|
HC LV LEAD PLACEMENT
|
Facility
|
IP
|
$9,737.48
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
36100070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,284.49 |
| Max. Negotiated Rate |
$8,763.73 |
| Rate for Payer: Aetna American Axle |
$6,329.36
|
| Rate for Payer: Aetna Commercial |
$8,276.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,329.36
|
| Rate for Payer: Cash Price |
$7,789.98
|
| Rate for Payer: Cofinity Advantage |
$6,816.24
|
| Rate for Payer: Cofinity Commercial |
$8,374.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,789.98
|
| Rate for Payer: Healthscope Commercial |
$8,763.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,816.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,303.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,276.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,303.11
|
| Rate for Payer: PHP Commercial |
$8,276.86
|
| Rate for Payer: Priority Health SBD |
$6,134.61
|
| Rate for Payer: UMR Bronson Commercial |
$4,284.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,303.11
|
|
|
HC LV LEAD REPOSITIONING
|
Facility
|
OP
|
$3,660.20
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
36100071
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,354.27 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$2,379.13
|
| Rate for Payer: Aetna Commercial |
$3,111.17
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,379.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,400.27
|
| Rate for Payer: BCN Commercial |
$2,400.27
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,928.16
|
| Rate for Payer: Cash Price |
$2,928.16
|
| Rate for Payer: Cash Price |
$2,928.16
|
| Rate for Payer: Cofinity Advantage |
$2,562.14
|
| Rate for Payer: Cofinity Commercial |
$3,147.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,928.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$3,294.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,562.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,745.15
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,111.17
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,745.15
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$3,111.17
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,305.93
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,354.27
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,745.15
|
|
|
HC LV LEAD REPOSITIONING
|
Facility
|
IP
|
$3,660.20
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
36100071
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,610.49 |
| Max. Negotiated Rate |
$3,294.18 |
| Rate for Payer: Aetna American Axle |
$2,379.13
|
| Rate for Payer: Aetna Commercial |
$3,111.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,379.13
|
| Rate for Payer: Cash Price |
$2,928.16
|
| Rate for Payer: Cofinity Advantage |
$2,562.14
|
| Rate for Payer: Cofinity Commercial |
$3,147.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,928.16
|
| Rate for Payer: Healthscope Commercial |
$3,294.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,562.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,745.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,111.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,745.15
|
| Rate for Payer: PHP Commercial |
$3,111.17
|
| Rate for Payer: Priority Health SBD |
$2,305.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,610.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,745.15
|
|
|
HC LYME AB CONFIRMATION CMPT
|
Facility
|
IP
|
$35.02
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.41 |
| Max. Negotiated Rate |
$31.52 |
| Rate for Payer: Aetna American Axle |
$22.76
|
| Rate for Payer: Aetna Commercial |
$29.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.76
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cofinity Advantage |
$24.51
|
| Rate for Payer: Cofinity Commercial |
$30.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.02
|
| Rate for Payer: Healthscope Commercial |
$31.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.27
|
| Rate for Payer: PHP Commercial |
$29.77
|
| Rate for Payer: Priority Health SBD |
$22.06
|
| Rate for Payer: UMR Bronson Commercial |
$15.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.27
|
|
|
HC LYME AB CONFIRMATION CMPT
|
Facility
|
OP
|
$35.02
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.10 |
| Max. Negotiated Rate |
$31.52 |
| Rate for Payer: Aetna American Axle |
$22.76
|
| Rate for Payer: Aetna Commercial |
$29.77
|
| Rate for Payer: Aetna Medicare |
$16.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.36
|
| Rate for Payer: BCBS Complete |
$8.51
|
| Rate for Payer: BCBS MAPPO |
$15.49
|
| Rate for Payer: BCBS Trust/PPO |
$17.91
|
| Rate for Payer: BCN Commercial |
$17.91
|
| Rate for Payer: BCN Medicare Advantage |
$15.49
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cofinity Advantage |
$24.51
|
| Rate for Payer: Cofinity Commercial |
$30.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.49
|
| Rate for Payer: Healthscope Commercial |
$31.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.27
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Mclaren Medicare |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.26
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.77
|
| Rate for Payer: Nomi Health Commercial |
$23.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.27
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.49
|
| Rate for Payer: PHP Commercial |
$29.77
|
| Rate for Payer: PHP Medicare Advantage |
$15.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.49
|
| Rate for Payer: Priority Health Medicare |
$15.49
|
| Rate for Payer: Priority Health SBD |
$22.06
|
| Rate for Payer: Priority Health Tiered Network |
$12.39
|
| Rate for Payer: Railroad Medicare Medicare |
$15.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.24
|
| Rate for Payer: UHC Core |
$23.24
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.49
|
| Rate for Payer: UHC Exchange |
$23.24
|
| Rate for Payer: UHC Medicaid |
$8.10
|
| Rate for Payer: UHCCP Medicaid |
$8.10
|
| Rate for Payer: UMR Bronson Commercial |
$12.96
|
| Rate for Payer: VA VA |
$15.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.27
|
|
|
HC LYME CSF COMPONENT 1
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100669
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.07 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna American Axle |
$39.90
|
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$8.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.72
|
| Rate for Payer: BCBS Complete |
$4.27
|
| Rate for Payer: BCBS MAPPO |
$7.78
|
| Rate for Payer: BCBS Trust/PPO |
$9.00
|
| Rate for Payer: BCN Commercial |
$9.00
|
| Rate for Payer: BCN Medicare Advantage |
$7.78
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Advantage |
$42.97
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.78
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Mclaren Medicaid |
$7.78
|
| Rate for Payer: Mclaren Medicare |
$7.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.17
|
| Rate for Payer: Meridian Medicaid |
$8.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$11.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.03
|
| Rate for Payer: PACE Medicare |
$7.39
|
| Rate for Payer: PACE SWMI |
$7.78
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: PHP Medicare Advantage |
$7.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.78
|
| Rate for Payer: Priority Health Medicare |
$7.78
|
| Rate for Payer: Priority Health SBD |
$38.67
|
| Rate for Payer: Priority Health Tiered Network |
$6.22
|
| Rate for Payer: Railroad Medicare Medicare |
$7.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.67
|
| Rate for Payer: UHC Core |
$11.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.78
|
| Rate for Payer: UHC Exchange |
$11.67
|
| Rate for Payer: UHC Medicaid |
$4.07
|
| Rate for Payer: UHCCP Medicaid |
$4.07
|
| Rate for Payer: UMR Bronson Commercial |
$22.71
|
| Rate for Payer: VA VA |
$7.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC LYME CSF COMPONENT 1
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100669
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.01 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna American Axle |
$39.90
|
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.90
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Advantage |
$42.97
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.03
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: Priority Health SBD |
$38.67
|
| Rate for Payer: UMR Bronson Commercial |
$27.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC LYME CSF COMPONENT 2
|
Facility
|
IP
|
$165.42
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.78 |
| Max. Negotiated Rate |
$148.88 |
| Rate for Payer: Aetna American Axle |
$107.52
|
| Rate for Payer: Aetna Commercial |
$140.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.52
|
| Rate for Payer: Cash Price |
$132.34
|
| Rate for Payer: Cofinity Advantage |
$115.79
|
| Rate for Payer: Cofinity Commercial |
$142.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.34
|
| Rate for Payer: Healthscope Commercial |
$148.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.06
|
| Rate for Payer: PHP Commercial |
$140.61
|
| Rate for Payer: Priority Health SBD |
$104.21
|
| Rate for Payer: UMR Bronson Commercial |
$72.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.06
|
|
|
HC LYME CSF COMPONENT 2
|
Facility
|
OP
|
$165.42
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200410
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$148.88 |
| Rate for Payer: Aetna American Axle |
$107.52
|
| Rate for Payer: Aetna Commercial |
$140.61
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$107.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.29
|
| Rate for Payer: BCBS Complete |
$9.35
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$19.68
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$132.34
|
| Rate for Payer: Cash Price |
$132.34
|
| Rate for Payer: Cofinity Advantage |
$115.79
|
| Rate for Payer: Cofinity Commercial |
$142.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$132.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$148.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.06
|
| Rate for Payer: Mclaren Medicaid |
$17.03
|
| Rate for Payer: Mclaren Medicare |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Meridian Medicaid |
$17.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$140.61
|
| Rate for Payer: Nomi Health Commercial |
$25.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.06
|
| Rate for Payer: PACE Medicare |
$16.18
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$140.61
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.03
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: Priority Health SBD |
$104.21
|
| Rate for Payer: Priority Health Tiered Network |
$13.62
|
| Rate for Payer: Railroad Medicare Medicare |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.55
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.03
|
| Rate for Payer: UHC Exchange |
$25.55
|
| Rate for Payer: UHC Medicaid |
$8.91
|
| Rate for Payer: UHCCP Medicaid |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$61.21
|
| Rate for Payer: VA VA |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.06
|
|
|
HC LYME CSF COMPONENT 3
|
Facility
|
OP
|
$90.51
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100670
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.86 |
| Max. Negotiated Rate |
$81.46 |
| Rate for Payer: Aetna American Axle |
$58.83
|
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: Aetna Medicare |
$9.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.62
|
| Rate for Payer: BCBS Complete |
$5.11
|
| Rate for Payer: BCBS MAPPO |
$9.30
|
| Rate for Payer: BCBS Trust/PPO |
$10.76
|
| Rate for Payer: BCN Commercial |
$10.76
|
| Rate for Payer: BCN Medicare Advantage |
$9.30
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Advantage |
$63.36
|
| Rate for Payer: Cofinity Commercial |
$77.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.30
|
| Rate for Payer: Healthscope Commercial |
$81.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.88
|
| Rate for Payer: Mclaren Medicaid |
$9.30
|
| Rate for Payer: Mclaren Medicare |
$9.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.77
|
| Rate for Payer: Meridian Medicaid |
$9.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Nomi Health Commercial |
$13.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.88
|
| Rate for Payer: PACE Medicare |
$8.84
|
| Rate for Payer: PACE SWMI |
$9.30
|
| Rate for Payer: PHP Commercial |
$76.93
|
| Rate for Payer: PHP Medicare Advantage |
$9.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.30
|
| Rate for Payer: Priority Health Medicare |
$9.30
|
| Rate for Payer: Priority Health SBD |
$57.02
|
| Rate for Payer: Priority Health Tiered Network |
$7.44
|
| Rate for Payer: Railroad Medicare Medicare |
$9.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.95
|
| Rate for Payer: UHC Core |
$13.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.30
|
| Rate for Payer: UHC Exchange |
$13.95
|
| Rate for Payer: UHC Medicaid |
$4.86
|
| Rate for Payer: UHCCP Medicaid |
$4.86
|
| Rate for Payer: UMR Bronson Commercial |
$33.49
|
| Rate for Payer: VA VA |
$9.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.88
|
|
|
HC LYME CSF COMPONENT 3
|
Facility
|
IP
|
$90.51
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100670
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.82 |
| Max. Negotiated Rate |
$81.46 |
| Rate for Payer: Aetna American Axle |
$58.83
|
| Rate for Payer: Aetna Commercial |
$76.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.83
|
| Rate for Payer: Cash Price |
$72.41
|
| Rate for Payer: Cofinity Advantage |
$63.36
|
| Rate for Payer: Cofinity Commercial |
$77.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.41
|
| Rate for Payer: Healthscope Commercial |
$81.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.88
|
| Rate for Payer: PHP Commercial |
$76.93
|
| Rate for Payer: Priority Health SBD |
$57.02
|
| Rate for Payer: UMR Bronson Commercial |
$39.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.88
|
|
|
HC LYME CSF IGG AB INDEX
|
Facility
|
OP
|
$73.87
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100668
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$66.48 |
| Rate for Payer: Aetna American Axle |
$48.02
|
| Rate for Payer: Aetna Commercial |
$62.79
|
| Rate for Payer: Aetna Medicare |
$5.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.19
|
| Rate for Payer: BCBS Complete |
$2.72
|
| Rate for Payer: BCBS MAPPO |
$4.95
|
| Rate for Payer: BCN Medicare Advantage |
$4.95
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cofinity Advantage |
$51.71
|
| Rate for Payer: Cofinity Commercial |
$63.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.95
|
| Rate for Payer: Healthscope Commercial |
$66.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.40
|
| Rate for Payer: Mclaren Medicaid |
$4.95
|
| Rate for Payer: Mclaren Medicare |
$4.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.20
|
| Rate for Payer: Meridian Medicaid |
$5.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.79
|
| Rate for Payer: Nomi Health Commercial |
$7.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.40
|
| Rate for Payer: PACE Medicare |
$4.70
|
| Rate for Payer: PACE SWMI |
$4.95
|
| Rate for Payer: PHP Commercial |
$62.79
|
| Rate for Payer: PHP Medicare Advantage |
$4.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.95
|
| Rate for Payer: Priority Health Medicare |
$4.95
|
| Rate for Payer: Priority Health SBD |
$46.54
|
| Rate for Payer: Priority Health Tiered Network |
$3.96
|
| Rate for Payer: Railroad Medicare Medicare |
$4.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.43
|
| Rate for Payer: UHC Core |
$7.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.95
|
| Rate for Payer: UHC Exchange |
$7.43
|
| Rate for Payer: UHC Medicaid |
$2.59
|
| Rate for Payer: UHCCP Medicaid |
$2.59
|
| Rate for Payer: UMR Bronson Commercial |
$27.33
|
| Rate for Payer: VA VA |
$4.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.40
|
|
|
HC LYME CSF IGG AB INDEX
|
Facility
|
IP
|
$73.87
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100668
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$66.48 |
| Rate for Payer: Aetna American Axle |
$48.02
|
| Rate for Payer: Aetna Commercial |
$62.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.02
|
| Rate for Payer: Cash Price |
$59.10
|
| Rate for Payer: Cofinity Advantage |
$51.71
|
| Rate for Payer: Cofinity Commercial |
$63.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.10
|
| Rate for Payer: Healthscope Commercial |
$66.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$55.40
|
| Rate for Payer: PHP Commercial |
$62.79
|
| Rate for Payer: Priority Health SBD |
$46.54
|
| Rate for Payer: UMR Bronson Commercial |
$32.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.40
|
|
|
HC LYME DISEASE ANTIBODY
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna American Axle |
$31.04
|
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: UMR Bronson Commercial |
$21.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC LYME DISEASE ANTIBODY
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 86618
|
| Hospital Charge Code |
30200486
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.91 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna American Axle |
$31.04
|
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$17.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.29
|
| Rate for Payer: BCBS Complete |
$9.35
|
| Rate for Payer: BCBS MAPPO |
$17.03
|
| Rate for Payer: BCBS Trust/PPO |
$19.68
|
| Rate for Payer: BCN Commercial |
$19.68
|
| Rate for Payer: BCN Medicare Advantage |
$17.03
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.03
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$17.03
|
| Rate for Payer: Mclaren Medicare |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.88
|
| Rate for Payer: Meridian Medicaid |
$17.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.58
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$25.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$16.18
|
| Rate for Payer: PACE SWMI |
$17.03
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$17.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.03
|
| Rate for Payer: Priority Health Medicare |
$17.03
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: Priority Health Tiered Network |
$13.62
|
| Rate for Payer: Railroad Medicare Medicare |
$17.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.55
|
| Rate for Payer: UHC Core |
$25.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.03
|
| Rate for Payer: UHC Exchange |
$25.55
|
| Rate for Payer: UHC Medicaid |
$8.91
|
| Rate for Payer: UHCCP Medicaid |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$17.67
|
| Rate for Payer: VA VA |
$17.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS
|
Facility
|
OP
|
$264.91
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200472
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$238.42 |
| Rate for Payer: Aetna American Axle |
$172.19
|
| Rate for Payer: Aetna Commercial |
$225.17
|
| Rate for Payer: Aetna Medicare |
$50.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$56.67
|
| Rate for Payer: BCN Commercial |
$56.67
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$211.93
|
| Rate for Payer: Cash Price |
$211.93
|
| Rate for Payer: Cofinity Advantage |
$185.44
|
| Rate for Payer: Cofinity Commercial |
$227.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$238.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.68
|
| Rate for Payer: Mclaren Medicaid |
$49.03
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: Meridian Medicaid |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.17
|
| Rate for Payer: Nomi Health Commercial |
$73.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.68
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$225.17
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.03
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health SBD |
$166.89
|
| Rate for Payer: Priority Health Tiered Network |
$39.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.55
|
| Rate for Payer: UHC Core |
$73.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.03
|
| Rate for Payer: UHC Exchange |
$73.55
|
| Rate for Payer: UHC Medicaid |
$25.64
|
| Rate for Payer: UHCCP Medicaid |
$25.64
|
| Rate for Payer: UMR Bronson Commercial |
$98.02
|
| Rate for Payer: VA VA |
$49.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.68
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS
|
Facility
|
IP
|
$264.91
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200472
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$116.56 |
| Max. Negotiated Rate |
$238.42 |
| Rate for Payer: Aetna American Axle |
$172.19
|
| Rate for Payer: Aetna Commercial |
$225.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.19
|
| Rate for Payer: Cash Price |
$211.93
|
| Rate for Payer: Cofinity Advantage |
$185.44
|
| Rate for Payer: Cofinity Commercial |
$227.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.93
|
| Rate for Payer: Healthscope Commercial |
$238.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.68
|
| Rate for Payer: PHP Commercial |
$225.17
|
| Rate for Payer: Priority Health SBD |
$166.89
|
| Rate for Payer: UMR Bronson Commercial |
$116.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.68
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS CMPT
|
Facility
|
OP
|
$285.69
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200475
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$257.12 |
| Rate for Payer: Aetna American Axle |
$185.70
|
| Rate for Payer: Aetna Commercial |
$242.84
|
| Rate for Payer: Aetna Medicare |
$50.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$56.67
|
| Rate for Payer: BCN Commercial |
$56.67
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cofinity Advantage |
$199.98
|
| Rate for Payer: Cofinity Commercial |
$245.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$257.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.27
|
| Rate for Payer: Mclaren Medicaid |
$49.03
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: Meridian Medicaid |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.84
|
| Rate for Payer: Nomi Health Commercial |
$73.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.27
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$242.84
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.03
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health SBD |
$179.98
|
| Rate for Payer: Priority Health Tiered Network |
$39.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.55
|
| Rate for Payer: UHC Core |
$73.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.03
|
| Rate for Payer: UHC Exchange |
$73.55
|
| Rate for Payer: UHC Medicaid |
$25.64
|
| Rate for Payer: UHCCP Medicaid |
$25.64
|
| Rate for Payer: UMR Bronson Commercial |
$105.71
|
| Rate for Payer: VA VA |
$49.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.27
|
|
|
HC LYMPHOCYTE PROLIFERATION, ANTIGENS CMPT
|
Facility
|
IP
|
$285.69
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200475
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$125.70 |
| Max. Negotiated Rate |
$257.12 |
| Rate for Payer: Aetna American Axle |
$185.70
|
| Rate for Payer: Aetna Commercial |
$242.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.70
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cofinity Advantage |
$199.98
|
| Rate for Payer: Cofinity Commercial |
$245.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.55
|
| Rate for Payer: Healthscope Commercial |
$257.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.27
|
| Rate for Payer: PHP Commercial |
$242.84
|
| Rate for Payer: Priority Health SBD |
$179.98
|
| Rate for Payer: UMR Bronson Commercial |
$125.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.27
|
|
|
HC LYMPHOCYTE PROLIFERATION MITOGEN
|
Facility
|
IP
|
$240.33
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$105.75 |
| Max. Negotiated Rate |
$216.30 |
| Rate for Payer: Aetna American Axle |
$156.21
|
| Rate for Payer: Aetna Commercial |
$204.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.21
|
| Rate for Payer: Cash Price |
$192.26
|
| Rate for Payer: Cofinity Advantage |
$168.23
|
| Rate for Payer: Cofinity Commercial |
$206.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.26
|
| Rate for Payer: Healthscope Commercial |
$216.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.25
|
| Rate for Payer: PHP Commercial |
$204.28
|
| Rate for Payer: Priority Health SBD |
$151.41
|
| Rate for Payer: UMR Bronson Commercial |
$105.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.25
|
|
|
HC LYMPHOCYTE PROLIFERATION MITOGEN
|
Facility
|
OP
|
$240.33
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200201
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$216.30 |
| Rate for Payer: Aetna American Axle |
$156.21
|
| Rate for Payer: Aetna Commercial |
$204.28
|
| Rate for Payer: Aetna Medicare |
$50.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$56.67
|
| Rate for Payer: BCN Commercial |
$56.67
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$192.26
|
| Rate for Payer: Cash Price |
$192.26
|
| Rate for Payer: Cofinity Advantage |
$168.23
|
| Rate for Payer: Cofinity Commercial |
$206.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$216.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.25
|
| Rate for Payer: Mclaren Medicaid |
$49.03
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: Meridian Medicaid |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.28
|
| Rate for Payer: Nomi Health Commercial |
$73.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.25
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$204.28
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.03
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health SBD |
$151.41
|
| Rate for Payer: Priority Health Tiered Network |
$39.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.55
|
| Rate for Payer: UHC Core |
$73.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.03
|
| Rate for Payer: UHC Exchange |
$73.55
|
| Rate for Payer: UHC Medicaid |
$25.64
|
| Rate for Payer: UHCCP Medicaid |
$25.64
|
| Rate for Payer: UMR Bronson Commercial |
$88.92
|
| Rate for Payer: VA VA |
$49.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.25
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
IP
|
$264.91
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$116.56 |
| Max. Negotiated Rate |
$238.42 |
| Rate for Payer: Aetna American Axle |
$172.19
|
| Rate for Payer: Aetna Commercial |
$225.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.19
|
| Rate for Payer: Cash Price |
$211.93
|
| Rate for Payer: Cofinity Advantage |
$185.44
|
| Rate for Payer: Cofinity Commercial |
$227.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.93
|
| Rate for Payer: Healthscope Commercial |
$238.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.68
|
| Rate for Payer: PHP Commercial |
$225.17
|
| Rate for Payer: Priority Health SBD |
$166.89
|
| Rate for Payer: UMR Bronson Commercial |
$116.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.68
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
OP
|
$264.91
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$238.42 |
| Rate for Payer: Aetna American Axle |
$172.19
|
| Rate for Payer: Aetna Commercial |
$225.17
|
| Rate for Payer: Aetna Medicare |
$50.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$172.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$56.67
|
| Rate for Payer: BCN Commercial |
$56.67
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$211.93
|
| Rate for Payer: Cash Price |
$211.93
|
| Rate for Payer: Cofinity Advantage |
$185.44
|
| Rate for Payer: Cofinity Commercial |
$227.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$238.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.68
|
| Rate for Payer: Mclaren Medicaid |
$49.03
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: Meridian Medicaid |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.17
|
| Rate for Payer: Nomi Health Commercial |
$73.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.68
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$225.17
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.03
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health SBD |
$166.89
|
| Rate for Payer: Priority Health Tiered Network |
$39.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.55
|
| Rate for Payer: UHC Core |
$73.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.03
|
| Rate for Payer: UHC Exchange |
$73.55
|
| Rate for Payer: UHC Medicaid |
$25.64
|
| Rate for Payer: UHCCP Medicaid |
$25.64
|
| Rate for Payer: UMR Bronson Commercial |
$98.02
|
| Rate for Payer: VA VA |
$49.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.68
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
IP
|
$285.69
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$125.70 |
| Max. Negotiated Rate |
$257.12 |
| Rate for Payer: Aetna American Axle |
$185.70
|
| Rate for Payer: Aetna Commercial |
$242.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.70
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cofinity Advantage |
$199.98
|
| Rate for Payer: Cofinity Commercial |
$245.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.55
|
| Rate for Payer: Healthscope Commercial |
$257.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.27
|
| Rate for Payer: PHP Commercial |
$242.84
|
| Rate for Payer: Priority Health SBD |
$179.98
|
| Rate for Payer: UMR Bronson Commercial |
$125.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.27
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
OP
|
$285.69
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$257.12 |
| Rate for Payer: Aetna American Axle |
$185.70
|
| Rate for Payer: Aetna Commercial |
$242.84
|
| Rate for Payer: Aetna Medicare |
$50.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$56.67
|
| Rate for Payer: BCN Commercial |
$56.67
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cofinity Advantage |
$199.98
|
| Rate for Payer: Cofinity Commercial |
$245.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$257.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.27
|
| Rate for Payer: Mclaren Medicaid |
$49.03
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: Meridian Medicaid |
$51.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.84
|
| Rate for Payer: Nomi Health Commercial |
$73.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.27
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$242.84
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.03
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health SBD |
$179.98
|
| Rate for Payer: Priority Health Tiered Network |
$39.22
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.55
|
| Rate for Payer: UHC Core |
$73.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.03
|
| Rate for Payer: UHC Exchange |
$73.55
|
| Rate for Payer: UHC Medicaid |
$25.64
|
| Rate for Payer: UHCCP Medicaid |
$25.64
|
| Rate for Payer: UMR Bronson Commercial |
$105.71
|
| Rate for Payer: VA VA |
$49.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.27
|
|
