer: Cash Price |
$395.54
|
| Rate for Payer: Cash Price |
$395.54
|
| Rate for Payer: Cofinity Advantage |
$346.10
|
| Rate for Payer: Cofinity Commercial |
$425.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$395.54
|
| Rate for Payer: Healthscope Commercial |
$444.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$346.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$370.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$395.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$420.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$370.82
|
| Rate for Payer: PHP Commercial |
$420.27
|
| Rate for Payer: Priority Health SBD |
$311.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.41
|
| Rate for Payer: UHC Core |
$446.41
|
| Rate for Payer: UHC Exchange |
$446.41
|
| Rate for Payer: UMR Bronson Commercial |
$182.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$370.82
|
|
|
HC F232 OVALBUMIN
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna American Axle |
$20.86
|
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.86
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Advantage |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health SBD |
$20.22
|
| Rate for Payer: UMR Bronson Commercial |
$14.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F232 OVALBUMIN
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200439
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna American Axle |
$20.86
|
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$20.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Advantage |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$20.22
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$11.88
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F233 OVOMUCOID
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna American Axle |
$20.86
|
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.86
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Advantage |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health SBD |
$20.22
|
| Rate for Payer: UMR Bronson Commercial |
$14.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F233 OVOMUCOID
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200440
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna American Axle |
$20.86
|
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$20.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Advantage |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$20.22
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$11.88
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F352 RARA H8 PR-10 PEANUT
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200450
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna American Axle |
$20.86
|
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$20.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Advantage |
$22.47
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$20.22
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$11.88
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
