|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$1,033.93
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$454.93 |
| Max. Negotiated Rate |
$930.54 |
| Rate for Payer: Aetna American Axle |
$672.05
|
| Rate for Payer: Aetna American Axle |
$1,651.65
|
| Rate for Payer: Aetna Commercial |
$2,159.85
|
| Rate for Payer: Aetna Commercial |
$878.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,651.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.05
|
| Rate for Payer: Cash Price |
$2,032.80
|
| Rate for Payer: Cash Price |
$827.14
|
| Rate for Payer: Cofinity Commercial |
$723.75
|
| Rate for Payer: Cofinity Commercial |
$1,778.70
|
| Rate for Payer: Cofinity Commercial |
$2,185.26
|
| Rate for Payer: Cofinity Commercial |
$889.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,032.80
|
| Rate for Payer: Healthscope Commercial |
$2,286.90
|
| Rate for Payer: Healthscope Commercial |
$930.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$723.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,778.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,905.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,159.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$878.84
|
| Rate for Payer: PHP Commercial |
$2,159.85
|
| Rate for Payer: PHP Commercial |
$878.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,778.70
|
| Rate for Payer: Priority Health SBD |
$651.38
|
| Rate for Payer: Priority Health SBD |
$1,600.83
|
| Rate for Payer: UMR Bronson Commercial |
$454.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,118.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,905.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.45
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
OP
|
$2,541.00
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$401.12 |
| Max. Negotiated Rate |
$2,286.90 |
| Rate for Payer: Aetna American Axle |
$1,651.65
|
| Rate for Payer: Aetna American Axle |
$672.05
|
| Rate for Payer: Aetna Commercial |
$2,159.85
|
| Rate for Payer: Aetna Commercial |
$878.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$672.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,651.65
|
| Rate for Payer: BCBS Complete |
$1,016.40
|
| Rate for Payer: BCBS Complete |
$413.57
|
| Rate for Payer: BCBS Trust/PPO |
$585.34
|
| Rate for Payer: BCBS Trust/PPO |
$585.34
|
| Rate for Payer: Cash Price |
$827.14
|
| Rate for Payer: Cash Price |
$827.14
|
| Rate for Payer: Cash Price |
$2,032.80
|
| Rate for Payer: Cash Price |
$827.14
|
| Rate for Payer: Cash Price |
$2,032.80
|
| Rate for Payer: Cash Price |
$2,032.80
|
| Rate for Payer: Cofinity Commercial |
$2,185.26
|
| Rate for Payer: Cofinity Commercial |
$889.18
|
| Rate for Payer: Cofinity Commercial |
$723.75
|
| Rate for Payer: Cofinity Commercial |
$1,778.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$827.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,032.80
|
| Rate for Payer: Healthscope Commercial |
$930.54
|
| Rate for Payer: Healthscope Commercial |
$2,286.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$723.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,778.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,905.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$775.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,159.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$878.84
|
| Rate for Payer: PHP Commercial |
$2,159.85
|
| Rate for Payer: PHP Commercial |
$878.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$723.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,778.70
|
| Rate for Payer: Priority Health SBD |
$1,600.83
|
| Rate for Payer: Priority Health SBD |
$651.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$441.23
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Exchange |
$401.12
|
| Rate for Payer: UHC Exchange |
$401.12
|
| Rate for Payer: UMR Bronson Commercial |
$382.55
|
| Rate for Payer: UMR Bronson Commercial |
$940.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$775.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,905.75
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$99.60
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$89.64 |
| Rate for Payer: Aetna American Axle |
$64.74
|
| Rate for Payer: Aetna Commercial |
$84.66
|
| Rate for Payer: Aetna Medicare |
$13.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: BCBS Complete |
$7.52
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$11.79
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$79.68
|
| Rate for Payer: Cash Price |
$79.68
|
| Rate for Payer: Cofinity Commercial |
$69.72
|
| Rate for Payer: Cofinity Commercial |
$85.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$89.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.70
|
| Rate for Payer: Mclaren Medicaid |
$7.17
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Medicaid |
$7.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.66
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$84.66
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$62.75
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.72
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.10
|
| Rate for Payer: UHC Exchange |
$13.10
|
| Rate for Payer: UHC Medicare Advantage |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$36.85
|
| Rate for Payer: VA VA |
$13.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.70
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$99.60
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.82 |
| Max. Negotiated Rate |
$89.64 |
| Rate for Payer: Aetna American Axle |
$64.74
|
| Rate for Payer: Aetna Commercial |
$84.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.74
|
| Rate for Payer: Cash Price |
$79.68
|
| Rate for Payer: Cofinity Commercial |
$69.72
|
| Rate for Payer: Cofinity Commercial |
$85.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.68
|
| Rate for Payer: Healthscope Commercial |
$89.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$84.66
|
| Rate for Payer: PHP Commercial |
$84.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.72
|
| Rate for Payer: Priority Health SBD |
$62.75
|
| Rate for Payer: UMR Bronson Commercial |
$43.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.70
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
OP
|
$71.80
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.34 |
| Max. Negotiated Rate |
$64.62 |
| Rate for Payer: Aetna American Axle |
$46.67
|
| Rate for Payer: Aetna Commercial |
$61.03
|
| Rate for Payer: Aetna Medicare |
$13.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.78
|
| Rate for Payer: BCBS Complete |
$7.71
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$12.07
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$57.44
|
| Rate for Payer: Cash Price |
$57.44
|
| Rate for Payer: Cofinity Commercial |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$61.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$64.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.85
|
| Rate for Payer: Mclaren Medicaid |
$7.34
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Medicaid |
$7.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.03
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$61.03
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$45.23
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.10
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.42
|
| Rate for Payer: UHC Exchange |
$13.42
|
| Rate for Payer: UHC Medicare Advantage |
$13.82
|
| Rate for Payer: UMR Bronson Commercial |
$26.57
|
| Rate for Payer: VA VA |
$13.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.85
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
IP
|
$71.80
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.59 |
| Max. Negotiated Rate |
$64.62 |
| Rate for Payer: Aetna American Axle |
$46.67
|
| Rate for Payer: Aetna Commercial |
$61.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.67
|
| Rate for Payer: Cash Price |
$57.44
|
| Rate for Payer: Cofinity Commercial |
$50.26
|
| Rate for Payer: Cofinity Commercial |
$61.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.44
|
| Rate for Payer: Healthscope Commercial |
$64.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.03
|
| Rate for Payer: PHP Commercial |
$61.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.26
|
| Rate for Payer: Priority Health SBD |
$45.23
|
| Rate for Payer: UMR Bronson Commercial |
$31.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.85
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
IP
|
$69.00
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.36 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Aetna American Axle |
$44.85
|
| Rate for Payer: Aetna Commercial |
$58.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.85
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$48.30
|
| Rate for Payer: Cofinity Commercial |
$59.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Healthscope Commercial |
$62.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: PHP Commercial |
$58.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health SBD |
$43.47
|
| Rate for Payer: UMR Bronson Commercial |
$30.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.75
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
OP
|
$69.00
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$62.10 |
| Rate for Payer: Aetna American Axle |
$44.85
|
| Rate for Payer: Aetna Commercial |
$58.65
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.88
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$10.78
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cash Price |
$55.20
|
| Rate for Payer: Cofinity Commercial |
$59.34
|
| Rate for Payer: Cofinity Commercial |
$48.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$62.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.75
|
| Rate for Payer: Mclaren Medicaid |
$6.55
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Medicaid |
$6.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$58.65
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$58.65
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$43.47
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.34
|
| Rate for Payer: UMR Bronson Commercial |
$25.53
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.75
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
IP
|
$4,931.74
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,169.97 |
| Max. Negotiated Rate |
$4,438.57 |
| Rate for Payer: Aetna American Axle |
$3,205.63
|
| Rate for Payer: Aetna Commercial |
$4,191.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,205.63
|
| Rate for Payer: Cash Price |
$3,945.39
|
| Rate for Payer: Cofinity Commercial |
$3,452.22
|
| Rate for Payer: Cofinity Commercial |
$4,241.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,945.39
|
| Rate for Payer: Healthscope Commercial |
$4,438.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,452.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,698.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,191.98
|
| Rate for Payer: PHP Commercial |
$4,191.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,452.22
|
| Rate for Payer: Priority Health SBD |
$3,107.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,169.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,698.80
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
OP
|
$4,931.74
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$185.80 |
| Max. Negotiated Rate |
$5,394.40 |
| Rate for Payer: Aetna American Axle |
$3,205.63
|
| Rate for Payer: Aetna Commercial |
$4,191.98
|
| Rate for Payer: Aetna Medicare |
$353.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,205.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$424.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$424.60
|
| Rate for Payer: BCBS Complete |
$195.11
|
| Rate for Payer: BCBS MAPPO |
$339.68
|
| Rate for Payer: BCBS Trust/PPO |
$5,394.40
|
| Rate for Payer: BCN Medicare Advantage |
$339.68
|
| Rate for Payer: Cash Price |
$3,945.39
|
| Rate for Payer: Cash Price |
$3,945.39
|
| Rate for Payer: Cofinity Commercial |
$4,241.30
|
| Rate for Payer: Cofinity Commercial |
$3,452.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,945.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$339.68
|
| Rate for Payer: Healthscope Commercial |
$4,438.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,452.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,698.80
|
| Rate for Payer: Mclaren Medicaid |
$185.80
|
| Rate for Payer: Mclaren Medicare |
$339.68
|
| Rate for Payer: Meridian Medicaid |
$195.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$356.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$390.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,191.98
|
| Rate for Payer: PACE Medicare |
$322.70
|
| Rate for Payer: PACE SWMI |
$339.68
|
| Rate for Payer: PHP Commercial |
$4,191.98
|
| Rate for Payer: PHP Medicare Advantage |
$339.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,452.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$997.60
|
| Rate for Payer: Priority Health Medicare |
$339.68
|
| Rate for Payer: Priority Health Narrow Network |
$798.08
|
| Rate for Payer: Priority Health SBD |
$3,107.00
|
| Rate for Payer: Railroad Medicare Medicare |
$339.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$339.68
|
| Rate for Payer: UHC Medicare Advantage |
$349.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,824.74
|
| Rate for Payer: VA VA |
$339.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,698.80
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
IP
|
$22.00
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Aetna American Axle |
$14.30
|
| Rate for Payer: Aetna Commercial |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.30
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$15.40
|
| Rate for Payer: Cofinity Commercial |
$18.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.60
|
| Rate for Payer: Healthscope Commercial |
$19.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.70
|
| Rate for Payer: PHP Commercial |
$18.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.40
|
| Rate for Payer: Priority Health SBD |
$13.86
|
| Rate for Payer: UMR Bronson Commercial |
$9.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.50
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
OP
|
$22.00
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Aetna American Axle |
$14.30
|
| Rate for Payer: Aetna Commercial |
$18.70
|
| Rate for Payer: Aetna Medicare |
$13.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: BCBS Complete |
$7.52
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$11.79
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cofinity Commercial |
$15.40
|
| Rate for Payer: Cofinity Commercial |
$18.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$19.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.50
|
| Rate for Payer: Mclaren Medicaid |
$7.17
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Medicaid |
$7.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$18.70
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$18.70
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.44
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health Narrow Network |
$13.15
|
| Rate for Payer: Priority Health SBD |
$13.86
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.72
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.10
|
| Rate for Payer: UHC Exchange |
$13.10
|
| Rate for Payer: UHC Medicare Advantage |
$13.49
|
| Rate for Payer: UMR Bronson Commercial |
$8.14
|
| Rate for Payer: VA VA |
$13.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.50
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| 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 |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| 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 |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.19 |
| Max. Negotiated Rate |
$57.89 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| 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 |
$20.16
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$19.19
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Medicaid |
$20.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.14
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$38.51
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Core |
$57.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.14
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
IP
|
$612.00
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$269.28 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna American Axle |
$397.80
|
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: UMR Bronson Commercial |
$269.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
OP
|
$612.00
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$179.86 |
| Max. Negotiated Rate |
$550.80 |
| Rate for Payer: Aetna American Axle |
$397.80
|
| Rate for Payer: Aetna Commercial |
$520.20
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$239.40
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$179.86
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cash Price |
$489.60
|
| Rate for Payer: Cofinity Commercial |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$526.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$489.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$550.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$428.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.00
|
| Rate for Payer: Mclaren Medicaid |
$227.98
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Medicaid |
$239.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$520.20
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$520.20
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$428.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$416.78
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$333.42
|
| Rate for Payer: Priority Health SBD |
$385.56
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.14
|
| Rate for Payer: UHC Core |
$500.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$429.28
|
| Rate for Payer: UMR Bronson Commercial |
$226.44
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.00
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
IP
|
$18.48
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.13 |
| Max. Negotiated Rate |
$16.63 |
| Rate for Payer: Aetna American Axle |
$12.01
|
| Rate for Payer: Aetna Commercial |
$15.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.01
|
| Rate for Payer: Cash Price |
$14.78
|
| Rate for Payer: Cofinity Commercial |
$12.94
|
| Rate for Payer: Cofinity Commercial |
$15.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.78
|
| Rate for Payer: Healthscope Commercial |
$16.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.71
|
| Rate for Payer: PHP Commercial |
$15.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health SBD |
$11.64
|
| Rate for Payer: UMR Bronson Commercial |
$8.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.86
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
OP
|
$18.48
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.84 |
| Max. Negotiated Rate |
$16.63 |
| Rate for Payer: Aetna American Axle |
$12.01
|
| Rate for Payer: Aetna Commercial |
$15.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.01
|
| Rate for Payer: BCBS Complete |
$7.39
|
| Rate for Payer: Cash Price |
$14.78
|
| Rate for Payer: Cofinity Commercial |
$12.94
|
| Rate for Payer: Cofinity Commercial |
$15.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.78
|
| Rate for Payer: Healthscope Commercial |
$16.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$15.71
|
| Rate for Payer: PHP Commercial |
$15.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health SBD |
$11.64
|
| Rate for Payer: UMR Bronson Commercial |
$6.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.86
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.93 |
| Max. Negotiated Rate |
$243.27 |
| Rate for Payer: Aetna American Axle |
$175.70
|
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Cofinity Commercial |
$189.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.24
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health SBD |
$170.29
|
| Rate for Payer: UMR Bronson Commercial |
$118.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.72
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.88 |
| Max. Negotiated Rate |
$560.20 |
| Rate for Payer: Aetna American Axle |
$175.70
|
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$133.28
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Cofinity Commercial |
$189.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.72
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$448.16
|
| Rate for Payer: Priority Health SBD |
$170.29
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$43.88
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$100.01
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.72
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
OP
|
$40.70
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.05 |
| Max. Negotiated Rate |
$36.63 |
| Rate for Payer: Aetna American Axle |
$26.46
|
| Rate for Payer: Aetna Commercial |
$34.60
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.96
|
| Rate for Payer: BCBS Complete |
$3.20
|
| Rate for Payer: BCBS MAPPO |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$5.01
|
| Rate for Payer: BCN Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cash Price |
$32.56
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Cofinity Commercial |
$28.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$36.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.52
|
| Rate for Payer: Mclaren Medicaid |
$3.05
|
| Rate for Payer: Mclaren Medicare |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.20
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.60
|
| Rate for Payer: PACE Medicare |
$5.29
|
| Rate for Payer: PACE SWMI |
$5.57
|
| Rate for Payer: PHP Commercial |
$34.60
|
| Rate for Payer: PHP Medicare Advantage |
$5.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.65
|
| Rate for Payer: Priority Health Medicare |
$5.57
|
| Rate for Payer: Priority Health Narrow Network |
$4.52
|
| Rate for Payer: Priority Health SBD |
$25.64
|
| Rate for Payer: Railroad Medicare Medicare |
$5.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.68
|
| Rate for Payer: UHC Core |
$9.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.57
|
| Rate for Payer: UHC Exchange |
$5.57
|
| Rate for Payer: UHC Medicare Advantage |
$5.74
|
| Rate for Payer: UMR Bronson Commercial |
$15.06
|
| Rate for Payer: VA VA |
$5.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.52
|
|
