|
HC MFM CORDOCENTESIS
|
Facility
|
IP
|
$446.38
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$196.41 |
| Max. Negotiated Rate |
$401.74 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: UMR Bronson Commercial |
$196.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
OP
|
$446.38
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$158.80 |
| Max. Negotiated Rate |
$981.93 |
| Rate for Payer: Aetna American Axle |
$290.15
|
| Rate for Payer: Aetna Commercial |
$379.42
|
| Rate for Payer: Aetna Medicare |
$315.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$290.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.54
|
| Rate for Payer: BCBS Complete |
$166.75
|
| Rate for Payer: BCBS MAPPO |
$303.63
|
| Rate for Payer: BCBS Trust/PPO |
$327.11
|
| Rate for Payer: BCN Commercial |
$327.11
|
| Rate for Payer: BCN Medicare Advantage |
$303.63
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cash Price |
$357.10
|
| Rate for Payer: Cofinity Advantage |
$312.47
|
| Rate for Payer: Cofinity Commercial |
$383.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$357.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.63
|
| Rate for Payer: Healthscope Commercial |
$401.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$312.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$334.79
|
| Rate for Payer: Mclaren Medicaid |
$303.63
|
| Rate for Payer: Mclaren Medicare |
$303.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.81
|
| Rate for Payer: Meridian Medicaid |
$318.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$333.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$379.42
|
| Rate for Payer: Nomi Health Commercial |
$910.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$334.79
|
| Rate for Payer: PACE Medicare |
$288.45
|
| Rate for Payer: PACE SWMI |
$303.63
|
| Rate for Payer: PHP Commercial |
$379.42
|
| Rate for Payer: PHP Medicare Advantage |
$303.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$981.93
|
| Rate for Payer: Priority Health Medicare |
$303.63
|
| Rate for Payer: Priority Health SBD |
$281.22
|
| Rate for Payer: Priority Health Tiered Network |
$785.54
|
| Rate for Payer: Railroad Medicare Medicare |
$303.63
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$303.63
|
| Rate for Payer: UHC Medicaid |
$158.80
|
| Rate for Payer: UHCCP Medicaid |
$158.80
|
| Rate for Payer: UMR Bronson Commercial |
$165.16
|
| Rate for Payer: VA VA |
$303.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$334.79
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
OP
|
$85.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$76.63 |
| Rate for Payer: Aetna American Axle |
$55.34
|
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$68.11
|
| Rate for Payer: Cash Price |
$68.11
|
| Rate for Payer: Cofinity Advantage |
$59.60
|
| Rate for Payer: Cofinity Commercial |
$73.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$76.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.37
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.85
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$72.37
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$53.64
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$31.50
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
|
HC MG EVALUATION WITH MUSK REFLEX, S
|
Facility
|
IP
|
$85.14
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000160
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$37.46 |
| Max. Negotiated Rate |
$76.63 |
| Rate for Payer: Aetna American Axle |
$55.34
|
| Rate for Payer: Aetna Commercial |
$72.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.34
|
| Rate for Payer: Cash Price |
$68.11
|
| Rate for Payer: Cofinity Advantage |
$59.60
|
| Rate for Payer: Cofinity Commercial |
$73.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.11
|
| Rate for Payer: Healthscope Commercial |
$76.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$63.85
|
| Rate for Payer: PHP Commercial |
$72.37
|
| Rate for Payer: Priority Health SBD |
$53.64
|
| Rate for Payer: UMR Bronson Commercial |
$37.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.85
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
IP
|
$82.77
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.42 |
| Max. Negotiated Rate |
$74.49 |
| Rate for Payer: Aetna American Axle |
$53.80
|
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.80
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Advantage |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: Priority Health SBD |
$52.15
|
| Rate for Payer: UMR Bronson Commercial |
$36.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.08
|
|
|
HC MG EVALUATION W REFLEX
|
Facility
|
OP
|
$82.77
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100724
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$74.49 |
| Rate for Payer: Aetna American Axle |
$53.80
|
| Rate for Payer: Aetna Commercial |
$70.35
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$53.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cash Price |
$66.22
|
| Rate for Payer: Cofinity Advantage |
$57.94
|
| Rate for Payer: Cofinity Commercial |
$71.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$74.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$57.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.08
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.35
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.08
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$70.35
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$52.15
|
| Rate for Payer: Priority Health Tiered Network |
$14.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.60
|
| Rate for Payer: UHC Core |
$27.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$27.60
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UMR Bronson Commercial |
$30.62
|
| Rate for Payer: VA VA |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.08
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Advantage |
$182.07
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$96.24
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC MGLUR1 AB CBA, S
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200464
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$114.44 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Advantage |
$182.07
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.07
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: UMR Bronson Commercial |
$114.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC MGLUR1 AB IFA, S
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200465
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna American Axle |
$51.73
|
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: UMR Bronson Commercial |
$35.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC MGLUR1 AB IFA, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200465
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna American Axle |
$51.73
|
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$29.45
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC MGLUR1 AB IFA TITER, S
|
Facility
|
IP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna American Axle |
$51.73
|
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: UMR Bronson Commercial |
$35.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC MGLUR1 AB IFA TITER, S
|
Facility
|
OP
|
$79.59
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200466
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$71.63 |
| Rate for Payer: Aetna American Axle |
$51.73
|
| Rate for Payer: Aetna Commercial |
$67.65
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cash Price |
$63.67
|
| Rate for Payer: Cofinity Advantage |
$55.71
|
| Rate for Payer: Cofinity Commercial |
$68.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$71.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.69
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.65
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.69
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$67.65
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$50.14
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$29.45
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.69
|
|
|
HC M. GRAVIS EVAL, ADULT
|
Facility
|
IP
|
$73.23
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.22 |
| Max. Negotiated Rate |
$65.91 |
| Rate for Payer: Aetna American Axle |
$47.60
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Advantage |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Healthscope Commercial |
$65.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health SBD |
$46.13
|
| Rate for Payer: UMR Bronson Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.92
|
|
|
HC M. GRAVIS EVAL, ADULT
|
Facility
|
OP
|
$73.23
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100603
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$65.91 |
| Rate for Payer: Aetna American Axle |
$47.60
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Advantage |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$65.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.92
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$46.13
|
| Rate for Payer: Priority Health Tiered Network |
$14.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.60
|
| Rate for Payer: UHC Core |
$27.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$27.60
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UMR Bronson Commercial |
$27.10
|
| Rate for Payer: VA VA |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.92
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT
|
Facility
|
OP
|
$73.23
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$65.91 |
| Rate for Payer: Aetna American Axle |
$47.60
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Advantage |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$65.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.92
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$46.13
|
| Rate for Payer: Priority Health Tiered Network |
$14.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.60
|
| Rate for Payer: UHC Core |
$27.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$27.60
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UMR Bronson Commercial |
$27.10
|
| Rate for Payer: VA VA |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.92
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT
|
Facility
|
IP
|
$73.23
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100604
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.22 |
| Max. Negotiated Rate |
$65.91 |
| Rate for Payer: Aetna American Axle |
$47.60
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Advantage |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Healthscope Commercial |
$65.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health SBD |
$46.13
|
| Rate for Payer: UMR Bronson Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.92
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT2
|
Facility
|
OP
|
$73.23
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100605
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$65.91 |
| Rate for Payer: Aetna American Axle |
$47.60
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Advantage |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$65.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.92
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$46.13
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$27.10
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.92
|
|
|
HC M. GRAVIS EVAL, ADULT CMPT2
|
Facility
|
IP
|
$73.23
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100605
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.22 |
| Max. Negotiated Rate |
$65.91 |
| Rate for Payer: Aetna American Axle |
$47.60
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.60
|
| Rate for Payer: Cash Price |
$58.58
|
| Rate for Payer: Cofinity Advantage |
$51.26
|
| Rate for Payer: Cofinity Commercial |
$62.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.58
|
| Rate for Payer: Healthscope Commercial |
$65.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.92
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health SBD |
$46.13
|
| Rate for Payer: UMR Bronson Commercial |
$32.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.92
|
|
|
HC MIC BY AGAR DILUTION
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600101
|
|
Hospital Revenue Code
|
306
|
| 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 MIC BY AGAR DILUTION
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
30600101
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.52 |
| 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 |
$9.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.81
|
| Rate for Payer: BCBS Complete |
$4.75
|
| Rate for Payer: BCBS MAPPO |
$8.65
|
| Rate for Payer: BCBS Trust/PPO |
$10.00
|
| Rate for Payer: BCN Commercial |
$10.00
|
| Rate for Payer: BCN Medicare Advantage |
$8.65
|
| 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 |
$8.65
|
| 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 |
$8.65
|
| Rate for Payer: Mclaren Medicare |
$8.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.08
|
| Rate for Payer: Meridian Medicaid |
$9.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$12.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Medicare |
$8.22
|
| Rate for Payer: PACE SWMI |
$8.65
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$8.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.65
|
| Rate for Payer: Priority Health Medicare |
$8.65
|
| Rate for Payer: Priority Health SBD |
$29.42
|
| Rate for Payer: Priority Health Tiered Network |
$6.92
|
| Rate for Payer: Railroad Medicare Medicare |
$8.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.98
|
| Rate for Payer: UHC Core |
$12.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.65
|
| Rate for Payer: UHC Exchange |
$12.98
|
| Rate for Payer: UHC Medicaid |
$4.52
|
| Rate for Payer: UHCCP Medicaid |
$4.52
|
| Rate for Payer: UMR Bronson Commercial |
$17.28
|
| Rate for Payer: VA VA |
$8.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC MICRA AR LEADLESS PACEMAKER
|
Facility
|
IP
|
$17,576.26
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500013
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$7,733.55 |
| Max. Negotiated Rate |
$15,818.63 |
| Rate for Payer: Aetna American Axle |
$11,424.57
|
| Rate for Payer: Aetna Commercial |
$14,939.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,424.57
|
| Rate for Payer: Cash Price |
$14,061.01
|
| Rate for Payer: Cofinity Advantage |
$12,303.38
|
| Rate for Payer: Cofinity Commercial |
$15,115.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,061.01
|
| Rate for Payer: Healthscope Commercial |
$15,818.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,303.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,182.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,939.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,182.19
|
| Rate for Payer: PHP Commercial |
$14,939.82
|
| Rate for Payer: Priority Health SBD |
$11,073.04
|
| Rate for Payer: UMR Bronson Commercial |
$7,733.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,182.19
|
|
|
HC MICRA AR LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,576.26
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500013
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,503.22 |
| Max. Negotiated Rate |
$15,818.63 |
| Rate for Payer: Aetna American Axle |
$11,424.57
|
| Rate for Payer: Aetna Commercial |
$14,939.82
|
| Rate for Payer: Aetna Medicare |
$8,788.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,424.57
|
| Rate for Payer: BCBS Complete |
$7,030.50
|
| Rate for Payer: Cash Price |
$14,061.01
|
| Rate for Payer: Cofinity Advantage |
$12,303.38
|
| Rate for Payer: Cofinity Commercial |
$15,115.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,061.01
|
| Rate for Payer: Healthscope Commercial |
$15,818.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,303.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,182.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,061.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,939.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,182.19
|
| Rate for Payer: PHP Commercial |
$14,939.82
|
| Rate for Payer: Priority Health SBD |
$11,073.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,424.57
|
| Rate for Payer: UHC Core |
$9,157.23
|
| Rate for Payer: UHC Exchange |
$6,907.47
|
| Rate for Payer: UMR Bronson Commercial |
$6,503.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,182.19
|
|
|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
IP
|
$17,967.59
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$7,905.74 |
| Max. Negotiated Rate |
$16,170.83 |
| Rate for Payer: Aetna American Axle |
$11,678.93
|
| Rate for Payer: Aetna Commercial |
$15,272.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,678.93
|
| Rate for Payer: Cash Price |
$14,374.07
|
| Rate for Payer: Cofinity Advantage |
$12,577.31
|
| Rate for Payer: Cofinity Commercial |
$15,452.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,374.07
|
| Rate for Payer: Healthscope Commercial |
$16,170.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,577.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,475.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,272.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,475.69
|
| Rate for Payer: PHP Commercial |
$15,272.45
|
| Rate for Payer: Priority Health SBD |
$11,319.58
|
| Rate for Payer: UMR Bronson Commercial |
$7,905.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,475.69
|
|
|
HC MICRA VV LEADLESS PACEMAKER
|
Facility
|
OP
|
$17,967.59
|
|
|
Service Code
|
HCPCS C1786
|
| Hospital Charge Code |
27500012
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,648.01 |
| Max. Negotiated Rate |
$16,170.83 |
| Rate for Payer: Aetna American Axle |
$11,678.93
|
| Rate for Payer: Aetna Commercial |
$15,272.45
|
| Rate for Payer: Aetna Medicare |
$8,983.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,678.93
|
| Rate for Payer: BCBS Complete |
$7,187.04
|
| Rate for Payer: Cash Price |
$14,374.07
|
| Rate for Payer: Cofinity Advantage |
$12,577.31
|
| Rate for Payer: Cofinity Commercial |
$15,452.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,374.07
|
| Rate for Payer: Healthscope Commercial |
$16,170.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,577.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,475.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14,374.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,272.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13,475.69
|
| Rate for Payer: PHP Commercial |
$15,272.45
|
| Rate for Payer: Priority Health SBD |
$11,319.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,678.93
|
| Rate for Payer: UHC Core |
$9,361.11
|
| Rate for Payer: UHC Exchange |
$7,061.26
|
| Rate for Payer: UMR Bronson Commercial |
$6,648.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,475.69
|
|
|
HC MICRO ALBUMIN URINE
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 82043
|
| Hospital Charge Code |
30100075
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.52 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna American Axle |
$50.99
|
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.99
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Advantage |
$54.91
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health SBD |
$49.42
|
| Rate for Payer: UMR Bronson Commercial |
$34.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
