|
HC T3 UPTAKE
|
Facility
|
OP
|
$134.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna American Axle |
$87.10
|
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$3.72
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$5.82
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Cofinity Commercial |
$93.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Mclaren Medicaid |
$3.54
|
| Rate for Payer: Mclaren Medicare |
$6.47
|
| Rate for Payer: Meridian Medicaid |
$3.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PACE Medicare |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8.87
|
| Rate for Payer: Priority Health Medicare |
$6.47
|
| Rate for Payer: Priority Health Narrow Network |
$7.10
|
| Rate for Payer: Priority Health SBD |
$84.42
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.76
|
| Rate for Payer: UHC Core |
$10.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.47
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicare Advantage |
$6.66
|
| Rate for Payer: UMR Bronson Commercial |
$49.58
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC T3 UPTAKE
|
Facility
|
IP
|
$134.00
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.96 |
| Max. Negotiated Rate |
$120.60 |
| Rate for Payer: Aetna American Axle |
$87.10
|
| Rate for Payer: Aetna Commercial |
$113.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.10
|
| Rate for Payer: Cash Price |
$107.20
|
| Rate for Payer: Cofinity Commercial |
$93.80
|
| Rate for Payer: Cofinity Commercial |
$115.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.20
|
| Rate for Payer: Healthscope Commercial |
$120.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$93.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$113.90
|
| Rate for Payer: PHP Commercial |
$113.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.80
|
| Rate for Payer: Priority Health SBD |
$84.42
|
| Rate for Payer: UMR Bronson Commercial |
$58.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.50
|
|
|
HC T4 TOTAL
|
Facility
|
IP
|
$46.00
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.24 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Aetna American Axle |
$29.90
|
| Rate for Payer: Aetna Commercial |
$39.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.90
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$32.20
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.10
|
| Rate for Payer: PHP Commercial |
$39.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health SBD |
$28.98
|
| Rate for Payer: UMR Bronson Commercial |
$20.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.50
|
|
|
HC T4 TOTAL
|
Facility
|
OP
|
$46.00
|
|
|
Service Code
|
CPT 84436
|
| Hospital Charge Code |
30100435
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$41.40 |
| Rate for Payer: Aetna American Axle |
$29.90
|
| Rate for Payer: Aetna Commercial |
$39.10
|
| Rate for Payer: Aetna Medicare |
$7.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.59
|
| Rate for Payer: BCBS Complete |
$3.95
|
| Rate for Payer: BCBS MAPPO |
$6.87
|
| Rate for Payer: BCBS Trust/PPO |
$6.18
|
| Rate for Payer: BCN Medicare Advantage |
$6.87
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cash Price |
$36.80
|
| Rate for Payer: Cofinity Commercial |
$39.56
|
| Rate for Payer: Cofinity Commercial |
$32.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.87
|
| Rate for Payer: Healthscope Commercial |
$41.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.50
|
| Rate for Payer: Mclaren Medicaid |
$3.76
|
| Rate for Payer: Mclaren Medicare |
$6.87
|
| Rate for Payer: Meridian Medicaid |
$3.95
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.10
|
| Rate for Payer: PACE Medicare |
$6.53
|
| Rate for Payer: PACE SWMI |
$6.87
|
| Rate for Payer: PHP Commercial |
$39.10
|
| Rate for Payer: PHP Medicare Advantage |
$6.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.42
|
| Rate for Payer: Priority Health Medicare |
$6.87
|
| Rate for Payer: Priority Health Narrow Network |
$7.54
|
| Rate for Payer: Priority Health SBD |
$28.98
|
| Rate for Payer: Railroad Medicare Medicare |
$6.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.24
|
| Rate for Payer: UHC Core |
$11.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.87
|
| Rate for Payer: UHC Exchange |
$6.87
|
| Rate for Payer: UHC Medicare Advantage |
$7.08
|
| Rate for Payer: UMR Bronson Commercial |
$17.02
|
| Rate for Payer: VA VA |
$6.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.50
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
OP
|
$64.26
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.51 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna American Axle |
$41.77
|
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: BCBS Complete |
$7.89
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$12.35
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Mclaren Medicaid |
$7.51
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Medicaid |
$7.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.84
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health Narrow Network |
$15.07
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.48
|
| Rate for Payer: UHC Core |
$22.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.73
|
| Rate for Payer: UHC Exchange |
$13.73
|
| Rate for Payer: UHC Medicare Advantage |
$14.14
|
| Rate for Payer: UMR Bronson Commercial |
$23.78
|
| Rate for Payer: VA VA |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC TACROLIMUS LEVEL
|
Facility
|
IP
|
$64.26
|
|
|
Service Code
|
CPT 80197
|
| Hospital Charge Code |
30100047
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.27 |
| Max. Negotiated Rate |
$57.83 |
| Rate for Payer: Aetna American Axle |
$41.77
|
| Rate for Payer: Aetna Commercial |
$54.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.77
|
| Rate for Payer: Cash Price |
$51.41
|
| Rate for Payer: Cofinity Commercial |
$44.98
|
| Rate for Payer: Cofinity Commercial |
$55.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.41
|
| Rate for Payer: Healthscope Commercial |
$57.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$54.62
|
| Rate for Payer: PHP Commercial |
$54.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.98
|
| Rate for Payer: Priority Health SBD |
$40.48
|
| Rate for Payer: UMR Bronson Commercial |
$28.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.20
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.51 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna American Axle |
$37.68
|
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.68
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$40.58
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health SBD |
$36.52
|
| Rate for Payer: UMR Bronson Commercial |
$25.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200204
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna American Axle |
$37.68
|
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna Medicare |
$39.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$33.93
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$40.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.75
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$41.40
|
| Rate for Payer: Priority Health SBD |
$36.52
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.28
|
| Rate for Payer: UHC Core |
$62.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.73
|
| Rate for Payer: UHC Exchange |
$37.73
|
| Rate for Payer: UHC Medicare Advantage |
$38.86
|
| Rate for Payer: UMR Bronson Commercial |
$21.45
|
| Rate for Payer: VA VA |
$37.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
OP
|
$72.20
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.70 |
| Max. Negotiated Rate |
$77.51 |
| Rate for Payer: Aetna American Axle |
$46.93
|
| Rate for Payer: Aetna Commercial |
$61.37
|
| Rate for Payer: Aetna Medicare |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.72
|
| Rate for Payer: BCBS Complete |
$26.99
|
| Rate for Payer: BCBS MAPPO |
$46.98
|
| Rate for Payer: BCBS Trust/PPO |
$42.26
|
| Rate for Payer: BCN Medicare Advantage |
$46.98
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cofinity Commercial |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$62.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.98
|
| Rate for Payer: Healthscope Commercial |
$64.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.15
|
| Rate for Payer: Mclaren Medicaid |
$25.70
|
| Rate for Payer: Mclaren Medicare |
$46.98
|
| Rate for Payer: Meridian Medicaid |
$26.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$49.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.37
|
| Rate for Payer: PACE Medicare |
$44.63
|
| Rate for Payer: PACE SWMI |
$46.98
|
| Rate for Payer: PHP Commercial |
$61.37
|
| Rate for Payer: PHP Medicare Advantage |
$46.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$64.45
|
| Rate for Payer: Priority Health Medicare |
$46.98
|
| Rate for Payer: Priority Health Narrow Network |
$51.56
|
| Rate for Payer: Priority Health SBD |
$45.49
|
| Rate for Payer: Railroad Medicare Medicare |
$46.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.38
|
| Rate for Payer: UHC Core |
$77.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.98
|
| Rate for Payer: UHC Exchange |
$46.98
|
| Rate for Payer: UHC Medicare Advantage |
$48.39
|
| Rate for Payer: UMR Bronson Commercial |
$26.71
|
| Rate for Payer: VA VA |
$46.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.15
|
|
|
HC T AND B CELL QUANTITATION CMPT1
|
Facility
|
IP
|
$72.20
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200206
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.77 |
| Max. Negotiated Rate |
$64.98 |
| Rate for Payer: Aetna American Axle |
$46.93
|
| Rate for Payer: Aetna Commercial |
$61.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.93
|
| Rate for Payer: Cash Price |
$57.76
|
| Rate for Payer: Cofinity Commercial |
$50.54
|
| Rate for Payer: Cofinity Commercial |
$62.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.76
|
| Rate for Payer: Healthscope Commercial |
$64.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$61.37
|
| Rate for Payer: PHP Commercial |
$61.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.54
|
| Rate for Payer: Priority Health SBD |
$45.49
|
| Rate for Payer: UMR Bronson Commercial |
$31.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.15
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna American Axle |
$37.68
|
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna Medicare |
$39.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$33.93
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$40.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.75
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$41.40
|
| Rate for Payer: Priority Health SBD |
$36.52
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.28
|
| Rate for Payer: UHC Core |
$62.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.73
|
| Rate for Payer: UHC Exchange |
$37.73
|
| Rate for Payer: UHC Medicare Advantage |
$38.86
|
| Rate for Payer: UMR Bronson Commercial |
$21.45
|
| Rate for Payer: VA VA |
$37.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION CMPT2
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86355
|
| Hospital Charge Code |
30200202
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.51 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna American Axle |
$37.68
|
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.68
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$40.58
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health SBD |
$36.52
|
| Rate for Payer: UMR Bronson Commercial |
$25.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
IP
|
$57.97
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.51 |
| Max. Negotiated Rate |
$52.17 |
| Rate for Payer: Aetna American Axle |
$37.68
|
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.68
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$40.58
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health SBD |
$36.52
|
| Rate for Payer: UMR Bronson Commercial |
$25.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC T AND B CELL QUANTITATION CMPT3
|
Facility
|
OP
|
$57.97
|
|
|
Service Code
|
CPT 86357
|
| Hospital Charge Code |
30200203
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$62.22 |
| Rate for Payer: Aetna American Axle |
$37.68
|
| Rate for Payer: Aetna Commercial |
$49.27
|
| Rate for Payer: Aetna Medicare |
$39.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$33.93
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cash Price |
$46.38
|
| Rate for Payer: Cofinity Commercial |
$49.85
|
| Rate for Payer: Cofinity Commercial |
$40.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$52.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.48
|
| Rate for Payer: Mclaren Medicaid |
$20.64
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.27
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$49.27
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.75
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$41.40
|
| Rate for Payer: Priority Health SBD |
$36.52
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.28
|
| Rate for Payer: UHC Core |
$62.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.73
|
| Rate for Payer: UHC Exchange |
$37.73
|
| Rate for Payer: UHC Medicare Advantage |
$38.86
|
| Rate for Payer: UMR Bronson Commercial |
$21.45
|
| Rate for Payer: VA VA |
$37.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.48
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
OP
|
$81.91
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.28 |
| Max. Negotiated Rate |
$171.41 |
| Rate for Payer: Aetna American Axle |
$53.24
|
| Rate for Payer: Aetna Commercial |
$69.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.24
|
| Rate for Payer: BCBS Complete |
$32.76
|
| Rate for Payer: BCBS Trust/PPO |
$171.41
|
| Rate for Payer: Cash Price |
$65.53
|
| Rate for Payer: Cash Price |
$65.53
|
| Rate for Payer: Cofinity Commercial |
$57.34
|
| Rate for Payer: Cofinity Commercial |
$70.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.53
|
| Rate for Payer: Healthscope Commercial |
$73.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.62
|
| Rate for Payer: PHP Commercial |
$69.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.34
|
| Rate for Payer: Priority Health SBD |
$51.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.41
|
| Rate for Payer: UHC Exchange |
$21.28
|
| Rate for Payer: UMR Bronson Commercial |
$30.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.43
|
|
|
HC TANGENTIAL BIOPSY SKIN ADDL LESION
|
Facility
|
IP
|
$81.91
|
|
|
Service Code
|
CPT 11103
|
| Hospital Charge Code |
76100149
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.04 |
| Max. Negotiated Rate |
$73.72 |
| Rate for Payer: Aetna American Axle |
$53.24
|
| Rate for Payer: Aetna Commercial |
$69.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.24
|
| Rate for Payer: Cash Price |
$65.53
|
| Rate for Payer: Cofinity Commercial |
$70.44
|
| Rate for Payer: Cofinity Commercial |
$57.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.53
|
| Rate for Payer: Healthscope Commercial |
$73.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$69.62
|
| Rate for Payer: PHP Commercial |
$69.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$57.34
|
| Rate for Payer: Priority Health SBD |
$51.60
|
| Rate for Payer: UMR Bronson Commercial |
$36.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.43
|
|
|
HC TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Facility
|
IP
|
$270.30
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
76100148
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$118.93 |
| Max. Negotiated Rate |
$243.27 |
| Rate for Payer: Aetna American Axle |
$175.70
|
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$189.21
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.24
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health SBD |
$170.29
|
| Rate for Payer: UMR Bronson Commercial |
$118.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.72
|
|
|
HC TANGENTIAL BIOPSY SKIN SINGLE LESION
|
Facility
|
OP
|
$270.30
|
|
|
Service Code
|
CPT 11102
|
| Hospital Charge Code |
76100148
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$36.67 |
| Max. Negotiated Rate |
$560.20 |
| Rate for Payer: Aetna American Axle |
$175.70
|
| Rate for Payer: Aetna Commercial |
$229.76
|
| Rate for Payer: Aetna Medicare |
$185.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.44
|
| Rate for Payer: BCBS Complete |
$102.21
|
| Rate for Payer: BCBS MAPPO |
$177.95
|
| Rate for Payer: BCBS Trust/PPO |
$90.51
|
| Rate for Payer: BCN Medicare Advantage |
$177.95
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cash Price |
$216.24
|
| Rate for Payer: Cofinity Commercial |
$189.21
|
| Rate for Payer: Cofinity Commercial |
$232.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$216.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.95
|
| Rate for Payer: Healthscope Commercial |
$243.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$189.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.72
|
| Rate for Payer: Mclaren Medicaid |
$97.34
|
| Rate for Payer: Mclaren Medicare |
$177.95
|
| Rate for Payer: Meridian Medicaid |
$102.21
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$186.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$229.76
|
| Rate for Payer: PACE Medicare |
$169.05
|
| Rate for Payer: PACE SWMI |
$177.95
|
| Rate for Payer: PHP Commercial |
$229.76
|
| Rate for Payer: PHP Medicare Advantage |
$177.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$97.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$189.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.20
|
| Rate for Payer: Priority Health Medicare |
$177.95
|
| Rate for Payer: Priority Health Narrow Network |
$448.16
|
| Rate for Payer: Priority Health SBD |
$170.29
|
| Rate for Payer: Railroad Medicare Medicare |
$177.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.95
|
| Rate for Payer: UHC Exchange |
$36.67
|
| Rate for Payer: UHC Medicare Advantage |
$183.29
|
| Rate for Payer: UMR Bronson Commercial |
$100.01
|
| Rate for Payer: VA VA |
$177.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.72
|
|
|
HC TAVR VALVE LVL 37
|
Facility
|
OP
|
$37,500.00
|
|
| Hospital Charge Code |
27800353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$13,875.00 |
| Max. Negotiated Rate |
$33,750.00 |
| Rate for Payer: Aetna American Axle |
$24,375.00
|
| Rate for Payer: Aetna Commercial |
$31,875.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24,375.00
|
| Rate for Payer: BCBS Complete |
$15,000.00
|
| Rate for Payer: Cash Price |
$30,000.00
|
| Rate for Payer: Cofinity Commercial |
$26,250.00
|
| Rate for Payer: Cofinity Commercial |
$32,250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30,000.00
|
| Rate for Payer: Healthscope Commercial |
$33,750.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26,250.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31,875.00
|
| Rate for Payer: PHP Commercial |
$31,875.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26,250.00
|
| Rate for Payer: Priority Health SBD |
$23,625.00
|
| Rate for Payer: UMR Bronson Commercial |
$13,875.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28,125.00
|
|
|
HC TAVR VALVE LVL 37
|
Facility
|
IP
|
$37,500.00
|
|
| Hospital Charge Code |
27800353
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$16,500.00 |
| Max. Negotiated Rate |
$33,750.00 |
| Rate for Payer: Aetna American Axle |
$24,375.00
|
| Rate for Payer: Aetna Commercial |
$31,875.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24,375.00
|
| Rate for Payer: Cash Price |
$30,000.00
|
| Rate for Payer: Cofinity Commercial |
$26,250.00
|
| Rate for Payer: Cofinity Commercial |
$32,250.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30,000.00
|
| Rate for Payer: Healthscope Commercial |
$33,750.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26,250.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28,125.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$31,875.00
|
| Rate for Payer: PHP Commercial |
$31,875.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26,250.00
|
| Rate for Payer: Priority Health SBD |
$23,625.00
|
| Rate for Payer: UMR Bronson Commercial |
$16,500.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28,125.00
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
OP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15,031.25 |
| Max. Negotiated Rate |
$36,562.50 |
| Rate for Payer: Aetna American Axle |
$26,406.25
|
| Rate for Payer: Aetna Commercial |
$34,531.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26,406.25
|
| Rate for Payer: BCBS Complete |
$16,250.00
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Commercial |
$28,437.50
|
| Rate for Payer: Cofinity Commercial |
$34,937.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Healthscope Commercial |
$36,562.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28,437.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30,468.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34,531.25
|
| Rate for Payer: PHP Commercial |
$34,531.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28,437.50
|
| Rate for Payer: Priority Health SBD |
$25,593.75
|
| Rate for Payer: UMR Bronson Commercial |
$15,031.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30,468.75
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
IP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17,875.00 |
| Max. Negotiated Rate |
$36,562.50 |
| Rate for Payer: Aetna American Axle |
$26,406.25
|
| Rate for Payer: Aetna Commercial |
$34,531.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26,406.25
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Commercial |
$28,437.50
|
| Rate for Payer: Cofinity Commercial |
$34,937.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Healthscope Commercial |
$36,562.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28,437.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30,468.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34,531.25
|
| Rate for Payer: PHP Commercial |
$34,531.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28,437.50
|
| Rate for Payer: Priority Health SBD |
$25,593.75
|
| Rate for Payer: UMR Bronson Commercial |
$17,875.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30,468.75
|
|
|
HC TBS TECHNICAL CALCULATION ONLY
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 77091
|
| Hospital Charge Code |
32000335
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$262.00 |
| Rate for Payer: Aetna American Axle |
$159.25
|
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna Medicare |
$84.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$100.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$100.96
|
| Rate for Payer: BCBS Complete |
$46.39
|
| Rate for Payer: BCBS MAPPO |
$80.77
|
| Rate for Payer: BCN Medicare Advantage |
$80.77
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Cofinity Commercial |
$171.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$80.77
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Mclaren Medicaid |
$44.18
|
| Rate for Payer: Mclaren Medicare |
$80.77
|
| Rate for Payer: Meridian Medicaid |
$46.39
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$84.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$92.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PACE Medicare |
$76.73
|
| Rate for Payer: PACE SWMI |
$80.77
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: PHP Medicare Advantage |
$80.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$254.27
|
| Rate for Payer: Priority Health Medicare |
$80.77
|
| Rate for Payer: Priority Health Narrow Network |
$203.42
|
| Rate for Payer: Priority Health SBD |
$154.35
|
| Rate for Payer: Railroad Medicare Medicare |
$80.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.26
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$80.77
|
| Rate for Payer: UHC Exchange |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$83.19
|
| Rate for Payer: UMR Bronson Commercial |
$90.65
|
| Rate for Payer: VA VA |
$80.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC TBS TECHNICAL CALCULATION ONLY
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 77091
|
| Hospital Charge Code |
32000335
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$107.80 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna American Axle |
$159.25
|
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.25
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$171.50
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health SBD |
$154.35
|
| Rate for Payer: UMR Bronson Commercial |
$107.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC TB TEST
|
Facility
|
IP
|
$24.00
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
30000069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.56 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Aetna American Axle |
$15.60
|
| Rate for Payer: Aetna Commercial |
$20.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.60
|
| Rate for Payer: Cash Price |
$19.20
|
| Rate for Payer: Cofinity Commercial |
$16.80
|
| Rate for Payer: Cofinity Commercial |
$20.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.20
|
| Rate for Payer: Healthscope Commercial |
$21.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$20.40
|
| Rate for Payer: PHP Commercial |
$20.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.80
|
| Rate for Payer: Priority Health SBD |
$15.12
|
| Rate for Payer: UMR Bronson Commercial |
$10.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.00
|
|
