|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$156.98
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$35.29 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$102.04
|
| Rate for Payer: Aetna Commercial |
$133.43
|
| Rate for Payer: Aetna Medicare |
$67.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.64
|
| Rate for Payer: BCBS Complete |
$37.05
|
| Rate for Payer: BCBS MAPPO |
$64.51
|
| Rate for Payer: BCBS Trust/PPO |
$218.53
|
| Rate for Payer: BCN Medicare Advantage |
$64.51
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cofinity Commercial |
$135.00
|
| Rate for Payer: Cofinity Commercial |
$109.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.51
|
| Rate for Payer: Healthscope Commercial |
$141.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.74
|
| Rate for Payer: Mclaren Medicaid |
$35.29
|
| Rate for Payer: Mclaren Medicare |
$64.51
|
| Rate for Payer: Meridian Medicaid |
$37.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.43
|
| Rate for Payer: PACE Medicare |
$61.28
|
| Rate for Payer: PACE SWMI |
$64.51
|
| Rate for Payer: PHP Commercial |
$133.43
|
| Rate for Payer: PHP Medicare Advantage |
$64.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$203.07
|
| Rate for Payer: Priority Health Medicare |
$64.51
|
| Rate for Payer: Priority Health Narrow Network |
$162.46
|
| Rate for Payer: Priority Health SBD |
$98.90
|
| Rate for Payer: Railroad Medicare Medicare |
$64.51
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.51
|
| Rate for Payer: UHC Medicare Advantage |
$66.45
|
| Rate for Payer: UMR Bronson Commercial |
$58.08
|
| Rate for Payer: VA VA |
$64.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.74
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$37.25 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna American Axle |
$55.03
|
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.03
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$59.26
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health SBD |
$53.34
|
| Rate for Payer: UMR Bronson Commercial |
$37.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.57 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna American Axle |
$55.03
|
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna Medicare |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.16
|
| Rate for Payer: BCBS Complete |
$3.75
|
| Rate for Payer: BCBS MAPPO |
$6.53
|
| Rate for Payer: BCBS Trust/PPO |
$5.88
|
| Rate for Payer: BCN Medicare Advantage |
$6.53
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Cofinity Commercial |
$59.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Mclaren Medicaid |
$3.57
|
| Rate for Payer: Mclaren Medicare |
$6.53
|
| Rate for Payer: Meridian Medicaid |
$3.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PACE Medicare |
$6.20
|
| Rate for Payer: PACE SWMI |
$6.53
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: PHP Medicare Advantage |
$6.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.96
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health Narrow Network |
$7.17
|
| Rate for Payer: Priority Health SBD |
$53.34
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.84
|
| Rate for Payer: UHC Core |
$10.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.53
|
| Rate for Payer: UHC Exchange |
$6.53
|
| Rate for Payer: UHC Medicare Advantage |
$6.73
|
| Rate for Payer: UMR Bronson Commercial |
$31.32
|
| Rate for Payer: VA VA |
$6.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$95.37
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$85.83 |
| Rate for Payer: Aetna American Axle |
$61.99
|
| Rate for Payer: Aetna Commercial |
$81.06
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$16.80
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$82.02
|
| Rate for Payer: Cofinity Commercial |
$66.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$85.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.53
|
| Rate for Payer: Mclaren Medicaid |
$13.63
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.06
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$81.06
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.47
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$23.58
|
| Rate for Payer: Priority Health SBD |
$60.08
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.89
|
| Rate for Payer: UHC Core |
$35.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$25.66
|
| Rate for Payer: UMR Bronson Commercial |
$35.29
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.53
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$95.37
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$85.83 |
| Rate for Payer: Aetna American Axle |
$61.99
|
| Rate for Payer: Aetna Commercial |
$81.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.99
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$66.76
|
| Rate for Payer: Cofinity Commercial |
$82.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.30
|
| Rate for Payer: Healthscope Commercial |
$85.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.06
|
| Rate for Payer: PHP Commercial |
$81.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.76
|
| Rate for Payer: Priority Health SBD |
$60.08
|
| Rate for Payer: UMR Bronson Commercial |
$41.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.53
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$97.92
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.08 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna American Axle |
$63.65
|
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.65
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$68.54
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.23
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.54
|
| Rate for Payer: Priority Health SBD |
$61.69
|
| Rate for Payer: UMR Bronson Commercial |
$43.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$97.92
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna American Axle |
$63.65
|
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.65
|
| 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 |
$10.55
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$16.52
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Cofinity Commercial |
$68.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Mclaren Medicaid |
$10.05
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Medicaid |
$10.55
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.23
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.59
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$15.67
|
| Rate for Payer: Priority Health SBD |
$61.69
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.04
|
| Rate for Payer: UHC Core |
$30.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$18.37
|
| Rate for Payer: UHC Medicare Advantage |
$18.92
|
| Rate for Payer: UMR Bronson Commercial |
$36.23
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$273.67
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$120.41 |
| Max. Negotiated Rate |
$246.30 |
| Rate for Payer: Aetna American Axle |
$177.89
|
| Rate for Payer: Aetna Commercial |
$232.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.89
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cofinity Commercial |
$191.57
|
| Rate for Payer: Cofinity Commercial |
$235.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.94
|
| Rate for Payer: Healthscope Commercial |
$246.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.62
|
| Rate for Payer: PHP Commercial |
$232.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.57
|
| Rate for Payer: Priority Health SBD |
$172.41
|
| Rate for Payer: UMR Bronson Commercial |
$120.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.25
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$273.67
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$66.79 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$177.89
|
| Rate for Payer: Aetna Commercial |
$232.62
|
| Rate for Payer: Aetna Medicare |
$126.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$177.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.62
|
| Rate for Payer: BCBS Complete |
$70.13
|
| Rate for Payer: BCBS MAPPO |
$122.10
|
| Rate for Payer: BCBS Trust/PPO |
$415.14
|
| Rate for Payer: BCN Medicare Advantage |
$122.10
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cofinity Commercial |
$235.36
|
| Rate for Payer: Cofinity Commercial |
$191.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.10
|
| Rate for Payer: Healthscope Commercial |
$246.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$191.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.25
|
| Rate for Payer: Mclaren Medicaid |
$66.79
|
| Rate for Payer: Mclaren Medicare |
$122.10
|
| Rate for Payer: Meridian Medicaid |
$70.13
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$128.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.62
|
| Rate for Payer: PACE Medicare |
$116.00
|
| Rate for Payer: PACE SWMI |
$122.10
|
| Rate for Payer: PHP Commercial |
$232.62
|
| Rate for Payer: PHP Medicare Advantage |
$122.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$384.38
|
| Rate for Payer: Priority Health Medicare |
$122.10
|
| Rate for Payer: Priority Health Narrow Network |
$307.50
|
| Rate for Payer: Priority Health SBD |
$172.41
|
| Rate for Payer: Railroad Medicare Medicare |
$122.10
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.10
|
| Rate for Payer: UHC Medicare Advantage |
$125.76
|
| Rate for Payer: UMR Bronson Commercial |
$101.26
|
| Rate for Payer: VA VA |
$122.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.25
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.45 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna American Axle |
$24.64
|
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.60
|
| Rate for Payer: BCBS Complete |
$2.57
|
| Rate for Payer: BCBS MAPPO |
$4.48
|
| Rate for Payer: BCBS Trust/PPO |
$4.03
|
| Rate for Payer: BCN Medicare Advantage |
$4.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$26.53
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.48
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$2.45
|
| Rate for Payer: Mclaren Medicare |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.57
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Medicare |
$4.26
|
| Rate for Payer: PACE SWMI |
$4.48
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$4.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.14
|
| Rate for Payer: Priority Health Medicare |
$4.48
|
| Rate for Payer: Priority Health Narrow Network |
$4.91
|
| Rate for Payer: Priority Health SBD |
$23.88
|
| Rate for Payer: Railroad Medicare Medicare |
$4.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.38
|
| Rate for Payer: UHC Core |
$7.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.48
|
| Rate for Payer: UHC Exchange |
$4.48
|
| Rate for Payer: UHC Medicare Advantage |
$4.61
|
| Rate for Payer: UMR Bronson Commercial |
$14.02
|
| Rate for Payer: VA VA |
$4.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.68 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna American Axle |
$24.64
|
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.64
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$26.53
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health SBD |
$23.88
|
| Rate for Payer: UMR Bronson Commercial |
$16.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$121.58
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$53.50 |
| Max. Negotiated Rate |
$109.42 |
| Rate for Payer: Aetna American Axle |
$79.03
|
| Rate for Payer: Aetna Commercial |
$103.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.03
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cofinity Commercial |
$104.56
|
| Rate for Payer: Cofinity Commercial |
$85.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.26
|
| Rate for Payer: Healthscope Commercial |
$109.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.34
|
| Rate for Payer: PHP Commercial |
$103.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.11
|
| Rate for Payer: Priority Health SBD |
$76.60
|
| Rate for Payer: UMR Bronson Commercial |
$53.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.18
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$121.58
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$109.42 |
| Rate for Payer: Aetna American Axle |
$79.03
|
| Rate for Payer: Aetna Commercial |
$103.34
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$16.80
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cofinity Commercial |
$104.56
|
| Rate for Payer: Cofinity Commercial |
$85.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$109.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.18
|
| Rate for Payer: Mclaren Medicaid |
$13.63
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.34
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$103.34
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.47
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$23.58
|
| Rate for Payer: Priority Health SBD |
$76.60
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.89
|
| Rate for Payer: UHC Core |
$35.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$25.66
|
| Rate for Payer: UMR Bronson Commercial |
$44.98
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.18
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$394.64
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$173.64 |
| Max. Negotiated Rate |
$355.18 |
| Rate for Payer: Aetna American Axle |
$256.52
|
| Rate for Payer: Aetna Commercial |
$335.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.52
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cofinity Commercial |
$276.25
|
| Rate for Payer: Cofinity Commercial |
$339.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.71
|
| Rate for Payer: Healthscope Commercial |
$355.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$335.44
|
| Rate for Payer: PHP Commercial |
$335.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.25
|
| Rate for Payer: Priority Health SBD |
$248.62
|
| Rate for Payer: UMR Bronson Commercial |
$173.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.98
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$394.64
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$117.69 |
| Max. Negotiated Rate |
$851.16 |
| Rate for Payer: Aetna American Axle |
$256.52
|
| Rate for Payer: Aetna Commercial |
$335.44
|
| Rate for Payer: Aetna Medicare |
$223.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$256.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.95
|
| Rate for Payer: BCBS Complete |
$123.59
|
| Rate for Payer: BCBS MAPPO |
$215.16
|
| Rate for Payer: BCBS Trust/PPO |
$851.16
|
| Rate for Payer: BCN Medicare Advantage |
$215.16
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cofinity Commercial |
$276.25
|
| Rate for Payer: Cofinity Commercial |
$339.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.16
|
| Rate for Payer: Healthscope Commercial |
$355.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$276.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.98
|
| Rate for Payer: Mclaren Medicaid |
$117.69
|
| Rate for Payer: Mclaren Medicare |
$215.16
|
| Rate for Payer: Meridian Medicaid |
$123.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$225.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$335.44
|
| Rate for Payer: PACE Medicare |
$204.40
|
| Rate for Payer: PACE SWMI |
$215.16
|
| Rate for Payer: PHP Commercial |
$335.44
|
| Rate for Payer: PHP Medicare Advantage |
$215.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$117.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$677.32
|
| Rate for Payer: Priority Health Medicare |
$215.16
|
| Rate for Payer: Priority Health Narrow Network |
$541.86
|
| Rate for Payer: Priority Health SBD |
$248.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.16
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$215.16
|
| Rate for Payer: UHC Medicare Advantage |
$221.61
|
| Rate for Payer: UMR Bronson Commercial |
$146.02
|
| Rate for Payer: VA VA |
$215.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.98
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
OP
|
$95.37
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$85.83 |
| Rate for Payer: Aetna American Axle |
$61.99
|
| Rate for Payer: Aetna Commercial |
$81.06
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$16.80
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$82.02
|
| Rate for Payer: Cofinity Commercial |
$66.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$85.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.53
|
| Rate for Payer: Mclaren Medicaid |
$13.63
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.06
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$81.06
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.47
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$23.58
|
| Rate for Payer: Priority Health SBD |
$60.08
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.89
|
| Rate for Payer: UHC Core |
$35.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$25.66
|
| Rate for Payer: UMR Bronson Commercial |
$35.29
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.53
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
IP
|
$95.37
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.96 |
| Max. Negotiated Rate |
$85.83 |
| Rate for Payer: Aetna American Axle |
$61.99
|
| Rate for Payer: Aetna Commercial |
$81.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.99
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$66.76
|
| Rate for Payer: Cofinity Commercial |
$82.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.30
|
| Rate for Payer: Healthscope Commercial |
$85.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.06
|
| Rate for Payer: PHP Commercial |
$81.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.76
|
| Rate for Payer: Priority Health SBD |
$60.08
|
| Rate for Payer: UMR Bronson Commercial |
$41.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.53
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
IP
|
$90.78
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.94 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna American Axle |
$59.01
|
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.01
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$77.16
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.55
|
| Rate for Payer: Priority Health SBD |
$57.19
|
| Rate for Payer: UMR Bronson Commercial |
$39.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
OP
|
$90.78
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$81.70 |
| Rate for Payer: Aetna American Axle |
$59.01
|
| Rate for Payer: Aetna Commercial |
$77.16
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$14.31
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$16.80
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cash Price |
$72.62
|
| Rate for Payer: Cofinity Commercial |
$78.07
|
| Rate for Payer: Cofinity Commercial |
$63.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$81.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.08
|
| Rate for Payer: Mclaren Medicaid |
$13.63
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Medicaid |
$14.31
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$77.16
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$77.16
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.47
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$23.58
|
| Rate for Payer: Priority Health SBD |
$57.19
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.89
|
| Rate for Payer: UHC Core |
$35.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$24.91
|
| Rate for Payer: UHC Medicare Advantage |
$25.66
|
| Rate for Payer: UMR Bronson Commercial |
$33.59
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.08
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
OP
|
$1,904.34
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.87 |
| Max. Negotiated Rate |
$3,877.29 |
| Rate for Payer: Aetna American Axle |
$1,237.82
|
| Rate for Payer: Aetna Commercial |
$1,618.69
|
| Rate for Payer: Aetna Medicare |
$1,280.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,539.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,539.56
|
| Rate for Payer: BCBS Complete |
$707.46
|
| Rate for Payer: BCBS MAPPO |
$1,231.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,433.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,231.65
|
| Rate for Payer: Cash Price |
$1,523.47
|
| Rate for Payer: Cash Price |
$1,523.47
|
| Rate for Payer: Cofinity Commercial |
$1,637.73
|
| Rate for Payer: Cofinity Commercial |
$1,333.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,231.65
|
| Rate for Payer: Healthscope Commercial |
$1,713.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,333.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,428.26
|
| Rate for Payer: Mclaren Medicaid |
$673.71
|
| Rate for Payer: Mclaren Medicare |
$1,231.65
|
| Rate for Payer: Meridian Medicaid |
$707.46
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,293.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,416.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.69
|
| Rate for Payer: PACE Medicare |
$1,170.07
|
| Rate for Payer: PACE SWMI |
$1,231.65
|
| Rate for Payer: PHP Commercial |
$1,618.69
|
| Rate for Payer: PHP Medicare Advantage |
$1,231.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$673.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,877.29
|
| Rate for Payer: Priority Health Medicare |
$1,231.65
|
| Rate for Payer: Priority Health Narrow Network |
$3,101.83
|
| Rate for Payer: Priority Health SBD |
$1,199.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,231.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,231.65
|
| Rate for Payer: UHC Exchange |
$99.87
|
| Rate for Payer: UHC Medicare Advantage |
$1,268.60
|
| Rate for Payer: UMR Bronson Commercial |
$704.61
|
| Rate for Payer: VA VA |
$1,231.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,428.26
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
IP
|
$1,904.34
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$837.91 |
| Max. Negotiated Rate |
$1,713.91 |
| Rate for Payer: Aetna American Axle |
$1,237.82
|
| Rate for Payer: Aetna Commercial |
$1,618.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,237.82
|
| Rate for Payer: Cash Price |
$1,523.47
|
| Rate for Payer: Cofinity Commercial |
$1,333.04
|
| Rate for Payer: Cofinity Commercial |
$1,637.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,523.47
|
| Rate for Payer: Healthscope Commercial |
$1,713.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,333.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,428.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,618.69
|
| Rate for Payer: PHP Commercial |
$1,618.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,333.04
|
| Rate for Payer: Priority Health SBD |
$1,199.73
|
| Rate for Payer: UMR Bronson Commercial |
$837.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,428.26
|
|
|
HC PLT PHER LEUKO REDUCED
|
Facility
|
OP
|
$2,161.08
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000071
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$241.04 |
| Max. Negotiated Rate |
$1,944.97 |
| Rate for Payer: Aetna American Axle |
$1,404.70
|
| Rate for Payer: Aetna Commercial |
$1,836.92
|
| Rate for Payer: Aetna Medicare |
$458.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$550.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$550.81
|
| Rate for Payer: BCBS Complete |
$253.11
|
| Rate for Payer: BCBS MAPPO |
$440.65
|
| Rate for Payer: BCBS Trust/PPO |
$1,540.37
|
| Rate for Payer: BCN Medicare Advantage |
$440.65
|
| Rate for Payer: Cash Price |
$1,728.86
|
| Rate for Payer: Cash Price |
$1,728.86
|
| Rate for Payer: Cash Price |
$1,728.86
|
| Rate for Payer: Cofinity Commercial |
$1,858.53
|
| Rate for Payer: Cofinity Commercial |
$1,512.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$440.65
|
| Rate for Payer: Healthscope Commercial |
$1,944.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,512.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,620.81
|
| Rate for Payer: Mclaren Medicaid |
$241.04
|
| Rate for Payer: Mclaren Medicare |
$440.65
|
| Rate for Payer: Meridian Medicaid |
$253.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$462.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$506.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,836.92
|
| Rate for Payer: PACE Medicare |
$418.62
|
| Rate for Payer: PACE SWMI |
$440.65
|
| Rate for Payer: PHP Commercial |
$1,836.92
|
| Rate for Payer: PHP Medicare Advantage |
$440.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,512.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,387.19
|
| Rate for Payer: Priority Health Medicare |
$440.65
|
| Rate for Payer: Priority Health Narrow Network |
$1,109.75
|
| Rate for Payer: Priority Health SBD |
$1,361.48
|
| Rate for Payer: Railroad Medicare Medicare |
$440.65
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$440.65
|
| Rate for Payer: UHC Medicare Advantage |
$453.87
|
| Rate for Payer: UMR Bronson Commercial |
$799.60
|
| Rate for Payer: VA VA |
$440.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,620.81
|
|
|
HC PLT PHER LEUKO REDUCED
|
Facility
|
IP
|
$2,161.08
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000071
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$950.88 |
| Max. Negotiated Rate |
$1,944.97 |
| Rate for Payer: Aetna American Axle |
$1,404.70
|
| Rate for Payer: Aetna Commercial |
$1,836.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,404.70
|
| Rate for Payer: Cash Price |
$1,728.86
|
| Rate for Payer: Cofinity Commercial |
$1,512.76
|
| Rate for Payer: Cofinity Commercial |
$1,858.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,728.86
|
| Rate for Payer: Healthscope Commercial |
$1,944.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,512.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,620.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,836.92
|
| Rate for Payer: PHP Commercial |
$1,836.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,512.76
|
| Rate for Payer: Priority Health SBD |
$1,361.48
|
| Rate for Payer: UMR Bronson Commercial |
$950.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,620.81
|
|
|
HC PLT PHER LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$2,830.07
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000070
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,245.23 |
| Max. Negotiated Rate |
$2,547.06 |
| Rate for Payer: Aetna American Axle |
$1,839.55
|
| Rate for Payer: Aetna Commercial |
$2,405.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,839.55
|
| Rate for Payer: Cash Price |
$2,264.06
|
| Rate for Payer: Cofinity Commercial |
$1,981.05
|
| Rate for Payer: Cofinity Commercial |
$2,433.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,264.06
|
| Rate for Payer: Healthscope Commercial |
$2,547.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,981.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,122.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,405.56
|
| Rate for Payer: PHP Commercial |
$2,405.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.05
|
| Rate for Payer: Priority Health SBD |
$1,782.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,245.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,122.55
|
|
|
HC PLT PHER LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$2,830.07
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000070
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$343.17 |
| Max. Negotiated Rate |
$2,547.06 |
| Rate for Payer: Aetna American Axle |
$1,839.55
|
| Rate for Payer: Aetna Commercial |
$2,405.56
|
| Rate for Payer: Aetna Medicare |
$652.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,839.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$784.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$784.21
|
| Rate for Payer: BCBS Complete |
$360.36
|
| Rate for Payer: BCBS MAPPO |
$627.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,024.15
|
| Rate for Payer: BCN Medicare Advantage |
$627.37
|
| Rate for Payer: Cash Price |
$2,264.06
|
| Rate for Payer: Cash Price |
$2,264.06
|
| Rate for Payer: Cash Price |
$2,264.06
|
| Rate for Payer: Cofinity Commercial |
$2,433.86
|
| Rate for Payer: Cofinity Commercial |
$1,981.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,264.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$627.37
|
| Rate for Payer: Healthscope Commercial |
$2,547.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,981.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,122.55
|
| Rate for Payer: Mclaren Medicaid |
$343.17
|
| Rate for Payer: Mclaren Medicare |
$627.37
|
| Rate for Payer: Meridian Medicaid |
$360.36
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$658.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$721.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,405.56
|
| Rate for Payer: PACE Medicare |
$596.00
|
| Rate for Payer: PACE SWMI |
$627.37
|
| Rate for Payer: PHP Commercial |
$2,405.56
|
| Rate for Payer: PHP Medicare Advantage |
$627.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$343.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,981.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,975.00
|
| Rate for Payer: Priority Health Medicare |
$627.37
|
| Rate for Payer: Priority Health Narrow Network |
$1,580.00
|
| Rate for Payer: Priority Health SBD |
$1,782.94
|
| Rate for Payer: Railroad Medicare Medicare |
$627.37
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$627.37
|
| Rate for Payer: UHC Medicare Advantage |
$646.19
|
| Rate for Payer: UMR Bronson Commercial |
$1,047.13
|
| Rate for Payer: VA VA |
$627.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,122.55
|
|
