|
HC KENTUCKY BLUE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200090
|
|
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 KENTUCKY BLUE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200090
|
|
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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| 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: Nomi Health Commercial |
$7.83
|
| 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 HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| 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 KETONES (ACETONE)
|
Facility
|
IP
|
$36.82
|
|
|
Service Code
|
CPT 82009
|
| Hospital Charge Code |
30100067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.20 |
| Max. Negotiated Rate |
$33.14 |
| Rate for Payer: Aetna American Axle |
$23.93
|
| Rate for Payer: Aetna Commercial |
$31.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.93
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Cofinity Commercial |
$31.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.46
|
| Rate for Payer: Healthscope Commercial |
$33.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.30
|
| Rate for Payer: PHP Commercial |
$31.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.93
|
| Rate for Payer: Priority Health SBD |
$23.20
|
| Rate for Payer: UMR Bronson Commercial |
$16.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.62
|
|
|
HC KETONES (ACETONE)
|
Facility
|
OP
|
$36.82
|
|
|
Service Code
|
CPT 82009
|
| Hospital Charge Code |
30100067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.42 |
| Max. Negotiated Rate |
$722.52 |
| Rate for Payer: Aetna American Axle |
$23.93
|
| Rate for Payer: Aetna Commercial |
$31.30
|
| Rate for Payer: Aetna Medicare |
$4.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.65
|
| Rate for Payer: BCBS Complete |
$2.54
|
| Rate for Payer: BCBS MAPPO |
$4.52
|
| Rate for Payer: BCBS Trust/PPO |
$4.35
|
| Rate for Payer: BCN Commercial |
$4.35
|
| Rate for Payer: BCN Medicare Advantage |
$4.52
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cash Price |
$29.46
|
| Rate for Payer: Cofinity Commercial |
$31.67
|
| Rate for Payer: Cofinity Commercial |
$25.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.52
|
| Rate for Payer: Healthscope Commercial |
$33.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.62
|
| Rate for Payer: Mclaren Medicaid |
$2.42
|
| Rate for Payer: Mclaren Medicare |
$4.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.75
|
| Rate for Payer: Meridian Medicaid |
$2.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.30
|
| Rate for Payer: Nomi Health Commercial |
$6.78
|
| Rate for Payer: PACE Medicare |
$4.29
|
| Rate for Payer: PACE SWMI |
$4.52
|
| Rate for Payer: PHP Commercial |
$31.30
|
| Rate for Payer: PHP Medicare Advantage |
$4.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.52
|
| Rate for Payer: Priority Health Medicare |
$4.52
|
| Rate for Payer: Priority Health Narrow Network |
$3.62
|
| Rate for Payer: Priority Health SBD |
$23.20
|
| Rate for Payer: Railroad Medicare Medicare |
$4.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.42
|
| Rate for Payer: UHC Core |
$722.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.52
|
| Rate for Payer: UHC Exchange |
$4.52
|
| Rate for Payer: UHC Medicare Advantage |
$4.52
|
| Rate for Payer: UHCCP Medicaid |
$2.42
|
| Rate for Payer: UMR Bronson Commercial |
$13.62
|
| Rate for Payer: VA VA |
$4.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.62
|
|
|
HC KIDNEY ENDOSCOPY
|
Facility
|
IP
|
$5,969.82
|
|
|
Service Code
|
CPT 50551
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,626.72 |
| Max. Negotiated Rate |
$5,372.84 |
| Rate for Payer: Aetna American Axle |
$3,880.38
|
| Rate for Payer: Aetna Commercial |
$5,074.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,880.38
|
| Rate for Payer: Cash Price |
$4,775.86
|
| Rate for Payer: Cofinity Commercial |
$4,178.87
|
| Rate for Payer: Cofinity Commercial |
$5,134.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,178.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,775.86
|
| Rate for Payer: Healthscope Commercial |
$5,372.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,178.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,477.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,074.35
|
| Rate for Payer: PHP Commercial |
$5,074.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,880.38
|
| Rate for Payer: Priority Health SBD |
$3,760.99
|
| Rate for Payer: UMR Bronson Commercial |
$2,626.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,477.36
|
|
|
HC KIDNEY ENDOSCOPY
|
Facility
|
OP
|
$5,969.82
|
|
|
Service Code
|
CPT 50551
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$280.45 |
| Max. Negotiated Rate |
$15,654.68 |
| Rate for Payer: Aetna American Axle |
$3,880.38
|
| Rate for Payer: Aetna Commercial |
$5,074.35
|
| Rate for Payer: Aetna Medicare |
$5,180.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,880.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,226.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,226.04
|
| Rate for Payer: BCBS Complete |
$2,803.21
|
| Rate for Payer: BCBS MAPPO |
$4,980.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,710.51
|
| Rate for Payer: BCN Commercial |
$2,710.51
|
| Rate for Payer: BCN Medicare Advantage |
$4,980.83
|
| Rate for Payer: Cash Price |
$4,775.86
|
| Rate for Payer: Cash Price |
$4,775.86
|
| Rate for Payer: Cash Price |
$4,775.86
|
| Rate for Payer: Cofinity Commercial |
$5,134.05
|
| Rate for Payer: Cofinity Commercial |
$4,178.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,178.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,775.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,980.83
|
| Rate for Payer: Healthscope Commercial |
$5,372.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,178.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,477.36
|
| Rate for Payer: Mclaren Medicaid |
$2,669.72
|
| Rate for Payer: Mclaren Medicare |
$4,980.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,229.87
|
| Rate for Payer: Meridian Medicaid |
$2,803.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,727.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,074.35
|
| Rate for Payer: Nomi Health Commercial |
$10,459.74
|
| Rate for Payer: PACE Medicare |
$4,731.79
|
| Rate for Payer: PACE SWMI |
$4,980.83
|
| Rate for Payer: PHP Commercial |
$5,074.35
|
| Rate for Payer: PHP Medicare Advantage |
$4,980.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,669.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,880.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,654.68
|
| Rate for Payer: Priority Health Medicare |
$4,980.83
|
| Rate for Payer: Priority Health Narrow Network |
$12,523.74
|
| Rate for Payer: Priority Health SBD |
$3,760.99
|
| Rate for Payer: Railroad Medicare Medicare |
$4,980.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.50
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,980.83
|
| Rate for Payer: UHC Exchange |
$280.45
|
| Rate for Payer: UHC Medicare Advantage |
$4,980.83
|
| Rate for Payer: UHCCP Medicaid |
$2,669.72
|
| Rate for Payer: UMR Bronson Commercial |
$2,208.83
|
| Rate for Payer: VA VA |
$4,980.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,477.36
|
|
|
HC KINEVAC 5 MCG IV
|
Facility
|
OP
|
$138.43
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
63600014
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.22 |
| Max. Negotiated Rate |
$333.31 |
| Rate for Payer: Aetna American Axle |
$89.98
|
| Rate for Payer: Aetna Commercial |
$117.67
|
| Rate for Payer: Aetna Medicare |
$69.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.98
|
| Rate for Payer: BCBS Complete |
$55.37
|
| Rate for Payer: BCBS Trust/PPO |
$333.31
|
| Rate for Payer: BCN Commercial |
$333.31
|
| Rate for Payer: Cash Price |
$110.74
|
| Rate for Payer: Cash Price |
$110.74
|
| Rate for Payer: Cofinity Commercial |
$119.05
|
| Rate for Payer: Cofinity Commercial |
$96.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$96.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.74
|
| Rate for Payer: Healthscope Commercial |
$124.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.67
|
| Rate for Payer: PHP Commercial |
$117.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.98
|
| Rate for Payer: Priority Health SBD |
$87.21
|
| Rate for Payer: UMR Bronson Commercial |
$51.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.82
|
|
|
HC KINEVAC 5 MCG IV
|
Facility
|
IP
|
$138.43
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
63600014
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$60.91 |
| Max. Negotiated Rate |
$124.59 |
| Rate for Payer: Aetna American Axle |
$89.98
|
| Rate for Payer: Aetna Commercial |
$117.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.98
|
| Rate for Payer: Cash Price |
$110.74
|
| Rate for Payer: Cofinity Commercial |
$119.05
|
| Rate for Payer: Cofinity Commercial |
$96.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$96.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.74
|
| Rate for Payer: Healthscope Commercial |
$124.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$96.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.67
|
| Rate for Payer: PHP Commercial |
$117.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.98
|
| Rate for Payer: Priority Health SBD |
$87.21
|
| Rate for Payer: UMR Bronson Commercial |
$60.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.82
|
|
|
HC KIT ATS
|
Facility
|
OP
|
$153.00
|
|
| Hospital Charge Code |
27000666
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$56.61 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: Aetna American Axle |
$99.45
|
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna Medicare |
$76.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: BCBS Complete |
$61.20
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health SBD |
$96.39
|
| Rate for Payer: UMR Bronson Commercial |
$56.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC KIT ATS
|
Facility
|
IP
|
$153.00
|
|
| Hospital Charge Code |
27000666
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$67.32 |
| Max. Negotiated Rate |
$137.70 |
| Rate for Payer: PHP Commercial |
$130.05
|
| Rate for Payer: Aetna American Axle |
$99.45
|
| Rate for Payer: Aetna Commercial |
$130.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.45
|
| Rate for Payer: Cash Price |
$122.40
|
| Rate for Payer: Cofinity Commercial |
$107.10
|
| Rate for Payer: Cofinity Commercial |
$131.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.40
|
| Rate for Payer: Healthscope Commercial |
$137.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.45
|
| Rate for Payer: Priority Health SBD |
$96.39
|
| Rate for Payer: UMR Bronson Commercial |
$67.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.75
|
|
|
HC KIT DILATOR VASC
|
Facility
|
OP
|
$535.50
|
|
| Hospital Charge Code |
27000101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$198.14 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna American Axle |
$348.08
|
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$267.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.08
|
| Rate for Payer: BCBS Complete |
$214.20
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$374.85
|
| Rate for Payer: Cofinity Commercial |
$460.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.40
|
| Rate for Payer: Healthscope Commercial |
$481.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.08
|
| Rate for Payer: Priority Health SBD |
$337.36
|
| Rate for Payer: UMR Bronson Commercial |
$198.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.62
|
|
|
HC KIT DILATOR VASC
|
Facility
|
IP
|
$535.50
|
|
| Hospital Charge Code |
27000101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$235.62 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: Aetna American Axle |
$348.08
|
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.08
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$374.85
|
| Rate for Payer: Cofinity Commercial |
$460.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.40
|
| Rate for Payer: Healthscope Commercial |
$481.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.08
|
| Rate for Payer: Priority Health SBD |
$337.36
|
| Rate for Payer: UMR Bronson Commercial |
$235.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.62
|
|
|
HC KLEIHAUER-BETKE STAIN
|
Facility
|
IP
|
$123.22
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
30500046
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$54.22 |
| Max. Negotiated Rate |
$110.90 |
| Rate for Payer: Aetna American Axle |
$80.09
|
| Rate for Payer: Aetna Commercial |
$104.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.09
|
| Rate for Payer: Cash Price |
$98.58
|
| Rate for Payer: Cofinity Commercial |
$105.97
|
| Rate for Payer: Cofinity Commercial |
$86.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.58
|
| Rate for Payer: Healthscope Commercial |
$110.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.74
|
| Rate for Payer: PHP Commercial |
$104.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.09
|
| Rate for Payer: Priority Health SBD |
$77.63
|
| Rate for Payer: UMR Bronson Commercial |
$54.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.42
|
|
|
HC KLEIHAUER-BETKE STAIN
|
Facility
|
OP
|
$123.22
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
30500046
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$110.90 |
| Rate for Payer: Aetna American Axle |
$80.09
|
| Rate for Payer: Aetna Commercial |
$104.74
|
| Rate for Payer: Aetna Medicare |
$8.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.66
|
| Rate for Payer: BCBS Complete |
$4.35
|
| Rate for Payer: BCBS MAPPO |
$7.73
|
| Rate for Payer: BCBS Trust/PPO |
$7.45
|
| Rate for Payer: BCN Commercial |
$7.45
|
| Rate for Payer: BCN Medicare Advantage |
$7.73
|
| Rate for Payer: Cash Price |
$98.58
|
| Rate for Payer: Cash Price |
$98.58
|
| Rate for Payer: Cofinity Commercial |
$86.25
|
| Rate for Payer: Cofinity Commercial |
$105.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.73
|
| Rate for Payer: Healthscope Commercial |
$110.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$92.42
|
| Rate for Payer: Mclaren Medicaid |
$4.14
|
| Rate for Payer: Mclaren Medicare |
$7.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.12
|
| Rate for Payer: Meridian Medicaid |
$4.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.74
|
| Rate for Payer: Nomi Health Commercial |
$11.60
|
| Rate for Payer: PACE Medicare |
$7.34
|
| Rate for Payer: PACE SWMI |
$7.73
|
| Rate for Payer: PHP Commercial |
$104.74
|
| Rate for Payer: PHP Medicare Advantage |
$7.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.96
|
| Rate for Payer: Priority Health Medicare |
$7.73
|
| Rate for Payer: Priority Health Narrow Network |
$6.37
|
| Rate for Payer: Priority Health SBD |
$77.63
|
| Rate for Payer: Railroad Medicare Medicare |
$7.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.73
|
| Rate for Payer: UHC Exchange |
$7.73
|
| Rate for Payer: UHC Medicare Advantage |
$7.73
|
| Rate for Payer: UHCCP Medicaid |
$4.14
|
| Rate for Payer: UMR Bronson Commercial |
$45.59
|
| Rate for Payer: VA VA |
$7.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$92.42
|
|
|
HC KOH PREPARATION
|
Facility
|
IP
|
$23.93
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600111
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.53 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Aetna American Axle |
$15.55
|
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.55
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$16.75
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.14
|
| Rate for Payer: Healthscope Commercial |
$21.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.34
|
| Rate for Payer: PHP Commercial |
$20.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.55
|
| Rate for Payer: Priority Health SBD |
$15.08
|
| Rate for Payer: UMR Bronson Commercial |
$10.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.95
|
|
|
HC KOH PREPARATION
|
Facility
|
OP
|
$23.93
|
|
|
Service Code
|
CPT 87220
|
| Hospital Charge Code |
30600111
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$21.54 |
| Rate for Payer: Aetna American Axle |
$15.55
|
| Rate for Payer: Aetna Commercial |
$20.34
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.11
|
| Rate for Payer: BCN Commercial |
$4.11
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cash Price |
$19.14
|
| Rate for Payer: Cofinity Commercial |
$20.58
|
| Rate for Payer: Cofinity Commercial |
$16.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$16.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$21.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$16.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.95
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.34
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$20.34
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.40
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$3.52
|
| Rate for Payer: Priority Health SBD |
$15.08
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: UMR Bronson Commercial |
$8.85
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.95
|
|
|
HC KYLEENA 19.5MG
|
Facility
|
IP
|
$2,936.43
|
|
|
Service Code
|
CPT J7296
|
| Hospital Charge Code |
63600165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,292.03 |
| Max. Negotiated Rate |
$2,642.79 |
| Rate for Payer: Aetna American Axle |
$1,908.68
|
| Rate for Payer: Aetna Commercial |
$2,495.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,908.68
|
| Rate for Payer: Cash Price |
$2,349.14
|
| Rate for Payer: Cofinity Commercial |
$2,055.50
|
| Rate for Payer: Cofinity Commercial |
$2,525.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,055.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.14
|
| Rate for Payer: Healthscope Commercial |
$2,642.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,055.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,202.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,495.97
|
| Rate for Payer: PHP Commercial |
$2,495.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.68
|
| Rate for Payer: Priority Health SBD |
$1,849.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,292.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,202.32
|
|
|
HC KYLEENA 19.5MG
|
Facility
|
OP
|
$2,936.43
|
|
|
Service Code
|
CPT J7296
|
| Hospital Charge Code |
63600165
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$980.96 |
| Max. Negotiated Rate |
$3,272.88 |
| Rate for Payer: Aetna American Axle |
$1,908.68
|
| Rate for Payer: Aetna Commercial |
$2,495.97
|
| Rate for Payer: Aetna Medicare |
$1,468.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,908.68
|
| Rate for Payer: BCBS Complete |
$1,174.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,272.88
|
| Rate for Payer: BCN Commercial |
$3,272.88
|
| Rate for Payer: Cash Price |
$2,349.14
|
| Rate for Payer: Cash Price |
$2,349.14
|
| Rate for Payer: Cofinity Commercial |
$2,055.50
|
| Rate for Payer: Cofinity Commercial |
$2,525.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,055.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.14
|
| Rate for Payer: Healthscope Commercial |
$2,642.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,055.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,202.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,495.97
|
| Rate for Payer: PHP Commercial |
$2,495.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,908.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,226.20
|
| Rate for Payer: Priority Health Narrow Network |
$980.96
|
| Rate for Payer: Priority Health SBD |
$1,849.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,086.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,202.32
|
|
|
HC LAAC IMPLANT
|
Facility
|
OP
|
$18,571.14
|
|
| Hospital Charge Code |
27800117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$6,871.32 |
| Max. Negotiated Rate |
$16,714.03 |
| Rate for Payer: Aetna American Axle |
$12,071.24
|
| Rate for Payer: Aetna Commercial |
$15,785.47
|
| Rate for Payer: Aetna Medicare |
$9,285.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,071.24
|
| Rate for Payer: BCBS Complete |
$7,428.46
|
| Rate for Payer: Cash Price |
$14,856.91
|
| Rate for Payer: Cofinity Commercial |
$12,999.80
|
| Rate for Payer: Cofinity Commercial |
$15,971.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,999.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,856.91
|
| Rate for Payer: Healthscope Commercial |
$16,714.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,999.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,928.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,785.47
|
| Rate for Payer: PHP Commercial |
$15,785.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,071.24
|
| Rate for Payer: Priority Health SBD |
$11,699.82
|
| Rate for Payer: UMR Bronson Commercial |
$6,871.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,928.36
|
|
|
HC LAAC IMPLANT
|
Facility
|
IP
|
$18,571.14
|
|
| Hospital Charge Code |
27800117
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,171.30 |
| Max. Negotiated Rate |
$16,714.03 |
| Rate for Payer: Aetna American Axle |
$12,071.24
|
| Rate for Payer: Aetna Commercial |
$15,785.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,071.24
|
| Rate for Payer: Cash Price |
$14,856.91
|
| Rate for Payer: Cofinity Commercial |
$12,999.80
|
| Rate for Payer: Cofinity Commercial |
$15,971.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$12,999.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14,856.91
|
| Rate for Payer: Healthscope Commercial |
$16,714.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$12,999.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13,928.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15,785.47
|
| Rate for Payer: PHP Commercial |
$15,785.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,071.24
|
| Rate for Payer: Priority Health SBD |
$11,699.82
|
| Rate for Payer: UMR Bronson Commercial |
$8,171.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13,928.36
|
|
|
HC LABOR CAT (1) 0-2HRS
|
Facility
|
IP
|
$1,531.01
|
|
| Hospital Charge Code |
72000001
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$673.64 |
| Max. Negotiated Rate |
$1,377.91 |
| Rate for Payer: Aetna American Axle |
$995.16
|
| Rate for Payer: Aetna Commercial |
$1,301.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.16
|
| Rate for Payer: Cash Price |
$1,224.81
|
| Rate for Payer: Cofinity Commercial |
$1,071.71
|
| Rate for Payer: Cofinity Commercial |
$1,316.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.81
|
| Rate for Payer: Healthscope Commercial |
$1,377.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,148.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.36
|
| Rate for Payer: PHP Commercial |
$1,301.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.16
|
| Rate for Payer: Priority Health SBD |
$964.54
|
| Rate for Payer: UMR Bronson Commercial |
$673.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,148.26
|
|
|
HC LABOR CAT (1) 0-2HRS
|
Facility
|
OP
|
$1,531.01
|
|
| Hospital Charge Code |
72000001
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$566.47 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna American Axle |
$995.16
|
| Rate for Payer: Aetna Commercial |
$1,301.36
|
| Rate for Payer: Aetna Medicare |
$765.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.16
|
| Rate for Payer: BCBS Complete |
$612.40
|
| Rate for Payer: Cash Price |
$1,224.81
|
| Rate for Payer: Cash Price |
$1,224.81
|
| Rate for Payer: Cofinity Commercial |
$1,071.71
|
| Rate for Payer: Cofinity Commercial |
$1,316.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.81
|
| Rate for Payer: Healthscope Commercial |
$1,377.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,148.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.36
|
| Rate for Payer: PHP Commercial |
$1,301.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.16
|
| Rate for Payer: Priority Health SBD |
$964.54
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$566.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,148.26
|
|
|
HC LABOR CAT (2) 2-5HRS
|
Facility
|
OP
|
$2,041.41
|
|
| Hospital Charge Code |
72000002
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$755.32 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna American Axle |
$1,326.92
|
| Rate for Payer: Aetna Commercial |
$1,735.20
|
| Rate for Payer: Aetna Medicare |
$1,020.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.92
|
| Rate for Payer: BCBS Complete |
$816.56
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,428.99
|
| Rate for Payer: Cofinity Commercial |
$1,755.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,428.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Healthscope Commercial |
$1,837.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,428.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,531.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: PHP Commercial |
$1,735.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: Priority Health SBD |
$1,286.09
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$755.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,531.06
|
|
|
HC LABOR CAT (2) 2-5HRS
|
Facility
|
IP
|
$2,041.41
|
|
| Hospital Charge Code |
72000002
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$898.22 |
| Max. Negotiated Rate |
$1,837.27 |
| Rate for Payer: Aetna American Axle |
$1,326.92
|
| Rate for Payer: Aetna Commercial |
$1,735.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,326.92
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,428.99
|
| Rate for Payer: Cofinity Commercial |
$1,755.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,428.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Healthscope Commercial |
$1,837.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,428.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,531.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: PHP Commercial |
$1,735.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: Priority Health SBD |
$1,286.09
|
| Rate for Payer: UMR Bronson Commercial |
$898.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,531.06
|
|
|
HC LABOR CAT (3) 5-8HRS
|
Facility
|
IP
|
$2,551.65
|
|
| Hospital Charge Code |
72000003
|
|
Hospital Revenue Code
|
720
|
| Min. Negotiated Rate |
$1,122.73 |
| Max. Negotiated Rate |
$2,296.48 |
| Rate for Payer: Aetna American Axle |
$1,658.57
|
| Rate for Payer: Aetna Commercial |
$2,168.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,658.57
|
| Rate for Payer: Cash Price |
$2,041.32
|
| Rate for Payer: Cofinity Commercial |
$1,786.16
|
| Rate for Payer: Cofinity Commercial |
$2,194.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,786.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,041.32
|
| Rate for Payer: Healthscope Commercial |
$2,296.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,786.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,913.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,168.90
|
| Rate for Payer: PHP Commercial |
$2,168.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,658.57
|
| Rate for Payer: Priority Health SBD |
$1,607.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,122.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,913.74
|
|
