|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
IP
|
$280.60
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$123.46 |
| Max. Negotiated Rate |
$252.54 |
| Rate for Payer: Aetna American Axle |
$182.39
|
| Rate for Payer: Aetna Commercial |
$238.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$182.39
|
| Rate for Payer: Cash Price |
$224.48
|
| Rate for Payer: Cofinity Advantage |
$196.42
|
| Rate for Payer: Cofinity Commercial |
$241.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.48
|
| Rate for Payer: Healthscope Commercial |
$252.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$196.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.45
|
| Rate for Payer: PHP Commercial |
$238.51
|
| Rate for Payer: Priority Health SBD |
$176.78
|
| Rate for Payer: UMR Bronson Commercial |
$123.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.45
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
OP
|
$12,117.67
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,483.54 |
| Max. Negotiated Rate |
$10,905.90 |
| Rate for Payer: Aetna American Axle |
$7,876.49
|
| Rate for Payer: Aetna Commercial |
$10,300.02
|
| Rate for Payer: Aetna Medicare |
$6,058.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,876.49
|
| Rate for Payer: BCBS Complete |
$4,847.07
|
| Rate for Payer: Cash Price |
$9,694.14
|
| Rate for Payer: Cofinity Advantage |
$8,482.37
|
| Rate for Payer: Cofinity Commercial |
$10,421.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,694.14
|
| Rate for Payer: Healthscope Commercial |
$10,905.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,482.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,088.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,694.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,300.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,088.25
|
| Rate for Payer: PHP Commercial |
$10,300.02
|
| Rate for Payer: Priority Health SBD |
$7,634.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,876.49
|
| Rate for Payer: UHC Core |
$6,313.31
|
| Rate for Payer: UHC Exchange |
$4,762.24
|
| Rate for Payer: UMR Bronson Commercial |
$4,483.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,088.25
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
IP
|
$12,117.67
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,331.77 |
| Max. Negotiated Rate |
$10,905.90 |
| Rate for Payer: Aetna American Axle |
$7,876.49
|
| Rate for Payer: Aetna Commercial |
$10,300.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,876.49
|
| Rate for Payer: Cash Price |
$9,694.14
|
| Rate for Payer: Cofinity Advantage |
$8,482.37
|
| Rate for Payer: Cofinity Commercial |
$10,421.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,694.14
|
| Rate for Payer: Healthscope Commercial |
$10,905.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,482.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,088.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,300.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,088.25
|
| Rate for Payer: PHP Commercial |
$10,300.02
|
| Rate for Payer: Priority Health SBD |
$7,634.13
|
| Rate for Payer: UMR Bronson Commercial |
$5,331.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,088.25
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
IP
|
$1,968.54
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$866.16 |
| Max. Negotiated Rate |
$1,771.69 |
| Rate for Payer: Aetna American Axle |
$1,279.55
|
| Rate for Payer: Aetna Commercial |
$1,673.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,279.55
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cofinity Advantage |
$1,377.98
|
| Rate for Payer: Cofinity Commercial |
$1,692.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,574.83
|
| Rate for Payer: Healthscope Commercial |
$1,771.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,377.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,476.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,673.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.40
|
| Rate for Payer: PHP Commercial |
$1,673.26
|
| Rate for Payer: Priority Health SBD |
$1,240.18
|
| Rate for Payer: UMR Bronson Commercial |
$866.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,476.40
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
OP
|
$1,968.54
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$460.91 |
| Max. Negotiated Rate |
$2,850.01 |
| Rate for Payer: Aetna American Axle |
$1,279.55
|
| Rate for Payer: Aetna Commercial |
$1,673.26
|
| Rate for Payer: Aetna Medicare |
$916.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,279.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,101.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,101.61
|
| Rate for Payer: BCBS Complete |
$484.00
|
| Rate for Payer: BCBS MAPPO |
$881.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,167.10
|
| Rate for Payer: BCN Commercial |
$1,167.10
|
| Rate for Payer: BCN Medicare Advantage |
$881.29
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cash Price |
$1,574.83
|
| Rate for Payer: Cofinity Advantage |
$1,377.98
|
| Rate for Payer: Cofinity Commercial |
$1,692.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,574.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.29
|
| Rate for Payer: Healthscope Commercial |
$1,771.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,377.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,476.40
|
| Rate for Payer: Mclaren Medicaid |
$881.29
|
| Rate for Payer: Mclaren Medicare |
$881.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.35
|
| Rate for Payer: Meridian Medicaid |
$925.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,013.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$969.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,673.26
|
| Rate for Payer: Nomi Health Commercial |
$2,643.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,476.40
|
| Rate for Payer: PACE Medicare |
$837.23
|
| Rate for Payer: PACE SWMI |
$881.29
|
| Rate for Payer: PHP Commercial |
$1,673.26
|
| Rate for Payer: PHP Medicare Advantage |
$881.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$460.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,850.01
|
| Rate for Payer: Priority Health Medicare |
$881.29
|
| Rate for Payer: Priority Health SBD |
$1,240.18
|
| Rate for Payer: Priority Health Tiered Network |
$2,280.01
|
| Rate for Payer: Railroad Medicare Medicare |
$881.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$881.29
|
| Rate for Payer: UHC Medicaid |
$460.91
|
| Rate for Payer: UHCCP Medicaid |
$460.91
|
| Rate for Payer: UMR Bronson Commercial |
$728.36
|
| Rate for Payer: VA VA |
$881.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,476.40
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
IP
|
$70.04
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.82 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna American Axle |
$45.53
|
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.53
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Advantage |
$49.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: Priority Health SBD |
$44.13
|
| Rate for Payer: UMR Bronson Commercial |
$30.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
OP
|
$70.04
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$63.04 |
| Rate for Payer: Aetna American Axle |
$45.53
|
| Rate for Payer: Aetna Commercial |
$59.53
|
| Rate for Payer: Aetna Medicare |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.11
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.27
|
| Rate for Payer: BCN Commercial |
$21.27
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cash Price |
$56.03
|
| Rate for Payer: Cofinity Advantage |
$49.03
|
| Rate for Payer: Cofinity Commercial |
$60.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| Rate for Payer: Healthscope Commercial |
$63.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.53
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.53
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.53
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$59.53
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health SBD |
$44.13
|
| Rate for Payer: Priority Health Tiered Network |
$14.72
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.60
|
| Rate for Payer: UHC Core |
$27.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.40
|
| Rate for Payer: UHC Exchange |
$27.60
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UMR Bronson Commercial |
$25.91
|
| Rate for Payer: VA VA |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.53
|
|
|
HC NEURON SPECIFIC ENOLASE
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna American Axle |
$46.91
|
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Advantage |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$45.47
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$26.70
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC NEURON SPECIFIC ENOLASE
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.75 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna American Axle |
$46.91
|
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.91
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Advantage |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: Priority Health SBD |
$45.47
|
| Rate for Payer: UMR Bronson Commercial |
$31.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC NEUROPSYCH TEST EVAL BY PHYS FIRST HR
|
Facility
|
OP
|
$71.10
|
|
|
Service Code
|
CPT 96132
|
| Hospital Charge Code |
91800007
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$26.31 |
| Max. Negotiated Rate |
$1,202.41 |
| Rate for Payer: Aetna American Axle |
$46.22
|
| Rate for Payer: Aetna Commercial |
$60.44
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Advantage |
$49.77
|
| Rate for Payer: Cofinity Commercial |
$61.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$63.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.33
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$60.44
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$44.79
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.22
|
| Rate for Payer: UHC Core |
$37.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$27.94
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: UMR Bronson Commercial |
$26.31
|
| Rate for Payer: VA VA |
$371.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.33
|
|
|
HC NEUROPSYCH TEST EVAL BY PHYS FIRST HR
|
Facility
|
IP
|
$71.10
|
|
|
Service Code
|
CPT 96132
|
| Hospital Charge Code |
91800007
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$31.28 |
| Max. Negotiated Rate |
$63.99 |
| Rate for Payer: Aetna American Axle |
$46.22
|
| Rate for Payer: Aetna Commercial |
$60.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.22
|
| Rate for Payer: Cash Price |
$56.88
|
| Rate for Payer: Cofinity Advantage |
$49.77
|
| Rate for Payer: Cofinity Commercial |
$61.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.88
|
| Rate for Payer: Healthscope Commercial |
$63.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.33
|
| Rate for Payer: PHP Commercial |
$60.44
|
| Rate for Payer: Priority Health SBD |
$44.79
|
| Rate for Payer: UMR Bronson Commercial |
$31.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.33
|
|
|
HC NEUROPSYCH TEST EVAL EA ADDL HR
|
Facility
|
IP
|
$37.14
|
|
|
Service Code
|
CPT 96133
|
| Hospital Charge Code |
91800008
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$16.34 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna American Axle |
$24.14
|
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Advantage |
$26.00
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: Priority Health SBD |
$23.40
|
| Rate for Payer: UMR Bronson Commercial |
$16.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC NEUROPSYCH TEST EVAL EA ADDL HR
|
Facility
|
OP
|
$37.14
|
|
|
Service Code
|
CPT 96133
|
| Hospital Charge Code |
91800008
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$13.74 |
| Max. Negotiated Rate |
$33.43 |
| Rate for Payer: Aetna American Axle |
$24.14
|
| Rate for Payer: Aetna Commercial |
$31.57
|
| Rate for Payer: Aetna Medicare |
$18.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.14
|
| Rate for Payer: BCBS Complete |
$14.86
|
| Rate for Payer: Cash Price |
$29.71
|
| Rate for Payer: Cofinity Advantage |
$26.00
|
| Rate for Payer: Cofinity Commercial |
$31.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.71
|
| Rate for Payer: Healthscope Commercial |
$33.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.86
|
| Rate for Payer: PHP Commercial |
$31.57
|
| Rate for Payer: Priority Health SBD |
$23.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.14
|
| Rate for Payer: UHC Core |
$19.35
|
| Rate for Payer: UHC Exchange |
$14.60
|
| Rate for Payer: UMR Bronson Commercial |
$13.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.86
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 15
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$673.20 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Advantage |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,147.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: UMR Bronson Commercial |
$673.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 15
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$566.10 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$765.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Advantage |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,224.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,147.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$994.50
|
| Rate for Payer: UHC Core |
$797.13
|
| Rate for Payer: UHC Exchange |
$601.29
|
| Rate for Payer: UMR Bronson Commercial |
$566.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 25
|
Facility
|
IP
|
$2,550.00
|
|
|
Service Code
|
CPT C1897
|
| Hospital Charge Code |
27800138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,122.00 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Aetna American Axle |
$1,657.50
|
| Rate for Payer: Aetna Commercial |
$2,167.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.50
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Advantage |
$1,785.00
|
| Rate for Payer: Cofinity Commercial |
$2,193.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.00
|
| Rate for Payer: Healthscope Commercial |
$2,295.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,785.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.50
|
| Rate for Payer: PHP Commercial |
$2,167.50
|
| Rate for Payer: Priority Health SBD |
$1,606.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,122.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 25
|
Facility
|
OP
|
$2,550.00
|
|
|
Service Code
|
CPT C1897
|
| Hospital Charge Code |
27800138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$943.50 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Aetna American Axle |
$1,657.50
|
| Rate for Payer: Aetna Commercial |
$2,167.50
|
| Rate for Payer: Aetna Medicare |
$1,275.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.50
|
| Rate for Payer: BCBS Complete |
$1,020.00
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Advantage |
$1,785.00
|
| Rate for Payer: Cofinity Commercial |
$2,193.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.00
|
| Rate for Payer: Healthscope Commercial |
$2,295.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,785.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,040.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.50
|
| Rate for Payer: PHP Commercial |
$2,167.50
|
| Rate for Payer: Priority Health SBD |
$1,606.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,657.50
|
| Rate for Payer: UHC Core |
$1,328.55
|
| Rate for Payer: UHC Exchange |
$1,002.15
|
| Rate for Payer: UMR Bronson Commercial |
$943.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.50
|
|
|
HC NEUROSYPHILIS SCR, IGG, CSF
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200517
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna American Axle |
$23.20
|
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Advantage |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.77
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health SBD |
$22.49
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.77
|
|
|
HC NEUROSYPHILIS SCR, IGG, CSF
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200517
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$39.72 |
| Rate for Payer: Aetna American Axle |
$23.20
|
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCN Commercial |
$15.31
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Advantage |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.77
|
| Rate for Payer: Mclaren Medicaid |
$13.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.34
|
| Rate for Payer: Nomi Health Commercial |
$39.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.77
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.24
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$22.49
|
| Rate for Payer: Priority Health Tiered Network |
$10.59
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.86
|
| Rate for Payer: UHC Core |
$19.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.24
|
| Rate for Payer: UHC Exchange |
$19.86
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: UMR Bronson Commercial |
$13.21
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.77
|
|
|
HC NEUTROPHIL OXIDATIVE BURST
|
Facility
|
IP
|
$161.53
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$71.07 |
| Max. Negotiated Rate |
$145.38 |
| Rate for Payer: Aetna American Axle |
$104.99
|
| Rate for Payer: Aetna Commercial |
$137.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.99
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Advantage |
$113.07
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Healthscope Commercial |
$145.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.15
|
| Rate for Payer: PHP Commercial |
$137.30
|
| Rate for Payer: Priority Health SBD |
$101.76
|
| Rate for Payer: UMR Bronson Commercial |
$71.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.15
|
|
|
HC NEUTROPHIL OXIDATIVE BURST
|
Facility
|
OP
|
$161.53
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$59.77 |
| Max. Negotiated Rate |
$1,155.01 |
| Rate for Payer: Aetna American Axle |
$104.99
|
| Rate for Payer: Aetna Commercial |
$137.30
|
| Rate for Payer: Aetna Medicare |
$371.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$446.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$446.45
|
| Rate for Payer: BCBS Complete |
$196.15
|
| Rate for Payer: BCBS MAPPO |
$357.16
|
| Rate for Payer: BCBS Trust/PPO |
$144.07
|
| Rate for Payer: BCN Commercial |
$144.07
|
| Rate for Payer: BCN Medicare Advantage |
$357.16
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Advantage |
$113.07
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$357.16
|
| Rate for Payer: Healthscope Commercial |
$145.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$113.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.15
|
| Rate for Payer: Mclaren Medicaid |
$357.16
|
| Rate for Payer: Mclaren Medicare |
$357.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$375.02
|
| Rate for Payer: Meridian Medicaid |
$375.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$410.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$392.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.30
|
| Rate for Payer: Nomi Health Commercial |
$1,071.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.15
|
| Rate for Payer: PACE Medicare |
$339.30
|
| Rate for Payer: PACE SWMI |
$357.16
|
| Rate for Payer: PHP Commercial |
$137.30
|
| Rate for Payer: PHP Medicare Advantage |
$357.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,155.01
|
| Rate for Payer: Priority Health Medicare |
$357.16
|
| Rate for Payer: Priority Health SBD |
$101.76
|
| Rate for Payer: Priority Health Tiered Network |
$924.01
|
| Rate for Payer: Railroad Medicare Medicare |
$357.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.58
|
| Rate for Payer: UHC Core |
$539.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$357.16
|
| Rate for Payer: UHC Exchange |
$539.58
|
| Rate for Payer: UHC Medicaid |
$186.79
|
| Rate for Payer: UHCCP Medicaid |
$186.79
|
| Rate for Payer: UMR Bronson Commercial |
$59.77
|
| Rate for Payer: VA VA |
$357.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.15
|
|
|
HC NEUTROPHIL OXIDATIVE BURST CMP
|
Facility
|
IP
|
$57.30
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$25.21 |
| Max. Negotiated Rate |
$51.57 |
| Rate for Payer: Aetna American Axle |
$37.24
|
| Rate for Payer: Aetna Commercial |
$48.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.24
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Advantage |
$40.11
|
| Rate for Payer: Cofinity Commercial |
$49.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Healthscope Commercial |
$51.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.98
|
| Rate for Payer: PHP Commercial |
$48.70
|
| Rate for Payer: Priority Health SBD |
$36.10
|
| Rate for Payer: UMR Bronson Commercial |
$25.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.98
|
|
|
HC NEUTROPHIL OXIDATIVE BURST CMP
|
Facility
|
OP
|
$57.30
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$51.57 |
| Rate for Payer: Aetna American Axle |
$37.24
|
| Rate for Payer: Aetna Commercial |
$48.70
|
| Rate for Payer: Aetna Medicare |
$28.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.24
|
| Rate for Payer: BCBS Complete |
$22.92
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Advantage |
$40.11
|
| Rate for Payer: Cofinity Commercial |
$49.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Healthscope Commercial |
$51.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.98
|
| Rate for Payer: PHP Commercial |
$48.70
|
| Rate for Payer: Priority Health SBD |
$36.10
|
| 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 |
$21.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.98
|
|
|
HC NEW PATIENT VISIT 99202
|
Facility
|
IP
|
$169.02
|
|
|
Service Code
|
CPT 99202
|
| Hospital Charge Code |
51000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$74.37 |
| Max. Negotiated Rate |
$152.12 |
| Rate for Payer: Aetna American Axle |
$109.86
|
| Rate for Payer: Aetna Commercial |
$143.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.86
|
| Rate for Payer: Cash Price |
$135.22
|
| Rate for Payer: Cofinity Advantage |
$118.31
|
| Rate for Payer: Cofinity Commercial |
$145.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.22
|
| Rate for Payer: Healthscope Commercial |
$152.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.77
|
| Rate for Payer: PHP Commercial |
$143.67
|
| Rate for Payer: Priority Health SBD |
$106.48
|
| Rate for Payer: UMR Bronson Commercial |
$74.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.77
|
|
|
HC NEW PATIENT VISIT 99202
|
Facility
|
OP
|
$169.02
|
|
|
Service Code
|
CPT 99202
|
| Hospital Charge Code |
51000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$62.54 |
| Max. Negotiated Rate |
$152.12 |
| Rate for Payer: Aetna American Axle |
$109.86
|
| Rate for Payer: Aetna Commercial |
$143.67
|
| Rate for Payer: Aetna Medicare |
$84.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.86
|
| Rate for Payer: BCBS Complete |
$67.61
|
| Rate for Payer: BCBS Trust/PPO |
$114.75
|
| Rate for Payer: BCCCP Commercial |
$68.62
|
| Rate for Payer: BCN Commercial |
$114.75
|
| Rate for Payer: Cash Price |
$135.22
|
| Rate for Payer: Cash Price |
$135.22
|
| Rate for Payer: Cofinity Advantage |
$118.31
|
| Rate for Payer: Cofinity Commercial |
$145.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.22
|
| Rate for Payer: Healthscope Commercial |
$152.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$118.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.77
|
| Rate for Payer: PHP Commercial |
$143.67
|
| Rate for Payer: Priority Health SBD |
$106.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.86
|
| Rate for Payer: UHC Core |
$88.06
|
| Rate for Payer: UHC Exchange |
$66.42
|
| Rate for Payer: UMR Bronson Commercial |
$62.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.77
|
|
