|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$346.61 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: UMR Bronson Commercial |
$346.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM PROC MISC 78999
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78999
|
| Hospital Charge Code |
34100061
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$291.47
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$346.61 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: UMR Bronson Commercial |
$346.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM RADPHARM THER 799
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 79999
|
| Hospital Charge Code |
34100066
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$120.96 |
| Max. Negotiated Rate |
$832.00 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$229.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$276.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$276.42
|
| Rate for Payer: BCBS Complete |
$127.02
|
| Rate for Payer: BCBS MAPPO |
$221.14
|
| Rate for Payer: BCN Medicare Advantage |
$221.14
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$221.14
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$120.96
|
| Rate for Payer: Mclaren Medicare |
$221.14
|
| Rate for Payer: Meridian Medicaid |
$127.02
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$232.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$254.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$210.08
|
| Rate for Payer: PACE SWMI |
$221.14
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$221.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$120.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$696.16
|
| Rate for Payer: Priority Health Medicare |
$221.14
|
| Rate for Payer: Priority Health Narrow Network |
$556.93
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: Railroad Medicare Medicare |
$221.14
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$221.14
|
| Rate for Payer: UHC Medicare Advantage |
$227.77
|
| Rate for Payer: UMR Bronson Commercial |
$291.47
|
| Rate for Payer: VA VA |
$221.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
OP
|
$787.76
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$200.54 |
| Max. Negotiated Rate |
$1,154.12 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna Medicare |
$381.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$458.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$458.26
|
| Rate for Payer: BCBS Complete |
$210.58
|
| Rate for Payer: BCBS MAPPO |
$366.61
|
| Rate for Payer: BCN Medicare Advantage |
$366.61
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$366.61
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Mclaren Medicaid |
$200.54
|
| Rate for Payer: Mclaren Medicare |
$366.61
|
| Rate for Payer: Meridian Medicaid |
$210.58
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$384.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$421.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PACE Medicare |
$348.28
|
| Rate for Payer: PACE SWMI |
$366.61
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: PHP Medicare Advantage |
$366.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$200.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,154.12
|
| Rate for Payer: Priority Health Medicare |
$366.61
|
| Rate for Payer: Priority Health Narrow Network |
$923.30
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: Railroad Medicare Medicare |
$366.61
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$366.61
|
| Rate for Payer: UHC Medicare Advantage |
$377.61
|
| Rate for Payer: UMR Bronson Commercial |
$291.47
|
| Rate for Payer: VA VA |
$366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL NM RESP 78599
|
Facility
|
IP
|
$787.76
|
|
|
Service Code
|
CPT 78599
|
| Hospital Charge Code |
34100036
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$346.61 |
| Max. Negotiated Rate |
$708.98 |
| Rate for Payer: Aetna American Axle |
$512.04
|
| Rate for Payer: Aetna Commercial |
$669.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$512.04
|
| Rate for Payer: Cash Price |
$630.21
|
| Rate for Payer: Cofinity Commercial |
$551.43
|
| Rate for Payer: Cofinity Commercial |
$677.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$630.21
|
| Rate for Payer: Healthscope Commercial |
$708.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$551.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$590.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$669.60
|
| Rate for Payer: PHP Commercial |
$669.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$551.43
|
| Rate for Payer: Priority Health SBD |
$496.29
|
| Rate for Payer: UMR Bronson Commercial |
$346.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$590.82
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
IP
|
$213.00
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$93.72 |
| Max. Negotiated Rate |
$191.70 |
| Rate for Payer: Aetna American Axle |
$138.45
|
| Rate for Payer: Aetna Commercial |
$181.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.45
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$149.10
|
| Rate for Payer: Cofinity Commercial |
$183.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.40
|
| Rate for Payer: Healthscope Commercial |
$191.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.05
|
| Rate for Payer: PHP Commercial |
$181.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health SBD |
$134.19
|
| Rate for Payer: UMR Bronson Commercial |
$93.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.75
|
|
|
HC RADXF UNL ULTRASOUND 76999
|
Facility
|
OP
|
$213.00
|
|
|
Service Code
|
CPT 76999
|
| Hospital Charge Code |
40200051
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$44.18 |
| Max. Negotiated Rate |
$367.00 |
| Rate for Payer: Aetna American Axle |
$138.45
|
| Rate for Payer: Aetna Commercial |
$181.05
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCBS Trust/PPO |
$104.18
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cash Price |
$170.40
|
| Rate for Payer: Cofinity Commercial |
$183.18
|
| Rate for Payer: Cofinity Commercial |
$149.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$191.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.75
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$181.05
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$181.05
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$149.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$134.19
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC Core |
$367.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$78.81
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.75
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC RAGWEED SHORT IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200056
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
IP
|
$148.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$65.12 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna American Axle |
$96.20
|
| Rate for Payer: Aetna Commercial |
$125.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.20
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$103.60
|
| Rate for Payer: Cofinity Commercial |
$127.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.40
|
| Rate for Payer: Healthscope Commercial |
$133.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PHP Commercial |
$125.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health SBD |
$93.24
|
| Rate for Payer: UMR Bronson Commercial |
$65.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.00
|
|
|
HC RAJI CELL ASSAY
|
Facility
|
OP
|
$148.00
|
|
|
Service Code
|
CPT 86332
|
| Hospital Charge Code |
30200192
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.89 |
| Max. Negotiated Rate |
$133.20 |
| Rate for Payer: Aetna American Axle |
$96.20
|
| Rate for Payer: Aetna Commercial |
$125.80
|
| Rate for Payer: Aetna Medicare |
$25.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.46
|
| Rate for Payer: BCBS Complete |
$14.00
|
| Rate for Payer: BCBS MAPPO |
$24.37
|
| Rate for Payer: BCBS Trust/PPO |
$21.92
|
| Rate for Payer: BCN Medicare Advantage |
$24.37
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cash Price |
$118.40
|
| Rate for Payer: Cofinity Commercial |
$103.60
|
| Rate for Payer: Cofinity Commercial |
$127.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$133.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$103.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.00
|
| Rate for Payer: Mclaren Medicaid |
$13.33
|
| Rate for Payer: Mclaren Medicare |
$24.37
|
| Rate for Payer: Meridian Medicaid |
$14.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.80
|
| Rate for Payer: PACE Medicare |
$23.15
|
| Rate for Payer: PACE SWMI |
$24.37
|
| Rate for Payer: PHP Commercial |
$125.80
|
| Rate for Payer: PHP Medicare Advantage |
$24.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.11
|
| Rate for Payer: Priority Health Medicare |
$24.37
|
| Rate for Payer: Priority Health Narrow Network |
$12.89
|
| Rate for Payer: Priority Health SBD |
$93.24
|
| Rate for Payer: Railroad Medicare Medicare |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.24
|
| Rate for Payer: UHC Core |
$40.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.37
|
| Rate for Payer: UHC Exchange |
$24.37
|
| Rate for Payer: UHC Medicare Advantage |
$25.10
|
| Rate for Payer: UMR Bronson Commercial |
$54.76
|
| Rate for Payer: VA VA |
$24.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.00
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
OP
|
$530.15
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.21 |
| Max. Negotiated Rate |
$1,114.93 |
| Rate for Payer: Aetna American Axle |
$344.60
|
| Rate for Payer: Aetna Commercial |
$450.63
|
| Rate for Payer: Aetna Medicare |
$368.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$442.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$442.70
|
| Rate for Payer: BCBS Complete |
$203.43
|
| Rate for Payer: BCBS MAPPO |
$354.16
|
| Rate for Payer: BCBS Trust/PPO |
$331.76
|
| Rate for Payer: BCN Medicare Advantage |
$354.16
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cofinity Commercial |
$371.10
|
| Rate for Payer: Cofinity Commercial |
$455.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$354.16
|
| Rate for Payer: Healthscope Commercial |
$477.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.61
|
| Rate for Payer: Mclaren Medicaid |
$193.73
|
| Rate for Payer: Mclaren Medicare |
$354.16
|
| Rate for Payer: Meridian Medicaid |
$203.43
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$371.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$407.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$450.63
|
| Rate for Payer: PACE Medicare |
$336.45
|
| Rate for Payer: PACE SWMI |
$354.16
|
| Rate for Payer: PHP Commercial |
$450.63
|
| Rate for Payer: PHP Medicare Advantage |
$354.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$193.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,114.93
|
| Rate for Payer: Priority Health Medicare |
$354.16
|
| Rate for Payer: Priority Health Narrow Network |
$891.94
|
| Rate for Payer: Priority Health SBD |
$333.99
|
| Rate for Payer: Railroad Medicare Medicare |
$354.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$354.16
|
| Rate for Payer: UHC Exchange |
$99.21
|
| Rate for Payer: UHC Medicare Advantage |
$364.78
|
| Rate for Payer: UMR Bronson Commercial |
$196.16
|
| Rate for Payer: VA VA |
$354.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.61
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
IP
|
$530.15
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.27 |
| Max. Negotiated Rate |
$477.14 |
| Rate for Payer: Aetna American Axle |
$344.60
|
| Rate for Payer: Aetna Commercial |
$450.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.60
|
| Rate for Payer: Cash Price |
$424.12
|
| Rate for Payer: Cofinity Commercial |
$371.10
|
| Rate for Payer: Cofinity Commercial |
$455.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.12
|
| Rate for Payer: Healthscope Commercial |
$477.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$450.63
|
| Rate for Payer: PHP Commercial |
$450.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$371.10
|
| Rate for Payer: Priority Health SBD |
$333.99
|
| Rate for Payer: UMR Bronson Commercial |
$233.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.61
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
IP
|
$150.70
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.31 |
| Max. Negotiated Rate |
$135.63 |
| Rate for Payer: Aetna American Axle |
$97.96
|
| Rate for Payer: Aetna Commercial |
$128.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.96
|
| Rate for Payer: Cash Price |
$120.56
|
| Rate for Payer: Cofinity Commercial |
$105.49
|
| Rate for Payer: Cofinity Commercial |
$129.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.56
|
| Rate for Payer: Healthscope Commercial |
$135.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.10
|
| Rate for Payer: PHP Commercial |
$128.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.49
|
| Rate for Payer: Priority Health SBD |
$94.94
|
| Rate for Payer: UMR Bronson Commercial |
$66.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.02
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
OP
|
$150.70
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$135.63 |
| Rate for Payer: Aetna American Axle |
$97.96
|
| Rate for Payer: Aetna Commercial |
$128.10
|
| Rate for Payer: Aetna Medicare |
$9.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.11
|
| Rate for Payer: BCBS Complete |
$5.11
|
| Rate for Payer: BCBS MAPPO |
$8.89
|
| Rate for Payer: BCBS Trust/PPO |
$8.00
|
| Rate for Payer: BCN Medicare Advantage |
$8.89
|
| Rate for Payer: Cash Price |
$120.56
|
| Rate for Payer: Cash Price |
$120.56
|
| Rate for Payer: Cofinity Commercial |
$129.60
|
| Rate for Payer: Cofinity Commercial |
$105.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$135.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.02
|
| Rate for Payer: Mclaren Medicaid |
$4.86
|
| Rate for Payer: Mclaren Medicare |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$5.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.10
|
| Rate for Payer: PACE Medicare |
$8.45
|
| Rate for Payer: PACE SWMI |
$8.89
|
| Rate for Payer: PHP Commercial |
$128.10
|
| Rate for Payer: PHP Medicare Advantage |
$8.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.19
|
| Rate for Payer: Priority Health Medicare |
$8.89
|
| Rate for Payer: Priority Health Narrow Network |
$9.75
|
| Rate for Payer: Priority Health SBD |
$94.94
|
| Rate for Payer: Railroad Medicare Medicare |
$8.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.67
|
| Rate for Payer: UHC Core |
$14.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.89
|
| Rate for Payer: UHC Exchange |
$8.89
|
| Rate for Payer: UHC Medicare Advantage |
$9.16
|
| Rate for Payer: UMR Bronson Commercial |
$55.76
|
| Rate for Payer: VA VA |
$8.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.02
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
IP
|
$76.40
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.62 |
| Max. Negotiated Rate |
$68.76 |
| Rate for Payer: Aetna American Axle |
$49.66
|
| Rate for Payer: Aetna Commercial |
$64.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.66
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Cofinity Commercial |
$53.48
|
| Rate for Payer: Cofinity Commercial |
$65.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.12
|
| Rate for Payer: Healthscope Commercial |
$68.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.94
|
| Rate for Payer: PHP Commercial |
$64.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.48
|
| Rate for Payer: Priority Health SBD |
$48.13
|
| Rate for Payer: UMR Bronson Commercial |
$33.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.30
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
OP
|
$76.40
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.05 |
| Max. Negotiated Rate |
$68.76 |
| Rate for Payer: Aetna American Axle |
$49.66
|
| Rate for Payer: Aetna Commercial |
$64.94
|
| Rate for Payer: Aetna Medicare |
$17.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.69
|
| Rate for Payer: BCBS Complete |
$9.51
|
| Rate for Payer: BCBS MAPPO |
$16.55
|
| Rate for Payer: BCBS Trust/PPO |
$14.88
|
| Rate for Payer: BCN Medicare Advantage |
$16.55
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Cash Price |
$61.12
|
| Rate for Payer: Cofinity Commercial |
$53.48
|
| Rate for Payer: Cofinity Commercial |
$65.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.55
|
| Rate for Payer: Healthscope Commercial |
$68.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.30
|
| Rate for Payer: Mclaren Medicaid |
$9.05
|
| Rate for Payer: Mclaren Medicare |
$16.55
|
| Rate for Payer: Meridian Medicaid |
$9.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.94
|
| Rate for Payer: PACE Medicare |
$15.72
|
| Rate for Payer: PACE SWMI |
$16.55
|
| Rate for Payer: PHP Commercial |
$64.94
|
| Rate for Payer: PHP Medicare Advantage |
$16.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$16.55
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$48.13
|
| Rate for Payer: Railroad Medicare Medicare |
$16.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.86
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.55
|
| Rate for Payer: UHC Exchange |
$16.55
|
| Rate for Payer: UHC Medicare Advantage |
$17.05
|
| Rate for Payer: UMR Bronson Commercial |
$28.27
|
| Rate for Payer: VA VA |
$16.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.30
|
|
|
HC RAPID INFUSER
|
Facility
|
IP
|
$1,404.36
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$617.92 |
| Max. Negotiated Rate |
$1,263.92 |
| Rate for Payer: Aetna American Axle |
$912.83
|
| Rate for Payer: Aetna Commercial |
$1,193.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.83
|
| Rate for Payer: Cash Price |
$1,123.49
|
| Rate for Payer: Cofinity Commercial |
$1,207.75
|
| Rate for Payer: Cofinity Commercial |
$983.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.49
|
| Rate for Payer: Healthscope Commercial |
$1,263.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$983.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,193.71
|
| Rate for Payer: PHP Commercial |
$1,193.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.05
|
| Rate for Payer: Priority Health SBD |
$884.75
|
| Rate for Payer: UMR Bronson Commercial |
$617.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.27
|
|
|
HC RAPID INFUSER
|
Facility
|
OP
|
$1,404.36
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$519.61 |
| Max. Negotiated Rate |
$1,263.92 |
| Rate for Payer: Aetna American Axle |
$912.83
|
| Rate for Payer: Aetna Commercial |
$1,193.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.83
|
| Rate for Payer: BCBS Complete |
$561.74
|
| Rate for Payer: Cash Price |
$1,123.49
|
| Rate for Payer: Cofinity Commercial |
$1,207.75
|
| Rate for Payer: Cofinity Commercial |
$983.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.49
|
| Rate for Payer: Healthscope Commercial |
$1,263.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$983.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,193.71
|
| Rate for Payer: PHP Commercial |
$1,193.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$983.05
|
| Rate for Payer: Priority Health SBD |
$884.75
|
| Rate for Payer: UMR Bronson Commercial |
$519.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.27
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$14.45
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.28
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$16.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
IP
|
$60.49
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.62 |
| Max. Negotiated Rate |
$54.44 |
| Rate for Payer: Aetna American Axle |
$39.32
|
| Rate for Payer: Aetna Commercial |
$51.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.32
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cofinity Commercial |
$42.34
|
| Rate for Payer: Cofinity Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.39
|
| Rate for Payer: Healthscope Commercial |
$54.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.42
|
| Rate for Payer: PHP Commercial |
$51.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.34
|
| Rate for Payer: Priority Health SBD |
$38.11
|
| Rate for Payer: UMR Bronson Commercial |
$26.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.37
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
OP
|
$60.49
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.04 |
| Max. Negotiated Rate |
$54.44 |
| Rate for Payer: Aetna American Axle |
$39.32
|
| Rate for Payer: Aetna Commercial |
$51.42
|
| Rate for Payer: Aetna Medicare |
$17.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.66
|
| Rate for Payer: BCBS Complete |
$9.49
|
| Rate for Payer: BCBS MAPPO |
$16.53
|
| Rate for Payer: BCBS Trust/PPO |
$14.87
|
| Rate for Payer: BCN Medicare Advantage |
$16.53
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cash Price |
$48.39
|
| Rate for Payer: Cofinity Commercial |
$42.34
|
| Rate for Payer: Cofinity Commercial |
$52.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.53
|
| Rate for Payer: Healthscope Commercial |
$54.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.37
|
| Rate for Payer: Mclaren Medicaid |
$9.04
|
| Rate for Payer: Mclaren Medicare |
$16.53
|
| Rate for Payer: Meridian Medicaid |
$9.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51.42
|
| Rate for Payer: PACE Medicare |
$15.70
|
| Rate for Payer: PACE SWMI |
$16.53
|
| Rate for Payer: PHP Commercial |
$51.42
|
| Rate for Payer: PHP Medicare Advantage |
$16.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$16.53
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$38.11
|
| Rate for Payer: Railroad Medicare Medicare |
$16.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.84
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.53
|
| Rate for Payer: UHC Exchange |
$16.53
|
| Rate for Payer: UHC Medicare Advantage |
$17.03
|
| Rate for Payer: UMR Bronson Commercial |
$22.38
|
| Rate for Payer: VA VA |
$16.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.37
|
|
|
HC RAVAS CTO/DES
|
Facility
|
OP
|
$29,091.52
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$8,525.86 |
| Max. Negotiated Rate |
$49,067.27 |
| Rate for Payer: Aetna American Axle |
$18,909.49
|
| Rate for Payer: Aetna Commercial |
$24,727.79
|
| Rate for Payer: Aetna Medicare |
$16,210.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18,909.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19,483.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19,483.22
|
| Rate for Payer: BCBS Complete |
$8,952.93
|
| Rate for Payer: BCBS MAPPO |
$15,586.58
|
| Rate for Payer: BCBS Trust/PPO |
$14,760.30
|
| Rate for Payer: BCN Medicare Advantage |
$15,586.58
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cash Price |
$23,273.22
|
| Rate for Payer: Cofinity Commercial |
$25,018.71
|
| Rate for Payer: Cofinity Commercial |
$20,364.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,273.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15,586.58
|
| Rate for Payer: Healthscope Commercial |
$26,182.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,364.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21,818.64
|
| Rate for Payer: Mclaren Medicaid |
$8,525.86
|
| Rate for Payer: Mclaren Medicare |
$15,586.58
|
| Rate for Payer: Meridian Medicaid |
$8,952.93
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,365.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17,924.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$24,727.79
|
| Rate for Payer: PACE Medicare |
$14,807.25
|
| Rate for Payer: PACE SWMI |
$15,586.58
|
| Rate for Payer: PHP Commercial |
$24,727.79
|
| Rate for Payer: PHP Medicare Advantage |
$15,586.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,525.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20,364.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$49,067.27
|
| Rate for Payer: Priority Health Medicare |
$15,586.58
|
| Rate for Payer: Priority Health Narrow Network |
$39,253.82
|
| Rate for Payer: Priority Health SBD |
$18,327.66
|
| Rate for Payer: Railroad Medicare Medicare |
$15,586.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43,700.09
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$15,586.58
|
| Rate for Payer: UHC Exchange |
$29,787.51
|
| Rate for Payer: UHC Medicare Advantage |
$16,054.18
|
| Rate for Payer: UMR Bronson Commercial |
$10,763.86
|
| Rate for Payer: VA VA |
$15,586.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21,818.64
|
|
