|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
OP
|
$905.11
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$334.89 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$588.32
|
| Rate for Payer: Aetna Commercial |
$769.34
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,456.83
|
| Rate for Payer: BCN Commercial |
$1,456.83
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cofinity Advantage |
$633.58
|
| Rate for Payer: Cofinity Commercial |
$778.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$814.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$633.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.83
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$769.34
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$678.83
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$769.34
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$570.22
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$334.89
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.83
|
|
|
HC GI REPLAC D OR J TUBE W F
|
Facility
|
IP
|
$905.11
|
|
|
Service Code
|
CPT 49451
|
| Hospital Charge Code |
36100230
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$398.25 |
| Max. Negotiated Rate |
$814.60 |
| Rate for Payer: Aetna American Axle |
$588.32
|
| Rate for Payer: Aetna Commercial |
$769.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$588.32
|
| Rate for Payer: Cash Price |
$724.09
|
| Rate for Payer: Cofinity Advantage |
$633.58
|
| Rate for Payer: Cofinity Commercial |
$778.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$724.09
|
| Rate for Payer: Healthscope Commercial |
$814.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$633.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$769.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$678.83
|
| Rate for Payer: PHP Commercial |
$769.34
|
| Rate for Payer: Priority Health SBD |
$570.22
|
| Rate for Payer: UMR Bronson Commercial |
$398.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.83
|
|
|
HC GI REPLAC GJ TUBE W FLUOR
|
Facility
|
IP
|
$931.73
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$409.96 |
| Max. Negotiated Rate |
$838.56 |
| Rate for Payer: Aetna American Axle |
$605.62
|
| Rate for Payer: Aetna Commercial |
$791.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.62
|
| Rate for Payer: Cash Price |
$745.38
|
| Rate for Payer: Cofinity Advantage |
$652.21
|
| Rate for Payer: Cofinity Commercial |
$801.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.38
|
| Rate for Payer: Healthscope Commercial |
$838.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$652.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$698.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$791.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$698.80
|
| Rate for Payer: PHP Commercial |
$791.97
|
| Rate for Payer: Priority Health SBD |
$586.99
|
| Rate for Payer: UMR Bronson Commercial |
$409.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$698.80
|
|
|
HC GI REPLAC GJ TUBE W FLUOR
|
Facility
|
OP
|
$931.73
|
|
|
Service Code
|
CPT 49452
|
| Hospital Charge Code |
36100231
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$344.74 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$605.62
|
| Rate for Payer: Aetna Commercial |
$791.97
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$605.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,118.57
|
| Rate for Payer: BCN Commercial |
$1,118.57
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$745.38
|
| Rate for Payer: Cash Price |
$745.38
|
| Rate for Payer: Cash Price |
$745.38
|
| Rate for Payer: Cofinity Advantage |
$652.21
|
| Rate for Payer: Cofinity Commercial |
$801.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$745.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$838.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$652.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$698.80
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$791.97
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$698.80
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$791.97
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$586.99
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$344.74
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$698.80
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
IP
|
$959.13
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$422.02 |
| Max. Negotiated Rate |
$863.22 |
| Rate for Payer: Aetna American Axle |
$623.43
|
| Rate for Payer: Aetna Commercial |
$815.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.43
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Advantage |
$671.39
|
| Rate for Payer: Cofinity Commercial |
$824.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Healthscope Commercial |
$863.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$671.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$719.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$815.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$719.35
|
| Rate for Payer: PHP Commercial |
$815.26
|
| Rate for Payer: Priority Health SBD |
$604.25
|
| Rate for Payer: UMR Bronson Commercial |
$422.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$719.35
|
|
|
HC GI REPLAC G OR EC TUBE W
|
Facility
|
OP
|
$959.13
|
|
|
Service Code
|
CPT 49450
|
| Hospital Charge Code |
36100229
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$354.88 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$623.43
|
| Rate for Payer: Aetna Commercial |
$815.26
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$623.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,224.45
|
| Rate for Payer: BCN Commercial |
$1,224.45
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cash Price |
$767.30
|
| Rate for Payer: Cofinity Advantage |
$671.39
|
| Rate for Payer: Cofinity Commercial |
$824.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$767.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$863.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$671.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$719.35
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$815.26
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$719.35
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$815.26
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$604.25
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$354.88
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$719.35
|
|
|
HC GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
OP
|
$1,251.04
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$462.88 |
| Max. Negotiated Rate |
$2,922.56 |
| Rate for Payer: Aetna American Axle |
$813.18
|
| Rate for Payer: Aetna Commercial |
$1,063.38
|
| Rate for Payer: Aetna Medicare |
$939.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,129.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,129.65
|
| Rate for Payer: BCBS Complete |
$496.32
|
| Rate for Payer: BCBS MAPPO |
$903.72
|
| Rate for Payer: BCN Medicare Advantage |
$903.72
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cofinity Advantage |
$875.73
|
| Rate for Payer: Cofinity Commercial |
$1,075.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$903.72
|
| Rate for Payer: Healthscope Commercial |
$1,125.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$875.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$938.28
|
| Rate for Payer: Mclaren Medicaid |
$903.72
|
| Rate for Payer: Mclaren Medicare |
$903.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$948.91
|
| Rate for Payer: Meridian Medicaid |
$948.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,039.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$994.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.38
|
| Rate for Payer: Nomi Health Commercial |
$2,711.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$938.28
|
| Rate for Payer: PACE Medicare |
$858.53
|
| Rate for Payer: PACE SWMI |
$903.72
|
| Rate for Payer: PHP Commercial |
$1,063.38
|
| Rate for Payer: PHP Medicare Advantage |
$903.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$472.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,922.56
|
| Rate for Payer: Priority Health Medicare |
$903.72
|
| Rate for Payer: Priority Health SBD |
$788.16
|
| Rate for Payer: Priority Health Tiered Network |
$2,338.05
|
| Rate for Payer: Railroad Medicare Medicare |
$903.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$903.72
|
| Rate for Payer: UHC Medicaid |
$472.65
|
| Rate for Payer: UHCCP Medicaid |
$472.65
|
| Rate for Payer: UMR Bronson Commercial |
$462.88
|
| Rate for Payer: VA VA |
$903.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$938.28
|
|
|
HC GI TRANSIT WIRELESS CAPSULE STOMACH TO COLON
|
Facility
|
IP
|
$1,251.04
|
|
|
Service Code
|
CPT 91112
|
| Hospital Charge Code |
75000010
|
|
Hospital Revenue Code
|
750
|
| Min. Negotiated Rate |
$550.46 |
| Max. Negotiated Rate |
$1,125.94 |
| Rate for Payer: Aetna American Axle |
$813.18
|
| Rate for Payer: Aetna Commercial |
$1,063.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$813.18
|
| Rate for Payer: Cash Price |
$1,000.83
|
| Rate for Payer: Cofinity Advantage |
$875.73
|
| Rate for Payer: Cofinity Commercial |
$1,075.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.83
|
| Rate for Payer: Healthscope Commercial |
$1,125.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$875.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$938.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,063.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$938.28
|
| Rate for Payer: PHP Commercial |
$1,063.38
|
| Rate for Payer: Priority Health SBD |
$788.16
|
| Rate for Payer: UMR Bronson Commercial |
$550.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$938.28
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$16.34 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna American Axle |
$24.14
|
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Advantage |
$26.00
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: Priority Health SBD |
$23.40
|
| Rate for Payer: UMR Bronson Commercial |
$16.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC GLIADIN AB DEAMINATED IGA
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200007
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna American Axle |
$24.14
|
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Advantage |
$26.00
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$23.40
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: UMR Bronson Commercial |
$13.74
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC GLIADIN AB DEAMINATED IGG
|
Facility
|
OP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna American Axle |
$18.84
|
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$18.26
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: UMR Bronson Commercial |
$10.72
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC GLIADIN AB DEAMINATED IGG
|
Facility
|
IP
|
$28.98
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200009
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$26.08 |
| Rate for Payer: Aetna American Axle |
$18.84
|
| Rate for Payer: Aetna Commercial |
$24.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.84
|
| Rate for Payer: Cash Price |
$23.18
|
| Rate for Payer: Cofinity Advantage |
$20.29
|
| Rate for Payer: Cofinity Commercial |
$24.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.18
|
| Rate for Payer: Healthscope Commercial |
$26.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.73
|
| Rate for Payer: PHP Commercial |
$24.63
|
| Rate for Payer: Priority Health SBD |
$18.26
|
| Rate for Payer: UMR Bronson Commercial |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.73
|
|
|
HC GLIADIN (DEAMIDATED) AB, IGA OR IGG, S
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
30200509
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.43 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna American Axle |
$33.14
|
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.14
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Advantage |
$35.69
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.23
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: Priority Health SBD |
$32.12
|
| Rate for Payer: UMR Bronson Commercial |
$22.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
|
HC GLIADIN (DEAMIDATED) AB, IGA OR IGG, S
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 86258
|
| Hospital Charge Code |
30200509
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna American Axle |
$33.14
|
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.93
|
| Rate for Payer: BCN Commercial |
$13.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Advantage |
$35.69
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.23
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.23
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$32.12
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.23
|
|
|
HC GLIDEWIRE EXCHANGE
|
Facility
|
IP
|
$315.42
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$138.78 |
| Max. Negotiated Rate |
$283.88 |
| Rate for Payer: Aetna American Axle |
$205.02
|
| Rate for Payer: Aetna Commercial |
$268.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.02
|
| Rate for Payer: Cash Price |
$252.34
|
| Rate for Payer: Cofinity Advantage |
$220.79
|
| Rate for Payer: Cofinity Commercial |
$271.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.34
|
| Rate for Payer: Healthscope Commercial |
$283.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.56
|
| Rate for Payer: PHP Commercial |
$268.11
|
| Rate for Payer: Priority Health SBD |
$198.71
|
| Rate for Payer: UMR Bronson Commercial |
$138.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.56
|
|
|
HC GLIDEWIRE EXCHANGE
|
Facility
|
OP
|
$315.42
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$116.71 |
| Max. Negotiated Rate |
$283.88 |
| Rate for Payer: Aetna American Axle |
$205.02
|
| Rate for Payer: Aetna Commercial |
$268.11
|
| Rate for Payer: Aetna Medicare |
$157.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.02
|
| Rate for Payer: BCBS Complete |
$126.17
|
| Rate for Payer: Cash Price |
$252.34
|
| Rate for Payer: Cofinity Advantage |
$220.79
|
| Rate for Payer: Cofinity Commercial |
$271.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.34
|
| Rate for Payer: Healthscope Commercial |
$283.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.56
|
| Rate for Payer: PHP Commercial |
$268.11
|
| Rate for Payer: Priority Health SBD |
$198.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$205.02
|
| Rate for Payer: UHC Core |
$164.33
|
| Rate for Payer: UHC Exchange |
$123.96
|
| Rate for Payer: UMR Bronson Commercial |
$116.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.56
|
|
|
HC GLUC 6 PHOS DEHYDROGENASE
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
30100228
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.07 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna American Axle |
$35.84
|
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna Medicare |
$10.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.12
|
| Rate for Payer: BCBS Complete |
$5.33
|
| Rate for Payer: BCBS MAPPO |
$9.70
|
| Rate for Payer: BCBS Trust/PPO |
$11.22
|
| Rate for Payer: BCN Commercial |
$11.22
|
| Rate for Payer: BCN Medicare Advantage |
$9.70
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Advantage |
$38.60
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.70
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: Mclaren Medicaid |
$9.70
|
| Rate for Payer: Mclaren Medicare |
$9.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.19
|
| Rate for Payer: Meridian Medicaid |
$10.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Nomi Health Commercial |
$14.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.35
|
| Rate for Payer: PACE Medicare |
$9.21
|
| Rate for Payer: PACE SWMI |
$9.70
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: PHP Medicare Advantage |
$9.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.70
|
| Rate for Payer: Priority Health Medicare |
$9.70
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: Priority Health Tiered Network |
$7.76
|
| Rate for Payer: Railroad Medicare Medicare |
$9.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.55
|
| Rate for Payer: UHC Core |
$14.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.70
|
| Rate for Payer: UHC Exchange |
$14.55
|
| Rate for Payer: UHC Medicaid |
$5.07
|
| Rate for Payer: UHCCP Medicaid |
$5.07
|
| Rate for Payer: UMR Bronson Commercial |
$20.40
|
| Rate for Payer: VA VA |
$9.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
|
HC GLUC 6 PHOS DEHYDROGENASE
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 82955
|
| Hospital Charge Code |
30100228
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna American Axle |
$35.84
|
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Advantage |
$38.60
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.35
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: UMR Bronson Commercial |
$24.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
|
HC GLUCAGON LEVEL
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
30100221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna American Axle |
$54.78
|
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Advantage |
$58.99
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.20
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: UMR Bronson Commercial |
$37.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC GLUCAGON LEVEL
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 82943
|
| Hospital Charge Code |
30100221
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.47 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna American Axle |
$54.78
|
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$14.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.86
|
| Rate for Payer: BCBS Complete |
$7.85
|
| Rate for Payer: BCBS MAPPO |
$14.29
|
| Rate for Payer: BCBS Trust/PPO |
$16.52
|
| Rate for Payer: BCN Commercial |
$16.52
|
| Rate for Payer: BCN Medicare Advantage |
$14.29
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Advantage |
$58.99
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.29
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Mclaren Medicaid |
$14.29
|
| Rate for Payer: Mclaren Medicare |
$14.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.00
|
| Rate for Payer: Meridian Medicaid |
$15.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$21.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.20
|
| Rate for Payer: PACE Medicare |
$13.58
|
| Rate for Payer: PACE SWMI |
$14.29
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: PHP Medicare Advantage |
$14.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.29
|
| Rate for Payer: Priority Health Medicare |
$14.29
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: Priority Health Tiered Network |
$11.43
|
| Rate for Payer: Railroad Medicare Medicare |
$14.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.44
|
| Rate for Payer: UHC Core |
$21.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.29
|
| Rate for Payer: UHC Exchange |
$21.44
|
| Rate for Payer: UHC Medicaid |
$7.47
|
| Rate for Payer: UHCCP Medicaid |
$7.47
|
| Rate for Payer: UMR Bronson Commercial |
$31.18
|
| Rate for Payer: VA VA |
$14.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC GLUCEPTATE PER STUDY
|
Facility
|
IP
|
$138.70
|
|
|
Service Code
|
HCPCS A9550
|
| Hospital Charge Code |
34300008
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$61.03 |
| Max. Negotiated Rate |
$124.83 |
| Rate for Payer: Aetna American Axle |
$90.16
|
| Rate for Payer: Aetna Commercial |
$117.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.16
|
| Rate for Payer: Cash Price |
$110.96
|
| Rate for Payer: Cofinity Advantage |
$97.09
|
| Rate for Payer: Cofinity Commercial |
$119.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.96
|
| Rate for Payer: Healthscope Commercial |
$124.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.03
|
| Rate for Payer: PHP Commercial |
$117.89
|
| Rate for Payer: Priority Health SBD |
$87.38
|
| Rate for Payer: UMR Bronson Commercial |
$61.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.03
|
|
|
HC GLUCEPTATE PER STUDY
|
Facility
|
OP
|
$138.70
|
|
|
Service Code
|
HCPCS A9550
|
| Hospital Charge Code |
34300008
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$51.32 |
| Max. Negotiated Rate |
$124.83 |
| Rate for Payer: Aetna American Axle |
$90.16
|
| Rate for Payer: Aetna Commercial |
$117.89
|
| Rate for Payer: Aetna Medicare |
$69.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.16
|
| Rate for Payer: BCBS Complete |
$55.48
|
| Rate for Payer: BCBS Trust/PPO |
$71.89
|
| Rate for Payer: BCN Commercial |
$71.89
|
| Rate for Payer: Cash Price |
$110.96
|
| Rate for Payer: Cash Price |
$110.96
|
| Rate for Payer: Cofinity Advantage |
$97.09
|
| Rate for Payer: Cofinity Commercial |
$119.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.96
|
| Rate for Payer: Healthscope Commercial |
$124.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.03
|
| Rate for Payer: PHP Commercial |
$117.89
|
| Rate for Payer: Priority Health SBD |
$87.38
|
| Rate for Payer: UMR Bronson Commercial |
$51.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.03
|
|
|
HC GLUCOSE (ADDITIONAL).
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
30100227
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC GLUCOSE (ADDITIONAL).
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 82952
|
| Hospital Charge Code |
30100227
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.05 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$4.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.90
|
| Rate for Payer: BCBS Complete |
$2.15
|
| Rate for Payer: BCBS MAPPO |
$3.92
|
| Rate for Payer: BCBS Trust/PPO |
$4.53
|
| Rate for Payer: BCN Commercial |
$4.53
|
| Rate for Payer: BCN Medicare Advantage |
$3.92
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.92
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$3.92
|
| Rate for Payer: Mclaren Medicare |
$3.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.12
|
| Rate for Payer: Meridian Medicaid |
$4.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$5.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$3.72
|
| Rate for Payer: PACE SWMI |
$3.92
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.92
|
| Rate for Payer: Priority Health Medicare |
$3.92
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$3.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.88
|
| Rate for Payer: UHC Core |
$5.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.92
|
| Rate for Payer: UHC Exchange |
$5.88
|
| Rate for Payer: UHC Medicaid |
$2.05
|
| Rate for Payer: UHCCP Medicaid |
$2.05
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$3.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC GLUCOSE BODY FLUID NOT BLOOD
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 82945
|
| Hospital Charge Code |
30100222
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.06 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$4.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.91
|
| Rate for Payer: BCBS Complete |
$2.16
|
| Rate for Payer: BCBS MAPPO |
$3.93
|
| Rate for Payer: BCBS Trust/PPO |
$4.55
|
| Rate for Payer: BCN Commercial |
$4.55
|
| Rate for Payer: BCN Medicare Advantage |
$3.93
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.93
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$3.93
|
| Rate for Payer: Mclaren Medicare |
$3.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.13
|
| Rate for Payer: Meridian Medicaid |
$4.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$5.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$3.73
|
| Rate for Payer: PACE SWMI |
$3.93
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.93
|
| Rate for Payer: Priority Health Medicare |
$3.93
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$3.14
|
| Rate for Payer: Railroad Medicare Medicare |
$3.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.90
|
| Rate for Payer: UHC Core |
$5.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.93
|
| Rate for Payer: UHC Exchange |
$5.90
|
| Rate for Payer: UHC Medicaid |
$2.06
|
| Rate for Payer: UHCCP Medicaid |
$2.06
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$3.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
