|
HC METANEPHRINES FRACTIONATION URINE
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100297
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.55 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna American Axle |
$30.36
|
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| 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: 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: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health SBD |
$29.42
|
| Rate for Payer: UMR Bronson Commercial |
$20.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC METANEPHRINES PLASMA
|
Facility
|
OP
|
$63.46
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna American Axle |
$41.25
|
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| 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 |
$50.77
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Advantage |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| 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 |
$53.94
|
| Rate for Payer: Nomi Health Commercial |
$25.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PACE Medicare |
$16.09
|
| Rate for Payer: PACE SWMI |
$16.94
|
| Rate for Payer: PHP Commercial |
$53.94
|
| 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 |
$39.98
|
| 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 |
$23.48
|
| Rate for Payer: VA VA |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC METANEPHRINES PLASMA
|
Facility
|
IP
|
$63.46
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.92 |
| Max. Negotiated Rate |
$57.11 |
| Rate for Payer: Aetna American Axle |
$41.25
|
| Rate for Payer: Aetna Commercial |
$53.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.25
|
| Rate for Payer: Cash Price |
$50.77
|
| Rate for Payer: Cofinity Advantage |
$44.42
|
| Rate for Payer: Cofinity Commercial |
$54.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.77
|
| Rate for Payer: Healthscope Commercial |
$57.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.59
|
| Rate for Payer: PHP Commercial |
$53.94
|
| Rate for Payer: Priority Health SBD |
$39.98
|
| Rate for Payer: UMR Bronson Commercial |
$27.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.59
|
|
|
HC METANEPHRINES URINE
|
Facility
|
IP
|
$54.12
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.81 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Aetna American Axle |
$35.18
|
| Rate for Payer: Aetna Commercial |
$46.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.18
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Advantage |
$37.88
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Healthscope Commercial |
$48.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PHP Commercial |
$46.00
|
| Rate for Payer: Priority Health SBD |
$34.10
|
| Rate for Payer: UMR Bronson Commercial |
$23.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.59
|
|
|
HC METANEPHRINES URINE
|
Facility
|
OP
|
$54.12
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$48.71 |
| Rate for Payer: Aetna American Axle |
$35.18
|
| Rate for Payer: Aetna Commercial |
$46.00
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.18
|
| 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 |
$43.30
|
| Rate for Payer: Cash Price |
$43.30
|
| Rate for Payer: Cofinity Advantage |
$37.88
|
| Rate for Payer: Cofinity Commercial |
$46.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$48.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.59
|
| 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 |
$46.00
|
| Rate for Payer: Nomi Health Commercial |
$25.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$40.59
|
| Rate for Payer: PACE Medicare |
$16.09
|
| Rate for Payer: PACE SWMI |
$16.94
|
| Rate for Payer: PHP Commercial |
$46.00
|
| 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 |
$34.10
|
| 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 |
$20.02
|
| Rate for Payer: VA VA |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.59
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
OP
|
$1,834.95
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$678.93 |
| Max. Negotiated Rate |
$13,077.42 |
| Rate for Payer: Aetna American Axle |
$1,192.72
|
| Rate for Payer: Aetna Commercial |
$1,559.71
|
| Rate for Payer: Aetna Medicare |
$4,312.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,182.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,182.93
|
| Rate for Payer: BCBS Complete |
$2,277.17
|
| Rate for Payer: BCBS MAPPO |
$4,146.34
|
| Rate for Payer: BCBS Trust/PPO |
$6,390.75
|
| Rate for Payer: BCN Commercial |
$6,390.75
|
| Rate for Payer: BCN Medicare Advantage |
$4,146.34
|
| Rate for Payer: Cash Price |
$1,467.96
|
| Rate for Payer: Cash Price |
$1,467.96
|
| Rate for Payer: Cofinity Advantage |
$1,284.46
|
| Rate for Payer: Cofinity Commercial |
$1,578.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,146.34
|
| Rate for Payer: Healthscope Commercial |
$1,651.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,284.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,376.21
|
| Rate for Payer: Mclaren Medicaid |
$4,146.34
|
| Rate for Payer: Mclaren Medicare |
$4,146.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,353.66
|
| Rate for Payer: Meridian Medicaid |
$4,353.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,768.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$4,560.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.71
|
| Rate for Payer: Nomi Health Commercial |
$12,439.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,376.21
|
| Rate for Payer: PACE Medicare |
$3,939.02
|
| Rate for Payer: PACE SWMI |
$4,146.34
|
| Rate for Payer: PHP Commercial |
$1,559.71
|
| Rate for Payer: PHP Medicare Advantage |
$4,146.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,168.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13,077.42
|
| Rate for Payer: Priority Health Medicare |
$4,146.34
|
| Rate for Payer: Priority Health SBD |
$1,156.02
|
| Rate for Payer: Priority Health Tiered Network |
$10,461.94
|
| Rate for Payer: Railroad Medicare Medicare |
$4,146.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,841.46
|
| Rate for Payer: UHC Core |
$6,841.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4,146.34
|
| Rate for Payer: UHC Exchange |
$6,841.46
|
| Rate for Payer: UHC Medicaid |
$2,168.54
|
| Rate for Payer: UHCCP Medicaid |
$2,168.54
|
| Rate for Payer: UMR Bronson Commercial |
$678.93
|
| Rate for Payer: VA VA |
$4,146.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,376.21
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
IP
|
$1,834.95
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$807.38 |
| Max. Negotiated Rate |
$1,651.45 |
| Rate for Payer: Aetna American Axle |
$1,192.72
|
| Rate for Payer: Aetna Commercial |
$1,559.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,192.72
|
| Rate for Payer: Cash Price |
$1,467.96
|
| Rate for Payer: Cofinity Advantage |
$1,284.46
|
| Rate for Payer: Cofinity Commercial |
$1,578.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,467.96
|
| Rate for Payer: Healthscope Commercial |
$1,651.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,284.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,376.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,559.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,376.21
|
| Rate for Payer: PHP Commercial |
$1,559.71
|
| Rate for Payer: Priority Health SBD |
$1,156.02
|
| Rate for Payer: UMR Bronson Commercial |
$807.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,376.21
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$59.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Advantage |
$83.75
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: UMR Bronson Commercial |
$44.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Advantage |
$83.75
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: UMR Bronson Commercial |
$52.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$93.21 |
| Rate for Payer: Aetna American Axle |
$62.67
|
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.84
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Advantage |
$67.49
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$60.74
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: UMR Bronson Commercial |
$35.68
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.42 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna American Axle |
$62.67
|
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.67
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Advantage |
$67.49
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: Priority Health SBD |
$60.74
|
| Rate for Payer: UMR Bronson Commercial |
$42.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC METHADONE SCRN URN
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC METHADONE SCRN URN
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$14.57
|
| Rate for Payer: BCN Commercial |
$14.57
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$12.60
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$10.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.90
|
| Rate for Payer: UHC Core |
$18.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicaid |
$6.59
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
IP
|
$81.15
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.71 |
| Max. Negotiated Rate |
$73.03 |
| Rate for Payer: Aetna American Axle |
$52.75
|
| Rate for Payer: Aetna Commercial |
$68.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.75
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Advantage |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$69.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Healthscope Commercial |
$73.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.86
|
| Rate for Payer: PHP Commercial |
$68.98
|
| Rate for Payer: Priority Health SBD |
$51.12
|
| Rate for Payer: UMR Bronson Commercial |
$35.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.86
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
OP
|
$81.15
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.03 |
| Max. Negotiated Rate |
$73.03 |
| Rate for Payer: Aetna American Axle |
$52.75
|
| Rate for Payer: Aetna Commercial |
$68.98
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.75
|
| Rate for Payer: BCBS Complete |
$32.46
|
| Rate for Payer: Cash Price |
$64.92
|
| Rate for Payer: Cofinity Advantage |
$56.80
|
| Rate for Payer: Cofinity Commercial |
$69.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.92
|
| Rate for Payer: Healthscope Commercial |
$73.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.86
|
| Rate for Payer: PHP Commercial |
$68.98
|
| Rate for Payer: Priority Health SBD |
$51.12
|
| Rate for Payer: UMR Bronson Commercial |
$30.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.86
|
|
|
HC METHADONE URN
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.10 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$31.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: BCBS Complete |
$24.97
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC METHADONE URN
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Advantage |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC METHANOL LVL
|
Facility
|
IP
|
$162.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.41 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Aetna American Axle |
$105.50
|
| Rate for Payer: Aetna Commercial |
$137.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.50
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Advantage |
$113.61
|
| Rate for Payer: Cofinity Commercial |
$139.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$146.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.72
|
| Rate for Payer: PHP Commercial |
$137.96
|
| Rate for Payer: Priority Health SBD |
$102.25
|
| Rate for Payer: UMR Bronson Commercial |
$71.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.72
|
|
|
HC METHANOL LVL
|
Facility
|
OP
|
$162.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$60.05 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Aetna American Axle |
$105.50
|
| Rate for Payer: Aetna Commercial |
$137.96
|
| Rate for Payer: Aetna Medicare |
$81.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$105.50
|
| Rate for Payer: BCBS Complete |
$64.92
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Advantage |
$113.61
|
| Rate for Payer: Cofinity Commercial |
$139.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$146.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$129.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.72
|
| Rate for Payer: PHP Commercial |
$137.96
|
| Rate for Payer: Priority Health SBD |
$102.25
|
| Rate for Payer: UMR Bronson Commercial |
$60.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.72
|
|
|
HC METHEMOGLOBIN
|
Facility
|
OP
|
$47.96
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.29 |
| Max. Negotiated Rate |
$43.16 |
| Rate for Payer: Aetna American Axle |
$31.17
|
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna Medicare |
$8.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.25
|
| Rate for Payer: BCBS Complete |
$4.50
|
| Rate for Payer: BCBS MAPPO |
$8.20
|
| Rate for Payer: BCBS Trust/PPO |
$9.48
|
| Rate for Payer: BCN Commercial |
$9.48
|
| Rate for Payer: BCN Medicare Advantage |
$8.20
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cofinity Advantage |
$33.57
|
| Rate for Payer: Cofinity Commercial |
$41.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.20
|
| Rate for Payer: Healthscope Commercial |
$43.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.97
|
| Rate for Payer: Mclaren Medicaid |
$8.20
|
| Rate for Payer: Mclaren Medicare |
$8.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.61
|
| Rate for Payer: Meridian Medicaid |
$8.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.77
|
| Rate for Payer: Nomi Health Commercial |
$12.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.97
|
| Rate for Payer: PACE Medicare |
$7.79
|
| Rate for Payer: PACE SWMI |
$8.20
|
| Rate for Payer: PHP Commercial |
$40.77
|
| Rate for Payer: PHP Medicare Advantage |
$8.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.20
|
| Rate for Payer: Priority Health Medicare |
$8.20
|
| Rate for Payer: Priority Health SBD |
$30.21
|
| Rate for Payer: Priority Health Tiered Network |
$6.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.30
|
| Rate for Payer: UHC Core |
$12.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.20
|
| Rate for Payer: UHC Exchange |
$12.30
|
| Rate for Payer: UHC Medicaid |
$4.29
|
| Rate for Payer: UHCCP Medicaid |
$4.29
|
| Rate for Payer: UMR Bronson Commercial |
$17.75
|
| Rate for Payer: VA VA |
$8.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.97
|
|
|
HC METHEMOGLOBIN
|
Facility
|
IP
|
$47.96
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.10 |
| Max. Negotiated Rate |
$43.16 |
| Rate for Payer: Aetna American Axle |
$31.17
|
| Rate for Payer: Aetna Commercial |
$40.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.17
|
| Rate for Payer: Cash Price |
$38.37
|
| Rate for Payer: Cofinity Advantage |
$33.57
|
| Rate for Payer: Cofinity Commercial |
$41.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.37
|
| Rate for Payer: Healthscope Commercial |
$43.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.97
|
| Rate for Payer: PHP Commercial |
$40.77
|
| Rate for Payer: Priority Health SBD |
$30.21
|
| Rate for Payer: UMR Bronson Commercial |
$21.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.97
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
IP
|
$180.51
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$79.42 |
| Max. Negotiated Rate |
$162.46 |
| Rate for Payer: Aetna American Axle |
$117.33
|
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.33
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cofinity Advantage |
$126.36
|
| Rate for Payer: Cofinity Commercial |
$155.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.41
|
| Rate for Payer: Healthscope Commercial |
$162.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.38
|
| Rate for Payer: PHP Commercial |
$153.43
|
| Rate for Payer: Priority Health SBD |
$113.72
|
| Rate for Payer: UMR Bronson Commercial |
$79.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.38
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
OP
|
$180.51
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$162.46 |
| Rate for Payer: Aetna American Axle |
$117.33
|
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$117.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$21.55
|
| Rate for Payer: BCN Commercial |
$21.55
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cofinity Advantage |
$126.36
|
| Rate for Payer: Cofinity Commercial |
$155.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$162.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$126.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.38
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.43
|
| Rate for Payer: Nomi Health Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.38
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$153.43
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$113.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.96
|
| Rate for Payer: UHC Core |
$27.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.64
|
| Rate for Payer: UHC Exchange |
$27.96
|
| Rate for Payer: UHC Medicaid |
$9.75
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: UMR Bronson Commercial |
$66.79
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.38
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
IP
|
$63.58
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.98 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna American Axle |
$41.33
|
| Rate for Payer: Aetna Commercial |
$54.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.33
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Advantage |
$44.51
|
| Rate for Payer: Cofinity Commercial |
$54.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.69
|
| Rate for Payer: PHP Commercial |
$54.04
|
| Rate for Payer: Priority Health SBD |
$40.06
|
| Rate for Payer: UMR Bronson Commercial |
$27.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.69
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
OP
|
$63.58
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.09 |
| Max. Negotiated Rate |
$57.22 |
| Rate for Payer: Aetna American Axle |
$41.33
|
| Rate for Payer: Aetna Commercial |
$54.04
|
| Rate for Payer: Aetna Medicare |
$22.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.51
|
| Rate for Payer: BCBS Complete |
$11.65
|
| Rate for Payer: BCBS MAPPO |
$21.21
|
| Rate for Payer: BCBS Trust/PPO |
$24.52
|
| Rate for Payer: BCN Commercial |
$24.52
|
| Rate for Payer: BCN Medicare Advantage |
$21.21
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cash Price |
$50.86
|
| Rate for Payer: Cofinity Advantage |
$44.51
|
| Rate for Payer: Cofinity Commercial |
$54.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.21
|
| Rate for Payer: Healthscope Commercial |
$57.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.69
|
| Rate for Payer: Mclaren Medicaid |
$21.21
|
| Rate for Payer: Mclaren Medicare |
$21.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.27
|
| Rate for Payer: Meridian Medicaid |
$22.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.04
|
| Rate for Payer: Nomi Health Commercial |
$31.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.69
|
| Rate for Payer: PACE Medicare |
$20.15
|
| Rate for Payer: PACE SWMI |
$21.21
|
| Rate for Payer: PHP Commercial |
$54.04
|
| Rate for Payer: PHP Medicare Advantage |
$21.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.21
|
| Rate for Payer: Priority Health Medicare |
$21.21
|
| Rate for Payer: Priority Health SBD |
$40.06
|
| Rate for Payer: Priority Health Tiered Network |
$16.97
|
| Rate for Payer: Railroad Medicare Medicare |
$21.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.82
|
| Rate for Payer: UHC Core |
$31.82
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.21
|
| Rate for Payer: UHC Exchange |
$31.82
|
| Rate for Payer: UHC Medicaid |
$11.09
|
| Rate for Payer: UHCCP Medicaid |
$11.09
|
| Rate for Payer: UMR Bronson Commercial |
$23.52
|
| Rate for Payer: VA VA |
$21.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.69
|
|
