|
HC HEPARIN NEUTRALIZATION
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
30500050
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.19 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna American Axle |
$30.71
|
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna Medicare |
$12.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.80
|
| Rate for Payer: BCBS Complete |
$6.50
|
| Rate for Payer: BCBS MAPPO |
$11.84
|
| Rate for Payer: BCBS Trust/PPO |
$13.69
|
| Rate for Payer: BCN Commercial |
$13.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.84
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Advantage |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.84
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Mclaren Medicaid |
$11.84
|
| Rate for Payer: Mclaren Medicare |
$11.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.43
|
| Rate for Payer: Meridian Medicaid |
$12.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$17.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PACE Medicare |
$11.25
|
| Rate for Payer: PACE SWMI |
$11.84
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.84
|
| Rate for Payer: Priority Health Medicare |
$11.84
|
| Rate for Payer: Priority Health SBD |
$29.76
|
| Rate for Payer: Priority Health Tiered Network |
$9.47
|
| Rate for Payer: Railroad Medicare Medicare |
$11.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.76
|
| Rate for Payer: UHC Core |
$17.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.84
|
| Rate for Payer: UHC Exchange |
$17.76
|
| Rate for Payer: UHC Medicaid |
$6.19
|
| Rate for Payer: UHCCP Medicaid |
$6.19
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
| Rate for Payer: VA VA |
$11.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC HEPARIN NEUTRALIZATION
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
30500050
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna American Axle |
$30.71
|
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Advantage |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: Priority Health SBD |
$29.76
|
| Rate for Payer: UMR Bronson Commercial |
$20.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC HEPARIN PF4 AB HIT
|
Facility
|
OP
|
$249.38
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200392
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$224.44 |
| Rate for Payer: Aetna American Axle |
$162.10
|
| Rate for Payer: Aetna Commercial |
$211.97
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$21.24
|
| Rate for Payer: BCN Commercial |
$21.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$199.50
|
| Rate for Payer: Cash Price |
$199.50
|
| Rate for Payer: Cofinity Advantage |
$174.57
|
| Rate for Payer: Cofinity Commercial |
$214.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$224.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.03
|
| Rate for Payer: Mclaren Medicaid |
$18.37
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.97
|
| Rate for Payer: Nomi Health Commercial |
$27.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.03
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$211.97
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$157.11
|
| Rate for Payer: Priority Health Tiered Network |
$14.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Core |
$27.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$27.56
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$92.27
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.03
|
|
|
HC HEPARIN PF4 AB HIT
|
Facility
|
IP
|
$249.38
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200392
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$109.73 |
| Max. Negotiated Rate |
$224.44 |
| Rate for Payer: Aetna American Axle |
$162.10
|
| Rate for Payer: Aetna Commercial |
$211.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.10
|
| Rate for Payer: Cash Price |
$199.50
|
| Rate for Payer: Cofinity Advantage |
$174.57
|
| Rate for Payer: Cofinity Commercial |
$214.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.50
|
| Rate for Payer: Healthscope Commercial |
$224.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$174.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$187.03
|
| Rate for Payer: PHP Commercial |
$211.97
|
| Rate for Payer: Priority Health SBD |
$157.11
|
| Rate for Payer: UMR Bronson Commercial |
$109.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.03
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
30100018
|
|
Hospital Revenue Code
|
301
|
| 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 HEPATIC FUNCTION PANEL
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
30100018
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.27 |
| 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 |
$8.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.21
|
| Rate for Payer: BCBS Complete |
$4.49
|
| Rate for Payer: BCBS MAPPO |
$8.17
|
| Rate for Payer: BCBS Trust/PPO |
$11.70
|
| Rate for Payer: BCN Commercial |
$11.70
|
| Rate for Payer: BCN Medicare Advantage |
$8.17
|
| 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 |
$8.17
|
| 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 |
$8.17
|
| Rate for Payer: Mclaren Medicare |
$8.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.58
|
| Rate for Payer: Meridian Medicaid |
$8.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$12.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$7.76
|
| Rate for Payer: PACE SWMI |
$8.17
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$8.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.17
|
| Rate for Payer: Priority Health Medicare |
$8.17
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$6.54
|
| Rate for Payer: Railroad Medicare Medicare |
$8.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.26
|
| Rate for Payer: UHC Core |
$12.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.17
|
| Rate for Payer: UHC Exchange |
$12.26
|
| Rate for Payer: UHC Medicaid |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$4.27
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$8.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC HEPATIC VENOGRAPHY WO HEMODYNAMIC EVAL
|
Facility
|
IP
|
$3,622.26
|
|
|
Service Code
|
CPT 75891
|
| Hospital Charge Code |
32000323
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,593.79 |
| Max. Negotiated Rate |
$3,260.03 |
| Rate for Payer: Aetna American Axle |
$2,354.47
|
| Rate for Payer: Aetna Commercial |
$3,078.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,354.47
|
| Rate for Payer: Cash Price |
$2,897.81
|
| Rate for Payer: Cofinity Advantage |
$2,535.58
|
| Rate for Payer: Cofinity Commercial |
$3,115.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,897.81
|
| Rate for Payer: Healthscope Commercial |
$3,260.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,535.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,716.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,078.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,716.70
|
| Rate for Payer: PHP Commercial |
$3,078.92
|
| Rate for Payer: Priority Health SBD |
$2,282.02
|
| Rate for Payer: UMR Bronson Commercial |
$1,593.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,716.70
|
|
|
HC HEPATIC VENOGRAPHY WO HEMODYNAMIC EVAL
|
Facility
|
OP
|
$3,622.26
|
|
|
Service Code
|
CPT 75891
|
| Hospital Charge Code |
32000323
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$178.96 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$2,354.47
|
| Rate for Payer: Aetna Commercial |
$3,078.92
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,354.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$178.96
|
| Rate for Payer: BCN Commercial |
$178.96
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,897.81
|
| Rate for Payer: Cash Price |
$2,897.81
|
| Rate for Payer: Cofinity Advantage |
$2,535.58
|
| Rate for Payer: Cofinity Commercial |
$3,115.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,897.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,260.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,535.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,716.70
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,078.92
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,716.70
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,078.92
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,282.02
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,354.47
|
| Rate for Payer: UHC Core |
$1,887.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Exchange |
$1,423.55
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,340.24
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,716.70
|
|
|
HC HEPATITIS A ANTIBODY IGM
|
Facility
|
IP
|
$133.38
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
30200299
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$58.69 |
| Max. Negotiated Rate |
$120.04 |
| Rate for Payer: Aetna American Axle |
$86.70
|
| Rate for Payer: Aetna Commercial |
$113.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cofinity Advantage |
$93.37
|
| Rate for Payer: Cofinity Commercial |
$114.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.70
|
| Rate for Payer: Healthscope Commercial |
$120.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.03
|
| Rate for Payer: PHP Commercial |
$113.37
|
| Rate for Payer: Priority Health SBD |
$84.03
|
| Rate for Payer: UMR Bronson Commercial |
$58.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.03
|
|
|
HC HEPATITIS A ANTIBODY IGM
|
Facility
|
OP
|
$133.38
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
30200299
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$120.04 |
| Rate for Payer: Aetna American Axle |
$86.70
|
| Rate for Payer: Aetna Commercial |
$113.37
|
| Rate for Payer: Aetna Medicare |
$11.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.07
|
| Rate for Payer: BCBS Complete |
$6.18
|
| Rate for Payer: BCBS MAPPO |
$11.26
|
| Rate for Payer: BCBS Trust/PPO |
$13.02
|
| Rate for Payer: BCN Commercial |
$13.02
|
| Rate for Payer: BCN Medicare Advantage |
$11.26
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cash Price |
$106.70
|
| Rate for Payer: Cofinity Advantage |
$93.37
|
| Rate for Payer: Cofinity Commercial |
$114.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.26
|
| Rate for Payer: Healthscope Commercial |
$120.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.03
|
| Rate for Payer: Mclaren Medicaid |
$11.26
|
| Rate for Payer: Mclaren Medicare |
$11.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.82
|
| Rate for Payer: Meridian Medicaid |
$11.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.37
|
| Rate for Payer: Nomi Health Commercial |
$16.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.03
|
| Rate for Payer: PACE Medicare |
$10.70
|
| Rate for Payer: PACE SWMI |
$11.26
|
| Rate for Payer: PHP Commercial |
$113.37
|
| Rate for Payer: PHP Medicare Advantage |
$11.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.26
|
| Rate for Payer: Priority Health Medicare |
$11.26
|
| Rate for Payer: Priority Health SBD |
$84.03
|
| Rate for Payer: Priority Health Tiered Network |
$9.01
|
| Rate for Payer: Railroad Medicare Medicare |
$11.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.89
|
| Rate for Payer: UHC Core |
$16.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.26
|
| Rate for Payer: UHC Exchange |
$16.89
|
| Rate for Payer: UHC Medicaid |
$5.89
|
| Rate for Payer: UHCCP Medicaid |
$5.89
|
| Rate for Payer: UMR Bronson Commercial |
$49.35
|
| Rate for Payer: VA VA |
$11.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.03
|
|
|
HC HEPATITIS ABC PANEL
|
Facility
|
OP
|
$312.12
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
30100017
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.91 |
| Max. Negotiated Rate |
$280.91 |
| Rate for Payer: Aetna American Axle |
$202.88
|
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna Medicare |
$49.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.54
|
| Rate for Payer: BCBS Complete |
$26.16
|
| Rate for Payer: BCBS MAPPO |
$47.63
|
| Rate for Payer: BCBS Trust/PPO |
$64.80
|
| Rate for Payer: BCN Commercial |
$64.80
|
| Rate for Payer: BCN Medicare Advantage |
$47.63
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Advantage |
$218.48
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.63
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.09
|
| Rate for Payer: Mclaren Medicaid |
$47.63
|
| Rate for Payer: Mclaren Medicare |
$47.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.01
|
| Rate for Payer: Meridian Medicaid |
$50.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Nomi Health Commercial |
$71.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PACE Medicare |
$45.25
|
| Rate for Payer: PACE SWMI |
$47.63
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: PHP Medicare Advantage |
$47.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$47.63
|
| Rate for Payer: Priority Health Medicare |
$47.63
|
| Rate for Payer: Priority Health SBD |
$196.64
|
| Rate for Payer: Priority Health Tiered Network |
$38.10
|
| Rate for Payer: Railroad Medicare Medicare |
$47.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.45
|
| Rate for Payer: UHC Core |
$71.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$47.63
|
| Rate for Payer: UHC Exchange |
$71.45
|
| Rate for Payer: UHC Medicaid |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$24.91
|
| Rate for Payer: UMR Bronson Commercial |
$115.48
|
| Rate for Payer: VA VA |
$47.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.09
|
|
|
HC HEPATITIS ABC PANEL
|
Facility
|
IP
|
$312.12
|
|
|
Service Code
|
CPT 80074
|
| Hospital Charge Code |
30100017
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$137.33 |
| Max. Negotiated Rate |
$280.91 |
| Rate for Payer: Aetna American Axle |
$202.88
|
| Rate for Payer: Aetna Commercial |
$265.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.88
|
| Rate for Payer: Cash Price |
$249.70
|
| Rate for Payer: Cofinity Advantage |
$218.48
|
| Rate for Payer: Cofinity Commercial |
$268.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.70
|
| Rate for Payer: Healthscope Commercial |
$280.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$218.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$234.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$265.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$234.09
|
| Rate for Payer: PHP Commercial |
$265.30
|
| Rate for Payer: Priority Health SBD |
$196.64
|
| Rate for Payer: UMR Bronson Commercial |
$137.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$234.09
|
|
|
HC HEPATITIS A IGG
|
Facility
|
IP
|
$44.57
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
30200408
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$40.11 |
| Rate for Payer: Aetna American Axle |
$28.97
|
| Rate for Payer: Aetna Commercial |
$37.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.97
|
| Rate for Payer: Cash Price |
$35.66
|
| Rate for Payer: Cofinity Advantage |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.66
|
| Rate for Payer: Healthscope Commercial |
$40.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.43
|
| Rate for Payer: PHP Commercial |
$37.88
|
| Rate for Payer: Priority Health SBD |
$28.08
|
| Rate for Payer: UMR Bronson Commercial |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.43
|
|
|
HC HEPATITIS A IGG
|
Facility
|
OP
|
$44.57
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
30200408
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$40.11 |
| Rate for Payer: Aetna American Axle |
$28.97
|
| Rate for Payer: Aetna Commercial |
$37.88
|
| Rate for Payer: Aetna Medicare |
$12.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.49
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$12.39
|
| Rate for Payer: BCBS Trust/PPO |
$14.32
|
| Rate for Payer: BCN Commercial |
$14.32
|
| Rate for Payer: BCN Medicare Advantage |
$12.39
|
| Rate for Payer: Cash Price |
$35.66
|
| Rate for Payer: Cash Price |
$35.66
|
| Rate for Payer: Cofinity Advantage |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$38.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.39
|
| Rate for Payer: Healthscope Commercial |
$40.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.43
|
| Rate for Payer: Mclaren Medicaid |
$12.39
|
| Rate for Payer: Mclaren Medicare |
$12.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.01
|
| Rate for Payer: Meridian Medicaid |
$13.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.88
|
| Rate for Payer: Nomi Health Commercial |
$18.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.43
|
| Rate for Payer: PACE Medicare |
$11.77
|
| Rate for Payer: PACE SWMI |
$12.39
|
| Rate for Payer: PHP Commercial |
$37.88
|
| Rate for Payer: PHP Medicare Advantage |
$12.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.39
|
| Rate for Payer: Priority Health Medicare |
$12.39
|
| Rate for Payer: Priority Health SBD |
$28.08
|
| Rate for Payer: Priority Health Tiered Network |
$9.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.59
|
| Rate for Payer: UHC Core |
$18.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.39
|
| Rate for Payer: UHC Exchange |
$18.59
|
| Rate for Payer: UHC Medicaid |
$6.48
|
| Rate for Payer: UHCCP Medicaid |
$6.48
|
| Rate for Payer: UMR Bronson Commercial |
$16.49
|
| Rate for Payer: VA VA |
$12.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.43
|
|
|
HC HEPATITIS A TOTAL ANTIBODY
|
Facility
|
IP
|
$48.82
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
30200298
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.48 |
| Max. Negotiated Rate |
$43.94 |
| Rate for Payer: Aetna American Axle |
$31.73
|
| Rate for Payer: Aetna Commercial |
$41.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.73
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.17
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Healthscope Commercial |
$43.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: UMR Bronson Commercial |
$21.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC HEPATITIS A TOTAL ANTIBODY
|
Facility
|
OP
|
$48.82
|
|
|
Service Code
|
CPT 86708
|
| Hospital Charge Code |
30200298
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.48 |
| Max. Negotiated Rate |
$43.94 |
| Rate for Payer: Aetna American Axle |
$31.73
|
| Rate for Payer: Aetna Commercial |
$41.50
|
| Rate for Payer: Aetna Medicare |
$12.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.49
|
| Rate for Payer: BCBS Complete |
$6.80
|
| Rate for Payer: BCBS MAPPO |
$12.39
|
| Rate for Payer: BCBS Trust/PPO |
$14.32
|
| Rate for Payer: BCN Commercial |
$14.32
|
| Rate for Payer: BCN Medicare Advantage |
$12.39
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cash Price |
$39.06
|
| Rate for Payer: Cofinity Advantage |
$34.17
|
| Rate for Payer: Cofinity Commercial |
$41.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.39
|
| Rate for Payer: Healthscope Commercial |
$43.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.62
|
| Rate for Payer: Mclaren Medicaid |
$12.39
|
| Rate for Payer: Mclaren Medicare |
$12.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.01
|
| Rate for Payer: Meridian Medicaid |
$13.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.50
|
| Rate for Payer: Nomi Health Commercial |
$18.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.62
|
| Rate for Payer: PACE Medicare |
$11.77
|
| Rate for Payer: PACE SWMI |
$12.39
|
| Rate for Payer: PHP Commercial |
$41.50
|
| Rate for Payer: PHP Medicare Advantage |
$12.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.39
|
| Rate for Payer: Priority Health Medicare |
$12.39
|
| Rate for Payer: Priority Health SBD |
$30.76
|
| Rate for Payer: Priority Health Tiered Network |
$9.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.59
|
| Rate for Payer: UHC Core |
$18.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.39
|
| Rate for Payer: UHC Exchange |
$18.59
|
| Rate for Payer: UHC Medicaid |
$6.48
|
| Rate for Payer: UHCCP Medicaid |
$6.48
|
| Rate for Payer: UMR Bronson Commercial |
$18.06
|
| Rate for Payer: VA VA |
$12.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.62
|
|
|
HC HEPATITIS A VACCINE (HEPA) ADULT IM
|
Facility
|
IP
|
$93.39
|
|
|
Service Code
|
CPT 90632
|
| Hospital Charge Code |
63600067
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.09 |
| Max. Negotiated Rate |
$84.05 |
| Rate for Payer: Aetna American Axle |
$60.70
|
| Rate for Payer: Aetna Commercial |
$79.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.70
|
| Rate for Payer: Cash Price |
$74.71
|
| Rate for Payer: Cofinity Advantage |
$65.37
|
| Rate for Payer: Cofinity Commercial |
$80.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.71
|
| Rate for Payer: Healthscope Commercial |
$84.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.04
|
| Rate for Payer: PHP Commercial |
$79.38
|
| Rate for Payer: Priority Health SBD |
$58.84
|
| Rate for Payer: UMR Bronson Commercial |
$41.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.04
|
|
|
HC HEPATITIS A VACCINE (HEPA) ADULT IM
|
Facility
|
OP
|
$93.39
|
|
|
Service Code
|
CPT 90632
|
| Hospital Charge Code |
63600067
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$34.55 |
| Max. Negotiated Rate |
$266.48 |
| Rate for Payer: Aetna American Axle |
$60.70
|
| Rate for Payer: Aetna Commercial |
$79.38
|
| Rate for Payer: Aetna Medicare |
$46.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.70
|
| Rate for Payer: BCBS Complete |
$37.36
|
| Rate for Payer: BCBS Trust/PPO |
$266.48
|
| Rate for Payer: BCN Commercial |
$266.48
|
| Rate for Payer: Cash Price |
$74.71
|
| Rate for Payer: Cash Price |
$74.71
|
| Rate for Payer: Cofinity Advantage |
$65.37
|
| Rate for Payer: Cofinity Commercial |
$80.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.71
|
| Rate for Payer: Healthscope Commercial |
$84.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.04
|
| Rate for Payer: PHP Commercial |
$79.38
|
| Rate for Payer: Priority Health SBD |
$58.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.34
|
| Rate for Payer: UHC Core |
$121.34
|
| Rate for Payer: UHC Exchange |
$121.34
|
| Rate for Payer: UMR Bronson Commercial |
$34.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.04
|
|
|
HC HEPATITIS A VAC (HEPA) PEDI/ADOLESCENT DOSAGE-2 DOSE SCHEDULE IM
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 90633
|
| Hospital Charge Code |
63600068
|
|
Hospital Revenue Code
|
636
|
| 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 HEPATITIS A VAC (HEPA) PEDI/ADOLESCENT DOSAGE-2 DOSE SCHEDULE IM
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 90633
|
| Hospital Charge Code |
63600068
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.63 |
| Max. Negotiated Rate |
$124.54 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$124.54
|
| Rate for Payer: BCN Commercial |
$124.54
|
| 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: 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: MI Amish Medical Board Commercial |
$42.45
|
| 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: UHC All Payor (Choice/PPO) |
$70.97
|
| Rate for Payer: UHC Core |
$70.97
|
| Rate for Payer: UHC Exchange |
$70.97
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC HEPATITIS B CORE AB IGM
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 86705
|
| Hospital Charge Code |
30200295
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.16 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna American Axle |
$66.27
|
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$12.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.71
|
| Rate for Payer: BCBS Complete |
$6.46
|
| Rate for Payer: BCBS MAPPO |
$11.77
|
| Rate for Payer: BCBS Trust/PPO |
$13.61
|
| Rate for Payer: BCN Commercial |
$13.61
|
| Rate for Payer: BCN Medicare Advantage |
$11.77
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Advantage |
$71.37
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.77
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Mclaren Medicaid |
$11.77
|
| Rate for Payer: Mclaren Medicare |
$11.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.36
|
| Rate for Payer: Meridian Medicaid |
$12.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$17.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PACE Medicare |
$11.18
|
| Rate for Payer: PACE SWMI |
$11.77
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: PHP Medicare Advantage |
$11.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.77
|
| Rate for Payer: Priority Health Medicare |
$11.77
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: Priority Health Tiered Network |
$9.42
|
| Rate for Payer: Railroad Medicare Medicare |
$11.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.66
|
| Rate for Payer: UHC Core |
$17.66
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.77
|
| Rate for Payer: UHC Exchange |
$17.66
|
| Rate for Payer: UHC Medicaid |
$6.16
|
| Rate for Payer: UHCCP Medicaid |
$6.16
|
| Rate for Payer: UMR Bronson Commercial |
$37.73
|
| Rate for Payer: VA VA |
$11.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC HEPATITIS B CORE AB IGM
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 86705
|
| Hospital Charge Code |
30200295
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.86 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna American Axle |
$66.27
|
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Advantage |
$71.37
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health SBD |
$64.23
|
| Rate for Payer: UMR Bronson Commercial |
$44.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC HEPATITIS B CORE AB TOTAL.
|
Facility
|
IP
|
$49.78
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200294
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.90 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna American Axle |
$32.36
|
| Rate for Payer: Aetna Commercial |
$42.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.36
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cofinity Advantage |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.82
|
| Rate for Payer: Healthscope Commercial |
$44.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.34
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: Priority Health SBD |
$31.36
|
| Rate for Payer: UMR Bronson Commercial |
$21.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.34
|
|
|
HC HEPATITIS B CORE AB TOTAL.
|
Facility
|
OP
|
$49.78
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200294
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna American Axle |
$32.36
|
| Rate for Payer: Aetna Commercial |
$42.31
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.36
|
| 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 |
$39.82
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cofinity Advantage |
$34.85
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$44.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.34
|
| 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 |
$42.31
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.34
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$42.31
|
| 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 |
$31.36
|
| 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 |
$18.42
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.34
|
|
|
HC HEPATITIS B CORE ANTIBODY TOTAL
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200511
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Advantage |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
