|
HC HSV CULTURE, NEONATE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600296
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.48 |
| 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 |
$20.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.45
|
| Rate for Payer: BCBS Complete |
$11.01
|
| Rate for Payer: BCBS MAPPO |
$19.56
|
| Rate for Payer: BCN Medicare Advantage |
$19.56
|
| 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 |
$19.56
|
| 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 |
$10.48
|
| Rate for Payer: Mclaren Medicare |
$19.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.54
|
| Rate for Payer: Meridian Medicaid |
$11.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PACE Medicare |
$18.58
|
| Rate for Payer: PACE SWMI |
$19.56
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$19.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health Medicare |
$19.56
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$19.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.56
|
| Rate for Payer: UHC Exchange |
$37.38
|
| Rate for Payer: UHC Medicare Advantage |
$19.56
|
| Rate for Payer: UHCCP Medicaid |
$10.48
|
| Rate for Payer: UMR Bronson Commercial |
$25.02
|
| Rate for Payer: VA VA |
$19.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC HSV CULTURE, NEONATE CMPT
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600297
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC HSV CULTURE, NEONATE CMPT
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600297
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.48 |
| Max. Negotiated Rate |
$55.06 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$20.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.45
|
| Rate for Payer: BCBS Complete |
$11.01
|
| Rate for Payer: BCBS MAPPO |
$19.56
|
| Rate for Payer: BCN Medicare Advantage |
$19.56
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.56
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$10.48
|
| Rate for Payer: Mclaren Medicare |
$19.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.54
|
| Rate for Payer: Meridian Medicaid |
$11.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PACE Medicare |
$18.58
|
| Rate for Payer: PACE SWMI |
$19.56
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$19.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health Medicare |
$19.56
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$19.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.56
|
| Rate for Payer: UHC Exchange |
$37.38
|
| Rate for Payer: UHC Medicare Advantage |
$19.56
|
| Rate for Payer: UHCCP Medicaid |
$10.48
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$19.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC HTLV I II ANTIBODY SCREEN,S
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200427
|
|
Hospital Revenue Code
|
302
|
| 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 HTLV I II ANTIBODY SCREEN,S
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 86790
|
| Hospital Charge Code |
30200427
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
| Rate for Payer: BCBS Complete |
$7.25
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| 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 |
$12.88
|
| 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 |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: Meridian Medicaid |
$7.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$12.24
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.88
|
| Rate for Payer: UHC Exchange |
$24.61
|
| Rate for Payer: UHC Medicare Advantage |
$12.88
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$12.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC HTLV I II CONFIRMATION
|
Facility
|
OP
|
$161.16
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200276
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.37 |
| Max. Negotiated Rate |
$145.04 |
| Rate for Payer: Aetna American Axle |
$104.75
|
| Rate for Payer: Aetna Commercial |
$136.99
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.75
|
| 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: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Cofinity Commercial |
$112.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$145.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.87
|
| 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 |
$136.99
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$136.99
|
| 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 |
$104.75
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health SBD |
$101.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$36.98
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: UMR Bronson Commercial |
$59.63
|
| Rate for Payer: VA VA |
$19.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.87
|
|
|
HC HTLV I II CONFIRMATION
|
Facility
|
IP
|
$161.16
|
|
|
Service Code
|
CPT 86689
|
| Hospital Charge Code |
30200276
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$70.91 |
| Max. Negotiated Rate |
$145.04 |
| Rate for Payer: Aetna American Axle |
$104.75
|
| Rate for Payer: Aetna Commercial |
$136.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.75
|
| Rate for Payer: Cash Price |
$128.93
|
| Rate for Payer: Cofinity Commercial |
$112.81
|
| Rate for Payer: Cofinity Commercial |
$138.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.93
|
| Rate for Payer: Healthscope Commercial |
$145.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.99
|
| Rate for Payer: PHP Commercial |
$136.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.75
|
| Rate for Payer: Priority Health SBD |
$101.53
|
| Rate for Payer: UMR Bronson Commercial |
$70.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.87
|
|
|
HC HUM/AEROSOL CONTINUOUS
|
Facility
|
IP
|
$379.19
|
|
| Hospital Charge Code |
27000115
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$166.84 |
| Max. Negotiated Rate |
$341.27 |
| Rate for Payer: Aetna American Axle |
$246.47
|
| Rate for Payer: Aetna Commercial |
$322.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.47
|
| Rate for Payer: Cash Price |
$303.35
|
| Rate for Payer: Cofinity Commercial |
$265.43
|
| Rate for Payer: Cofinity Commercial |
$326.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$265.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.35
|
| Rate for Payer: Healthscope Commercial |
$341.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.31
|
| Rate for Payer: PHP Commercial |
$322.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.47
|
| Rate for Payer: Priority Health SBD |
$238.89
|
| Rate for Payer: UMR Bronson Commercial |
$166.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.39
|
|
|
HC HUM/AEROSOL CONTINUOUS
|
Facility
|
OP
|
$379.19
|
|
| Hospital Charge Code |
27000115
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$140.30 |
| Max. Negotiated Rate |
$341.27 |
| Rate for Payer: Aetna American Axle |
$246.47
|
| Rate for Payer: Aetna Commercial |
$322.31
|
| Rate for Payer: Aetna Medicare |
$189.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$246.47
|
| Rate for Payer: BCBS Complete |
$151.68
|
| Rate for Payer: Cash Price |
$303.35
|
| Rate for Payer: Cofinity Commercial |
$265.43
|
| Rate for Payer: Cofinity Commercial |
$326.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$265.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.35
|
| Rate for Payer: Healthscope Commercial |
$341.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$265.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.31
|
| Rate for Payer: PHP Commercial |
$322.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.47
|
| Rate for Payer: Priority Health SBD |
$238.89
|
| Rate for Payer: UMR Bronson Commercial |
$140.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.39
|
|
|
HC HUMAN HERPESVIRUS 6 (HHV-6)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87532
|
| Hospital Charge Code |
30600272
|
|
Hospital Revenue Code
|
306
|
| 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 HUMAN HERPESVIRUS 6 (HHV-6)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87532
|
| Hospital Charge Code |
30600272
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| 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 |
$35.09
|
| 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 |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC HUMAN PAPILLOMAVIRUS HIGH RISK
|
Facility
|
OP
|
$99.07
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
30600221
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$64.40
|
| Rate for Payer: Aetna Commercial |
$84.21
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cofinity Commercial |
$85.20
|
| Rate for Payer: Cofinity Commercial |
$69.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$89.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.30
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.21
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$84.21
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.40
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$62.41
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$36.66
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.30
|
|
|
HC HUMAN PAPILLOMAVIRUS HIGH RISK
|
Facility
|
IP
|
$99.07
|
|
|
Service Code
|
CPT 87624
|
| Hospital Charge Code |
30600221
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$43.59 |
| Max. Negotiated Rate |
$89.16 |
| Rate for Payer: Aetna American Axle |
$64.40
|
| Rate for Payer: Aetna Commercial |
$84.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.40
|
| Rate for Payer: Cash Price |
$79.26
|
| Rate for Payer: Cofinity Commercial |
$69.35
|
| Rate for Payer: Cofinity Commercial |
$85.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.26
|
| Rate for Payer: Healthscope Commercial |
$89.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.21
|
| Rate for Payer: PHP Commercial |
$84.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.40
|
| Rate for Payer: Priority Health SBD |
$62.41
|
| Rate for Payer: UMR Bronson Commercial |
$43.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.30
|
|
|
HC HUMAN PARECHOVIRUS
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600273
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| 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 |
$35.09
|
| 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 |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC HUMAN PARECHOVIRUS
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600273
|
|
Hospital Revenue Code
|
306
|
| 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 HYALUORAN OR DERIVATIVE, SYN OR SYN1, INTRA-ARTICULAR INJ, 1MG
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
63600107
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.26 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$8.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.94
|
| Rate for Payer: BCBS Complete |
$4.47
|
| Rate for Payer: BCBS MAPPO |
$7.95
|
| Rate for Payer: BCN Medicare Advantage |
$7.95
|
| 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 |
$7.95
|
| 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 |
$4.26
|
| Rate for Payer: Mclaren Medicare |
$7.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.35
|
| Rate for Payer: Meridian Medicaid |
$4.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$7.55
|
| Rate for Payer: PACE SWMI |
$7.95
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$7.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$7.95
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$7.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.95
|
| Rate for Payer: UHC Exchange |
$15.19
|
| Rate for Payer: UHC Medicare Advantage |
$7.95
|
| Rate for Payer: UHCCP Medicaid |
$4.26
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$7.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC HYALUORAN OR DERIVATIVE, SYN OR SYN1, INTRA-ARTICULAR INJ, 1MG
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT J7325
|
| Hospital Charge Code |
63600107
|
|
Hospital Revenue Code
|
636
|
| 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 HYALURONAN FOR IA INJ PER DOSE
|
Facility
|
OP
|
$309.00
|
|
|
Service Code
|
HCPCS J7321
|
| Hospital Charge Code |
63600157
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$114.33 |
| Max. Negotiated Rate |
$278.10 |
| Rate for Payer: Aetna American Axle |
$200.85
|
| Rate for Payer: Aetna Commercial |
$262.65
|
| Rate for Payer: Aetna Medicare |
$154.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.85
|
| Rate for Payer: BCBS Complete |
$123.60
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$216.30
|
| Rate for Payer: Cofinity Commercial |
$265.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.20
|
| Rate for Payer: Healthscope Commercial |
$278.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.65
|
| Rate for Payer: PHP Commercial |
$262.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health SBD |
$194.67
|
| Rate for Payer: UMR Bronson Commercial |
$114.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.75
|
|
|
HC HYALURONAN FOR IA INJ PER DOSE
|
Facility
|
IP
|
$309.00
|
|
|
Service Code
|
HCPCS J7321
|
| Hospital Charge Code |
63600157
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$135.96 |
| Max. Negotiated Rate |
$278.10 |
| Rate for Payer: Aetna American Axle |
$200.85
|
| Rate for Payer: Aetna Commercial |
$262.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$200.85
|
| Rate for Payer: Cash Price |
$247.20
|
| Rate for Payer: Cofinity Commercial |
$216.30
|
| Rate for Payer: Cofinity Commercial |
$265.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$216.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$247.20
|
| Rate for Payer: Healthscope Commercial |
$278.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$216.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$231.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$262.65
|
| Rate for Payer: PHP Commercial |
$262.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$200.85
|
| Rate for Payer: Priority Health SBD |
$194.67
|
| Rate for Payer: UMR Bronson Commercial |
$135.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$231.75
|
|
|
HC HYALURONAN OR DERIVATIVE, DURALONE, INTRAARTICULAR INJ, 1MG
|
Facility
|
OP
|
$21.50
|
|
|
Service Code
|
HCPCS J7318
|
| Hospital Charge Code |
63600163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.63 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna American Axle |
$13.97
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna Medicare |
$7.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.46
|
| Rate for Payer: BCBS Complete |
$3.81
|
| Rate for Payer: BCBS MAPPO |
$6.77
|
| Rate for Payer: BCN Medicare Advantage |
$6.77
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Cofinity Commercial |
$15.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.77
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Mclaren Medicaid |
$3.63
|
| Rate for Payer: Mclaren Medicare |
$6.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.11
|
| Rate for Payer: Meridian Medicaid |
$3.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: PACE Medicare |
$6.43
|
| Rate for Payer: PACE SWMI |
$6.77
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: PHP Medicare Advantage |
$6.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.97
|
| Rate for Payer: Priority Health Medicare |
$6.77
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: Railroad Medicare Medicare |
$6.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.77
|
| Rate for Payer: UHC Exchange |
$12.94
|
| Rate for Payer: UHC Medicare Advantage |
$6.77
|
| Rate for Payer: UHCCP Medicaid |
$3.63
|
| Rate for Payer: UMR Bronson Commercial |
$7.96
|
| Rate for Payer: VA VA |
$6.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
|
HC HYALURONAN OR DERIVATIVE, DURALONE, INTRAARTICULAR INJ, 1MG
|
Facility
|
IP
|
$21.50
|
|
|
Service Code
|
HCPCS J7318
|
| Hospital Charge Code |
63600163
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$19.35 |
| Rate for Payer: Aetna American Axle |
$13.97
|
| Rate for Payer: Aetna Commercial |
$18.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.97
|
| Rate for Payer: Cash Price |
$17.20
|
| Rate for Payer: Cofinity Commercial |
$15.05
|
| Rate for Payer: Cofinity Commercial |
$18.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.20
|
| Rate for Payer: Healthscope Commercial |
$19.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.27
|
| Rate for Payer: PHP Commercial |
$18.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.97
|
| Rate for Payer: Priority Health SBD |
$13.54
|
| Rate for Payer: UMR Bronson Commercial |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.12
|
|
|
HC HYALURONAN OR DERIVATIVE, GEL 1, INTRA-ARTICULAR INJ PER DOSE
|
Facility
|
IP
|
$1,394.14
|
|
|
Service Code
|
CPT J7326
|
| Hospital Charge Code |
63600108
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$613.42 |
| Max. Negotiated Rate |
$1,254.73 |
| Rate for Payer: Aetna American Axle |
$906.19
|
| Rate for Payer: Aetna Commercial |
$1,185.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.19
|
| Rate for Payer: Cash Price |
$1,115.31
|
| Rate for Payer: Cofinity Commercial |
$1,198.96
|
| Rate for Payer: Cofinity Commercial |
$975.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$975.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,115.31
|
| Rate for Payer: Healthscope Commercial |
$1,254.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$975.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,045.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,185.02
|
| Rate for Payer: PHP Commercial |
$1,185.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.19
|
| Rate for Payer: Priority Health SBD |
$878.31
|
| Rate for Payer: UMR Bronson Commercial |
$613.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,045.61
|
|
|
HC HYALURONAN OR DERIVATIVE, GEL 1, INTRA-ARTICULAR INJ PER DOSE
|
Facility
|
OP
|
$1,394.14
|
|
|
Service Code
|
CPT J7326
|
| Hospital Charge Code |
63600108
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$283.68 |
| Max. Negotiated Rate |
$1,489.81 |
| Rate for Payer: Aetna American Axle |
$906.19
|
| Rate for Payer: Aetna Commercial |
$1,185.02
|
| Rate for Payer: Aetna Medicare |
$550.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$906.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$661.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$661.58
|
| Rate for Payer: BCBS Complete |
$297.87
|
| Rate for Payer: BCBS MAPPO |
$529.26
|
| Rate for Payer: BCN Medicare Advantage |
$529.26
|
| Rate for Payer: Cash Price |
$1,115.31
|
| Rate for Payer: Cash Price |
$1,115.31
|
| Rate for Payer: Cofinity Commercial |
$975.90
|
| Rate for Payer: Cofinity Commercial |
$1,198.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$975.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,115.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$529.26
|
| Rate for Payer: Healthscope Commercial |
$1,254.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$975.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,045.61
|
| Rate for Payer: Mclaren Medicaid |
$283.68
|
| Rate for Payer: Mclaren Medicare |
$529.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$555.72
|
| Rate for Payer: Meridian Medicaid |
$297.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$608.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,185.02
|
| Rate for Payer: PACE Medicare |
$502.80
|
| Rate for Payer: PACE SWMI |
$529.26
|
| Rate for Payer: PHP Commercial |
$1,185.02
|
| Rate for Payer: PHP Medicare Advantage |
$529.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$283.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$906.19
|
| Rate for Payer: Priority Health Medicare |
$529.26
|
| Rate for Payer: Priority Health SBD |
$878.31
|
| Rate for Payer: Railroad Medicare Medicare |
$529.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,489.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$529.26
|
| Rate for Payer: UHC Exchange |
$1,011.47
|
| Rate for Payer: UHC Medicare Advantage |
$529.26
|
| Rate for Payer: UHCCP Medicaid |
$283.68
|
| Rate for Payer: UMR Bronson Commercial |
$515.83
|
| Rate for Payer: VA VA |
$529.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,045.61
|
|
|
HC HYDROCODONE AND MTB, FREE
|
Facility
|
IP
|
$99.96
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100685
|
|
Hospital Revenue Code
|
301
|
| 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 HYDROCODONE AND MTB, FREE
|
Facility
|
OP
|
$99.96
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100685
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$36.99 |
| 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 |
$49.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.97
|
| Rate for Payer: BCBS Complete |
$39.98
|
| 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 |
$36.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.97
|
|
