|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$33.96 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna Medicare |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: BCBS Complete |
$6.37
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.61
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: Priority Health Tiered Network |
$6.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.96
|
| Rate for Payer: UHC Core |
$33.96
|
| Rate for Payer: UHC Exchange |
$33.96
|
| Rate for Payer: UMR Bronson Commercial |
$5.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$14.33 |
| Rate for Payer: Aetna American Axle |
$10.35
|
| Rate for Payer: Aetna Commercial |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.35
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Advantage |
$11.14
|
| Rate for Payer: Cofinity Commercial |
$13.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$14.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: PHP Commercial |
$13.53
|
| Rate for Payer: Priority Health SBD |
$10.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.94
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
IP
|
$686.66
|
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$302.13 |
| Max. Negotiated Rate |
$617.99 |
| Rate for Payer: Aetna American Axle |
$446.33
|
| Rate for Payer: Aetna Commercial |
$583.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.33
|
| Rate for Payer: Cash Price |
$549.33
|
| Rate for Payer: Cofinity Advantage |
$480.66
|
| Rate for Payer: Cofinity Commercial |
$590.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.33
|
| Rate for Payer: Healthscope Commercial |
$617.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$480.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.00
|
| Rate for Payer: PHP Commercial |
$583.66
|
| Rate for Payer: Priority Health SBD |
$432.60
|
| Rate for Payer: UMR Bronson Commercial |
$302.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.00
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
OP
|
$686.66
|
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$254.06 |
| Max. Negotiated Rate |
$617.99 |
| Rate for Payer: Aetna American Axle |
$446.33
|
| Rate for Payer: Aetna Commercial |
$583.66
|
| Rate for Payer: Aetna Medicare |
$343.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$446.33
|
| Rate for Payer: BCBS Complete |
$274.66
|
| Rate for Payer: Cash Price |
$549.33
|
| Rate for Payer: Cofinity Advantage |
$480.66
|
| Rate for Payer: Cofinity Commercial |
$590.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.33
|
| Rate for Payer: Healthscope Commercial |
$617.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$480.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$515.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$549.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.00
|
| Rate for Payer: PHP Commercial |
$583.66
|
| Rate for Payer: Priority Health SBD |
$432.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$446.33
|
| Rate for Payer: UHC Core |
$357.75
|
| Rate for Payer: UHC Exchange |
$269.86
|
| Rate for Payer: UMR Bronson Commercial |
$254.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$515.00
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
OP
|
$3,805.47
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$2,473.56
|
| Rate for Payer: Aetna Commercial |
$3,234.65
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,473.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$2,275.78
|
| Rate for Payer: BCN Commercial |
$2,275.78
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$3,044.38
|
| Rate for Payer: Cash Price |
$3,044.38
|
| Rate for Payer: Cash Price |
$3,044.38
|
| Rate for Payer: Cofinity Advantage |
$2,663.83
|
| Rate for Payer: Cofinity Commercial |
$3,272.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,044.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$3,424.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,663.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,854.10
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,234.65
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,854.10
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$3,234.65
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$2,397.45
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,408.02
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,854.10
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
IP
|
$3,805.47
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,674.41 |
| Max. Negotiated Rate |
$3,424.92 |
| Rate for Payer: Aetna American Axle |
$2,473.56
|
| Rate for Payer: Aetna Commercial |
$3,234.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,473.56
|
| Rate for Payer: Cash Price |
$3,044.38
|
| Rate for Payer: Cofinity Advantage |
$2,663.83
|
| Rate for Payer: Cofinity Commercial |
$3,272.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,044.38
|
| Rate for Payer: Healthscope Commercial |
$3,424.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,663.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,854.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,234.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,854.10
|
| Rate for Payer: PHP Commercial |
$3,234.65
|
| Rate for Payer: Priority Health SBD |
$2,397.45
|
| Rate for Payer: UMR Bronson Commercial |
$1,674.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,854.10
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
OP
|
$1,404.54
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.05 |
| Max. Negotiated Rate |
$1,737.88 |
| Rate for Payer: Aetna American Axle |
$912.95
|
| Rate for Payer: Aetna Commercial |
$1,193.86
|
| Rate for Payer: Aetna Medicare |
$558.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$450.05
|
| Rate for Payer: BCN Commercial |
$450.05
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Advantage |
$983.18
|
| Rate for Payer: Cofinity Commercial |
$1,207.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$1,264.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.40
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$564.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,612.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$1,193.86
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,737.88
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health SBD |
$884.86
|
| Rate for Payer: Priority Health Tiered Network |
$1,390.30
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$912.95
|
| Rate for Payer: UHC Core |
$731.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$551.98
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: UMR Bronson Commercial |
$519.68
|
| Rate for Payer: VA VA |
$537.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.40
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
IP
|
$1,404.54
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$618.00 |
| Max. Negotiated Rate |
$1,264.09 |
| Rate for Payer: Aetna American Axle |
$912.95
|
| Rate for Payer: Aetna Commercial |
$1,193.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$912.95
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Advantage |
$983.18
|
| Rate for Payer: Cofinity Commercial |
$1,207.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Healthscope Commercial |
$1,264.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$983.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,053.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PHP Commercial |
$1,193.86
|
| Rate for Payer: Priority Health SBD |
$884.86
|
| Rate for Payer: UMR Bronson Commercial |
$618.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,053.40
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
IP
|
$7,940.33
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,493.75 |
| Max. Negotiated Rate |
$7,146.30 |
| Rate for Payer: Aetna American Axle |
$5,161.21
|
| Rate for Payer: Aetna Commercial |
$6,749.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,161.21
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cofinity Advantage |
$5,558.23
|
| Rate for Payer: Cofinity Commercial |
$6,828.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,352.26
|
| Rate for Payer: Healthscope Commercial |
$7,146.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,558.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,955.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,749.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,955.25
|
| Rate for Payer: PHP Commercial |
$6,749.28
|
| Rate for Payer: Priority Health SBD |
$5,002.41
|
| Rate for Payer: UMR Bronson Commercial |
$3,493.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,955.25
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
OP
|
$7,940.33
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$5,161.21
|
| Rate for Payer: Aetna Commercial |
$6,749.28
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,161.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,006.33
|
| Rate for Payer: BCN Commercial |
$2,006.33
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cofinity Advantage |
$5,558.23
|
| Rate for Payer: Cofinity Commercial |
$6,828.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,352.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,146.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,558.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,955.25
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,749.28
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,955.25
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$6,749.28
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$5,002.41
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,161.21
|
| Rate for Payer: UHC Core |
$4,136.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$3,120.55
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$2,937.92
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,955.25
|
|
|
HC LYSOZYME (MURAMIDASE)
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
30500108
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna American Axle |
$43.28
|
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$21.67
|
| Rate for Payer: BCN Commercial |
$21.67
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Advantage |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Mclaren Medicaid |
$18.75
|
| Rate for Payer: Mclaren Medicare |
$18.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: Meridian Medicaid |
$19.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$28.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PACE Medicare |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.75
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: Priority Health Tiered Network |
$15.00
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.13
|
| Rate for Payer: UHC Core |
$28.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.75
|
| Rate for Payer: UHC Exchange |
$28.13
|
| Rate for Payer: UHC Medicaid |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$9.81
|
| Rate for Payer: UMR Bronson Commercial |
$24.64
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC LYSOZYME (MURAMIDASE)
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
30500108
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.30 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna American Axle |
$43.28
|
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Advantage |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: UMR Bronson Commercial |
$29.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC MAC/REGIONAL PER MINUTE
|
Facility
|
OP
|
$14.28
|
|
| Hospital Charge Code |
37000025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna American Axle |
$9.28
|
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna Medicare |
$7.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.28
|
| Rate for Payer: BCBS Complete |
$5.71
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Advantage |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health SBD |
$9.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.28
|
| Rate for Payer: UHC Core |
$7.44
|
| Rate for Payer: UHC Exchange |
$5.61
|
| Rate for Payer: UMR Bronson Commercial |
$5.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC MAC/REGIONAL PER MINUTE
|
Facility
|
IP
|
$14.28
|
|
| Hospital Charge Code |
37000025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna American Axle |
$9.28
|
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.28
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Advantage |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health SBD |
$9.00
|
| Rate for Payer: UMR Bronson Commercial |
$6.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
OP
|
$45.84
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$41.26 |
| Rate for Payer: Aetna American Axle |
$29.80
|
| Rate for Payer: Aetna Commercial |
$38.96
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.93
|
| Rate for Payer: BCN Commercial |
$4.93
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cofinity Advantage |
$32.09
|
| Rate for Payer: Cofinity Commercial |
$39.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$41.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.38
|
| Rate for Payer: Mclaren Medicaid |
$4.27
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.96
|
| Rate for Payer: Nomi Health Commercial |
$6.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.38
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$38.96
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.27
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health SBD |
$28.88
|
| Rate for Payer: Priority Health Tiered Network |
$3.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.41
|
| Rate for Payer: UHC Core |
$6.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.41
|
| Rate for Payer: UHC Medicaid |
$2.23
|
| Rate for Payer: UHCCP Medicaid |
$2.23
|
| Rate for Payer: UMR Bronson Commercial |
$16.96
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.38
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
IP
|
$45.84
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.17 |
| Max. Negotiated Rate |
$41.26 |
| Rate for Payer: Aetna American Axle |
$29.80
|
| Rate for Payer: Aetna Commercial |
$38.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.80
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cofinity Advantage |
$32.09
|
| Rate for Payer: Cofinity Commercial |
$39.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.67
|
| Rate for Payer: Healthscope Commercial |
$41.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.38
|
| Rate for Payer: PHP Commercial |
$38.96
|
| Rate for Payer: Priority Health SBD |
$28.88
|
| Rate for Payer: UMR Bronson Commercial |
$20.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.38
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
IP
|
$44.94
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.77 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna American Axle |
$29.21
|
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.21
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Advantage |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: Priority Health SBD |
$28.31
|
| Rate for Payer: UMR Bronson Commercial |
$19.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.70
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
OP
|
$44.94
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$40.45 |
| Rate for Payer: Aetna American Axle |
$29.21
|
| Rate for Payer: Aetna Commercial |
$38.20
|
| Rate for Payer: Aetna Medicare |
$4.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.39
|
| Rate for Payer: BCBS Complete |
$2.37
|
| Rate for Payer: BCBS MAPPO |
$4.31
|
| Rate for Payer: BCBS Trust/PPO |
$4.98
|
| Rate for Payer: BCN Commercial |
$4.98
|
| Rate for Payer: BCN Medicare Advantage |
$4.31
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Advantage |
$31.46
|
| Rate for Payer: Cofinity Commercial |
$38.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.31
|
| Rate for Payer: Healthscope Commercial |
$40.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.70
|
| Rate for Payer: Mclaren Medicaid |
$4.31
|
| Rate for Payer: Mclaren Medicare |
$4.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.53
|
| Rate for Payer: Meridian Medicaid |
$4.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$6.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PACE Medicare |
$4.09
|
| Rate for Payer: PACE SWMI |
$4.31
|
| Rate for Payer: PHP Commercial |
$38.20
|
| Rate for Payer: PHP Medicare Advantage |
$4.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.31
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Priority Health SBD |
$28.31
|
| Rate for Payer: Priority Health Tiered Network |
$3.45
|
| Rate for Payer: Railroad Medicare Medicare |
$4.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.47
|
| Rate for Payer: UHC Core |
$6.47
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.31
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$2.25
|
| Rate for Payer: UHCCP Medicaid |
$2.25
|
| Rate for Payer: UMR Bronson Commercial |
$16.63
|
| Rate for Payer: VA VA |
$4.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.70
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
IP
|
$994.85
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$437.73 |
| Max. Negotiated Rate |
$895.37 |
| Rate for Payer: Aetna American Axle |
$646.65
|
| Rate for Payer: Aetna Commercial |
$845.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.65
|
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Cofinity Advantage |
$696.39
|
| Rate for Payer: Cofinity Commercial |
$855.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.88
|
| Rate for Payer: Healthscope Commercial |
$895.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$696.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.14
|
| Rate for Payer: PHP Commercial |
$845.62
|
| Rate for Payer: Priority Health SBD |
$626.76
|
| Rate for Payer: UMR Bronson Commercial |
$437.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.14
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
OP
|
$994.85
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$368.09 |
| Max. Negotiated Rate |
$1,308.90 |
| Rate for Payer: Aetna American Axle |
$646.65
|
| Rate for Payer: Aetna Commercial |
$845.62
|
| Rate for Payer: Aetna Medicare |
$497.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$646.65
|
| Rate for Payer: BCBS Complete |
$397.94
|
| Rate for Payer: BCBS Trust/PPO |
$689.27
|
| Rate for Payer: BCN Commercial |
$689.27
|
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Cofinity Advantage |
$696.39
|
| Rate for Payer: Cofinity Commercial |
$855.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.88
|
| Rate for Payer: Healthscope Commercial |
$895.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$696.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$746.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$795.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.14
|
| Rate for Payer: PHP Commercial |
$845.62
|
| Rate for Payer: Priority Health SBD |
$626.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,308.90
|
| Rate for Payer: UHC Core |
$1,308.90
|
| Rate for Payer: UHC Exchange |
$1,308.90
|
| Rate for Payer: UMR Bronson Commercial |
$368.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$746.14
|
|
|
HC MAGGOT THERAPY
|
Facility
|
OP
|
$1,114.27
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$412.28 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna American Axle |
$724.28
|
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna Medicare |
$557.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.28
|
| Rate for Payer: BCBS Complete |
$445.71
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Advantage |
$779.99
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$779.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health SBD |
$701.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$724.28
|
| Rate for Payer: UHC Core |
$580.53
|
| Rate for Payer: UHC Exchange |
$437.91
|
| Rate for Payer: UMR Bronson Commercial |
$412.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.70
|
|
|
HC MAGGOT THERAPY
|
Facility
|
IP
|
$1,114.27
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$490.28 |
| Max. Negotiated Rate |
$1,002.84 |
| Rate for Payer: Aetna American Axle |
$724.28
|
| Rate for Payer: Aetna Commercial |
$947.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$724.28
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Advantage |
$779.99
|
| Rate for Payer: Cofinity Commercial |
$958.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,002.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$779.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$835.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: PHP Commercial |
$947.13
|
| Rate for Payer: Priority Health SBD |
$701.99
|
| Rate for Payer: UMR Bronson Commercial |
$490.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$835.70
|
|
|
HC MAGNESIUM LEVEL
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
30100284
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.38
|
| Rate for Payer: BCBS Complete |
$3.68
|
| Rate for Payer: BCBS MAPPO |
$6.70
|
| Rate for Payer: BCBS Trust/PPO |
$7.75
|
| Rate for Payer: BCN Commercial |
$7.75
|
| Rate for Payer: BCN Medicare Advantage |
$6.70
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.70
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$6.70
|
| Rate for Payer: Mclaren Medicare |
$6.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.04
|
| Rate for Payer: Meridian Medicaid |
$7.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$10.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$6.37
|
| Rate for Payer: PACE SWMI |
$6.70
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.70
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$5.36
|
| Rate for Payer: Railroad Medicare Medicare |
$6.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.05
|
| Rate for Payer: UHC Core |
$10.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.70
|
| Rate for Payer: UHC Exchange |
$10.05
|
| Rate for Payer: UHC Medicaid |
$3.50
|
| Rate for Payer: UHCCP Medicaid |
$3.50
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$6.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC MAGNESIUM LEVEL
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 83735
|
| Hospital Charge Code |
30100284
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC MAKENA 10 MG
|
Facility
|
IP
|
$2.65
|
|
|
Service Code
|
HCPCS J1726
|
| Hospital Charge Code |
63600141
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.17 |
| Max. Negotiated Rate |
$2.38 |
| Rate for Payer: Aetna American Axle |
$1.72
|
| Rate for Payer: Aetna Commercial |
$2.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.72
|
| Rate for Payer: Cash Price |
$2.12
|
| Rate for Payer: Cofinity Advantage |
$1.85
|
| Rate for Payer: Cofinity Commercial |
$2.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.12
|
| Rate for Payer: Healthscope Commercial |
$2.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.99
|
| Rate for Payer: PHP Commercial |
$2.25
|
| Rate for Payer: Priority Health SBD |
$1.67
|
| Rate for Payer: UMR Bronson Commercial |
$1.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.99
|
|
