|
HC GRAFIX PRIME 3 X 4 PER SQ CM
|
Facility
|
OP
|
$277.98
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600161
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$102.85 |
| Max. Negotiated Rate |
$278.49 |
| Rate for Payer: Aetna American Axle |
$180.69
|
| Rate for Payer: Aetna Commercial |
$236.28
|
| Rate for Payer: Aetna Medicare |
$138.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.69
|
| Rate for Payer: BCBS Complete |
$111.19
|
| Rate for Payer: BCBS Trust/PPO |
$278.49
|
| Rate for Payer: BCN Commercial |
$278.49
|
| Rate for Payer: Cash Price |
$222.38
|
| Rate for Payer: Cash Price |
$222.38
|
| Rate for Payer: Cofinity Commercial |
$194.59
|
| Rate for Payer: Cofinity Commercial |
$239.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.38
|
| Rate for Payer: Healthscope Commercial |
$250.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.28
|
| Rate for Payer: PHP Commercial |
$236.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.69
|
| Rate for Payer: Priority Health SBD |
$175.13
|
| Rate for Payer: UMR Bronson Commercial |
$102.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.48
|
|
|
HC GRAFIX PRIME 3 X 4 PER SQ CM
|
Facility
|
IP
|
$277.98
|
|
|
Service Code
|
HCPCS Q4133
|
| Hospital Charge Code |
63600161
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$122.31 |
| Max. Negotiated Rate |
$250.18 |
| Rate for Payer: Aetna American Axle |
$180.69
|
| Rate for Payer: Aetna Commercial |
$236.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.69
|
| Rate for Payer: Cash Price |
$222.38
|
| Rate for Payer: Cofinity Commercial |
$194.59
|
| Rate for Payer: Cofinity Commercial |
$239.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.38
|
| Rate for Payer: Healthscope Commercial |
$250.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.28
|
| Rate for Payer: PHP Commercial |
$236.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.69
|
| Rate for Payer: Priority Health SBD |
$175.13
|
| Rate for Payer: UMR Bronson Commercial |
$122.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.48
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM FEET, HANDS, FACE
|
Facility
|
IP
|
$2,458.78
|
|
|
Service Code
|
CPT 15115
|
| Hospital Charge Code |
76100067
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,081.86 |
| Max. Negotiated Rate |
$2,212.90 |
| Rate for Payer: Aetna American Axle |
$1,598.21
|
| Rate for Payer: Aetna Commercial |
$2,089.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,598.21
|
| Rate for Payer: Cash Price |
$1,967.02
|
| Rate for Payer: Cofinity Commercial |
$1,721.15
|
| Rate for Payer: Cofinity Commercial |
$2,114.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,721.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.02
|
| Rate for Payer: Healthscope Commercial |
$2,212.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,721.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,844.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,089.96
|
| Rate for Payer: PHP Commercial |
$2,089.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.21
|
| Rate for Payer: Priority Health SBD |
$1,549.03
|
| Rate for Payer: UMR Bronson Commercial |
$1,081.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,844.08
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM FEET, HANDS, FACE
|
Facility
|
OP
|
$2,458.78
|
|
|
Service Code
|
CPT 15115
|
| Hospital Charge Code |
76100067
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$671.25 |
| Max. Negotiated Rate |
$5,632.99 |
| Rate for Payer: Aetna American Axle |
$1,598.21
|
| Rate for Payer: Aetna Commercial |
$2,089.96
|
| Rate for Payer: Aetna Medicare |
$1,863.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,598.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,240.30
|
| Rate for Payer: BCBS Complete |
$1,008.67
|
| Rate for Payer: BCBS MAPPO |
$1,792.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,401.99
|
| Rate for Payer: BCN Commercial |
$1,401.99
|
| Rate for Payer: BCN Medicare Advantage |
$1,792.24
|
| Rate for Payer: Cash Price |
$1,967.02
|
| Rate for Payer: Cash Price |
$1,967.02
|
| Rate for Payer: Cash Price |
$1,967.02
|
| Rate for Payer: Cofinity Commercial |
$2,114.55
|
| Rate for Payer: Cofinity Commercial |
$1,721.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,721.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,967.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,792.24
|
| Rate for Payer: Healthscope Commercial |
$2,212.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,721.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,844.08
|
| Rate for Payer: Mclaren Medicaid |
$960.64
|
| Rate for Payer: Mclaren Medicare |
$1,792.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.85
|
| Rate for Payer: Meridian Medicaid |
$1,008.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,061.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,089.96
|
| Rate for Payer: Nomi Health Commercial |
$3,763.70
|
| Rate for Payer: PACE Medicare |
$1,702.63
|
| Rate for Payer: PACE SWMI |
$1,792.24
|
| Rate for Payer: PHP Commercial |
$2,089.96
|
| Rate for Payer: PHP Medicare Advantage |
$1,792.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$960.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,598.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,632.99
|
| Rate for Payer: Priority Health Medicare |
$1,792.24
|
| Rate for Payer: Priority Health Narrow Network |
$4,506.39
|
| Rate for Payer: Priority Health SBD |
$1,549.03
|
| Rate for Payer: Railroad Medicare Medicare |
$1,792.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$738.38
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,792.24
|
| Rate for Payer: UHC Exchange |
$671.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.24
|
| Rate for Payer: UHCCP Medicaid |
$960.64
|
| Rate for Payer: UMR Bronson Commercial |
$909.75
|
| Rate for Payer: VA VA |
$1,792.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,844.08
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
IP
|
$3,219.34
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,416.51 |
| Max. Negotiated Rate |
$2,897.41 |
| Rate for Payer: Aetna American Axle |
$2,092.57
|
| Rate for Payer: Aetna Commercial |
$2,736.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,092.57
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cofinity Commercial |
$2,253.54
|
| Rate for Payer: Cofinity Commercial |
$2,768.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,253.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,575.47
|
| Rate for Payer: Healthscope Commercial |
$2,897.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,253.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,414.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,736.44
|
| Rate for Payer: PHP Commercial |
$2,736.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.57
|
| Rate for Payer: Priority Health SBD |
$2,028.18
|
| Rate for Payer: UMR Bronson Commercial |
$1,416.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,414.50
|
|
|
HC GRAFT EPIDERMAL 1ST 100 SQ CM LEGS, ARMS, TRUNK
|
Facility
|
OP
|
$3,219.34
|
|
|
Service Code
|
CPT 15110
|
| Hospital Charge Code |
76100066
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$690.73 |
| Max. Negotiated Rate |
$5,632.99 |
| Rate for Payer: Aetna American Axle |
$2,092.57
|
| Rate for Payer: Aetna Commercial |
$2,736.44
|
| Rate for Payer: Aetna Medicare |
$1,863.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,092.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,240.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,240.30
|
| Rate for Payer: BCBS Complete |
$1,008.67
|
| Rate for Payer: BCBS MAPPO |
$1,792.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,023.65
|
| Rate for Payer: BCN Commercial |
$1,023.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,792.24
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cash Price |
$2,575.47
|
| Rate for Payer: Cofinity Commercial |
$2,768.63
|
| Rate for Payer: Cofinity Commercial |
$2,253.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,253.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,575.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,792.24
|
| Rate for Payer: Healthscope Commercial |
$2,897.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,253.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,414.50
|
| Rate for Payer: Mclaren Medicaid |
$960.64
|
| Rate for Payer: Mclaren Medicare |
$1,792.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,881.85
|
| Rate for Payer: Meridian Medicaid |
$1,008.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,061.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,736.44
|
| Rate for Payer: Nomi Health Commercial |
$3,763.70
|
| Rate for Payer: PACE Medicare |
$1,702.63
|
| Rate for Payer: PACE SWMI |
$1,792.24
|
| Rate for Payer: PHP Commercial |
$2,736.44
|
| Rate for Payer: PHP Medicare Advantage |
$1,792.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$960.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,092.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,632.99
|
| Rate for Payer: Priority Health Medicare |
$1,792.24
|
| Rate for Payer: Priority Health Narrow Network |
$4,506.39
|
| Rate for Payer: Priority Health SBD |
$2,028.18
|
| Rate for Payer: Railroad Medicare Medicare |
$1,792.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$759.80
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,792.24
|
| Rate for Payer: UHC Exchange |
$690.73
|
| Rate for Payer: UHC Medicare Advantage |
$1,792.24
|
| Rate for Payer: UHCCP Medicaid |
$960.64
|
| Rate for Payer: UMR Bronson Commercial |
$1,191.16
|
| Rate for Payer: VA VA |
$1,792.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,414.50
|
|
|
HC GRAM STAIN
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna American Axle |
$33.35
|
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.11
|
| Rate for Payer: BCN Commercial |
$4.11
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.40
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$3.52
|
| Rate for Payer: Priority Health SBD |
$32.33
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: UMR Bronson Commercial |
$18.98
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC GRAM STAIN
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87205
|
| Hospital Charge Code |
30600104
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna American Axle |
$33.35
|
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health SBD |
$32.33
|
| Rate for Payer: UMR Bronson Commercial |
$22.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC GRANULOCYTES
|
Facility
|
OP
|
$1,925.76
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$446.00 |
| Max. Negotiated Rate |
$4,018.51 |
| Rate for Payer: Aetna American Axle |
$1,251.74
|
| Rate for Payer: Aetna Commercial |
$1,636.90
|
| Rate for Payer: Aetna Medicare |
$962.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.74
|
| Rate for Payer: BCBS Complete |
$770.30
|
| Rate for Payer: BCBS Trust/PPO |
$4,018.51
|
| Rate for Payer: BCN Commercial |
$4,018.51
|
| Rate for Payer: Cash Price |
$1,540.61
|
| Rate for Payer: Cash Price |
$1,540.61
|
| Rate for Payer: Cash Price |
$1,540.61
|
| Rate for Payer: Cofinity Commercial |
$1,348.03
|
| Rate for Payer: Cofinity Commercial |
$1,656.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,348.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.61
|
| Rate for Payer: Healthscope Commercial |
$1,733.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,348.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.90
|
| Rate for Payer: PHP Commercial |
$1,636.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.74
|
| Rate for Payer: Priority Health SBD |
$1,213.23
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UMR Bronson Commercial |
$712.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.32
|
|
|
HC GRANULOCYTES
|
Facility
|
IP
|
$1,925.76
|
|
|
Service Code
|
HCPCS P9050
|
| Hospital Charge Code |
39000057
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$847.33 |
| Max. Negotiated Rate |
$1,733.18 |
| Rate for Payer: Aetna American Axle |
$1,251.74
|
| Rate for Payer: Aetna Commercial |
$1,636.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,251.74
|
| Rate for Payer: Cash Price |
$1,540.61
|
| Rate for Payer: Cofinity Commercial |
$1,348.03
|
| Rate for Payer: Cofinity Commercial |
$1,656.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,348.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,540.61
|
| Rate for Payer: Healthscope Commercial |
$1,733.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,348.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,444.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,636.90
|
| Rate for Payer: PHP Commercial |
$1,636.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,251.74
|
| Rate for Payer: Priority Health SBD |
$1,213.23
|
| Rate for Payer: UMR Bronson Commercial |
$847.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,444.32
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC GRASS ALLERGEN PANEL
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200122
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| 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 |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC GREAT LAKES DISABILITY FILM(EACH)
|
Facility
|
OP
|
$20.00
|
|
| Hospital Charge Code |
32000267
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$7.40 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$13.00
|
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna Medicare |
$10.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.00
|
| Rate for Payer: BCBS Complete |
$8.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$14.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: PHP Commercial |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health SBD |
$12.60
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$7.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.00
|
|
|
HC GREAT LAKES DISABILITY FILM(EACH)
|
Facility
|
IP
|
$20.00
|
|
| Hospital Charge Code |
32000267
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$18.00 |
| Rate for Payer: Aetna American Axle |
$13.00
|
| Rate for Payer: Aetna Commercial |
$17.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.00
|
| Rate for Payer: Cash Price |
$16.00
|
| Rate for Payer: Cofinity Commercial |
$14.00
|
| Rate for Payer: Cofinity Commercial |
$17.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.00
|
| Rate for Payer: Healthscope Commercial |
$18.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.00
|
| Rate for Payer: PHP Commercial |
$17.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.00
|
| Rate for Payer: Priority Health SBD |
$12.60
|
| Rate for Payer: UMR Bronson Commercial |
$8.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.00
|
|
|
HC GROIN/PSEUDO IMAGING BILATERAL
|
Facility
|
IP
|
$1,443.73
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$635.24 |
| Max. Negotiated Rate |
$1,299.36 |
| Rate for Payer: Aetna American Axle |
$938.42
|
| Rate for Payer: Aetna Commercial |
$1,227.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.42
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cofinity Commercial |
$1,010.61
|
| Rate for Payer: Cofinity Commercial |
$1,241.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,010.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.98
|
| Rate for Payer: Healthscope Commercial |
$1,299.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,010.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,082.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,227.17
|
| Rate for Payer: PHP Commercial |
$1,227.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.42
|
| Rate for Payer: Priority Health SBD |
$909.55
|
| Rate for Payer: UMR Bronson Commercial |
$635.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,082.80
|
|
|
HC GROIN/PSEUDO IMAGING BILATERAL
|
Facility
|
OP
|
$1,443.73
|
|
|
Service Code
|
CPT 93925
|
| Hospital Charge Code |
92100027
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$1,299.36 |
| Rate for Payer: Aetna American Axle |
$938.42
|
| Rate for Payer: Aetna Commercial |
$1,227.17
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$938.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$859.79
|
| Rate for Payer: BCN Commercial |
$859.79
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cash Price |
$1,154.98
|
| Rate for Payer: Cofinity Commercial |
$1,010.61
|
| Rate for Payer: Cofinity Commercial |
$1,241.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,010.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,154.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,299.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,010.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,082.80
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,227.17
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$1,227.17
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$938.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$909.55
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.18
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$218.35
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$534.18
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,082.80
|
|
|
HC GROIN/PSEUDO IMAGING (R OR L)
|
Facility
|
IP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100026
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$405.77 |
| Max. Negotiated Rate |
$829.99 |
| Rate for Payer: Aetna American Axle |
$599.44
|
| Rate for Payer: Aetna Commercial |
$783.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.44
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$645.55
|
| Rate for Payer: Cofinity Commercial |
$793.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Healthscope Commercial |
$829.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$645.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: PHP Commercial |
$783.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health SBD |
$580.99
|
| Rate for Payer: UMR Bronson Commercial |
$405.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.66
|
|
|
HC GROIN/PSEUDO IMAGING (R OR L)
|
Facility
|
OP
|
$922.21
|
|
|
Service Code
|
CPT 93926
|
| Hospital Charge Code |
92100026
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$55.85 |
| Max. Negotiated Rate |
$829.99 |
| Rate for Payer: Aetna American Axle |
$599.44
|
| Rate for Payer: Aetna Commercial |
$783.88
|
| Rate for Payer: Aetna Medicare |
$108.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$599.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.24
|
| Rate for Payer: BCBS Complete |
$58.64
|
| Rate for Payer: BCBS MAPPO |
$104.19
|
| Rate for Payer: BCBS Trust/PPO |
$513.06
|
| Rate for Payer: BCN Commercial |
$513.06
|
| Rate for Payer: BCN Medicare Advantage |
$104.19
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cash Price |
$737.77
|
| Rate for Payer: Cofinity Commercial |
$645.55
|
| Rate for Payer: Cofinity Commercial |
$793.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$645.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$737.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.19
|
| Rate for Payer: Healthscope Commercial |
$829.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$645.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$691.66
|
| Rate for Payer: Mclaren Medicaid |
$55.85
|
| Rate for Payer: Mclaren Medicare |
$104.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.40
|
| Rate for Payer: Meridian Medicaid |
$58.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$783.88
|
| Rate for Payer: Nomi Health Commercial |
$312.57
|
| Rate for Payer: PACE Medicare |
$98.98
|
| Rate for Payer: PACE SWMI |
$104.19
|
| Rate for Payer: PHP Commercial |
$783.88
|
| Rate for Payer: PHP Medicare Advantage |
$104.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$599.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$327.48
|
| Rate for Payer: Priority Health Medicare |
$104.19
|
| Rate for Payer: Priority Health Narrow Network |
$261.98
|
| Rate for Payer: Priority Health SBD |
$580.99
|
| Rate for Payer: Railroad Medicare Medicare |
$104.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.11
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$104.19
|
| Rate for Payer: UHC Exchange |
$131.01
|
| Rate for Payer: UHC Medicare Advantage |
$104.19
|
| Rate for Payer: UHCCP Medicaid |
$55.85
|
| Rate for Payer: UMR Bronson Commercial |
$341.22
|
| Rate for Payer: VA VA |
$104.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$691.66
|
|
|
HC GROSHONG REPAIR KIT
|
Facility
|
OP
|
$464.18
|
|
| Hospital Charge Code |
27200125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$171.75 |
| Max. Negotiated Rate |
$417.76 |
| Rate for Payer: Aetna American Axle |
$301.72
|
| Rate for Payer: Aetna Commercial |
$394.55
|
| Rate for Payer: Aetna Medicare |
$232.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.72
|
| Rate for Payer: BCBS Complete |
$185.67
|
| Rate for Payer: Cash Price |
$371.34
|
| Rate for Payer: Cofinity Commercial |
$324.93
|
| Rate for Payer: Cofinity Commercial |
$399.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.34
|
| Rate for Payer: Healthscope Commercial |
$417.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.55
|
| Rate for Payer: PHP Commercial |
$394.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.72
|
| Rate for Payer: Priority Health SBD |
$292.43
|
| Rate for Payer: UMR Bronson Commercial |
$171.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.14
|
|
|
HC GROSHONG REPAIR KIT
|
Facility
|
IP
|
$464.18
|
|
| Hospital Charge Code |
27200125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$204.24 |
| Max. Negotiated Rate |
$417.76 |
| Rate for Payer: Aetna American Axle |
$301.72
|
| Rate for Payer: Aetna Commercial |
$394.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$301.72
|
| Rate for Payer: Cash Price |
$371.34
|
| Rate for Payer: Cofinity Commercial |
$324.93
|
| Rate for Payer: Cofinity Commercial |
$399.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$324.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$371.34
|
| Rate for Payer: Healthscope Commercial |
$417.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$324.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$348.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$394.55
|
| Rate for Payer: PHP Commercial |
$394.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$301.72
|
| Rate for Payer: Priority Health SBD |
$292.43
|
| Rate for Payer: UMR Bronson Commercial |
$204.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$348.14
|
|
|
HC GROUP B STREP, AMPLIFIED
|
Facility
|
IP
|
$104.04
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.78 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: UMR Bronson Commercial |
$45.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC GROUP B STREP, AMPLIFIED
|
Facility
|
OP
|
$104.04
|
|
|
Service Code
|
CPT 87150
|
| Hospital Charge Code |
30600210
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$93.64 |
| Rate for Payer: Aetna American Axle |
$67.63
|
| Rate for Payer: Aetna Commercial |
$88.43
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cash Price |
$83.23
|
| Rate for Payer: Cofinity Commercial |
$89.47
|
| Rate for Payer: Cofinity Commercial |
$72.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$93.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.03
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.43
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$88.43
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.63
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$65.55
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$38.49
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.03
|
|
|
HC GROUP CAREGIVER TRAINING
|
Facility
|
OP
|
$53.04
|
|
|
Service Code
|
CPT 97552
|
| Hospital Charge Code |
42000067
|
| Min. Negotiated Rate |
$10.30 |
| Max. Negotiated Rate |
$60.60 |
| Rate for Payer: Aetna American Axle |
$34.48
|
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna Medicare |
$26.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: BCBS Trust/PPO |
$60.60
|
| Rate for Payer: BCN Commercial |
$60.60
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.94
|
| Rate for Payer: Priority Health Narrow Network |
$17.55
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.33
|
| Rate for Payer: UHC Exchange |
$10.30
|
| Rate for Payer: UMR Bronson Commercial |
$19.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC GROUP CAREGIVER TRAINING
|
Facility
|
IP
|
$53.04
|
|
|
Service Code
|
CPT 97552
|
| Hospital Charge Code |
42000067
|
| Min. Negotiated Rate |
$23.34 |
| Max. Negotiated Rate |
$47.74 |
| Rate for Payer: Aetna American Axle |
$34.48
|
| Rate for Payer: Aetna Commercial |
$45.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.48
|
| Rate for Payer: Cash Price |
$42.43
|
| Rate for Payer: Cofinity Commercial |
$37.13
|
| Rate for Payer: Cofinity Commercial |
$45.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.43
|
| Rate for Payer: Healthscope Commercial |
$47.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.08
|
| Rate for Payer: PHP Commercial |
$45.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.48
|
| Rate for Payer: Priority Health SBD |
$33.42
|
| Rate for Payer: UMR Bronson Commercial |
$23.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.78
|
|
|
HC GROUP PSYCHOTHERAPY
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
91500001
|
|
Hospital Revenue Code
|
915
|
| Min. Negotiated Rate |
$21.12 |
| Max. Negotiated Rate |
$284.86 |
| Rate for Payer: Aetna American Axle |
$64.25
|
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$94.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$113.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$113.29
|
| Rate for Payer: BCBS Complete |
$51.01
|
| Rate for Payer: BCBS MAPPO |
$90.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.12
|
| Rate for Payer: BCN Commercial |
$21.12
|
| Rate for Payer: BCN Medicare Advantage |
$90.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$69.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$90.63
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$48.58
|
| Rate for Payer: Mclaren Medicare |
$90.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.16
|
| Rate for Payer: Meridian Medicaid |
$51.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$271.89
|
| Rate for Payer: PACE Medicare |
$86.10
|
| Rate for Payer: PACE SWMI |
$90.63
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$90.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$284.86
|
| Rate for Payer: Priority Health Medicare |
$90.63
|
| Rate for Payer: Priority Health Narrow Network |
$227.89
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| Rate for Payer: Railroad Medicare Medicare |
$90.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$90.63
|
| Rate for Payer: UHC Exchange |
$23.46
|
| Rate for Payer: UHC Medicare Advantage |
$90.63
|
| Rate for Payer: UHCCP Medicaid |
$48.58
|
| Rate for Payer: UMR Bronson Commercial |
$36.57
|
| Rate for Payer: VA VA |
$90.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
