|
HC HEART CATH LT ONLY
|
Facility
|
IP
|
$8,481.03
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,731.65 |
| Max. Negotiated Rate |
$7,632.93 |
| Rate for Payer: Aetna American Axle |
$5,512.67
|
| Rate for Payer: Aetna Commercial |
$7,208.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,512.67
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cofinity Commercial |
$5,936.72
|
| Rate for Payer: Cofinity Commercial |
$7,293.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,936.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,784.82
|
| Rate for Payer: Healthscope Commercial |
$7,632.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,936.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,360.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,208.88
|
| Rate for Payer: PHP Commercial |
$7,208.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,512.67
|
| Rate for Payer: Priority Health SBD |
$5,343.05
|
| Rate for Payer: UMR Bronson Commercial |
$3,731.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,360.77
|
|
|
HC HEART CATH LT ONLY
|
Facility
|
OP
|
$8,481.03
|
|
|
Service Code
|
CPT 93452
|
| Hospital Charge Code |
48100011
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$8,830.06 |
| Rate for Payer: Aetna American Axle |
$5,512.67
|
| Rate for Payer: Aetna Commercial |
$7,208.88
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,512.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cash Price |
$6,784.82
|
| Rate for Payer: Cofinity Commercial |
$7,293.69
|
| Rate for Payer: Cofinity Commercial |
$5,936.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,936.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,784.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$7,632.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,936.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,360.77
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,208.88
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$7,208.88
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,512.67
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$5,343.05
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$5,994.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: UMR Bronson Commercial |
$3,137.98
|
| Rate for Payer: VA VA |
$3,136.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,360.77
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
OP
|
$15,100.65
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$13,590.58 |
| Rate for Payer: Aetna American Axle |
$9,815.42
|
| Rate for Payer: Aetna Commercial |
$12,835.55
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,815.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cofinity Commercial |
$12,986.56
|
| Rate for Payer: Cofinity Commercial |
$10,570.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,570.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,080.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$13,590.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,570.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,325.49
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,835.55
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$12,835.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,815.42
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$9,513.41
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$5,994.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: UMR Bronson Commercial |
$5,587.24
|
| Rate for Payer: VA VA |
$3,136.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,325.49
|
|
|
HC HEART CATH LT/RT/C/CABGS
|
Facility
|
IP
|
$15,100.65
|
|
|
Service Code
|
CPT 93461
|
| Hospital Charge Code |
48100052
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,644.29 |
| Max. Negotiated Rate |
$13,590.58 |
| Rate for Payer: Aetna American Axle |
$9,815.42
|
| Rate for Payer: Aetna Commercial |
$12,835.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,815.42
|
| Rate for Payer: Cash Price |
$12,080.52
|
| Rate for Payer: Cofinity Commercial |
$10,570.45
|
| Rate for Payer: Cofinity Commercial |
$12,986.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,570.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,080.52
|
| Rate for Payer: Healthscope Commercial |
$13,590.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,570.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,325.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,835.55
|
| Rate for Payer: PHP Commercial |
$12,835.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,815.42
|
| Rate for Payer: Priority Health SBD |
$9,513.41
|
| Rate for Payer: UMR Bronson Commercial |
$6,644.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,325.49
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
OP
|
$12,764.58
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$11,488.12 |
| Rate for Payer: Aetna American Axle |
$8,296.98
|
| Rate for Payer: Aetna Commercial |
$10,849.89
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,296.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cofinity Commercial |
$8,935.21
|
| Rate for Payer: Cofinity Commercial |
$10,977.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,935.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,211.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$11,488.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,935.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,573.43
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,849.89
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$10,849.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,296.98
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$8,041.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$5,994.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: UMR Bronson Commercial |
$4,722.89
|
| Rate for Payer: VA VA |
$3,136.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,573.43
|
|
|
HC HEART CATH LT/RT CORONARIES
|
Facility
|
IP
|
$12,764.58
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100019
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,616.42 |
| Max. Negotiated Rate |
$11,488.12 |
| Rate for Payer: Aetna American Axle |
$8,296.98
|
| Rate for Payer: Aetna Commercial |
$10,849.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,296.98
|
| Rate for Payer: Cash Price |
$10,211.66
|
| Rate for Payer: Cofinity Commercial |
$10,977.54
|
| Rate for Payer: Cofinity Commercial |
$8,935.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,935.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,211.66
|
| Rate for Payer: Healthscope Commercial |
$11,488.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,935.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,573.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,849.89
|
| Rate for Payer: PHP Commercial |
$10,849.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,296.98
|
| Rate for Payer: Priority Health SBD |
$8,041.69
|
| Rate for Payer: UMR Bronson Commercial |
$5,616.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,573.43
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
IP
|
$8,961.61
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,943.11 |
| Max. Negotiated Rate |
$8,065.45 |
| Rate for Payer: Aetna American Axle |
$5,825.05
|
| Rate for Payer: Aetna Commercial |
$7,617.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,825.05
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cofinity Commercial |
$6,273.13
|
| Rate for Payer: Cofinity Commercial |
$7,706.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,273.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,169.29
|
| Rate for Payer: Healthscope Commercial |
$8,065.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,273.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,721.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,617.37
|
| Rate for Payer: PHP Commercial |
$7,617.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,825.05
|
| Rate for Payer: Priority Health SBD |
$5,645.81
|
| Rate for Payer: UMR Bronson Commercial |
$3,943.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,721.21
|
|
|
HC HEART CATH LT/RT ONLY
|
Facility
|
OP
|
$8,961.61
|
|
|
Service Code
|
CPT 93453
|
| Hospital Charge Code |
48100012
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$8,830.06 |
| Rate for Payer: Aetna American Axle |
$5,825.05
|
| Rate for Payer: Aetna Commercial |
$7,617.37
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,825.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cash Price |
$7,169.29
|
| Rate for Payer: Cofinity Commercial |
$7,706.98
|
| Rate for Payer: Cofinity Commercial |
$6,273.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,273.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,169.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$8,065.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,273.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,721.21
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,617.37
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$7,617.37
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,825.05
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$5,645.81
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$5,994.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: UMR Bronson Commercial |
$3,315.80
|
| Rate for Payer: VA VA |
$3,136.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,721.21
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
IP
|
$12,850.11
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,654.05 |
| Max. Negotiated Rate |
$11,565.10 |
| Rate for Payer: Aetna American Axle |
$8,352.57
|
| Rate for Payer: Aetna Commercial |
$10,922.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,352.57
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cofinity Commercial |
$11,051.09
|
| Rate for Payer: Cofinity Commercial |
$8,995.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,995.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,280.09
|
| Rate for Payer: Healthscope Commercial |
$11,565.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,995.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,637.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,922.59
|
| Rate for Payer: PHP Commercial |
$10,922.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,352.57
|
| Rate for Payer: Priority Health SBD |
$8,095.57
|
| Rate for Payer: UMR Bronson Commercial |
$5,654.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,637.58
|
|
|
HC HEART CATH LT W CORONARIES
|
Facility
|
OP
|
$12,850.11
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100017
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$11,565.10 |
| Rate for Payer: Aetna American Axle |
$8,352.57
|
| Rate for Payer: Aetna Commercial |
$10,922.59
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,352.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cash Price |
$10,280.09
|
| Rate for Payer: Cofinity Commercial |
$8,995.08
|
| Rate for Payer: Cofinity Commercial |
$11,051.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,995.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,280.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$11,565.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,995.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,637.58
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,922.59
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$10,922.59
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,352.57
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$8,095.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$5,994.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: UMR Bronson Commercial |
$4,754.54
|
| Rate for Payer: VA VA |
$3,136.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,637.58
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
OP
|
$43.10
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.95 |
| Max. Negotiated Rate |
$38.79 |
| Rate for Payer: Aetna American Axle |
$28.02
|
| Rate for Payer: Aetna Commercial |
$36.63
|
| Rate for Payer: Aetna Medicare |
$21.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.02
|
| Rate for Payer: BCBS Complete |
$17.24
|
| Rate for Payer: Cash Price |
$34.48
|
| Rate for Payer: Cofinity Commercial |
$30.17
|
| Rate for Payer: Cofinity Commercial |
$37.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.63
|
| Rate for Payer: PHP Commercial |
$36.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.02
|
| Rate for Payer: Priority Health SBD |
$27.15
|
| Rate for Payer: UMR Bronson Commercial |
$15.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.33
|
|
|
HC HEART CATH NEEDLE
|
Facility
|
IP
|
$43.10
|
|
| Hospital Charge Code |
62200006
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.96 |
| Max. Negotiated Rate |
$38.79 |
| Rate for Payer: Aetna American Axle |
$28.02
|
| Rate for Payer: Aetna Commercial |
$36.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.02
|
| Rate for Payer: Cash Price |
$34.48
|
| Rate for Payer: Cofinity Commercial |
$30.17
|
| Rate for Payer: Cofinity Commercial |
$37.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$30.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.48
|
| Rate for Payer: Healthscope Commercial |
$38.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.63
|
| Rate for Payer: PHP Commercial |
$36.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.02
|
| Rate for Payer: Priority Health SBD |
$27.15
|
| Rate for Payer: UMR Bronson Commercial |
$18.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.33
|
|
|
HC HEART CATH PACK
|
Facility
|
OP
|
$518.38
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$191.80 |
| Max. Negotiated Rate |
$466.54 |
| Rate for Payer: Aetna American Axle |
$336.95
|
| Rate for Payer: Aetna Commercial |
$440.62
|
| Rate for Payer: Aetna Medicare |
$259.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.95
|
| Rate for Payer: BCBS Complete |
$207.35
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Cofinity Commercial |
$362.87
|
| Rate for Payer: Cofinity Commercial |
$445.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$362.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.70
|
| Rate for Payer: Healthscope Commercial |
$466.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$362.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.62
|
| Rate for Payer: PHP Commercial |
$440.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.95
|
| Rate for Payer: Priority Health SBD |
$326.58
|
| Rate for Payer: UMR Bronson Commercial |
$191.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.79
|
|
|
HC HEART CATH PACK
|
Facility
|
IP
|
$518.38
|
|
| Hospital Charge Code |
62200007
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$228.09 |
| Max. Negotiated Rate |
$466.54 |
| Rate for Payer: Aetna American Axle |
$336.95
|
| Rate for Payer: Aetna Commercial |
$440.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$336.95
|
| Rate for Payer: Cash Price |
$414.70
|
| Rate for Payer: Cofinity Commercial |
$362.87
|
| Rate for Payer: Cofinity Commercial |
$445.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$362.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$414.70
|
| Rate for Payer: Healthscope Commercial |
$466.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$362.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$388.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$440.62
|
| Rate for Payer: PHP Commercial |
$440.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$336.95
|
| Rate for Payer: Priority Health SBD |
$326.58
|
| Rate for Payer: UMR Bronson Commercial |
$228.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$388.79
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
IP
|
$9,551.63
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,202.72 |
| Max. Negotiated Rate |
$8,596.47 |
| Rate for Payer: Aetna American Axle |
$6,208.56
|
| Rate for Payer: Aetna Commercial |
$8,118.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,208.56
|
| Rate for Payer: Cash Price |
$7,641.30
|
| Rate for Payer: Cofinity Commercial |
$6,686.14
|
| Rate for Payer: Cofinity Commercial |
$8,214.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,686.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,641.30
|
| Rate for Payer: Healthscope Commercial |
$8,596.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,686.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,163.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.89
|
| Rate for Payer: PHP Commercial |
$8,118.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,208.56
|
| Rate for Payer: Priority Health SBD |
$6,017.53
|
| Rate for Payer: UMR Bronson Commercial |
$4,202.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,163.72
|
|
|
HC HEART CATH RT ONLY
|
Facility
|
OP
|
$9,551.63
|
|
|
Service Code
|
CPT 93451
|
| Hospital Charge Code |
48100010
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,681.38 |
| Max. Negotiated Rate |
$8,830.06 |
| Rate for Payer: Aetna American Axle |
$6,208.56
|
| Rate for Payer: Aetna Commercial |
$8,118.89
|
| Rate for Payer: Aetna Medicare |
$3,262.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,208.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,921.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,921.12
|
| Rate for Payer: BCBS Complete |
$1,765.45
|
| Rate for Payer: BCBS MAPPO |
$3,136.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,136.90
|
| Rate for Payer: Cash Price |
$7,641.30
|
| Rate for Payer: Cash Price |
$7,641.30
|
| Rate for Payer: Cofinity Commercial |
$8,214.40
|
| Rate for Payer: Cofinity Commercial |
$6,686.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,686.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,641.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,136.90
|
| Rate for Payer: Healthscope Commercial |
$8,596.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,686.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,163.72
|
| Rate for Payer: Mclaren Medicaid |
$1,681.38
|
| Rate for Payer: Mclaren Medicare |
$3,136.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,293.74
|
| Rate for Payer: Meridian Medicaid |
$1,765.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,607.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,118.89
|
| Rate for Payer: PACE Medicare |
$2,980.05
|
| Rate for Payer: PACE SWMI |
$3,136.90
|
| Rate for Payer: PHP Commercial |
$8,118.89
|
| Rate for Payer: PHP Medicare Advantage |
$3,136.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,681.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,208.56
|
| Rate for Payer: Priority Health Medicare |
$3,136.90
|
| Rate for Payer: Priority Health SBD |
$6,017.53
|
| Rate for Payer: Railroad Medicare Medicare |
$3,136.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,830.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,136.90
|
| Rate for Payer: UHC Exchange |
$5,994.93
|
| Rate for Payer: UHC Medicare Advantage |
$3,136.90
|
| Rate for Payer: UHCCP Medicaid |
$1,681.38
|
| Rate for Payer: UMR Bronson Commercial |
$3,534.10
|
| Rate for Payer: VA VA |
$3,136.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,163.72
|
|
|
HC HEART CATH WIRE
|
Facility
|
IP
|
$33.27
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.64 |
| Max. Negotiated Rate |
$29.94 |
| Rate for Payer: Aetna American Axle |
$21.63
|
| Rate for Payer: Aetna Commercial |
$28.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.63
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cofinity Commercial |
$23.29
|
| Rate for Payer: Cofinity Commercial |
$28.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$29.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.28
|
| Rate for Payer: PHP Commercial |
$28.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health SBD |
$20.96
|
| Rate for Payer: UMR Bronson Commercial |
$14.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.95
|
|
|
HC HEART CATH WIRE
|
Facility
|
OP
|
$33.27
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200048
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$29.94 |
| Rate for Payer: Aetna American Axle |
$21.63
|
| Rate for Payer: Aetna Commercial |
$28.28
|
| Rate for Payer: Aetna Medicare |
$16.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.63
|
| Rate for Payer: BCBS Complete |
$13.31
|
| Rate for Payer: Cash Price |
$26.62
|
| Rate for Payer: Cofinity Commercial |
$23.29
|
| Rate for Payer: Cofinity Commercial |
$28.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.62
|
| Rate for Payer: Healthscope Commercial |
$29.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$28.28
|
| Rate for Payer: PHP Commercial |
$28.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$21.63
|
| Rate for Payer: Priority Health SBD |
$20.96
|
| Rate for Payer: UMR Bronson Commercial |
$12.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.95
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
OP
|
$31.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$53.40 |
| Rate for Payer: Aetna American Axle |
$20.18
|
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.71
|
| Rate for Payer: BCBS Complete |
$10.68
|
| Rate for Payer: BCBS MAPPO |
$18.97
|
| Rate for Payer: BCN Medicare Advantage |
$18.97
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cofinity Commercial |
$26.69
|
| Rate for Payer: Cofinity Commercial |
$21.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.97
|
| Rate for Payer: Healthscope Commercial |
$27.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.28
|
| Rate for Payer: Mclaren Medicaid |
$10.17
|
| Rate for Payer: Mclaren Medicare |
$18.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: Meridian Medicaid |
$10.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: PACE Medicare |
$18.02
|
| Rate for Payer: PACE SWMI |
$18.97
|
| Rate for Payer: PHP Commercial |
$26.38
|
| Rate for Payer: PHP Medicare Advantage |
$18.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.18
|
| Rate for Payer: Priority Health Medicare |
$18.97
|
| Rate for Payer: Priority Health SBD |
$19.56
|
| Rate for Payer: Railroad Medicare Medicare |
$18.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.97
|
| Rate for Payer: UHC Exchange |
$36.25
|
| Rate for Payer: UHC Medicare Advantage |
$18.97
|
| Rate for Payer: UHCCP Medicaid |
$10.17
|
| Rate for Payer: UMR Bronson Commercial |
$11.48
|
| Rate for Payer: VA VA |
$18.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.28
|
|
|
HC HEAVY METAL ARSENIC
|
Facility
|
IP
|
$31.04
|
|
|
Service Code
|
CPT 82175
|
| Hospital Charge Code |
30100111
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.66 |
| Max. Negotiated Rate |
$27.94 |
| Rate for Payer: Aetna American Axle |
$20.18
|
| Rate for Payer: Aetna Commercial |
$26.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.18
|
| Rate for Payer: Cash Price |
$24.83
|
| Rate for Payer: Cofinity Commercial |
$21.73
|
| Rate for Payer: Cofinity Commercial |
$26.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.83
|
| Rate for Payer: Healthscope Commercial |
$27.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.38
|
| Rate for Payer: PHP Commercial |
$26.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.18
|
| Rate for Payer: Priority Health SBD |
$19.56
|
| Rate for Payer: UMR Bronson Commercial |
$13.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.28
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
OP
|
$26.61
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$45.77 |
| Rate for Payer: Aetna American Axle |
$17.30
|
| Rate for Payer: Aetna Commercial |
$22.62
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$21.29
|
| Rate for Payer: Cash Price |
$21.29
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$23.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.96
|
| Rate for Payer: Mclaren Medicaid |
$8.72
|
| Rate for Payer: Mclaren Medicare |
$16.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.62
|
| Rate for Payer: PACE Medicare |
$15.45
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$22.62
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.30
|
| Rate for Payer: Priority Health Medicare |
$16.26
|
| Rate for Payer: Priority Health SBD |
$16.76
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.26
|
| Rate for Payer: UHC Exchange |
$31.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.26
|
| Rate for Payer: UHCCP Medicaid |
$8.72
|
| Rate for Payer: UMR Bronson Commercial |
$9.85
|
| Rate for Payer: VA VA |
$16.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.96
|
|
|
HC HEAVY METAL MERCURY
|
Facility
|
IP
|
$26.61
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100293
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.71 |
| Max. Negotiated Rate |
$23.95 |
| Rate for Payer: Aetna American Axle |
$17.30
|
| Rate for Payer: Aetna Commercial |
$22.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.30
|
| Rate for Payer: Cash Price |
$21.29
|
| Rate for Payer: Cofinity Commercial |
$18.63
|
| Rate for Payer: Cofinity Commercial |
$22.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.29
|
| Rate for Payer: Healthscope Commercial |
$23.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.62
|
| Rate for Payer: PHP Commercial |
$22.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.30
|
| Rate for Payer: Priority Health SBD |
$16.76
|
| Rate for Payer: UMR Bronson Commercial |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.96
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
OP
|
$38.67
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.67 |
| Max. Negotiated Rate |
$66.54 |
| Rate for Payer: Aetna American Axle |
$25.14
|
| Rate for Payer: Aetna Commercial |
$32.87
|
| Rate for Payer: Aetna Medicare |
$24.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.55
|
| Rate for Payer: BCBS Complete |
$13.30
|
| Rate for Payer: BCBS MAPPO |
$23.64
|
| Rate for Payer: BCN Medicare Advantage |
$23.64
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Cofinity Commercial |
$33.26
|
| Rate for Payer: Cofinity Commercial |
$27.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.64
|
| Rate for Payer: Healthscope Commercial |
$34.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$12.67
|
| Rate for Payer: Mclaren Medicare |
$23.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.82
|
| Rate for Payer: Meridian Medicaid |
$13.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.87
|
| Rate for Payer: PACE Medicare |
$22.46
|
| Rate for Payer: PACE SWMI |
$23.64
|
| Rate for Payer: PHP Commercial |
$32.87
|
| Rate for Payer: PHP Medicare Advantage |
$23.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.14
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$23.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.64
|
| Rate for Payer: UHC Exchange |
$45.18
|
| Rate for Payer: UHC Medicare Advantage |
$23.64
|
| Rate for Payer: UHCCP Medicaid |
$12.67
|
| Rate for Payer: UMR Bronson Commercial |
$14.31
|
| Rate for Payer: VA VA |
$23.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC HEAVY METAL PANEL CADMIUM LEVEL
|
Facility
|
IP
|
$38.67
|
|
|
Service Code
|
CPT 82300
|
| Hospital Charge Code |
30100125
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$34.80 |
| Rate for Payer: Aetna American Axle |
$25.14
|
| Rate for Payer: Aetna Commercial |
$32.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.14
|
| Rate for Payer: Cash Price |
$30.94
|
| Rate for Payer: Cofinity Commercial |
$27.07
|
| Rate for Payer: Cofinity Commercial |
$33.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.94
|
| Rate for Payer: Healthscope Commercial |
$34.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.87
|
| Rate for Payer: PHP Commercial |
$32.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.14
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: UMR Bronson Commercial |
$17.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC HEAVY METAL PANEL LEAD
|
Facility
|
IP
|
$19.80
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100276
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$17.82 |
| Rate for Payer: Aetna American Axle |
$12.87
|
| Rate for Payer: Aetna Commercial |
$16.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.87
|
| Rate for Payer: Cash Price |
$15.84
|
| Rate for Payer: Cofinity Commercial |
$13.86
|
| Rate for Payer: Cofinity Commercial |
$17.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.84
|
| Rate for Payer: Healthscope Commercial |
$17.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.83
|
| Rate for Payer: PHP Commercial |
$16.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.87
|
| Rate for Payer: Priority Health SBD |
$12.47
|
| Rate for Payer: UMR Bronson Commercial |
$8.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.85
|
|
