|
HC INJECTION INTRALESIONAL UP TO 7 LESIONS
|
Facility
|
IP
|
$150.05
|
|
|
Service Code
|
CPT 11900
|
| Hospital Charge Code |
76100134
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.02 |
| Max. Negotiated Rate |
$135.04 |
| Rate for Payer: Aetna American Axle |
$97.53
|
| Rate for Payer: Aetna Commercial |
$127.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.53
|
| Rate for Payer: Cash Price |
$120.04
|
| Rate for Payer: Cofinity Advantage |
$105.03
|
| Rate for Payer: Cofinity Commercial |
$129.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.04
|
| Rate for Payer: Healthscope Commercial |
$135.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.54
|
| Rate for Payer: PHP Commercial |
$127.54
|
| Rate for Payer: Priority Health SBD |
$94.53
|
| Rate for Payer: UMR Bronson Commercial |
$66.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.54
|
|
|
HC INJECTION, IRON DEXTRAN, 50 MG
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT J1750
|
| Hospital Charge Code |
63600097
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.47 |
| Max. Negotiated Rate |
$58.62 |
| Rate for Payer: Aetna American Axle |
$41.39
|
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$18.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.64
|
| Rate for Payer: BCBS Complete |
$9.95
|
| Rate for Payer: BCBS MAPPO |
$18.11
|
| Rate for Payer: BCBS Trust/PPO |
$58.62
|
| Rate for Payer: BCN Commercial |
$58.62
|
| Rate for Payer: BCN Medicare Advantage |
$18.11
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.11
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$18.11
|
| Rate for Payer: Mclaren Medicare |
$18.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.02
|
| Rate for Payer: Meridian Medicaid |
$19.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$54.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Medicare |
$17.20
|
| Rate for Payer: PACE SWMI |
$18.11
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$18.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$57.12
|
| Rate for Payer: Priority Health Medicare |
$18.11
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: Priority Health Tiered Network |
$45.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.83
|
| Rate for Payer: UHC Core |
$29.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.11
|
| Rate for Payer: UHC Exchange |
$29.83
|
| Rate for Payer: UHC Medicaid |
$9.47
|
| Rate for Payer: UHCCP Medicaid |
$9.47
|
| Rate for Payer: UMR Bronson Commercial |
$23.56
|
| Rate for Payer: VA VA |
$18.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC INJECTION, IRON DEXTRAN, 50 MG
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT J1750
|
| Hospital Charge Code |
63600097
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna American Axle |
$41.39
|
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: UMR Bronson Commercial |
$28.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT J1885
|
| Hospital Charge Code |
63600098
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJECTION, KETOROLAC TROMETHAMINE, PER 15 MG
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT J1885
|
| Hospital Charge Code |
63600098
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$0.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.41
|
| Rate for Payer: BCBS Complete |
$0.18
|
| Rate for Payer: BCBS MAPPO |
$0.33
|
| Rate for Payer: BCBS Trust/PPO |
$1.05
|
| Rate for Payer: BCN Commercial |
$1.05
|
| Rate for Payer: BCN Medicare Advantage |
$0.33
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.33
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$0.33
|
| Rate for Payer: Mclaren Medicare |
$0.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.35
|
| Rate for Payer: Meridian Medicaid |
$0.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$0.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$0.31
|
| Rate for Payer: PACE SWMI |
$0.33
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$0.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$0.95
|
| Rate for Payer: Priority Health Medicare |
$0.33
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$0.76
|
| Rate for Payer: Railroad Medicare Medicare |
$0.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.54
|
| Rate for Payer: UHC Core |
$0.54
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$0.33
|
| Rate for Payer: UHC Exchange |
$0.54
|
| Rate for Payer: UHC Medicaid |
$0.17
|
| Rate for Payer: UHCCP Medicaid |
$0.17
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: VA VA |
$0.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC INJECTION, LINCOMYCIN HCL, UP TO 300 MG
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT J2010
|
| Hospital Charge Code |
63600099
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna American Axle |
$30.36
|
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Advantage |
$32.69
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health SBD |
$29.42
|
| Rate for Payer: UMR Bronson Commercial |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC INJECTION, LINCOMYCIN HCL, UP TO 300 MG
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT J2010
|
| Hospital Charge Code |
63600099
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna American Axle |
$30.36
|
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$23.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| Rate for Payer: BCBS Complete |
$18.68
|
| Rate for Payer: BCBS Trust/PPO |
$17.50
|
| Rate for Payer: BCN Commercial |
$17.50
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Advantage |
$32.69
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health SBD |
$29.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.91
|
| Rate for Payer: UHC Core |
$8.91
|
| Rate for Payer: UHC Exchange |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$17.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC INJECTION LUMBAR DISKOGRAPHY
|
Facility
|
OP
|
$2,396.52
|
|
|
Service Code
|
CPT 62290
|
| Hospital Charge Code |
36100282
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$886.71 |
| Max. Negotiated Rate |
$2,156.87 |
| Rate for Payer: Aetna American Axle |
$1,557.74
|
| Rate for Payer: Aetna Commercial |
$2,037.04
|
| Rate for Payer: Aetna Medicare |
$1,198.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,557.74
|
| Rate for Payer: BCBS Complete |
$958.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,428.70
|
| Rate for Payer: BCN Commercial |
$1,428.70
|
| Rate for Payer: Cash Price |
$1,917.22
|
| Rate for Payer: Cash Price |
$1,917.22
|
| Rate for Payer: Cash Price |
$1,917.22
|
| Rate for Payer: Cofinity Advantage |
$1,677.56
|
| Rate for Payer: Cofinity Commercial |
$2,061.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,917.22
|
| Rate for Payer: Healthscope Commercial |
$2,156.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,677.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,797.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,917.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,037.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,797.39
|
| Rate for Payer: PHP Commercial |
$2,037.04
|
| Rate for Payer: Priority Health SBD |
$1,509.81
|
| Rate for Payer: UMR Bronson Commercial |
$886.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,797.39
|
|
|
HC INJECTION LUMBAR DISKOGRAPHY
|
Facility
|
IP
|
$2,396.52
|
|
|
Service Code
|
CPT 62290
|
| Hospital Charge Code |
36100282
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,054.47 |
| Max. Negotiated Rate |
$2,156.87 |
| Rate for Payer: Aetna American Axle |
$1,557.74
|
| Rate for Payer: Aetna Commercial |
$2,037.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,557.74
|
| Rate for Payer: Cash Price |
$1,917.22
|
| Rate for Payer: Cofinity Advantage |
$1,677.56
|
| Rate for Payer: Cofinity Commercial |
$2,061.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,917.22
|
| Rate for Payer: Healthscope Commercial |
$2,156.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,677.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,797.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,037.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,797.39
|
| Rate for Payer: PHP Commercial |
$2,037.04
|
| Rate for Payer: Priority Health SBD |
$1,509.81
|
| Rate for Payer: UMR Bronson Commercial |
$1,054.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,797.39
|
|
|
HC INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG
|
Facility
|
IP
|
$1.06
|
|
|
Service Code
|
CPT J1050
|
| Hospital Charge Code |
63600096
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.47 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna American Axle |
$0.69
|
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.69
|
| Rate for Payer: Cash Price |
$0.85
|
| Rate for Payer: Cofinity Advantage |
$0.74
|
| Rate for Payer: Cofinity Commercial |
$0.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.85
|
| Rate for Payer: Healthscope Commercial |
$0.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.80
|
| Rate for Payer: PHP Commercial |
$0.90
|
| Rate for Payer: Priority Health SBD |
$0.67
|
| Rate for Payer: UMR Bronson Commercial |
$0.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.80
|
|
|
HC INJECTION, MEDROXYPROGESTERONE ACETATE, 1 MG
|
Facility
|
OP
|
$1.06
|
|
|
Service Code
|
CPT J1050
|
| Hospital Charge Code |
63600096
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Aetna American Axle |
$0.69
|
| Rate for Payer: Aetna Commercial |
$0.90
|
| Rate for Payer: Aetna Medicare |
$0.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.69
|
| Rate for Payer: BCBS Complete |
$0.42
|
| Rate for Payer: BCBS Trust/PPO |
$0.45
|
| Rate for Payer: BCN Commercial |
$0.45
|
| Rate for Payer: Cash Price |
$0.85
|
| Rate for Payer: Cash Price |
$0.85
|
| Rate for Payer: Cofinity Advantage |
$0.74
|
| Rate for Payer: Cofinity Commercial |
$0.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.85
|
| Rate for Payer: Healthscope Commercial |
$0.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.80
|
| Rate for Payer: PHP Commercial |
$0.90
|
| Rate for Payer: Priority Health SBD |
$0.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.79
|
| Rate for Payer: UHC Core |
$0.79
|
| Rate for Payer: UHC Exchange |
$0.79
|
| Rate for Payer: UMR Bronson Commercial |
$0.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.80
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG
|
Facility
|
IP
|
$10.61
|
|
|
Service Code
|
CPT J1020
|
| Hospital Charge Code |
63600093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.67 |
| Max. Negotiated Rate |
$9.55 |
| Rate for Payer: Aetna American Axle |
$6.90
|
| Rate for Payer: Aetna Commercial |
$9.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.90
|
| Rate for Payer: Cash Price |
$8.49
|
| Rate for Payer: Cofinity Advantage |
$7.43
|
| Rate for Payer: Cofinity Commercial |
$9.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.49
|
| Rate for Payer: Healthscope Commercial |
$9.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.96
|
| Rate for Payer: PHP Commercial |
$9.02
|
| Rate for Payer: Priority Health SBD |
$6.68
|
| Rate for Payer: UMR Bronson Commercial |
$4.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.96
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 20 MG
|
Facility
|
OP
|
$10.61
|
|
|
Service Code
|
CPT J1020
|
| Hospital Charge Code |
63600093
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$9.55 |
| Rate for Payer: Aetna American Axle |
$6.90
|
| Rate for Payer: Aetna Commercial |
$9.02
|
| Rate for Payer: Aetna Medicare |
$5.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.90
|
| Rate for Payer: BCBS Complete |
$4.24
|
| Rate for Payer: Cash Price |
$8.49
|
| Rate for Payer: Cofinity Advantage |
$7.43
|
| Rate for Payer: Cofinity Commercial |
$9.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.49
|
| Rate for Payer: Healthscope Commercial |
$9.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.96
|
| Rate for Payer: PHP Commercial |
$9.02
|
| Rate for Payer: Priority Health SBD |
$6.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.30
|
| Rate for Payer: UHC Core |
$5.30
|
| Rate for Payer: UHC Exchange |
$5.30
|
| Rate for Payer: UMR Bronson Commercial |
$3.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.96
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
63600094
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: BCBS Complete |
$6.37
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$7.96
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UMR Bronson Commercial |
$5.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 40 MG
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
63600094
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT J1040
|
| Hospital Charge Code |
63600095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC INJECTION, METHYLPREDNISOLONE ACETATE, 80 MG
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT J1040
|
| Hospital Charge Code |
63600095
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$13.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.27
|
| Rate for Payer: UHC Core |
$13.27
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC INJECTION MYELOGRAM
|
Facility
|
IP
|
$1,088.69
|
|
|
Service Code
|
CPT 62284
|
| Hospital Charge Code |
36100281
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$479.02 |
| Max. Negotiated Rate |
$979.82 |
| Rate for Payer: Aetna American Axle |
$707.65
|
| Rate for Payer: Aetna Commercial |
$925.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.65
|
| Rate for Payer: Cash Price |
$870.95
|
| Rate for Payer: Cofinity Advantage |
$762.08
|
| Rate for Payer: Cofinity Commercial |
$936.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$870.95
|
| Rate for Payer: Healthscope Commercial |
$979.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$762.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$816.52
|
| Rate for Payer: PHP Commercial |
$925.39
|
| Rate for Payer: Priority Health SBD |
$685.87
|
| Rate for Payer: UMR Bronson Commercial |
$479.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.52
|
|
|
HC INJECTION MYELOGRAM
|
Facility
|
OP
|
$1,088.69
|
|
|
Service Code
|
CPT 62284
|
| Hospital Charge Code |
36100281
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$402.82 |
| Max. Negotiated Rate |
$979.82 |
| Rate for Payer: Aetna American Axle |
$707.65
|
| Rate for Payer: Aetna Commercial |
$925.39
|
| Rate for Payer: Aetna Medicare |
$544.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$707.65
|
| Rate for Payer: BCBS Complete |
$435.48
|
| Rate for Payer: BCBS Trust/PPO |
$928.81
|
| Rate for Payer: BCN Commercial |
$928.81
|
| Rate for Payer: Cash Price |
$870.95
|
| Rate for Payer: Cash Price |
$870.95
|
| Rate for Payer: Cash Price |
$870.95
|
| Rate for Payer: Cofinity Advantage |
$762.08
|
| Rate for Payer: Cofinity Commercial |
$936.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$870.95
|
| Rate for Payer: Healthscope Commercial |
$979.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$762.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$816.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$870.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$925.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$816.52
|
| Rate for Payer: PHP Commercial |
$925.39
|
| Rate for Payer: Priority Health SBD |
$685.87
|
| Rate for Payer: UMR Bronson Commercial |
$402.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$816.52
|
|
|
HC INJECTION PLANTAR DIGIT
|
Facility
|
OP
|
$358.69
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100263
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$132.72 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$233.15
|
| Rate for Payer: Aetna Commercial |
$304.89
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$286.95
|
| Rate for Payer: Cash Price |
$286.95
|
| Rate for Payer: Cash Price |
$286.95
|
| Rate for Payer: Cofinity Advantage |
$251.08
|
| Rate for Payer: Cofinity Commercial |
$308.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$322.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.02
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.89
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.02
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$304.89
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$225.97
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.15
|
| Rate for Payer: UHC Core |
$186.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$140.97
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$132.72
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.02
|
|
|
HC INJECTION PLANTAR DIGIT
|
Facility
|
IP
|
$358.69
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100263
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.82 |
| Max. Negotiated Rate |
$322.82 |
| Rate for Payer: Aetna American Axle |
$233.15
|
| Rate for Payer: Aetna Commercial |
$304.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.15
|
| Rate for Payer: Cash Price |
$286.95
|
| Rate for Payer: Cofinity Advantage |
$251.08
|
| Rate for Payer: Cofinity Commercial |
$308.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.95
|
| Rate for Payer: Healthscope Commercial |
$322.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$269.02
|
| Rate for Payer: PHP Commercial |
$304.89
|
| Rate for Payer: Priority Health SBD |
$225.97
|
| Rate for Payer: UMR Bronson Commercial |
$157.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.02
|
|
|
HC INJECTION PLANTAR DIGIT BILATERAL
|
Facility
|
OP
|
$538.03
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$159.96 |
| Max. Negotiated Rate |
$989.08 |
| Rate for Payer: Aetna American Axle |
$349.72
|
| Rate for Payer: Aetna Commercial |
$457.33
|
| Rate for Payer: Aetna Medicare |
$318.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$382.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$382.31
|
| Rate for Payer: BCBS Complete |
$167.97
|
| Rate for Payer: BCBS MAPPO |
$305.85
|
| Rate for Payer: BCBS Trust/PPO |
$368.41
|
| Rate for Payer: BCN Commercial |
$368.41
|
| Rate for Payer: BCN Medicare Advantage |
$305.85
|
| Rate for Payer: Cash Price |
$430.42
|
| Rate for Payer: Cash Price |
$430.42
|
| Rate for Payer: Cash Price |
$430.42
|
| Rate for Payer: Cofinity Advantage |
$376.62
|
| Rate for Payer: Cofinity Commercial |
$462.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.85
|
| Rate for Payer: Healthscope Commercial |
$484.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$376.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.52
|
| Rate for Payer: Mclaren Medicaid |
$305.85
|
| Rate for Payer: Mclaren Medicare |
$305.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$321.14
|
| Rate for Payer: Meridian Medicaid |
$321.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$351.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$336.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.33
|
| Rate for Payer: Nomi Health Commercial |
$917.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.52
|
| Rate for Payer: PACE Medicare |
$290.56
|
| Rate for Payer: PACE SWMI |
$305.85
|
| Rate for Payer: PHP Commercial |
$457.33
|
| Rate for Payer: PHP Medicare Advantage |
$305.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$989.08
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health SBD |
$338.96
|
| Rate for Payer: Priority Health Tiered Network |
$791.26
|
| Rate for Payer: Railroad Medicare Medicare |
$305.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.72
|
| Rate for Payer: UHC Core |
$280.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$305.85
|
| Rate for Payer: UHC Exchange |
$211.45
|
| Rate for Payer: UHC Medicaid |
$159.96
|
| Rate for Payer: UHCCP Medicaid |
$159.96
|
| Rate for Payer: UMR Bronson Commercial |
$199.07
|
| Rate for Payer: VA VA |
$305.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.52
|
|
|
HC INJECTION PLANTAR DIGIT BILATERAL
|
Facility
|
IP
|
$538.03
|
|
|
Service Code
|
CPT 64455
|
| Hospital Charge Code |
76100510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$236.73 |
| Max. Negotiated Rate |
$484.23 |
| Rate for Payer: Aetna American Axle |
$349.72
|
| Rate for Payer: Aetna Commercial |
$457.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$349.72
|
| Rate for Payer: Cash Price |
$430.42
|
| Rate for Payer: Cofinity Advantage |
$376.62
|
| Rate for Payer: Cofinity Commercial |
$462.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$430.42
|
| Rate for Payer: Healthscope Commercial |
$484.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$376.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$403.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$457.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$403.52
|
| Rate for Payer: PHP Commercial |
$457.33
|
| Rate for Payer: Priority Health SBD |
$338.96
|
| Rate for Payer: UMR Bronson Commercial |
$236.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$403.52
|
|
|
HC INJECTION PLATELET PLASMA W/IMG HARVEST/PREP
|
Facility
|
IP
|
$821.92
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
76100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$361.64 |
| Max. Negotiated Rate |
$739.73 |
| Rate for Payer: Aetna American Axle |
$534.25
|
| Rate for Payer: Aetna Commercial |
$698.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.25
|
| Rate for Payer: Cash Price |
$657.54
|
| Rate for Payer: Cofinity Advantage |
$575.34
|
| Rate for Payer: Cofinity Commercial |
$706.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$657.54
|
| Rate for Payer: Healthscope Commercial |
$739.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$575.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$616.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$616.44
|
| Rate for Payer: PHP Commercial |
$698.63
|
| Rate for Payer: Priority Health SBD |
$517.81
|
| Rate for Payer: UMR Bronson Commercial |
$361.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$616.44
|
|
|
HC INJECTION PLATELET PLASMA W/IMG HARVEST/PREP
|
Facility
|
OP
|
$821.92
|
|
|
Service Code
|
CPT 0232T
|
| Hospital Charge Code |
76100473
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$232.80 |
| Max. Negotiated Rate |
$1,439.47 |
| Rate for Payer: Aetna American Axle |
$534.25
|
| Rate for Payer: Aetna Commercial |
$698.63
|
| Rate for Payer: Aetna Medicare |
$462.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$534.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$657.54
|
| Rate for Payer: Cash Price |
$657.54
|
| Rate for Payer: Cofinity Advantage |
$575.34
|
| Rate for Payer: Cofinity Commercial |
$706.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$657.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$739.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$575.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$616.44
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$467.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$698.63
|
| Rate for Payer: Nomi Health Commercial |
$1,335.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$616.44
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$698.63
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.47
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health SBD |
$517.81
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.58
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$534.25
|
| Rate for Payer: UHC Core |
$428.22
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Exchange |
$323.01
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: UMR Bronson Commercial |
$304.11
|
| Rate for Payer: VA VA |
$445.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$616.44
|
|
