|
HC TOTAL PROTEIN URINE
|
Facility
|
IP
|
$38.10
|
|
|
Service Code
|
CPT 84156
|
| Hospital Charge Code |
30100407
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.76 |
| Max. Negotiated Rate |
$34.29 |
| Rate for Payer: Aetna American Axle |
$24.76
|
| Rate for Payer: Aetna Commercial |
$32.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.76
|
| Rate for Payer: Cash Price |
$30.48
|
| Rate for Payer: Cofinity Commercial |
$26.67
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.48
|
| Rate for Payer: Healthscope Commercial |
$34.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.38
|
| Rate for Payer: PHP Commercial |
$32.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.67
|
| Rate for Payer: Priority Health SBD |
$24.00
|
| Rate for Payer: UMR Bronson Commercial |
$16.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.58
|
|
|
HC TOTAL T3
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$14.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: BCBS Complete |
$8.14
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$12.76
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$7.76
|
| Rate for Payer: Mclaren Medicare |
$14.18
|
| Rate for Payer: Meridian Medicaid |
$8.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.80
|
| Rate for Payer: PACE Medicare |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.45
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow Network |
$15.56
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.02
|
| Rate for Payer: UHC Core |
$23.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.18
|
| Rate for Payer: UHC Exchange |
$14.18
|
| Rate for Payer: UHC Medicare Advantage |
$14.61
|
| Rate for Payer: UMR Bronson Commercial |
$17.32
|
| Rate for Payer: VA VA |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC TOTAL T3
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 84480
|
| Hospital Charge Code |
30100447
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.77
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
IP
|
$163.20
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.81 |
| Max. Negotiated Rate |
$146.88 |
| Rate for Payer: Aetna American Axle |
$106.08
|
| Rate for Payer: Aetna Commercial |
$138.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.08
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cofinity Commercial |
$114.24
|
| Rate for Payer: Cofinity Commercial |
$140.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
| Rate for Payer: Healthscope Commercial |
$146.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.72
|
| Rate for Payer: PHP Commercial |
$138.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.24
|
| Rate for Payer: Priority Health SBD |
$102.82
|
| Rate for Payer: UMR Bronson Commercial |
$71.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.40
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
OP
|
$163.20
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.99 |
| Max. Negotiated Rate |
$146.88 |
| Rate for Payer: Aetna American Axle |
$106.08
|
| Rate for Payer: Aetna Commercial |
$138.72
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$35.69
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$55.89
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cash Price |
$130.56
|
| Rate for Payer: Cofinity Commercial |
$140.35
|
| Rate for Payer: Cofinity Commercial |
$114.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$146.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.40
|
| Rate for Payer: Mclaren Medicaid |
$33.99
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Medicaid |
$35.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.72
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$138.72
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.58
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$38.86
|
| Rate for Payer: Priority Health SBD |
$102.82
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Core |
$95.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$64.00
|
| Rate for Payer: UMR Bronson Commercial |
$60.38
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.40
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$113.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$101.70 |
| Rate for Payer: Aetna American Axle |
$73.45
|
| Rate for Payer: Aetna Commercial |
$96.05
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$8.27
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$12.94
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$79.10
|
| Rate for Payer: Cofinity Commercial |
$97.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$101.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.75
|
| Rate for Payer: Mclaren Medicaid |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Medicaid |
$8.27
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.05
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$96.05
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.88
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$15.10
|
| Rate for Payer: Priority Health SBD |
$71.19
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC Core |
$23.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$14.39
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: UMR Bronson Commercial |
$41.81
|
| Rate for Payer: VA VA |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.75
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$113.00
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$101.70 |
| Rate for Payer: Aetna American Axle |
$73.45
|
| Rate for Payer: Aetna Commercial |
$96.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.45
|
| Rate for Payer: Cash Price |
$90.40
|
| Rate for Payer: Cofinity Commercial |
$79.10
|
| Rate for Payer: Cofinity Commercial |
$97.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.40
|
| Rate for Payer: Healthscope Commercial |
$101.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.05
|
| Rate for Payer: PHP Commercial |
$96.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.10
|
| Rate for Payer: Priority Health SBD |
$71.19
|
| Rate for Payer: UMR Bronson Commercial |
$49.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.75
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$14.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.01
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$14.41
|
| Rate for Payer: BCBS Trust/PPO |
$12.96
|
| Rate for Payer: BCN Medicare Advantage |
$14.41
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.41
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$7.88
|
| Rate for Payer: Mclaren Medicare |
$14.41
|
| Rate for Payer: Meridian Medicaid |
$8.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Medicare |
$13.69
|
| Rate for Payer: PACE SWMI |
$14.41
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$14.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
| Rate for Payer: Priority Health Medicare |
$14.41
|
| Rate for Payer: Priority Health Narrow Network |
$14.58
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: Railroad Medicare Medicare |
$14.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.29
|
| Rate for Payer: UHC Core |
$23.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.41
|
| Rate for Payer: UHC Exchange |
$14.41
|
| Rate for Payer: UHC Medicare Advantage |
$14.84
|
| Rate for Payer: UMR Bronson Commercial |
$15.10
|
| Rate for Payer: VA VA |
$14.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.95 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna American Axle |
$26.52
|
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.52
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health SBD |
$25.70
|
| Rate for Payer: UMR Bronson Commercial |
$17.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
IP
|
$519.09
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$228.40 |
| Max. Negotiated Rate |
$467.18 |
| Rate for Payer: Aetna American Axle |
$337.41
|
| Rate for Payer: Aetna Commercial |
$441.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.41
|
| Rate for Payer: Cash Price |
$415.27
|
| Rate for Payer: Cofinity Commercial |
$363.36
|
| Rate for Payer: Cofinity Commercial |
$446.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.27
|
| Rate for Payer: Healthscope Commercial |
$467.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$363.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$389.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$441.23
|
| Rate for Payer: PHP Commercial |
$441.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.36
|
| Rate for Payer: Priority Health SBD |
$327.03
|
| Rate for Payer: UMR Bronson Commercial |
$228.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$389.32
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
OP
|
$519.09
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$192.06 |
| Max. Negotiated Rate |
$582.71 |
| Rate for Payer: Aetna American Axle |
$337.41
|
| Rate for Payer: Aetna Commercial |
$441.23
|
| Rate for Payer: Aetna Medicare |
$484.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$337.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$582.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$582.71
|
| Rate for Payer: BCBS Complete |
$267.77
|
| Rate for Payer: BCBS MAPPO |
$466.17
|
| Rate for Payer: BCBS Trust/PPO |
$419.24
|
| Rate for Payer: BCN Medicare Advantage |
$466.17
|
| Rate for Payer: Cash Price |
$415.27
|
| Rate for Payer: Cash Price |
$415.27
|
| Rate for Payer: Cofinity Commercial |
$363.36
|
| Rate for Payer: Cofinity Commercial |
$446.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$415.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.17
|
| Rate for Payer: Healthscope Commercial |
$467.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$363.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$389.32
|
| Rate for Payer: Mclaren Medicaid |
$254.99
|
| Rate for Payer: Mclaren Medicare |
$466.17
|
| Rate for Payer: Meridian Medicaid |
$267.77
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$489.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$536.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$441.23
|
| Rate for Payer: PACE Medicare |
$442.86
|
| Rate for Payer: PACE SWMI |
$466.17
|
| Rate for Payer: PHP Commercial |
$441.23
|
| Rate for Payer: PHP Medicare Advantage |
$466.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$363.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$466.17
|
| Rate for Payer: Priority Health Medicare |
$466.17
|
| Rate for Payer: Priority Health Narrow Network |
$372.94
|
| Rate for Payer: Priority Health SBD |
$327.03
|
| Rate for Payer: Railroad Medicare Medicare |
$466.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$559.40
|
| Rate for Payer: UHC Core |
$559.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.17
|
| Rate for Payer: UHC Exchange |
$466.17
|
| Rate for Payer: UHC Medicare Advantage |
$480.16
|
| Rate for Payer: UMR Bronson Commercial |
$192.06
|
| Rate for Payer: VA VA |
$466.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$389.32
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
OP
|
$293.45
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$108.58 |
| Max. Negotiated Rate |
$264.10 |
| Rate for Payer: Aetna American Axle |
$190.74
|
| Rate for Payer: Aetna Commercial |
$249.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.74
|
| Rate for Payer: BCBS Complete |
$117.38
|
| Rate for Payer: Cash Price |
$234.76
|
| Rate for Payer: Cofinity Commercial |
$205.42
|
| Rate for Payer: Cofinity Commercial |
$252.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.76
|
| Rate for Payer: Healthscope Commercial |
$264.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.43
|
| Rate for Payer: PHP Commercial |
$249.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.42
|
| Rate for Payer: Priority Health SBD |
$184.87
|
| Rate for Payer: UMR Bronson Commercial |
$108.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.09
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
IP
|
$293.45
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$129.12 |
| Max. Negotiated Rate |
$264.10 |
| Rate for Payer: Aetna American Axle |
$190.74
|
| Rate for Payer: Aetna Commercial |
$249.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$190.74
|
| Rate for Payer: Cash Price |
$234.76
|
| Rate for Payer: Cofinity Commercial |
$205.42
|
| Rate for Payer: Cofinity Commercial |
$252.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.76
|
| Rate for Payer: Healthscope Commercial |
$264.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$205.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$249.43
|
| Rate for Payer: PHP Commercial |
$249.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.42
|
| Rate for Payer: Priority Health SBD |
$184.87
|
| Rate for Payer: UMR Bronson Commercial |
$129.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.09
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
IP
|
$1,300.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$572.00 |
| Max. Negotiated Rate |
$1,170.00 |
| Rate for Payer: Aetna American Axle |
$845.00
|
| Rate for Payer: Aetna Commercial |
$1,105.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.00
|
| Rate for Payer: Cash Price |
$1,040.00
|
| Rate for Payer: Cofinity Commercial |
$1,118.00
|
| Rate for Payer: Cofinity Commercial |
$910.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.00
|
| Rate for Payer: Healthscope Commercial |
$1,170.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$910.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$975.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.00
|
| Rate for Payer: PHP Commercial |
$1,105.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.00
|
| Rate for Payer: Priority Health SBD |
$819.00
|
| Rate for Payer: UMR Bronson Commercial |
$572.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$975.00
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
OP
|
$1,300.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$113.29 |
| Max. Negotiated Rate |
$1,539.60 |
| Rate for Payer: Aetna American Axle |
$845.00
|
| Rate for Payer: Aetna Commercial |
$1,105.00
|
| Rate for Payer: Aetna Medicare |
$508.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$845.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$611.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$611.32
|
| Rate for Payer: BCBS Complete |
$280.92
|
| Rate for Payer: BCBS MAPPO |
$489.06
|
| Rate for Payer: BCBS Trust/PPO |
$673.96
|
| Rate for Payer: BCN Medicare Advantage |
$489.06
|
| Rate for Payer: Cash Price |
$1,040.00
|
| Rate for Payer: Cash Price |
$1,040.00
|
| Rate for Payer: Cofinity Commercial |
$910.00
|
| Rate for Payer: Cofinity Commercial |
$1,118.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,040.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$489.06
|
| Rate for Payer: Healthscope Commercial |
$1,170.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$910.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$975.00
|
| Rate for Payer: Mclaren Medicaid |
$267.52
|
| Rate for Payer: Mclaren Medicare |
$489.06
|
| Rate for Payer: Meridian Medicaid |
$280.92
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$513.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$562.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,105.00
|
| Rate for Payer: PACE Medicare |
$464.61
|
| Rate for Payer: PACE SWMI |
$489.06
|
| Rate for Payer: PHP Commercial |
$1,105.00
|
| Rate for Payer: PHP Medicare Advantage |
$489.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$910.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,539.60
|
| Rate for Payer: Priority Health Medicare |
$489.06
|
| Rate for Payer: Priority Health Narrow Network |
$1,231.68
|
| Rate for Payer: Priority Health SBD |
$819.00
|
| Rate for Payer: Railroad Medicare Medicare |
$489.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$124.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$489.06
|
| Rate for Payer: UHC Exchange |
$113.29
|
| Rate for Payer: UHC Medicare Advantage |
$503.73
|
| Rate for Payer: UMR Bronson Commercial |
$481.00
|
| Rate for Payer: VA VA |
$489.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$975.00
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
OP
|
$7,910.00
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$419.13 |
| Max. Negotiated Rate |
$9,009.23 |
| Rate for Payer: Aetna American Axle |
$5,141.50
|
| Rate for Payer: Aetna Commercial |
$6,723.50
|
| Rate for Payer: Aetna Medicare |
$2,976.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,141.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,577.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,577.30
|
| Rate for Payer: BCBS Complete |
$1,643.84
|
| Rate for Payer: BCBS MAPPO |
$2,861.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,629.30
|
| Rate for Payer: BCN Medicare Advantage |
$2,861.84
|
| Rate for Payer: Cash Price |
$6,328.00
|
| Rate for Payer: Cash Price |
$6,328.00
|
| Rate for Payer: Cofinity Commercial |
$5,537.00
|
| Rate for Payer: Cofinity Commercial |
$6,802.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,328.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,861.84
|
| Rate for Payer: Healthscope Commercial |
$7,119.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,537.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,932.50
|
| Rate for Payer: Mclaren Medicaid |
$1,565.43
|
| Rate for Payer: Mclaren Medicare |
$2,861.84
|
| Rate for Payer: Meridian Medicaid |
$1,643.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,004.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,291.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,723.50
|
| Rate for Payer: PACE Medicare |
$2,718.75
|
| Rate for Payer: PACE SWMI |
$2,861.84
|
| Rate for Payer: PHP Commercial |
$6,723.50
|
| Rate for Payer: PHP Medicare Advantage |
$2,861.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,565.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,537.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,009.23
|
| Rate for Payer: Priority Health Medicare |
$2,861.84
|
| Rate for Payer: Priority Health Narrow Network |
$7,207.38
|
| Rate for Payer: Priority Health SBD |
$4,983.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2,861.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,861.84
|
| Rate for Payer: UHC Exchange |
$419.13
|
| Rate for Payer: UHC Medicare Advantage |
$2,947.70
|
| Rate for Payer: UMR Bronson Commercial |
$2,926.70
|
| Rate for Payer: VA VA |
$2,861.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,932.50
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
IP
|
$7,910.00
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,480.40 |
| Max. Negotiated Rate |
$7,119.00 |
| Rate for Payer: Aetna American Axle |
$5,141.50
|
| Rate for Payer: Aetna Commercial |
$6,723.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,141.50
|
| Rate for Payer: Cash Price |
$6,328.00
|
| Rate for Payer: Cofinity Commercial |
$5,537.00
|
| Rate for Payer: Cofinity Commercial |
$6,802.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,328.00
|
| Rate for Payer: Healthscope Commercial |
$7,119.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,537.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,932.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,723.50
|
| Rate for Payer: PHP Commercial |
$6,723.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,537.00
|
| Rate for Payer: Priority Health SBD |
$4,983.30
|
| Rate for Payer: UMR Bronson Commercial |
$3,480.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,932.50
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
OP
|
$497.59
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$184.11 |
| Max. Negotiated Rate |
$447.83 |
| Rate for Payer: Aetna American Axle |
$323.43
|
| Rate for Payer: Aetna Commercial |
$422.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.43
|
| Rate for Payer: BCBS Complete |
$199.04
|
| Rate for Payer: Cash Price |
$398.07
|
| Rate for Payer: Cofinity Commercial |
$348.31
|
| Rate for Payer: Cofinity Commercial |
$427.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.07
|
| Rate for Payer: Healthscope Commercial |
$447.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$348.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$422.95
|
| Rate for Payer: PHP Commercial |
$422.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.31
|
| Rate for Payer: Priority Health SBD |
$313.48
|
| Rate for Payer: UMR Bronson Commercial |
$184.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.19
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
IP
|
$497.59
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$218.94 |
| Max. Negotiated Rate |
$447.83 |
| Rate for Payer: Aetna American Axle |
$323.43
|
| Rate for Payer: Aetna Commercial |
$422.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$323.43
|
| Rate for Payer: Cash Price |
$398.07
|
| Rate for Payer: Cofinity Commercial |
$348.31
|
| Rate for Payer: Cofinity Commercial |
$427.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$398.07
|
| Rate for Payer: Healthscope Commercial |
$447.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$348.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$373.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$422.95
|
| Rate for Payer: PHP Commercial |
$422.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.31
|
| Rate for Payer: Priority Health SBD |
$313.48
|
| Rate for Payer: UMR Bronson Commercial |
$218.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$373.19
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
OP
|
$174.08
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$34.05 |
| Max. Negotiated Rate |
$683.51 |
| Rate for Payer: Aetna American Axle |
$113.15
|
| Rate for Payer: Aetna Commercial |
$147.97
|
| Rate for Payer: Aetna Medicare |
$225.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$271.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$271.40
|
| Rate for Payer: BCBS Complete |
$124.71
|
| Rate for Payer: BCBS MAPPO |
$217.12
|
| Rate for Payer: BCBS Trust/PPO |
$142.11
|
| Rate for Payer: BCN Medicare Advantage |
$217.12
|
| Rate for Payer: Cash Price |
$139.26
|
| Rate for Payer: Cash Price |
$139.26
|
| Rate for Payer: Cofinity Commercial |
$121.86
|
| Rate for Payer: Cofinity Commercial |
$149.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$217.12
|
| Rate for Payer: Healthscope Commercial |
$156.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.56
|
| Rate for Payer: Mclaren Medicaid |
$118.76
|
| Rate for Payer: Mclaren Medicare |
$217.12
|
| Rate for Payer: Meridian Medicaid |
$124.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$227.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.97
|
| Rate for Payer: PACE Medicare |
$206.26
|
| Rate for Payer: PACE SWMI |
$217.12
|
| Rate for Payer: PHP Commercial |
$147.97
|
| Rate for Payer: PHP Medicare Advantage |
$217.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$683.51
|
| Rate for Payer: Priority Health Medicare |
$217.12
|
| Rate for Payer: Priority Health Narrow Network |
$546.81
|
| Rate for Payer: Priority Health SBD |
$109.67
|
| Rate for Payer: Railroad Medicare Medicare |
$217.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$217.12
|
| Rate for Payer: UHC Exchange |
$34.05
|
| Rate for Payer: UHC Medicare Advantage |
$223.63
|
| Rate for Payer: UMR Bronson Commercial |
$64.41
|
| Rate for Payer: VA VA |
$217.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.56
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
IP
|
$174.08
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$76.60 |
| Max. Negotiated Rate |
$156.67 |
| Rate for Payer: Aetna American Axle |
$113.15
|
| Rate for Payer: Aetna Commercial |
$147.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$113.15
|
| Rate for Payer: Cash Price |
$139.26
|
| Rate for Payer: Cofinity Commercial |
$121.86
|
| Rate for Payer: Cofinity Commercial |
$149.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.26
|
| Rate for Payer: Healthscope Commercial |
$156.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$121.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$147.97
|
| Rate for Payer: PHP Commercial |
$147.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.86
|
| Rate for Payer: Priority Health SBD |
$109.67
|
| Rate for Payer: UMR Bronson Commercial |
$76.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.56
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: BCBS Trust/PPO |
$10.09
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.00
|
| Rate for Payer: Priority Health Narrow Network |
$12.00
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$13.75
|
| Rate for Payer: UMR Bronson Commercial |
$43.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$51.61 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.11
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UMR Bronson Commercial |
$51.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$369.91 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$122.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.88
|
| Rate for Payer: BCBS Complete |
$67.49
|
| Rate for Payer: BCBS MAPPO |
$117.50
|
| Rate for Payer: BCN Medicare Advantage |
$117.50
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.50
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Mclaren Medicaid |
$64.27
|
| Rate for Payer: Mclaren Medicare |
$117.50
|
| Rate for Payer: Meridian Medicaid |
$67.49
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$123.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.70
|
| Rate for Payer: PACE Medicare |
$111.62
|
| Rate for Payer: PACE SWMI |
$117.50
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$117.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$369.91
|
| Rate for Payer: Priority Health Medicare |
$117.50
|
| Rate for Payer: Priority Health Narrow Network |
$295.93
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: Railroad Medicare Medicare |
$117.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$117.50
|
| Rate for Payer: UHC Exchange |
$136.22
|
| Rate for Payer: UHC Medicare Advantage |
$121.02
|
| Rate for Payer: UMR Bronson Commercial |
$43.40
|
| Rate for Payer: VA VA |
$117.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$51.61 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.11
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UMR Bronson Commercial |
$51.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
