|
HC HEPATITIS B SURFACE ANTIGEN
|
Facility
|
IP
|
$38.85
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600139
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.09 |
| Max. Negotiated Rate |
$34.97 |
| Rate for Payer: Aetna American Axle |
$25.25
|
| Rate for Payer: Aetna Commercial |
$33.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.25
|
| Rate for Payer: Cash Price |
$31.08
|
| Rate for Payer: Cofinity Commercial |
$27.20
|
| Rate for Payer: Cofinity Commercial |
$33.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.08
|
| Rate for Payer: Healthscope Commercial |
$34.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.02
|
| Rate for Payer: PHP Commercial |
$33.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.25
|
| Rate for Payer: Priority Health SBD |
$24.48
|
| Rate for Payer: UMR Bronson Commercial |
$17.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.14
|
|
|
HC HEPATITIS B SURFACE ANTIGEN NEUTRALIZATION
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 87341
|
| Hospital Charge Code |
30600141
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna American Axle |
$48.40
|
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$10.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.91
|
| Rate for Payer: BCBS Complete |
$5.81
|
| Rate for Payer: BCBS MAPPO |
$10.33
|
| Rate for Payer: BCN Medicare Advantage |
$10.33
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.33
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$5.54
|
| Rate for Payer: Mclaren Medicare |
$10.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.85
|
| Rate for Payer: Meridian Medicaid |
$5.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: PACE Medicare |
$9.81
|
| Rate for Payer: PACE SWMI |
$10.33
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$10.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health Medicare |
$10.33
|
| Rate for Payer: Priority Health SBD |
$46.91
|
| Rate for Payer: Railroad Medicare Medicare |
$10.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.33
|
| Rate for Payer: UHC Exchange |
$19.74
|
| Rate for Payer: UHC Medicare Advantage |
$10.33
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$27.55
|
| Rate for Payer: VA VA |
$10.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC HEPATITIS B SURFACE ANTIGEN NEUTRALIZATION
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 87341
|
| Hospital Charge Code |
30600141
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.76 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna American Axle |
$48.40
|
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.40
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$52.12
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health SBD |
$46.91
|
| Rate for Payer: UMR Bronson Commercial |
$32.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC HEPATITIS B VACCINE ADULT, 3 DOSE IM
|
Facility
|
IP
|
$84.27
|
|
|
Service Code
|
CPT 90746
|
| Hospital Charge Code |
63600026
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna American Axle |
$54.78
|
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$58.99
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: UMR Bronson Commercial |
$37.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC HEPATITIS B VACCINE ADULT, 3 DOSE IM
|
Facility
|
OP
|
$84.27
|
|
|
Service Code
|
CPT 90746
|
| Hospital Charge Code |
63600026
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$31.18 |
| Max. Negotiated Rate |
$75.84 |
| Rate for Payer: Aetna American Axle |
$54.78
|
| Rate for Payer: Aetna Commercial |
$71.63
|
| Rate for Payer: Aetna Medicare |
$42.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
| Rate for Payer: BCBS Complete |
$33.71
|
| Rate for Payer: Cash Price |
$67.42
|
| Rate for Payer: Cofinity Commercial |
$58.99
|
| Rate for Payer: Cofinity Commercial |
$72.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$58.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
| Rate for Payer: Healthscope Commercial |
$75.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.63
|
| Rate for Payer: PHP Commercial |
$71.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$54.78
|
| Rate for Payer: Priority Health SBD |
$53.09
|
| Rate for Payer: UMR Bronson Commercial |
$31.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
|
HC HEPATITIS C ANTIBODY
|
Facility
|
IP
|
$49.23
|
|
|
Service Code
|
CPT 86803
|
| Hospital Charge Code |
30200336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.66 |
| Max. Negotiated Rate |
$44.31 |
| Rate for Payer: Aetna American Axle |
$32.00
|
| Rate for Payer: Aetna Commercial |
$41.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.00
|
| Rate for Payer: Cash Price |
$39.38
|
| Rate for Payer: Cofinity Commercial |
$34.46
|
| Rate for Payer: Cofinity Commercial |
$42.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.38
|
| Rate for Payer: Healthscope Commercial |
$44.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.85
|
| Rate for Payer: PHP Commercial |
$41.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.00
|
| Rate for Payer: Priority Health SBD |
$31.01
|
| Rate for Payer: UMR Bronson Commercial |
$21.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.92
|
|
|
HC HEPATITIS C ANTIBODY
|
Facility
|
OP
|
$49.23
|
|
|
Service Code
|
CPT 86803
|
| Hospital Charge Code |
30200336
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.65 |
| Max. Negotiated Rate |
$44.31 |
| Rate for Payer: Aetna American Axle |
$32.00
|
| Rate for Payer: Aetna Commercial |
$41.85
|
| Rate for Payer: Aetna Medicare |
$14.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.84
|
| Rate for Payer: BCBS Complete |
$8.03
|
| Rate for Payer: BCBS MAPPO |
$14.27
|
| Rate for Payer: BCN Medicare Advantage |
$14.27
|
| Rate for Payer: Cash Price |
$39.38
|
| Rate for Payer: Cash Price |
$39.38
|
| Rate for Payer: Cofinity Commercial |
$42.34
|
| Rate for Payer: Cofinity Commercial |
$34.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.27
|
| Rate for Payer: Healthscope Commercial |
$44.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.92
|
| Rate for Payer: Mclaren Medicaid |
$7.65
|
| Rate for Payer: Mclaren Medicare |
$14.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.98
|
| Rate for Payer: Meridian Medicaid |
$8.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.85
|
| Rate for Payer: PACE Medicare |
$13.56
|
| Rate for Payer: PACE SWMI |
$14.27
|
| Rate for Payer: PHP Commercial |
$41.85
|
| Rate for Payer: PHP Medicare Advantage |
$14.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.00
|
| Rate for Payer: Priority Health Medicare |
$14.27
|
| Rate for Payer: Priority Health SBD |
$31.01
|
| Rate for Payer: Railroad Medicare Medicare |
$14.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.27
|
| Rate for Payer: UHC Exchange |
$27.27
|
| Rate for Payer: UHC Medicare Advantage |
$14.27
|
| Rate for Payer: UHCCP Medicaid |
$7.65
|
| Rate for Payer: UMR Bronson Commercial |
$18.22
|
| Rate for Payer: VA VA |
$14.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.92
|
|
|
HC HEPATITIS C ANTIBODY BY RIBA
|
Facility
|
IP
|
$82.62
|
|
|
Service Code
|
CPT 86804
|
| Hospital Charge Code |
30200337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.35 |
| Max. Negotiated Rate |
$74.36 |
| Rate for Payer: Aetna American Axle |
$53.70
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cofinity Commercial |
$57.83
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.70
|
| Rate for Payer: Priority Health SBD |
$52.05
|
| Rate for Payer: UMR Bronson Commercial |
$36.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.97
|
|
|
HC HEPATITIS C ANTIBODY BY RIBA
|
Facility
|
OP
|
$82.62
|
|
|
Service Code
|
CPT 86804
|
| Hospital Charge Code |
30200337
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.30 |
| Max. Negotiated Rate |
$74.36 |
| Rate for Payer: Aetna American Axle |
$53.70
|
| Rate for Payer: Aetna Commercial |
$70.23
|
| Rate for Payer: Aetna Medicare |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.36
|
| Rate for Payer: BCBS Complete |
$8.72
|
| Rate for Payer: BCBS MAPPO |
$15.49
|
| Rate for Payer: BCN Medicare Advantage |
$15.49
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cash Price |
$66.10
|
| Rate for Payer: Cofinity Commercial |
$71.05
|
| Rate for Payer: Cofinity Commercial |
$57.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$57.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.49
|
| Rate for Payer: Healthscope Commercial |
$74.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.97
|
| Rate for Payer: Mclaren Medicaid |
$8.30
|
| Rate for Payer: Mclaren Medicare |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.26
|
| Rate for Payer: Meridian Medicaid |
$8.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.23
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.49
|
| Rate for Payer: PHP Commercial |
$70.23
|
| Rate for Payer: PHP Medicare Advantage |
$15.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.70
|
| Rate for Payer: Priority Health Medicare |
$15.49
|
| Rate for Payer: Priority Health SBD |
$52.05
|
| Rate for Payer: Railroad Medicare Medicare |
$15.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.49
|
| Rate for Payer: UHC Exchange |
$29.60
|
| Rate for Payer: UHC Medicare Advantage |
$15.49
|
| Rate for Payer: UHCCP Medicaid |
$8.30
|
| Rate for Payer: UMR Bronson Commercial |
$30.57
|
| Rate for Payer: VA VA |
$15.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.97
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANT
|
Facility
|
IP
|
$152.94
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600295
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.29 |
| Max. Negotiated Rate |
$137.65 |
| Rate for Payer: Aetna American Axle |
$99.41
|
| Rate for Payer: Aetna Commercial |
$130.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.41
|
| Rate for Payer: Cash Price |
$122.35
|
| Rate for Payer: Cofinity Commercial |
$107.06
|
| Rate for Payer: Cofinity Commercial |
$131.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.35
|
| Rate for Payer: Healthscope Commercial |
$137.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.00
|
| Rate for Payer: PHP Commercial |
$130.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.41
|
| Rate for Payer: Priority Health SBD |
$96.35
|
| Rate for Payer: UMR Bronson Commercial |
$67.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.70
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANT
|
Facility
|
OP
|
$152.94
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600295
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$137.65 |
| Rate for Payer: Aetna American Axle |
$99.41
|
| Rate for Payer: Aetna Commercial |
$130.00
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.11
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$122.35
|
| Rate for Payer: Cash Price |
$122.35
|
| Rate for Payer: Cofinity Commercial |
$131.53
|
| Rate for Payer: Cofinity Commercial |
$107.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$137.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.70
|
| Rate for Payer: Mclaren Medicaid |
$22.96
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$24.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.00
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$130.00
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.41
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$96.35
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$81.87
|
| Rate for Payer: UHC Medicare Advantage |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$22.96
|
| Rate for Payer: UMR Bronson Commercial |
$56.59
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.70
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANTIFICATION
|
Facility
|
IP
|
$152.94
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$67.29 |
| Max. Negotiated Rate |
$137.65 |
| Rate for Payer: Aetna American Axle |
$99.41
|
| Rate for Payer: Aetna Commercial |
$130.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.41
|
| Rate for Payer: Cash Price |
$122.35
|
| Rate for Payer: Cofinity Commercial |
$107.06
|
| Rate for Payer: Cofinity Commercial |
$131.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.35
|
| Rate for Payer: Healthscope Commercial |
$137.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.00
|
| Rate for Payer: PHP Commercial |
$130.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.41
|
| Rate for Payer: Priority Health SBD |
$96.35
|
| Rate for Payer: UMR Bronson Commercial |
$67.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.70
|
|
|
HC HEPATITIS C RNA PCR DETECT & QUANTIFICATION
|
Facility
|
OP
|
$152.94
|
|
|
Service Code
|
CPT 87522
|
| Hospital Charge Code |
30600157
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.96 |
| Max. Negotiated Rate |
$137.65 |
| Rate for Payer: Aetna American Axle |
$99.41
|
| Rate for Payer: Aetna Commercial |
$130.00
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$24.11
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$122.35
|
| Rate for Payer: Cash Price |
$122.35
|
| Rate for Payer: Cofinity Commercial |
$131.53
|
| Rate for Payer: Cofinity Commercial |
$107.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$137.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.70
|
| Rate for Payer: Mclaren Medicaid |
$22.96
|
| Rate for Payer: Mclaren Medicare |
$42.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$24.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.00
|
| Rate for Payer: PACE Medicare |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$130.00
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.41
|
| Rate for Payer: Priority Health Medicare |
$42.84
|
| Rate for Payer: Priority Health SBD |
$96.35
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$81.87
|
| Rate for Payer: UHC Medicare Advantage |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$22.96
|
| Rate for Payer: UMR Bronson Commercial |
$56.59
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.70
|
|
|
HC HEPATITS B VACCINE (HEPB), PEDIATRIC/ADOLESCENT, 3 DOSE IM
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
63600086
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna American Axle |
$23.67
|
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: UMR Bronson Commercial |
$16.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC HEPATITS B VACCINE (HEPB), PEDIATRIC/ADOLESCENT, 3 DOSE IM
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 90744
|
| Hospital Charge Code |
63600086
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.47 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna American Axle |
$23.67
|
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$18.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: BCBS Complete |
$14.56
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: UMR Bronson Commercial |
$13.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC HEP B ADMINISTRATION
|
Facility
|
OP
|
$34.17
|
|
|
Service Code
|
HCPCS G0010
|
| Hospital Charge Code |
77100008
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$12.64 |
| Max. Negotiated Rate |
$126.67 |
| Rate for Payer: Aetna American Axle |
$22.21
|
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna Medicare |
$46.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.25
|
| Rate for Payer: BCBS Complete |
$25.33
|
| Rate for Payer: BCBS MAPPO |
$45.00
|
| Rate for Payer: BCN Medicare Advantage |
$45.00
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cofinity Commercial |
$23.92
|
| Rate for Payer: Cofinity Commercial |
$29.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.00
|
| Rate for Payer: Healthscope Commercial |
$30.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.63
|
| Rate for Payer: Mclaren Medicaid |
$24.12
|
| Rate for Payer: Mclaren Medicare |
$45.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.25
|
| Rate for Payer: Meridian Medicaid |
$25.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.04
|
| Rate for Payer: PACE Medicare |
$42.75
|
| Rate for Payer: PACE SWMI |
$45.00
|
| Rate for Payer: PHP Commercial |
$29.04
|
| Rate for Payer: PHP Medicare Advantage |
$45.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.21
|
| Rate for Payer: Priority Health Medicare |
$45.00
|
| Rate for Payer: Priority Health SBD |
$21.53
|
| Rate for Payer: Railroad Medicare Medicare |
$45.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$126.67
|
| Rate for Payer: UHC Core |
$47.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.00
|
| Rate for Payer: UHC Exchange |
$86.00
|
| Rate for Payer: UHC Medicare Advantage |
$45.00
|
| Rate for Payer: UHCCP Medicaid |
$24.12
|
| Rate for Payer: UMR Bronson Commercial |
$12.64
|
| Rate for Payer: VA VA |
$45.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.63
|
|
|
HC HEP B ADMINISTRATION
|
Facility
|
IP
|
$34.17
|
|
|
Service Code
|
HCPCS G0010
|
| Hospital Charge Code |
77100008
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$15.03 |
| Max. Negotiated Rate |
$30.75 |
| Rate for Payer: Aetna American Axle |
$22.21
|
| Rate for Payer: Aetna Commercial |
$29.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.21
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cofinity Commercial |
$23.92
|
| Rate for Payer: Cofinity Commercial |
$29.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$23.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.34
|
| Rate for Payer: Healthscope Commercial |
$30.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.04
|
| Rate for Payer: PHP Commercial |
$29.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.21
|
| Rate for Payer: Priority Health SBD |
$21.53
|
| Rate for Payer: UMR Bronson Commercial |
$15.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.63
|
|
|
HC HEP B CORE AB TOTAL.
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200293
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.98 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna American Axle |
$64.97
|
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health SBD |
$62.97
|
| Rate for Payer: UMR Bronson Commercial |
$43.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC HEP B CORE AB TOTAL.
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 86704
|
| Hospital Charge Code |
30200293
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$89.96 |
| Rate for Payer: Aetna American Axle |
$64.97
|
| Rate for Payer: Aetna Commercial |
$84.97
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cash Price |
$79.97
|
| Rate for Payer: Cofinity Commercial |
$85.97
|
| Rate for Payer: Cofinity Commercial |
$69.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$89.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.97
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.97
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$84.97
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.97
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$62.97
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$36.99
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
|
HC HEP B SURFACE ANTIGEN CONFIRMATION
|
Facility
|
OP
|
$45.93
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600140
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.54 |
| Max. Negotiated Rate |
$41.34 |
| Rate for Payer: Aetna American Axle |
$29.85
|
| Rate for Payer: Aetna Commercial |
$39.04
|
| Rate for Payer: Aetna Medicare |
$10.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.91
|
| Rate for Payer: BCBS Complete |
$5.81
|
| Rate for Payer: BCBS MAPPO |
$10.33
|
| Rate for Payer: BCN Medicare Advantage |
$10.33
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.33
|
| Rate for Payer: Healthscope Commercial |
$41.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.45
|
| Rate for Payer: Mclaren Medicaid |
$5.54
|
| Rate for Payer: Mclaren Medicare |
$10.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.85
|
| Rate for Payer: Meridian Medicaid |
$5.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: PACE Medicare |
$9.81
|
| Rate for Payer: PACE SWMI |
$10.33
|
| Rate for Payer: PHP Commercial |
$39.04
|
| Rate for Payer: PHP Medicare Advantage |
$10.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health Medicare |
$10.33
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: Railroad Medicare Medicare |
$10.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.33
|
| Rate for Payer: UHC Exchange |
$19.74
|
| Rate for Payer: UHC Medicare Advantage |
$10.33
|
| Rate for Payer: UHCCP Medicaid |
$5.54
|
| Rate for Payer: UMR Bronson Commercial |
$16.99
|
| Rate for Payer: VA VA |
$10.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.45
|
|
|
HC HEP B SURFACE ANTIGEN CONFIRMATION
|
Facility
|
IP
|
$45.93
|
|
|
Service Code
|
CPT 87340
|
| Hospital Charge Code |
30600140
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.21 |
| Max. Negotiated Rate |
$41.34 |
| Rate for Payer: Aetna American Axle |
$29.85
|
| Rate for Payer: Aetna Commercial |
$39.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.85
|
| Rate for Payer: Cash Price |
$36.74
|
| Rate for Payer: Cofinity Commercial |
$32.15
|
| Rate for Payer: Cofinity Commercial |
$39.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.74
|
| Rate for Payer: Healthscope Commercial |
$41.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.04
|
| Rate for Payer: PHP Commercial |
$39.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.85
|
| Rate for Payer: Priority Health SBD |
$28.94
|
| Rate for Payer: UMR Bronson Commercial |
$20.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.45
|
|
|
HC HEP B VACC 2 DOSE ADULT IM
|
Facility
|
OP
|
$332.93
|
|
|
Service Code
|
CPT 90739
|
| Hospital Charge Code |
63600181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$123.18 |
| Max. Negotiated Rate |
$299.64 |
| Rate for Payer: Aetna American Axle |
$216.40
|
| Rate for Payer: Aetna Commercial |
$282.99
|
| Rate for Payer: Aetna Medicare |
$166.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.40
|
| Rate for Payer: BCBS Complete |
$133.17
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$233.05
|
| Rate for Payer: Cofinity Commercial |
$286.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$233.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Healthscope Commercial |
$299.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: PHP Commercial |
$282.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health SBD |
$209.75
|
| Rate for Payer: UMR Bronson Commercial |
$123.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.70
|
|
|
HC HEP B VACC 2 DOSE ADULT IM
|
Facility
|
IP
|
$332.93
|
|
|
Service Code
|
CPT 90739
|
| Hospital Charge Code |
63600181
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$146.49 |
| Max. Negotiated Rate |
$299.64 |
| Rate for Payer: Aetna American Axle |
$216.40
|
| Rate for Payer: Aetna Commercial |
$282.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$216.40
|
| Rate for Payer: Cash Price |
$266.34
|
| Rate for Payer: Cofinity Commercial |
$233.05
|
| Rate for Payer: Cofinity Commercial |
$286.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$233.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$266.34
|
| Rate for Payer: Healthscope Commercial |
$299.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$233.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$249.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.99
|
| Rate for Payer: PHP Commercial |
$282.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$216.40
|
| Rate for Payer: Priority Health SBD |
$209.75
|
| Rate for Payer: UMR Bronson Commercial |
$146.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$249.70
|
|
|
HC HEP C GENO SUBTYPES
|
Facility
|
OP
|
$421.13
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600256
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$137.99 |
| Max. Negotiated Rate |
$724.70 |
| Rate for Payer: Aetna American Axle |
$273.73
|
| Rate for Payer: Aetna Commercial |
$357.96
|
| Rate for Payer: Aetna Medicare |
$267.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$321.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$321.81
|
| Rate for Payer: BCBS Complete |
$144.89
|
| Rate for Payer: BCBS MAPPO |
$257.45
|
| Rate for Payer: BCN Medicare Advantage |
$257.45
|
| Rate for Payer: Cash Price |
$336.90
|
| Rate for Payer: Cash Price |
$336.90
|
| Rate for Payer: Cofinity Commercial |
$362.17
|
| Rate for Payer: Cofinity Commercial |
$294.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$294.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.45
|
| Rate for Payer: Healthscope Commercial |
$379.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.85
|
| Rate for Payer: Mclaren Medicaid |
$137.99
|
| Rate for Payer: Mclaren Medicare |
$257.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.32
|
| Rate for Payer: Meridian Medicaid |
$144.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.96
|
| Rate for Payer: PACE Medicare |
$244.58
|
| Rate for Payer: PACE SWMI |
$257.45
|
| Rate for Payer: PHP Commercial |
$357.96
|
| Rate for Payer: PHP Medicare Advantage |
$257.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$137.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.73
|
| Rate for Payer: Priority Health Medicare |
$257.45
|
| Rate for Payer: Priority Health SBD |
$265.31
|
| Rate for Payer: Railroad Medicare Medicare |
$257.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.45
|
| Rate for Payer: UHC Exchange |
$492.01
|
| Rate for Payer: UHC Medicare Advantage |
$257.45
|
| Rate for Payer: UHCCP Medicaid |
$137.99
|
| Rate for Payer: UMR Bronson Commercial |
$155.82
|
| Rate for Payer: VA VA |
$257.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.85
|
|
|
HC HEP C GENO SUBTYPES
|
Facility
|
IP
|
$421.13
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
30600256
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$185.30 |
| Max. Negotiated Rate |
$379.02 |
| Rate for Payer: Aetna American Axle |
$273.73
|
| Rate for Payer: Aetna Commercial |
$357.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$273.73
|
| Rate for Payer: Cash Price |
$336.90
|
| Rate for Payer: Cofinity Commercial |
$294.79
|
| Rate for Payer: Cofinity Commercial |
$362.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$294.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$336.90
|
| Rate for Payer: Healthscope Commercial |
$379.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$294.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$315.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$357.96
|
| Rate for Payer: PHP Commercial |
$357.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$273.73
|
| Rate for Payer: Priority Health SBD |
$265.31
|
| Rate for Payer: UMR Bronson Commercial |
$185.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$315.85
|
|
