|
HC LINE VACUUM
|
Facility
|
IP
|
$14.05
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$12.64 |
| Rate for Payer: Aetna American Axle |
$9.13
|
| Rate for Payer: Aetna Commercial |
$11.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.13
|
| Rate for Payer: Cash Price |
$11.24
|
| Rate for Payer: Cofinity Advantage |
$9.84
|
| Rate for Payer: Cofinity Commercial |
$12.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.24
|
| Rate for Payer: Healthscope Commercial |
$12.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.54
|
| Rate for Payer: PHP Commercial |
$11.94
|
| Rate for Payer: Priority Health SBD |
$8.85
|
| Rate for Payer: UMR Bronson Commercial |
$6.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.54
|
|
|
HC LIPASE
|
Facility
|
OP
|
$31.83
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$7.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.61
|
| Rate for Payer: BCBS Complete |
$3.78
|
| Rate for Payer: BCBS MAPPO |
$6.89
|
| Rate for Payer: BCBS Trust/PPO |
$7.97
|
| Rate for Payer: BCN Commercial |
$7.97
|
| Rate for Payer: BCN Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.89
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Mclaren Medicare |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: Meridian Medicaid |
$7.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$10.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PACE Medicare |
$6.55
|
| Rate for Payer: PACE SWMI |
$6.89
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$6.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.89
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: Priority Health Tiered Network |
$5.51
|
| Rate for Payer: Railroad Medicare Medicare |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.34
|
| Rate for Payer: UHC Core |
$10.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.89
|
| Rate for Payer: UHC Exchange |
$10.34
|
| Rate for Payer: UHC Medicaid |
$3.60
|
| Rate for Payer: UHCCP Medicaid |
$3.60
|
| Rate for Payer: UMR Bronson Commercial |
$11.78
|
| Rate for Payer: VA VA |
$6.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC LIPASE
|
Facility
|
IP
|
$31.83
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.01 |
| Max. Negotiated Rate |
$28.65 |
| Rate for Payer: Aetna American Axle |
$20.69
|
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.69
|
| Rate for Payer: Cash Price |
$25.46
|
| Rate for Payer: Cofinity Advantage |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$27.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.46
|
| Rate for Payer: Healthscope Commercial |
$28.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.87
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health SBD |
$20.05
|
| Rate for Payer: UMR Bronson Commercial |
$14.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.87
|
|
|
HC LIPASE BF
|
Facility
|
IP
|
$58.45
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.72 |
| Max. Negotiated Rate |
$52.60 |
| Rate for Payer: Aetna American Axle |
$37.99
|
| Rate for Payer: Aetna Commercial |
$49.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.99
|
| Rate for Payer: Cash Price |
$46.76
|
| Rate for Payer: Cofinity Advantage |
$40.91
|
| Rate for Payer: Cofinity Commercial |
$50.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.76
|
| Rate for Payer: Healthscope Commercial |
$52.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.84
|
| Rate for Payer: PHP Commercial |
$49.68
|
| Rate for Payer: Priority Health SBD |
$36.82
|
| Rate for Payer: UMR Bronson Commercial |
$25.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.84
|
|
|
HC LIPASE BF
|
Facility
|
OP
|
$58.45
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$52.60 |
| Rate for Payer: Aetna American Axle |
$37.99
|
| Rate for Payer: Aetna Commercial |
$49.68
|
| Rate for Payer: Aetna Medicare |
$7.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.61
|
| Rate for Payer: BCBS Complete |
$3.78
|
| Rate for Payer: BCBS MAPPO |
$6.89
|
| Rate for Payer: BCBS Trust/PPO |
$7.97
|
| Rate for Payer: BCN Commercial |
$7.97
|
| Rate for Payer: BCN Medicare Advantage |
$6.89
|
| Rate for Payer: Cash Price |
$46.76
|
| Rate for Payer: Cash Price |
$46.76
|
| Rate for Payer: Cofinity Advantage |
$40.91
|
| Rate for Payer: Cofinity Commercial |
$50.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.89
|
| Rate for Payer: Healthscope Commercial |
$52.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.84
|
| Rate for Payer: Mclaren Medicaid |
$6.89
|
| Rate for Payer: Mclaren Medicare |
$6.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.23
|
| Rate for Payer: Meridian Medicaid |
$7.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.68
|
| Rate for Payer: Nomi Health Commercial |
$10.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.84
|
| Rate for Payer: PACE Medicare |
$6.55
|
| Rate for Payer: PACE SWMI |
$6.89
|
| Rate for Payer: PHP Commercial |
$49.68
|
| Rate for Payer: PHP Medicare Advantage |
$6.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.89
|
| Rate for Payer: Priority Health Medicare |
$6.89
|
| Rate for Payer: Priority Health SBD |
$36.82
|
| Rate for Payer: Priority Health Tiered Network |
$5.51
|
| Rate for Payer: Railroad Medicare Medicare |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.34
|
| Rate for Payer: UHC Core |
$10.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.89
|
| Rate for Payer: UHC Exchange |
$10.34
|
| Rate for Payer: UHC Medicaid |
$3.60
|
| Rate for Payer: UHCCP Medicaid |
$3.60
|
| Rate for Payer: UMR Bronson Commercial |
$21.63
|
| Rate for Payer: VA VA |
$6.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.84
|
|
|
HC LIPID PANEL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.74
|
| Rate for Payer: BCBS Complete |
$7.35
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCBS Trust/PPO |
$17.85
|
| Rate for Payer: BCN Commercial |
$17.85
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Mclaren Medicare |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$40.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$12.72
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.39
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$10.71
|
| Rate for Payer: Railroad Medicare Medicare |
$13.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.09
|
| Rate for Payer: UHC Core |
$20.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.39
|
| Rate for Payer: UHC Exchange |
$20.09
|
| Rate for Payer: UHC Medicaid |
$7.00
|
| Rate for Payer: UHCCP Medicaid |
$7.00
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$13.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC LIPID PANEL
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC LIPID PANEL LMPP
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100767
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.74
|
| Rate for Payer: BCBS Complete |
$7.35
|
| Rate for Payer: BCBS MAPPO |
$13.39
|
| Rate for Payer: BCBS Trust/PPO |
$17.85
|
| Rate for Payer: BCN Commercial |
$17.85
|
| Rate for Payer: BCN Medicare Advantage |
$13.39
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Advantage |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.39
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Mclaren Medicare |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.06
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$40.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Medicare |
$12.72
|
| Rate for Payer: PACE SWMI |
$13.39
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.39
|
| Rate for Payer: Priority Health Medicare |
$13.39
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Priority Health Tiered Network |
$10.71
|
| Rate for Payer: Railroad Medicare Medicare |
$13.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.09
|
| Rate for Payer: UHC Core |
$20.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.39
|
| Rate for Payer: UHC Exchange |
$20.09
|
| Rate for Payer: UHC Medicaid |
$7.00
|
| Rate for Payer: UHCCP Medicaid |
$7.00
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$13.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC LIPID PANEL LMPP
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100767
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Advantage |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC LIPOPROTEIN A
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
30100280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.49 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$14.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.90
|
| Rate for Payer: BCBS Complete |
$7.86
|
| Rate for Payer: BCBS MAPPO |
$14.32
|
| Rate for Payer: BCBS Trust/PPO |
$16.55
|
| Rate for Payer: BCN Commercial |
$16.55
|
| Rate for Payer: BCN Medicare Advantage |
$14.32
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.32
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$14.32
|
| Rate for Payer: Mclaren Medicare |
$14.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.04
|
| Rate for Payer: Meridian Medicaid |
$15.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$21.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$13.60
|
| Rate for Payer: PACE SWMI |
$14.32
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$14.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.32
|
| Rate for Payer: Priority Health Medicare |
$14.32
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$11.46
|
| Rate for Payer: Railroad Medicare Medicare |
$14.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.48
|
| Rate for Payer: UHC Core |
$21.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.32
|
| Rate for Payer: UHC Exchange |
$21.48
|
| Rate for Payer: UHC Medicaid |
$7.49
|
| Rate for Payer: UHCCP Medicaid |
$7.49
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$14.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC LIPOPROTEIN A
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
30100280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC LIQUID PLASMA IRRADIATED
|
Facility
|
IP
|
$372.35
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000096
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$163.83 |
| Max. Negotiated Rate |
$335.12 |
| Rate for Payer: Aetna American Axle |
$242.03
|
| Rate for Payer: Aetna Commercial |
$316.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.03
|
| Rate for Payer: Cash Price |
$297.88
|
| Rate for Payer: Cofinity Advantage |
$260.64
|
| Rate for Payer: Cofinity Commercial |
$320.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.88
|
| Rate for Payer: Healthscope Commercial |
$335.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.26
|
| Rate for Payer: PHP Commercial |
$316.50
|
| Rate for Payer: Priority Health SBD |
$234.58
|
| Rate for Payer: UMR Bronson Commercial |
$163.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.26
|
|
|
HC LIQUID PLASMA IRRADIATED
|
Facility
|
OP
|
$372.35
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000096
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$43.85 |
| Max. Negotiated Rate |
$335.12 |
| Rate for Payer: Aetna American Axle |
$242.03
|
| Rate for Payer: Aetna Commercial |
$316.50
|
| Rate for Payer: Aetna Medicare |
$87.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.81
|
| Rate for Payer: BCBS Complete |
$46.05
|
| Rate for Payer: BCBS MAPPO |
$83.85
|
| Rate for Payer: BCBS Trust/PPO |
$222.97
|
| Rate for Payer: BCN Commercial |
$222.97
|
| Rate for Payer: BCN Medicare Advantage |
$83.85
|
| Rate for Payer: Cash Price |
$297.88
|
| Rate for Payer: Cash Price |
$297.88
|
| Rate for Payer: Cofinity Advantage |
$260.64
|
| Rate for Payer: Cofinity Commercial |
$320.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$297.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.85
|
| Rate for Payer: Healthscope Commercial |
$335.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$260.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.26
|
| Rate for Payer: Mclaren Medicaid |
$83.85
|
| Rate for Payer: Mclaren Medicare |
$83.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.04
|
| Rate for Payer: Meridian Medicaid |
$88.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$316.50
|
| Rate for Payer: Nomi Health Commercial |
$251.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$279.26
|
| Rate for Payer: PACE Medicare |
$79.66
|
| Rate for Payer: PACE SWMI |
$83.85
|
| Rate for Payer: PHP Commercial |
$316.50
|
| Rate for Payer: PHP Medicare Advantage |
$83.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$43.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$271.16
|
| Rate for Payer: Priority Health Medicare |
$83.85
|
| Rate for Payer: Priority Health SBD |
$234.58
|
| Rate for Payer: Priority Health Tiered Network |
$216.93
|
| Rate for Payer: Railroad Medicare Medicare |
$83.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.03
|
| Rate for Payer: UHC Core |
$193.99
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$83.85
|
| Rate for Payer: UHC Exchange |
$146.33
|
| Rate for Payer: UHC Medicaid |
$43.85
|
| Rate for Payer: UHCCP Medicaid |
$43.85
|
| Rate for Payer: UMR Bronson Commercial |
$137.77
|
| Rate for Payer: VA VA |
$83.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.26
|
|
|
HC LISTERIA MONOCYTOGENES
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600274
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC LISTERIA MONOCYTOGENES
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600274
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC LITHIUM LEVEL
|
Facility
|
IP
|
$56.04
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
30100034
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.66 |
| Max. Negotiated Rate |
$50.44 |
| Rate for Payer: Aetna American Axle |
$36.43
|
| Rate for Payer: Aetna Commercial |
$47.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.43
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Advantage |
$39.23
|
| Rate for Payer: Cofinity Commercial |
$48.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PHP Commercial |
$47.63
|
| Rate for Payer: Priority Health SBD |
$35.31
|
| Rate for Payer: UMR Bronson Commercial |
$24.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.03
|
|
|
HC LITHIUM LEVEL
|
Facility
|
OP
|
$56.04
|
|
|
Service Code
|
CPT 80178
|
| Hospital Charge Code |
30100034
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$50.44 |
| Rate for Payer: Aetna American Axle |
$36.43
|
| Rate for Payer: Aetna Commercial |
$47.63
|
| Rate for Payer: Aetna Medicare |
$6.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.26
|
| Rate for Payer: BCBS Complete |
$3.63
|
| Rate for Payer: BCBS MAPPO |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$7.64
|
| Rate for Payer: BCN Commercial |
$7.64
|
| Rate for Payer: BCN Medicare Advantage |
$6.61
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Advantage |
$39.23
|
| Rate for Payer: Cofinity Commercial |
$48.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.61
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$6.61
|
| Rate for Payer: Mclaren Medicare |
$6.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.94
|
| Rate for Payer: Meridian Medicaid |
$6.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Nomi Health Commercial |
$9.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PACE Medicare |
$6.28
|
| Rate for Payer: PACE SWMI |
$6.61
|
| Rate for Payer: PHP Commercial |
$47.63
|
| Rate for Payer: PHP Medicare Advantage |
$6.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.61
|
| Rate for Payer: Priority Health Medicare |
$6.61
|
| Rate for Payer: Priority Health SBD |
$35.31
|
| Rate for Payer: Priority Health Tiered Network |
$5.29
|
| Rate for Payer: Railroad Medicare Medicare |
$6.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.92
|
| Rate for Payer: UHC Core |
$9.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.61
|
| Rate for Payer: UHC Exchange |
$9.92
|
| Rate for Payer: UHC Medicaid |
$3.46
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UMR Bronson Commercial |
$20.73
|
| Rate for Payer: VA VA |
$6.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.03
|
|
|
HC LITHOTRIPSY
|
Facility
|
IP
|
$2,909.09
|
|
| Hospital Charge Code |
36000072
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,280.00 |
| Max. Negotiated Rate |
$2,618.18 |
| Rate for Payer: Aetna American Axle |
$1,890.91
|
| Rate for Payer: Aetna Commercial |
$2,472.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,890.91
|
| Rate for Payer: Cash Price |
$2,327.27
|
| Rate for Payer: Cofinity Advantage |
$2,036.36
|
| Rate for Payer: Cofinity Commercial |
$2,501.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.27
|
| Rate for Payer: Healthscope Commercial |
$2,618.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,036.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.82
|
| Rate for Payer: PHP Commercial |
$2,472.73
|
| Rate for Payer: Priority Health SBD |
$1,832.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,280.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.82
|
|
|
HC LITHOTRIPSY
|
Facility
|
OP
|
$2,909.09
|
|
| Hospital Charge Code |
36000072
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,076.36 |
| Max. Negotiated Rate |
$2,618.18 |
| Rate for Payer: Aetna American Axle |
$1,890.91
|
| Rate for Payer: Aetna Commercial |
$2,472.73
|
| Rate for Payer: Aetna Medicare |
$1,454.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,890.91
|
| Rate for Payer: BCBS Complete |
$1,163.64
|
| Rate for Payer: Cash Price |
$2,327.27
|
| Rate for Payer: Cofinity Advantage |
$2,036.36
|
| Rate for Payer: Cofinity Commercial |
$2,501.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,327.27
|
| Rate for Payer: Healthscope Commercial |
$2,618.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,036.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,181.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,327.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,472.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,181.82
|
| Rate for Payer: PHP Commercial |
$2,472.73
|
| Rate for Payer: Priority Health SBD |
$1,832.73
|
| Rate for Payer: UMR Bronson Commercial |
$1,076.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,181.82
|
|
|
HC LIVER BIOPSY
|
Facility
|
IP
|
$1,508.57
|
|
| Hospital Charge Code |
36000073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$663.77 |
| Max. Negotiated Rate |
$1,357.71 |
| Rate for Payer: Aetna American Axle |
$980.57
|
| Rate for Payer: Aetna Commercial |
$1,282.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.57
|
| Rate for Payer: Cash Price |
$1,206.86
|
| Rate for Payer: Cofinity Advantage |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,297.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,206.86
|
| Rate for Payer: Healthscope Commercial |
$1,357.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,056.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,131.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,282.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.43
|
| Rate for Payer: PHP Commercial |
$1,282.28
|
| Rate for Payer: Priority Health SBD |
$950.40
|
| Rate for Payer: UMR Bronson Commercial |
$663.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,131.43
|
|
|
HC LIVER BIOPSY
|
Facility
|
OP
|
$1,508.57
|
|
| Hospital Charge Code |
36000073
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$558.17 |
| Max. Negotiated Rate |
$1,357.71 |
| Rate for Payer: Aetna American Axle |
$980.57
|
| Rate for Payer: Aetna Commercial |
$1,282.28
|
| Rate for Payer: Aetna Medicare |
$754.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$980.57
|
| Rate for Payer: BCBS Complete |
$603.43
|
| Rate for Payer: Cash Price |
$1,206.86
|
| Rate for Payer: Cofinity Advantage |
$1,056.00
|
| Rate for Payer: Cofinity Commercial |
$1,297.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,206.86
|
| Rate for Payer: Healthscope Commercial |
$1,357.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,056.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,131.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,206.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,282.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,131.43
|
| Rate for Payer: PHP Commercial |
$1,282.28
|
| Rate for Payer: Priority Health SBD |
$950.40
|
| Rate for Payer: UMR Bronson Commercial |
$558.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,131.43
|
|
|
HC LIVER KIDNEY MICROSOME ANTIBODY
|
Facility
|
OP
|
$57.73
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200208
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.61 |
| Max. Negotiated Rate |
$51.96 |
| Rate for Payer: Aetna American Axle |
$37.52
|
| Rate for Payer: Aetna Commercial |
$49.07
|
| Rate for Payer: Aetna Medicare |
$15.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.19
|
| Rate for Payer: BCBS Complete |
$7.99
|
| Rate for Payer: BCBS MAPPO |
$14.55
|
| Rate for Payer: BCBS Trust/PPO |
$16.82
|
| Rate for Payer: BCN Commercial |
$16.82
|
| Rate for Payer: BCN Medicare Advantage |
$14.55
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Cofinity Advantage |
$40.41
|
| Rate for Payer: Cofinity Commercial |
$49.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.55
|
| Rate for Payer: Healthscope Commercial |
$51.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.30
|
| Rate for Payer: Mclaren Medicaid |
$14.55
|
| Rate for Payer: Mclaren Medicare |
$14.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.28
|
| Rate for Payer: Meridian Medicaid |
$15.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.07
|
| Rate for Payer: Nomi Health Commercial |
$21.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.30
|
| Rate for Payer: PACE Medicare |
$13.82
|
| Rate for Payer: PACE SWMI |
$14.55
|
| Rate for Payer: PHP Commercial |
$49.07
|
| Rate for Payer: PHP Medicare Advantage |
$14.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.55
|
| Rate for Payer: Priority Health Medicare |
$14.55
|
| Rate for Payer: Priority Health SBD |
$36.37
|
| Rate for Payer: Priority Health Tiered Network |
$11.64
|
| Rate for Payer: Railroad Medicare Medicare |
$14.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.83
|
| Rate for Payer: UHC Core |
$21.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.55
|
| Rate for Payer: UHC Exchange |
$21.83
|
| Rate for Payer: UHC Medicaid |
$7.61
|
| Rate for Payer: UHCCP Medicaid |
$7.61
|
| Rate for Payer: UMR Bronson Commercial |
$21.36
|
| Rate for Payer: VA VA |
$14.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.30
|
|
|
HC LIVER KIDNEY MICROSOME ANTIBODY
|
Facility
|
IP
|
$57.73
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200208
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.40 |
| Max. Negotiated Rate |
$51.96 |
| Rate for Payer: Aetna American Axle |
$37.52
|
| Rate for Payer: Aetna Commercial |
$49.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.52
|
| Rate for Payer: Cash Price |
$46.18
|
| Rate for Payer: Cofinity Advantage |
$40.41
|
| Rate for Payer: Cofinity Commercial |
$49.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.18
|
| Rate for Payer: Healthscope Commercial |
$51.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.30
|
| Rate for Payer: PHP Commercial |
$49.07
|
| Rate for Payer: Priority Health SBD |
$36.37
|
| Rate for Payer: UMR Bronson Commercial |
$25.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.30
|
|
|
HC LOBSTER IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200045
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC LOBSTER IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200045
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
