|
HC HIV TYPE 1 AB IFA
|
Facility
|
IP
|
$103.02
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$45.33 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna American Axle |
$66.96
|
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.96
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$72.11
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.96
|
| Rate for Payer: Priority Health SBD |
$64.90
|
| Rate for Payer: UMR Bronson Commercial |
$45.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.26
|
|
|
HC HIV TYPE 1 AB IFA
|
Facility
|
OP
|
$103.02
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200275
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$92.72 |
| Rate for Payer: Aetna American Axle |
$66.96
|
| Rate for Payer: Aetna Commercial |
$87.57
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$18.64
|
| Rate for Payer: BCN Commercial |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cash Price |
$82.42
|
| Rate for Payer: Cofinity Commercial |
$88.60
|
| Rate for Payer: Cofinity Commercial |
$72.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$72.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$92.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.26
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.57
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$87.57
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$64.90
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: UMR Bronson Commercial |
$38.12
|
| Rate for Payer: VA VA |
$19.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.26
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.62
|
| Rate for Payer: Aetna Commercial |
$91.04
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$18.64
|
| Rate for Payer: BCN Commercial |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.32
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$91.04
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: UMR Bronson Commercial |
$39.63
|
| Rate for Payer: VA VA |
$19.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.32
|
|
|
HC HIV TYPE 2 AB IMMUNOBLOT
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200274
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.62
|
| Rate for Payer: Aetna Commercial |
$91.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.62
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: PHP Commercial |
$91.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.32
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$14.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.90
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$13.03
|
| Rate for Payer: BCN Commercial |
$13.03
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Mclaren Medicare |
$13.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$20.28
|
| Rate for Payer: PACE Medicare |
$12.84
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.67
|
| Rate for Payer: Priority Health Medicare |
$13.52
|
| Rate for Payer: Priority Health Narrow Network |
$10.94
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Exchange |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.52
|
| Rate for Payer: UHCCP Medicaid |
$7.25
|
| Rate for Payer: UMR Bronson Commercial |
$25.02
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC HIV TYPE 2 ANTIBODY
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 86702
|
| Hospital Charge Code |
30200291
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: UMR Bronson Commercial |
$29.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.72
|
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: UMR Bronson Commercial |
$33.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC HIV WESTERN BLOT CONFIRMATION
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200273
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.72
|
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$18.64
|
| Rate for Payer: BCN Commercial |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: VA VA |
$19.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
OP
|
$277.92
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$91.07 |
| Max. Negotiated Rate |
$509.70 |
| Rate for Payer: Aetna American Axle |
$180.65
|
| Rate for Payer: Aetna Commercial |
$236.23
|
| Rate for Payer: Aetna Medicare |
$176.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.38
|
| Rate for Payer: BCBS Complete |
$95.62
|
| Rate for Payer: BCBS MAPPO |
$169.90
|
| Rate for Payer: BCBS Trust/PPO |
$163.70
|
| Rate for Payer: BCN Commercial |
$163.70
|
| Rate for Payer: BCN Medicare Advantage |
$169.90
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Commercial |
$239.01
|
| Rate for Payer: Cofinity Commercial |
$194.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.90
|
| Rate for Payer: Healthscope Commercial |
$250.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.44
|
| Rate for Payer: Mclaren Medicaid |
$91.07
|
| Rate for Payer: Mclaren Medicare |
$169.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.40
|
| Rate for Payer: Meridian Medicaid |
$95.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.23
|
| Rate for Payer: Nomi Health Commercial |
$509.70
|
| Rate for Payer: PACE Medicare |
$161.40
|
| Rate for Payer: PACE SWMI |
$169.90
|
| Rate for Payer: PHP Commercial |
$236.23
|
| Rate for Payer: PHP Medicare Advantage |
$169.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$169.90
|
| Rate for Payer: Priority Health Medicare |
$169.90
|
| Rate for Payer: Priority Health Narrow Network |
$135.92
|
| Rate for Payer: Priority Health SBD |
$175.09
|
| Rate for Payer: Railroad Medicare Medicare |
$169.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$203.88
|
| Rate for Payer: UHC Core |
$222.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$169.90
|
| Rate for Payer: UHC Exchange |
$169.90
|
| Rate for Payer: UHC Medicare Advantage |
$169.90
|
| Rate for Payer: UHCCP Medicaid |
$91.07
|
| Rate for Payer: UMR Bronson Commercial |
$102.83
|
| Rate for Payer: VA VA |
$169.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.44
|
|
|
HC HLA57 GENOTYPE, ABACAVIR
|
Facility
|
IP
|
$277.92
|
|
|
Service Code
|
CPT 81381
|
| Hospital Charge Code |
31000137
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$122.28 |
| Max. Negotiated Rate |
$250.13 |
| Rate for Payer: Aetna American Axle |
$180.65
|
| Rate for Payer: Aetna Commercial |
$236.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$180.65
|
| Rate for Payer: Cash Price |
$222.34
|
| Rate for Payer: Cofinity Commercial |
$194.54
|
| Rate for Payer: Cofinity Commercial |
$239.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$194.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$222.34
|
| Rate for Payer: Healthscope Commercial |
$250.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$194.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$208.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$236.23
|
| Rate for Payer: PHP Commercial |
$236.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.65
|
| Rate for Payer: Priority Health SBD |
$175.09
|
| Rate for Payer: UMR Bronson Commercial |
$122.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$208.44
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.97 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: UMR Bronson Commercial |
$21.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.46
|
|
|
HC HLA B27 TISSUE TYPING
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 86812
|
| Hospital Charge Code |
30200338
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$26.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.26
|
| Rate for Payer: BCBS Complete |
$14.53
|
| Rate for Payer: BCBS MAPPO |
$25.81
|
| Rate for Payer: BCBS Trust/PPO |
$24.87
|
| Rate for Payer: BCN Commercial |
$24.87
|
| Rate for Payer: BCN Medicare Advantage |
$25.81
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.81
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$13.83
|
| Rate for Payer: Mclaren Medicare |
$25.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.10
|
| Rate for Payer: Meridian Medicaid |
$14.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$38.72
|
| Rate for Payer: PACE Medicare |
$24.52
|
| Rate for Payer: PACE SWMI |
$25.81
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$25.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$26.55
|
| Rate for Payer: Priority Health Medicare |
$25.81
|
| Rate for Payer: Priority Health Narrow Network |
$21.24
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Railroad Medicare Medicare |
$25.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.81
|
| Rate for Payer: UHC Exchange |
$25.81
|
| Rate for Payer: UHC Medicare Advantage |
$25.81
|
| Rate for Payer: UHCCP Medicaid |
$13.83
|
| Rate for Payer: UMR Bronson Commercial |
$18.48
|
| Rate for Payer: VA VA |
$25.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.46
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
IP
|
$2,756.75
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,212.97 |
| Max. Negotiated Rate |
$2,481.08 |
| Rate for Payer: Aetna American Axle |
$1,791.89
|
| Rate for Payer: Aetna Commercial |
$2,343.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,791.89
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cofinity Commercial |
$1,929.72
|
| Rate for Payer: Cofinity Commercial |
$2,370.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,929.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,205.40
|
| Rate for Payer: Healthscope Commercial |
$2,481.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,929.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,067.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.24
|
| Rate for Payer: PHP Commercial |
$2,343.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.89
|
| Rate for Payer: Priority Health SBD |
$1,736.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,212.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,067.56
|
|
|
HC HLA MATCH PLATELETS
|
Facility
|
OP
|
$2,756.75
|
|
|
Service Code
|
HCPCS P9052
|
| Hospital Charge Code |
39000062
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$408.31 |
| Max. Negotiated Rate |
$2,481.08 |
| Rate for Payer: Aetna American Axle |
$1,791.89
|
| Rate for Payer: Aetna Commercial |
$2,343.24
|
| Rate for Payer: Aetna Medicare |
$792.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,791.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$952.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$952.21
|
| Rate for Payer: BCBS Complete |
$428.72
|
| Rate for Payer: BCBS MAPPO |
$761.77
|
| Rate for Payer: BCBS Trust/PPO |
$1,907.18
|
| Rate for Payer: BCN Commercial |
$1,907.18
|
| Rate for Payer: BCN Medicare Advantage |
$761.77
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cash Price |
$2,205.40
|
| Rate for Payer: Cofinity Commercial |
$1,929.72
|
| Rate for Payer: Cofinity Commercial |
$2,370.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,929.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,205.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$761.77
|
| Rate for Payer: Healthscope Commercial |
$2,481.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,929.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,067.56
|
| Rate for Payer: Mclaren Medicaid |
$408.31
|
| Rate for Payer: Mclaren Medicare |
$761.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$799.86
|
| Rate for Payer: Meridian Medicaid |
$428.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$876.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,343.24
|
| Rate for Payer: Nomi Health Commercial |
$2,285.31
|
| Rate for Payer: PACE Medicare |
$723.68
|
| Rate for Payer: PACE SWMI |
$761.77
|
| Rate for Payer: PHP Commercial |
$2,343.24
|
| Rate for Payer: PHP Medicare Advantage |
$761.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$408.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,791.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,394.23
|
| Rate for Payer: Priority Health Medicare |
$761.77
|
| Rate for Payer: Priority Health Narrow Network |
$1,915.38
|
| Rate for Payer: Priority Health SBD |
$1,736.75
|
| Rate for Payer: Railroad Medicare Medicare |
$761.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,144.31
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$761.77
|
| Rate for Payer: UHC Exchange |
$1,455.82
|
| Rate for Payer: UHC Medicare Advantage |
$761.77
|
| Rate for Payer: UHCCP Medicaid |
$408.31
|
| Rate for Payer: UMR Bronson Commercial |
$1,020.00
|
| Rate for Payer: VA VA |
$761.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,067.56
|
|
|
HC HOLTER MONITOR
|
Facility
|
IP
|
$665.72
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$292.92 |
| Max. Negotiated Rate |
$599.15 |
| Rate for Payer: Aetna American Axle |
$432.72
|
| Rate for Payer: Aetna Commercial |
$565.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.72
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cofinity Commercial |
$466.00
|
| Rate for Payer: Cofinity Commercial |
$572.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$466.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.58
|
| Rate for Payer: Healthscope Commercial |
$599.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$466.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$499.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.86
|
| Rate for Payer: PHP Commercial |
$565.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.72
|
| Rate for Payer: Priority Health SBD |
$419.40
|
| Rate for Payer: UMR Bronson Commercial |
$292.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$499.29
|
|
|
HC HOLTER MONITOR
|
Facility
|
OP
|
$665.72
|
|
|
Service Code
|
CPT 93225
|
| Hospital Charge Code |
73100001
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$16.49 |
| Max. Negotiated Rate |
$816.00 |
| Rate for Payer: Aetna American Axle |
$432.72
|
| Rate for Payer: Aetna Commercial |
$565.86
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$432.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$76.11
|
| Rate for Payer: BCN Commercial |
$76.11
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cash Price |
$532.58
|
| Rate for Payer: Cofinity Commercial |
$466.00
|
| Rate for Payer: Cofinity Commercial |
$572.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$466.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$532.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$599.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$466.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$499.29
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$565.86
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$565.86
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$432.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$419.40
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.14
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$16.49
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$246.32
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$499.29
|
|
|
HC HOLTER SCAN
|
Facility
|
OP
|
$1,053.67
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$31.20 |
| Max. Negotiated Rate |
$948.30 |
| Rate for Payer: Aetna American Axle |
$684.89
|
| Rate for Payer: Aetna Commercial |
$895.62
|
| Rate for Payer: Aetna Medicare |
$60.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$72.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$72.75
|
| Rate for Payer: BCBS Complete |
$32.75
|
| Rate for Payer: BCBS MAPPO |
$58.20
|
| Rate for Payer: BCBS Trust/PPO |
$149.42
|
| Rate for Payer: BCN Commercial |
$149.42
|
| Rate for Payer: BCN Medicare Advantage |
$58.20
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cofinity Commercial |
$737.57
|
| Rate for Payer: Cofinity Commercial |
$906.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$737.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$58.20
|
| Rate for Payer: Healthscope Commercial |
$948.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$737.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.25
|
| Rate for Payer: Mclaren Medicaid |
$31.20
|
| Rate for Payer: Mclaren Medicare |
$58.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$61.11
|
| Rate for Payer: Meridian Medicaid |
$32.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$66.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.62
|
| Rate for Payer: Nomi Health Commercial |
$174.60
|
| Rate for Payer: PACE Medicare |
$55.29
|
| Rate for Payer: PACE SWMI |
$58.20
|
| Rate for Payer: PHP Commercial |
$895.62
|
| Rate for Payer: PHP Medicare Advantage |
$58.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$182.90
|
| Rate for Payer: Priority Health Medicare |
$58.20
|
| Rate for Payer: Priority Health Narrow Network |
$146.32
|
| Rate for Payer: Priority Health SBD |
$663.81
|
| Rate for Payer: Railroad Medicare Medicare |
$58.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.20
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$58.20
|
| Rate for Payer: UHC Exchange |
$32.00
|
| Rate for Payer: UHC Medicare Advantage |
$58.20
|
| Rate for Payer: UHCCP Medicaid |
$31.20
|
| Rate for Payer: UMR Bronson Commercial |
$389.86
|
| Rate for Payer: VA VA |
$58.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.25
|
|
|
HC HOLTER SCAN
|
Facility
|
IP
|
$1,053.67
|
|
|
Service Code
|
CPT 93226
|
| Hospital Charge Code |
73100003
|
|
Hospital Revenue Code
|
731
|
| Min. Negotiated Rate |
$463.61 |
| Max. Negotiated Rate |
$948.30 |
| Rate for Payer: Aetna American Axle |
$684.89
|
| Rate for Payer: Aetna Commercial |
$895.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$684.89
|
| Rate for Payer: Cash Price |
$842.94
|
| Rate for Payer: Cofinity Commercial |
$737.57
|
| Rate for Payer: Cofinity Commercial |
$906.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$737.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$842.94
|
| Rate for Payer: Healthscope Commercial |
$948.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$737.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$895.62
|
| Rate for Payer: PHP Commercial |
$895.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$684.89
|
| Rate for Payer: Priority Health SBD |
$663.81
|
| Rate for Payer: UMR Bronson Commercial |
$463.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.25
|
|
|
HC HOME SLEEP TEST TYPE 3 PORTA
|
Facility
|
IP
|
$212.17
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000027
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Aetna American Axle |
$137.91
|
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.91
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$182.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$148.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Healthscope Commercial |
$190.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health SBD |
$133.67
|
| Rate for Payer: UMR Bronson Commercial |
$93.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.13
|
|
|
HC HOME SLEEP TEST TYPE 3 PORTA
|
Facility
|
OP
|
$212.17
|
|
|
Service Code
|
HCPCS G0399
|
| Hospital Charge Code |
92000027
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$78.50 |
| Max. Negotiated Rate |
$983.00 |
| Rate for Payer: Aetna American Axle |
$137.91
|
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna Medicare |
$159.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.62
|
| Rate for Payer: BCBS Complete |
$86.28
|
| Rate for Payer: BCBS MAPPO |
$153.30
|
| Rate for Payer: BCBS Trust/PPO |
$393.86
|
| Rate for Payer: BCN Commercial |
$393.86
|
| Rate for Payer: BCN Medicare Advantage |
$153.30
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$182.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$148.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.30
|
| Rate for Payer: Healthscope Commercial |
$190.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.13
|
| Rate for Payer: Mclaren Medicaid |
$82.17
|
| Rate for Payer: Mclaren Medicare |
$153.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.96
|
| Rate for Payer: Meridian Medicaid |
$86.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: Nomi Health Commercial |
$459.90
|
| Rate for Payer: PACE Medicare |
$145.64
|
| Rate for Payer: PACE SWMI |
$153.30
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: PHP Medicare Advantage |
$153.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$481.80
|
| Rate for Payer: Priority Health Medicare |
$153.30
|
| Rate for Payer: Priority Health Narrow Network |
$385.44
|
| Rate for Payer: Priority Health SBD |
$133.67
|
| Rate for Payer: Railroad Medicare Medicare |
$153.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$431.52
|
| Rate for Payer: UHC Core |
$983.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.30
|
| Rate for Payer: UHC Exchange |
$292.97
|
| Rate for Payer: UHC Medicare Advantage |
$153.30
|
| Rate for Payer: UHCCP Medicaid |
$82.17
|
| Rate for Payer: UMR Bronson Commercial |
$78.50
|
| Rate for Payer: VA VA |
$153.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.13
|
|
|
HC HOME SLEEP TEST/TYPE 4 PORTA
|
Facility
|
OP
|
$212.17
|
|
|
Service Code
|
HCPCS G0400
|
| Hospital Charge Code |
92000028
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$78.50 |
| Max. Negotiated Rate |
$983.00 |
| Rate for Payer: Aetna American Axle |
$137.91
|
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$182.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$148.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$190.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.13
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$133.67
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$858.83
|
| Rate for Payer: UHC Core |
$983.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$583.08
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: UMR Bronson Commercial |
$78.50
|
| Rate for Payer: VA VA |
$305.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.13
|
|
|
HC HOME SLEEP TEST/TYPE 4 PORTA
|
Facility
|
IP
|
$212.17
|
|
|
Service Code
|
HCPCS G0400
|
| Hospital Charge Code |
92000028
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$93.35 |
| Max. Negotiated Rate |
$190.95 |
| Rate for Payer: Aetna American Axle |
$137.91
|
| Rate for Payer: Aetna Commercial |
$180.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$137.91
|
| Rate for Payer: Cash Price |
$169.74
|
| Rate for Payer: Cofinity Commercial |
$148.52
|
| Rate for Payer: Cofinity Commercial |
$182.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$148.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$169.74
|
| Rate for Payer: Healthscope Commercial |
$190.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$148.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.34
|
| Rate for Payer: PHP Commercial |
$180.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$137.91
|
| Rate for Payer: Priority Health SBD |
$133.67
|
| Rate for Payer: UMR Bronson Commercial |
$93.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.13
|
|
|
HC HOMOCYSTEINE SERUM
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
30100243
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC HOMOCYSTEINE SERUM
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 83090
|
| Hospital Charge Code |
30100243
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$18.64
|
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.40
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.92
|
| Rate for Payer: BCBS Trust/PPO |
$17.27
|
| Rate for Payer: BCN Commercial |
$17.27
|
| Rate for Payer: BCN Medicare Advantage |
$17.92
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.92
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.82
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$26.88
|
| Rate for Payer: PACE Medicare |
$17.02
|
| Rate for Payer: PACE SWMI |
$17.92
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$17.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.92
|
| Rate for Payer: Priority Health Medicare |
$17.92
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$17.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.92
|
| Rate for Payer: UHC Exchange |
$17.92
|
| Rate for Payer: UHC Medicare Advantage |
$17.92
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$17.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC HOMOVANILLIC ACID RANDOM URINE
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100474
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna American Axle |
$41.25
|
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$23.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.01
|
| Rate for Payer: BCBS Complete |
$12.61
|
| Rate for Payer: BCBS MAPPO |
$22.41
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Cofinity Commercial |
$44.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.41
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.60
|
| Rate for Payer: Mclaren Medicaid |
$12.01
|
| Rate for Payer: Mclaren Medicare |
$22.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.53
|
| Rate for Payer: Meridian Medicaid |
$12.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$33.62
|
| Rate for Payer: PACE Medicare |
$21.29
|
| Rate for Payer: PACE SWMI |
$22.41
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: PHP Medicare Advantage |
$22.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.41
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow Network |
$17.93
|
| Rate for Payer: Priority Health SBD |
$39.98
|
| Rate for Payer: Railroad Medicare Medicare |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.41
|
| Rate for Payer: UHC Exchange |
$22.41
|
| Rate for Payer: UHC Medicare Advantage |
$22.41
|
| Rate for Payer: UHCCP Medicaid |
$12.01
|
| Rate for Payer: UMR Bronson Commercial |
$23.48
|
| Rate for Payer: VA VA |
$22.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.60
|
|
