HC UNNA BOOT
|
Facility
|
OP
|
$360.06
|
|
Service Code
|
CPT 29580
|
Hospital Charge Code |
42000006
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$25.54 |
Max. Negotiated Rate |
$440.92 |
Rate for Payer: Aetna American Axle |
$234.04
|
Rate for Payer: Aetna Commercial |
$306.05
|
Rate for Payer: Aetna Medicare |
$145.66
|
Rate for Payer: Aetna New Business (MI Preferred) |
$234.04
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.08
|
Rate for Payer: Amish Plain Church Group Commercial |
$175.08
|
Rate for Payer: BCBS Complete |
$80.45
|
Rate for Payer: BCBS MAPPO |
$140.06
|
Rate for Payer: BCBS Trust/PPO |
$155.88
|
Rate for Payer: BCN Medicare Advantage |
$140.06
|
Rate for Payer: Cash Price |
$288.05
|
Rate for Payer: Cash Price |
$288.05
|
Rate for Payer: Cofinity Commercial |
$309.65
|
Rate for Payer: Cofinity Commercial |
$252.04
|
Rate for Payer: Encore Health Key Benefits Commercial |
$288.05
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.06
|
Rate for Payer: Healthscope Commercial |
$324.05
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.04
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.04
|
Rate for Payer: Mclaren Medicaid |
$76.61
|
Rate for Payer: Mclaren Medicare |
$140.06
|
Rate for Payer: Meridian Medicaid |
$80.45
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$147.06
|
Rate for Payer: MI Amish Medical Board Commercial |
$161.07
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.05
|
Rate for Payer: PACE Medicare |
$133.06
|
Rate for Payer: PACE SWMI |
$140.06
|
Rate for Payer: PHP Commercial |
$306.05
|
Rate for Payer: PHP Medicare Advantage |
$140.06
|
Rate for Payer: Priority Health Choice Medicaid |
$76.61
|
Rate for Payer: Priority Health Cigna Priority Health |
$252.04
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$440.92
|
Rate for Payer: Priority Health Medicare |
$140.06
|
Rate for Payer: Priority Health Narrow Network |
$352.74
|
Rate for Payer: Priority Health SBD |
$226.84
|
Rate for Payer: Railroad Medicare Medicare |
$140.06
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$28.09
|
Rate for Payer: UHC Dual Complete DSNP |
$140.06
|
Rate for Payer: UHC Exchange |
$25.54
|
Rate for Payer: UHC Medicare Advantage |
$144.26
|
Rate for Payer: UMR Bronson Commercial |
$133.22
|
Rate for Payer: VA VA |
$140.06
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.04
|
|
HC UNNA BOOT
|
Facility
|
IP
|
$360.06
|
|
Service Code
|
CPT 29580
|
Hospital Charge Code |
42000006
|
Hospital Revenue Code
|
761
|
Min. Negotiated Rate |
$158.43 |
Max. Negotiated Rate |
$324.05 |
Rate for Payer: Aetna American Axle |
$234.04
|
Rate for Payer: Aetna Commercial |
$306.05
|
Rate for Payer: Aetna New Business (MI Preferred) |
$234.04
|
Rate for Payer: Cash Price |
$288.05
|
Rate for Payer: Cofinity Commercial |
$252.04
|
Rate for Payer: Cofinity Commercial |
$309.65
|
Rate for Payer: Encore Health Key Benefits Commercial |
$288.05
|
Rate for Payer: Healthscope Commercial |
$324.05
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$252.04
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$270.04
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$306.05
|
Rate for Payer: PHP Commercial |
$306.05
|
Rate for Payer: Priority Health Cigna Priority Health |
$252.04
|
Rate for Payer: Priority Health SBD |
$226.84
|
Rate for Payer: UMR Bronson Commercial |
$158.43
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$270.04
|
|
HC UPGRADE PACEMAKER
|
Facility
|
IP
|
$8,845.22
|
|
Service Code
|
CPT 33214
|
Hospital Charge Code |
36100063
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$3,891.90 |
Max. Negotiated Rate |
$7,960.70 |
Rate for Payer: Aetna American Axle |
$5,749.39
|
Rate for Payer: Aetna Commercial |
$7,518.44
|
Rate for Payer: Aetna New Business (MI Preferred) |
$5,749.39
|
Rate for Payer: Cash Price |
$7,076.18
|
Rate for Payer: Cofinity Commercial |
$6,191.65
|
Rate for Payer: Cofinity Commercial |
$7,606.89
|
Rate for Payer: Encore Health Key Benefits Commercial |
$7,076.18
|
Rate for Payer: Healthscope Commercial |
$7,960.70
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,191.65
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,633.92
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,518.44
|
Rate for Payer: PHP Commercial |
$7,518.44
|
Rate for Payer: Priority Health Cigna Priority Health |
$6,191.65
|
Rate for Payer: Priority Health SBD |
$5,572.49
|
Rate for Payer: UMR Bronson Commercial |
$3,891.90
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,633.92
|
|
HC UPGRADE PACEMAKER
|
Facility
|
OP
|
$8,845.22
|
|
Service Code
|
CPT 33214
|
Hospital Charge Code |
36100063
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$462.68 |
Max. Negotiated Rate |
$29,880.23 |
Rate for Payer: Aetna American Axle |
$5,749.39
|
Rate for Payer: Aetna Commercial |
$7,518.44
|
Rate for Payer: Aetna Medicare |
$9,871.35
|
Rate for Payer: Aetna New Business (MI Preferred) |
$5,749.39
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,864.60
|
Rate for Payer: Amish Plain Church Group Commercial |
$11,864.60
|
Rate for Payer: BCBS Complete |
$5,452.02
|
Rate for Payer: BCBS MAPPO |
$9,491.68
|
Rate for Payer: BCBS Trust/PPO |
$13,130.99
|
Rate for Payer: BCN Medicare Advantage |
$9,491.68
|
Rate for Payer: Cash Price |
$7,076.18
|
Rate for Payer: Cash Price |
$7,076.18
|
Rate for Payer: Cofinity Commercial |
$6,191.65
|
Rate for Payer: Cofinity Commercial |
$7,606.89
|
Rate for Payer: Encore Health Key Benefits Commercial |
$7,076.18
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,491.68
|
Rate for Payer: Healthscope Commercial |
$7,960.70
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,191.65
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,633.92
|
Rate for Payer: Mclaren Medicaid |
$5,191.95
|
Rate for Payer: Mclaren Medicare |
$9,491.68
|
Rate for Payer: Meridian Medicaid |
$5,452.02
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,966.26
|
Rate for Payer: MI Amish Medical Board Commercial |
$10,915.43
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$7,518.44
|
Rate for Payer: PACE Medicare |
$9,017.10
|
Rate for Payer: PACE SWMI |
$9,491.68
|
Rate for Payer: PHP Commercial |
$7,518.44
|
Rate for Payer: PHP Medicare Advantage |
$9,491.68
|
Rate for Payer: Priority Health Choice Medicaid |
$5,191.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$6,191.65
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29,880.23
|
Rate for Payer: Priority Health Medicare |
$9,491.68
|
Rate for Payer: Priority Health Narrow Network |
$23,904.18
|
Rate for Payer: Priority Health SBD |
$5,572.49
|
Rate for Payer: Railroad Medicare Medicare |
$9,491.68
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$508.95
|
Rate for Payer: UHC Core |
$18,337.00
|
Rate for Payer: UHC Dual Complete DSNP |
$9,491.68
|
Rate for Payer: UHC Exchange |
$462.68
|
Rate for Payer: UHC Medicare Advantage |
$9,776.43
|
Rate for Payer: UMR Bronson Commercial |
$3,272.73
|
Rate for Payer: VA VA |
$9,491.68
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,633.92
|
|
HC UPGRADE TO BI-V PACEMAKER/ICD
|
Facility
|
IP
|
$4,556.67
|
|
Service Code
|
CPT 33224
|
Hospital Charge Code |
36100069
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$2,004.93 |
Max. Negotiated Rate |
$4,101.00 |
Rate for Payer: Aetna American Axle |
$2,961.84
|
Rate for Payer: Aetna Commercial |
$3,873.17
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,961.84
|
Rate for Payer: Cash Price |
$3,645.34
|
Rate for Payer: Cofinity Commercial |
$3,189.67
|
Rate for Payer: Cofinity Commercial |
$3,918.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3,645.34
|
Rate for Payer: Healthscope Commercial |
$4,101.00
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,189.67
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,417.50
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,873.17
|
Rate for Payer: PHP Commercial |
$3,873.17
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,189.67
|
Rate for Payer: Priority Health SBD |
$2,870.70
|
Rate for Payer: UMR Bronson Commercial |
$2,004.93
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,417.50
|
|
HC UPGRADE TO BI-V PACEMAKER/ICD
|
Facility
|
OP
|
$4,556.67
|
|
Service Code
|
CPT 33224
|
Hospital Charge Code |
36100069
|
Hospital Revenue Code
|
361
|
Min. Negotiated Rate |
$490.84 |
Max. Negotiated Rate |
$29,880.23 |
Rate for Payer: Aetna American Axle |
$2,961.84
|
Rate for Payer: Aetna Commercial |
$3,873.17
|
Rate for Payer: Aetna Medicare |
$9,871.35
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,961.84
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$11,864.60
|
Rate for Payer: Amish Plain Church Group Commercial |
$11,864.60
|
Rate for Payer: BCBS Complete |
$5,452.02
|
Rate for Payer: BCBS MAPPO |
$9,491.68
|
Rate for Payer: BCBS Trust/PPO |
$17,491.00
|
Rate for Payer: BCN Medicare Advantage |
$9,491.68
|
Rate for Payer: Cash Price |
$3,645.34
|
Rate for Payer: Cash Price |
$3,645.34
|
Rate for Payer: Cofinity Commercial |
$3,189.67
|
Rate for Payer: Cofinity Commercial |
$3,918.74
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3,645.34
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$9,491.68
|
Rate for Payer: Healthscope Commercial |
$4,101.00
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,189.67
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,417.50
|
Rate for Payer: Mclaren Medicaid |
$5,191.95
|
Rate for Payer: Mclaren Medicare |
$9,491.68
|
Rate for Payer: Meridian Medicaid |
$5,452.02
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9,966.26
|
Rate for Payer: MI Amish Medical Board Commercial |
$10,915.43
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,873.17
|
Rate for Payer: PACE Medicare |
$9,017.10
|
Rate for Payer: PACE SWMI |
$9,491.68
|
Rate for Payer: PHP Commercial |
$3,873.17
|
Rate for Payer: PHP Medicare Advantage |
$9,491.68
|
Rate for Payer: Priority Health Choice Medicaid |
$5,191.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,189.67
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$29,880.23
|
Rate for Payer: Priority Health Medicare |
$9,491.68
|
Rate for Payer: Priority Health Narrow Network |
$23,904.18
|
Rate for Payer: Priority Health SBD |
$2,870.70
|
Rate for Payer: Railroad Medicare Medicare |
$9,491.68
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$539.92
|
Rate for Payer: UHC Core |
$18,337.00
|
Rate for Payer: UHC Dual Complete DSNP |
$9,491.68
|
Rate for Payer: UHC Exchange |
$490.84
|
Rate for Payer: UHC Medicare Advantage |
$9,776.43
|
Rate for Payer: UMR Bronson Commercial |
$1,685.97
|
Rate for Payer: VA VA |
$9,491.68
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,417.50
|
|
HC UREA NITROGEN BUN
|
Facility
|
IP
|
$20.40
|
|
Service Code
|
CPT 84520
|
Hospital Charge Code |
30100450
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$8.98 |
Max. Negotiated Rate |
$18.36 |
Rate for Payer: Aetna American Axle |
$13.26
|
Rate for Payer: Aetna Commercial |
$17.34
|
Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cofinity Commercial |
$14.28
|
Rate for Payer: Cofinity Commercial |
$17.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
Rate for Payer: Healthscope Commercial |
$18.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
Rate for Payer: PHP Commercial |
$17.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
Rate for Payer: Priority Health SBD |
$12.85
|
Rate for Payer: UMR Bronson Commercial |
$8.98
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
HC UREA NITROGEN BUN
|
Facility
|
OP
|
$20.40
|
|
Service Code
|
CPT 84520
|
Hospital Charge Code |
30100450
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$2.16 |
Max. Negotiated Rate |
$18.36 |
Rate for Payer: Aetna American Axle |
$13.26
|
Rate for Payer: Aetna Commercial |
$17.34
|
Rate for Payer: Aetna Medicare |
$4.11
|
Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.94
|
Rate for Payer: Amish Plain Church Group Commercial |
$4.94
|
Rate for Payer: BCBS Complete |
$2.27
|
Rate for Payer: BCBS MAPPO |
$3.95
|
Rate for Payer: BCN Medicare Advantage |
$3.95
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cofinity Commercial |
$14.28
|
Rate for Payer: Cofinity Commercial |
$17.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.95
|
Rate for Payer: Healthscope Commercial |
$18.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
Rate for Payer: Mclaren Medicaid |
$2.16
|
Rate for Payer: Mclaren Medicare |
$3.95
|
Rate for Payer: Meridian Medicaid |
$2.27
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.15
|
Rate for Payer: MI Amish Medical Board Commercial |
$4.54
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
Rate for Payer: PACE Medicare |
$3.75
|
Rate for Payer: PACE SWMI |
$3.95
|
Rate for Payer: PHP Commercial |
$17.34
|
Rate for Payer: PHP Medicare Advantage |
$3.95
|
Rate for Payer: Priority Health Choice Medicaid |
$2.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.17
|
Rate for Payer: Priority Health Medicare |
$3.95
|
Rate for Payer: Priority Health Narrow Network |
$4.14
|
Rate for Payer: Priority Health SBD |
$12.85
|
Rate for Payer: Railroad Medicare Medicare |
$3.95
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$4.74
|
Rate for Payer: UHC Core |
$6.52
|
Rate for Payer: UHC Dual Complete DSNP |
$3.95
|
Rate for Payer: UHC Exchange |
$3.95
|
Rate for Payer: UHC Medicare Advantage |
$4.07
|
Rate for Payer: UMR Bronson Commercial |
$7.55
|
Rate for Payer: VA VA |
$3.95
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
HC UREA NITROGEN BUN URINE
|
Facility
|
IP
|
$38.66
|
|
Service Code
|
CPT 84540
|
Hospital Charge Code |
30100451
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$17.01 |
Max. Negotiated Rate |
$34.79 |
Rate for Payer: Aetna American Axle |
$25.13
|
Rate for Payer: Aetna Commercial |
$32.86
|
Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
Rate for Payer: Cash Price |
$30.93
|
Rate for Payer: Cofinity Commercial |
$27.06
|
Rate for Payer: Cofinity Commercial |
$33.25
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
Rate for Payer: Healthscope Commercial |
$34.79
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.06
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.86
|
Rate for Payer: PHP Commercial |
$32.86
|
Rate for Payer: Priority Health Cigna Priority Health |
$27.06
|
Rate for Payer: Priority Health SBD |
$24.36
|
Rate for Payer: UMR Bronson Commercial |
$17.01
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
HC UREA NITROGEN BUN URINE
|
Facility
|
OP
|
$38.66
|
|
Service Code
|
CPT 84540
|
Hospital Charge Code |
30100451
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$3.04 |
Max. Negotiated Rate |
$34.79 |
Rate for Payer: Aetna American Axle |
$25.13
|
Rate for Payer: Aetna Commercial |
$32.86
|
Rate for Payer: Aetna Medicare |
$5.78
|
Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.95
|
Rate for Payer: Amish Plain Church Group Commercial |
$6.95
|
Rate for Payer: BCBS Complete |
$3.19
|
Rate for Payer: BCBS MAPPO |
$5.56
|
Rate for Payer: BCBS Trust/PPO |
$5.00
|
Rate for Payer: BCN Medicare Advantage |
$5.56
|
Rate for Payer: Cash Price |
$30.93
|
Rate for Payer: Cash Price |
$30.93
|
Rate for Payer: Cofinity Commercial |
$27.06
|
Rate for Payer: Cofinity Commercial |
$33.25
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.56
|
Rate for Payer: Healthscope Commercial |
$34.79
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.06
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
Rate for Payer: Mclaren Medicaid |
$3.04
|
Rate for Payer: Mclaren Medicare |
$5.56
|
Rate for Payer: Meridian Medicaid |
$3.19
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.84
|
Rate for Payer: MI Amish Medical Board Commercial |
$6.39
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.86
|
Rate for Payer: PACE Medicare |
$5.28
|
Rate for Payer: PACE SWMI |
$5.56
|
Rate for Payer: PHP Commercial |
$32.86
|
Rate for Payer: PHP Medicare Advantage |
$5.56
|
Rate for Payer: Priority Health Choice Medicaid |
$3.04
|
Rate for Payer: Priority Health Cigna Priority Health |
$27.06
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.51
|
Rate for Payer: Priority Health Medicare |
$5.56
|
Rate for Payer: Priority Health Narrow Network |
$5.21
|
Rate for Payer: Priority Health SBD |
$24.36
|
Rate for Payer: Railroad Medicare Medicare |
$5.56
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$6.67
|
Rate for Payer: UHC Core |
$7.84
|
Rate for Payer: UHC Dual Complete DSNP |
$5.56
|
Rate for Payer: UHC Exchange |
$5.56
|
Rate for Payer: UHC Medicare Advantage |
$5.73
|
Rate for Payer: UMR Bronson Commercial |
$14.30
|
Rate for Payer: VA VA |
$5.56
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
HC UREAPLASMA PCR
|
Facility
|
OP
|
$84.27
|
|
Service Code
|
CPT 87798
|
Hospital Charge Code |
30600301
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$19.19 |
Max. Negotiated Rate |
$75.84 |
Rate for Payer: Aetna American Axle |
$54.78
|
Rate for Payer: Aetna Commercial |
$71.63
|
Rate for Payer: Aetna Medicare |
$36.49
|
Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
Rate for Payer: BCBS Complete |
$20.16
|
Rate for Payer: BCBS MAPPO |
$35.09
|
Rate for Payer: BCBS Trust/PPO |
$31.56
|
Rate for Payer: BCN Medicare Advantage |
$35.09
|
Rate for Payer: Cash Price |
$67.42
|
Rate for Payer: Cash Price |
$67.42
|
Rate for Payer: Cofinity Commercial |
$58.99
|
Rate for Payer: Cofinity Commercial |
$72.47
|
Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
Rate for Payer: Healthscope Commercial |
$75.84
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
Rate for Payer: Mclaren Medicaid |
$19.19
|
Rate for Payer: Mclaren Medicare |
$35.09
|
Rate for Payer: Meridian Medicaid |
$20.16
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.63
|
Rate for Payer: PACE Medicare |
$33.34
|
Rate for Payer: PACE SWMI |
$35.09
|
Rate for Payer: PHP Commercial |
$71.63
|
Rate for Payer: PHP Medicare Advantage |
$35.09
|
Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
Rate for Payer: Priority Health Cigna Priority Health |
$58.99
|
Rate for Payer: Priority Health Medicare |
$35.09
|
Rate for Payer: Priority Health SBD |
$53.09
|
Rate for Payer: Railroad Medicare Medicare |
$35.09
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
Rate for Payer: UHC Core |
$57.89
|
Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
Rate for Payer: UHC Exchange |
$35.09
|
Rate for Payer: UHC Medicare Advantage |
$36.14
|
Rate for Payer: UMR Bronson Commercial |
$31.18
|
Rate for Payer: VA VA |
$35.09
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
HC UREAPLASMA PCR
|
Facility
|
IP
|
$84.27
|
|
Service Code
|
CPT 87798
|
Hospital Charge Code |
30600301
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$37.08 |
Max. Negotiated Rate |
$75.84 |
Rate for Payer: Aetna American Axle |
$54.78
|
Rate for Payer: Aetna Commercial |
$71.63
|
Rate for Payer: Aetna New Business (MI Preferred) |
$54.78
|
Rate for Payer: Cash Price |
$67.42
|
Rate for Payer: Cofinity Commercial |
$58.99
|
Rate for Payer: Cofinity Commercial |
$72.47
|
Rate for Payer: Encore Health Key Benefits Commercial |
$67.42
|
Rate for Payer: Healthscope Commercial |
$75.84
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.20
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.63
|
Rate for Payer: PHP Commercial |
$71.63
|
Rate for Payer: Priority Health Cigna Priority Health |
$58.99
|
Rate for Payer: Priority Health SBD |
$53.09
|
Rate for Payer: UMR Bronson Commercial |
$37.08
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.20
|
|
HC UREAPLASMA PCR CMPT
|
Facility
|
OP
|
$58.77
|
|
Service Code
|
CPT 87798
|
Hospital Charge Code |
30600302
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$19.19 |
Max. Negotiated Rate |
$57.89 |
Rate for Payer: Aetna American Axle |
$38.20
|
Rate for Payer: Aetna Commercial |
$49.95
|
Rate for Payer: Aetna Medicare |
$36.49
|
Rate for Payer: Aetna New Business (MI Preferred) |
$38.20
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
Rate for Payer: BCBS Complete |
$20.16
|
Rate for Payer: BCBS MAPPO |
$35.09
|
Rate for Payer: BCBS Trust/PPO |
$31.56
|
Rate for Payer: BCN Medicare Advantage |
$35.09
|
Rate for Payer: Cash Price |
$47.02
|
Rate for Payer: Cash Price |
$47.02
|
Rate for Payer: Cofinity Commercial |
$41.14
|
Rate for Payer: Cofinity Commercial |
$50.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$47.02
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
Rate for Payer: Healthscope Commercial |
$52.89
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.14
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.08
|
Rate for Payer: Mclaren Medicaid |
$19.19
|
Rate for Payer: Mclaren Medicare |
$35.09
|
Rate for Payer: Meridian Medicaid |
$20.16
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.84
|
Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.95
|
Rate for Payer: PACE Medicare |
$33.34
|
Rate for Payer: PACE SWMI |
$35.09
|
Rate for Payer: PHP Commercial |
$49.95
|
Rate for Payer: PHP Medicare Advantage |
$35.09
|
Rate for Payer: Priority Health Choice Medicaid |
$19.19
|
Rate for Payer: Priority Health Cigna Priority Health |
$41.14
|
Rate for Payer: Priority Health Medicare |
$35.09
|
Rate for Payer: Priority Health SBD |
$37.03
|
Rate for Payer: Railroad Medicare Medicare |
$35.09
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
Rate for Payer: UHC Core |
$57.89
|
Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
Rate for Payer: UHC Exchange |
$35.09
|
Rate for Payer: UHC Medicare Advantage |
$36.14
|
Rate for Payer: UMR Bronson Commercial |
$21.74
|
Rate for Payer: VA VA |
$35.09
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.08
|
|
HC UREAPLASMA PCR CMPT
|
Facility
|
IP
|
$58.77
|
|
Service Code
|
CPT 87798
|
Hospital Charge Code |
30600302
|
Hospital Revenue Code
|
306
|
Min. Negotiated Rate |
$25.86 |
Max. Negotiated Rate |
$52.89 |
Rate for Payer: Aetna American Axle |
$38.20
|
Rate for Payer: Aetna Commercial |
$49.95
|
Rate for Payer: Aetna New Business (MI Preferred) |
$38.20
|
Rate for Payer: Cash Price |
$47.02
|
Rate for Payer: Cofinity Commercial |
$41.14
|
Rate for Payer: Cofinity Commercial |
$50.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$47.02
|
Rate for Payer: Healthscope Commercial |
$52.89
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.14
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.08
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$49.95
|
Rate for Payer: PHP Commercial |
$49.95
|
Rate for Payer: Priority Health Cigna Priority Health |
$41.14
|
Rate for Payer: Priority Health SBD |
$37.03
|
Rate for Payer: UMR Bronson Commercial |
$25.86
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.08
|
|
HC URETERAL DILITATION CATH
|
Facility
|
IP
|
$349.74
|
|
Service Code
|
HCPCS C1758
|
Hospital Charge Code |
27200077
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$153.89 |
Max. Negotiated Rate |
$314.77 |
Rate for Payer: Aetna American Axle |
$227.33
|
Rate for Payer: Aetna Commercial |
$297.28
|
Rate for Payer: Aetna New Business (MI Preferred) |
$227.33
|
Rate for Payer: Cash Price |
$279.79
|
Rate for Payer: Cofinity Commercial |
$244.82
|
Rate for Payer: Cofinity Commercial |
$300.78
|
Rate for Payer: Encore Health Key Benefits Commercial |
$279.79
|
Rate for Payer: Healthscope Commercial |
$314.77
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$244.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.28
|
Rate for Payer: PHP Commercial |
$297.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$244.82
|
Rate for Payer: Priority Health SBD |
$220.34
|
Rate for Payer: UMR Bronson Commercial |
$153.89
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.30
|
|
HC URETERAL DILITATION CATH
|
Facility
|
OP
|
$349.74
|
|
Service Code
|
HCPCS C1758
|
Hospital Charge Code |
27200077
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$0.03 |
Max. Negotiated Rate |
$314.77 |
Rate for Payer: Aetna American Axle |
$227.33
|
Rate for Payer: Aetna Commercial |
$297.28
|
Rate for Payer: Aetna New Business (MI Preferred) |
$227.33
|
Rate for Payer: BCBS Complete |
$139.90
|
Rate for Payer: BCBS Trust/PPO |
$0.03
|
Rate for Payer: Cash Price |
$279.79
|
Rate for Payer: Cash Price |
$279.79
|
Rate for Payer: Cofinity Commercial |
$244.82
|
Rate for Payer: Cofinity Commercial |
$300.78
|
Rate for Payer: Encore Health Key Benefits Commercial |
$279.79
|
Rate for Payer: Healthscope Commercial |
$314.77
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$244.82
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$262.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$297.28
|
Rate for Payer: PHP Commercial |
$297.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$244.82
|
Rate for Payer: Priority Health SBD |
$220.34
|
Rate for Payer: UMR Bronson Commercial |
$129.40
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$262.30
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
IP
|
$37.90
|
|
Service Code
|
CPT 84560
|
Hospital Charge Code |
30100453
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$16.68 |
Max. Negotiated Rate |
$34.11 |
Rate for Payer: Aetna American Axle |
$24.64
|
Rate for Payer: Aetna Commercial |
$32.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$24.64
|
Rate for Payer: Cash Price |
$30.32
|
Rate for Payer: Cofinity Commercial |
$26.53
|
Rate for Payer: Cofinity Commercial |
$32.59
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
Rate for Payer: Healthscope Commercial |
$34.11
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.53
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
Rate for Payer: PHP Commercial |
$32.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
Rate for Payer: Priority Health SBD |
$23.88
|
Rate for Payer: UMR Bronson Commercial |
$16.68
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
OP
|
$37.90
|
|
Service Code
|
CPT 84560
|
Hospital Charge Code |
30100453
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$2.78 |
Max. Negotiated Rate |
$34.11 |
Rate for Payer: Aetna American Axle |
$24.64
|
Rate for Payer: Aetna Commercial |
$32.22
|
Rate for Payer: Aetna Medicare |
$5.28
|
Rate for Payer: Aetna New Business (MI Preferred) |
$24.64
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.35
|
Rate for Payer: Amish Plain Church Group Commercial |
$6.35
|
Rate for Payer: BCBS Complete |
$2.92
|
Rate for Payer: BCBS MAPPO |
$5.08
|
Rate for Payer: BCBS Trust/PPO |
$4.57
|
Rate for Payer: BCN Medicare Advantage |
$5.08
|
Rate for Payer: Cash Price |
$30.32
|
Rate for Payer: Cash Price |
$30.32
|
Rate for Payer: Cofinity Commercial |
$32.59
|
Rate for Payer: Cofinity Commercial |
$26.53
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.08
|
Rate for Payer: Healthscope Commercial |
$34.11
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.53
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
Rate for Payer: Mclaren Medicaid |
$2.78
|
Rate for Payer: Mclaren Medicare |
$5.08
|
Rate for Payer: Meridian Medicaid |
$2.92
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.33
|
Rate for Payer: MI Amish Medical Board Commercial |
$5.84
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
Rate for Payer: PACE Medicare |
$4.83
|
Rate for Payer: PACE SWMI |
$5.08
|
Rate for Payer: PHP Commercial |
$32.22
|
Rate for Payer: PHP Medicare Advantage |
$5.08
|
Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.37
|
Rate for Payer: Priority Health Medicare |
$5.08
|
Rate for Payer: Priority Health Narrow Network |
$5.10
|
Rate for Payer: Priority Health SBD |
$23.88
|
Rate for Payer: Railroad Medicare Medicare |
$5.08
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$6.10
|
Rate for Payer: UHC Core |
$7.84
|
Rate for Payer: UHC Dual Complete DSNP |
$5.08
|
Rate for Payer: UHC Exchange |
$5.08
|
Rate for Payer: UHC Medicare Advantage |
$5.23
|
Rate for Payer: UMR Bronson Commercial |
$14.02
|
Rate for Payer: VA VA |
$5.08
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
HC URIC ACID SERUM
|
Facility
|
IP
|
$20.40
|
|
Service Code
|
CPT 84550
|
Hospital Charge Code |
30100452
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$8.98 |
Max. Negotiated Rate |
$18.36 |
Rate for Payer: Aetna American Axle |
$13.26
|
Rate for Payer: Aetna Commercial |
$17.34
|
Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cofinity Commercial |
$14.28
|
Rate for Payer: Cofinity Commercial |
$17.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
Rate for Payer: Healthscope Commercial |
$18.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
Rate for Payer: PHP Commercial |
$17.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
Rate for Payer: Priority Health SBD |
$12.85
|
Rate for Payer: UMR Bronson Commercial |
$8.98
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
HC URIC ACID SERUM
|
Facility
|
OP
|
$20.40
|
|
Service Code
|
CPT 84550
|
Hospital Charge Code |
30100452
|
Hospital Revenue Code
|
301
|
Min. Negotiated Rate |
$2.47 |
Max. Negotiated Rate |
$18.36 |
Rate for Payer: Aetna American Axle |
$13.26
|
Rate for Payer: Aetna Commercial |
$17.34
|
Rate for Payer: Aetna Medicare |
$4.70
|
Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.65
|
Rate for Payer: Amish Plain Church Group Commercial |
$5.65
|
Rate for Payer: BCBS Complete |
$2.60
|
Rate for Payer: BCBS MAPPO |
$4.52
|
Rate for Payer: BCN Medicare Advantage |
$4.52
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cofinity Commercial |
$17.54
|
Rate for Payer: Cofinity Commercial |
$14.28
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.52
|
Rate for Payer: Healthscope Commercial |
$18.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
Rate for Payer: Mclaren Medicaid |
$2.47
|
Rate for Payer: Mclaren Medicare |
$4.52
|
Rate for Payer: Meridian Medicaid |
$2.60
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$4.75
|
Rate for Payer: MI Amish Medical Board Commercial |
$5.20
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
Rate for Payer: PACE Medicare |
$4.29
|
Rate for Payer: PACE SWMI |
$4.52
|
Rate for Payer: PHP Commercial |
$17.34
|
Rate for Payer: PHP Medicare Advantage |
$4.52
|
Rate for Payer: Priority Health Choice Medicaid |
$2.47
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.20
|
Rate for Payer: Priority Health Medicare |
$4.52
|
Rate for Payer: Priority Health Narrow Network |
$4.96
|
Rate for Payer: Priority Health SBD |
$12.85
|
Rate for Payer: Railroad Medicare Medicare |
$4.52
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$5.42
|
Rate for Payer: UHC Core |
$7.45
|
Rate for Payer: UHC Dual Complete DSNP |
$4.52
|
Rate for Payer: UHC Exchange |
$4.52
|
Rate for Payer: UHC Medicare Advantage |
$4.66
|
Rate for Payer: UMR Bronson Commercial |
$7.55
|
Rate for Payer: VA VA |
$4.52
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
HC URINALYSIS
|
Facility
|
IP
|
$20.40
|
|
Service Code
|
CPT 81001
|
Hospital Charge Code |
30700001
|
Hospital Revenue Code
|
307
|
Min. Negotiated Rate |
$8.98 |
Max. Negotiated Rate |
$18.36 |
Rate for Payer: Aetna American Axle |
$13.26
|
Rate for Payer: Aetna Commercial |
$17.34
|
Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cofinity Commercial |
$14.28
|
Rate for Payer: Cofinity Commercial |
$17.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
Rate for Payer: Healthscope Commercial |
$18.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
Rate for Payer: PHP Commercial |
$17.34
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
Rate for Payer: Priority Health SBD |
$12.85
|
Rate for Payer: UMR Bronson Commercial |
$8.98
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
HC URINALYSIS
|
Facility
|
OP
|
$20.40
|
|
Service Code
|
CPT 81001
|
Hospital Charge Code |
30700001
|
Hospital Revenue Code
|
307
|
Min. Negotiated Rate |
$1.73 |
Max. Negotiated Rate |
$18.36 |
Rate for Payer: Aetna American Axle |
$13.26
|
Rate for Payer: Aetna Commercial |
$17.34
|
Rate for Payer: Aetna Medicare |
$3.30
|
Rate for Payer: Aetna New Business (MI Preferred) |
$13.26
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.96
|
Rate for Payer: Amish Plain Church Group Commercial |
$3.96
|
Rate for Payer: BCBS Complete |
$1.82
|
Rate for Payer: BCBS MAPPO |
$3.17
|
Rate for Payer: BCBS Trust/PPO |
$2.85
|
Rate for Payer: BCN Medicare Advantage |
$3.17
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cash Price |
$16.32
|
Rate for Payer: Cofinity Commercial |
$14.28
|
Rate for Payer: Cofinity Commercial |
$17.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.32
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.17
|
Rate for Payer: Healthscope Commercial |
$18.36
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.30
|
Rate for Payer: Mclaren Medicaid |
$1.73
|
Rate for Payer: Mclaren Medicare |
$3.17
|
Rate for Payer: Meridian Medicaid |
$1.82
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3.33
|
Rate for Payer: MI Amish Medical Board Commercial |
$3.65
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.34
|
Rate for Payer: PACE Medicare |
$3.01
|
Rate for Payer: PACE SWMI |
$3.17
|
Rate for Payer: PHP Commercial |
$17.34
|
Rate for Payer: PHP Medicare Advantage |
$3.17
|
Rate for Payer: Priority Health Choice Medicaid |
$1.73
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.28
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.35
|
Rate for Payer: Priority Health Medicare |
$3.17
|
Rate for Payer: Priority Health Narrow Network |
$3.48
|
Rate for Payer: Priority Health SBD |
$12.85
|
Rate for Payer: Railroad Medicare Medicare |
$3.17
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$3.80
|
Rate for Payer: UHC Core |
$5.22
|
Rate for Payer: UHC Dual Complete DSNP |
$3.17
|
Rate for Payer: UHC Exchange |
$3.17
|
Rate for Payer: UHC Medicare Advantage |
$3.27
|
Rate for Payer: UMR Bronson Commercial |
$7.55
|
Rate for Payer: VA VA |
$3.17
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.30
|
|
HC URINALYSIS, DIPSTICK ONLY
|
Facility
|
IP
|
$20.80
|
|
Service Code
|
CPT 81003
|
Hospital Charge Code |
30700002
|
Hospital Revenue Code
|
307
|
Min. Negotiated Rate |
$9.15 |
Max. Negotiated Rate |
$18.72 |
Rate for Payer: Aetna American Axle |
$13.52
|
Rate for Payer: Aetna Commercial |
$17.68
|
Rate for Payer: Aetna New Business (MI Preferred) |
$13.52
|
Rate for Payer: Cash Price |
$16.64
|
Rate for Payer: Cofinity Commercial |
$14.56
|
Rate for Payer: Cofinity Commercial |
$17.89
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.64
|
Rate for Payer: Healthscope Commercial |
$18.72
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.56
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.60
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.68
|
Rate for Payer: PHP Commercial |
$17.68
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.56
|
Rate for Payer: Priority Health SBD |
$13.10
|
Rate for Payer: UMR Bronson Commercial |
$9.15
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.60
|
|
HC URINALYSIS, DIPSTICK ONLY
|
Facility
|
OP
|
$20.80
|
|
Service Code
|
CPT 81003
|
Hospital Charge Code |
30700002
|
Hospital Revenue Code
|
307
|
Min. Negotiated Rate |
$1.23 |
Max. Negotiated Rate |
$18.72 |
Rate for Payer: Aetna American Axle |
$13.52
|
Rate for Payer: Aetna Commercial |
$17.68
|
Rate for Payer: Aetna Medicare |
$2.34
|
Rate for Payer: Aetna New Business (MI Preferred) |
$13.52
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.81
|
Rate for Payer: Amish Plain Church Group Commercial |
$2.81
|
Rate for Payer: BCBS Complete |
$1.29
|
Rate for Payer: BCBS MAPPO |
$2.25
|
Rate for Payer: BCBS Trust/PPO |
$2.03
|
Rate for Payer: BCN Medicare Advantage |
$2.25
|
Rate for Payer: Cash Price |
$16.64
|
Rate for Payer: Cash Price |
$16.64
|
Rate for Payer: Cofinity Commercial |
$14.56
|
Rate for Payer: Cofinity Commercial |
$17.89
|
Rate for Payer: Encore Health Key Benefits Commercial |
$16.64
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.25
|
Rate for Payer: Healthscope Commercial |
$18.72
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.56
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.60
|
Rate for Payer: Mclaren Medicaid |
$1.23
|
Rate for Payer: Mclaren Medicare |
$2.25
|
Rate for Payer: Meridian Medicaid |
$1.29
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.36
|
Rate for Payer: MI Amish Medical Board Commercial |
$2.59
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$17.68
|
Rate for Payer: PACE Medicare |
$2.14
|
Rate for Payer: PACE SWMI |
$2.25
|
Rate for Payer: PHP Commercial |
$17.68
|
Rate for Payer: PHP Medicare Advantage |
$2.25
|
Rate for Payer: Priority Health Choice Medicaid |
$1.23
|
Rate for Payer: Priority Health Cigna Priority Health |
$14.56
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.08
|
Rate for Payer: Priority Health Medicare |
$2.25
|
Rate for Payer: Priority Health Narrow Network |
$2.46
|
Rate for Payer: Priority Health SBD |
$13.10
|
Rate for Payer: Railroad Medicare Medicare |
$2.25
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$2.70
|
Rate for Payer: UHC Core |
$3.71
|
Rate for Payer: UHC Dual Complete DSNP |
$2.25
|
Rate for Payer: UHC Exchange |
$2.25
|
Rate for Payer: UHC Medicare Advantage |
$2.32
|
Rate for Payer: UMR Bronson Commercial |
$7.70
|
Rate for Payer: VA VA |
$2.25
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.60
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
IP
|
$37.90
|
|
Service Code
|
CPT 81015
|
Hospital Charge Code |
30700004
|
Hospital Revenue Code
|
307
|
Min. Negotiated Rate |
$16.68 |
Max. Negotiated Rate |
$34.11 |
Rate for Payer: Aetna American Axle |
$24.64
|
Rate for Payer: Aetna Commercial |
$32.22
|
Rate for Payer: Aetna New Business (MI Preferred) |
$24.64
|
Rate for Payer: Cash Price |
$30.32
|
Rate for Payer: Cofinity Commercial |
$26.53
|
Rate for Payer: Cofinity Commercial |
$32.59
|
Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
Rate for Payer: Healthscope Commercial |
$34.11
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.53
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
Rate for Payer: PHP Commercial |
$32.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
Rate for Payer: Priority Health SBD |
$23.88
|
Rate for Payer: UMR Bronson Commercial |
$16.68
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|