|
HC IR Z ABSCESS PERIANAL
|
Facility
|
OP
|
$1,208.35
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$447.09 |
| Max. Negotiated Rate |
$2,502.92 |
| Rate for Payer: Aetna American Axle |
$785.43
|
| Rate for Payer: Aetna Commercial |
$1,027.10
|
| Rate for Payer: Aetna Medicare |
$924.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,111.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,111.46
|
| Rate for Payer: BCBS Complete |
$500.42
|
| Rate for Payer: BCBS MAPPO |
$889.17
|
| Rate for Payer: BCN Medicare Advantage |
$889.17
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cofinity Commercial |
$845.85
|
| Rate for Payer: Cofinity Commercial |
$1,039.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$845.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$889.17
|
| Rate for Payer: Healthscope Commercial |
$1,087.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$845.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$906.26
|
| Rate for Payer: Mclaren Medicaid |
$476.60
|
| Rate for Payer: Mclaren Medicare |
$889.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$933.63
|
| Rate for Payer: Meridian Medicaid |
$500.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,022.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.10
|
| Rate for Payer: PACE Medicare |
$844.71
|
| Rate for Payer: PACE SWMI |
$889.17
|
| Rate for Payer: PHP Commercial |
$1,027.10
|
| Rate for Payer: PHP Medicare Advantage |
$889.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$476.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.43
|
| Rate for Payer: Priority Health Medicare |
$889.17
|
| Rate for Payer: Priority Health SBD |
$761.26
|
| Rate for Payer: Railroad Medicare Medicare |
$889.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,502.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$889.17
|
| Rate for Payer: UHC Exchange |
$1,699.29
|
| Rate for Payer: UHC Medicare Advantage |
$889.17
|
| Rate for Payer: UHCCP Medicaid |
$476.60
|
| Rate for Payer: UMR Bronson Commercial |
$447.09
|
| Rate for Payer: VA VA |
$889.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$906.26
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
IP
|
$1,208.35
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$531.67 |
| Max. Negotiated Rate |
$1,087.52 |
| Rate for Payer: Aetna American Axle |
$785.43
|
| Rate for Payer: Aetna Commercial |
$1,027.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$785.43
|
| Rate for Payer: Cash Price |
$966.68
|
| Rate for Payer: Cofinity Commercial |
$1,039.18
|
| Rate for Payer: Cofinity Commercial |
$845.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$845.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$966.68
|
| Rate for Payer: Healthscope Commercial |
$1,087.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$845.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$906.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,027.10
|
| Rate for Payer: PHP Commercial |
$1,027.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$785.43
|
| Rate for Payer: Priority Health SBD |
$761.26
|
| Rate for Payer: UMR Bronson Commercial |
$531.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$906.26
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
IP
|
$161.36
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$71.00 |
| Max. Negotiated Rate |
$145.22 |
| Rate for Payer: Aetna American Axle |
$104.88
|
| Rate for Payer: Aetna Commercial |
$137.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.88
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cofinity Commercial |
$112.95
|
| Rate for Payer: Cofinity Commercial |
$138.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.09
|
| Rate for Payer: Healthscope Commercial |
$145.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.16
|
| Rate for Payer: PHP Commercial |
$137.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.88
|
| Rate for Payer: Priority Health SBD |
$101.66
|
| Rate for Payer: UMR Bronson Commercial |
$71.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.02
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
OP
|
$161.36
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.19 |
| Max. Negotiated Rate |
$145.22 |
| Rate for Payer: Aetna American Axle |
$104.88
|
| Rate for Payer: Aetna Commercial |
$137.16
|
| Rate for Payer: Aetna Medicare |
$35.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.42
|
| Rate for Payer: BCBS Complete |
$19.10
|
| Rate for Payer: BCBS MAPPO |
$33.94
|
| Rate for Payer: BCN Medicare Advantage |
$33.94
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cash Price |
$129.09
|
| Rate for Payer: Cofinity Commercial |
$138.77
|
| Rate for Payer: Cofinity Commercial |
$112.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.94
|
| Rate for Payer: Healthscope Commercial |
$145.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.02
|
| Rate for Payer: Mclaren Medicaid |
$18.19
|
| Rate for Payer: Mclaren Medicare |
$33.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.64
|
| Rate for Payer: Meridian Medicaid |
$19.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.16
|
| Rate for Payer: PACE Medicare |
$32.24
|
| Rate for Payer: PACE SWMI |
$33.94
|
| Rate for Payer: PHP Commercial |
$137.16
|
| Rate for Payer: PHP Medicare Advantage |
$33.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.88
|
| Rate for Payer: Priority Health Medicare |
$33.94
|
| Rate for Payer: Priority Health SBD |
$101.66
|
| Rate for Payer: Railroad Medicare Medicare |
$33.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.94
|
| Rate for Payer: UHC Exchange |
$64.86
|
| Rate for Payer: UHC Medicare Advantage |
$33.94
|
| Rate for Payer: UHCCP Medicaid |
$18.19
|
| Rate for Payer: UMR Bronson Commercial |
$59.70
|
| Rate for Payer: VA VA |
$33.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.02
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
OP
|
$55.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$66.35 |
| Rate for Payer: Aetna American Axle |
$35.84
|
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna Medicare |
$24.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Exchange |
$45.04
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.63
|
| Rate for Payer: UMR Bronson Commercial |
$20.40
|
| Rate for Payer: VA VA |
$23.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
IP
|
$55.14
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.26 |
| Max. Negotiated Rate |
$49.63 |
| Rate for Payer: Aetna American Axle |
$35.84
|
| Rate for Payer: Aetna Commercial |
$46.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.84
|
| Rate for Payer: Cash Price |
$44.11
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Cofinity Commercial |
$47.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.11
|
| Rate for Payer: Healthscope Commercial |
$49.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.87
|
| Rate for Payer: PHP Commercial |
$46.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.84
|
| Rate for Payer: Priority Health SBD |
$34.74
|
| Rate for Payer: UMR Bronson Commercial |
$24.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.35
|
|
|
HC ISOAGGLUTININ TITER ANTI A
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.07 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: UMR Bronson Commercial |
$48.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC ISOAGGLUTININ TITER ANTI A
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Cofinity Commercial |
$76.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$9.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: UMR Bronson Commercial |
$40.42
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC ISOAGGLUTININ TITER ANTI B
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Cofinity Commercial |
$76.47
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$9.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: UMR Bronson Commercial |
$40.42
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC ISOAGGLUTININ TITER ANTI B
|
Facility
|
IP
|
$109.24
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.07 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$76.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.01
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: UMR Bronson Commercial |
$48.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC ISOPROPANOL LVL
|
Facility
|
OP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.87 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna American Axle |
$103.43
|
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: Aetna Medicare |
$79.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.43
|
| Rate for Payer: BCBS Complete |
$63.65
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$111.38
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$111.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health SBD |
$100.25
|
| Rate for Payer: UMR Bronson Commercial |
$58.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC ISOPROPANOL LVL
|
Facility
|
IP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.01 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna American Axle |
$103.43
|
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.43
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$111.38
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$111.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health SBD |
$100.25
|
| Rate for Payer: UMR Bronson Commercial |
$70.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC ISOVUE 200M PER ML
|
Facility
|
IP
|
$2.40
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600033
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.06 |
| Max. Negotiated Rate |
$2.16 |
| Rate for Payer: Aetna American Axle |
$1.56
|
| Rate for Payer: Aetna Commercial |
$2.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.56
|
| Rate for Payer: Cash Price |
$1.92
|
| Rate for Payer: Cofinity Commercial |
$1.68
|
| Rate for Payer: Cofinity Commercial |
$2.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.92
|
| Rate for Payer: Healthscope Commercial |
$2.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.04
|
| Rate for Payer: PHP Commercial |
$2.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.56
|
| Rate for Payer: Priority Health SBD |
$1.51
|
| Rate for Payer: UMR Bronson Commercial |
$1.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.80
|
|
|
HC ISOVUE 200M PER ML
|
Facility
|
OP
|
$2.40
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600033
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.89 |
| Max. Negotiated Rate |
$2.16 |
| Rate for Payer: Aetna American Axle |
$1.56
|
| Rate for Payer: Aetna Commercial |
$2.04
|
| Rate for Payer: Aetna Medicare |
$1.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.56
|
| Rate for Payer: BCBS Complete |
$0.96
|
| Rate for Payer: Cash Price |
$1.92
|
| Rate for Payer: Cofinity Commercial |
$1.68
|
| Rate for Payer: Cofinity Commercial |
$2.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.92
|
| Rate for Payer: Healthscope Commercial |
$2.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.04
|
| Rate for Payer: PHP Commercial |
$2.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.56
|
| Rate for Payer: Priority Health SBD |
$1.51
|
| Rate for Payer: UMR Bronson Commercial |
$0.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.80
|
|
|
HC ISOVUE 200 PER ML
|
Facility
|
OP
|
$4.46
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600011
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.65 |
| Max. Negotiated Rate |
$4.01 |
| Rate for Payer: Aetna American Axle |
$2.90
|
| Rate for Payer: Aetna Commercial |
$3.79
|
| Rate for Payer: Aetna Medicare |
$2.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.90
|
| Rate for Payer: BCBS Complete |
$1.78
|
| Rate for Payer: Cash Price |
$3.57
|
| Rate for Payer: Cofinity Commercial |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$3.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.57
|
| Rate for Payer: Healthscope Commercial |
$4.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.79
|
| Rate for Payer: PHP Commercial |
$3.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.90
|
| Rate for Payer: Priority Health SBD |
$2.81
|
| Rate for Payer: UMR Bronson Commercial |
$1.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.35
|
|
|
HC ISOVUE 200 PER ML
|
Facility
|
IP
|
$4.46
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600011
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.96 |
| Max. Negotiated Rate |
$4.01 |
| Rate for Payer: Aetna American Axle |
$2.90
|
| Rate for Payer: Aetna Commercial |
$3.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.90
|
| Rate for Payer: Cash Price |
$3.57
|
| Rate for Payer: Cofinity Commercial |
$3.12
|
| Rate for Payer: Cofinity Commercial |
$3.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.57
|
| Rate for Payer: Healthscope Commercial |
$4.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.79
|
| Rate for Payer: PHP Commercial |
$3.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.90
|
| Rate for Payer: Priority Health SBD |
$2.81
|
| Rate for Payer: UMR Bronson Commercial |
$1.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.35
|
|
|
HC ISOVUE 300M PER ML
|
Facility
|
IP
|
$1.94
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600034
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.85 |
| Max. Negotiated Rate |
$1.75 |
| Rate for Payer: Aetna American Axle |
$1.26
|
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.26
|
| Rate for Payer: Cash Price |
$1.55
|
| Rate for Payer: Cofinity Commercial |
$1.36
|
| Rate for Payer: Cofinity Commercial |
$1.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.55
|
| Rate for Payer: Healthscope Commercial |
$1.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.65
|
| Rate for Payer: PHP Commercial |
$1.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.26
|
| Rate for Payer: Priority Health SBD |
$1.22
|
| Rate for Payer: UMR Bronson Commercial |
$0.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.46
|
|
|
HC ISOVUE 300M PER ML
|
Facility
|
OP
|
$1.94
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600034
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$1.75 |
| Rate for Payer: Aetna American Axle |
$1.26
|
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare |
$0.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.26
|
| Rate for Payer: BCBS Complete |
$0.78
|
| Rate for Payer: Cash Price |
$1.55
|
| Rate for Payer: Cofinity Commercial |
$1.36
|
| Rate for Payer: Cofinity Commercial |
$1.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.55
|
| Rate for Payer: Healthscope Commercial |
$1.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.65
|
| Rate for Payer: PHP Commercial |
$1.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.26
|
| Rate for Payer: Priority Health SBD |
$1.22
|
| Rate for Payer: UMR Bronson Commercial |
$0.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.46
|
|
|
HC ISOVUE 300 PER ML
|
Facility
|
IP
|
$1.67
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600012
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.73 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna American Axle |
$1.09
|
| Rate for Payer: Aetna Commercial |
$1.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.09
|
| Rate for Payer: Cash Price |
$1.34
|
| Rate for Payer: Cofinity Commercial |
$1.17
|
| Rate for Payer: Cofinity Commercial |
$1.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.34
|
| Rate for Payer: Healthscope Commercial |
$1.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.42
|
| Rate for Payer: PHP Commercial |
$1.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.09
|
| Rate for Payer: Priority Health SBD |
$1.05
|
| Rate for Payer: UMR Bronson Commercial |
$0.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.25
|
|
|
HC ISOVUE 300 PER ML
|
Facility
|
OP
|
$1.67
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600012
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Aetna American Axle |
$1.09
|
| Rate for Payer: Aetna Commercial |
$1.42
|
| Rate for Payer: Aetna Medicare |
$0.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.09
|
| Rate for Payer: BCBS Complete |
$0.67
|
| Rate for Payer: Cash Price |
$1.34
|
| Rate for Payer: Cofinity Commercial |
$1.17
|
| Rate for Payer: Cofinity Commercial |
$1.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.34
|
| Rate for Payer: Healthscope Commercial |
$1.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.42
|
| Rate for Payer: PHP Commercial |
$1.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.09
|
| Rate for Payer: Priority Health SBD |
$1.05
|
| Rate for Payer: UMR Bronson Commercial |
$0.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.25
|
|
|
HC ISOVUE 370 PER ML
|
Facility
|
OP
|
$1.90
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600013
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$1.71 |
| Rate for Payer: Aetna American Axle |
$1.24
|
| Rate for Payer: Aetna Commercial |
$1.61
|
| Rate for Payer: Aetna Medicare |
$0.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.24
|
| Rate for Payer: BCBS Complete |
$0.76
|
| Rate for Payer: Cash Price |
$1.52
|
| Rate for Payer: Cofinity Commercial |
$1.33
|
| Rate for Payer: Cofinity Commercial |
$1.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.52
|
| Rate for Payer: Healthscope Commercial |
$1.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.61
|
| Rate for Payer: PHP Commercial |
$1.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.24
|
| Rate for Payer: Priority Health SBD |
$1.20
|
| Rate for Payer: UMR Bronson Commercial |
$0.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.43
|
|
|
HC ISOVUE 370 PER ML
|
Facility
|
IP
|
$1.90
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600013
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$1.71 |
| Rate for Payer: Aetna American Axle |
$1.24
|
| Rate for Payer: Aetna Commercial |
$1.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.24
|
| Rate for Payer: Cash Price |
$1.52
|
| Rate for Payer: Cofinity Commercial |
$1.33
|
| Rate for Payer: Cofinity Commercial |
$1.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.52
|
| Rate for Payer: Healthscope Commercial |
$1.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.61
|
| Rate for Payer: PHP Commercial |
$1.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.24
|
| Rate for Payer: Priority Health SBD |
$1.20
|
| Rate for Payer: UMR Bronson Commercial |
$0.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.43
|
|
|
HC IUD REMOVAL
|
Facility
|
OP
|
$321.69
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
45000086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$119.03 |
| Max. Negotiated Rate |
$835.10 |
| Rate for Payer: Aetna American Axle |
$209.10
|
| Rate for Payer: Aetna Commercial |
$273.44
|
| Rate for Payer: Aetna Medicare |
$308.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.84
|
| Rate for Payer: BCBS Complete |
$166.97
|
| Rate for Payer: BCBS MAPPO |
$296.67
|
| Rate for Payer: BCN Medicare Advantage |
$296.67
|
| Rate for Payer: Cash Price |
$257.35
|
| Rate for Payer: Cash Price |
$257.35
|
| Rate for Payer: Cofinity Commercial |
$276.65
|
| Rate for Payer: Cofinity Commercial |
$225.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$225.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.67
|
| Rate for Payer: Healthscope Commercial |
$289.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.27
|
| Rate for Payer: Mclaren Medicaid |
$159.02
|
| Rate for Payer: Mclaren Medicare |
$296.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.50
|
| Rate for Payer: Meridian Medicaid |
$166.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$341.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.44
|
| Rate for Payer: PACE Medicare |
$281.84
|
| Rate for Payer: PACE SWMI |
$296.67
|
| Rate for Payer: PHP Commercial |
$273.44
|
| Rate for Payer: PHP Medicare Advantage |
$296.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.10
|
| Rate for Payer: Priority Health Medicare |
$296.67
|
| Rate for Payer: Priority Health SBD |
$202.66
|
| Rate for Payer: Railroad Medicare Medicare |
$296.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.67
|
| Rate for Payer: UHC Exchange |
$566.97
|
| Rate for Payer: UHC Medicare Advantage |
$296.67
|
| Rate for Payer: UHCCP Medicaid |
$159.02
|
| Rate for Payer: UMR Bronson Commercial |
$119.03
|
| Rate for Payer: VA VA |
$296.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.27
|
|
|
HC IUD REMOVAL
|
Facility
|
IP
|
$321.69
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
45000086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$141.54 |
| Max. Negotiated Rate |
$289.52 |
| Rate for Payer: Aetna American Axle |
$209.10
|
| Rate for Payer: Aetna Commercial |
$273.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$209.10
|
| Rate for Payer: Cash Price |
$257.35
|
| Rate for Payer: Cofinity Commercial |
$225.18
|
| Rate for Payer: Cofinity Commercial |
$276.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$225.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$257.35
|
| Rate for Payer: Healthscope Commercial |
$289.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$225.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$241.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$273.44
|
| Rate for Payer: PHP Commercial |
$273.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$209.10
|
| Rate for Payer: Priority Health SBD |
$202.66
|
| Rate for Payer: UMR Bronson Commercial |
$141.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$241.27
|
|
|
HC IUPC ASSIST
|
Facility
|
OP
|
$119.72
|
|
| Hospital Charge Code |
27000120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$44.30 |
| Max. Negotiated Rate |
$107.75 |
| Rate for Payer: Aetna American Axle |
$77.82
|
| Rate for Payer: Aetna Commercial |
$101.76
|
| Rate for Payer: Aetna Medicare |
$59.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.82
|
| Rate for Payer: BCBS Complete |
$47.89
|
| Rate for Payer: Cash Price |
$95.78
|
| Rate for Payer: Cofinity Commercial |
$102.96
|
| Rate for Payer: Cofinity Commercial |
$83.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.78
|
| Rate for Payer: Healthscope Commercial |
$107.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.76
|
| Rate for Payer: PHP Commercial |
$101.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.82
|
| Rate for Payer: Priority Health SBD |
$75.42
|
| Rate for Payer: UMR Bronson Commercial |
$44.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.79
|
|
