|
HC HEMO CMS INITIAL COMP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500001
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$138.02 |
| 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: BCBS Trust/PPO |
$198.98
|
| Rate for Payer: BCN Commercial |
$198.98
|
| Rate for Payer: Cash Price |
$360.00
|
| 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: UHC All Payor (Choice/PPO) |
$151.82
|
| Rate for Payer: UHC Exchange |
$138.02
|
| Rate for Payer: UMR Bronson Commercial |
$166.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC HEMO CMS INITIAL COMP
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500001
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$198.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna American Axle |
$292.50
|
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.50
|
| 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 |
$198.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC HEMO CMS SUPP/SERV
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500004
|
|
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 HEMO CMS SUPP/SERV
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500004
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$8.37 |
| 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: BCBS Trust/PPO |
$47.13
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$47.13
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Cofinity Commercial |
$52.50
|
| 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: UHC All Payor (Choice/PPO) |
$9.21
|
| Rate for Payer: UHC Exchange |
$8.37
|
| Rate for Payer: UMR Bronson Commercial |
$27.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HEMOCONCENTRATOR
|
Facility
|
OP
|
$233.23
|
|
| Hospital Charge Code |
27006703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$86.30 |
| Max. Negotiated Rate |
$209.91 |
| Rate for Payer: Cofinity Commercial |
$200.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.26
|
| Rate for Payer: Aetna American Axle |
$151.60
|
| Rate for Payer: Aetna Commercial |
$198.25
|
| Rate for Payer: Aetna Medicare |
$116.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.60
|
| Rate for Payer: BCBS Complete |
$93.29
|
| Rate for Payer: Cash Price |
$186.58
|
| Rate for Payer: Cofinity Commercial |
$163.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.58
|
| Rate for Payer: Healthscope Commercial |
$209.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.25
|
| Rate for Payer: PHP Commercial |
$198.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.60
|
| Rate for Payer: Priority Health SBD |
$146.93
|
| Rate for Payer: UMR Bronson Commercial |
$86.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.92
|
|
|
HC HEMOCONCENTRATOR
|
Facility
|
IP
|
$233.23
|
|
| Hospital Charge Code |
27006703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$102.62 |
| Max. Negotiated Rate |
$209.91 |
| Rate for Payer: Aetna American Axle |
$151.60
|
| Rate for Payer: Aetna Commercial |
$198.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$151.60
|
| Rate for Payer: Cash Price |
$186.58
|
| Rate for Payer: Cofinity Commercial |
$163.26
|
| Rate for Payer: Cofinity Commercial |
$200.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$163.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$186.58
|
| Rate for Payer: Healthscope Commercial |
$209.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$163.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$174.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$198.25
|
| Rate for Payer: PHP Commercial |
$198.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$151.60
|
| Rate for Payer: Priority Health SBD |
$146.93
|
| Rate for Payer: UMR Bronson Commercial |
$102.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$174.92
|
|
|
HC HEMOCONCENTRATOR DHF
|
Facility
|
IP
|
$257.04
|
|
| Hospital Charge Code |
27000658
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$113.10 |
| Max. Negotiated Rate |
$231.34 |
| Rate for Payer: Aetna American Axle |
$167.08
|
| Rate for Payer: Aetna Commercial |
$218.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.08
|
| Rate for Payer: Cash Price |
$205.63
|
| Rate for Payer: Cofinity Commercial |
$179.93
|
| Rate for Payer: Cofinity Commercial |
$221.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$179.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.63
|
| Rate for Payer: Healthscope Commercial |
$231.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.48
|
| Rate for Payer: PHP Commercial |
$218.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.08
|
| Rate for Payer: Priority Health SBD |
$161.94
|
| Rate for Payer: UMR Bronson Commercial |
$113.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.78
|
|
|
HC HEMOCONCENTRATOR DHF
|
Facility
|
OP
|
$257.04
|
|
| Hospital Charge Code |
27000658
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$95.10 |
| Max. Negotiated Rate |
$231.34 |
| Rate for Payer: Aetna American Axle |
$167.08
|
| Rate for Payer: Aetna Commercial |
$218.48
|
| Rate for Payer: Aetna Medicare |
$128.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.08
|
| Rate for Payer: BCBS Complete |
$102.82
|
| Rate for Payer: Cash Price |
$205.63
|
| Rate for Payer: Cofinity Commercial |
$179.93
|
| Rate for Payer: Cofinity Commercial |
$221.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$179.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$205.63
|
| Rate for Payer: Healthscope Commercial |
$231.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$179.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$192.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$218.48
|
| Rate for Payer: PHP Commercial |
$218.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$167.08
|
| Rate for Payer: Priority Health SBD |
$161.94
|
| Rate for Payer: UMR Bronson Commercial |
$95.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$192.78
|
|
|
HC HEMOCONCENTRATOR LONG
|
Facility
|
IP
|
$214.20
|
|
| Hospital Charge Code |
27000103
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$94.25 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna American Axle |
$139.23
|
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.23
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$149.94
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.07
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.23
|
| Rate for Payer: Priority Health SBD |
$134.95
|
| Rate for Payer: UMR Bronson Commercial |
$94.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC HEMOCONCENTRATOR LONG
|
Facility
|
OP
|
$214.20
|
|
| Hospital Charge Code |
27000103
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$79.25 |
| Max. Negotiated Rate |
$192.78 |
| Rate for Payer: Aetna American Axle |
$139.23
|
| Rate for Payer: Aetna Commercial |
$182.07
|
| Rate for Payer: Aetna Medicare |
$107.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$139.23
|
| Rate for Payer: BCBS Complete |
$85.68
|
| Rate for Payer: Cash Price |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$149.94
|
| Rate for Payer: Cofinity Commercial |
$184.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$171.36
|
| Rate for Payer: Healthscope Commercial |
$192.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$160.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$182.07
|
| Rate for Payer: PHP Commercial |
$182.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$139.23
|
| Rate for Payer: Priority Health SBD |
$134.95
|
| Rate for Payer: UMR Bronson Commercial |
$79.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$160.65
|
|
|
HC HEMODIALYSIS NON-URGENT
|
Facility
|
OP
|
$969.00
|
|
| Hospital Charge Code |
88100003
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$358.53 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna American Axle |
$629.85
|
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna Medicare |
$484.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.85
|
| Rate for Payer: BCBS Complete |
$387.60
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$678.30
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$678.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health SBD |
$610.47
|
| Rate for Payer: UMR Bronson Commercial |
$358.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC HEMODIALYSIS NON-URGENT
|
Facility
|
IP
|
$969.00
|
|
| Hospital Charge Code |
88100003
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$426.36 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Aetna American Axle |
$629.85
|
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.85
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$678.30
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$678.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health SBD |
$610.47
|
| Rate for Payer: UMR Bronson Commercial |
$426.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC HEMOFILTRATION MONITORING HOUR
|
Facility
|
IP
|
$408.67
|
|
| Hospital Charge Code |
27000114
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$179.81 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna American Axle |
$265.64
|
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.64
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$286.07
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$286.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$286.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.37
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.64
|
| Rate for Payer: Priority Health SBD |
$257.46
|
| Rate for Payer: UMR Bronson Commercial |
$179.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC HEMOFILTRATION MONITORING HOUR
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
27000114
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$151.21 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$286.07
|
| Rate for Payer: Aetna American Axle |
$265.64
|
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: Aetna Medicare |
$204.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.64
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$286.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$286.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$347.37
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.64
|
| Rate for Payer: Priority Health SBD |
$257.46
|
| Rate for Payer: UMR Bronson Commercial |
$151.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC HEMOGLOBIN
|
Facility
|
IP
|
$31.62
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
30500006
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.91 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna American Axle |
$20.55
|
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.55
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$22.13
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health SBD |
$19.92
|
| Rate for Payer: UMR Bronson Commercial |
$13.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC HEMOGLOBIN
|
Facility
|
OP
|
$31.62
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
30500006
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$28.46 |
| Rate for Payer: Aetna American Axle |
$20.55
|
| Rate for Payer: Aetna Commercial |
$26.88
|
| Rate for Payer: Aetna Medicare |
$2.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.96
|
| Rate for Payer: BCBS Complete |
$1.33
|
| Rate for Payer: BCBS MAPPO |
$2.37
|
| Rate for Payer: BCBS Trust/PPO |
$2.29
|
| Rate for Payer: BCN Commercial |
$2.29
|
| Rate for Payer: BCN Medicare Advantage |
$2.37
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cash Price |
$25.30
|
| Rate for Payer: Cofinity Commercial |
$27.19
|
| Rate for Payer: Cofinity Commercial |
$22.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$22.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.37
|
| Rate for Payer: Healthscope Commercial |
$28.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.72
|
| Rate for Payer: Mclaren Medicaid |
$1.27
|
| Rate for Payer: Mclaren Medicare |
$2.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.49
|
| Rate for Payer: Meridian Medicaid |
$1.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.88
|
| Rate for Payer: Nomi Health Commercial |
$3.56
|
| Rate for Payer: PACE Medicare |
$2.25
|
| Rate for Payer: PACE SWMI |
$2.37
|
| Rate for Payer: PHP Commercial |
$26.88
|
| Rate for Payer: PHP Medicare Advantage |
$2.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2.44
|
| Rate for Payer: Priority Health Medicare |
$2.37
|
| Rate for Payer: Priority Health Narrow Network |
$1.95
|
| Rate for Payer: Priority Health SBD |
$19.92
|
| Rate for Payer: Railroad Medicare Medicare |
$2.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.37
|
| Rate for Payer: UHC Exchange |
$2.37
|
| Rate for Payer: UHC Medicare Advantage |
$2.37
|
| Rate for Payer: UHCCP Medicaid |
$1.27
|
| Rate for Payer: UMR Bronson Commercial |
$11.70
|
| Rate for Payer: VA VA |
$2.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.72
|
|
|
HC HEMOGLOBIN A2 AND F
|
Facility
|
OP
|
$27.48
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
30100624
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$27.09 |
| Rate for Payer: BCN Commercial |
$17.41
|
| Rate for Payer: BCN Medicare Advantage |
$18.06
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cofinity Commercial |
$23.63
|
| Rate for Payer: Cofinity Commercial |
$19.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.06
|
| Rate for Payer: Healthscope Commercial |
$24.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.61
|
| Rate for Payer: Mclaren Medicaid |
$9.68
|
| Rate for Payer: Mclaren Medicare |
$18.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.96
|
| Rate for Payer: Meridian Medicaid |
$10.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.36
|
| Rate for Payer: Nomi Health Commercial |
$27.09
|
| Rate for Payer: PACE Medicare |
$17.16
|
| Rate for Payer: PACE SWMI |
$18.06
|
| Rate for Payer: PHP Commercial |
$23.36
|
| Rate for Payer: PHP Medicare Advantage |
$18.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.06
|
| Rate for Payer: Priority Health Medicare |
$18.06
|
| Rate for Payer: Priority Health Narrow Network |
$14.45
|
| Rate for Payer: Priority Health SBD |
$17.31
|
| Rate for Payer: Railroad Medicare Medicare |
$18.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.06
|
| Rate for Payer: UHC Exchange |
$18.06
|
| Rate for Payer: UHC Medicare Advantage |
$18.06
|
| Rate for Payer: UHCCP Medicaid |
$9.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.17
|
| Rate for Payer: VA VA |
$18.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.61
|
| Rate for Payer: Aetna American Axle |
$17.86
|
| Rate for Payer: Aetna Commercial |
$23.36
|
| Rate for Payer: Aetna Medicare |
$18.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.58
|
| Rate for Payer: BCBS Complete |
$10.16
|
| Rate for Payer: BCBS MAPPO |
$18.06
|
| Rate for Payer: BCBS Trust/PPO |
$17.41
|
|
|
HC HEMOGLOBIN A2 AND F
|
Facility
|
IP
|
$27.48
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
30100624
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.09 |
| Max. Negotiated Rate |
$24.73 |
| Rate for Payer: Aetna American Axle |
$17.86
|
| Rate for Payer: Aetna Commercial |
$23.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.86
|
| Rate for Payer: Cash Price |
$21.98
|
| Rate for Payer: Cofinity Commercial |
$19.24
|
| Rate for Payer: Cofinity Commercial |
$23.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.98
|
| Rate for Payer: Healthscope Commercial |
$24.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.36
|
| Rate for Payer: PHP Commercial |
$23.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.86
|
| Rate for Payer: Priority Health SBD |
$17.31
|
| Rate for Payer: UMR Bronson Commercial |
$12.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.61
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
IP
|
$97.10
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100235
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.72 |
| Max. Negotiated Rate |
$87.39 |
| Rate for Payer: Aetna American Axle |
$63.12
|
| Rate for Payer: Aetna Commercial |
$82.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.12
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cofinity Commercial |
$67.97
|
| Rate for Payer: Cofinity Commercial |
$83.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.68
|
| Rate for Payer: Healthscope Commercial |
$87.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.54
|
| Rate for Payer: PHP Commercial |
$82.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: Priority Health SBD |
$61.17
|
| Rate for Payer: UMR Bronson Commercial |
$42.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.82
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
OP
|
$97.10
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100235
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$87.39 |
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Aetna American Axle |
$63.12
|
| Rate for Payer: Aetna Commercial |
$82.54
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cofinity Commercial |
$83.51
|
| Rate for Payer: Cofinity Commercial |
$67.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$87.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.82
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.54
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$82.54
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$10.60
|
| Rate for Payer: Priority Health SBD |
$61.17
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$12.87
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$35.93
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.82
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS, B
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100623
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.94 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: UMR Bronson Commercial |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS, B
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100623
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna American Axle |
$25.02
|
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Cofinity Commercial |
$26.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$26.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$10.60
|
| Rate for Payer: Priority Health SBD |
$24.25
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$12.87
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$14.24
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS CMP
|
Facility
|
IP
|
$97.10
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.72 |
| Max. Negotiated Rate |
$87.39 |
| Rate for Payer: Aetna American Axle |
$63.12
|
| Rate for Payer: Aetna Commercial |
$82.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.12
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cofinity Commercial |
$67.97
|
| Rate for Payer: Cofinity Commercial |
$83.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.68
|
| Rate for Payer: Healthscope Commercial |
$87.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.54
|
| Rate for Payer: PHP Commercial |
$82.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: Priority Health SBD |
$61.17
|
| Rate for Payer: UMR Bronson Commercial |
$42.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.82
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS CMP
|
Facility
|
OP
|
$97.10
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$87.39 |
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$35.93
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Aetna American Axle |
$63.12
|
| Rate for Payer: Aetna Commercial |
$82.54
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$9.29
|
| Rate for Payer: BCN Commercial |
$9.29
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cash Price |
$77.68
|
| Rate for Payer: Cofinity Commercial |
$83.51
|
| Rate for Payer: Cofinity Commercial |
$67.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$87.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.82
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.54
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$82.54
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$10.60
|
| Rate for Payer: Priority Health SBD |
$61.17
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.82
|
|
|
HC HEM/ONC CMS COMP
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500006
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$111.00 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna American Axle |
$195.00
|
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$150.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.00
|
| Rate for Payer: BCBS Complete |
$120.00
|
| Rate for Payer: BCBS Trust/PPO |
$198.98
|
| Rate for Payer: BCN Commercial |
$198.98
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$210.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$210.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.00
|
| Rate for Payer: Priority Health SBD |
$189.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.82
|
| Rate for Payer: UHC Exchange |
$138.02
|
| Rate for Payer: UMR Bronson Commercial |
$111.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
