|
HC MENENCEPH CMPT 5
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200253
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$16.24
|
| Rate for Payer: BCN Commercial |
$16.24
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$25.28
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.85
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$13.48
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$16.85
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$5.24
|
| Rate for Payer: VA VA |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 5
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200253
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 6
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200257
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$19.78 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$12.70
|
| Rate for Payer: BCN Commercial |
$12.70
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$19.78
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.57
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow Network |
$10.86
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Exchange |
$13.19
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.07
|
| Rate for Payer: UMR Bronson Commercial |
$5.24
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 6
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200257
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 7
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200282
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$19.78 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$13.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.49
|
| Rate for Payer: BCBS Complete |
$7.42
|
| Rate for Payer: BCBS MAPPO |
$13.19
|
| Rate for Payer: BCBS Trust/PPO |
$12.70
|
| Rate for Payer: BCN Commercial |
$12.70
|
| Rate for Payer: BCN Medicare Advantage |
$13.19
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.19
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$7.07
|
| Rate for Payer: Mclaren Medicare |
$13.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.85
|
| Rate for Payer: Meridian Medicaid |
$7.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$19.78
|
| Rate for Payer: PACE Medicare |
$12.53
|
| Rate for Payer: PACE SWMI |
$13.19
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$13.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.57
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow Network |
$10.86
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: Railroad Medicare Medicare |
$13.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.19
|
| Rate for Payer: UHC Exchange |
$13.19
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: UHCCP Medicaid |
$7.07
|
| Rate for Payer: UMR Bronson Commercial |
$5.24
|
| Rate for Payer: VA VA |
$13.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 7
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86695
|
| Hospital Charge Code |
30200282
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 8
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200284
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$20.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$10.89
|
| Rate for Payer: BCBS MAPPO |
$19.35
|
| Rate for Payer: BCBS Trust/PPO |
$18.64
|
| Rate for Payer: BCN Commercial |
$18.64
|
| Rate for Payer: BCN Medicare Advantage |
$19.35
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.35
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$10.37
|
| Rate for Payer: Mclaren Medicare |
$19.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$10.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: PACE Medicare |
$18.38
|
| Rate for Payer: PACE SWMI |
$19.35
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$19.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$19.35
|
| Rate for Payer: Priority Health Narrow Network |
$15.93
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: Railroad Medicare Medicare |
$19.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.35
|
| Rate for Payer: UHC Exchange |
$19.35
|
| Rate for Payer: UHC Medicare Advantage |
$19.35
|
| Rate for Payer: UHCCP Medicaid |
$10.37
|
| Rate for Payer: UMR Bronson Commercial |
$5.24
|
| Rate for Payer: VA VA |
$19.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 8
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86696
|
| Hospital Charge Code |
30200284
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 9
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
30200304
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENENCEPH CMPT 9
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
30200304
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$19.30 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$12.40
|
| Rate for Payer: BCN Commercial |
$12.40
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.24
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$10.59
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$12.87
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$5.24
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENIGOCOCCAL, QUADRIVALENT (MCV4 OR MENACWY) IM
|
Facility
|
IP
|
$160.22
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
63600085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$70.50 |
| Max. Negotiated Rate |
$144.20 |
| Rate for Payer: Aetna American Axle |
$104.14
|
| Rate for Payer: Aetna Commercial |
$136.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.14
|
| Rate for Payer: Cash Price |
$128.18
|
| Rate for Payer: Cofinity Commercial |
$112.15
|
| Rate for Payer: Cofinity Commercial |
$137.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.18
|
| Rate for Payer: Healthscope Commercial |
$144.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.19
|
| Rate for Payer: PHP Commercial |
$136.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.14
|
| Rate for Payer: Priority Health SBD |
$100.94
|
| Rate for Payer: UMR Bronson Commercial |
$70.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.16
|
|
|
HC MENIGOCOCCAL, QUADRIVALENT (MCV4 OR MENACWY) IM
|
Facility
|
OP
|
$160.22
|
|
|
Service Code
|
CPT 90734
|
| Hospital Charge Code |
63600085
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.28 |
| Max. Negotiated Rate |
$409.40 |
| Rate for Payer: Aetna American Axle |
$104.14
|
| Rate for Payer: Aetna Commercial |
$136.19
|
| Rate for Payer: Aetna Medicare |
$80.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.14
|
| Rate for Payer: BCBS Complete |
$64.09
|
| Rate for Payer: BCBS Trust/PPO |
$409.40
|
| Rate for Payer: BCN Commercial |
$409.40
|
| Rate for Payer: Cash Price |
$128.18
|
| Rate for Payer: Cash Price |
$128.18
|
| Rate for Payer: Cofinity Commercial |
$112.15
|
| Rate for Payer: Cofinity Commercial |
$137.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.18
|
| Rate for Payer: Healthscope Commercial |
$144.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.19
|
| Rate for Payer: PHP Commercial |
$136.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$179.24
|
| Rate for Payer: Priority Health Narrow Network |
$143.39
|
| Rate for Payer: Priority Health SBD |
$100.94
|
| Rate for Payer: UMR Bronson Commercial |
$59.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.16
|
|
|
HC MENINGITIS/ENCEPHALITIS PANEL
|
Facility
|
IP
|
$728.28
|
|
|
Service Code
|
CPT 87483
|
| Hospital Charge Code |
30600287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$320.44 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna American Axle |
$473.38
|
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.38
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$509.80
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$509.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$509.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.38
|
| Rate for Payer: Priority Health SBD |
$458.82
|
| Rate for Payer: UMR Bronson Commercial |
$320.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC MENINGITIS/ENCEPHALITIS PANEL
|
Facility
|
OP
|
$728.28
|
|
|
Service Code
|
CPT 87483
|
| Hospital Charge Code |
30600287
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$223.39 |
| Max. Negotiated Rate |
$655.45 |
| Rate for Payer: Aetna American Axle |
$473.38
|
| Rate for Payer: Aetna Commercial |
$619.04
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$473.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cash Price |
$582.62
|
| Rate for Payer: Cofinity Commercial |
$626.32
|
| Rate for Payer: Cofinity Commercial |
$509.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$509.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$582.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$655.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$509.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$546.21
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$619.04
|
| Rate for Payer: Nomi Health Commercial |
$625.17
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$619.04
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$473.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.79
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$343.03
|
| Rate for Payer: Priority Health SBD |
$458.82
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$223.39
|
| Rate for Payer: UMR Bronson Commercial |
$269.46
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$546.21
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
OP
|
$14.15
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$25.28 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCBS Trust/PPO |
$16.24
|
| Rate for Payer: BCN Commercial |
$16.24
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: Nomi Health Commercial |
$25.28
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.85
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health Narrow Network |
$13.48
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$16.85
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$5.24
|
| Rate for Payer: VA VA |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
OP
|
$9.36
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200218
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$19.30 |
| Rate for Payer: Aetna American Axle |
$6.08
|
| Rate for Payer: Aetna Commercial |
$7.96
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$12.40
|
| Rate for Payer: BCN Commercial |
$12.40
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$7.49
|
| Rate for Payer: Cash Price |
$7.49
|
| Rate for Payer: Cofinity Commercial |
$8.05
|
| Rate for Payer: Cofinity Commercial |
$6.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$8.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.02
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.96
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$7.96
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.24
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$10.59
|
| Rate for Payer: Priority Health SBD |
$5.90
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$12.87
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$3.46
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.02
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
IP
|
$9.36
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200218
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$8.42 |
| Rate for Payer: Aetna American Axle |
$6.08
|
| Rate for Payer: Aetna Commercial |
$7.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6.08
|
| Rate for Payer: Cash Price |
$7.49
|
| Rate for Payer: Cofinity Commercial |
$6.55
|
| Rate for Payer: Cofinity Commercial |
$8.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.49
|
| Rate for Payer: Healthscope Commercial |
$8.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.96
|
| Rate for Payer: PHP Commercial |
$7.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6.08
|
| Rate for Payer: Priority Health SBD |
$5.90
|
| Rate for Payer: UMR Bronson Commercial |
$4.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.02
|
|
|
HC MENINGOENCEPHALITIS PANEL CSF
|
Facility
|
IP
|
$14.15
|
|
|
Service Code
|
CPT 86788
|
| Hospital Charge Code |
30200356
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$12.74 |
| Rate for Payer: Aetna American Axle |
$9.20
|
| Rate for Payer: Aetna Commercial |
$12.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.20
|
| Rate for Payer: Cash Price |
$11.32
|
| Rate for Payer: Cofinity Commercial |
$12.17
|
| Rate for Payer: Cofinity Commercial |
$9.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$9.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.32
|
| Rate for Payer: Healthscope Commercial |
$12.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.03
|
| Rate for Payer: PHP Commercial |
$12.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.20
|
| Rate for Payer: Priority Health SBD |
$8.91
|
| Rate for Payer: UMR Bronson Commercial |
$6.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.61
|
|
|
HC MENINGOENCEPHALITIS PANEL SERUM
|
Facility
|
OP
|
$14.57
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200217
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$19.30 |
| Rate for Payer: Aetna American Axle |
$9.47
|
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$12.40
|
| Rate for Payer: BCN Commercial |
$12.40
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.47
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.24
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$10.59
|
| Rate for Payer: Priority Health SBD |
$9.18
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$12.87
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$5.39
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC MENINGOENCEPHALITIS PANEL SERUM
|
Facility
|
IP
|
$14.57
|
|
|
Service Code
|
CPT 86603
|
| Hospital Charge Code |
30200217
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.41 |
| Max. Negotiated Rate |
$13.11 |
| Rate for Payer: Aetna American Axle |
$9.47
|
| Rate for Payer: Aetna Commercial |
$12.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.47
|
| Rate for Payer: Cash Price |
$11.66
|
| Rate for Payer: Cofinity Commercial |
$10.20
|
| Rate for Payer: Cofinity Commercial |
$12.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.66
|
| Rate for Payer: Healthscope Commercial |
$13.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.38
|
| Rate for Payer: PHP Commercial |
$12.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.47
|
| Rate for Payer: Priority Health SBD |
$9.18
|
| Rate for Payer: UMR Bronson Commercial |
$6.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.93
|
|
|
HC MERCURY
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.97 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: UMR Bronson Commercial |
$21.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.46
|
|
|
HC MERCURY
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 83825
|
| Hospital Charge Code |
30100291
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.72 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$16.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.32
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$16.26
|
| Rate for Payer: BCBS Trust/PPO |
$15.67
|
| Rate for Payer: BCN Commercial |
$15.67
|
| Rate for Payer: BCN Medicare Advantage |
$16.26
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Cofinity Commercial |
$34.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.26
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.46
|
| Rate for Payer: Mclaren Medicaid |
$8.72
|
| Rate for Payer: Mclaren Medicare |
$16.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.07
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$24.39
|
| Rate for Payer: PACE Medicare |
$15.45
|
| Rate for Payer: PACE SWMI |
$16.26
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$16.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.26
|
| Rate for Payer: Priority Health Medicare |
$16.26
|
| Rate for Payer: Priority Health Narrow Network |
$13.01
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Railroad Medicare Medicare |
$16.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.26
|
| Rate for Payer: UHC Exchange |
$16.26
|
| Rate for Payer: UHC Medicare Advantage |
$16.26
|
| Rate for Payer: UHCCP Medicaid |
$8.72
|
| Rate for Payer: UMR Bronson Commercial |
$18.48
|
| Rate for Payer: VA VA |
$16.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.46
|
|
|
HC MESH
|
Facility
|
IP
|
$4,646.30
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27800022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,044.37 |
| Max. Negotiated Rate |
$4,181.67 |
| Rate for Payer: Aetna American Axle |
$3,020.10
|
| Rate for Payer: Aetna Commercial |
$3,949.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,020.10
|
| Rate for Payer: Cash Price |
$3,717.04
|
| Rate for Payer: Cofinity Commercial |
$3,252.41
|
| Rate for Payer: Cofinity Commercial |
$3,995.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,252.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,717.04
|
| Rate for Payer: Healthscope Commercial |
$4,181.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,252.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,484.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,949.36
|
| Rate for Payer: PHP Commercial |
$3,949.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,020.10
|
| Rate for Payer: Priority Health SBD |
$2,927.17
|
| Rate for Payer: UMR Bronson Commercial |
$2,044.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,484.72
|
|
|
HC MESH
|
Facility
|
OP
|
$4,646.30
|
|
|
Service Code
|
HCPCS C1781
|
| Hospital Charge Code |
27800022
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,719.13 |
| Max. Negotiated Rate |
$4,181.67 |
| Rate for Payer: Cofinity Commercial |
$3,995.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,252.41
|
| Rate for Payer: Aetna American Axle |
$3,020.10
|
| Rate for Payer: Aetna Commercial |
$3,949.36
|
| Rate for Payer: Aetna Medicare |
$2,323.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,020.10
|
| Rate for Payer: BCBS Complete |
$1,858.52
|
| Rate for Payer: Cash Price |
$3,717.04
|
| Rate for Payer: Cofinity Commercial |
$3,252.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,717.04
|
| Rate for Payer: Healthscope Commercial |
$4,181.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,252.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,484.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,949.36
|
| Rate for Payer: PHP Commercial |
$3,949.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,020.10
|
| Rate for Payer: Priority Health SBD |
$2,927.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,719.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,484.72
|
|
|
HC METANEB SUPPLY
|
Facility
|
OP
|
$259.27
|
|
| Hospital Charge Code |
27000466
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$95.93 |
| Max. Negotiated Rate |
$233.34 |
| Rate for Payer: Aetna American Axle |
$168.53
|
| Rate for Payer: Aetna Commercial |
$220.38
|
| Rate for Payer: Aetna Medicare |
$129.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$168.53
|
| Rate for Payer: BCBS Complete |
$103.71
|
| Rate for Payer: Cash Price |
$207.42
|
| Rate for Payer: Cofinity Commercial |
$181.49
|
| Rate for Payer: Cofinity Commercial |
$222.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$181.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.42
|
| Rate for Payer: Healthscope Commercial |
$233.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$181.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.38
|
| Rate for Payer: PHP Commercial |
$220.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.53
|
| Rate for Payer: Priority Health SBD |
$163.34
|
| Rate for Payer: UMR Bronson Commercial |
$95.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.45
|
|
