|
HC MYCOPLASMA PNEUMONIAE DNA PCR
|
Facility
|
IP
|
$224.73
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600162
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$98.88 |
| Max. Negotiated Rate |
$202.26 |
| Rate for Payer: Aetna American Axle |
$146.07
|
| Rate for Payer: Aetna Commercial |
$191.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.07
|
| Rate for Payer: Cash Price |
$179.78
|
| Rate for Payer: Cofinity Advantage |
$157.31
|
| Rate for Payer: Cofinity Commercial |
$193.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.78
|
| Rate for Payer: Healthscope Commercial |
$202.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.55
|
| Rate for Payer: PHP Commercial |
$191.02
|
| Rate for Payer: Priority Health SBD |
$141.58
|
| Rate for Payer: UMR Bronson Commercial |
$98.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.55
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
OP
|
$657.95
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$91.73 |
| Max. Negotiated Rate |
$592.15 |
| Rate for Payer: Aetna American Axle |
$427.67
|
| Rate for Payer: Aetna Commercial |
$559.26
|
| Rate for Payer: Aetna Medicare |
$182.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.25
|
| Rate for Payer: BCBS Complete |
$96.33
|
| Rate for Payer: BCBS MAPPO |
$175.40
|
| Rate for Payer: BCBS Trust/PPO |
$202.76
|
| Rate for Payer: BCN Commercial |
$202.76
|
| Rate for Payer: BCN Medicare Advantage |
$175.40
|
| Rate for Payer: Cash Price |
$526.36
|
| Rate for Payer: Cash Price |
$526.36
|
| Rate for Payer: Cofinity Advantage |
$460.56
|
| Rate for Payer: Cofinity Commercial |
$565.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.40
|
| Rate for Payer: Healthscope Commercial |
$592.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$460.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.46
|
| Rate for Payer: Mclaren Medicaid |
$175.40
|
| Rate for Payer: Mclaren Medicare |
$175.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.17
|
| Rate for Payer: Meridian Medicaid |
$184.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$192.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.26
|
| Rate for Payer: Nomi Health Commercial |
$526.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.46
|
| Rate for Payer: PACE Medicare |
$166.63
|
| Rate for Payer: PACE SWMI |
$175.40
|
| Rate for Payer: PHP Commercial |
$559.26
|
| Rate for Payer: PHP Medicare Advantage |
$175.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$91.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$175.40
|
| Rate for Payer: Priority Health Medicare |
$175.40
|
| Rate for Payer: Priority Health SBD |
$414.51
|
| Rate for Payer: Priority Health Tiered Network |
$140.32
|
| Rate for Payer: Railroad Medicare Medicare |
$175.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$263.10
|
| Rate for Payer: UHC Core |
$263.10
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$175.40
|
| Rate for Payer: UHC Exchange |
$263.10
|
| Rate for Payer: UHC Medicaid |
$91.73
|
| Rate for Payer: UHCCP Medicaid |
$91.73
|
| Rate for Payer: UMR Bronson Commercial |
$243.44
|
| Rate for Payer: VA VA |
$175.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.46
|
|
|
HC MYD88 L265P GENE MUTATION ANALYSIS
|
Facility
|
IP
|
$657.95
|
|
|
Service Code
|
CPT 81305
|
| Hospital Charge Code |
30000111
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$289.50 |
| Max. Negotiated Rate |
$592.15 |
| Rate for Payer: Aetna American Axle |
$427.67
|
| Rate for Payer: Aetna Commercial |
$559.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$427.67
|
| Rate for Payer: Cash Price |
$526.36
|
| Rate for Payer: Cofinity Advantage |
$460.56
|
| Rate for Payer: Cofinity Commercial |
$565.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$526.36
|
| Rate for Payer: Healthscope Commercial |
$592.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$460.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$493.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$559.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$493.46
|
| Rate for Payer: PHP Commercial |
$559.26
|
| Rate for Payer: Priority Health SBD |
$414.51
|
| Rate for Payer: UMR Bronson Commercial |
$289.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$493.46
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
IP
|
$127.35
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$56.03 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna American Axle |
$82.78
|
| Rate for Payer: Aetna Commercial |
$108.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.78
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Advantage |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$109.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Healthscope Commercial |
$114.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PHP Commercial |
$108.25
|
| Rate for Payer: Priority Health SBD |
$80.23
|
| Rate for Payer: UMR Bronson Commercial |
$56.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.51
|
|
|
HC MYELODYSPLASTIC SYNDROME
|
Facility
|
OP
|
$127.35
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000132
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$114.61 |
| Rate for Payer: Aetna American Axle |
$82.78
|
| Rate for Payer: Aetna Commercial |
$108.25
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$24.77
|
| Rate for Payer: BCN Commercial |
$24.77
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cash Price |
$101.88
|
| Rate for Payer: Cofinity Advantage |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$109.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$114.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.51
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$108.25
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$95.51
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$108.25
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$80.23
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.51
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$44.36 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna American Axle |
$65.53
|
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: Priority Health SBD |
$63.52
|
| Rate for Payer: UMR Bronson Commercial |
$44.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC MYELODYSPLASTIC SYNDROME CMPT
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000025
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna American Axle |
$65.53
|
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$24.77
|
| Rate for Payer: BCN Commercial |
$24.77
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Advantage |
$70.57
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$63.52
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: UMR Bronson Commercial |
$37.30
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
IP
|
$178.29
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$78.45 |
| Max. Negotiated Rate |
$160.46 |
| Rate for Payer: Aetna American Axle |
$115.89
|
| Rate for Payer: Aetna Commercial |
$151.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.89
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cofinity Advantage |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$153.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$160.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.72
|
| Rate for Payer: PHP Commercial |
$151.55
|
| Rate for Payer: Priority Health SBD |
$112.32
|
| Rate for Payer: UMR Bronson Commercial |
$78.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.72
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
OP
|
$178.29
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$26.77 |
| Max. Negotiated Rate |
$160.46 |
| Rate for Payer: Aetna American Axle |
$115.89
|
| Rate for Payer: Aetna Commercial |
$151.55
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.11
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$59.17
|
| Rate for Payer: BCN Commercial |
$59.17
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cofinity Advantage |
$124.80
|
| Rate for Payer: Cofinity Commercial |
$153.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$160.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.72
|
| Rate for Payer: Mclaren Medicaid |
$51.19
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$53.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.55
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.72
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$151.55
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health SBD |
$112.32
|
| Rate for Payer: Priority Health Tiered Network |
$40.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.79
|
| Rate for Payer: UHC Core |
$76.79
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.19
|
| Rate for Payer: UHC Exchange |
$76.79
|
| Rate for Payer: UHC Medicaid |
$26.77
|
| Rate for Payer: UHCCP Medicaid |
$26.77
|
| Rate for Payer: UMR Bronson Commercial |
$65.97
|
| Rate for Payer: VA VA |
$51.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.72
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.71 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna American Axle |
$34.63
|
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$26.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: BCBS Complete |
$21.31
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Advantage |
$37.30
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health SBD |
$33.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.00
|
| Rate for Payer: UHC Core |
$33.00
|
| Rate for Payer: UHC Exchange |
$33.00
|
| Rate for Payer: UMR Bronson Commercial |
$19.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$23.44 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna American Axle |
$34.63
|
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Advantage |
$37.30
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health SBD |
$33.57
|
| Rate for Payer: UMR Bronson Commercial |
$23.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$23.44 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna American Axle |
$34.63
|
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Advantage |
$37.30
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health SBD |
$33.57
|
| Rate for Payer: UMR Bronson Commercial |
$23.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.71 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna American Axle |
$34.63
|
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$26.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.63
|
| Rate for Payer: BCBS Complete |
$21.31
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Advantage |
$37.30
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health SBD |
$33.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.00
|
| Rate for Payer: UHC Core |
$33.00
|
| Rate for Payer: UHC Exchange |
$33.00
|
| Rate for Payer: UMR Bronson Commercial |
$19.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
IP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna American Axle |
$20.00
|
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: Priority Health SBD |
$19.39
|
| Rate for Payer: UMR Bronson Commercial |
$13.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna American Axle |
$20.00
|
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$13.33
|
| Rate for Payer: BCN Commercial |
$13.33
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Mclaren Medicaid |
$11.53
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$12.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.53
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$19.39
|
| Rate for Payer: Priority Health Tiered Network |
$9.22
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.30
|
| Rate for Payer: UHC Core |
$17.30
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.53
|
| Rate for Payer: UHC Exchange |
$17.30
|
| Rate for Payer: UHC Medicaid |
$6.03
|
| Rate for Payer: UHCCP Medicaid |
$6.03
|
| Rate for Payer: UMR Bronson Commercial |
$11.38
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
OP
|
$35.39
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.95 |
| Max. Negotiated Rate |
$43.06 |
| Rate for Payer: Aetna American Axle |
$23.00
|
| Rate for Payer: Aetna Commercial |
$30.08
|
| Rate for Payer: Aetna Medicare |
$13.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.60
|
| Rate for Payer: BCBS Complete |
$7.29
|
| Rate for Payer: BCBS MAPPO |
$13.28
|
| Rate for Payer: BCBS Trust/PPO |
$43.06
|
| Rate for Payer: BCN Commercial |
$43.06
|
| Rate for Payer: BCN Medicare Advantage |
$13.28
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cofinity Advantage |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.28
|
| Rate for Payer: Healthscope Commercial |
$31.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.54
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Mclaren Medicare |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.94
|
| Rate for Payer: Meridian Medicaid |
$13.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.08
|
| Rate for Payer: Nomi Health Commercial |
$39.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.54
|
| Rate for Payer: PACE Medicare |
$12.62
|
| Rate for Payer: PACE SWMI |
$13.28
|
| Rate for Payer: PHP Commercial |
$30.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41.92
|
| Rate for Payer: Priority Health Medicare |
$13.28
|
| Rate for Payer: Priority Health SBD |
$22.30
|
| Rate for Payer: Priority Health Tiered Network |
$33.54
|
| Rate for Payer: Railroad Medicare Medicare |
$13.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.62
|
| Rate for Payer: UHC Core |
$14.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.28
|
| Rate for Payer: UHC Exchange |
$14.62
|
| Rate for Payer: UHC Medicaid |
$6.95
|
| Rate for Payer: UHCCP Medicaid |
$6.95
|
| Rate for Payer: UMR Bronson Commercial |
$13.09
|
| Rate for Payer: VA VA |
$13.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.54
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
IP
|
$35.39
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.57 |
| Max. Negotiated Rate |
$31.85 |
| Rate for Payer: Aetna American Axle |
$23.00
|
| Rate for Payer: Aetna Commercial |
$30.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.00
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cofinity Advantage |
$24.77
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.31
|
| Rate for Payer: Healthscope Commercial |
$31.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.54
|
| Rate for Payer: PHP Commercial |
$30.08
|
| Rate for Payer: Priority Health SBD |
$22.30
|
| Rate for Payer: UMR Bronson Commercial |
$15.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.54
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
IP
|
$148.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$65.51 |
| Max. Negotiated Rate |
$133.99 |
| Rate for Payer: Aetna American Axle |
$96.77
|
| Rate for Payer: Aetna Commercial |
$126.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.77
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cofinity Advantage |
$104.22
|
| Rate for Payer: Cofinity Commercial |
$128.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.10
|
| Rate for Payer: Healthscope Commercial |
$133.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.66
|
| Rate for Payer: PHP Commercial |
$126.55
|
| Rate for Payer: Priority Health SBD |
$93.79
|
| Rate for Payer: UMR Bronson Commercial |
$65.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.66
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
OP
|
$148.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$133.99 |
| Rate for Payer: Aetna American Axle |
$96.77
|
| Rate for Payer: Aetna Commercial |
$126.55
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$96.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.10
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$14.94
|
| Rate for Payer: BCN Commercial |
$14.94
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cofinity Advantage |
$104.22
|
| Rate for Payer: Cofinity Commercial |
$128.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$133.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.66
|
| Rate for Payer: Mclaren Medicaid |
$12.92
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$13.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.55
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.66
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$126.55
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.92
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$93.79
|
| Rate for Payer: Priority Health Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$19.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.92
|
| Rate for Payer: UHC Exchange |
$19.38
|
| Rate for Payer: UHC Medicaid |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$6.76
|
| Rate for Payer: UMR Bronson Commercial |
$55.09
|
| Rate for Payer: VA VA |
$12.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.66
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.28 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna American Axle |
$35.87
|
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.87
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Advantage |
$38.63
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: Priority Health SBD |
$34.76
|
| Rate for Payer: UMR Bronson Commercial |
$24.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna American Axle |
$35.87
|
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.10
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$14.94
|
| Rate for Payer: BCN Commercial |
$14.94
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Advantage |
$38.63
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Mclaren Medicaid |
$12.92
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$13.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.92
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$34.76
|
| Rate for Payer: Priority Health Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$19.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.92
|
| Rate for Payer: UHC Exchange |
$19.38
|
| Rate for Payer: UHC Medicaid |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$6.76
|
| Rate for Payer: UMR Bronson Commercial |
$20.42
|
| Rate for Payer: VA VA |
$12.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.95 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: UMR Bronson Commercial |
$21.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.76 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna American Axle |
$32.42
|
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$13.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.15
|
| Rate for Payer: BCBS Complete |
$7.10
|
| Rate for Payer: BCBS MAPPO |
$12.92
|
| Rate for Payer: BCBS Trust/PPO |
$14.94
|
| Rate for Payer: BCN Commercial |
$14.94
|
| Rate for Payer: BCN Medicare Advantage |
$12.92
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Advantage |
$34.92
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.92
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Mclaren Medicaid |
$12.92
|
| Rate for Payer: Mclaren Medicare |
$12.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.57
|
| Rate for Payer: Meridian Medicaid |
$13.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$19.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Medicare |
$12.27
|
| Rate for Payer: PACE SWMI |
$12.92
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$12.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.92
|
| Rate for Payer: Priority Health Medicare |
$12.92
|
| Rate for Payer: Priority Health SBD |
$31.42
|
| Rate for Payer: Priority Health Tiered Network |
$10.34
|
| Rate for Payer: Railroad Medicare Medicare |
$12.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.38
|
| Rate for Payer: UHC Core |
$19.38
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.92
|
| Rate for Payer: UHC Exchange |
$19.38
|
| Rate for Payer: UHC Medicaid |
$6.76
|
| Rate for Payer: UHCCP Medicaid |
$6.76
|
| Rate for Payer: UMR Bronson Commercial |
$18.46
|
| Rate for Payer: VA VA |
$12.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$31.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.38 |
| Max. Negotiated Rate |
$28.68 |
| Rate for Payer: Aetna American Axle |
$20.72
|
| Rate for Payer: Aetna Commercial |
$27.09
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.72
|
| 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 |
$9.85
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$20.73
|
| Rate for Payer: BCN Commercial |
$20.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Advantage |
$22.31
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.90
|
| Rate for Payer: Mclaren Medicaid |
$17.93
|
| 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 |
$18.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: Nomi Health Commercial |
$26.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$27.09
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health SBD |
$20.08
|
| Rate for Payer: Priority Health Tiered Network |
$14.34
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.90
|
| Rate for Payer: UHC Core |
$26.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.93
|
| Rate for Payer: UHC Exchange |
$26.90
|
| Rate for Payer: UHC Medicaid |
$9.38
|
| Rate for Payer: UHCCP Medicaid |
$9.38
|
| Rate for Payer: UMR Bronson Commercial |
$11.79
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.90
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
IP
|
$31.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.02 |
| Max. Negotiated Rate |
$28.68 |
| Rate for Payer: Aetna American Axle |
$20.72
|
| Rate for Payer: Aetna Commercial |
$27.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.72
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Advantage |
$22.31
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.90
|
| Rate for Payer: PHP Commercial |
$27.09
|
| Rate for Payer: Priority Health SBD |
$20.08
|
| Rate for Payer: UMR Bronson Commercial |
$14.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.90
|
|
