|
HC MENENCEPH CMPT 6
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200257
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 6
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200257
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.34 |
| Max. Negotiated Rate |
$19.79 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$13.19
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.19
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: Priority Health Tiered Network |
$10.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.79
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.19
|
| Rate for Payer: UHC Exchange |
$19.79
|
| Rate for Payer: UHC Medicaid |
$6.90
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$5.34
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 7
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200282
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.34 |
| Max. Negotiated Rate |
$19.79 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$15.24
|
| Rate for Payer: BCN Commercial |
$15.24
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$13.19
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$13.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$19.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.19
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: Priority Health Tiered Network |
$10.55
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.79
|
| Rate for Payer: UHC Core |
$19.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.19
|
| Rate for Payer: UHC Exchange |
$19.79
|
| Rate for Payer: UHC Medicaid |
$6.90
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$5.34
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 7
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200282
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 8
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200284
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.34 |
| Max. Negotiated Rate |
$29.03 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.63
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$22.36
|
| Rate for Payer: BCN Commercial |
$22.36
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$19.35
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$20.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.35
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: Priority Health Tiered Network |
$15.48
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.03
|
| Rate for Payer: UHC Core |
$29.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.35
|
| Rate for Payer: UHC Exchange |
$29.03
|
| Rate for Payer: UHC Medicaid |
$10.12
|
| Rate for Payer: UHCCP Medicaid |
$10.12
|
| Rate for Payer: UMR Bronson Commercial |
$5.34
|
| Rate for Payer: VA VA |
$19.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 8
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200284
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 9
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
30200304
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.34 |
| Max. Negotiated Rate |
$19.31 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$14.87
|
| Rate for Payer: BCN Commercial |
$14.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$12.87
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$13.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.87
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: Priority Health Tiered Network |
$10.30
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.31
|
| Rate for Payer: UHC Core |
$19.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.31
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: UMR Bronson Commercial |
$5.34
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENENCEPH CMPT 9
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
30200304
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENIGOCOCCAL, QUADRIVALENT (MCV4 OR MENACWY) IM
|
Facility
|
IP
|
$163.42
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
63600085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$71.90 |
| Max. Negotiated Rate |
$147.08 |
| Rate for Payer: Aetna American Axle |
$106.22
|
| Rate for Payer: Aetna Commercial |
$138.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.22
|
| Rate for Payer: Cash Price |
$130.74
|
| Rate for Payer: Cofinity Advantage |
$114.39
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.74
|
| Rate for Payer: Healthscope Commercial |
$147.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.56
|
| Rate for Payer: PHP Commercial |
$138.91
|
| Rate for Payer: Priority Health SBD |
$102.95
|
| Rate for Payer: UMR Bronson Commercial |
$71.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.56
|
|
|
HC MENIGOCOCCAL, QUADRIVALENT (MCV4 OR MENACWY) IM
|
Facility
|
OP
|
$163.42
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
63600085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.47 |
| Max. Negotiated Rate |
$530.70 |
| Rate for Payer: Aetna American Axle |
$106.22
|
| Rate for Payer: Aetna Commercial |
$138.91
|
| Rate for Payer: Aetna Medicare |
$81.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.22
|
| Rate for Payer: BCBS Complete |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$530.70
|
| Rate for Payer: BCN Commercial |
$530.70
|
| Rate for Payer: Cash Price |
$130.74
|
| Rate for Payer: Cash Price |
$130.74
|
| Rate for Payer: Cofinity Advantage |
$114.39
|
| Rate for Payer: Cofinity Commercial |
$140.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.74
|
| Rate for Payer: Healthscope Commercial |
$147.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$130.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.56
|
| Rate for Payer: PHP Commercial |
$138.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$189.95
|
| Rate for Payer: Priority Health SBD |
$102.95
|
| Rate for Payer: Priority Health Tiered Network |
$151.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$349.64
|
| Rate for Payer: UHC Core |
$349.64
|
| Rate for Payer: UHC Exchange |
$349.64
|
| Rate for Payer: UMR Bronson Commercial |
$60.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.56
|
|
|
HC MENINGITIS/ENCEPHALITIS PANEL
|
Facility
|
OP
|
$746.09
|
|
|
Service Code
|
CPT 87483
|
| Hospital Charge Code |
30600287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$217.98 |
| Max. Negotiated Rate |
$671.48 |
| Rate for Payer: Aetna American Axle |
$484.96
|
| Rate for Payer: Aetna Commercial |
$634.18
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$228.90
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$481.79
|
| Rate for Payer: BCN Commercial |
$481.79
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$596.87
|
| Rate for Payer: Cash Price |
$596.87
|
| Rate for Payer: Cofinity Advantage |
$522.26
|
| Rate for Payer: Cofinity Commercial |
$641.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$671.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$522.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.57
|
| Rate for Payer: Mclaren Medicaid |
$416.78
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$458.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.18
|
| Rate for Payer: Nomi Health Commercial |
$625.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$559.57
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$634.18
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$416.78
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health SBD |
$470.04
|
| Rate for Payer: Priority Health Tiered Network |
$333.42
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.17
|
| Rate for Payer: UHC Core |
$625.17
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$416.78
|
| Rate for Payer: UHC Exchange |
$625.17
|
| Rate for Payer: UHC Medicaid |
$217.98
|
| Rate for Payer: UHCCP Medicaid |
$217.98
|
| Rate for Payer: UMR Bronson Commercial |
$276.05
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.57
|
|
|
HC MENINGITIS/ENCEPHALITIS PANEL
|
Facility
|
IP
|
$746.09
|
|
|
Service Code
|
CPT 87483
|
| Hospital Charge Code |
30600287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$328.28 |
| Max. Negotiated Rate |
$671.48 |
| Rate for Payer: Aetna American Axle |
$484.96
|
| Rate for Payer: Aetna Commercial |
$634.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$484.96
|
| Rate for Payer: Cash Price |
$596.87
|
| Rate for Payer: Cofinity Advantage |
$522.26
|
| Rate for Payer: Cofinity Commercial |
$641.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.87
|
| Rate for Payer: Healthscope Commercial |
$671.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$522.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$634.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$559.57
|
| Rate for Payer: PHP Commercial |
$634.18
|
| Rate for Payer: Priority Health SBD |
$470.04
|
| Rate for Payer: UMR Bronson Commercial |
$328.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.57
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
OP
|
$14.43
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.34 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.25
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$19.48
|
| Rate for Payer: BCN Commercial |
$19.48
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Mclaren Medicaid |
$16.85
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$17.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Nomi Health Commercial |
$25.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.85
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: Priority Health Tiered Network |
$13.48
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.28
|
| Rate for Payer: UHC Core |
$25.28
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.85
|
| Rate for Payer: UHC Exchange |
$25.28
|
| Rate for Payer: UHC Medicaid |
$8.81
|
| Rate for Payer: UHCCP Medicaid |
$8.81
|
| Rate for Payer: UMR Bronson Commercial |
$5.34
|
| Rate for Payer: VA VA |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
IP
|
$14.43
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$12.99 |
| Rate for Payer: Aetna American Axle |
$9.38
|
| Rate for Payer: Aetna Commercial |
$12.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.38
|
| Rate for Payer: Cash Price |
$11.54
|
| Rate for Payer: Cofinity Advantage |
$10.10
|
| Rate for Payer: Cofinity Commercial |
$12.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.54
|
| Rate for Payer: Healthscope Commercial |
$12.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.82
|
| Rate for Payer: PHP Commercial |
$12.27
|
| Rate for Payer: Priority Health SBD |
$9.09
|
| Rate for Payer: UMR Bronson Commercial |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.82
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
OP
|
$9.55
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200218
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$19.31 |
| Rate for Payer: Aetna American Axle |
$6.21
|
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$14.87
|
| Rate for Payer: BCN Commercial |
$14.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cofinity Advantage |
$6.68
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: Mclaren Medicaid |
$12.87
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$13.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.87
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health SBD |
$6.02
|
| Rate for Payer: Priority Health Tiered Network |
$10.30
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.31
|
| Rate for Payer: UHC Core |
$19.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.31
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: UMR Bronson Commercial |
$3.53
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
IP
|
$9.55
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200218
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$8.60 |
| Rate for Payer: Aetna American Axle |
$6.21
|
| Rate for Payer: Aetna Commercial |
$8.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.21
|
| Rate for Payer: Cash Price |
$7.64
|
| Rate for Payer: Cofinity Advantage |
$6.68
|
| Rate for Payer: Cofinity Commercial |
$8.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.64
|
| Rate for Payer: Healthscope Commercial |
$8.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.16
|
| Rate for Payer: PHP Commercial |
$8.12
|
| Rate for Payer: Priority Health SBD |
$6.02
|
| Rate for Payer: UMR Bronson Commercial |
$4.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.16
|
|
|
HC MENINGOENCEPHALITIS PANEL SERUM
|
Facility
|
IP
|
$14.86
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200217
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.54 |
| Max. Negotiated Rate |
$13.37 |
| Rate for Payer: Aetna American Axle |
$9.66
|
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.66
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Advantage |
$10.40
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: Priority Health SBD |
$9.36
|
| Rate for Payer: UMR Bronson Commercial |
$6.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC MENINGOENCEPHALITIS PANEL SERUM
|
Facility
|
OP
|
$14.86
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200217
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$19.31 |
| Rate for Payer: Aetna American Axle |
$9.66
|
| Rate for Payer: Aetna Commercial |
$12.63
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$14.87
|
| Rate for Payer: BCN Commercial |
$14.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cash Price |
$11.89
|
| Rate for Payer: Cofinity Advantage |
$10.40
|
| Rate for Payer: Cofinity Commercial |
$12.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$13.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.14
|
| Rate for Payer: Mclaren Medicaid |
$12.87
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$13.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.63
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.14
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$12.63
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.87
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health SBD |
$9.36
|
| Rate for Payer: Priority Health Tiered Network |
$10.30
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.31
|
| Rate for Payer: UHC Core |
$19.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.87
|
| Rate for Payer: UHC Exchange |
$19.31
|
| Rate for Payer: UHC Medicaid |
$6.73
|
| Rate for Payer: UHCCP Medicaid |
$6.73
|
| Rate for Payer: UMR Bronson Commercial |
$5.50
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.14
|
|
|
HC MERCURY
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.41 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna American Axle |
$33.11
|
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.11
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Advantage |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health SBD |
$32.09
|
| Rate for Payer: UMR Bronson Commercial |
$22.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC MERCURY
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.50 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna American Axle |
$33.11
|
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS Trust/PPO |
$18.80
|
| Rate for Payer: BCN Commercial |
$18.80
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Advantage |
$35.66
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$16.26
|
| Rate for Payer: Mclaren Medicare |
$16.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: Meridian Medicaid |
$17.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$24.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Medicare |
$15.45
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.26
|
| Rate for Payer: Priority Health Medicare |
$16.26
|
| Rate for Payer: Priority Health SBD |
$32.09
|
| Rate for Payer: Priority Health Tiered Network |
$13.01
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.39
|
| Rate for Payer: UHC Core |
$24.39
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.26
|
| Rate for Payer: UHC Exchange |
$24.39
|
| Rate for Payer: UHC Medicaid |
$8.50
|
| Rate for Payer: UHCCP Medicaid |
$8.50
|
| Rate for Payer: UMR Bronson Commercial |
$18.85
|
| Rate for Payer: VA VA |
$16.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC MESH
|
Facility
|
IP
|
$4,739.23
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27800022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,085.26 |
| Max. Negotiated Rate |
$4,265.31 |
| Rate for Payer: Aetna American Axle |
$3,080.50
|
| Rate for Payer: Aetna Commercial |
$4,028.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,080.50
|
| Rate for Payer: Cash Price |
$3,791.38
|
| Rate for Payer: Cofinity Advantage |
$3,317.46
|
| Rate for Payer: Cofinity Commercial |
$4,075.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,791.38
|
| Rate for Payer: Healthscope Commercial |
$4,265.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,317.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,554.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,028.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,554.42
|
| Rate for Payer: PHP Commercial |
$4,028.35
|
| Rate for Payer: Priority Health SBD |
$2,985.71
|
| Rate for Payer: UMR Bronson Commercial |
$2,085.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,554.42
|
|
|
HC MESH
|
Facility
|
OP
|
$4,739.23
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27800022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,753.52 |
| Max. Negotiated Rate |
$4,265.31 |
| Rate for Payer: Aetna American Axle |
$3,080.50
|
| Rate for Payer: Aetna Commercial |
$4,028.35
|
| Rate for Payer: Aetna Medicare |
$2,369.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,080.50
|
| Rate for Payer: BCBS Complete |
$1,895.69
|
| Rate for Payer: Cash Price |
$3,791.38
|
| Rate for Payer: Cofinity Advantage |
$3,317.46
|
| Rate for Payer: Cofinity Commercial |
$4,075.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,791.38
|
| Rate for Payer: Healthscope Commercial |
$4,265.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,317.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,554.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,791.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,028.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,554.42
|
| Rate for Payer: PHP Commercial |
$4,028.35
|
| Rate for Payer: Priority Health SBD |
$2,985.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,080.50
|
| Rate for Payer: UHC Core |
$2,469.14
|
| Rate for Payer: UHC Exchange |
$1,862.52
|
| Rate for Payer: UMR Bronson Commercial |
$1,753.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,554.42
|
|
|
HC METANEB SUPPLY
|
Facility
|
OP
|
$264.46
|
|
| Hospital Charge Code |
27000466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$97.85 |
| Max. Negotiated Rate |
$238.01 |
| Rate for Payer: Aetna American Axle |
$171.90
|
| Rate for Payer: Aetna Commercial |
$224.79
|
| Rate for Payer: Aetna Medicare |
$132.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.90
|
| Rate for Payer: BCBS Complete |
$105.78
|
| Rate for Payer: Cash Price |
$211.57
|
| Rate for Payer: Cofinity Advantage |
$185.12
|
| Rate for Payer: Cofinity Commercial |
$227.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.57
|
| Rate for Payer: Healthscope Commercial |
$238.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$211.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.34
|
| Rate for Payer: PHP Commercial |
$224.79
|
| Rate for Payer: Priority Health SBD |
$166.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$171.90
|
| Rate for Payer: UHC Core |
$137.78
|
| Rate for Payer: UHC Exchange |
$103.93
|
| Rate for Payer: UMR Bronson Commercial |
$97.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.34
|
|
|
HC METANEB SUPPLY
|
Facility
|
IP
|
$264.46
|
|
| Hospital Charge Code |
27000466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$116.36 |
| Max. Negotiated Rate |
$238.01 |
| Rate for Payer: Aetna American Axle |
$171.90
|
| Rate for Payer: Aetna Commercial |
$224.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$171.90
|
| Rate for Payer: Cash Price |
$211.57
|
| Rate for Payer: Cofinity Advantage |
$185.12
|
| Rate for Payer: Cofinity Commercial |
$227.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.57
|
| Rate for Payer: Healthscope Commercial |
$238.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$185.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.34
|
| Rate for Payer: PHP Commercial |
$224.79
|
| Rate for Payer: Priority Health SBD |
$166.61
|
| Rate for Payer: UMR Bronson Commercial |
$116.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.34
|
|
|
HC METANEPHRINES FRACTIONATION URINE
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100297
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna American Axle |
$30.36
|
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.18
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$16.94
|
| Rate for Payer: BCBS Trust/PPO |
$19.59
|
| Rate for Payer: BCN Commercial |
$19.59
|
| Rate for Payer: BCN Medicare Advantage |
$16.94
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Advantage |
$32.69
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Mclaren Medicaid |
$16.94
|
| Rate for Payer: Mclaren Medicare |
$16.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.79
|
| Rate for Payer: Meridian Medicaid |
$17.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$25.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Medicare |
$16.09
|
| Rate for Payer: PACE SWMI |
$16.94
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$16.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.94
|
| Rate for Payer: Priority Health Medicare |
$16.94
|
| Rate for Payer: Priority Health SBD |
$29.42
|
| Rate for Payer: Priority Health Tiered Network |
$13.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.41
|
| Rate for Payer: UHC Core |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.94
|
| Rate for Payer: UHC Exchange |
$25.41
|
| Rate for Payer: UHC Medicaid |
$8.86
|
| Rate for Payer: UHCCP Medicaid |
$8.86
|
| Rate for Payer: UMR Bronson Commercial |
$17.28
|
| Rate for Payer: VA VA |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
