|
HC IVUS EA ADDL NON CORONARY VESSEL
|
Facility
|
OP
|
$1,324.84
|
|
|
Service Code
|
CPT 37253
|
| Hospital Charge Code |
36100484
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$67.96 |
| Max. Negotiated Rate |
$1,192.36 |
| Rate for Payer: Aetna American Axle |
$861.15
|
| Rate for Payer: Aetna Commercial |
$1,126.11
|
| Rate for Payer: Aetna Medicare |
$662.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.15
|
| Rate for Payer: BCBS Complete |
$529.94
|
| Rate for Payer: BCBS Trust/PPO |
$850.88
|
| Rate for Payer: BCN Commercial |
$850.88
|
| Rate for Payer: Cash Price |
$1,059.87
|
| Rate for Payer: Cash Price |
$1,059.87
|
| Rate for Payer: Cash Price |
$1,059.87
|
| Rate for Payer: Cofinity Commercial |
$927.39
|
| Rate for Payer: Cofinity Commercial |
$1,139.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$927.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,059.87
|
| Rate for Payer: Healthscope Commercial |
$1,192.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$927.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$993.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.11
|
| Rate for Payer: PHP Commercial |
$1,126.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.15
|
| Rate for Payer: Priority Health SBD |
$834.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.76
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$67.96
|
| Rate for Payer: UMR Bronson Commercial |
$490.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$993.63
|
|
|
HC IVUS NON CORONARY INITIAL
|
Facility
|
IP
|
$7,832.55
|
|
|
Service Code
|
CPT 37252
|
| Hospital Charge Code |
36100483
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,446.32 |
| Max. Negotiated Rate |
$7,049.30 |
| Rate for Payer: Aetna American Axle |
$5,091.16
|
| Rate for Payer: Aetna Commercial |
$6,657.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,091.16
|
| Rate for Payer: Cash Price |
$6,266.04
|
| Rate for Payer: Cofinity Commercial |
$5,482.78
|
| Rate for Payer: Cofinity Commercial |
$6,735.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,482.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,266.04
|
| Rate for Payer: Healthscope Commercial |
$7,049.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,482.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,874.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,657.67
|
| Rate for Payer: PHP Commercial |
$6,657.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,091.16
|
| Rate for Payer: Priority Health SBD |
$4,934.51
|
| Rate for Payer: UMR Bronson Commercial |
$3,446.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,874.41
|
|
|
HC IVUS NON CORONARY INITIAL
|
Facility
|
OP
|
$7,832.55
|
|
|
Service Code
|
CPT 37252
|
| Hospital Charge Code |
36100483
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.51 |
| Max. Negotiated Rate |
$7,049.30 |
| Rate for Payer: Aetna American Axle |
$5,091.16
|
| Rate for Payer: Aetna Commercial |
$6,657.67
|
| Rate for Payer: Aetna Medicare |
$3,916.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,091.16
|
| Rate for Payer: BCBS Complete |
$3,133.02
|
| Rate for Payer: BCBS Trust/PPO |
$5,766.76
|
| Rate for Payer: BCN Commercial |
$5,766.76
|
| Rate for Payer: Cash Price |
$6,266.04
|
| Rate for Payer: Cash Price |
$6,266.04
|
| Rate for Payer: Cash Price |
$6,266.04
|
| Rate for Payer: Cofinity Commercial |
$6,735.99
|
| Rate for Payer: Cofinity Commercial |
$5,482.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,482.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,266.04
|
| Rate for Payer: Healthscope Commercial |
$7,049.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,482.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,874.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,657.67
|
| Rate for Payer: PHP Commercial |
$6,657.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,091.16
|
| Rate for Payer: Priority Health SBD |
$4,934.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.06
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$85.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,898.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,874.41
|
|
|
HC IVUS OR OCT EACH ADDL VESSEL
|
Facility
|
OP
|
$1,532.20
|
|
|
Service Code
|
CPT 92979
|
| Hospital Charge Code |
48100107
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$566.91 |
| Max. Negotiated Rate |
$1,378.98 |
| Rate for Payer: Aetna American Axle |
$995.93
|
| Rate for Payer: Aetna Commercial |
$1,302.37
|
| Rate for Payer: Aetna Medicare |
$766.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.93
|
| Rate for Payer: BCBS Complete |
$612.88
|
| Rate for Payer: BCBS Trust/PPO |
$624.20
|
| Rate for Payer: BCN Commercial |
$624.20
|
| Rate for Payer: Cash Price |
$1,225.76
|
| Rate for Payer: Cash Price |
$1,225.76
|
| Rate for Payer: Cash Price |
$1,225.76
|
| Rate for Payer: Cofinity Commercial |
$1,317.69
|
| Rate for Payer: Cofinity Commercial |
$1,072.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,072.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,225.76
|
| Rate for Payer: Healthscope Commercial |
$1,378.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,072.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,149.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,302.37
|
| Rate for Payer: PHP Commercial |
$1,302.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.93
|
| Rate for Payer: Priority Health SBD |
$965.29
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UMR Bronson Commercial |
$566.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,149.15
|
|
|
HC IVUS OR OCT EACH ADDL VESSEL
|
Facility
|
IP
|
$1,532.20
|
|
|
Service Code
|
CPT 92979
|
| Hospital Charge Code |
48100107
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$674.17 |
| Max. Negotiated Rate |
$1,378.98 |
| Rate for Payer: Aetna American Axle |
$995.93
|
| Rate for Payer: Aetna Commercial |
$1,302.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.93
|
| Rate for Payer: Cash Price |
$1,225.76
|
| Rate for Payer: Cofinity Commercial |
$1,072.54
|
| Rate for Payer: Cofinity Commercial |
$1,317.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,072.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,225.76
|
| Rate for Payer: Healthscope Commercial |
$1,378.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,072.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,149.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,302.37
|
| Rate for Payer: PHP Commercial |
$1,302.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.93
|
| Rate for Payer: Priority Health SBD |
$965.29
|
| Rate for Payer: UMR Bronson Commercial |
$674.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,149.15
|
|
|
HC IVUS OR OCT INITIAL VESSEL
|
Facility
|
OP
|
$3,693.88
|
|
|
Service Code
|
CPT 92978
|
| Hospital Charge Code |
48100106
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$700.00 |
| Max. Negotiated Rate |
$3,324.49 |
| Rate for Payer: Aetna American Axle |
$2,401.02
|
| Rate for Payer: Aetna Commercial |
$3,139.80
|
| Rate for Payer: Aetna Medicare |
$1,846.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,401.02
|
| Rate for Payer: BCBS Complete |
$1,477.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,037.74
|
| Rate for Payer: BCN Commercial |
$1,037.74
|
| Rate for Payer: Cash Price |
$2,955.10
|
| Rate for Payer: Cash Price |
$2,955.10
|
| Rate for Payer: Cash Price |
$2,955.10
|
| Rate for Payer: Cofinity Commercial |
$3,176.74
|
| Rate for Payer: Cofinity Commercial |
$2,585.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,585.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,955.10
|
| Rate for Payer: Healthscope Commercial |
$3,324.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.80
|
| Rate for Payer: PHP Commercial |
$3,139.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,401.02
|
| Rate for Payer: Priority Health SBD |
$2,327.14
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,366.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.41
|
|
|
HC IVUS OR OCT INITIAL VESSEL
|
Facility
|
IP
|
$3,693.88
|
|
|
Service Code
|
CPT 92978
|
| Hospital Charge Code |
48100106
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,625.31 |
| Max. Negotiated Rate |
$3,324.49 |
| Rate for Payer: Aetna American Axle |
$2,401.02
|
| Rate for Payer: Aetna Commercial |
$3,139.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,401.02
|
| Rate for Payer: Cash Price |
$2,955.10
|
| Rate for Payer: Cofinity Commercial |
$2,585.72
|
| Rate for Payer: Cofinity Commercial |
$3,176.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,585.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,955.10
|
| Rate for Payer: Healthscope Commercial |
$3,324.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.80
|
| Rate for Payer: PHP Commercial |
$3,139.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,401.02
|
| Rate for Payer: Priority Health SBD |
$2,327.14
|
| Rate for Payer: UMR Bronson Commercial |
$1,625.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.41
|
|
|
HC JAK2 EXON 12 MUTATION DETECTION
|
Facility
|
IP
|
$373.32
|
|
|
Service Code
|
CPT 0027U
|
| Hospital Charge Code |
31000148
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$164.26 |
| Max. Negotiated Rate |
$335.99 |
| Rate for Payer: Aetna American Axle |
$242.66
|
| Rate for Payer: Aetna Commercial |
$317.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.66
|
| Rate for Payer: Cash Price |
$298.66
|
| Rate for Payer: Cofinity Commercial |
$261.32
|
| Rate for Payer: Cofinity Commercial |
$321.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$261.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.66
|
| Rate for Payer: Healthscope Commercial |
$335.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$261.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.32
|
| Rate for Payer: PHP Commercial |
$317.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.66
|
| Rate for Payer: Priority Health SBD |
$235.19
|
| Rate for Payer: UMR Bronson Commercial |
$164.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.99
|
|
|
HC JAK2 EXON 12 MUTATION DETECTION
|
Facility
|
OP
|
$373.32
|
|
|
Service Code
|
CPT 0027U
|
| Hospital Charge Code |
31000148
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$65.34 |
| Max. Negotiated Rate |
$4,320.00 |
| Rate for Payer: Aetna American Axle |
$242.66
|
| Rate for Payer: Aetna Commercial |
$317.32
|
| Rate for Payer: Aetna Medicare |
$126.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$242.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$152.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$152.39
|
| Rate for Payer: BCBS Complete |
$68.61
|
| Rate for Payer: BCBS MAPPO |
$121.91
|
| Rate for Payer: BCBS Trust/PPO |
$117.45
|
| Rate for Payer: BCN Commercial |
$117.45
|
| Rate for Payer: BCN Medicare Advantage |
$121.91
|
| Rate for Payer: Cash Price |
$298.66
|
| Rate for Payer: Cash Price |
$298.66
|
| Rate for Payer: Cofinity Commercial |
$321.06
|
| Rate for Payer: Cofinity Commercial |
$261.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$261.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$121.91
|
| Rate for Payer: Healthscope Commercial |
$335.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$261.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.99
|
| Rate for Payer: Mclaren Medicaid |
$65.34
|
| Rate for Payer: Mclaren Medicare |
$121.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.01
|
| Rate for Payer: Meridian Medicaid |
$68.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$140.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.32
|
| Rate for Payer: Nomi Health Commercial |
$365.73
|
| Rate for Payer: PACE Medicare |
$115.81
|
| Rate for Payer: PACE SWMI |
$121.91
|
| Rate for Payer: PHP Commercial |
$317.32
|
| Rate for Payer: PHP Medicare Advantage |
$121.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.66
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$121.91
|
| Rate for Payer: Priority Health Medicare |
$121.91
|
| Rate for Payer: Priority Health Narrow Network |
$97.53
|
| Rate for Payer: Priority Health SBD |
$235.19
|
| Rate for Payer: Railroad Medicare Medicare |
$121.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.29
|
| Rate for Payer: UHC Core |
$4,320.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$121.91
|
| Rate for Payer: UHC Exchange |
$121.91
|
| Rate for Payer: UHC Medicare Advantage |
$121.91
|
| Rate for Payer: UHCCP Medicaid |
$65.34
|
| Rate for Payer: UMR Bronson Commercial |
$138.13
|
| Rate for Payer: VA VA |
$121.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.99
|
|
|
HC JAK2 V617F MUTATION
|
Facility
|
OP
|
$388.07
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
31000101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$49.13 |
| Max. Negotiated Rate |
$349.26 |
| Rate for Payer: Aetna American Axle |
$252.25
|
| Rate for Payer: Aetna Commercial |
$329.86
|
| Rate for Payer: Aetna Medicare |
$95.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.58
|
| Rate for Payer: BCBS Complete |
$51.59
|
| Rate for Payer: BCBS MAPPO |
$91.66
|
| Rate for Payer: BCBS Trust/PPO |
$88.32
|
| Rate for Payer: BCN Commercial |
$88.32
|
| Rate for Payer: BCN Medicare Advantage |
$91.66
|
| Rate for Payer: Cash Price |
$310.46
|
| Rate for Payer: Cash Price |
$310.46
|
| Rate for Payer: Cofinity Commercial |
$333.74
|
| Rate for Payer: Cofinity Commercial |
$271.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$271.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.66
|
| Rate for Payer: Healthscope Commercial |
$349.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$271.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.05
|
| Rate for Payer: Mclaren Medicaid |
$49.13
|
| Rate for Payer: Mclaren Medicare |
$91.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.24
|
| Rate for Payer: Meridian Medicaid |
$51.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.86
|
| Rate for Payer: Nomi Health Commercial |
$274.98
|
| Rate for Payer: PACE Medicare |
$87.08
|
| Rate for Payer: PACE SWMI |
$91.66
|
| Rate for Payer: PHP Commercial |
$329.86
|
| Rate for Payer: PHP Medicare Advantage |
$91.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$94.31
|
| Rate for Payer: Priority Health Medicare |
$91.66
|
| Rate for Payer: Priority Health Narrow Network |
$75.45
|
| Rate for Payer: Priority Health SBD |
$244.48
|
| Rate for Payer: Railroad Medicare Medicare |
$91.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.99
|
| Rate for Payer: UHC Core |
$164.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.66
|
| Rate for Payer: UHC Exchange |
$91.66
|
| Rate for Payer: UHC Medicare Advantage |
$91.66
|
| Rate for Payer: UHCCP Medicaid |
$49.13
|
| Rate for Payer: UMR Bronson Commercial |
$143.59
|
| Rate for Payer: VA VA |
$91.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.05
|
|
|
HC JAK2 V617F MUTATION
|
Facility
|
IP
|
$388.07
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
31000101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$170.75 |
| Max. Negotiated Rate |
$349.26 |
| Rate for Payer: Aetna American Axle |
$252.25
|
| Rate for Payer: Aetna Commercial |
$329.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.25
|
| Rate for Payer: Cash Price |
$310.46
|
| Rate for Payer: Cofinity Commercial |
$271.65
|
| Rate for Payer: Cofinity Commercial |
$333.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$271.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.46
|
| Rate for Payer: Healthscope Commercial |
$349.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$271.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.86
|
| Rate for Payer: PHP Commercial |
$329.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.25
|
| Rate for Payer: Priority Health SBD |
$244.48
|
| Rate for Payer: UMR Bronson Commercial |
$170.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.05
|
|
|
HC JC VIRUS, PCR, CSF
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600335
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.57 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna American Axle |
$70.28
|
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.28
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health SBD |
$68.12
|
| Rate for Payer: UMR Bronson Commercial |
$47.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC JC VIRUS, PCR, CSF
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600335
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna American Axle |
$70.28
|
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.28
|
| 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 |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$68.12
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$40.00
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC JET VENT INITIAL DAY
|
Facility
|
IP
|
$2,576.21
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000057
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,133.53 |
| Max. Negotiated Rate |
$2,318.59 |
| Rate for Payer: Aetna American Axle |
$1,674.54
|
| Rate for Payer: Aetna Commercial |
$2,189.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,674.54
|
| Rate for Payer: Cash Price |
$2,060.97
|
| Rate for Payer: Cofinity Commercial |
$1,803.35
|
| Rate for Payer: Cofinity Commercial |
$2,215.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,803.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,060.97
|
| Rate for Payer: Healthscope Commercial |
$2,318.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,803.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,932.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,189.78
|
| Rate for Payer: PHP Commercial |
$2,189.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,674.54
|
| Rate for Payer: Priority Health SBD |
$1,623.01
|
| Rate for Payer: UMR Bronson Commercial |
$1,133.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,932.16
|
|
|
HC JET VENT INITIAL DAY
|
Facility
|
OP
|
$2,576.21
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000057
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$77.51 |
| Max. Negotiated Rate |
$2,318.59 |
| Rate for Payer: Aetna American Axle |
$1,674.54
|
| Rate for Payer: Aetna Commercial |
$2,189.78
|
| Rate for Payer: Aetna Medicare |
$673.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,674.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$809.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$809.66
|
| Rate for Payer: BCBS Complete |
$364.54
|
| Rate for Payer: BCBS MAPPO |
$647.73
|
| Rate for Payer: BCBS Trust/PPO |
$77.51
|
| Rate for Payer: BCN Commercial |
$77.51
|
| Rate for Payer: BCN Medicare Advantage |
$647.73
|
| Rate for Payer: Cash Price |
$2,060.97
|
| Rate for Payer: Cash Price |
$2,060.97
|
| Rate for Payer: Cash Price |
$2,060.97
|
| Rate for Payer: Cofinity Commercial |
$1,803.35
|
| Rate for Payer: Cofinity Commercial |
$2,215.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,803.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,060.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.73
|
| Rate for Payer: Healthscope Commercial |
$2,318.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,803.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,932.16
|
| Rate for Payer: Mclaren Medicaid |
$347.18
|
| Rate for Payer: Mclaren Medicare |
$647.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.12
|
| Rate for Payer: Meridian Medicaid |
$364.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$744.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,189.78
|
| Rate for Payer: Nomi Health Commercial |
$1,943.19
|
| Rate for Payer: PACE Medicare |
$615.34
|
| Rate for Payer: PACE SWMI |
$647.73
|
| Rate for Payer: PHP Commercial |
$2,189.78
|
| Rate for Payer: PHP Medicare Advantage |
$647.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,674.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,035.81
|
| Rate for Payer: Priority Health Medicare |
$647.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,628.65
|
| Rate for Payer: Priority Health SBD |
$1,623.01
|
| Rate for Payer: Railroad Medicare Medicare |
$647.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.48
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.73
|
| Rate for Payer: UHC Exchange |
$87.71
|
| Rate for Payer: UHC Medicare Advantage |
$647.73
|
| Rate for Payer: UHCCP Medicaid |
$347.18
|
| Rate for Payer: UMR Bronson Commercial |
$953.20
|
| Rate for Payer: VA VA |
$647.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,932.16
|
|
|
HC JET VENT SUB DAY
|
Facility
|
OP
|
$1,897.80
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000058
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$2,035.81 |
| Rate for Payer: Aetna American Axle |
$1,233.57
|
| Rate for Payer: Aetna Commercial |
$1,613.13
|
| Rate for Payer: Aetna Medicare |
$673.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,233.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$809.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$809.66
|
| Rate for Payer: BCBS Complete |
$364.54
|
| Rate for Payer: BCBS MAPPO |
$647.73
|
| Rate for Payer: BCBS Trust/PPO |
$59.20
|
| Rate for Payer: BCN Commercial |
$59.20
|
| Rate for Payer: BCN Medicare Advantage |
$647.73
|
| Rate for Payer: Cash Price |
$1,518.24
|
| Rate for Payer: Cash Price |
$1,518.24
|
| Rate for Payer: Cash Price |
$1,518.24
|
| Rate for Payer: Cofinity Commercial |
$1,328.46
|
| Rate for Payer: Cofinity Commercial |
$1,632.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,328.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$647.73
|
| Rate for Payer: Healthscope Commercial |
$1,708.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,328.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.35
|
| Rate for Payer: Mclaren Medicaid |
$347.18
|
| Rate for Payer: Mclaren Medicare |
$647.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$680.12
|
| Rate for Payer: Meridian Medicaid |
$364.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$744.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.13
|
| Rate for Payer: Nomi Health Commercial |
$1,943.19
|
| Rate for Payer: PACE Medicare |
$615.34
|
| Rate for Payer: PACE SWMI |
$647.73
|
| Rate for Payer: PHP Commercial |
$1,613.13
|
| Rate for Payer: PHP Medicare Advantage |
$647.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,233.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,035.81
|
| Rate for Payer: Priority Health Medicare |
$647.73
|
| Rate for Payer: Priority Health Narrow Network |
$1,628.65
|
| Rate for Payer: Priority Health SBD |
$1,195.61
|
| Rate for Payer: Railroad Medicare Medicare |
$647.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.77
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$647.73
|
| Rate for Payer: UHC Exchange |
$61.61
|
| Rate for Payer: UHC Medicare Advantage |
$647.73
|
| Rate for Payer: UHCCP Medicaid |
$347.18
|
| Rate for Payer: UMR Bronson Commercial |
$702.19
|
| Rate for Payer: VA VA |
$647.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.35
|
|
|
HC JET VENT SUB DAY
|
Facility
|
IP
|
$1,897.80
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000058
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$835.03 |
| Max. Negotiated Rate |
$1,708.02 |
| Rate for Payer: Aetna American Axle |
$1,233.57
|
| Rate for Payer: Aetna Commercial |
$1,613.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,233.57
|
| Rate for Payer: Cash Price |
$1,518.24
|
| Rate for Payer: Cofinity Commercial |
$1,328.46
|
| Rate for Payer: Cofinity Commercial |
$1,632.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,328.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.24
|
| Rate for Payer: Healthscope Commercial |
$1,708.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,328.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.13
|
| Rate for Payer: PHP Commercial |
$1,613.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,233.57
|
| Rate for Payer: Priority Health SBD |
$1,195.61
|
| Rate for Payer: UMR Bronson Commercial |
$835.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.35
|
|
|
HC JO 1 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC JO 1 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC JOBST FOAM PADDING
|
Facility
|
IP
|
$11.11
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000364
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Cofinity Commercial |
$7.78
|
| Rate for Payer: Cofinity Commercial |
$9.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.78
|
| Rate for Payer: Aetna American Axle |
$7.22
|
| Rate for Payer: Aetna Commercial |
$9.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.22
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$10.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.44
|
| Rate for Payer: PHP Commercial |
$9.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.22
|
| Rate for Payer: Priority Health SBD |
$7.00
|
| Rate for Payer: UMR Bronson Commercial |
$4.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.33
|
|
|
HC JOBST FOAM PADDING
|
Facility
|
OP
|
$11.11
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000364
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.11 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Aetna American Axle |
$7.22
|
| Rate for Payer: Aetna Commercial |
$9.44
|
| Rate for Payer: Aetna Medicare |
$5.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.22
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Cofinity Commercial |
$7.78
|
| Rate for Payer: Cofinity Commercial |
$9.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$7.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$10.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.44
|
| Rate for Payer: PHP Commercial |
$9.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.22
|
| Rate for Payer: Priority Health SBD |
$7.00
|
| Rate for Payer: UMR Bronson Commercial |
$4.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.33
|
|
|
HC JOINT W MANUAL STRESS
|
Facility
|
OP
|
$212.87
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
32000287
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$271.13 |
| Rate for Payer: Aetna American Axle |
$138.37
|
| Rate for Payer: Aetna Commercial |
$180.94
|
| Rate for Payer: Aetna Medicare |
$89.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.84
|
| Rate for Payer: BCBS Complete |
$48.55
|
| Rate for Payer: BCBS MAPPO |
$86.27
|
| Rate for Payer: BCBS Trust/PPO |
$112.89
|
| Rate for Payer: BCN Commercial |
$112.89
|
| Rate for Payer: BCN Medicare Advantage |
$86.27
|
| Rate for Payer: Cash Price |
$170.30
|
| Rate for Payer: Cash Price |
$170.30
|
| Rate for Payer: Cofinity Commercial |
$183.07
|
| Rate for Payer: Cofinity Commercial |
$149.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.27
|
| Rate for Payer: Healthscope Commercial |
$191.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.65
|
| Rate for Payer: Mclaren Medicaid |
$46.24
|
| Rate for Payer: Mclaren Medicare |
$86.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.58
|
| Rate for Payer: Meridian Medicaid |
$48.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.94
|
| Rate for Payer: Nomi Health Commercial |
$258.81
|
| Rate for Payer: PACE Medicare |
$81.96
|
| Rate for Payer: PACE SWMI |
$86.27
|
| Rate for Payer: PHP Commercial |
$180.94
|
| Rate for Payer: PHP Medicare Advantage |
$86.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$271.13
|
| Rate for Payer: Priority Health Medicare |
$86.27
|
| Rate for Payer: Priority Health Narrow Network |
$216.90
|
| Rate for Payer: Priority Health SBD |
$134.11
|
| Rate for Payer: Railroad Medicare Medicare |
$86.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.11
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$86.27
|
| Rate for Payer: UHC Exchange |
$51.01
|
| Rate for Payer: UHC Medicare Advantage |
$86.27
|
| Rate for Payer: UHCCP Medicaid |
$46.24
|
| Rate for Payer: UMR Bronson Commercial |
$78.76
|
| Rate for Payer: VA VA |
$86.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.65
|
|
|
HC JOINT W MANUAL STRESS
|
Facility
|
IP
|
$212.87
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
32000287
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$93.66 |
| Max. Negotiated Rate |
$191.58 |
| Rate for Payer: Aetna American Axle |
$138.37
|
| Rate for Payer: Aetna Commercial |
$180.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$138.37
|
| Rate for Payer: Cash Price |
$170.30
|
| Rate for Payer: Cofinity Commercial |
$149.01
|
| Rate for Payer: Cofinity Commercial |
$183.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$149.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.30
|
| Rate for Payer: Healthscope Commercial |
$191.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$149.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.94
|
| Rate for Payer: PHP Commercial |
$180.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.37
|
| Rate for Payer: Priority Health SBD |
$134.11
|
| Rate for Payer: UMR Bronson Commercial |
$93.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.65
|
|
|
HC KAPPA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100307
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.06 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna American Axle |
$50.32
|
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.32
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$54.19
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health SBD |
$48.77
|
| Rate for Payer: UMR Bronson Commercial |
$34.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC KAPPA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100307
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna American Axle |
$50.32
|
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.32
|
| 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 |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$16.64
|
| Rate for Payer: BCN Commercial |
$16.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$54.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| 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 |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$25.90
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$13.82
|
| Rate for Payer: Priority Health SBD |
$48.77
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: UMR Bronson Commercial |
$28.65
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
