|
HC LEAD
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 83655
|
| Hospital Charge Code |
30100275
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.14 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna American Axle |
$29.76
|
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.76
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Advantage |
$32.05
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.34
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health SBD |
$28.84
|
| Rate for Payer: UMR Bronson Commercial |
$20.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC LEAD CARDIOVERTER DEFIB ENDOCARDIAL SINGLE COIL
|
Facility
|
OP
|
$15,033.78
|
|
|
Service Code
|
HCPCS C1777
|
| Hospital Charge Code |
27800088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,562.50 |
| Max. Negotiated Rate |
$13,530.40 |
| Rate for Payer: Aetna American Axle |
$9,771.96
|
| Rate for Payer: Aetna Commercial |
$12,778.71
|
| Rate for Payer: Aetna Medicare |
$7,516.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,771.96
|
| Rate for Payer: BCBS Complete |
$6,013.51
|
| Rate for Payer: Cash Price |
$12,027.02
|
| Rate for Payer: Cofinity Advantage |
$10,523.65
|
| Rate for Payer: Cofinity Commercial |
$12,929.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,027.02
|
| Rate for Payer: Healthscope Commercial |
$13,530.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,523.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,275.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,027.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,778.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,275.33
|
| Rate for Payer: PHP Commercial |
$12,778.71
|
| Rate for Payer: Priority Health SBD |
$9,471.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,771.96
|
| Rate for Payer: UHC Core |
$7,832.60
|
| Rate for Payer: UHC Exchange |
$5,908.28
|
| Rate for Payer: UMR Bronson Commercial |
$5,562.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,275.33
|
|
|
HC LEAD CARDIOVERTER DEFIB ENDOCARDIAL SINGLE COIL
|
Facility
|
IP
|
$15,033.78
|
|
|
Service Code
|
HCPCS C1777
|
| Hospital Charge Code |
27800088
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,614.86 |
| Max. Negotiated Rate |
$13,530.40 |
| Rate for Payer: Aetna American Axle |
$9,771.96
|
| Rate for Payer: Aetna Commercial |
$12,778.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,771.96
|
| Rate for Payer: Cash Price |
$12,027.02
|
| Rate for Payer: Cofinity Advantage |
$10,523.65
|
| Rate for Payer: Cofinity Commercial |
$12,929.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,027.02
|
| Rate for Payer: Healthscope Commercial |
$13,530.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,523.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,275.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,778.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11,275.33
|
| Rate for Payer: PHP Commercial |
$12,778.71
|
| Rate for Payer: Priority Health SBD |
$9,471.28
|
| Rate for Payer: UMR Bronson Commercial |
$6,614.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,275.33
|
|
|
HC LEAD NEUROSTIM TEST KIT LEVEL 20
|
Facility
|
OP
|
$2,080.80
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$769.90 |
| Max. Negotiated Rate |
$1,872.72 |
| Rate for Payer: Aetna American Axle |
$1,352.52
|
| Rate for Payer: Aetna Commercial |
$1,768.68
|
| Rate for Payer: Aetna Medicare |
$1,040.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.52
|
| Rate for Payer: BCBS Complete |
$832.32
|
| Rate for Payer: Cash Price |
$1,664.64
|
| Rate for Payer: Cofinity Advantage |
$1,456.56
|
| Rate for Payer: Cofinity Commercial |
$1,789.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.64
|
| Rate for Payer: Healthscope Commercial |
$1,872.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,456.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,664.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,768.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,560.60
|
| Rate for Payer: PHP Commercial |
$1,768.68
|
| Rate for Payer: Priority Health SBD |
$1,310.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,352.52
|
| Rate for Payer: UHC Core |
$1,084.10
|
| Rate for Payer: UHC Exchange |
$817.75
|
| Rate for Payer: UMR Bronson Commercial |
$769.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.60
|
|
|
HC LEAD NEUROSTIM TEST KIT LEVEL 20
|
Facility
|
IP
|
$2,080.80
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800134
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$915.55 |
| Max. Negotiated Rate |
$1,872.72 |
| Rate for Payer: Aetna American Axle |
$1,352.52
|
| Rate for Payer: Aetna Commercial |
$1,768.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,352.52
|
| Rate for Payer: Cash Price |
$1,664.64
|
| Rate for Payer: Cofinity Advantage |
$1,456.56
|
| Rate for Payer: Cofinity Commercial |
$1,789.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,664.64
|
| Rate for Payer: Healthscope Commercial |
$1,872.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,456.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,560.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,768.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,560.60
|
| Rate for Payer: PHP Commercial |
$1,768.68
|
| Rate for Payer: Priority Health SBD |
$1,310.90
|
| Rate for Payer: UMR Bronson Commercial |
$915.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,560.60
|
|
|
HC LEAD NEUROSTIMULATOR
|
Facility
|
IP
|
$7,965.30
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
27800017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,504.73 |
| Max. Negotiated Rate |
$7,168.77 |
| Rate for Payer: Aetna American Axle |
$5,177.44
|
| Rate for Payer: Aetna Commercial |
$6,770.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,177.44
|
| Rate for Payer: Cash Price |
$6,372.24
|
| Rate for Payer: Cofinity Advantage |
$5,575.71
|
| Rate for Payer: Cofinity Commercial |
$6,850.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,372.24
|
| Rate for Payer: Healthscope Commercial |
$7,168.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,575.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,973.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,770.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,973.98
|
| Rate for Payer: PHP Commercial |
$6,770.51
|
| Rate for Payer: Priority Health SBD |
$5,018.14
|
| Rate for Payer: UMR Bronson Commercial |
$3,504.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,973.98
|
|
|
HC LEAD NEUROSTIMULATOR
|
Facility
|
OP
|
$7,965.30
|
|
|
Service Code
|
HCPCS C1778
|
| Hospital Charge Code |
27800017
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,947.16 |
| Max. Negotiated Rate |
$7,168.77 |
| Rate for Payer: Aetna American Axle |
$5,177.44
|
| Rate for Payer: Aetna Commercial |
$6,770.51
|
| Rate for Payer: Aetna Medicare |
$3,982.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,177.44
|
| Rate for Payer: BCBS Complete |
$3,186.12
|
| Rate for Payer: Cash Price |
$6,372.24
|
| Rate for Payer: Cofinity Advantage |
$5,575.71
|
| Rate for Payer: Cofinity Commercial |
$6,850.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,372.24
|
| Rate for Payer: Healthscope Commercial |
$7,168.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,575.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,973.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,372.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,770.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,973.98
|
| Rate for Payer: PHP Commercial |
$6,770.51
|
| Rate for Payer: Priority Health SBD |
$5,018.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,177.44
|
| Rate for Payer: UHC Core |
$4,149.92
|
| Rate for Payer: UHC Exchange |
$3,130.36
|
| Rate for Payer: UMR Bronson Commercial |
$2,947.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,973.98
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
IP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$87.52 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna American Axle |
$129.28
|
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.28
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Advantage |
$139.23
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.18
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: Priority Health SBD |
$125.31
|
| Rate for Payer: UMR Bronson Commercial |
$87.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC LEAD NOS LVL 1
|
Facility
|
OP
|
$198.90
|
|
|
Service Code
|
HCPCS C1889
|
| Hospital Charge Code |
27800144
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$179.01 |
| Rate for Payer: Aetna American Axle |
$129.28
|
| Rate for Payer: Aetna Commercial |
$169.06
|
| Rate for Payer: Aetna Medicare |
$99.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$129.28
|
| Rate for Payer: BCBS Complete |
$79.56
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cash Price |
$159.12
|
| Rate for Payer: Cofinity Advantage |
$139.23
|
| Rate for Payer: Cofinity Commercial |
$171.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$159.12
|
| Rate for Payer: Healthscope Commercial |
$179.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$139.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$149.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$169.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$149.18
|
| Rate for Payer: PHP Commercial |
$169.06
|
| Rate for Payer: Priority Health SBD |
$125.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$129.28
|
| Rate for Payer: UHC Core |
$103.63
|
| Rate for Payer: UHC Exchange |
$78.17
|
| Rate for Payer: UMR Bronson Commercial |
$73.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$149.18
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
OP
|
$2,984.04
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,104.09 |
| Max. Negotiated Rate |
$12,041.54 |
| Rate for Payer: Aetna American Axle |
$1,939.63
|
| Rate for Payer: Aetna Commercial |
$2,536.43
|
| Rate for Payer: Aetna Medicare |
$3,872.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,939.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,654.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,654.40
|
| Rate for Payer: BCBS Complete |
$2,044.96
|
| Rate for Payer: BCBS MAPPO |
$3,723.52
|
| Rate for Payer: BCBS Trust/PPO |
$3,036.38
|
| Rate for Payer: BCN Commercial |
$3,036.38
|
| Rate for Payer: BCN Medicare Advantage |
$3,723.52
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cofinity Advantage |
$2,088.83
|
| Rate for Payer: Cofinity Commercial |
$2,566.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,387.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,723.52
|
| Rate for Payer: Healthscope Commercial |
$2,685.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,088.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,238.03
|
| Rate for Payer: Mclaren Medicaid |
$3,723.52
|
| Rate for Payer: Mclaren Medicare |
$3,723.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,909.70
|
| Rate for Payer: Meridian Medicaid |
$3,909.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,282.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,095.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,536.43
|
| Rate for Payer: Nomi Health Commercial |
$11,170.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,238.03
|
| Rate for Payer: PACE Medicare |
$3,537.34
|
| Rate for Payer: PACE SWMI |
$3,723.52
|
| Rate for Payer: PHP Commercial |
$2,536.43
|
| Rate for Payer: PHP Medicare Advantage |
$3,723.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,947.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,041.54
|
| Rate for Payer: Priority Health Medicare |
$3,723.52
|
| Rate for Payer: Priority Health SBD |
$1,879.95
|
| Rate for Payer: Priority Health Tiered Network |
$9,633.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,723.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,723.52
|
| Rate for Payer: UHC Medicaid |
$1,947.40
|
| Rate for Payer: UHCCP Medicaid |
$1,947.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,104.09
|
| Rate for Payer: VA VA |
$3,723.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,238.03
|
|
|
HC LEAD REMOVAL DUAL
|
Facility
|
IP
|
$2,984.04
|
|
|
Service Code
|
CPT 33235
|
| Hospital Charge Code |
36100074
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,312.98 |
| Max. Negotiated Rate |
$2,685.64 |
| Rate for Payer: Aetna American Axle |
$1,939.63
|
| Rate for Payer: Aetna Commercial |
$2,536.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,939.63
|
| Rate for Payer: Cash Price |
$2,387.23
|
| Rate for Payer: Cofinity Advantage |
$2,088.83
|
| Rate for Payer: Cofinity Commercial |
$2,566.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,387.23
|
| Rate for Payer: Healthscope Commercial |
$2,685.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,088.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,238.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,536.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,238.03
|
| Rate for Payer: PHP Commercial |
$2,536.43
|
| Rate for Payer: Priority Health SBD |
$1,879.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,312.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,238.03
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
OP
|
$3,778.97
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,398.22 |
| Max. Negotiated Rate |
$12,041.54 |
| Rate for Payer: Aetna American Axle |
$2,456.33
|
| Rate for Payer: Aetna Commercial |
$3,212.12
|
| Rate for Payer: Aetna Medicare |
$3,872.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,456.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,654.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,654.40
|
| Rate for Payer: BCBS Complete |
$2,044.96
|
| Rate for Payer: BCBS MAPPO |
$3,723.52
|
| Rate for Payer: BCBS Trust/PPO |
$2,602.60
|
| Rate for Payer: BCN Commercial |
$2,602.60
|
| Rate for Payer: BCN Medicare Advantage |
$3,723.52
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cofinity Advantage |
$2,645.28
|
| Rate for Payer: Cofinity Commercial |
$3,249.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,023.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,723.52
|
| Rate for Payer: Healthscope Commercial |
$3,401.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,645.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,834.23
|
| Rate for Payer: Mclaren Medicaid |
$3,723.52
|
| Rate for Payer: Mclaren Medicare |
$3,723.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,909.70
|
| Rate for Payer: Meridian Medicaid |
$3,909.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,282.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,095.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,212.12
|
| Rate for Payer: Nomi Health Commercial |
$11,170.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,834.23
|
| Rate for Payer: PACE Medicare |
$3,537.34
|
| Rate for Payer: PACE SWMI |
$3,723.52
|
| Rate for Payer: PHP Commercial |
$3,212.12
|
| Rate for Payer: PHP Medicare Advantage |
$3,723.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,947.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12,041.54
|
| Rate for Payer: Priority Health Medicare |
$3,723.52
|
| Rate for Payer: Priority Health SBD |
$2,380.75
|
| Rate for Payer: Priority Health Tiered Network |
$9,633.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3,723.52
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,723.52
|
| Rate for Payer: UHC Medicaid |
$1,947.40
|
| Rate for Payer: UHCCP Medicaid |
$1,947.40
|
| Rate for Payer: UMR Bronson Commercial |
$1,398.22
|
| Rate for Payer: VA VA |
$3,723.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,834.23
|
|
|
HC LEAD REMOVAL SINGLE
|
Facility
|
IP
|
$3,778.97
|
|
|
Service Code
|
CPT 33234
|
| Hospital Charge Code |
36100073
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,662.75 |
| Max. Negotiated Rate |
$3,401.07 |
| Rate for Payer: Aetna American Axle |
$2,456.33
|
| Rate for Payer: Aetna Commercial |
$3,212.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,456.33
|
| Rate for Payer: Cash Price |
$3,023.18
|
| Rate for Payer: Cofinity Advantage |
$2,645.28
|
| Rate for Payer: Cofinity Commercial |
$3,249.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,023.18
|
| Rate for Payer: Healthscope Commercial |
$3,401.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,645.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,834.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,212.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,834.23
|
| Rate for Payer: PHP Commercial |
$3,212.12
|
| Rate for Payer: Priority Health SBD |
$2,380.75
|
| Rate for Payer: UMR Bronson Commercial |
$1,662.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,834.23
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.49 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna American Axle |
$64.25
|
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Advantage |
$69.19
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| Rate for Payer: UMR Bronson Commercial |
$43.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC LECITHIN-SPHINGOMYELIN
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 83661
|
| Hospital Charge Code |
30100634
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna American Axle |
$64.25
|
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$22.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.49
|
| Rate for Payer: BCBS Complete |
$12.08
|
| Rate for Payer: BCBS MAPPO |
$21.99
|
| Rate for Payer: BCBS Trust/PPO |
$25.42
|
| Rate for Payer: BCN Commercial |
$25.42
|
| Rate for Payer: BCN Medicare Advantage |
$21.99
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Advantage |
$69.19
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.99
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$21.99
|
| Rate for Payer: Mclaren Medicare |
$21.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.09
|
| Rate for Payer: Meridian Medicaid |
$23.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$32.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PACE Medicare |
$20.89
|
| Rate for Payer: PACE SWMI |
$21.99
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$21.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.99
|
| Rate for Payer: Priority Health Medicare |
$21.99
|
| Rate for Payer: Priority Health SBD |
$62.27
|
| Rate for Payer: Priority Health Tiered Network |
$17.59
|
| Rate for Payer: Railroad Medicare Medicare |
$21.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.99
|
| Rate for Payer: UHC Core |
$32.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.99
|
| Rate for Payer: UHC Exchange |
$32.99
|
| Rate for Payer: UHC Medicaid |
$11.50
|
| Rate for Payer: UHCCP Medicaid |
$11.50
|
| Rate for Payer: UMR Bronson Commercial |
$36.57
|
| Rate for Payer: VA VA |
$21.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
IP
|
$30,085.25
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,237.51 |
| Max. Negotiated Rate |
$27,076.72 |
| Rate for Payer: Aetna American Axle |
$19,555.41
|
| Rate for Payer: Aetna Commercial |
$25,572.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,555.41
|
| Rate for Payer: Cash Price |
$24,068.20
|
| Rate for Payer: Cofinity Advantage |
$21,059.67
|
| Rate for Payer: Cofinity Commercial |
$25,873.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,068.20
|
| Rate for Payer: Healthscope Commercial |
$27,076.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,059.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,563.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,572.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,563.94
|
| Rate for Payer: PHP Commercial |
$25,572.46
|
| Rate for Payer: Priority Health SBD |
$18,953.71
|
| Rate for Payer: UMR Bronson Commercial |
$13,237.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,563.94
|
|
|
HC LEFT ATRIAL APPENDAGE CLOS WITH ENDOCARDIAL IMPLANT
|
Facility
|
OP
|
$30,085.25
|
|
|
Service Code
|
CPT 33340
|
| Hospital Charge Code |
48100112
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,544.30 |
| Max. Negotiated Rate |
$27,076.72 |
| Rate for Payer: Aetna American Axle |
$19,555.41
|
| Rate for Payer: Aetna Commercial |
$25,572.46
|
| Rate for Payer: Aetna Medicare |
$15,042.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,555.41
|
| Rate for Payer: BCBS Complete |
$12,034.10
|
| Rate for Payer: BCBS Trust/PPO |
$3,544.30
|
| Rate for Payer: BCN Commercial |
$3,544.30
|
| Rate for Payer: Cash Price |
$24,068.20
|
| Rate for Payer: Cash Price |
$24,068.20
|
| Rate for Payer: Cash Price |
$24,068.20
|
| Rate for Payer: Cofinity Advantage |
$21,059.67
|
| Rate for Payer: Cofinity Commercial |
$25,873.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24,068.20
|
| Rate for Payer: Healthscope Commercial |
$27,076.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21,059.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,563.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24,068.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,572.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22,563.94
|
| Rate for Payer: PHP Commercial |
$25,572.46
|
| Rate for Payer: Priority Health SBD |
$18,953.71
|
| Rate for Payer: UMR Bronson Commercial |
$11,131.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,563.94
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
OP
|
$10,051.10
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,689.43 |
| Max. Negotiated Rate |
$10,446.41 |
| Rate for Payer: Aetna American Axle |
$6,533.22
|
| Rate for Payer: Aetna Commercial |
$8,543.43
|
| Rate for Payer: Aetna Medicare |
$3,359.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,533.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,037.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,037.84
|
| Rate for Payer: BCBS Complete |
$1,774.06
|
| Rate for Payer: BCBS MAPPO |
$3,230.27
|
| Rate for Payer: BCBS Trust/PPO |
$2,985.43
|
| Rate for Payer: BCN Commercial |
$2,985.43
|
| Rate for Payer: BCN Medicare Advantage |
$3,230.27
|
| Rate for Payer: Cash Price |
$8,040.88
|
| Rate for Payer: Cash Price |
$8,040.88
|
| Rate for Payer: Cofinity Advantage |
$7,035.77
|
| Rate for Payer: Cofinity Commercial |
$8,643.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,230.27
|
| Rate for Payer: Healthscope Commercial |
$9,045.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,035.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,538.32
|
| Rate for Payer: Mclaren Medicaid |
$3,230.27
|
| Rate for Payer: Mclaren Medicare |
$3,230.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,391.78
|
| Rate for Payer: Meridian Medicaid |
$3,391.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,714.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,553.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.43
|
| Rate for Payer: Nomi Health Commercial |
$9,690.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.32
|
| Rate for Payer: PACE Medicare |
$3,068.76
|
| Rate for Payer: PACE SWMI |
$3,230.27
|
| Rate for Payer: PHP Commercial |
$8,543.43
|
| Rate for Payer: PHP Medicare Advantage |
$3,230.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,446.41
|
| Rate for Payer: Priority Health Medicare |
$3,230.27
|
| Rate for Payer: Priority Health SBD |
$6,332.19
|
| Rate for Payer: Priority Health Tiered Network |
$8,357.13
|
| Rate for Payer: Railroad Medicare Medicare |
$3,230.27
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,230.27
|
| Rate for Payer: UHC Medicaid |
$1,689.43
|
| Rate for Payer: UHCCP Medicaid |
$1,689.43
|
| Rate for Payer: UMR Bronson Commercial |
$3,718.91
|
| Rate for Payer: VA VA |
$3,230.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,538.32
|
|
|
HC LEFT CATH W INTERVENTION
|
Facility
|
IP
|
$10,051.10
|
|
|
Service Code
|
CPT 93458
|
| Hospital Charge Code |
48100049
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,422.48 |
| Max. Negotiated Rate |
$9,045.99 |
| Rate for Payer: Aetna American Axle |
$6,533.22
|
| Rate for Payer: Aetna Commercial |
$8,543.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,533.22
|
| Rate for Payer: Cash Price |
$8,040.88
|
| Rate for Payer: Cofinity Advantage |
$7,035.77
|
| Rate for Payer: Cofinity Commercial |
$8,643.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,040.88
|
| Rate for Payer: Healthscope Commercial |
$9,045.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,035.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,538.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,543.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,538.32
|
| Rate for Payer: PHP Commercial |
$8,543.43
|
| Rate for Payer: Priority Health SBD |
$6,332.19
|
| Rate for Payer: UMR Bronson Commercial |
$4,422.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,538.32
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
IP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna American Axle |
$65.00
|
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Advantage |
$70.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health SBD |
$63.00
|
| Rate for Payer: UMR Bronson Commercial |
$44.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC LEGAL BLOOD DRAW KZO CO/STATE/OTHER
|
Facility
|
OP
|
$100.00
|
|
|
Service Code
|
CPT 36415
|
| Hospital Charge Code |
30000049
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$4.88 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna American Axle |
$65.00
|
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$9.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.68
|
| Rate for Payer: BCBS Complete |
$5.13
|
| Rate for Payer: BCBS MAPPO |
$9.34
|
| Rate for Payer: BCBS Trust/PPO |
$7.80
|
| Rate for Payer: BCN Commercial |
$7.80
|
| Rate for Payer: BCN Medicare Advantage |
$9.34
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: City of Battle Creek Police Dept Commercial |
$50.00
|
| Rate for Payer: Cofinity Advantage |
$70.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.34
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Mclaren Medicaid |
$9.34
|
| Rate for Payer: Mclaren Medicare |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.81
|
| Rate for Payer: Meridian Medicaid |
$9.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.74
|
| Rate for Payer: Michigan State Police Michigan State Police |
$50.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$14.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PACE Medicare |
$8.87
|
| Rate for Payer: PACE SWMI |
$9.34
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: PHP Medicare Advantage |
$9.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.09
|
| Rate for Payer: Priority Health Medicare |
$9.34
|
| Rate for Payer: Priority Health SBD |
$63.00
|
| Rate for Payer: Priority Health Tiered Network |
$7.27
|
| Rate for Payer: Railroad Medicare Medicare |
$9.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.64
|
| Rate for Payer: UHC Core |
$13.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.34
|
| Rate for Payer: UHC Exchange |
$13.64
|
| Rate for Payer: UHC Medicaid |
$4.88
|
| Rate for Payer: UHCCP Medicaid |
$4.88
|
| Rate for Payer: UMR Bronson Commercial |
$37.00
|
| Rate for Payer: VA VA |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC LEGIONELLA
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna American Axle |
$33.80
|
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$18.57
|
| Rate for Payer: BCN Commercial |
$18.57
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$16.07
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$24.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.11
|
| Rate for Payer: UHC Core |
$24.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.11
|
| Rate for Payer: UHC Medicaid |
$8.40
|
| Rate for Payer: UHCCP Medicaid |
$8.40
|
| Rate for Payer: UMR Bronson Commercial |
$19.24
|
| Rate for Payer: VA VA |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600300
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.88 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna American Axle |
$33.80
|
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: UMR Bronson Commercial |
$22.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA AG
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna American Axle |
$33.80
|
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$8.83
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$18.57
|
| Rate for Payer: BCN Commercial |
$18.57
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$16.07
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$16.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$24.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.11
|
| Rate for Payer: UHC Core |
$24.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.07
|
| Rate for Payer: UHC Exchange |
$24.11
|
| Rate for Payer: UHC Medicaid |
$8.40
|
| Rate for Payer: UHCCP Medicaid |
$8.40
|
| Rate for Payer: UMR Bronson Commercial |
$19.24
|
| Rate for Payer: VA VA |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
|
HC LEGIONELLA AG
|
Facility
|
IP
|
$52.00
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600255
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.88 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna American Axle |
$33.80
|
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.80
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Advantage |
$36.40
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: Priority Health SBD |
$32.76
|
| Rate for Payer: UMR Bronson Commercial |
$22.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
