|
HC SOFTGOOD HIP PILLOW ABD
|
Facility
|
OP
|
$158.37
|
|
| Hospital Charge Code |
27000149
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$58.60 |
| Max. Negotiated Rate |
$142.53 |
| Rate for Payer: Aetna American Axle |
$102.94
|
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.94
|
| Rate for Payer: BCBS Complete |
$63.35
|
| Rate for Payer: Cash Price |
$126.70
|
| Rate for Payer: Cofinity Commercial |
$110.86
|
| Rate for Payer: Cofinity Commercial |
$136.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.70
|
| Rate for Payer: Healthscope Commercial |
$142.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$134.61
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.86
|
| Rate for Payer: Priority Health SBD |
$99.77
|
| Rate for Payer: UMR Bronson Commercial |
$58.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.78
|
|
|
HC SOFTGOOD SHOULDER PILLOW ABD
|
Facility
|
OP
|
$234.51
|
|
| Hospital Charge Code |
27000150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$86.77 |
| Max. Negotiated Rate |
$211.06 |
| Rate for Payer: Aetna American Axle |
$152.43
|
| Rate for Payer: Aetna Commercial |
$199.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.43
|
| Rate for Payer: BCBS Complete |
$93.80
|
| Rate for Payer: Cash Price |
$187.61
|
| Rate for Payer: Cofinity Commercial |
$164.16
|
| Rate for Payer: Cofinity Commercial |
$201.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.61
|
| Rate for Payer: Healthscope Commercial |
$211.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.33
|
| Rate for Payer: PHP Commercial |
$199.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.16
|
| Rate for Payer: Priority Health SBD |
$147.74
|
| Rate for Payer: UMR Bronson Commercial |
$86.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.88
|
|
|
HC SOFTGOOD SHOULDER PILLOW ABD
|
Facility
|
IP
|
$234.51
|
|
| Hospital Charge Code |
27000150
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$103.18 |
| Max. Negotiated Rate |
$211.06 |
| Rate for Payer: Aetna American Axle |
$152.43
|
| Rate for Payer: Aetna Commercial |
$199.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$152.43
|
| Rate for Payer: Cash Price |
$187.61
|
| Rate for Payer: Cofinity Commercial |
$164.16
|
| Rate for Payer: Cofinity Commercial |
$201.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$187.61
|
| Rate for Payer: Healthscope Commercial |
$211.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$164.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$175.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$199.33
|
| Rate for Payer: PHP Commercial |
$199.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$164.16
|
| Rate for Payer: Priority Health SBD |
$147.74
|
| Rate for Payer: UMR Bronson Commercial |
$103.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$175.88
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
IP
|
$56.70
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.95 |
| Max. Negotiated Rate |
$51.03 |
| Rate for Payer: Aetna American Axle |
$36.86
|
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.86
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$39.69
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.36
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.20
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.69
|
| Rate for Payer: Priority Health SBD |
$35.72
|
| Rate for Payer: UMR Bronson Commercial |
$24.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.52
|
|
|
HC SOLUBLE TRANSFERRIN RECEPTOR
|
Facility
|
OP
|
$56.70
|
|
|
Service Code
|
CPT 84238
|
| Hospital Charge Code |
30100631
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.00 |
| Max. Negotiated Rate |
$60.32 |
| Rate for Payer: Aetna American Axle |
$36.86
|
| Rate for Payer: Aetna Commercial |
$48.20
|
| Rate for Payer: Aetna Medicare |
$38.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.71
|
| Rate for Payer: BCBS Complete |
$21.01
|
| Rate for Payer: BCBS MAPPO |
$36.57
|
| Rate for Payer: BCBS Trust/PPO |
$32.89
|
| Rate for Payer: BCN Medicare Advantage |
$36.57
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cash Price |
$45.36
|
| Rate for Payer: Cofinity Commercial |
$48.76
|
| Rate for Payer: Cofinity Commercial |
$39.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.57
|
| Rate for Payer: Healthscope Commercial |
$51.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.52
|
| Rate for Payer: Mclaren Medicaid |
$20.00
|
| Rate for Payer: Mclaren Medicare |
$36.57
|
| Rate for Payer: Meridian Medicaid |
$21.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$48.20
|
| Rate for Payer: PACE Medicare |
$34.74
|
| Rate for Payer: PACE SWMI |
$36.57
|
| Rate for Payer: PHP Commercial |
$48.20
|
| Rate for Payer: PHP Medicare Advantage |
$36.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.69
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50.16
|
| Rate for Payer: Priority Health Medicare |
$36.57
|
| Rate for Payer: Priority Health Narrow Network |
$40.13
|
| Rate for Payer: Priority Health SBD |
$35.72
|
| Rate for Payer: Railroad Medicare Medicare |
$36.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.88
|
| Rate for Payer: UHC Core |
$60.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.57
|
| Rate for Payer: UHC Exchange |
$36.57
|
| Rate for Payer: UHC Medicare Advantage |
$37.67
|
| Rate for Payer: UMR Bronson Commercial |
$20.98
|
| Rate for Payer: VA VA |
$36.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.52
|
|
|
HC SOMATOMEDIN
|
Facility
|
OP
|
$54.06
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.63 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna American Axle |
$35.14
|
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna Medicare |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.58
|
| Rate for Payer: BCBS Complete |
$12.21
|
| Rate for Payer: BCBS MAPPO |
$21.26
|
| Rate for Payer: BCBS Trust/PPO |
$19.13
|
| Rate for Payer: BCN Medicare Advantage |
$21.26
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.26
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Mclaren Medicaid |
$11.63
|
| Rate for Payer: Mclaren Medicare |
$21.26
|
| Rate for Payer: Meridian Medicaid |
$12.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PACE Medicare |
$20.20
|
| Rate for Payer: PACE SWMI |
$21.26
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: PHP Medicare Advantage |
$21.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$23.85
|
| Rate for Payer: Priority Health Medicare |
$21.26
|
| Rate for Payer: Priority Health Narrow Network |
$19.08
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: Railroad Medicare Medicare |
$21.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.51
|
| Rate for Payer: UHC Core |
$35.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.26
|
| Rate for Payer: UHC Exchange |
$21.26
|
| Rate for Payer: UHC Medicare Advantage |
$21.90
|
| Rate for Payer: UMR Bronson Commercial |
$20.00
|
| Rate for Payer: VA VA |
$21.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC SOMATOMEDIN
|
Facility
|
IP
|
$54.06
|
|
|
Service Code
|
CPT 84305
|
| Hospital Charge Code |
30100425
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.79 |
| Max. Negotiated Rate |
$48.65 |
| Rate for Payer: Aetna American Axle |
$35.14
|
| Rate for Payer: Aetna Commercial |
$45.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.14
|
| Rate for Payer: Cash Price |
$43.25
|
| Rate for Payer: Cofinity Commercial |
$37.84
|
| Rate for Payer: Cofinity Commercial |
$46.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.25
|
| Rate for Payer: Healthscope Commercial |
$48.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$45.95
|
| Rate for Payer: PHP Commercial |
$45.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.84
|
| Rate for Payer: Priority Health SBD |
$34.06
|
| Rate for Payer: UMR Bronson Commercial |
$23.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.54
|
|
|
HC SOYBEAN IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SOYBEAN IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200062
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
IP
|
$5,930.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,609.20 |
| Max. Negotiated Rate |
$5,337.00 |
| Rate for Payer: Aetna American Axle |
$3,854.50
|
| Rate for Payer: Aetna Commercial |
$5,040.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,854.50
|
| Rate for Payer: Cash Price |
$4,744.00
|
| Rate for Payer: Cofinity Commercial |
$4,151.00
|
| Rate for Payer: Cofinity Commercial |
$5,099.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,744.00
|
| Rate for Payer: Healthscope Commercial |
$5,337.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,151.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,447.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,040.50
|
| Rate for Payer: PHP Commercial |
$5,040.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,151.00
|
| Rate for Payer: Priority Health SBD |
$3,735.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,609.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,447.50
|
|
|
HC SPACEOAR HYDROGEL
|
Facility
|
OP
|
$5,930.00
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800131
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$5,337.00 |
| Rate for Payer: Aetna American Axle |
$3,854.50
|
| Rate for Payer: Aetna Commercial |
$5,040.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,854.50
|
| Rate for Payer: BCBS Complete |
$2,372.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: Cash Price |
$4,744.00
|
| Rate for Payer: Cash Price |
$4,744.00
|
| Rate for Payer: Cofinity Commercial |
$4,151.00
|
| Rate for Payer: Cofinity Commercial |
$5,099.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,744.00
|
| Rate for Payer: Healthscope Commercial |
$5,337.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,151.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,447.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,040.50
|
| Rate for Payer: PHP Commercial |
$5,040.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,151.00
|
| Rate for Payer: Priority Health SBD |
$3,735.90
|
| Rate for Payer: UMR Bronson Commercial |
$2,194.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,447.50
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
OP
|
$3,774.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$341.52 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,453.10
|
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,453.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$2,641.80
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,641.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,377.62
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$375.67
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$341.52
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,396.38
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC SP ANGIOGRAPHY RENAL BIL
|
Facility
|
IP
|
$3,774.00
|
|
|
Service Code
|
CPT 36252
|
| Hospital Charge Code |
36100348
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,660.56 |
| Max. Negotiated Rate |
$3,396.60 |
| Rate for Payer: Aetna American Axle |
$2,453.10
|
| Rate for Payer: Aetna Commercial |
$3,207.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,453.10
|
| Rate for Payer: Cash Price |
$3,019.20
|
| Rate for Payer: Cofinity Commercial |
$2,641.80
|
| Rate for Payer: Cofinity Commercial |
$3,245.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,019.20
|
| Rate for Payer: Healthscope Commercial |
$3,396.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,641.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,830.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,207.90
|
| Rate for Payer: PHP Commercial |
$3,207.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,641.80
|
| Rate for Payer: Priority Health SBD |
$2,377.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,660.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,830.50
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
IP
|
$3,903.99
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,717.76 |
| Max. Negotiated Rate |
$3,513.59 |
| Rate for Payer: Aetna American Axle |
$2,537.59
|
| Rate for Payer: Aetna Commercial |
$3,318.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,537.59
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cofinity Commercial |
$2,732.79
|
| Rate for Payer: Cofinity Commercial |
$3,357.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,123.19
|
| Rate for Payer: Healthscope Commercial |
$3,513.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,732.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,927.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,318.39
|
| Rate for Payer: PHP Commercial |
$3,318.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,732.79
|
| Rate for Payer: Priority Health SBD |
$2,459.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,717.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,927.99
|
|
|
HC SP ANGIOGRAPHY RENAL UNI
|
Facility
|
OP
|
$3,903.99
|
|
|
Service Code
|
CPT 36251
|
| Hospital Charge Code |
36100347
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$244.27 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,537.59
|
| Rate for Payer: Aetna Commercial |
$3,318.39
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,537.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cash Price |
$3,123.19
|
| Rate for Payer: Cofinity Commercial |
$2,732.79
|
| Rate for Payer: Cofinity Commercial |
$3,357.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,123.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$3,513.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,732.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,927.99
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,318.39
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$3,318.39
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,732.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,459.51
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$268.70
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$244.27
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,444.48
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,927.99
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
IP
|
$3,202.09
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,408.92 |
| Max. Negotiated Rate |
$2,881.88 |
| Rate for Payer: Aetna American Axle |
$2,081.36
|
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,081.36
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,241.46
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,561.67
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,241.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,401.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health SBD |
$2,017.32
|
| Rate for Payer: UMR Bronson Commercial |
$1,408.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,401.57
|
|
|
HC SP AORTAGRAM ABDOMEN W RUNOFF
|
Facility
|
OP
|
$3,202.09
|
|
|
Service Code
|
CPT 75630
|
| Hospital Charge Code |
32000177
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$122.26 |
| Max. Negotiated Rate |
$8,919.33 |
| Rate for Payer: Aetna American Axle |
$2,081.36
|
| Rate for Payer: Aetna Commercial |
$2,721.78
|
| Rate for Payer: Aetna Medicare |
$2,946.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,081.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,541.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,541.61
|
| Rate for Payer: BCBS Complete |
$1,627.44
|
| Rate for Payer: BCBS MAPPO |
$2,833.29
|
| Rate for Payer: BCBS Trust/PPO |
$122.26
|
| Rate for Payer: BCN Medicare Advantage |
$2,833.29
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cash Price |
$2,561.67
|
| Rate for Payer: Cofinity Commercial |
$2,753.80
|
| Rate for Payer: Cofinity Commercial |
$2,241.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,561.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,833.29
|
| Rate for Payer: Healthscope Commercial |
$2,881.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,241.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,401.57
|
| Rate for Payer: Mclaren Medicaid |
$1,549.81
|
| Rate for Payer: Mclaren Medicare |
$2,833.29
|
| Rate for Payer: Meridian Medicaid |
$1,627.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,974.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,258.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,721.78
|
| Rate for Payer: PACE Medicare |
$2,691.63
|
| Rate for Payer: PACE SWMI |
$2,833.29
|
| Rate for Payer: PHP Commercial |
$2,721.78
|
| Rate for Payer: PHP Medicare Advantage |
$2,833.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,549.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,241.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,919.33
|
| Rate for Payer: Priority Health Medicare |
$2,833.29
|
| Rate for Payer: Priority Health Narrow Network |
$7,135.46
|
| Rate for Payer: Priority Health SBD |
$2,017.32
|
| Rate for Payer: Railroad Medicare Medicare |
$2,833.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.29
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,833.29
|
| Rate for Payer: UHC Exchange |
$153.90
|
| Rate for Payer: UHC Medicare Advantage |
$2,918.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,184.77
|
| Rate for Payer: VA VA |
$2,833.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,401.57
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
OP
|
$150.96
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$36.10 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$98.12
|
| Rate for Payer: Aetna American Axle |
$83.85
|
| Rate for Payer: Aetna Commercial |
$109.65
|
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: Aetna Medicare |
$125.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$150.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$150.76
|
| Rate for Payer: BCBS Complete |
$69.28
|
| Rate for Payer: BCBS Complete |
$69.28
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS MAPPO |
$120.61
|
| Rate for Payer: BCBS Trust/PPO |
$36.10
|
| Rate for Payer: BCBS Trust/PPO |
$36.10
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: BCN Medicare Advantage |
$120.61
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cofinity Commercial |
$110.94
|
| Rate for Payer: Cofinity Commercial |
$105.67
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$120.61
|
| Rate for Payer: Healthscope Commercial |
$116.10
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.75
|
| Rate for Payer: Mclaren Medicaid |
$65.97
|
| Rate for Payer: Mclaren Medicaid |
$65.97
|
| Rate for Payer: Mclaren Medicare |
$120.61
|
| Rate for Payer: Mclaren Medicare |
$120.61
|
| Rate for Payer: Meridian Medicaid |
$69.28
|
| Rate for Payer: Meridian Medicaid |
$69.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$126.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$138.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.65
|
| Rate for Payer: PACE Medicare |
$114.58
|
| Rate for Payer: PACE Medicare |
$114.58
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PACE SWMI |
$120.61
|
| Rate for Payer: PHP Commercial |
$109.65
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: PHP Medicare Advantage |
$120.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$379.68
|
| Rate for Payer: Priority Health Medicare |
$120.61
|
| Rate for Payer: Priority Health Medicare |
$120.61
|
| Rate for Payer: Priority Health Narrow Network |
$303.74
|
| Rate for Payer: Priority Health Narrow Network |
$303.74
|
| Rate for Payer: Priority Health SBD |
$81.27
|
| Rate for Payer: Priority Health SBD |
$95.10
|
| Rate for Payer: Railroad Medicare Medicare |
$120.61
|
| Rate for Payer: Railroad Medicare Medicare |
$120.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.24
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$120.61
|
| Rate for Payer: UHC Exchange |
$63.85
|
| Rate for Payer: UHC Exchange |
$63.85
|
| Rate for Payer: UHC Medicare Advantage |
$124.23
|
| Rate for Payer: UHC Medicare Advantage |
$124.23
|
| Rate for Payer: UMR Bronson Commercial |
$47.73
|
| Rate for Payer: UMR Bronson Commercial |
$55.86
|
| Rate for Payer: VA VA |
$120.61
|
| Rate for Payer: VA VA |
$120.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.75
|
|
|
HC SPECIAL DOSIMETRY
|
Facility
|
IP
|
$150.96
|
|
|
Service Code
|
CPT 77331
|
| Hospital Charge Code |
33300013
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$66.42 |
| Max. Negotiated Rate |
$135.86 |
| Rate for Payer: Aetna American Axle |
$98.12
|
| Rate for Payer: Aetna American Axle |
$83.85
|
| Rate for Payer: Aetna Commercial |
$128.32
|
| Rate for Payer: Aetna Commercial |
$109.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.85
|
| Rate for Payer: Cash Price |
$120.77
|
| Rate for Payer: Cash Price |
$103.20
|
| Rate for Payer: Cofinity Commercial |
$110.94
|
| Rate for Payer: Cofinity Commercial |
$90.30
|
| Rate for Payer: Cofinity Commercial |
$129.83
|
| Rate for Payer: Cofinity Commercial |
$105.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.20
|
| Rate for Payer: Healthscope Commercial |
$116.10
|
| Rate for Payer: Healthscope Commercial |
$135.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$109.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$128.32
|
| Rate for Payer: PHP Commercial |
$128.32
|
| Rate for Payer: PHP Commercial |
$109.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.67
|
| Rate for Payer: Priority Health SBD |
$95.10
|
| Rate for Payer: Priority Health SBD |
$81.27
|
| Rate for Payer: UMR Bronson Commercial |
$56.76
|
| Rate for Payer: UMR Bronson Commercial |
$66.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.75
|
|
|
HC SPECIAL STAINS
|
Facility
|
IP
|
$187.96
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$82.70 |
| Max. Negotiated Rate |
$169.16 |
| Rate for Payer: Aetna American Axle |
$122.17
|
| Rate for Payer: Aetna Commercial |
$159.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.17
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cofinity Commercial |
$131.57
|
| Rate for Payer: Cofinity Commercial |
$161.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.37
|
| Rate for Payer: Healthscope Commercial |
$169.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$159.77
|
| Rate for Payer: PHP Commercial |
$159.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.57
|
| Rate for Payer: Priority Health SBD |
$118.41
|
| Rate for Payer: UMR Bronson Commercial |
$82.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.97
|
|
|
HC SPECIAL STAINS
|
Facility
|
OP
|
$187.96
|
|
|
Service Code
|
CPT 88312
|
| Hospital Charge Code |
31000053
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.35 |
| Max. Negotiated Rate |
$169.16 |
| Rate for Payer: Aetna American Axle |
$122.17
|
| Rate for Payer: Aetna Commercial |
$159.77
|
| Rate for Payer: Aetna Medicare |
$50.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.21
|
| Rate for Payer: BCBS Complete |
$27.67
|
| Rate for Payer: BCBS MAPPO |
$48.17
|
| Rate for Payer: BCBS Trust/PPO |
$122.58
|
| Rate for Payer: BCN Medicare Advantage |
$48.17
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cash Price |
$150.37
|
| Rate for Payer: Cofinity Commercial |
$131.57
|
| Rate for Payer: Cofinity Commercial |
$161.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.17
|
| Rate for Payer: Healthscope Commercial |
$169.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.97
|
| Rate for Payer: Mclaren Medicaid |
$26.35
|
| Rate for Payer: Mclaren Medicare |
$48.17
|
| Rate for Payer: Meridian Medicaid |
$27.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$50.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$159.77
|
| Rate for Payer: PACE Medicare |
$45.76
|
| Rate for Payer: PACE SWMI |
$48.17
|
| Rate for Payer: PHP Commercial |
$159.77
|
| Rate for Payer: PHP Medicare Advantage |
$48.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$131.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$151.62
|
| Rate for Payer: Priority Health Medicare |
$48.17
|
| Rate for Payer: Priority Health Narrow Network |
$121.30
|
| Rate for Payer: Priority Health SBD |
$118.41
|
| Rate for Payer: Railroad Medicare Medicare |
$48.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.75
|
| Rate for Payer: UHC Core |
$28.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$48.17
|
| Rate for Payer: UHC Exchange |
$110.68
|
| Rate for Payer: UHC Medicare Advantage |
$49.62
|
| Rate for Payer: UMR Bronson Commercial |
$69.55
|
| Rate for Payer: VA VA |
$48.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.97
|
|
|
HC SPECIAL STAINS II
|
Facility
|
IP
|
$180.58
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$79.46 |
| Max. Negotiated Rate |
$162.52 |
| Rate for Payer: Aetna American Axle |
$117.38
|
| Rate for Payer: Aetna Commercial |
$153.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.38
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cofinity Commercial |
$126.41
|
| Rate for Payer: Cofinity Commercial |
$155.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.46
|
| Rate for Payer: Healthscope Commercial |
$162.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.49
|
| Rate for Payer: PHP Commercial |
$153.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.41
|
| Rate for Payer: Priority Health SBD |
$113.77
|
| Rate for Payer: UMR Bronson Commercial |
$79.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.44
|
|
|
HC SPECIAL STAINS II
|
Facility
|
OP
|
$180.58
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31000054
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.12 |
| Max. Negotiated Rate |
$171.15 |
| Rate for Payer: Aetna American Axle |
$117.38
|
| Rate for Payer: Aetna Commercial |
$153.49
|
| Rate for Payer: Aetna Medicare |
$56.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.96
|
| Rate for Payer: BCBS Complete |
$31.23
|
| Rate for Payer: BCBS MAPPO |
$54.37
|
| Rate for Payer: BCBS Trust/PPO |
$99.30
|
| Rate for Payer: BCN Medicare Advantage |
$54.37
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cash Price |
$144.46
|
| Rate for Payer: Cofinity Commercial |
$155.30
|
| Rate for Payer: Cofinity Commercial |
$126.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.37
|
| Rate for Payer: Healthscope Commercial |
$162.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.44
|
| Rate for Payer: Mclaren Medicaid |
$29.74
|
| Rate for Payer: Mclaren Medicare |
$54.37
|
| Rate for Payer: Meridian Medicaid |
$31.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$57.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$153.49
|
| Rate for Payer: PACE Medicare |
$51.65
|
| Rate for Payer: PACE SWMI |
$54.37
|
| Rate for Payer: PHP Commercial |
$153.49
|
| Rate for Payer: PHP Medicare Advantage |
$54.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$126.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$171.15
|
| Rate for Payer: Priority Health Medicare |
$54.37
|
| Rate for Payer: Priority Health Narrow Network |
$136.92
|
| Rate for Payer: Priority Health SBD |
$113.77
|
| Rate for Payer: Railroad Medicare Medicare |
$54.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.68
|
| Rate for Payer: UHC Core |
$28.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$54.37
|
| Rate for Payer: UHC Exchange |
$81.53
|
| Rate for Payer: UHC Medicare Advantage |
$56.00
|
| Rate for Payer: UMR Bronson Commercial |
$66.81
|
| Rate for Payer: VA VA |
$54.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.44
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
OP
|
$12.10
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna American Axle |
$7.86
|
| Rate for Payer: Aetna Commercial |
$10.28
|
| Rate for Payer: Aetna Medicare |
$3.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.10
|
| Rate for Payer: BCBS Complete |
$1.88
|
| Rate for Payer: BCBS MAPPO |
$3.28
|
| Rate for Payer: BCBS Trust/PPO |
$2.95
|
| Rate for Payer: BCN Medicare Advantage |
$3.28
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Cofinity Commercial |
$8.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.28
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.08
|
| Rate for Payer: Mclaren Medicaid |
$1.79
|
| Rate for Payer: Mclaren Medicare |
$3.28
|
| Rate for Payer: Meridian Medicaid |
$1.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.28
|
| Rate for Payer: PACE Medicare |
$3.12
|
| Rate for Payer: PACE SWMI |
$3.28
|
| Rate for Payer: PHP Commercial |
$10.28
|
| Rate for Payer: PHP Medicare Advantage |
$3.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.31
|
| Rate for Payer: Priority Health Medicare |
$3.28
|
| Rate for Payer: Priority Health Narrow Network |
$2.65
|
| Rate for Payer: Priority Health SBD |
$7.62
|
| Rate for Payer: Railroad Medicare Medicare |
$3.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.94
|
| Rate for Payer: UHC Core |
$4.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.28
|
| Rate for Payer: UHC Exchange |
$3.28
|
| Rate for Payer: UHC Medicare Advantage |
$3.38
|
| Rate for Payer: UMR Bronson Commercial |
$4.48
|
| Rate for Payer: VA VA |
$3.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.08
|
|
|
HC SPECIFIC GRAVITY FLUID NOT URINE
|
Facility
|
IP
|
$12.10
|
|
|
Service Code
|
CPT 84315
|
| Hospital Charge Code |
30100426
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.32 |
| Max. Negotiated Rate |
$10.89 |
| Rate for Payer: Aetna American Axle |
$7.86
|
| Rate for Payer: Aetna Commercial |
$10.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.86
|
| Rate for Payer: Cash Price |
$9.68
|
| Rate for Payer: Cofinity Commercial |
$10.41
|
| Rate for Payer: Cofinity Commercial |
$8.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.68
|
| Rate for Payer: Healthscope Commercial |
$10.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10.28
|
| Rate for Payer: PHP Commercial |
$10.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.47
|
| Rate for Payer: Priority Health SBD |
$7.62
|
| Rate for Payer: UMR Bronson Commercial |
$5.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.08
|
|
