|
HC HEPATITIS C ANTIBODY BY RIBA
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 86804
|
| Hospital Charge Code |
30200337
|
|
Hospital Revenue Code
|
302
|
| 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 HEPATITIS C ANTIBODY BY RIBA
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 86804
|
| Hospital Charge Code |
30200337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.10 |
| 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 |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.36
|
| Rate for Payer: BCBS Complete |
$8.51
|
| Rate for Payer: BCBS MAPPO |
$15.49
|
| Rate for Payer: BCBS Trust/PPO |
$17.91
|
| Rate for Payer: BCN Commercial |
$17.91
|
| Rate for Payer: BCN Medicare Advantage |
$15.49
|
| 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 |
$15.49
|
| 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 |
$15.49
|
| Rate for Payer: Mclaren Medicare |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.26
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: Nomi Health Commercial |
$23.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.20
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.49
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: PHP Medicare Advantage |
$15.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.49
|
| Rate for Payer: Priority Health Medicare |
$15.49
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: Priority Health Tiered Network |
$12.39
|
| Rate for Payer: Railroad Medicare Medicare |
$15.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.24
|
| Rate for Payer: UHC Core |
$23.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.49
|
| Rate for Payer: UHC Exchange |
$23.24
|
| Rate for Payer: UHC Medicaid |
$8.10
|
| Rate for Payer: UHCCP Medicaid |
$8.10
|
| Rate for Payer: UMR Bronson Commercial |
$31.18
|
| Rate for Payer: VA VA |
$15.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANT
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600295
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$68.64 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna American Axle |
$101.40
|
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.40
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Advantage |
$109.20
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: Priority Health SBD |
$98.28
|
| Rate for Payer: UMR Bronson Commercial |
$68.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANT
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600295
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna American Axle |
$101.40
|
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$23.53
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$49.52
|
| Rate for Payer: BCN Commercial |
$49.52
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Advantage |
$109.20
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Mclaren Medicaid |
$42.84
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Nomi Health Commercial |
$64.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.84
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$98.28
|
| Rate for Payer: Priority Health Tiered Network |
$34.27
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.26
|
| Rate for Payer: UHC Core |
$64.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.84
|
| Rate for Payer: UHC Exchange |
$64.26
|
| Rate for Payer: UHC Medicaid |
$22.41
|
| Rate for Payer: UHCCP Medicaid |
$22.41
|
| Rate for Payer: UMR Bronson Commercial |
$57.72
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANTIFICATION
|
Facility
|
IP
|
$156.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$68.64 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna American Axle |
$101.40
|
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.40
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Advantage |
$109.20
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: Priority Health SBD |
$98.28
|
| Rate for Payer: UMR Bronson Commercial |
$68.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANTIFICATION
|
Facility
|
OP
|
$156.00
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$140.40 |
| Rate for Payer: Aetna American Axle |
$101.40
|
| Rate for Payer: Aetna Commercial |
$132.60
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$23.53
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$49.52
|
| Rate for Payer: BCN Commercial |
$49.52
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cash Price |
$124.80
|
| Rate for Payer: Cofinity Advantage |
$109.20
|
| Rate for Payer: Cofinity Commercial |
$134.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$140.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.00
|
| Rate for Payer: Mclaren Medicaid |
$42.84
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$44.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.60
|
| Rate for Payer: Nomi Health Commercial |
$64.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.00
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$132.60
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.84
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$98.28
|
| Rate for Payer: Priority Health Tiered Network |
$34.27
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.26
|
| Rate for Payer: UHC Core |
$64.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.84
|
| Rate for Payer: UHC Exchange |
$64.26
|
| Rate for Payer: UHC Medicaid |
$22.41
|
| Rate for Payer: UHCCP Medicaid |
$22.41
|
| Rate for Payer: UMR Bronson Commercial |
$57.72
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.00
|
|
|
HC HEPATITS B VACCINE (HEPB), PEDIATRIC/ADOLESCENT, 3 DOSE IM
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
63600086
|
|
Hospital Revenue Code
|
636
|
| 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 HEPATITS B VACCINE (HEPB), PEDIATRIC/ADOLESCENT, 3 DOSE IM
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
63600086
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$93.09 |
| Rate for Payer: Aetna American Axle |
$24.14
|
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna Medicare |
$18.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: BCBS Complete |
$14.86
|
| Rate for Payer: BCBS Trust/PPO |
$93.09
|
| Rate for Payer: BCN Commercial |
$93.09
|
| 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: 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: MI Amish Medical Board Commercial |
$29.71
|
| 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 Cigna Priority Health/HMO/PPO/Narrow Network |
$33.20
|
| Rate for Payer: Priority Health SBD |
$23.40
|
| Rate for Payer: Priority Health Tiered Network |
$26.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.78
|
| Rate for Payer: UHC Core |
$54.78
|
| Rate for Payer: UHC Exchange |
$54.78
|
| Rate for Payer: UMR Bronson Commercial |
$13.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC HEP B ADMINISTRATION
|
Facility
|
OP
|
$34.85
|
|
|
Service Code
|
HCPCS G0010
|
| Hospital Charge Code |
77100008
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.89 |
| Max. Negotiated Rate |
$150.88 |
| Rate for Payer: Aetna American Axle |
$22.65
|
| Rate for Payer: Aetna Commercial |
$29.62
|
| Rate for Payer: Aetna Medicare |
$48.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.33
|
| Rate for Payer: BCBS Complete |
$25.63
|
| Rate for Payer: BCBS MAPPO |
$46.66
|
| Rate for Payer: BCBS Trust/PPO |
$75.27
|
| Rate for Payer: BCN Commercial |
$75.27
|
| Rate for Payer: BCN Medicare Advantage |
$46.66
|
| Rate for Payer: Cash Price |
$27.88
|
| Rate for Payer: Cash Price |
$27.88
|
| Rate for Payer: Cofinity Advantage |
$24.39
|
| Rate for Payer: Cofinity Commercial |
$29.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.66
|
| Rate for Payer: Healthscope Commercial |
$31.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.14
|
| Rate for Payer: Mclaren Medicaid |
$46.66
|
| Rate for Payer: Mclaren Medicare |
$46.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.99
|
| Rate for Payer: Meridian Medicaid |
$48.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.62
|
| Rate for Payer: Nomi Health Commercial |
$139.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.14
|
| Rate for Payer: PACE Medicare |
$44.33
|
| Rate for Payer: PACE SWMI |
$46.66
|
| Rate for Payer: PHP Commercial |
$29.62
|
| Rate for Payer: PHP Medicare Advantage |
$46.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$150.88
|
| Rate for Payer: Priority Health Medicare |
$46.66
|
| Rate for Payer: Priority Health SBD |
$21.96
|
| Rate for Payer: Priority Health Tiered Network |
$120.70
|
| Rate for Payer: Railroad Medicare Medicare |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.65
|
| Rate for Payer: UHC Core |
$18.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.66
|
| Rate for Payer: UHC Exchange |
$13.70
|
| Rate for Payer: UHC Medicaid |
$24.40
|
| Rate for Payer: UHCCP Medicaid |
$24.40
|
| Rate for Payer: UMR Bronson Commercial |
$12.89
|
| Rate for Payer: VA VA |
$46.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.14
|
|
|
HC HEP B ADMINISTRATION
|
Facility
|
IP
|
$34.85
|
|
|
Service Code
|
HCPCS G0010
|
| Hospital Charge Code |
77100008
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$15.33 |
| Max. Negotiated Rate |
$31.36 |
| Rate for Payer: Aetna American Axle |
$22.65
|
| Rate for Payer: Aetna Commercial |
$29.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.65
|
| Rate for Payer: Cash Price |
$27.88
|
| Rate for Payer: Cofinity Advantage |
$24.39
|
| Rate for Payer: Cofinity Commercial |
$29.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.88
|
| Rate for Payer: Healthscope Commercial |
$31.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.14
|
| Rate for Payer: PHP Commercial |
$29.62
|
| Rate for Payer: Priority Health SBD |
$21.96
|
| Rate for Payer: UMR Bronson Commercial |
$15.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.14
|
|
|
HC HEP B CORE AB TOTAL.
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200293
|
|
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 HEP B CORE AB TOTAL.
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200293
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| 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 |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.27
|
| 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 |
$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 |
$12.05
|
| 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 |
$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 |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$86.67
|
| 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 |
$64.23
|
| 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 |
$37.73
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC HEP B SURFACE ANTIGEN CONFIRMATION
|
Facility
|
IP
|
$46.85
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600140
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.61 |
| Max. Negotiated Rate |
$42.16 |
| Rate for Payer: Aetna American Axle |
$30.45
|
| Rate for Payer: Aetna Commercial |
$39.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.45
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cofinity Advantage |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$40.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.48
|
| Rate for Payer: Healthscope Commercial |
$42.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.14
|
| Rate for Payer: PHP Commercial |
$39.82
|
| Rate for Payer: Priority Health SBD |
$29.52
|
| Rate for Payer: UMR Bronson Commercial |
$20.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.14
|
|
|
HC HEP B SURFACE ANTIGEN CONFIRMATION
|
Facility
|
OP
|
$46.85
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600140
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.40 |
| Max. Negotiated Rate |
$42.16 |
| Rate for Payer: Aetna American Axle |
$30.45
|
| Rate for Payer: Aetna Commercial |
$39.82
|
| Rate for Payer: Aetna Medicare |
$10.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.91
|
| Rate for Payer: BCBS Complete |
$5.67
|
| Rate for Payer: BCBS MAPPO |
$10.33
|
| Rate for Payer: BCBS Trust/PPO |
$11.95
|
| Rate for Payer: BCN Commercial |
$11.95
|
| Rate for Payer: BCN Medicare Advantage |
$10.33
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cash Price |
$37.48
|
| Rate for Payer: Cofinity Advantage |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$40.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.33
|
| Rate for Payer: Healthscope Commercial |
$42.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.14
|
| Rate for Payer: Mclaren Medicaid |
$10.33
|
| Rate for Payer: Mclaren Medicare |
$10.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.85
|
| Rate for Payer: Meridian Medicaid |
$10.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.82
|
| Rate for Payer: Nomi Health Commercial |
$15.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.14
|
| Rate for Payer: PACE Medicare |
$9.81
|
| Rate for Payer: PACE SWMI |
$10.33
|
| Rate for Payer: PHP Commercial |
$39.82
|
| Rate for Payer: PHP Medicare Advantage |
$10.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10.33
|
| Rate for Payer: Priority Health Medicare |
$10.33
|
| Rate for Payer: Priority Health SBD |
$29.52
|
| Rate for Payer: Priority Health Tiered Network |
$8.26
|
| Rate for Payer: Railroad Medicare Medicare |
$10.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.50
|
| Rate for Payer: UHC Core |
$15.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$10.33
|
| Rate for Payer: UHC Exchange |
$15.50
|
| Rate for Payer: UHC Medicaid |
$5.40
|
| Rate for Payer: UHCCP Medicaid |
$5.40
|
| Rate for Payer: UMR Bronson Commercial |
$17.33
|
| Rate for Payer: VA VA |
$10.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.14
|
|
|
HC HEP B VACC 2 DOSE ADULT IM
|
Facility
|
IP
|
$339.59
|
|
|
Service Code
|
CPT 90739
|
| Hospital Charge Code |
63600181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$149.42 |
| Max. Negotiated Rate |
$305.63 |
| Rate for Payer: Aetna American Axle |
$220.73
|
| Rate for Payer: Aetna Commercial |
$288.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.73
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cofinity Advantage |
$237.71
|
| Rate for Payer: Cofinity Commercial |
$292.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.67
|
| Rate for Payer: Healthscope Commercial |
$305.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.69
|
| Rate for Payer: PHP Commercial |
$288.65
|
| Rate for Payer: Priority Health SBD |
$213.94
|
| Rate for Payer: UMR Bronson Commercial |
$149.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.69
|
|
|
HC HEP B VACC 2 DOSE ADULT IM
|
Facility
|
OP
|
$339.59
|
|
|
Service Code
|
CPT 90739
|
| Hospital Charge Code |
63600181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$125.65 |
| Max. Negotiated Rate |
$495.69 |
| Rate for Payer: Aetna American Axle |
$220.73
|
| Rate for Payer: Aetna Commercial |
$288.65
|
| Rate for Payer: Aetna Medicare |
$169.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.73
|
| Rate for Payer: BCBS Complete |
$135.84
|
| Rate for Payer: BCBS Trust/PPO |
$495.69
|
| Rate for Payer: BCN Commercial |
$495.69
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cofinity Advantage |
$237.71
|
| Rate for Payer: Cofinity Commercial |
$292.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.67
|
| Rate for Payer: Healthscope Commercial |
$305.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$271.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.69
|
| Rate for Payer: PHP Commercial |
$288.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$177.56
|
| Rate for Payer: Priority Health SBD |
$213.94
|
| Rate for Payer: Priority Health Tiered Network |
$142.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.97
|
| Rate for Payer: UHC Core |
$292.97
|
| Rate for Payer: UHC Exchange |
$292.97
|
| Rate for Payer: UMR Bronson Commercial |
$125.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.69
|
|
|
HC HEP C GENO SUBTYPES
|
Facility
|
OP
|
$460.87
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600256
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$134.65 |
| Max. Negotiated Rate |
$414.78 |
| Rate for Payer: Aetna American Axle |
$299.57
|
| Rate for Payer: Aetna Commercial |
$391.74
|
| Rate for Payer: Aetna Medicare |
$267.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$321.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$321.81
|
| Rate for Payer: BCBS Complete |
$141.39
|
| Rate for Payer: BCBS MAPPO |
$257.45
|
| Rate for Payer: BCBS Trust/PPO |
$297.61
|
| Rate for Payer: BCN Commercial |
$297.61
|
| Rate for Payer: BCN Medicare Advantage |
$257.45
|
| Rate for Payer: Cash Price |
$368.70
|
| Rate for Payer: Cash Price |
$368.70
|
| Rate for Payer: Cofinity Advantage |
$322.61
|
| Rate for Payer: Cofinity Commercial |
$396.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.45
|
| Rate for Payer: Healthscope Commercial |
$414.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$322.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.65
|
| Rate for Payer: Mclaren Medicaid |
$257.45
|
| Rate for Payer: Mclaren Medicare |
$257.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.32
|
| Rate for Payer: Meridian Medicaid |
$270.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$283.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.74
|
| Rate for Payer: Nomi Health Commercial |
$386.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.65
|
| Rate for Payer: PACE Medicare |
$244.58
|
| Rate for Payer: PACE SWMI |
$257.45
|
| Rate for Payer: PHP Commercial |
$391.74
|
| Rate for Payer: PHP Medicare Advantage |
$257.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.45
|
| Rate for Payer: Priority Health Medicare |
$257.45
|
| Rate for Payer: Priority Health SBD |
$290.35
|
| Rate for Payer: Priority Health Tiered Network |
$205.96
|
| Rate for Payer: Railroad Medicare Medicare |
$257.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.18
|
| Rate for Payer: UHC Core |
$386.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$257.45
|
| Rate for Payer: UHC Exchange |
$386.18
|
| Rate for Payer: UHC Medicaid |
$134.65
|
| Rate for Payer: UHCCP Medicaid |
$134.65
|
| Rate for Payer: UMR Bronson Commercial |
$170.52
|
| Rate for Payer: VA VA |
$257.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.65
|
|
|
HC HEP C GENO SUBTYPES
|
Facility
|
IP
|
$460.87
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600256
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$202.78 |
| Max. Negotiated Rate |
$414.78 |
| Rate for Payer: Aetna American Axle |
$299.57
|
| Rate for Payer: Aetna Commercial |
$391.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$299.57
|
| Rate for Payer: Cash Price |
$368.70
|
| Rate for Payer: Cofinity Advantage |
$322.61
|
| Rate for Payer: Cofinity Commercial |
$396.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$368.70
|
| Rate for Payer: Healthscope Commercial |
$414.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$322.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$345.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$391.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$345.65
|
| Rate for Payer: PHP Commercial |
$391.74
|
| Rate for Payer: Priority Health SBD |
$290.35
|
| Rate for Payer: UMR Bronson Commercial |
$202.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$345.65
|
|
|
HC HER2 DUAL ISH
|
Facility
|
IP
|
$318.36
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000065
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$140.08 |
| Max. Negotiated Rate |
$286.52 |
| Rate for Payer: Aetna American Axle |
$206.93
|
| Rate for Payer: Aetna Commercial |
$270.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.93
|
| Rate for Payer: Cash Price |
$254.69
|
| Rate for Payer: Cofinity Advantage |
$222.85
|
| Rate for Payer: Cofinity Commercial |
$273.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.69
|
| Rate for Payer: Healthscope Commercial |
$286.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.77
|
| Rate for Payer: PHP Commercial |
$270.61
|
| Rate for Payer: Priority Health SBD |
$200.57
|
| Rate for Payer: UMR Bronson Commercial |
$140.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.77
|
|
|
HC HER2 DUAL ISH
|
Facility
|
OP
|
$318.36
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000065
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$117.79 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna American Axle |
$206.93
|
| Rate for Payer: Aetna Commercial |
$270.61
|
| Rate for Payer: Aetna Medicare |
$371.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$199.48
|
| Rate for Payer: BCCCP Commercial |
$138.78
|
| Rate for Payer: BCN Commercial |
$199.48
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$254.69
|
| Rate for Payer: Cash Price |
$254.69
|
| Rate for Payer: Cofinity Advantage |
$222.85
|
| Rate for Payer: Cofinity Commercial |
$273.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$286.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.77
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$375.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.61
|
| Rate for Payer: Nomi Health Commercial |
$1,071.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.77
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$270.61
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health SBD |
$200.57
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.58
|
| Rate for Payer: UHC Core |
$539.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$539.58
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: UMR Bronson Commercial |
$117.79
|
| Rate for Payer: VA VA |
$357.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.77
|
|
|
HC HER2 DUAL ISH CMPT
|
Facility
|
OP
|
$318.36
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000066
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$117.79 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna American Axle |
$206.93
|
| Rate for Payer: Aetna Commercial |
$270.61
|
| Rate for Payer: Aetna Medicare |
$371.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$199.48
|
| Rate for Payer: BCCCP Commercial |
$138.78
|
| Rate for Payer: BCN Commercial |
$199.48
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$254.69
|
| Rate for Payer: Cash Price |
$254.69
|
| Rate for Payer: Cofinity Advantage |
$222.85
|
| Rate for Payer: Cofinity Commercial |
$273.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$286.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.77
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$375.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.61
|
| Rate for Payer: Nomi Health Commercial |
$1,071.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.77
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$270.61
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health SBD |
$200.57
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.58
|
| Rate for Payer: UHC Core |
$539.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$539.58
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: UMR Bronson Commercial |
$117.79
|
| Rate for Payer: VA VA |
$357.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.77
|
|
|
HC HER2 DUAL ISH CMPT
|
Facility
|
IP
|
$318.36
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000066
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$140.08 |
| Max. Negotiated Rate |
$286.52 |
| Rate for Payer: Aetna American Axle |
$206.93
|
| Rate for Payer: Aetna Commercial |
$270.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$206.93
|
| Rate for Payer: Cash Price |
$254.69
|
| Rate for Payer: Cofinity Advantage |
$222.85
|
| Rate for Payer: Cofinity Commercial |
$273.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$254.69
|
| Rate for Payer: Healthscope Commercial |
$286.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$222.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$238.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$270.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$238.77
|
| Rate for Payer: PHP Commercial |
$270.61
|
| Rate for Payer: Priority Health SBD |
$200.57
|
| Rate for Payer: UMR Bronson Commercial |
$140.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$238.77
|
|
|
HC HER-2 NEU QUANTITATIVE
|
Facility
|
IP
|
$253.86
|
|
|
Service Code
|
CPT 83950
|
| Hospital Charge Code |
30100382
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$111.70 |
| Max. Negotiated Rate |
$228.47 |
| Rate for Payer: Aetna American Axle |
$165.01
|
| Rate for Payer: Aetna Commercial |
$215.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.01
|
| Rate for Payer: Cash Price |
$203.09
|
| Rate for Payer: Cofinity Advantage |
$177.70
|
| Rate for Payer: Cofinity Commercial |
$218.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.09
|
| Rate for Payer: Healthscope Commercial |
$228.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.40
|
| Rate for Payer: PHP Commercial |
$215.78
|
| Rate for Payer: Priority Health SBD |
$159.93
|
| Rate for Payer: UMR Bronson Commercial |
$111.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.40
|
|
|
HC HER-2 NEU QUANTITATIVE
|
Facility
|
OP
|
$253.86
|
|
|
Service Code
|
CPT 83950
|
| Hospital Charge Code |
30100382
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.69 |
| Max. Negotiated Rate |
$228.47 |
| Rate for Payer: Aetna American Axle |
$165.01
|
| Rate for Payer: Aetna Commercial |
$215.78
|
| Rate for Payer: Aetna Medicare |
$66.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.51
|
| Rate for Payer: BCBS Complete |
$35.37
|
| Rate for Payer: BCBS MAPPO |
$64.41
|
| Rate for Payer: BCBS Trust/PPO |
$74.46
|
| Rate for Payer: BCN Commercial |
$74.46
|
| Rate for Payer: BCN Medicare Advantage |
$64.41
|
| Rate for Payer: Cash Price |
$203.09
|
| Rate for Payer: Cash Price |
$203.09
|
| Rate for Payer: Cofinity Advantage |
$177.70
|
| Rate for Payer: Cofinity Commercial |
$218.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.41
|
| Rate for Payer: Healthscope Commercial |
$228.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$177.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.40
|
| Rate for Payer: Mclaren Medicaid |
$64.41
|
| Rate for Payer: Mclaren Medicare |
$64.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.63
|
| Rate for Payer: Meridian Medicaid |
$67.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.78
|
| Rate for Payer: Nomi Health Commercial |
$96.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.40
|
| Rate for Payer: PACE Medicare |
$61.19
|
| Rate for Payer: PACE SWMI |
$64.41
|
| Rate for Payer: PHP Commercial |
$215.78
|
| Rate for Payer: PHP Medicare Advantage |
$64.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$64.41
|
| Rate for Payer: Priority Health Medicare |
$64.41
|
| Rate for Payer: Priority Health SBD |
$159.93
|
| Rate for Payer: Priority Health Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$64.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.62
|
| Rate for Payer: UHC Core |
$96.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$64.41
|
| Rate for Payer: UHC Exchange |
$96.62
|
| Rate for Payer: UHC Medicaid |
$33.69
|
| Rate for Payer: UHCCP Medicaid |
$33.69
|
| Rate for Payer: UMR Bronson Commercial |
$93.93
|
| Rate for Payer: VA VA |
$64.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.40
|
|
|
HC HERPES PCR
|
Facility
|
OP
|
$74.29
|
|
|
Service Code
|
CPT 87529
|
| Hospital Charge Code |
30600211
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$66.86 |
| Rate for Payer: Aetna American Axle |
$48.29
|
| Rate for Payer: Aetna Commercial |
$63.15
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cash Price |
$59.43
|
| Rate for Payer: Cofinity Advantage |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$63.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$66.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.72
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.15
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.72
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$63.15
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$46.80
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$27.49
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.72
|
|
