|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.79 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna American Axle |
$35.14
|
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: UMR Bronson Commercial |
$23.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200147
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna American Axle |
$35.14
|
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$14.45
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.04
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$17.63
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.28
|
| Rate for Payer: UHC Core |
$26.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$16.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UMR Bronson Commercial |
$20.00
|
| Rate for Payer: VA VA |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna American Axle |
$34.48
|
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$14.45
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.04
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health Narrow Network |
$17.63
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.28
|
| Rate for Payer: UHC Core |
$26.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$16.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UMR Bronson Commercial |
$19.62
|
| Rate for Payer: VA VA |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.34 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna American Axle |
$34.48
|
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: UMR Bronson Commercial |
$23.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
IP
|
$276.60
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$121.70 |
| Max. Negotiated Rate |
$248.94 |
| Rate for Payer: Aetna American Axle |
$179.79
|
| Rate for Payer: Aetna Commercial |
$235.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.79
|
| Rate for Payer: Cash Price |
$221.28
|
| Rate for Payer: Cofinity Commercial |
$193.62
|
| Rate for Payer: Cofinity Commercial |
$237.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.28
|
| Rate for Payer: Healthscope Commercial |
$248.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.11
|
| Rate for Payer: PHP Commercial |
$235.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.62
|
| Rate for Payer: Priority Health SBD |
$174.26
|
| Rate for Payer: UMR Bronson Commercial |
$121.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.45
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
OP
|
$276.60
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$248.94 |
| Rate for Payer: Aetna American Axle |
$179.79
|
| Rate for Payer: Aetna Commercial |
$235.11
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.79
|
| 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 |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$8.13
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$221.28
|
| Rate for Payer: Cash Price |
$221.28
|
| Rate for Payer: Cofinity Commercial |
$193.62
|
| Rate for Payer: Cofinity Commercial |
$237.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$248.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.45
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$235.11
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$235.11
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$193.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.53
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$13.22
|
| Rate for Payer: Priority Health SBD |
$174.26
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Core |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: UMR Bronson Commercial |
$102.34
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.45
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$90.64 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna American Axle |
$133.90
|
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.90
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$144.20
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.10
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health SBD |
$129.78
|
| Rate for Payer: UMR Bronson Commercial |
$90.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
OP
|
$206.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna American Axle |
$133.90
|
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.90
|
| 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 |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$8.13
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Cofinity Commercial |
$144.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.10
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.53
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$13.22
|
| Rate for Payer: Priority Health SBD |
$129.78
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Core |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: UMR Bronson Commercial |
$76.22
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$90.64 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna American Axle |
$133.90
|
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.90
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$144.20
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.10
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health SBD |
$129.78
|
| Rate for Payer: UMR Bronson Commercial |
$90.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
OP
|
$206.00
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna American Axle |
$133.90
|
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.90
|
| 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 |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$8.13
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$144.20
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Mclaren Medicaid |
$6.59
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Medicaid |
$6.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$175.10
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$144.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.53
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health Narrow Network |
$13.22
|
| Rate for Payer: Priority Health SBD |
$129.78
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.46
|
| Rate for Payer: UHC Core |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$12.05
|
| Rate for Payer: UHC Medicare Advantage |
$12.41
|
| Rate for Payer: UMR Bronson Commercial |
$76.22
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
IP
|
$20.40
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: UMR Bronson Commercial |
$8.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
OP
|
$20.40
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$18.36 |
| Rate for Payer: Aetna American Axle |
$13.26
|
| Rate for Payer: Aetna Commercial |
$17.34
|
| Rate for Payer: Aetna Medicare |
$4.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.92
|
| Rate for Payer: BCBS Complete |
$2.72
|
| Rate for Payer: BCBS MAPPO |
$4.74
|
| Rate for Payer: BCN Medicare Advantage |
$4.74
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cash Price |
$16.32
|
| Rate for Payer: Cofinity Commercial |
$14.28
|
| Rate for Payer: Cofinity Commercial |
$17.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.74
|
| Rate for Payer: Healthscope Commercial |
$18.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
| Rate for Payer: Mclaren Medicaid |
$2.59
|
| Rate for Payer: Mclaren Medicare |
$4.74
|
| Rate for Payer: Meridian Medicaid |
$2.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
| Rate for Payer: PACE Medicare |
$4.50
|
| Rate for Payer: PACE SWMI |
$4.74
|
| Rate for Payer: PHP Commercial |
$17.34
|
| Rate for Payer: PHP Medicare Advantage |
$4.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.65
|
| Rate for Payer: Priority Health Medicare |
$4.74
|
| Rate for Payer: Priority Health Narrow Network |
$4.52
|
| Rate for Payer: Priority Health SBD |
$12.85
|
| Rate for Payer: Railroad Medicare Medicare |
$4.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.69
|
| Rate for Payer: UHC Core |
$7.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.74
|
| Rate for Payer: UHC Exchange |
$4.74
|
| Rate for Payer: UHC Medicare Advantage |
$4.88
|
| Rate for Payer: UMR Bronson Commercial |
$7.55
|
| Rate for Payer: VA VA |
$4.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
OP
|
$51.90
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.16 |
| Max. Negotiated Rate |
$46.71 |
| Rate for Payer: Aetna American Axle |
$33.74
|
| Rate for Payer: Aetna Commercial |
$44.12
|
| Rate for Payer: Aetna Medicare |
$6.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.22
|
| Rate for Payer: BCBS Complete |
$3.32
|
| Rate for Payer: BCBS MAPPO |
$5.78
|
| Rate for Payer: BCBS Trust/PPO |
$5.20
|
| Rate for Payer: BCN Medicare Advantage |
$5.78
|
| Rate for Payer: Cash Price |
$41.52
|
| Rate for Payer: Cash Price |
$41.52
|
| Rate for Payer: Cofinity Commercial |
$36.33
|
| Rate for Payer: Cofinity Commercial |
$44.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.78
|
| Rate for Payer: Healthscope Commercial |
$46.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.92
|
| Rate for Payer: Mclaren Medicaid |
$3.16
|
| Rate for Payer: Mclaren Medicare |
$5.78
|
| Rate for Payer: Meridian Medicaid |
$3.32
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.12
|
| Rate for Payer: PACE Medicare |
$5.49
|
| Rate for Payer: PACE SWMI |
$5.78
|
| Rate for Payer: PHP Commercial |
$44.12
|
| Rate for Payer: PHP Medicare Advantage |
$5.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.65
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow Network |
$4.52
|
| Rate for Payer: Priority Health SBD |
$32.70
|
| Rate for Payer: Railroad Medicare Medicare |
$5.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.94
|
| Rate for Payer: UHC Core |
$8.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.78
|
| Rate for Payer: UHC Exchange |
$5.78
|
| Rate for Payer: UHC Medicare Advantage |
$5.95
|
| Rate for Payer: UMR Bronson Commercial |
$19.20
|
| Rate for Payer: VA VA |
$5.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.92
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
IP
|
$51.90
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.84 |
| Max. Negotiated Rate |
$46.71 |
| Rate for Payer: Aetna American Axle |
$33.74
|
| Rate for Payer: Aetna Commercial |
$44.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.74
|
| Rate for Payer: Cash Price |
$41.52
|
| Rate for Payer: Cofinity Commercial |
$36.33
|
| Rate for Payer: Cofinity Commercial |
$44.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.52
|
| Rate for Payer: Healthscope Commercial |
$46.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$44.12
|
| Rate for Payer: PHP Commercial |
$44.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.33
|
| Rate for Payer: Priority Health SBD |
$32.70
|
| Rate for Payer: UMR Bronson Commercial |
$22.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.92
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$40.39 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna American Axle |
$59.67
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: UMR Bronson Commercial |
$40.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$59.67
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS Trust/PPO |
$23.69
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.00
|
| Rate for Payer: Priority Health Narrow Network |
$23.20
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.74
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$33.40
|
| Rate for Payer: UMR Bronson Commercial |
$33.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC PICC INTRODUCER
|
Facility
|
IP
|
$96.39
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$42.41 |
| Max. Negotiated Rate |
$86.75 |
| Rate for Payer: Aetna American Axle |
$62.65
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.65
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.93
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.47
|
| Rate for Payer: Priority Health SBD |
$60.73
|
| Rate for Payer: UMR Bronson Commercial |
$42.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.29
|
|
|
HC PICC INTRODUCER
|
Facility
|
OP
|
$96.39
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.66 |
| Max. Negotiated Rate |
$86.75 |
| Rate for Payer: Aetna American Axle |
$62.65
|
| Rate for Payer: Aetna Commercial |
$81.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.65
|
| Rate for Payer: BCBS Complete |
$38.56
|
| Rate for Payer: Cash Price |
$77.11
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Cofinity Commercial |
$82.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.11
|
| Rate for Payer: Healthscope Commercial |
$86.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.93
|
| Rate for Payer: PHP Commercial |
$81.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.47
|
| Rate for Payer: Priority Health SBD |
$60.73
|
| Rate for Payer: UMR Bronson Commercial |
$35.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.29
|
|
|
HC PICU 30" NITROUS OXIDE SED RECOVERY
|
Facility
|
OP
|
$110.38
|
|
| Hospital Charge Code |
37000019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$40.84 |
| Max. Negotiated Rate |
$99.34 |
| Rate for Payer: Aetna American Axle |
$71.75
|
| Rate for Payer: Aetna Commercial |
$93.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.75
|
| Rate for Payer: BCBS Complete |
$44.15
|
| Rate for Payer: Cash Price |
$88.30
|
| Rate for Payer: Cofinity Commercial |
$77.27
|
| Rate for Payer: Cofinity Commercial |
$94.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.30
|
| Rate for Payer: Healthscope Commercial |
$99.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.82
|
| Rate for Payer: PHP Commercial |
$93.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.27
|
| Rate for Payer: Priority Health SBD |
$69.54
|
| Rate for Payer: UMR Bronson Commercial |
$40.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.78
|
|
|
HC PICU 30" NITROUS OXIDE SED RECOVERY
|
Facility
|
IP
|
$110.38
|
|
| Hospital Charge Code |
37000019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$48.57 |
| Max. Negotiated Rate |
$99.34 |
| Rate for Payer: Aetna American Axle |
$71.75
|
| Rate for Payer: Aetna Commercial |
$93.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.75
|
| Rate for Payer: Cash Price |
$88.30
|
| Rate for Payer: Cofinity Commercial |
$77.27
|
| Rate for Payer: Cofinity Commercial |
$94.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.30
|
| Rate for Payer: Healthscope Commercial |
$99.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.82
|
| Rate for Payer: PHP Commercial |
$93.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.27
|
| Rate for Payer: Priority Health SBD |
$69.54
|
| Rate for Payer: UMR Bronson Commercial |
$48.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.78
|
|
|
HC PICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$186.06
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200017
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$81.87 |
| Max. Negotiated Rate |
$167.45 |
| Rate for Payer: Aetna American Axle |
$120.94
|
| Rate for Payer: Aetna Commercial |
$158.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.94
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cofinity Commercial |
$130.24
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.85
|
| Rate for Payer: Healthscope Commercial |
$167.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.15
|
| Rate for Payer: PHP Commercial |
$158.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.24
|
| Rate for Payer: Priority Health SBD |
$117.22
|
| Rate for Payer: UMR Bronson Commercial |
$81.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.54
|
|
|
HC PICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$186.06
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200017
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$68.84 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$120.94
|
| Rate for Payer: Aetna Commercial |
$158.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.94
|
| Rate for Payer: BCBS Complete |
$74.42
|
| Rate for Payer: BCBS Trust/PPO |
$118.88
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cash Price |
$148.85
|
| Rate for Payer: Cofinity Commercial |
$130.24
|
| Rate for Payer: Cofinity Commercial |
$160.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$148.85
|
| Rate for Payer: Healthscope Commercial |
$167.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$130.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$139.54
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$158.15
|
| Rate for Payer: PHP Commercial |
$158.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.24
|
| Rate for Payer: Priority Health SBD |
$117.22
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$68.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$139.54
|
|
|
HC PICU OR PED CRITICAL CARE R&B
|
Facility
|
IP
|
$7,648.92
|
|
| Hospital Charge Code |
20300001
|
|
Hospital Revenue Code
|
203
|
| Min. Negotiated Rate |
$3,365.52 |
| Max. Negotiated Rate |
$6,884.03 |
| Rate for Payer: Aetna American Axle |
$4,971.80
|
| Rate for Payer: Aetna Commercial |
$6,501.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,971.80
|
| Rate for Payer: Cash Price |
$6,119.14
|
| Rate for Payer: Cofinity Commercial |
$5,354.24
|
| Rate for Payer: Cofinity Commercial |
$6,578.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,119.14
|
| Rate for Payer: Healthscope Commercial |
$6,884.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,354.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,736.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,501.58
|
| Rate for Payer: PHP Commercial |
$6,501.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,354.24
|
| Rate for Payer: Priority Health SBD |
$4,818.82
|
| Rate for Payer: UMR Bronson Commercial |
$3,365.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,736.69
|
|
|
HC PICU OR PED INTERMEDIATE CARE R&B
|
Facility
|
IP
|
$6,382.60
|
|
| Hospital Charge Code |
20600002
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$2,808.34 |
| Max. Negotiated Rate |
$5,744.34 |
| Rate for Payer: Aetna American Axle |
$4,148.69
|
| Rate for Payer: Aetna Commercial |
$5,425.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,148.69
|
| Rate for Payer: Cash Price |
$5,106.08
|
| Rate for Payer: Cofinity Commercial |
$4,467.82
|
| Rate for Payer: Cofinity Commercial |
$5,489.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,106.08
|
| Rate for Payer: Healthscope Commercial |
$5,744.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,467.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,786.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,425.21
|
| Rate for Payer: PHP Commercial |
$5,425.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,467.82
|
| Rate for Payer: Priority Health SBD |
$4,021.04
|
| Rate for Payer: UMR Bronson Commercial |
$2,808.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,786.95
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
OP
|
$308.88
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$114.29 |
| Max. Negotiated Rate |
$277.99 |
| Rate for Payer: Aetna American Axle |
$200.77
|
| Rate for Payer: Aetna Commercial |
$262.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.77
|
| Rate for Payer: BCBS Complete |
$123.55
|
| Rate for Payer: Cash Price |
$247.10
|
| Rate for Payer: Cofinity Commercial |
$216.22
|
| Rate for Payer: Cofinity Commercial |
$265.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.10
|
| Rate for Payer: Healthscope Commercial |
$277.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$262.55
|
| Rate for Payer: PHP Commercial |
$262.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.22
|
| Rate for Payer: Priority Health SBD |
$194.59
|
| Rate for Payer: UMR Bronson Commercial |
$114.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.66
|
|
