|
HC METANEPHRINES PLASMA
|
Facility
|
IP
|
$62.22
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30200013
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.38 |
| Max. Negotiated Rate |
$56.00 |
| Rate for Payer: Aetna American Axle |
$40.44
|
| Rate for Payer: Aetna Commercial |
$52.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.44
|
| Rate for Payer: Cash Price |
$49.78
|
| Rate for Payer: Cofinity Commercial |
$43.55
|
| Rate for Payer: Cofinity Commercial |
$53.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.78
|
| Rate for Payer: Healthscope Commercial |
$56.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.89
|
| Rate for Payer: PHP Commercial |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.44
|
| Rate for Payer: Priority Health SBD |
$39.20
|
| Rate for Payer: UMR Bronson Commercial |
$27.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.66
|
|
|
HC METANEPHRINES URINE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC METANEPHRINES URINE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 83835
|
| Hospital Charge Code |
30100295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.08 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.18
|
| Rate for Payer: BCBS Complete |
$9.53
|
| Rate for Payer: BCBS MAPPO |
$16.94
|
| Rate for Payer: BCN Medicare Advantage |
$16.94
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Cofinity Commercial |
$37.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.08
|
| Rate for Payer: Mclaren Medicare |
$16.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.79
|
| Rate for Payer: Meridian Medicaid |
$9.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: PACE Medicare |
$16.09
|
| Rate for Payer: PACE SWMI |
$16.94
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$16.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.49
|
| Rate for Payer: Priority Health Medicare |
$16.94
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Railroad Medicare Medicare |
$16.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.94
|
| Rate for Payer: UHC Exchange |
$32.37
|
| Rate for Payer: UHC Medicare Advantage |
$16.94
|
| Rate for Payer: UHCCP Medicaid |
$9.08
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
IP
|
$1,798.97
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$791.55 |
| Max. Negotiated Rate |
$1,619.07 |
| Rate for Payer: Aetna American Axle |
$1,169.33
|
| Rate for Payer: Aetna Commercial |
$1,529.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.33
|
| Rate for Payer: Cash Price |
$1,439.18
|
| Rate for Payer: Cofinity Commercial |
$1,259.28
|
| Rate for Payer: Cofinity Commercial |
$1,547.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,259.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,439.18
|
| Rate for Payer: Healthscope Commercial |
$1,619.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,259.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,349.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,529.12
|
| Rate for Payer: PHP Commercial |
$1,529.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.33
|
| Rate for Payer: Priority Health SBD |
$1,133.35
|
| Rate for Payer: UMR Bronson Commercial |
$791.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,349.23
|
|
|
HC METASTRON SR 89 THERAPEUTIC PER MCI
|
Facility
|
OP
|
$1,798.97
|
|
|
Service Code
|
HCPCS A9600
|
| Hospital Charge Code |
34400003
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$665.62 |
| Max. Negotiated Rate |
$11,671.53 |
| Rate for Payer: Aetna American Axle |
$1,169.33
|
| Rate for Payer: Aetna Commercial |
$1,529.12
|
| Rate for Payer: Aetna Medicare |
$4,312.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,169.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5,182.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5,182.93
|
| Rate for Payer: BCBS Complete |
$2,333.56
|
| Rate for Payer: BCBS MAPPO |
$4,146.34
|
| Rate for Payer: BCN Medicare Advantage |
$4,146.34
|
| Rate for Payer: Cash Price |
$1,439.18
|
| Rate for Payer: Cash Price |
$1,439.18
|
| Rate for Payer: Cofinity Commercial |
$1,547.11
|
| Rate for Payer: Cofinity Commercial |
$1,259.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,259.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,439.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,146.34
|
| Rate for Payer: Healthscope Commercial |
$1,619.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,259.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,349.23
|
| Rate for Payer: Mclaren Medicaid |
$2,222.44
|
| Rate for Payer: Mclaren Medicare |
$4,146.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4,353.66
|
| Rate for Payer: Meridian Medicaid |
$2,333.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,768.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,529.12
|
| Rate for Payer: PACE Medicare |
$3,939.02
|
| Rate for Payer: PACE SWMI |
$4,146.34
|
| Rate for Payer: PHP Commercial |
$1,529.12
|
| Rate for Payer: PHP Medicare Advantage |
$4,146.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,222.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,169.33
|
| Rate for Payer: Priority Health Medicare |
$4,146.34
|
| Rate for Payer: Priority Health SBD |
$1,133.35
|
| Rate for Payer: Railroad Medicare Medicare |
$4,146.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,671.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,146.34
|
| Rate for Payer: UHC Exchange |
$7,924.07
|
| Rate for Payer: UHC Medicare Advantage |
$4,146.34
|
| Rate for Payer: UHCCP Medicaid |
$2,222.44
|
| Rate for Payer: UMR Bronson Commercial |
$665.62
|
| Rate for Payer: VA VA |
$4,146.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,349.23
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.40 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna American Axle |
$76.25
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$58.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.25
|
| Rate for Payer: BCBS Complete |
$46.92
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UMR Bronson Commercial |
$43.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC METHADONE CONFIRM MECON
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100574
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.61 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna American Axle |
$76.25
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.25
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.25
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UMR Bronson Commercial |
$51.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.97
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
OP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$174.92 |
| Rate for Payer: Aetna American Axle |
$61.44
|
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Cofinity Commercial |
$66.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$59.55
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$118.76
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$34.98
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC METHADONE SCRN URIN
|
Facility
|
IP
|
$94.53
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000118
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$41.59 |
| Max. Negotiated Rate |
$85.08 |
| Rate for Payer: Aetna American Axle |
$61.44
|
| Rate for Payer: Aetna Commercial |
$80.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.44
|
| Rate for Payer: Cash Price |
$75.62
|
| Rate for Payer: Cofinity Commercial |
$66.17
|
| Rate for Payer: Cofinity Commercial |
$81.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.62
|
| Rate for Payer: Healthscope Commercial |
$85.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.35
|
| Rate for Payer: PHP Commercial |
$80.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.44
|
| Rate for Payer: Priority Health SBD |
$59.55
|
| Rate for Payer: UMR Bronson Commercial |
$41.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.90
|
|
|
HC METHADONE SCRN URN
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$24.08
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC METHADONE SCRN URN
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000117
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
OP
|
$79.56
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.44 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna American Axle |
$51.71
|
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: Aetna Medicare |
$39.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.71
|
| Rate for Payer: BCBS Complete |
$31.82
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$55.69
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: Priority Health SBD |
$50.12
|
| Rate for Payer: UMR Bronson Commercial |
$29.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC METHADONE SERUM LVL
|
Facility
|
IP
|
$79.56
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100575
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.01 |
| Max. Negotiated Rate |
$71.60 |
| Rate for Payer: Aetna American Axle |
$51.71
|
| Rate for Payer: Aetna Commercial |
$67.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.71
|
| Rate for Payer: Cash Price |
$63.65
|
| Rate for Payer: Cofinity Commercial |
$55.69
|
| Rate for Payer: Cofinity Commercial |
$68.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$55.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.65
|
| Rate for Payer: Healthscope Commercial |
$71.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.63
|
| Rate for Payer: PHP Commercial |
$67.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.71
|
| Rate for Payer: Priority Health SBD |
$50.12
|
| Rate for Payer: UMR Bronson Commercial |
$35.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.67
|
|
|
HC METHADONE URN
|
Facility
|
OP
|
$61.20
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.64 |
| 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 |
$30.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.78
|
| Rate for Payer: BCBS Complete |
$24.48
|
| Rate for Payer: Cash Price |
$48.96
|
| Rate for Payer: Cofinity Commercial |
$42.84
|
| Rate for Payer: Cofinity Commercial |
$52.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.84
|
| 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 Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| Rate for Payer: Priority Health SBD |
$38.56
|
| Rate for Payer: UMR Bronson Commercial |
$22.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.90
|
|
|
HC METHADONE URN
|
Facility
|
IP
|
$61.20
|
|
|
Service Code
|
CPT 80358
|
| Hospital Charge Code |
30100576
|
|
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: Cofinity Medicare Advantage |
$42.84
|
| 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 Commercial |
$52.02
|
| Rate for Payer: PHP Commercial |
$52.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.78
|
| 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 METHANOL LVL
|
Facility
|
OP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.87 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna American Axle |
$103.43
|
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: Aetna Medicare |
$79.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.43
|
| Rate for Payer: BCBS Complete |
$63.65
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$111.38
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$111.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health SBD |
$100.25
|
| Rate for Payer: UMR Bronson Commercial |
$58.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC METHANOL LVL
|
Facility
|
IP
|
$159.12
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100581
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$70.01 |
| Max. Negotiated Rate |
$143.21 |
| Rate for Payer: Aetna American Axle |
$103.43
|
| Rate for Payer: Aetna Commercial |
$135.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$103.43
|
| Rate for Payer: Cash Price |
$127.30
|
| Rate for Payer: Cofinity Commercial |
$111.38
|
| Rate for Payer: Cofinity Commercial |
$136.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$111.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.30
|
| Rate for Payer: Healthscope Commercial |
$143.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$111.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.25
|
| Rate for Payer: PHP Commercial |
$135.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.43
|
| Rate for Payer: Priority Health SBD |
$100.25
|
| Rate for Payer: UMR Bronson Commercial |
$70.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.34
|
|
|
HC METHEMOGLOBIN
|
Facility
|
OP
|
$47.02
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.40 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna American Axle |
$30.56
|
| Rate for Payer: Aetna Commercial |
$39.97
|
| Rate for Payer: Aetna Medicare |
$8.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.25
|
| Rate for Payer: BCBS Complete |
$4.61
|
| Rate for Payer: BCBS MAPPO |
$8.20
|
| Rate for Payer: BCN Medicare Advantage |
$8.20
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$40.44
|
| Rate for Payer: Cofinity Commercial |
$32.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.20
|
| Rate for Payer: Healthscope Commercial |
$42.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.27
|
| Rate for Payer: Mclaren Medicaid |
$4.40
|
| Rate for Payer: Mclaren Medicare |
$8.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.61
|
| Rate for Payer: Meridian Medicaid |
$4.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.97
|
| Rate for Payer: PACE Medicare |
$7.79
|
| Rate for Payer: PACE SWMI |
$8.20
|
| Rate for Payer: PHP Commercial |
$39.97
|
| Rate for Payer: PHP Medicare Advantage |
$8.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.56
|
| Rate for Payer: Priority Health Medicare |
$8.20
|
| Rate for Payer: Priority Health SBD |
$29.62
|
| Rate for Payer: Railroad Medicare Medicare |
$8.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.20
|
| Rate for Payer: UHC Exchange |
$15.67
|
| Rate for Payer: UHC Medicare Advantage |
$8.20
|
| Rate for Payer: UHCCP Medicaid |
$4.40
|
| Rate for Payer: UMR Bronson Commercial |
$17.40
|
| Rate for Payer: VA VA |
$8.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.27
|
|
|
HC METHEMOGLOBIN
|
Facility
|
IP
|
$47.02
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
30100239
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.69 |
| Max. Negotiated Rate |
$42.32 |
| Rate for Payer: Aetna American Axle |
$30.56
|
| Rate for Payer: Aetna Commercial |
$39.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.56
|
| Rate for Payer: Cash Price |
$37.62
|
| Rate for Payer: Cofinity Commercial |
$32.91
|
| Rate for Payer: Cofinity Commercial |
$40.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.62
|
| Rate for Payer: Healthscope Commercial |
$42.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.97
|
| Rate for Payer: PHP Commercial |
$39.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.56
|
| Rate for Payer: Priority Health SBD |
$29.62
|
| Rate for Payer: UMR Bronson Commercial |
$20.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.27
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
OP
|
$176.97
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$159.27 |
| Rate for Payer: Aetna American Axle |
$115.03
|
| Rate for Payer: Aetna Commercial |
$150.42
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$152.19
|
| Rate for Payer: Cofinity Commercial |
$123.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$159.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.73
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$150.42
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$111.49
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.64
|
| Rate for Payer: UHC Exchange |
$35.62
|
| Rate for Payer: UHC Medicare Advantage |
$18.64
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: UMR Bronson Commercial |
$65.48
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.73
|
|
|
HC METHOTREXATE LEVEL
|
Facility
|
IP
|
$176.97
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100064
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$77.87 |
| Max. Negotiated Rate |
$159.27 |
| Rate for Payer: Aetna American Axle |
$115.03
|
| Rate for Payer: Aetna Commercial |
$150.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.03
|
| Rate for Payer: Cash Price |
$141.58
|
| Rate for Payer: Cofinity Commercial |
$123.88
|
| Rate for Payer: Cofinity Commercial |
$152.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.58
|
| Rate for Payer: Healthscope Commercial |
$159.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.42
|
| Rate for Payer: PHP Commercial |
$150.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.03
|
| Rate for Payer: Priority Health SBD |
$111.49
|
| Rate for Payer: UMR Bronson Commercial |
$77.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.73
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
OP
|
$62.33
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$59.70 |
| Rate for Payer: Aetna American Axle |
$40.51
|
| Rate for Payer: Aetna Commercial |
$52.98
|
| Rate for Payer: Aetna Medicare |
$22.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.51
|
| Rate for Payer: BCBS Complete |
$11.94
|
| Rate for Payer: BCBS MAPPO |
$21.21
|
| Rate for Payer: BCN Medicare Advantage |
$21.21
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cofinity Commercial |
$53.60
|
| Rate for Payer: Cofinity Commercial |
$43.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.21
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.75
|
| Rate for Payer: Mclaren Medicaid |
$11.37
|
| Rate for Payer: Mclaren Medicare |
$21.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.27
|
| Rate for Payer: Meridian Medicaid |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.98
|
| Rate for Payer: PACE Medicare |
$20.15
|
| Rate for Payer: PACE SWMI |
$21.21
|
| Rate for Payer: PHP Commercial |
$52.98
|
| Rate for Payer: PHP Medicare Advantage |
$21.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.51
|
| Rate for Payer: Priority Health Medicare |
$21.21
|
| Rate for Payer: Priority Health SBD |
$39.27
|
| Rate for Payer: Railroad Medicare Medicare |
$21.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.21
|
| Rate for Payer: UHC Exchange |
$40.53
|
| Rate for Payer: UHC Medicare Advantage |
$21.21
|
| Rate for Payer: UHCCP Medicaid |
$11.37
|
| Rate for Payer: UMR Bronson Commercial |
$23.06
|
| Rate for Payer: VA VA |
$21.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.75
|
|
|
HC METHYLMALONIC ACID
|
Facility
|
IP
|
$62.33
|
|
|
Service Code
|
CPT 83921
|
| Hospital Charge Code |
30100373
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.43 |
| Max. Negotiated Rate |
$56.10 |
| Rate for Payer: Aetna American Axle |
$40.51
|
| Rate for Payer: Aetna Commercial |
$52.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.51
|
| Rate for Payer: Cash Price |
$49.86
|
| Rate for Payer: Cofinity Commercial |
$43.63
|
| Rate for Payer: Cofinity Commercial |
$53.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.86
|
| Rate for Payer: Healthscope Commercial |
$56.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.98
|
| Rate for Payer: PHP Commercial |
$52.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.51
|
| Rate for Payer: Priority Health SBD |
$39.27
|
| Rate for Payer: UMR Bronson Commercial |
$27.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.75
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$159.02 |
| Max. Negotiated Rate |
$835.10 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$308.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$370.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$370.84
|
| Rate for Payer: BCBS Complete |
$166.97
|
| Rate for Payer: BCBS MAPPO |
$296.67
|
| Rate for Payer: BCN Medicare Advantage |
$296.67
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$296.67
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$159.02
|
| Rate for Payer: Mclaren Medicare |
$296.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$311.50
|
| Rate for Payer: Meridian Medicaid |
$166.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$341.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PACE Medicare |
$281.84
|
| Rate for Payer: PACE SWMI |
$296.67
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$296.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health Medicare |
$296.67
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: Railroad Medicare Medicare |
$296.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$835.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$296.67
|
| Rate for Payer: UHC Exchange |
$566.97
|
| Rate for Payer: UHC Medicare Advantage |
$296.67
|
| Rate for Payer: UHCCP Medicaid |
$159.02
|
| Rate for Payer: UMR Bronson Commercial |
$161.92
|
| Rate for Payer: VA VA |
$296.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC MFM CORDOCENTESIS
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 59012
|
| Hospital Charge Code |
36100262
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$192.56 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: UMR Bronson Commercial |
$192.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
