|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
OP
|
$236.45
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$271.16 |
| Rate for Payer: Aetna American Axle |
$153.69
|
| Rate for Payer: Aetna Commercial |
$200.98
|
| Rate for Payer: Aetna Medicare |
$87.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.81
|
| Rate for Payer: BCBS Complete |
$46.05
|
| Rate for Payer: BCBS MAPPO |
$83.85
|
| Rate for Payer: BCBS Trust/PPO |
$222.97
|
| Rate for Payer: BCN Commercial |
$222.97
|
| Rate for Payer: BCN Medicare Advantage |
$83.85
|
| Rate for Payer: Cash Price |
$189.16
|
| Rate for Payer: Cash Price |
$189.16
|
| Rate for Payer: Cofinity Advantage |
$165.51
|
| Rate for Payer: Cofinity Commercial |
$203.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.85
|
| Rate for Payer: Healthscope Commercial |
$212.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.34
|
| Rate for Payer: Mclaren Medicaid |
$83.85
|
| Rate for Payer: Mclaren Medicare |
$83.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.04
|
| Rate for Payer: Meridian Medicaid |
$88.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.98
|
| Rate for Payer: Nomi Health Commercial |
$251.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.34
|
| Rate for Payer: PACE Medicare |
$79.66
|
| Rate for Payer: PACE SWMI |
$83.85
|
| Rate for Payer: PHP Commercial |
$200.98
|
| Rate for Payer: PHP Medicare Advantage |
$83.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.16
|
| Rate for Payer: Priority Health Medicare |
$83.85
|
| Rate for Payer: Priority Health SBD |
$148.96
|
| Rate for Payer: Priority Health Tiered Network |
$216.93
|
| Rate for Payer: Railroad Medicare Medicare |
$83.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.69
|
| Rate for Payer: UHC Core |
$123.19
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$83.85
|
| Rate for Payer: UHC Exchange |
$92.92
|
| Rate for Payer: UHC Medicaid |
$43.85
|
| Rate for Payer: UHCCP Medicaid |
$43.85
|
| Rate for Payer: UMR Bronson Commercial |
$87.49
|
| Rate for Payer: VA VA |
$83.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.34
|
|
|
HC FRESH FROZEN PLASMA 3X CMPT2
|
Facility
|
IP
|
$236.45
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000055
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$104.04 |
| Max. Negotiated Rate |
$212.81 |
| Rate for Payer: Aetna American Axle |
$153.69
|
| Rate for Payer: Aetna Commercial |
$200.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.69
|
| Rate for Payer: Cash Price |
$189.16
|
| Rate for Payer: Cofinity Advantage |
$165.51
|
| Rate for Payer: Cofinity Commercial |
$203.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.16
|
| Rate for Payer: Healthscope Commercial |
$212.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$177.34
|
| Rate for Payer: PHP Commercial |
$200.98
|
| Rate for Payer: Priority Health SBD |
$148.96
|
| Rate for Payer: UMR Bronson Commercial |
$104.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.34
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
IP
|
$98.52
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$43.35 |
| Max. Negotiated Rate |
$88.67 |
| Rate for Payer: Aetna American Axle |
$64.04
|
| Rate for Payer: Aetna Commercial |
$83.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.04
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cofinity Advantage |
$68.96
|
| Rate for Payer: Cofinity Commercial |
$84.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.82
|
| Rate for Payer: Healthscope Commercial |
$88.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.89
|
| Rate for Payer: PHP Commercial |
$83.74
|
| Rate for Payer: Priority Health SBD |
$62.07
|
| Rate for Payer: UMR Bronson Commercial |
$43.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.89
|
|
|
HC FRESH FROZEN PLASMA SPLIT
|
Facility
|
OP
|
$98.52
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000056
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$36.45 |
| Max. Negotiated Rate |
$271.16 |
| Rate for Payer: Aetna American Axle |
$64.04
|
| Rate for Payer: Aetna Commercial |
$83.74
|
| Rate for Payer: Aetna Medicare |
$87.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.81
|
| Rate for Payer: BCBS Complete |
$46.05
|
| Rate for Payer: BCBS MAPPO |
$83.85
|
| Rate for Payer: BCBS Trust/PPO |
$222.97
|
| Rate for Payer: BCN Commercial |
$222.97
|
| Rate for Payer: BCN Medicare Advantage |
$83.85
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cash Price |
$78.82
|
| Rate for Payer: Cofinity Advantage |
$68.96
|
| Rate for Payer: Cofinity Commercial |
$84.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.85
|
| Rate for Payer: Healthscope Commercial |
$88.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.89
|
| Rate for Payer: Mclaren Medicaid |
$83.85
|
| Rate for Payer: Mclaren Medicare |
$83.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.04
|
| Rate for Payer: Meridian Medicaid |
$88.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.74
|
| Rate for Payer: Nomi Health Commercial |
$251.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$73.89
|
| Rate for Payer: PACE Medicare |
$79.66
|
| Rate for Payer: PACE SWMI |
$83.85
|
| Rate for Payer: PHP Commercial |
$83.74
|
| Rate for Payer: PHP Medicare Advantage |
$83.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.16
|
| Rate for Payer: Priority Health Medicare |
$83.85
|
| Rate for Payer: Priority Health SBD |
$62.07
|
| Rate for Payer: Priority Health Tiered Network |
$216.93
|
| Rate for Payer: Railroad Medicare Medicare |
$83.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.04
|
| Rate for Payer: UHC Core |
$51.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$83.85
|
| Rate for Payer: UHC Exchange |
$38.72
|
| Rate for Payer: UHC Medicaid |
$43.85
|
| Rate for Payer: UHCCP Medicaid |
$43.85
|
| Rate for Payer: UMR Bronson Commercial |
$36.45
|
| Rate for Payer: VA VA |
$83.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.89
|
|
|
HC FROZEN SECTION
|
Facility
|
IP
|
$129.57
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$57.01 |
| Max. Negotiated Rate |
$116.61 |
| Rate for Payer: Aetna American Axle |
$84.22
|
| Rate for Payer: Aetna Commercial |
$110.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.22
|
| Rate for Payer: Cash Price |
$103.66
|
| Rate for Payer: Cofinity Advantage |
$90.70
|
| Rate for Payer: Cofinity Commercial |
$111.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.66
|
| Rate for Payer: Healthscope Commercial |
$116.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.18
|
| Rate for Payer: PHP Commercial |
$110.13
|
| Rate for Payer: Priority Health SBD |
$81.63
|
| Rate for Payer: UMR Bronson Commercial |
$57.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.18
|
|
|
HC FROZEN SECTION
|
Facility
|
OP
|
$129.57
|
|
|
Service Code
|
CPT 88331
|
| Hospital Charge Code |
31000056
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$47.94 |
| Max. Negotiated Rate |
$548.99 |
| Rate for Payer: Aetna American Axle |
$84.22
|
| Rate for Payer: Aetna Commercial |
$110.13
|
| Rate for Payer: Aetna Medicare |
$176.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$75.12
|
| Rate for Payer: BCCCP Commercial |
$94.70
|
| Rate for Payer: BCN Commercial |
$75.12
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$103.66
|
| Rate for Payer: Cash Price |
$103.66
|
| Rate for Payer: Cofinity Advantage |
$90.70
|
| Rate for Payer: Cofinity Commercial |
$111.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$116.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.18
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.13
|
| Rate for Payer: Nomi Health Commercial |
$509.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$97.18
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$110.13
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$548.99
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health SBD |
$81.63
|
| Rate for Payer: Priority Health Tiered Network |
$439.19
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.04
|
| Rate for Payer: UHC Core |
$257.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$257.04
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: UMR Bronson Commercial |
$47.94
|
| Rate for Payer: VA VA |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.18
|
|
|
HC FRUCTOSAMINE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC FRUCTOSAMINE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 82985
|
| Hospital Charge Code |
30100627
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.77 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$17.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.95
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$16.76
|
| Rate for Payer: BCBS Trust/PPO |
$19.37
|
| Rate for Payer: BCN Commercial |
$19.37
|
| Rate for Payer: BCN Medicare Advantage |
$16.76
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.76
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$16.76
|
| Rate for Payer: Mclaren Medicare |
$16.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.60
|
| Rate for Payer: Meridian Medicaid |
$17.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$25.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$15.92
|
| Rate for Payer: PACE SWMI |
$16.76
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$16.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.76
|
| Rate for Payer: Priority Health Medicare |
$16.76
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$13.41
|
| Rate for Payer: Railroad Medicare Medicare |
$16.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.14
|
| Rate for Payer: UHC Core |
$25.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.76
|
| Rate for Payer: UHC Exchange |
$25.14
|
| Rate for Payer: UHC Medicaid |
$8.77
|
| Rate for Payer: UHCCP Medicaid |
$8.77
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$16.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
OP
|
$98.74
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.07 |
| Max. Negotiated Rate |
$88.87 |
| Rate for Payer: Aetna American Axle |
$64.18
|
| Rate for Payer: Aetna Commercial |
$83.93
|
| Rate for Payer: Aetna Medicare |
$18.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.68
|
| Rate for Payer: BCBS Complete |
$9.52
|
| Rate for Payer: BCBS MAPPO |
$17.34
|
| Rate for Payer: BCBS Trust/PPO |
$20.05
|
| Rate for Payer: BCN Commercial |
$20.05
|
| Rate for Payer: BCN Medicare Advantage |
$17.34
|
| Rate for Payer: Cash Price |
$78.99
|
| Rate for Payer: Cash Price |
$78.99
|
| Rate for Payer: Cofinity Advantage |
$69.12
|
| Rate for Payer: Cofinity Commercial |
$84.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.34
|
| Rate for Payer: Healthscope Commercial |
$88.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.06
|
| Rate for Payer: Mclaren Medicaid |
$17.34
|
| Rate for Payer: Mclaren Medicare |
$17.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.21
|
| Rate for Payer: Meridian Medicaid |
$18.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.93
|
| Rate for Payer: Nomi Health Commercial |
$26.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.06
|
| Rate for Payer: PACE Medicare |
$16.47
|
| Rate for Payer: PACE SWMI |
$17.34
|
| Rate for Payer: PHP Commercial |
$83.93
|
| Rate for Payer: PHP Medicare Advantage |
$17.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.34
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health SBD |
$62.21
|
| Rate for Payer: Priority Health Tiered Network |
$13.87
|
| Rate for Payer: Railroad Medicare Medicare |
$17.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.01
|
| Rate for Payer: UHC Core |
$26.01
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.34
|
| Rate for Payer: UHC Exchange |
$26.01
|
| Rate for Payer: UHC Medicaid |
$9.07
|
| Rate for Payer: UHCCP Medicaid |
$9.07
|
| Rate for Payer: UMR Bronson Commercial |
$36.53
|
| Rate for Payer: VA VA |
$17.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.06
|
|
|
HC FRUCTOSE SEMEN
|
Facility
|
IP
|
$98.74
|
|
|
Service Code
|
CPT 82757
|
| Hospital Charge Code |
30100206
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.45 |
| Max. Negotiated Rate |
$88.87 |
| Rate for Payer: Aetna American Axle |
$64.18
|
| Rate for Payer: Aetna Commercial |
$83.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.18
|
| Rate for Payer: Cash Price |
$78.99
|
| Rate for Payer: Cofinity Advantage |
$69.12
|
| Rate for Payer: Cofinity Commercial |
$84.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.99
|
| Rate for Payer: Healthscope Commercial |
$88.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.06
|
| Rate for Payer: PHP Commercial |
$83.93
|
| Rate for Payer: Priority Health SBD |
$62.21
|
| Rate for Payer: UMR Bronson Commercial |
$43.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.06
|
|
|
HC FTH/GFT FREE W/DIR CLSR N/E/E/L EA ADDL 20 SQ CM
|
Facility
|
OP
|
$2,439.15
|
|
|
Service Code
|
CPT 15261
|
| Hospital Charge Code |
76100561
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$902.49 |
| Max. Negotiated Rate |
$2,195.24 |
| Rate for Payer: Aetna American Axle |
$1,585.45
|
| Rate for Payer: Aetna Commercial |
$2,073.28
|
| Rate for Payer: Aetna Medicare |
$1,219.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,585.45
|
| Rate for Payer: BCBS Complete |
$975.66
|
| Rate for Payer: BCBS Trust/PPO |
$1,197.59
|
| Rate for Payer: BCN Commercial |
$1,197.59
|
| Rate for Payer: Cash Price |
$1,951.32
|
| Rate for Payer: Cash Price |
$1,951.32
|
| Rate for Payer: Cash Price |
$1,951.32
|
| Rate for Payer: Cofinity Advantage |
$1,707.40
|
| Rate for Payer: Cofinity Commercial |
$2,097.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.32
|
| Rate for Payer: Healthscope Commercial |
$2,195.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,707.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,829.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,951.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,829.36
|
| Rate for Payer: PHP Commercial |
$2,073.28
|
| Rate for Payer: Priority Health SBD |
$1,536.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,585.45
|
| Rate for Payer: UHC Core |
$1,270.80
|
| Rate for Payer: UHC Exchange |
$958.59
|
| Rate for Payer: UMR Bronson Commercial |
$902.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.36
|
|
|
HC FTH/GFT FREE W/DIR CLSR N/E/E/L EA ADDL 20 SQ CM
|
Facility
|
IP
|
$2,439.15
|
|
|
Service Code
|
CPT 15261
|
| Hospital Charge Code |
76100561
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,073.23 |
| Max. Negotiated Rate |
$2,195.24 |
| Rate for Payer: Aetna American Axle |
$1,585.45
|
| Rate for Payer: Aetna Commercial |
$2,073.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,585.45
|
| Rate for Payer: Cash Price |
$1,951.32
|
| Rate for Payer: Cofinity Advantage |
$1,707.40
|
| Rate for Payer: Cofinity Commercial |
$2,097.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,951.32
|
| Rate for Payer: Healthscope Commercial |
$2,195.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,707.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,829.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,073.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,829.36
|
| Rate for Payer: PHP Commercial |
$2,073.28
|
| Rate for Payer: Priority Health SBD |
$1,536.66
|
| Rate for Payer: UMR Bronson Commercial |
$1,073.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,829.36
|
|
|
HC FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<
|
Facility
|
IP
|
$3,515.06
|
|
|
Service Code
|
CPT 15260
|
| Hospital Charge Code |
76100560
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,546.63 |
| Max. Negotiated Rate |
$3,163.55 |
| Rate for Payer: Aetna American Axle |
$2,284.79
|
| Rate for Payer: Aetna Commercial |
$2,987.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,284.79
|
| Rate for Payer: Cash Price |
$2,812.05
|
| Rate for Payer: Cofinity Advantage |
$2,460.54
|
| Rate for Payer: Cofinity Commercial |
$3,022.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.05
|
| Rate for Payer: Healthscope Commercial |
$3,163.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,460.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,636.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,987.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.30
|
| Rate for Payer: PHP Commercial |
$2,987.80
|
| Rate for Payer: Priority Health SBD |
$2,214.49
|
| Rate for Payer: UMR Bronson Commercial |
$1,546.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,636.30
|
|
|
HC FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<
|
Facility
|
OP
|
$3,515.06
|
|
|
Service Code
|
CPT 15260
|
| Hospital Charge Code |
76100560
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,075.21 |
| Max. Negotiated Rate |
$6,648.46 |
| Rate for Payer: Aetna American Axle |
$2,284.79
|
| Rate for Payer: Aetna Commercial |
$2,987.80
|
| Rate for Payer: Aetna Medicare |
$2,138.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,284.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,569.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,569.82
|
| Rate for Payer: BCBS Complete |
$1,129.08
|
| Rate for Payer: BCBS MAPPO |
$2,055.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,725.85
|
| Rate for Payer: BCN Commercial |
$1,725.85
|
| Rate for Payer: BCN Medicare Advantage |
$2,055.86
|
| Rate for Payer: Cash Price |
$2,812.05
|
| Rate for Payer: Cash Price |
$2,812.05
|
| Rate for Payer: Cash Price |
$2,812.05
|
| Rate for Payer: Cofinity Advantage |
$2,460.54
|
| Rate for Payer: Cofinity Commercial |
$3,022.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,812.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,055.86
|
| Rate for Payer: Healthscope Commercial |
$3,163.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,460.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,636.30
|
| Rate for Payer: Mclaren Medicaid |
$2,055.86
|
| Rate for Payer: Mclaren Medicare |
$2,055.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,158.65
|
| Rate for Payer: Meridian Medicaid |
$2,158.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,364.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,261.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,987.80
|
| Rate for Payer: Nomi Health Commercial |
$6,167.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,636.30
|
| Rate for Payer: PACE Medicare |
$1,953.07
|
| Rate for Payer: PACE SWMI |
$2,055.86
|
| Rate for Payer: PHP Commercial |
$2,987.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,055.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,075.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,648.46
|
| Rate for Payer: Priority Health Medicare |
$2,055.86
|
| Rate for Payer: Priority Health SBD |
$2,214.49
|
| Rate for Payer: Priority Health Tiered Network |
$5,318.77
|
| Rate for Payer: Railroad Medicare Medicare |
$2,055.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,284.79
|
| Rate for Payer: UHC Core |
$1,831.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,055.86
|
| Rate for Payer: UHC Exchange |
$1,381.42
|
| Rate for Payer: UHC Medicaid |
$1,075.21
|
| Rate for Payer: UHCCP Medicaid |
$1,075.21
|
| Rate for Payer: UMR Bronson Commercial |
$1,300.57
|
| Rate for Payer: VA VA |
$2,055.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,636.30
|
|
|
HC F/U EP STUDY
|
Facility
|
IP
|
$5,725.83
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,519.37 |
| Max. Negotiated Rate |
$5,153.25 |
| Rate for Payer: Aetna American Axle |
$3,721.79
|
| Rate for Payer: Aetna Commercial |
$4,866.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,721.79
|
| Rate for Payer: Cash Price |
$4,580.66
|
| Rate for Payer: Cofinity Advantage |
$4,008.08
|
| Rate for Payer: Cofinity Commercial |
$4,924.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,580.66
|
| Rate for Payer: Healthscope Commercial |
$5,153.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,008.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,294.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,866.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,294.37
|
| Rate for Payer: PHP Commercial |
$4,866.96
|
| Rate for Payer: Priority Health SBD |
$3,607.27
|
| Rate for Payer: UMR Bronson Commercial |
$2,519.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,294.37
|
|
|
HC F/U EP STUDY
|
Facility
|
OP
|
$5,725.83
|
|
|
Service Code
|
CPT 93624
|
| Hospital Charge Code |
48100040
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,118.56 |
| Max. Negotiated Rate |
$25,132.71 |
| Rate for Payer: Aetna American Axle |
$3,721.79
|
| Rate for Payer: Aetna Commercial |
$4,866.96
|
| Rate for Payer: Aetna Medicare |
$8,082.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,721.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,714.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,714.52
|
| Rate for Payer: BCBS Complete |
$4,268.17
|
| Rate for Payer: BCBS MAPPO |
$7,771.62
|
| Rate for Payer: BCBS Trust/PPO |
$20,072.80
|
| Rate for Payer: BCN Commercial |
$20,072.80
|
| Rate for Payer: BCN Medicare Advantage |
$7,771.62
|
| Rate for Payer: Cash Price |
$4,580.66
|
| Rate for Payer: Cash Price |
$4,580.66
|
| Rate for Payer: Cofinity Advantage |
$4,008.08
|
| Rate for Payer: Cofinity Commercial |
$4,924.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,580.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,771.62
|
| Rate for Payer: Healthscope Commercial |
$5,153.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,008.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,294.37
|
| Rate for Payer: Mclaren Medicaid |
$7,771.62
|
| Rate for Payer: Mclaren Medicare |
$7,771.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,160.20
|
| Rate for Payer: Meridian Medicaid |
$8,160.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,937.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,548.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,866.96
|
| Rate for Payer: Nomi Health Commercial |
$23,314.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,294.37
|
| Rate for Payer: PACE Medicare |
$7,383.04
|
| Rate for Payer: PACE SWMI |
$7,771.62
|
| Rate for Payer: PHP Commercial |
$4,866.96
|
| Rate for Payer: PHP Medicare Advantage |
$7,771.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,064.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$25,132.71
|
| Rate for Payer: Priority Health Medicare |
$7,771.62
|
| Rate for Payer: Priority Health SBD |
$3,607.27
|
| Rate for Payer: Priority Health Tiered Network |
$20,106.17
|
| Rate for Payer: Railroad Medicare Medicare |
$7,771.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,771.62
|
| Rate for Payer: UHC Medicaid |
$4,064.56
|
| Rate for Payer: UHCCP Medicaid |
$4,064.56
|
| Rate for Payer: UMR Bronson Commercial |
$2,118.56
|
| Rate for Payer: VA VA |
$7,771.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,294.37
|
|
|
HC FUNC BACK EVAL
|
Facility
|
OP
|
$128.16
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$47.42 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$83.30
|
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: Aetna Medicare |
$64.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.30
|
| Rate for Payer: BCBS Complete |
$51.26
|
| Rate for Payer: Cash Price |
$102.53
|
| Rate for Payer: Cash Price |
$102.53
|
| Rate for Payer: Cofinity Advantage |
$89.71
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.53
|
| Rate for Payer: Healthscope Commercial |
$115.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.94
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.12
|
| Rate for Payer: PHP Commercial |
$108.94
|
| Rate for Payer: Priority Health SBD |
$80.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.30
|
| Rate for Payer: UHC Core |
$66.77
|
| Rate for Payer: UHC Exchange |
$50.37
|
| Rate for Payer: UMR Bronson Commercial |
$47.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.12
|
|
|
HC FUNC BACK EVAL
|
Facility
|
IP
|
$128.16
|
|
| Hospital Charge Code |
42400003
|
|
Hospital Revenue Code
|
424
|
| Min. Negotiated Rate |
$56.39 |
| Max. Negotiated Rate |
$115.34 |
| Rate for Payer: Aetna American Axle |
$83.30
|
| Rate for Payer: Aetna Commercial |
$108.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.30
|
| Rate for Payer: Cash Price |
$102.53
|
| Rate for Payer: Cofinity Advantage |
$89.71
|
| Rate for Payer: Cofinity Commercial |
$110.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.53
|
| Rate for Payer: Healthscope Commercial |
$115.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.12
|
| Rate for Payer: PHP Commercial |
$108.94
|
| Rate for Payer: Priority Health SBD |
$80.74
|
| Rate for Payer: UMR Bronson Commercial |
$56.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.12
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
IP
|
$68.77
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.26 |
| Max. Negotiated Rate |
$61.89 |
| Rate for Payer: Aetna American Axle |
$44.70
|
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.70
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cofinity Advantage |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$59.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.02
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.58
|
| Rate for Payer: PHP Commercial |
$58.45
|
| Rate for Payer: Priority Health SBD |
$43.33
|
| Rate for Payer: UMR Bronson Commercial |
$30.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.58
|
|
|
HC FUNGAL ID MOLD
|
Facility
|
OP
|
$68.77
|
|
|
Service Code
|
CPT 87107
|
| Hospital Charge Code |
30600085
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$61.89 |
| Rate for Payer: Aetna American Axle |
$44.70
|
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: Aetna Medicare |
$10.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: BCBS Complete |
$5.67
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$11.93
|
| Rate for Payer: BCN Commercial |
$11.93
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cofinity Advantage |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$59.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.58
|
| Rate for Payer: Mclaren Medicaid |
$10.32
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: Meridian Medicaid |
$10.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.45
|
| Rate for Payer: Nomi Health Commercial |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.58
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$58.45
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.32
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health SBD |
$43.33
|
| Rate for Payer: Priority Health Tiered Network |
$8.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.48
|
| Rate for Payer: UHC Core |
$15.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.32
|
| Rate for Payer: UHC Exchange |
$15.48
|
| Rate for Payer: UHC Medicaid |
$5.40
|
| Rate for Payer: UHCCP Medicaid |
$5.40
|
| Rate for Payer: UMR Bronson Commercial |
$25.44
|
| Rate for Payer: VA VA |
$10.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.58
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
IP
|
$68.77
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.26 |
| Max. Negotiated Rate |
$61.89 |
| Rate for Payer: Aetna American Axle |
$44.70
|
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.70
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cofinity Advantage |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$59.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.02
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.58
|
| Rate for Payer: PHP Commercial |
$58.45
|
| Rate for Payer: Priority Health SBD |
$43.33
|
| Rate for Payer: UMR Bronson Commercial |
$30.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.58
|
|
|
HC FUNGAL ID YEAST
|
Facility
|
OP
|
$68.77
|
|
|
Service Code
|
CPT 87106
|
| Hospital Charge Code |
30600084
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$61.89 |
| Rate for Payer: Aetna American Axle |
$44.70
|
| Rate for Payer: Aetna Commercial |
$58.45
|
| Rate for Payer: Aetna Medicare |
$10.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.90
|
| Rate for Payer: BCBS Complete |
$5.67
|
| Rate for Payer: BCBS MAPPO |
$10.32
|
| Rate for Payer: BCBS Trust/PPO |
$11.93
|
| Rate for Payer: BCN Commercial |
$11.93
|
| Rate for Payer: BCN Medicare Advantage |
$10.32
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cash Price |
$55.02
|
| Rate for Payer: Cofinity Advantage |
$48.14
|
| Rate for Payer: Cofinity Commercial |
$59.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.32
|
| Rate for Payer: Healthscope Commercial |
$61.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.58
|
| Rate for Payer: Mclaren Medicaid |
$10.32
|
| Rate for Payer: Mclaren Medicare |
$10.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.84
|
| Rate for Payer: Meridian Medicaid |
$10.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.45
|
| Rate for Payer: Nomi Health Commercial |
$15.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.58
|
| Rate for Payer: PACE Medicare |
$9.80
|
| Rate for Payer: PACE SWMI |
$10.32
|
| Rate for Payer: PHP Commercial |
$58.45
|
| Rate for Payer: PHP Medicare Advantage |
$10.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.32
|
| Rate for Payer: Priority Health Medicare |
$10.32
|
| Rate for Payer: Priority Health SBD |
$43.33
|
| Rate for Payer: Priority Health Tiered Network |
$8.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.48
|
| Rate for Payer: UHC Core |
$15.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.32
|
| Rate for Payer: UHC Exchange |
$15.48
|
| Rate for Payer: UHC Medicaid |
$5.40
|
| Rate for Payer: UHCCP Medicaid |
$5.40
|
| Rate for Payer: UMR Bronson Commercial |
$25.44
|
| Rate for Payer: VA VA |
$10.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.58
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC FUNGAL SEROLOGY SURVEY
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 87327
|
| Hospital Charge Code |
30600137
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$13.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.77
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$15.52
|
| Rate for Payer: BCN Commercial |
$15.52
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$20.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.42
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$10.74
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.13
|
| Rate for Payer: UHC Core |
$20.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.42
|
| Rate for Payer: UHC Exchange |
$20.13
|
| Rate for Payer: UHC Medicaid |
$7.02
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$13.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC FUNGAL SEROLOGY SURVEY CMPT1
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86612
|
| Hospital Charge Code |
30200229
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$13.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.12
|
| Rate for Payer: BCBS Complete |
$7.08
|
| Rate for Payer: BCBS MAPPO |
$12.90
|
| Rate for Payer: BCBS Trust/PPO |
$14.92
|
| Rate for Payer: BCN Commercial |
$14.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.90
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Advantage |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.90
|
| 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 |
$12.90
|
| Rate for Payer: Mclaren Medicare |
$12.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.54
|
| Rate for Payer: Meridian Medicaid |
$13.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$19.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.21
|
| Rate for Payer: PACE Medicare |
$12.26
|
| Rate for Payer: PACE SWMI |
$12.90
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$12.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.90
|
| Rate for Payer: Priority Health Medicare |
$12.90
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Priority Health Tiered Network |
$10.32
|
| Rate for Payer: Railroad Medicare Medicare |
$12.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.35
|
| Rate for Payer: UHC Core |
$19.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.90
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicaid |
$6.75
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$12.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
