|
HC IMMUNODIFFUSION AB OR AG ADDITIONAL
|
Facility
|
OP
|
$79.07
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200402
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$71.16 |
| Rate for Payer: Aetna American Axle |
$51.40
|
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$11.55
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$68.00
|
| Rate for Payer: Cofinity Commercial |
$55.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$71.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.30
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$67.21
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$9.86
|
| Rate for Payer: Priority Health SBD |
$49.81
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: UMR Bronson Commercial |
$29.26
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.30
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
OP
|
$91.56
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna American Axle |
$59.51
|
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$11.55
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Cofinity Commercial |
$64.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.32
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$9.86
|
| Rate for Payer: Priority Health SBD |
$57.68
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: UMR Bronson Commercial |
$33.88
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC IMMUNODIFFUSION AB OR AG FIRST
|
Facility
|
IP
|
$91.56
|
|
|
Service Code
|
CPT 86331
|
| Hospital Charge Code |
30200401
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.29 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna American Axle |
$59.51
|
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.51
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$64.09
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health SBD |
$57.68
|
| Rate for Payer: UMR Bronson Commercial |
$40.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC IMMUNOFIXATION
|
Facility
|
IP
|
$91.56
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$40.29 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna American Axle |
$59.51
|
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.51
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$64.09
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health SBD |
$57.68
|
| Rate for Payer: UMR Bronson Commercial |
$40.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC IMMUNOFIXATION
|
Facility
|
OP
|
$91.56
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200195
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$82.40 |
| Rate for Payer: Aetna American Axle |
$59.51
|
| Rate for Payer: Aetna Commercial |
$77.83
|
| Rate for Payer: Aetna Medicare |
$23.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.92
|
| Rate for Payer: BCBS Complete |
$12.57
|
| Rate for Payer: BCBS MAPPO |
$22.34
|
| Rate for Payer: BCBS Trust/PPO |
$16.15
|
| Rate for Payer: BCN Commercial |
$16.15
|
| Rate for Payer: BCN Medicare Advantage |
$22.34
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cash Price |
$73.25
|
| Rate for Payer: Cofinity Commercial |
$78.74
|
| Rate for Payer: Cofinity Commercial |
$64.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.34
|
| Rate for Payer: Healthscope Commercial |
$82.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.67
|
| Rate for Payer: Mclaren Medicaid |
$11.97
|
| Rate for Payer: Mclaren Medicare |
$22.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.46
|
| Rate for Payer: Meridian Medicaid |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.83
|
| Rate for Payer: Nomi Health Commercial |
$33.51
|
| Rate for Payer: PACE Medicare |
$21.22
|
| Rate for Payer: PACE SWMI |
$22.34
|
| Rate for Payer: PHP Commercial |
$77.83
|
| Rate for Payer: PHP Medicare Advantage |
$22.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.99
|
| Rate for Payer: Priority Health Medicare |
$22.34
|
| Rate for Payer: Priority Health Narrow Network |
$18.39
|
| Rate for Payer: Priority Health SBD |
$57.68
|
| Rate for Payer: Railroad Medicare Medicare |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.34
|
| Rate for Payer: UHC Exchange |
$22.34
|
| Rate for Payer: UHC Medicare Advantage |
$22.34
|
| Rate for Payer: UHCCP Medicaid |
$11.97
|
| Rate for Payer: UMR Bronson Commercial |
$33.88
|
| Rate for Payer: VA VA |
$22.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.67
|
|
|
HC IMMUNOFIXATION ELECTRO SERUM
|
Facility
|
OP
|
$169.12
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$152.21 |
| Rate for Payer: Aetna American Axle |
$109.93
|
| Rate for Payer: Aetna Commercial |
$143.75
|
| Rate for Payer: Aetna Medicare |
$23.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.92
|
| Rate for Payer: BCBS Complete |
$12.57
|
| Rate for Payer: BCBS MAPPO |
$22.34
|
| Rate for Payer: BCBS Trust/PPO |
$16.15
|
| Rate for Payer: BCN Commercial |
$16.15
|
| Rate for Payer: BCN Medicare Advantage |
$22.34
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Cofinity Commercial |
$118.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$118.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.34
|
| Rate for Payer: Healthscope Commercial |
$152.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.84
|
| Rate for Payer: Mclaren Medicaid |
$11.97
|
| Rate for Payer: Mclaren Medicare |
$22.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.46
|
| Rate for Payer: Meridian Medicaid |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: Nomi Health Commercial |
$33.51
|
| Rate for Payer: PACE Medicare |
$21.22
|
| Rate for Payer: PACE SWMI |
$22.34
|
| Rate for Payer: PHP Commercial |
$143.75
|
| Rate for Payer: PHP Medicare Advantage |
$22.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.99
|
| Rate for Payer: Priority Health Medicare |
$22.34
|
| Rate for Payer: Priority Health Narrow Network |
$18.39
|
| Rate for Payer: Priority Health SBD |
$106.55
|
| Rate for Payer: Railroad Medicare Medicare |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.34
|
| Rate for Payer: UHC Exchange |
$22.34
|
| Rate for Payer: UHC Medicare Advantage |
$22.34
|
| Rate for Payer: UHCCP Medicaid |
$11.97
|
| Rate for Payer: UMR Bronson Commercial |
$62.57
|
| Rate for Payer: VA VA |
$22.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.84
|
|
|
HC IMMUNOFIXATION ELECTRO SERUM
|
Facility
|
IP
|
$169.12
|
|
|
Service Code
|
CPT 86334
|
| Hospital Charge Code |
30200194
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$74.41 |
| Max. Negotiated Rate |
$152.21 |
| Rate for Payer: Aetna American Axle |
$109.93
|
| Rate for Payer: Aetna Commercial |
$143.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.93
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$118.38
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$118.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Healthscope Commercial |
$152.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: PHP Commercial |
$143.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health SBD |
$106.55
|
| Rate for Payer: UMR Bronson Commercial |
$74.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.84
|
|
|
HC IMMUNOFIXATION ELEC URINE/CSF
|
Facility
|
OP
|
$169.12
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200196
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.73 |
| Max. Negotiated Rate |
$152.21 |
| Rate for Payer: Aetna American Axle |
$109.93
|
| Rate for Payer: Aetna Commercial |
$143.75
|
| Rate for Payer: Aetna Medicare |
$30.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.69
|
| Rate for Payer: BCBS Complete |
$16.52
|
| Rate for Payer: BCBS MAPPO |
$29.35
|
| Rate for Payer: BCBS Trust/PPO |
$21.20
|
| Rate for Payer: BCN Commercial |
$21.20
|
| Rate for Payer: BCN Medicare Advantage |
$29.35
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Cofinity Commercial |
$118.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$118.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.35
|
| Rate for Payer: Healthscope Commercial |
$152.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.84
|
| Rate for Payer: Mclaren Medicaid |
$15.73
|
| Rate for Payer: Mclaren Medicare |
$29.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.82
|
| Rate for Payer: Meridian Medicaid |
$16.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: Nomi Health Commercial |
$44.02
|
| Rate for Payer: PACE Medicare |
$27.88
|
| Rate for Payer: PACE SWMI |
$29.35
|
| Rate for Payer: PHP Commercial |
$143.75
|
| Rate for Payer: PHP Medicare Advantage |
$29.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29.35
|
| Rate for Payer: Priority Health Medicare |
$29.35
|
| Rate for Payer: Priority Health Narrow Network |
$23.48
|
| Rate for Payer: Priority Health SBD |
$106.55
|
| Rate for Payer: Railroad Medicare Medicare |
$29.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.35
|
| Rate for Payer: UHC Exchange |
$29.35
|
| Rate for Payer: UHC Medicare Advantage |
$29.35
|
| Rate for Payer: UHCCP Medicaid |
$15.73
|
| Rate for Payer: UMR Bronson Commercial |
$62.57
|
| Rate for Payer: VA VA |
$29.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.84
|
|
|
HC IMMUNOFIXATION ELEC URINE/CSF
|
Facility
|
IP
|
$169.12
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200196
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$74.41 |
| Max. Negotiated Rate |
$152.21 |
| Rate for Payer: Aetna American Axle |
$109.93
|
| Rate for Payer: Aetna Commercial |
$143.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.93
|
| Rate for Payer: Cash Price |
$135.30
|
| Rate for Payer: Cofinity Commercial |
$118.38
|
| Rate for Payer: Cofinity Commercial |
$145.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$118.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.30
|
| Rate for Payer: Healthscope Commercial |
$152.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.75
|
| Rate for Payer: PHP Commercial |
$143.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.93
|
| Rate for Payer: Priority Health SBD |
$106.55
|
| Rate for Payer: UMR Bronson Commercial |
$74.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.84
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$8.97
|
| Rate for Payer: BCN Commercial |
$8.97
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$13.95
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.57
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$7.66
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.30
|
| Rate for Payer: UHC Exchange |
$9.30
|
| Rate for Payer: UHC Medicare Advantage |
$9.30
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: UMR Bronson Commercial |
$28.46
|
| Rate for Payer: VA VA |
$9.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.84 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: UMR Bronson Commercial |
$33.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
OP
|
$39.78
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: UHC Medicare Advantage |
$9.30
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: UMR Bronson Commercial |
$14.72
|
| Rate for Payer: VA VA |
$9.30
|
| Rate for Payer: Aetna American Axle |
$25.86
|
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna Medicare |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$8.97
|
| Rate for Payer: BCN Commercial |
$8.97
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Cofinity Commercial |
$27.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.81
|
| Rate for Payer: Nomi Health Commercial |
$13.95
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.57
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$7.66
|
| Rate for Payer: Priority Health SBD |
$25.06
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.30
|
| Rate for Payer: UHC Exchange |
$9.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
IP
|
$39.78
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.50 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna American Axle |
$25.86
|
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.86
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$27.85
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.81
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.86
|
| Rate for Payer: Priority Health SBD |
$25.06
|
| Rate for Payer: UMR Bronson Commercial |
$17.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
OP
|
$63.26
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$56.93 |
| Rate for Payer: Aetna Commercial |
$53.77
|
| Rate for Payer: Aetna Medicare |
$17.12
|
| Rate for Payer: Aetna American Axle |
$41.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.58
|
| Rate for Payer: BCBS Complete |
$9.26
|
| Rate for Payer: BCBS MAPPO |
$16.46
|
| Rate for Payer: BCBS Trust/PPO |
$15.86
|
| Rate for Payer: BCN Commercial |
$15.86
|
| Rate for Payer: BCN Medicare Advantage |
$16.46
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Cofinity Commercial |
$44.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.46
|
| Rate for Payer: Healthscope Commercial |
$56.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.44
|
| Rate for Payer: Mclaren Medicaid |
$8.82
|
| Rate for Payer: Mclaren Medicare |
$16.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.28
|
| Rate for Payer: Meridian Medicaid |
$9.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.77
|
| Rate for Payer: Nomi Health Commercial |
$24.69
|
| Rate for Payer: PACE Medicare |
$15.64
|
| Rate for Payer: PACE SWMI |
$16.46
|
| Rate for Payer: PHP Commercial |
$53.77
|
| Rate for Payer: PHP Medicare Advantage |
$16.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.94
|
| Rate for Payer: Priority Health Medicare |
$16.46
|
| Rate for Payer: Priority Health Narrow Network |
$13.55
|
| Rate for Payer: Priority Health SBD |
$39.85
|
| Rate for Payer: Railroad Medicare Medicare |
$16.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.46
|
| Rate for Payer: UHC Exchange |
$16.46
|
| Rate for Payer: UHC Medicare Advantage |
$16.46
|
| Rate for Payer: UHCCP Medicaid |
$8.82
|
| Rate for Payer: UMR Bronson Commercial |
$23.41
|
| Rate for Payer: VA VA |
$16.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.44
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
IP
|
$63.26
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.83 |
| Max. Negotiated Rate |
$56.93 |
| Rate for Payer: Aetna American Axle |
$41.12
|
| Rate for Payer: Aetna Commercial |
$53.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.12
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cofinity Commercial |
$44.28
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.61
|
| Rate for Payer: Healthscope Commercial |
$56.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.77
|
| Rate for Payer: PHP Commercial |
$53.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.12
|
| Rate for Payer: Priority Health SBD |
$39.85
|
| Rate for Payer: UMR Bronson Commercial |
$27.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.44
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.84 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: UMR Bronson Commercial |
$33.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: UHC Medicare Advantage |
$9.30
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: UMR Bronson Commercial |
$28.46
|
| Rate for Payer: VA VA |
$9.30
|
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$8.97
|
| Rate for Payer: BCN Commercial |
$8.97
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$13.95
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.57
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$7.66
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.30
|
| Rate for Payer: UHC Exchange |
$9.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$9.67
|
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$8.97
|
| Rate for Payer: BCN Commercial |
$8.97
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$13.95
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.57
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$7.66
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.30
|
| Rate for Payer: UHC Exchange |
$9.30
|
| Rate for Payer: UHC Medicare Advantage |
$9.30
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: UMR Bronson Commercial |
$28.46
|
| Rate for Payer: VA VA |
$9.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.84 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna American Axle |
$49.99
|
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.99
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$53.84
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health SBD |
$48.45
|
| Rate for Payer: UMR Bronson Commercial |
$33.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.07 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna American Axle |
$14.88
|
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.88
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$16.02
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health SBD |
$14.42
|
| Rate for Payer: UMR Bronson Commercial |
$10.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: UHC Medicare Advantage |
$9.30
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: UMR Bronson Commercial |
$8.47
|
| Rate for Payer: VA VA |
$9.30
|
| Rate for Payer: Aetna American Axle |
$14.88
|
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Medicare |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$8.97
|
| Rate for Payer: BCN Commercial |
$8.97
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Cofinity Commercial |
$16.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.76
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$13.95
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.57
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health Narrow Network |
$7.66
|
| Rate for Payer: Priority Health SBD |
$14.42
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.30
|
| Rate for Payer: UHC Exchange |
$9.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
OP
|
$168.30
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$62.27 |
| Max. Negotiated Rate |
$151.47 |
| Rate for Payer: Aetna American Axle |
$109.40
|
| Rate for Payer: Aetna Commercial |
$143.06
|
| Rate for Payer: Aetna Medicare |
$84.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.40
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCBS Trust/PPO |
$98.01
|
| Rate for Payer: BCCCP Commercial |
$89.57
|
| Rate for Payer: BCN Commercial |
$98.01
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Cofinity Commercial |
$117.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.64
|
| Rate for Payer: Healthscope Commercial |
$151.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.06
|
| Rate for Payer: PHP Commercial |
$143.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.40
|
| Rate for Payer: Priority Health SBD |
$106.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.15
|
| Rate for Payer: UHC Exchange |
$82.86
|
| Rate for Payer: UMR Bronson Commercial |
$62.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.22
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
IP
|
$168.30
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$74.05 |
| Max. Negotiated Rate |
$151.47 |
| Rate for Payer: Aetna American Axle |
$109.40
|
| Rate for Payer: Aetna Commercial |
$143.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.40
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cofinity Commercial |
$117.81
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$117.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.64
|
| Rate for Payer: Healthscope Commercial |
$151.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.06
|
| Rate for Payer: PHP Commercial |
$143.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.40
|
| Rate for Payer: Priority Health SBD |
$106.03
|
| Rate for Payer: UMR Bronson Commercial |
$74.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.22
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
OP
|
$190.42
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$70.46 |
| Max. Negotiated Rate |
$527.71 |
| Rate for Payer: Aetna American Axle |
$123.77
|
| Rate for Payer: Aetna Commercial |
$161.86
|
| Rate for Payer: Aetna Medicare |
$174.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$209.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$209.88
|
| Rate for Payer: BCBS Complete |
$94.49
|
| Rate for Payer: BCBS MAPPO |
$167.90
|
| Rate for Payer: BCBS Trust/PPO |
$111.35
|
| Rate for Payer: BCCCP Commercial |
$104.63
|
| Rate for Payer: BCN Commercial |
$111.35
|
| Rate for Payer: BCN Medicare Advantage |
$167.90
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Cofinity Commercial |
$133.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$133.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.90
|
| Rate for Payer: Healthscope Commercial |
$171.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.82
|
| Rate for Payer: Mclaren Medicaid |
$89.99
|
| Rate for Payer: Mclaren Medicare |
$167.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$176.30
|
| Rate for Payer: Meridian Medicaid |
$94.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$193.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.86
|
| Rate for Payer: Nomi Health Commercial |
$503.70
|
| Rate for Payer: PACE Medicare |
$159.50
|
| Rate for Payer: PACE SWMI |
$167.90
|
| Rate for Payer: PHP Commercial |
$161.86
|
| Rate for Payer: PHP Medicare Advantage |
$167.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$527.71
|
| Rate for Payer: Priority Health Medicare |
$167.90
|
| Rate for Payer: Priority Health Narrow Network |
$422.17
|
| Rate for Payer: Priority Health SBD |
$119.96
|
| Rate for Payer: Railroad Medicare Medicare |
$167.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.90
|
| Rate for Payer: UHC Exchange |
$97.07
|
| Rate for Payer: UHC Medicare Advantage |
$167.90
|
| Rate for Payer: UHCCP Medicaid |
$89.99
|
| Rate for Payer: UMR Bronson Commercial |
$70.46
|
| Rate for Payer: VA VA |
$167.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.82
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
IP
|
$190.42
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$83.78 |
| Max. Negotiated Rate |
$171.38 |
| Rate for Payer: Aetna American Axle |
$123.77
|
| Rate for Payer: Aetna Commercial |
$161.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$123.77
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cofinity Commercial |
$133.29
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$133.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.34
|
| Rate for Payer: Healthscope Commercial |
$171.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$133.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.86
|
| Rate for Payer: PHP Commercial |
$161.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.77
|
| Rate for Payer: Priority Health SBD |
$119.96
|
| Rate for Payer: UMR Bronson Commercial |
$83.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.82
|
|
