|
HC HEM/ONC CMS INITIAL COMP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500005
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$166.50 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna American Axle |
$292.50
|
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna Medicare |
$225.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.50
|
| Rate for Payer: BCBS Complete |
$180.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$315.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$315.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$315.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health SBD |
$283.50
|
| Rate for Payer: UMR Bronson Commercial |
$166.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC HEM/ONC CMS SUPP/SERV
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500008
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$33.00 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna American Axle |
$48.75
|
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health SBD |
$47.25
|
| Rate for Payer: UMR Bronson Commercial |
$33.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HEM/ONC CMS SUPP/SERV
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500008
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$27.75 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna American Axle |
$48.75
|
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$37.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.75
|
| Rate for Payer: BCBS Complete |
$30.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.75
|
| Rate for Payer: Priority Health SBD |
$47.25
|
| Rate for Payer: UMR Bronson Commercial |
$27.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
OP
|
$1,162.48
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
76100187
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$430.12 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna American Axle |
$755.61
|
| Rate for Payer: Aetna Commercial |
$988.11
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$999.73
|
| Rate for Payer: Cofinity Commercial |
$813.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$813.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$1,046.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$813.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.86
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$988.11
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$732.36
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,502.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,699.29
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: UMR Bronson Commercial |
$430.12
|
| Rate for Payer: VA VA |
$889.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.86
|
|
|
HC HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS
|
Facility
|
IP
|
$1,162.48
|
|
|
Service Code
|
CPT 46221
|
| Hospital Charge Code |
76100187
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$511.49 |
| Max. Negotiated Rate |
$1,046.23 |
| Rate for Payer: Aetna American Axle |
$755.61
|
| Rate for Payer: Aetna Commercial |
$988.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$755.61
|
| Rate for Payer: Cash Price |
$929.98
|
| Rate for Payer: Cofinity Commercial |
$813.74
|
| Rate for Payer: Cofinity Commercial |
$999.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$813.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$929.98
|
| Rate for Payer: Healthscope Commercial |
$1,046.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$813.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$871.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$988.11
|
| Rate for Payer: PHP Commercial |
$988.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$755.61
|
| Rate for Payer: Priority Health SBD |
$732.36
|
| Rate for Payer: UMR Bronson Commercial |
$511.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$871.86
|
|
|
HC HEMOSIDERIN
|
Facility
|
OP
|
$23.46
|
|
|
Service Code
|
CPT 83070
|
| Hospital Charge Code |
30100241
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna American Axle |
$15.25
|
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna Medicare |
$4.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.94
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.75
|
| Rate for Payer: BCN Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Cofinity Commercial |
$16.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.75
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.59
|
| Rate for Payer: Mclaren Medicaid |
$2.55
|
| Rate for Payer: Mclaren Medicare |
$4.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.99
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.94
|
| Rate for Payer: PACE Medicare |
$4.51
|
| Rate for Payer: PACE SWMI |
$4.75
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: PHP Medicare Advantage |
$4.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.25
|
| Rate for Payer: Priority Health Medicare |
$4.75
|
| Rate for Payer: Priority Health SBD |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$4.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.75
|
| Rate for Payer: UHC Exchange |
$9.08
|
| Rate for Payer: UHC Medicare Advantage |
$4.75
|
| Rate for Payer: UHCCP Medicaid |
$2.55
|
| Rate for Payer: UMR Bronson Commercial |
$8.68
|
| Rate for Payer: VA VA |
$4.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.59
|
|
|
HC HEMOSIDERIN
|
Facility
|
IP
|
$23.46
|
|
|
Service Code
|
CPT 83070
|
| Hospital Charge Code |
30100241
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.32 |
| Max. Negotiated Rate |
$21.11 |
| Rate for Payer: Aetna American Axle |
$15.25
|
| Rate for Payer: Aetna Commercial |
$19.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.25
|
| Rate for Payer: Cash Price |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$16.42
|
| Rate for Payer: Cofinity Commercial |
$20.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.77
|
| Rate for Payer: Healthscope Commercial |
$21.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.94
|
| Rate for Payer: PHP Commercial |
$19.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.25
|
| Rate for Payer: Priority Health SBD |
$14.78
|
| Rate for Payer: UMR Bronson Commercial |
$10.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.59
|
|
|
HC HEMOSTASIS PATCH
|
Facility
|
OP
|
$486.27
|
|
| Hospital Charge Code |
27200153
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$179.92 |
| Max. Negotiated Rate |
$437.64 |
| Rate for Payer: Aetna American Axle |
$316.08
|
| Rate for Payer: Aetna Commercial |
$413.33
|
| Rate for Payer: Aetna Medicare |
$243.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.08
|
| Rate for Payer: BCBS Complete |
$194.51
|
| Rate for Payer: Cash Price |
$389.02
|
| Rate for Payer: Cofinity Commercial |
$340.39
|
| Rate for Payer: Cofinity Commercial |
$418.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$389.02
|
| Rate for Payer: Healthscope Commercial |
$437.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.33
|
| Rate for Payer: PHP Commercial |
$413.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.08
|
| Rate for Payer: Priority Health SBD |
$306.35
|
| Rate for Payer: UMR Bronson Commercial |
$179.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.70
|
|
|
HC HEMOSTASIS PATCH
|
Facility
|
IP
|
$486.27
|
|
| Hospital Charge Code |
27200153
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$213.96 |
| Max. Negotiated Rate |
$437.64 |
| Rate for Payer: Aetna American Axle |
$316.08
|
| Rate for Payer: Aetna Commercial |
$413.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$316.08
|
| Rate for Payer: Cash Price |
$389.02
|
| Rate for Payer: Cofinity Commercial |
$340.39
|
| Rate for Payer: Cofinity Commercial |
$418.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$340.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$389.02
|
| Rate for Payer: Healthscope Commercial |
$437.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$340.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$364.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$413.33
|
| Rate for Payer: PHP Commercial |
$413.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$316.08
|
| Rate for Payer: Priority Health SBD |
$306.35
|
| Rate for Payer: UMR Bronson Commercial |
$213.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$364.70
|
|
|
HC HEMOSTATIC AGENT GI TOPICAL
|
Facility
|
OP
|
$5,357.00
|
|
|
Service Code
|
CPT C1052
|
| Hospital Charge Code |
27800146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,885.66 |
| Max. Negotiated Rate |
$4,821.30 |
| Rate for Payer: Aetna American Axle |
$3,482.05
|
| Rate for Payer: Aetna Commercial |
$4,553.45
|
| Rate for Payer: Aetna Medicare |
$2,678.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,482.05
|
| Rate for Payer: BCBS Complete |
$2,142.80
|
| Rate for Payer: Cash Price |
$4,285.60
|
| Rate for Payer: Cofinity Commercial |
$3,749.90
|
| Rate for Payer: Cofinity Commercial |
$4,607.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,749.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,285.60
|
| Rate for Payer: Healthscope Commercial |
$4,821.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,749.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,017.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,553.45
|
| Rate for Payer: PHP Commercial |
$4,553.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,482.05
|
| Rate for Payer: Priority Health SBD |
$3,374.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,885.66
|
| Rate for Payer: UHC Exchange |
$2,196.37
|
| Rate for Payer: UMR Bronson Commercial |
$1,982.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,017.75
|
|
|
HC HEMOSTATIC AGENT GI TOPICAL
|
Facility
|
IP
|
$5,357.00
|
|
|
Service Code
|
CPT C1052
|
| Hospital Charge Code |
27800146
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,357.08 |
| Max. Negotiated Rate |
$4,821.30 |
| Rate for Payer: Aetna American Axle |
$3,482.05
|
| Rate for Payer: Aetna Commercial |
$4,553.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,482.05
|
| Rate for Payer: Cash Price |
$4,285.60
|
| Rate for Payer: Cofinity Commercial |
$3,749.90
|
| Rate for Payer: Cofinity Commercial |
$4,607.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,749.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,285.60
|
| Rate for Payer: Healthscope Commercial |
$4,821.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,749.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,017.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,553.45
|
| Rate for Payer: PHP Commercial |
$4,553.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,482.05
|
| Rate for Payer: Priority Health SBD |
$3,374.91
|
| Rate for Payer: UMR Bronson Commercial |
$2,357.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,017.75
|
|
|
HC HEP A & HEP B VACC ADULT IM
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 90636
|
| Hospital Charge Code |
63600193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$57.74 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna American Axle |
$101.44
|
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$78.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: BCBS Complete |
$62.42
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: UMR Bronson Commercial |
$57.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC HEP A & HEP B VACC ADULT IM
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 90636
|
| Hospital Charge Code |
63600193
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$68.67 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna American Axle |
$101.44
|
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$101.44
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: UMR Bronson Commercial |
$68.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC HEPARIN ANTI-XA
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500083
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$13.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.36
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.09
|
| Rate for Payer: BCN Medicare Advantage |
$13.09
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.09
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Mclaren Medicare |
$13.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.74
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.09
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$13.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health Medicare |
$13.09
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Railroad Medicare Medicare |
$13.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.09
|
| Rate for Payer: UHC Exchange |
$25.02
|
| Rate for Payer: UHC Medicare Advantage |
$13.09
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$13.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC HEPARIN ANTI-XA
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 85520
|
| Hospital Charge Code |
30500083
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC HEPARIN NEUTRALIZATION
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
30500050
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna American Axle |
$30.10
|
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$12.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.80
|
| Rate for Payer: BCBS Complete |
$6.66
|
| Rate for Payer: BCBS MAPPO |
$11.84
|
| Rate for Payer: BCN Medicare Advantage |
$11.84
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.84
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Mclaren Medicaid |
$6.35
|
| Rate for Payer: Mclaren Medicare |
$11.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.43
|
| Rate for Payer: Meridian Medicaid |
$6.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: PACE Medicare |
$11.25
|
| Rate for Payer: PACE SWMI |
$11.84
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$11.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health Medicare |
$11.84
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: Railroad Medicare Medicare |
$11.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.84
|
| Rate for Payer: UHC Exchange |
$22.63
|
| Rate for Payer: UHC Medicare Advantage |
$11.84
|
| Rate for Payer: UHCCP Medicaid |
$6.35
|
| Rate for Payer: UMR Bronson Commercial |
$17.13
|
| Rate for Payer: VA VA |
$11.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC HEPARIN NEUTRALIZATION
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 85525
|
| Hospital Charge Code |
30500050
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.38 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna American Axle |
$30.10
|
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.10
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$32.42
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.36
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health SBD |
$29.18
|
| Rate for Payer: UMR Bronson Commercial |
$20.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC HEPARIN PF4 AB HIT
|
Facility
|
IP
|
$244.49
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200392
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$107.58 |
| Max. Negotiated Rate |
$220.04 |
| Rate for Payer: Aetna American Axle |
$158.92
|
| Rate for Payer: Aetna Commercial |
$207.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.92
|
| Rate for Payer: Cash Price |
$195.59
|
| Rate for Payer: Cofinity Commercial |
$171.14
|
| Rate for Payer: Cofinity Commercial |
$210.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.59
|
| Rate for Payer: Healthscope Commercial |
$220.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.82
|
| Rate for Payer: PHP Commercial |
$207.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.92
|
| Rate for Payer: Priority Health SBD |
$154.03
|
| Rate for Payer: UMR Bronson Commercial |
$107.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.37
|
|
|
HC HEPARIN PF4 AB HIT
|
Facility
|
OP
|
$244.49
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200392
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$220.04 |
| Rate for Payer: Aetna American Axle |
$158.92
|
| Rate for Payer: Aetna Commercial |
$207.82
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$158.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.34
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$195.59
|
| Rate for Payer: Cash Price |
$195.59
|
| Rate for Payer: Cofinity Commercial |
$210.26
|
| Rate for Payer: Cofinity Commercial |
$171.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$220.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.37
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$207.82
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$207.82
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$158.92
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$154.03
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$35.11
|
| Rate for Payer: UHC Medicare Advantage |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.85
|
| Rate for Payer: UMR Bronson Commercial |
$90.46
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.37
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
30100018
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC HEPATIC FUNCTION PANEL
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80076
|
| Hospital Charge Code |
30100018
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.38 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$8.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.21
|
| Rate for Payer: BCBS Complete |
$4.60
|
| Rate for Payer: BCBS MAPPO |
$8.17
|
| Rate for Payer: BCN Medicare Advantage |
$8.17
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.17
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$4.38
|
| Rate for Payer: Mclaren Medicare |
$8.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.58
|
| Rate for Payer: Meridian Medicaid |
$4.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PACE Medicare |
$7.76
|
| Rate for Payer: PACE SWMI |
$8.17
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$8.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health Medicare |
$8.17
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$8.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.17
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicare Advantage |
$8.17
|
| Rate for Payer: UHCCP Medicaid |
$4.38
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$8.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC HEPATIC VENOGRAPHY WO HEMODYNAMIC EVAL
|
Facility
|
IP
|
$3,551.24
|
|
|
Service Code
|
CPT 75891
|
| Hospital Charge Code |
32000323
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,562.55 |
| Max. Negotiated Rate |
$3,196.12 |
| Rate for Payer: Aetna American Axle |
$2,308.31
|
| Rate for Payer: Aetna Commercial |
$3,018.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,308.31
|
| Rate for Payer: Cash Price |
$2,840.99
|
| Rate for Payer: Cofinity Commercial |
$2,485.87
|
| Rate for Payer: Cofinity Commercial |
$3,054.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,485.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,840.99
|
| Rate for Payer: Healthscope Commercial |
$3,196.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,485.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,663.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,018.55
|
| Rate for Payer: PHP Commercial |
$3,018.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,308.31
|
| Rate for Payer: Priority Health SBD |
$2,237.28
|
| Rate for Payer: UMR Bronson Commercial |
$1,562.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,663.43
|
|
|
HC HEPATIC VENOGRAPHY WO HEMODYNAMIC EVAL
|
Facility
|
OP
|
$3,551.24
|
|
|
Service Code
|
CPT 75891
|
| Hospital Charge Code |
32000323
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$2,308.31
|
| Rate for Payer: Aetna Commercial |
$3,018.55
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,308.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$2,840.99
|
| Rate for Payer: Cash Price |
$2,840.99
|
| Rate for Payer: Cofinity Commercial |
$3,054.07
|
| Rate for Payer: Cofinity Commercial |
$2,485.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,485.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,840.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$3,196.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,485.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,663.43
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,018.55
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$3,018.55
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,308.31
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$2,237.28
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,313.96
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,663.43
|
|
|
HC HEPATITIS A ANTIBODY IGM
|
Facility
|
IP
|
$130.76
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
30200299
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$57.53 |
| Max. Negotiated Rate |
$117.68 |
| Rate for Payer: Aetna American Axle |
$84.99
|
| Rate for Payer: Aetna Commercial |
$111.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.99
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cofinity Commercial |
$112.45
|
| Rate for Payer: Cofinity Commercial |
$91.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.61
|
| Rate for Payer: Healthscope Commercial |
$117.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.15
|
| Rate for Payer: PHP Commercial |
$111.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.99
|
| Rate for Payer: Priority Health SBD |
$82.38
|
| Rate for Payer: UMR Bronson Commercial |
$57.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.07
|
|
|
HC HEPATITIS A ANTIBODY IGM
|
Facility
|
OP
|
$130.76
|
|
|
Service Code
|
CPT 86709
|
| Hospital Charge Code |
30200299
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$117.68 |
| Rate for Payer: Aetna American Axle |
$84.99
|
| Rate for Payer: Aetna Commercial |
$111.15
|
| Rate for Payer: Aetna Medicare |
$11.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.07
|
| Rate for Payer: BCBS Complete |
$6.34
|
| Rate for Payer: BCBS MAPPO |
$11.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.26
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cash Price |
$104.61
|
| Rate for Payer: Cofinity Commercial |
$91.53
|
| Rate for Payer: Cofinity Commercial |
$112.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.26
|
| Rate for Payer: Healthscope Commercial |
$117.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.07
|
| Rate for Payer: Mclaren Medicaid |
$6.04
|
| Rate for Payer: Mclaren Medicare |
$11.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.82
|
| Rate for Payer: Meridian Medicaid |
$6.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.15
|
| Rate for Payer: PACE Medicare |
$10.70
|
| Rate for Payer: PACE SWMI |
$11.26
|
| Rate for Payer: PHP Commercial |
$111.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.99
|
| Rate for Payer: Priority Health Medicare |
$11.26
|
| Rate for Payer: Priority Health SBD |
$82.38
|
| Rate for Payer: Railroad Medicare Medicare |
$11.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.26
|
| Rate for Payer: UHC Exchange |
$21.52
|
| Rate for Payer: UHC Medicare Advantage |
$11.26
|
| Rate for Payer: UHCCP Medicaid |
$6.04
|
| Rate for Payer: UMR Bronson Commercial |
$48.38
|
| Rate for Payer: VA VA |
$11.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.07
|
|
