|
HC LABOR CAT (5) 12-17HRS
|
Facility
|
OP
|
$4,589.55
|
|
| Hospital Charge Code |
72000007
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,698.13 |
| Max. Negotiated Rate |
$4,130.60 |
| Rate for Payer: Aetna American Axle |
$2,983.21
|
| Rate for Payer: Aetna Commercial |
$3,901.12
|
| Rate for Payer: Aetna Medicare |
$2,294.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,983.21
|
| Rate for Payer: BCBS Complete |
$1,835.82
|
| Rate for Payer: Cash Price |
$3,671.64
|
| Rate for Payer: Cash Price |
$3,671.64
|
| Rate for Payer: Cofinity Commercial |
$3,212.68
|
| Rate for Payer: Cofinity Commercial |
$3,947.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,212.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,671.64
|
| Rate for Payer: Healthscope Commercial |
$4,130.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,212.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,442.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,901.12
|
| Rate for Payer: PHP Commercial |
$3,901.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,983.21
|
| Rate for Payer: Priority Health SBD |
$2,891.42
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,698.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,442.16
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
OP
|
$6,790.05
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,286.00 |
| Max. Negotiated Rate |
$6,111.05 |
| Rate for Payer: Aetna American Axle |
$4,413.53
|
| Rate for Payer: Aetna Commercial |
$5,771.54
|
| Rate for Payer: Aetna Medicare |
$3,395.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,413.53
|
| Rate for Payer: BCBS Complete |
$2,716.02
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cofinity Commercial |
$4,753.03
|
| Rate for Payer: Cofinity Commercial |
$5,839.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,753.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,432.04
|
| Rate for Payer: Healthscope Commercial |
$6,111.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,753.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,092.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,771.54
|
| Rate for Payer: PHP Commercial |
$5,771.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,413.53
|
| Rate for Payer: Priority Health SBD |
$4,277.73
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,512.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,092.54
|
|
|
HC LABOR CAT (6) 17 OR MORE HRS
|
Facility
|
IP
|
$6,790.05
|
|
| Hospital Charge Code |
72000008
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$2,987.62 |
| Max. Negotiated Rate |
$6,111.05 |
| Rate for Payer: Aetna American Axle |
$4,413.53
|
| Rate for Payer: Aetna Commercial |
$5,771.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,413.53
|
| Rate for Payer: Cash Price |
$5,432.04
|
| Rate for Payer: Cofinity Commercial |
$4,753.03
|
| Rate for Payer: Cofinity Commercial |
$5,839.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,753.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,432.04
|
| Rate for Payer: Healthscope Commercial |
$6,111.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,753.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,092.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,771.54
|
| Rate for Payer: PHP Commercial |
$5,771.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,413.53
|
| Rate for Payer: Priority Health SBD |
$4,277.73
|
| Rate for Payer: UMR Bronson Commercial |
$2,987.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,092.54
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
IP
|
$4,015.74
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,766.93 |
| Max. Negotiated Rate |
$3,614.17 |
| Rate for Payer: Aetna American Axle |
$2,610.23
|
| Rate for Payer: Aetna Commercial |
$3,413.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,610.23
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$2,811.02
|
| Rate for Payer: Cofinity Commercial |
$3,453.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,811.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Healthscope Commercial |
$3,614.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,811.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,011.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: PHP Commercial |
$3,413.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health SBD |
$2,529.92
|
| Rate for Payer: UMR Bronson Commercial |
$1,766.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,011.80
|
|
|
HC LABYRINTHOTOMY TRANSCANAL
|
Facility
|
OP
|
$4,015.74
|
|
|
Service Code
|
CPT 69801
|
| Hospital Charge Code |
76100487
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$774.34 |
| Max. Negotiated Rate |
$4,066.57 |
| Rate for Payer: Aetna American Axle |
$2,610.23
|
| Rate for Payer: Aetna Commercial |
$3,413.38
|
| Rate for Payer: Aetna Medicare |
$1,502.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,610.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,805.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,805.83
|
| Rate for Payer: BCBS Complete |
$813.05
|
| Rate for Payer: BCBS MAPPO |
$1,444.66
|
| Rate for Payer: BCN Medicare Advantage |
$1,444.66
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cash Price |
$3,212.59
|
| Rate for Payer: Cofinity Commercial |
$3,453.54
|
| Rate for Payer: Cofinity Commercial |
$2,811.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,811.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,212.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,444.66
|
| Rate for Payer: Healthscope Commercial |
$3,614.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,811.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,011.80
|
| Rate for Payer: Mclaren Medicaid |
$774.34
|
| Rate for Payer: Mclaren Medicare |
$1,444.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,516.89
|
| Rate for Payer: Meridian Medicaid |
$813.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,661.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,413.38
|
| Rate for Payer: PACE Medicare |
$1,372.43
|
| Rate for Payer: PACE SWMI |
$1,444.66
|
| Rate for Payer: PHP Commercial |
$3,413.38
|
| Rate for Payer: PHP Medicare Advantage |
$1,444.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$774.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,610.23
|
| Rate for Payer: Priority Health Medicare |
$1,444.66
|
| Rate for Payer: Priority Health SBD |
$2,529.92
|
| Rate for Payer: Railroad Medicare Medicare |
$1,444.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,066.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,444.66
|
| Rate for Payer: UHC Exchange |
$2,760.89
|
| Rate for Payer: UHC Medicare Advantage |
$1,444.66
|
| Rate for Payer: UHCCP Medicaid |
$774.34
|
| Rate for Payer: UMR Bronson Commercial |
$1,485.82
|
| Rate for Payer: VA VA |
$1,444.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,011.80
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
OP
|
$1,555.91
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$575.69 |
| Max. Negotiated Rate |
$1,400.32 |
| Rate for Payer: Aetna American Axle |
$1,011.34
|
| Rate for Payer: Aetna Commercial |
$1,322.52
|
| Rate for Payer: Aetna Medicare |
$777.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.34
|
| Rate for Payer: BCBS Complete |
$622.36
|
| Rate for Payer: Cash Price |
$1,244.73
|
| Rate for Payer: Cofinity Commercial |
$1,089.14
|
| Rate for Payer: Cofinity Commercial |
$1,338.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,089.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.73
|
| Rate for Payer: Healthscope Commercial |
$1,400.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,089.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,166.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,322.52
|
| Rate for Payer: PHP Commercial |
$1,322.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.34
|
| Rate for Payer: Priority Health SBD |
$980.22
|
| Rate for Payer: UMR Bronson Commercial |
$575.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,166.93
|
|
|
HC LA/CS PACING + RECORDING
|
Facility
|
IP
|
$1,555.91
|
|
|
Service Code
|
CPT 93621
|
| Hospital Charge Code |
48100038
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$684.60 |
| Max. Negotiated Rate |
$1,400.32 |
| Rate for Payer: Aetna American Axle |
$1,011.34
|
| Rate for Payer: Aetna Commercial |
$1,322.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,011.34
|
| Rate for Payer: Cash Price |
$1,244.73
|
| Rate for Payer: Cofinity Commercial |
$1,089.14
|
| Rate for Payer: Cofinity Commercial |
$1,338.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,089.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,244.73
|
| Rate for Payer: Healthscope Commercial |
$1,400.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,089.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,166.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,322.52
|
| Rate for Payer: PHP Commercial |
$1,322.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,011.34
|
| Rate for Payer: Priority Health SBD |
$980.22
|
| Rate for Payer: UMR Bronson Commercial |
$684.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,166.93
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
OP
|
$22.20
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna American Axle |
$14.43
|
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna Medicare |
$6.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.55
|
| Rate for Payer: BCBS Complete |
$3.40
|
| Rate for Payer: BCBS MAPPO |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$6.04
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.04
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Mclaren Medicaid |
$3.24
|
| Rate for Payer: Mclaren Medicare |
$6.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.34
|
| Rate for Payer: Meridian Medicaid |
$3.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: PACE Medicare |
$5.74
|
| Rate for Payer: PACE SWMI |
$6.04
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: PHP Medicare Advantage |
$6.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: Priority Health Medicare |
$6.04
|
| Rate for Payer: Priority Health SBD |
$13.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.04
|
| Rate for Payer: UHC Exchange |
$11.54
|
| Rate for Payer: UHC Medicare Advantage |
$6.04
|
| Rate for Payer: UHCCP Medicaid |
$3.24
|
| Rate for Payer: UMR Bronson Commercial |
$8.21
|
| Rate for Payer: VA VA |
$6.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
HC LACTATE DEHYDROGENASE
|
Facility
|
IP
|
$22.20
|
|
|
Service Code
|
CPT 83615
|
| Hospital Charge Code |
30100272
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.77 |
| Max. Negotiated Rate |
$19.98 |
| Rate for Payer: Aetna American Axle |
$14.43
|
| Rate for Payer: Aetna Commercial |
$18.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.43
|
| Rate for Payer: Cash Price |
$17.76
|
| Rate for Payer: Cofinity Commercial |
$15.54
|
| Rate for Payer: Cofinity Commercial |
$19.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.76
|
| Rate for Payer: Healthscope Commercial |
$19.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.87
|
| Rate for Payer: PHP Commercial |
$18.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.43
|
| Rate for Payer: Priority Health SBD |
$13.99
|
| Rate for Payer: UMR Bronson Commercial |
$9.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.65
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
OP
|
$59.30
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.20 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna Medicare |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.46
|
| Rate for Payer: BCBS Complete |
$6.51
|
| Rate for Payer: BCBS MAPPO |
$11.57
|
| Rate for Payer: BCN Medicare Advantage |
$11.57
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Cofinity Commercial |
$41.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.57
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Mclaren Medicaid |
$6.20
|
| Rate for Payer: Mclaren Medicare |
$11.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.15
|
| Rate for Payer: Meridian Medicaid |
$6.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: PACE Medicare |
$10.99
|
| Rate for Payer: PACE SWMI |
$11.57
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$11.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.55
|
| Rate for Payer: Priority Health Medicare |
$11.57
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: Railroad Medicare Medicare |
$11.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.57
|
| Rate for Payer: UHC Exchange |
$22.11
|
| Rate for Payer: UHC Medicare Advantage |
$11.57
|
| Rate for Payer: UHCCP Medicaid |
$6.20
|
| Rate for Payer: UMR Bronson Commercial |
$21.94
|
| Rate for Payer: VA VA |
$11.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC LACTATE LACTIC ACID
|
Facility
|
IP
|
$59.30
|
|
|
Service Code
|
CPT 83605
|
| Hospital Charge Code |
30100270
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.09 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$41.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$38.55
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: UMR Bronson Commercial |
$26.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna American Axle |
$61.13
|
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Cofinity Commercial |
$65.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.13
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health SBD |
$59.25
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$24.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$34.80
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC LACTOSE TOLERANCE
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 82951
|
| Hospital Charge Code |
30100226
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.38 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna American Axle |
$61.13
|
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.13
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$65.83
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.13
|
| Rate for Payer: Priority Health SBD |
$59.25
|
| Rate for Payer: UMR Bronson Commercial |
$41.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
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: 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: 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 Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$48.77
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$33.00
|
| 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
|
|
|
HC LAMBDA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100308
|
|
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 LAMBS QUARTERS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC LAMBS QUARTERS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200091
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UMR Bronson Commercial |
$31.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC LAMELLAR BODY COUNT AMNIOTIC
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 83664
|
| Hospital Charge Code |
30100278
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.36 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$20.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.15
|
| Rate for Payer: BCBS Complete |
$10.87
|
| Rate for Payer: BCBS MAPPO |
$19.32
|
| Rate for Payer: BCN Medicare Advantage |
$19.32
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.32
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Mclaren Medicaid |
$10.36
|
| Rate for Payer: Mclaren Medicare |
$19.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.29
|
| Rate for Payer: Meridian Medicaid |
$10.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PACE Medicare |
$18.35
|
| Rate for Payer: PACE SWMI |
$19.32
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Medicare Advantage |
$19.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: Railroad Medicare Medicare |
$19.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.32
|
| Rate for Payer: UHC Exchange |
$36.92
|
| Rate for Payer: UHC Medicare Advantage |
$19.32
|
| Rate for Payer: UHCCP Medicaid |
$10.36
|
| Rate for Payer: UMR Bronson Commercial |
$26.42
|
| Rate for Payer: VA VA |
$19.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: UMR Bronson Commercial |
$23.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC LAMICTAL LEVEL
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 80175
|
| Hospital Charge Code |
30100054
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: BCBS Complete |
$7.46
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$7.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Exchange |
$25.32
|
| Rate for Payer: UHC Medicare Advantage |
$13.25
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: UMR Bronson Commercial |
$20.02
|
| Rate for Payer: VA VA |
$13.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
OP
|
$10,480.00
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,927.35 |
| Max. Negotiated Rate |
$10,121.85 |
| Rate for Payer: Aetna American Axle |
$6,812.00
|
| Rate for Payer: Aetna Commercial |
$8,908.00
|
| Rate for Payer: Aetna Medicare |
$3,739.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,812.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,494.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,494.76
|
| Rate for Payer: BCBS Complete |
$2,023.72
|
| Rate for Payer: BCBS MAPPO |
$3,595.81
|
| Rate for Payer: BCN Medicare Advantage |
$3,595.81
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cofinity Commercial |
$9,012.80
|
| Rate for Payer: Cofinity Commercial |
$7,336.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,336.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,384.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,595.81
|
| Rate for Payer: Healthscope Commercial |
$9,432.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,336.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,860.00
|
| Rate for Payer: Mclaren Medicaid |
$1,927.35
|
| Rate for Payer: Mclaren Medicare |
$3,595.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,775.60
|
| Rate for Payer: Meridian Medicaid |
$2,023.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,135.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,908.00
|
| Rate for Payer: PACE Medicare |
$3,416.02
|
| Rate for Payer: PACE SWMI |
$3,595.81
|
| Rate for Payer: PHP Commercial |
$8,908.00
|
| Rate for Payer: PHP Medicare Advantage |
$3,595.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,927.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,812.00
|
| Rate for Payer: Priority Health Medicare |
$3,595.81
|
| Rate for Payer: Priority Health SBD |
$6,602.40
|
| Rate for Payer: Railroad Medicare Medicare |
$3,595.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,121.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,595.81
|
| Rate for Payer: UHC Exchange |
$6,871.95
|
| Rate for Payer: UHC Medicare Advantage |
$3,595.81
|
| Rate for Payer: UHCCP Medicaid |
$1,927.35
|
| Rate for Payer: UMR Bronson Commercial |
$3,877.60
|
| Rate for Payer: VA VA |
$3,595.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,860.00
|
|
|
HC LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE
|
Facility
|
IP
|
$10,480.00
|
|
|
Service Code
|
CPT 31571
|
| Hospital Charge Code |
76100432
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$4,611.20 |
| Max. Negotiated Rate |
$9,432.00 |
| Rate for Payer: Aetna American Axle |
$6,812.00
|
| Rate for Payer: Aetna Commercial |
$8,908.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,812.00
|
| Rate for Payer: Cash Price |
$8,384.00
|
| Rate for Payer: Cofinity Commercial |
$7,336.00
|
| Rate for Payer: Cofinity Commercial |
$9,012.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,336.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,384.00
|
| Rate for Payer: Healthscope Commercial |
$9,432.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,336.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,860.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,908.00
|
| Rate for Payer: PHP Commercial |
$8,908.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,812.00
|
| Rate for Payer: Priority Health SBD |
$6,602.40
|
| Rate for Payer: UMR Bronson Commercial |
$4,611.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,860.00
|
|
|
HC LA RO SSB SJOGRENS AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
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 LA RO SSB SJOGRENS AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200160
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$50.47 |
| 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: 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: 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 Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$34.27
|
| 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
|
|
