|
HC VISIPAQUE 320 PER ML
|
Facility
|
IP
|
$2.78
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600019
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.22 |
| Max. Negotiated Rate |
$2.50 |
| Rate for Payer: Aetna American Axle |
$1.81
|
| Rate for Payer: Aetna Commercial |
$2.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.81
|
| Rate for Payer: Cash Price |
$2.22
|
| Rate for Payer: Cofinity Commercial |
$1.95
|
| Rate for Payer: Cofinity Commercial |
$2.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2.22
|
| Rate for Payer: Healthscope Commercial |
$2.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2.36
|
| Rate for Payer: PHP Commercial |
$2.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.95
|
| Rate for Payer: Priority Health SBD |
$1.75
|
| Rate for Payer: UMR Bronson Commercial |
$1.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2.08
|
|
|
HC VISUAL ACUITY SCREEN
|
Facility
|
OP
|
$38.95
|
|
|
Service Code
|
CPT 99173
|
| Hospital Charge Code |
51000099
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$35.06 |
| Rate for Payer: Aetna American Axle |
$25.32
|
| Rate for Payer: Aetna Commercial |
$33.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.32
|
| Rate for Payer: BCBS Complete |
$15.58
|
| Rate for Payer: BCBS Trust/PPO |
$13.42
|
| Rate for Payer: Cash Price |
$31.16
|
| Rate for Payer: Cash Price |
$31.16
|
| Rate for Payer: Cofinity Commercial |
$27.26
|
| Rate for Payer: Cofinity Commercial |
$33.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.16
|
| Rate for Payer: Healthscope Commercial |
$35.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.11
|
| Rate for Payer: PHP Commercial |
$33.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.26
|
| Rate for Payer: Priority Health SBD |
$24.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.60
|
| Rate for Payer: UHC Exchange |
$3.27
|
| Rate for Payer: UMR Bronson Commercial |
$14.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.21
|
|
|
HC VISUAL ACUITY SCREEN
|
Facility
|
IP
|
$38.95
|
|
|
Service Code
|
CPT 99173
|
| Hospital Charge Code |
51000099
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.14 |
| Max. Negotiated Rate |
$35.06 |
| Rate for Payer: Aetna American Axle |
$25.32
|
| Rate for Payer: Aetna Commercial |
$33.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.32
|
| Rate for Payer: Cash Price |
$31.16
|
| Rate for Payer: Cofinity Commercial |
$27.26
|
| Rate for Payer: Cofinity Commercial |
$33.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.16
|
| Rate for Payer: Healthscope Commercial |
$35.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$33.11
|
| Rate for Payer: PHP Commercial |
$33.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.26
|
| Rate for Payer: Priority Health SBD |
$24.54
|
| Rate for Payer: UMR Bronson Commercial |
$17.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.21
|
|
|
HC VISUAL AUDIOMETRY VRA
|
Facility
|
OP
|
$208.01
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
47100013
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$35.69 |
| Max. Negotiated Rate |
$437.09 |
| Rate for Payer: Aetna American Axle |
$135.21
|
| Rate for Payer: Aetna Commercial |
$176.81
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$103.87
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Cofinity Commercial |
$145.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$187.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.01
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$176.81
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$349.67
|
| Rate for Payer: Priority Health SBD |
$131.05
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.26
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$35.69
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$76.96
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.01
|
|
|
HC VISUAL AUDIOMETRY VRA
|
Facility
|
IP
|
$208.01
|
|
|
Service Code
|
CPT 92579
|
| Hospital Charge Code |
47100013
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$91.52 |
| Max. Negotiated Rate |
$187.21 |
| Rate for Payer: Aetna American Axle |
$135.21
|
| Rate for Payer: Aetna Commercial |
$176.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$135.21
|
| Rate for Payer: Cash Price |
$166.41
|
| Rate for Payer: Cofinity Commercial |
$145.61
|
| Rate for Payer: Cofinity Commercial |
$178.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.41
|
| Rate for Payer: Healthscope Commercial |
$187.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$145.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$176.81
|
| Rate for Payer: PHP Commercial |
$176.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.61
|
| Rate for Payer: Priority Health SBD |
$131.05
|
| Rate for Payer: UMR Bronson Commercial |
$91.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.01
|
|
|
HC VITAL CAPACITY
|
Facility
|
OP
|
$262.79
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
46000016
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$24.89 |
| Max. Negotiated Rate |
$437.09 |
| Rate for Payer: Aetna American Axle |
$170.81
|
| Rate for Payer: Aetna Commercial |
$223.37
|
| Rate for Payer: Aetna Medicare |
$144.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$173.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$173.56
|
| Rate for Payer: BCBS Complete |
$79.76
|
| Rate for Payer: BCBS MAPPO |
$138.85
|
| Rate for Payer: BCBS Trust/PPO |
$105.55
|
| Rate for Payer: BCN Medicare Advantage |
$138.85
|
| Rate for Payer: Cash Price |
$210.23
|
| Rate for Payer: Cash Price |
$210.23
|
| Rate for Payer: Cash Price |
$210.23
|
| Rate for Payer: Cofinity Commercial |
$183.95
|
| Rate for Payer: Cofinity Commercial |
$226.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.85
|
| Rate for Payer: Healthscope Commercial |
$236.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.09
|
| Rate for Payer: Mclaren Medicaid |
$75.95
|
| Rate for Payer: Mclaren Medicare |
$138.85
|
| Rate for Payer: Meridian Medicaid |
$79.76
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$145.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.37
|
| Rate for Payer: PACE Medicare |
$131.91
|
| Rate for Payer: PACE SWMI |
$138.85
|
| Rate for Payer: PHP Commercial |
$223.37
|
| Rate for Payer: PHP Medicare Advantage |
$138.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$75.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$437.09
|
| Rate for Payer: Priority Health Medicare |
$138.85
|
| Rate for Payer: Priority Health Narrow Network |
$349.67
|
| Rate for Payer: Priority Health SBD |
$165.56
|
| Rate for Payer: Railroad Medicare Medicare |
$138.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.38
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.85
|
| Rate for Payer: UHC Exchange |
$24.89
|
| Rate for Payer: UHC Medicare Advantage |
$143.02
|
| Rate for Payer: UMR Bronson Commercial |
$97.23
|
| Rate for Payer: VA VA |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.09
|
|
|
HC VITAL CAPACITY
|
Facility
|
IP
|
$262.79
|
|
|
Service Code
|
CPT 94150
|
| Hospital Charge Code |
46000016
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$115.63 |
| Max. Negotiated Rate |
$236.51 |
| Rate for Payer: Aetna American Axle |
$170.81
|
| Rate for Payer: Aetna Commercial |
$223.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.81
|
| Rate for Payer: Cash Price |
$210.23
|
| Rate for Payer: Cofinity Commercial |
$183.95
|
| Rate for Payer: Cofinity Commercial |
$226.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.23
|
| Rate for Payer: Healthscope Commercial |
$236.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.37
|
| Rate for Payer: PHP Commercial |
$223.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.95
|
| Rate for Payer: Priority Health SBD |
$165.56
|
| Rate for Payer: UMR Bronson Commercial |
$115.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.09
|
|
|
HC VITAMIN A LEVEL
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 84590
|
| Hospital Charge Code |
30100458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.20 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: UMR Bronson Commercial |
$20.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC VITAMIN A LEVEL
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 84590
|
| Hospital Charge Code |
30100458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.35 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna American Axle |
$29.84
|
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$12.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.51
|
| Rate for Payer: BCBS Complete |
$6.67
|
| Rate for Payer: BCBS MAPPO |
$11.61
|
| Rate for Payer: BCBS Trust/PPO |
$10.44
|
| Rate for Payer: BCN Medicare Advantage |
$11.61
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$32.13
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.61
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$6.35
|
| Rate for Payer: Mclaren Medicare |
$11.61
|
| Rate for Payer: Meridian Medicaid |
$6.67
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Medicare |
$11.03
|
| Rate for Payer: PACE SWMI |
$11.61
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.92
|
| Rate for Payer: Priority Health Medicare |
$11.61
|
| Rate for Payer: Priority Health Narrow Network |
$12.74
|
| Rate for Payer: Priority Health SBD |
$28.92
|
| Rate for Payer: Railroad Medicare Medicare |
$11.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.93
|
| Rate for Payer: UHC Core |
$19.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.61
|
| Rate for Payer: UHC Exchange |
$11.61
|
| Rate for Payer: UHC Medicare Advantage |
$11.96
|
| Rate for Payer: UMR Bronson Commercial |
$16.98
|
| Rate for Payer: VA VA |
$11.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC VITAMIN B12 LEVEL
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100185
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.93 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC VITAMIN B12 LEVEL
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100185
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$55.08 |
| Rate for Payer: Aetna American Axle |
$39.78
|
| Rate for Payer: Aetna Commercial |
$52.02
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: BCBS Complete |
$8.66
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$13.56
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$55.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.90
|
| Rate for Payer: Mclaren Medicaid |
$8.25
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Medicaid |
$8.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$52.02
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$42.84
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$20.68
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow Network |
$16.54
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.10
|
| Rate for Payer: UHC Core |
$24.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Exchange |
$15.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.53
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC VITAMIN B3 AND METABOLITES, P
|
Facility
|
OP
|
$184.75
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100754
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.33 |
| Max. Negotiated Rate |
$166.28 |
| Rate for Payer: Aetna American Axle |
$120.09
|
| Rate for Payer: Aetna Commercial |
$157.04
|
| Rate for Payer: Aetna Medicare |
$17.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.32
|
| Rate for Payer: BCBS Complete |
$9.80
|
| Rate for Payer: BCBS MAPPO |
$17.06
|
| Rate for Payer: BCBS Trust/PPO |
$15.35
|
| Rate for Payer: BCN Medicare Advantage |
$17.06
|
| Rate for Payer: Cash Price |
$147.80
|
| Rate for Payer: Cash Price |
$147.80
|
| Rate for Payer: Cofinity Commercial |
$129.32
|
| Rate for Payer: Cofinity Commercial |
$158.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$166.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.56
|
| Rate for Payer: Mclaren Medicaid |
$9.33
|
| Rate for Payer: Mclaren Medicare |
$17.06
|
| Rate for Payer: Meridian Medicaid |
$9.80
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.04
|
| Rate for Payer: PACE Medicare |
$16.21
|
| Rate for Payer: PACE SWMI |
$17.06
|
| Rate for Payer: PHP Commercial |
$157.04
|
| Rate for Payer: PHP Medicare Advantage |
$17.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.92
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health Narrow Network |
$12.74
|
| Rate for Payer: Priority Health SBD |
$116.39
|
| Rate for Payer: Railroad Medicare Medicare |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.47
|
| Rate for Payer: UHC Core |
$19.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.06
|
| Rate for Payer: UHC Exchange |
$17.06
|
| Rate for Payer: UHC Medicare Advantage |
$17.57
|
| Rate for Payer: UMR Bronson Commercial |
$68.36
|
| Rate for Payer: VA VA |
$17.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.56
|
|
|
HC VITAMIN B3 AND METABOLITES, P
|
Facility
|
IP
|
$184.75
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100754
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$81.29 |
| Max. Negotiated Rate |
$166.28 |
| Rate for Payer: Aetna American Axle |
$120.09
|
| Rate for Payer: Aetna Commercial |
$157.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$120.09
|
| Rate for Payer: Cash Price |
$147.80
|
| Rate for Payer: Cofinity Commercial |
$129.32
|
| Rate for Payer: Cofinity Commercial |
$158.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.80
|
| Rate for Payer: Healthscope Commercial |
$166.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$129.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$157.04
|
| Rate for Payer: PHP Commercial |
$157.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$129.32
|
| Rate for Payer: Priority Health SBD |
$116.39
|
| Rate for Payer: UMR Bronson Commercial |
$81.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.56
|
|
|
HC VITAMIN B6 LEVEL
|
Facility
|
IP
|
$56.10
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
30100413
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.68 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna American Axle |
$36.46
|
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health SBD |
$35.34
|
| Rate for Payer: UMR Bronson Commercial |
$24.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC VITAMIN B6 LEVEL
|
Facility
|
OP
|
$56.10
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
30100413
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.37 |
| Max. Negotiated Rate |
$50.49 |
| Rate for Payer: Aetna American Axle |
$36.46
|
| Rate for Payer: Aetna Commercial |
$47.68
|
| Rate for Payer: Aetna Medicare |
$29.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.12
|
| Rate for Payer: BCBS Complete |
$16.14
|
| Rate for Payer: BCBS MAPPO |
$28.10
|
| Rate for Payer: BCBS Trust/PPO |
$25.28
|
| Rate for Payer: BCN Medicare Advantage |
$28.10
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cash Price |
$44.88
|
| Rate for Payer: Cofinity Commercial |
$39.27
|
| Rate for Payer: Cofinity Commercial |
$48.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.10
|
| Rate for Payer: Healthscope Commercial |
$50.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.08
|
| Rate for Payer: Mclaren Medicaid |
$15.37
|
| Rate for Payer: Mclaren Medicare |
$28.10
|
| Rate for Payer: Meridian Medicaid |
$16.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$47.68
|
| Rate for Payer: PACE Medicare |
$26.70
|
| Rate for Payer: PACE SWMI |
$28.10
|
| Rate for Payer: PHP Commercial |
$47.68
|
| Rate for Payer: PHP Medicare Advantage |
$28.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.54
|
| Rate for Payer: Priority Health Medicare |
$28.10
|
| Rate for Payer: Priority Health Narrow Network |
$30.83
|
| Rate for Payer: Priority Health SBD |
$35.34
|
| Rate for Payer: Railroad Medicare Medicare |
$28.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.72
|
| Rate for Payer: UHC Core |
$46.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.10
|
| Rate for Payer: UHC Exchange |
$28.10
|
| Rate for Payer: UHC Medicare Advantage |
$28.94
|
| Rate for Payer: UMR Bronson Commercial |
$20.76
|
| Rate for Payer: VA VA |
$28.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.08
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
OP
|
$65.00
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna American Axle |
$42.25
|
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna Medicare |
$10.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.36
|
| Rate for Payer: BCBS Complete |
$5.68
|
| Rate for Payer: BCBS MAPPO |
$9.89
|
| Rate for Payer: BCBS Trust/PPO |
$8.90
|
| Rate for Payer: BCN Medicare Advantage |
$9.89
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$45.50
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.89
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Mclaren Medicaid |
$5.41
|
| Rate for Payer: Mclaren Medicare |
$9.89
|
| Rate for Payer: Meridian Medicaid |
$5.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PACE Medicare |
$9.40
|
| Rate for Payer: PACE SWMI |
$9.89
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: PHP Medicare Advantage |
$9.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.56
|
| Rate for Payer: Priority Health Medicare |
$9.89
|
| Rate for Payer: Priority Health Narrow Network |
$10.85
|
| Rate for Payer: Priority Health SBD |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$9.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.87
|
| Rate for Payer: UHC Core |
$16.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.89
|
| Rate for Payer: UHC Exchange |
$9.89
|
| Rate for Payer: UHC Medicare Advantage |
$10.19
|
| Rate for Payer: UMR Bronson Commercial |
$24.05
|
| Rate for Payer: VA VA |
$9.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
IP
|
$65.00
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.60 |
| Max. Negotiated Rate |
$58.50 |
| Rate for Payer: Aetna American Axle |
$42.25
|
| Rate for Payer: Aetna Commercial |
$55.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.25
|
| Rate for Payer: Cash Price |
$52.00
|
| Rate for Payer: Cofinity Commercial |
$55.90
|
| Rate for Payer: Cofinity Commercial |
$45.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.00
|
| Rate for Payer: Healthscope Commercial |
$58.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$55.25
|
| Rate for Payer: PHP Commercial |
$55.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.50
|
| Rate for Payer: Priority Health SBD |
$40.95
|
| Rate for Payer: UMR Bronson Commercial |
$28.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.75
|
|
|
HC VITAMIN D
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.72
|
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: UMR Bronson Commercial |
$33.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC VITAMIN D
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.72
|
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$30.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.00
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$26.62
|
| Rate for Payer: BCN Medicare Advantage |
$29.60
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Mclaren Medicare |
$29.60
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Medicare |
$28.12
|
| Rate for Payer: PACE SWMI |
$29.60
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$29.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.61
|
| Rate for Payer: Priority Health Medicare |
$29.60
|
| Rate for Payer: Priority Health Narrow Network |
$32.49
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: Railroad Medicare Medicare |
$29.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Core |
$48.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.60
|
| Rate for Payer: UHC Exchange |
$29.60
|
| Rate for Payer: UHC Medicare Advantage |
$30.49
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: VA VA |
$29.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.39 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna American Axle |
$59.67
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: UMR Bronson Commercial |
$40.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.06 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna American Axle |
$59.67
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$40.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.12
|
| Rate for Payer: BCBS Complete |
$22.11
|
| Rate for Payer: BCBS MAPPO |
$38.50
|
| Rate for Payer: BCBS Trust/PPO |
$34.63
|
| Rate for Payer: BCN Medicare Advantage |
$38.50
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.50
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$21.06
|
| Rate for Payer: Mclaren Medicare |
$38.50
|
| Rate for Payer: Meridian Medicaid |
$22.11
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$78.03
|
| Rate for Payer: PACE Medicare |
$36.58
|
| Rate for Payer: PACE SWMI |
$38.50
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$38.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$52.81
|
| Rate for Payer: Priority Health Medicare |
$38.50
|
| Rate for Payer: Priority Health Narrow Network |
$42.25
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: Railroad Medicare Medicare |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.20
|
| Rate for Payer: UHC Core |
$63.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.50
|
| Rate for Payer: UHC Exchange |
$38.50
|
| Rate for Payer: UHC Medicare Advantage |
$39.66
|
| Rate for Payer: UMR Bronson Commercial |
$33.97
|
| Rate for Payer: VA VA |
$38.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.72
|
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: UMR Bronson Commercial |
$33.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.19 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.72
|
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$30.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.00
|
| Rate for Payer: BCBS Complete |
$17.00
|
| Rate for Payer: BCBS MAPPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$26.62
|
| Rate for Payer: BCN Medicare Advantage |
$29.60
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$16.19
|
| Rate for Payer: Mclaren Medicare |
$29.60
|
| Rate for Payer: Meridian Medicaid |
$17.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$65.02
|
| Rate for Payer: PACE Medicare |
$28.12
|
| Rate for Payer: PACE SWMI |
$29.60
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$29.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.61
|
| Rate for Payer: Priority Health Medicare |
$29.60
|
| Rate for Payer: Priority Health Narrow Network |
$32.49
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: Railroad Medicare Medicare |
$29.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Core |
$48.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.60
|
| Rate for Payer: UHC Exchange |
$29.60
|
| Rate for Payer: UHC Medicare Advantage |
$30.49
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: VA VA |
$29.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$14.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: BCBS Complete |
$8.14
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$12.76
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$7.76
|
| Rate for Payer: Mclaren Medicare |
$14.18
|
| Rate for Payer: Meridian Medicaid |
$8.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$14.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Medicare |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.45
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow Network |
$15.56
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.02
|
| Rate for Payer: UHC Core |
$23.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.18
|
| Rate for Payer: UHC Exchange |
$14.18
|
| Rate for Payer: UHC Medicare Advantage |
$14.61
|
| Rate for Payer: UMR Bronson Commercial |
$18.87
|
| Rate for Payer: VA VA |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.44 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna American Axle |
$33.15
|
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.15
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health SBD |
$32.13
|
| Rate for Payer: UMR Bronson Commercial |
$22.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
