|
HC OCT CATHETER
|
Facility
|
OP
|
$2,631.90
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200243
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$973.80 |
| Max. Negotiated Rate |
$2,368.71 |
| Rate for Payer: Aetna American Axle |
$1,710.73
|
| Rate for Payer: Aetna Commercial |
$2,237.11
|
| Rate for Payer: Aetna Medicare |
$1,315.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,710.73
|
| Rate for Payer: BCBS Complete |
$1,052.76
|
| Rate for Payer: Cash Price |
$2,105.52
|
| Rate for Payer: Cofinity Advantage |
$1,842.33
|
| Rate for Payer: Cofinity Commercial |
$2,263.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.52
|
| Rate for Payer: Healthscope Commercial |
$2,368.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,842.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,973.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,105.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,973.92
|
| Rate for Payer: PHP Commercial |
$2,237.11
|
| Rate for Payer: Priority Health SBD |
$1,658.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,710.73
|
| Rate for Payer: UHC Core |
$1,371.22
|
| Rate for Payer: UHC Exchange |
$1,034.34
|
| Rate for Payer: UMR Bronson Commercial |
$973.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,973.92
|
|
|
HC OCTOPUS SET CARDIOPLEGIA
|
Facility
|
IP
|
$46.82
|
|
| Hospital Charge Code |
27000106
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Advantage |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC OCTOPUS SET CARDIOPLEGIA
|
Facility
|
OP
|
$46.82
|
|
| Hospital Charge Code |
27000106
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.32 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$23.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: BCBS Complete |
$18.73
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Advantage |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.12
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.43
|
| Rate for Payer: UHC Core |
$24.39
|
| Rate for Payer: UHC Exchange |
$18.40
|
| Rate for Payer: UMR Bronson Commercial |
$17.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC OCULAR INSTRMNT SCREEN BILAT
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 99174
|
| Hospital Charge Code |
51000105
|
|
Hospital Revenue Code
|
510
|
| 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 Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| 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: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| 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 OCULAR INSTRMNT SCREEN BILAT
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 99174
|
| Hospital Charge Code |
51000105
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.63 |
| 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 |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: BCBS Complete |
$21.22
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| 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: MI Amish Medical Board Commercial |
$42.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.49
|
| Rate for Payer: UHC Core |
$27.64
|
| Rate for Payer: UHC Exchange |
$20.85
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC OLIGOCLONAL BANDS
|
Facility
|
OP
|
$49.02
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100371
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.32 |
| Max. Negotiated Rate |
$44.12 |
| Rate for Payer: Aetna American Axle |
$31.86
|
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare |
$28.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.24
|
| Rate for Payer: BCBS Complete |
$15.04
|
| Rate for Payer: BCBS MAPPO |
$27.39
|
| Rate for Payer: BCBS Trust/PPO |
$31.66
|
| Rate for Payer: BCN Commercial |
$31.66
|
| Rate for Payer: BCN Medicare Advantage |
$27.39
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cofinity Advantage |
$34.31
|
| Rate for Payer: Cofinity Commercial |
$42.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$44.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.77
|
| Rate for Payer: Mclaren Medicaid |
$27.39
|
| Rate for Payer: Mclaren Medicare |
$27.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.76
|
| Rate for Payer: Meridian Medicaid |
$28.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.67
|
| Rate for Payer: Nomi Health Commercial |
$41.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.77
|
| Rate for Payer: PACE Medicare |
$26.02
|
| Rate for Payer: PACE SWMI |
$27.39
|
| Rate for Payer: PHP Commercial |
$41.67
|
| Rate for Payer: PHP Medicare Advantage |
$27.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.39
|
| Rate for Payer: Priority Health Medicare |
$27.39
|
| Rate for Payer: Priority Health SBD |
$30.88
|
| Rate for Payer: Priority Health Tiered Network |
$21.91
|
| Rate for Payer: Railroad Medicare Medicare |
$27.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.09
|
| Rate for Payer: UHC Core |
$41.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.39
|
| Rate for Payer: UHC Exchange |
$41.09
|
| Rate for Payer: UHC Medicaid |
$14.32
|
| Rate for Payer: UHCCP Medicaid |
$14.32
|
| Rate for Payer: UMR Bronson Commercial |
$18.14
|
| Rate for Payer: VA VA |
$27.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.77
|
|
|
HC OLIGOCLONAL BANDS
|
Facility
|
IP
|
$49.02
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100371
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.57 |
| Max. Negotiated Rate |
$44.12 |
| Rate for Payer: Aetna American Axle |
$31.86
|
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.86
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cofinity Advantage |
$34.31
|
| Rate for Payer: Cofinity Commercial |
$42.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.22
|
| Rate for Payer: Healthscope Commercial |
$44.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.77
|
| Rate for Payer: PHP Commercial |
$41.67
|
| Rate for Payer: Priority Health SBD |
$30.88
|
| Rate for Payer: UMR Bronson Commercial |
$21.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.77
|
|
|
HC OLIGOCLONAL BANDS CMPT
|
Facility
|
IP
|
$49.02
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100551
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.57 |
| Max. Negotiated Rate |
$44.12 |
| Rate for Payer: Aetna American Axle |
$31.86
|
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.86
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cofinity Advantage |
$34.31
|
| Rate for Payer: Cofinity Commercial |
$42.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.22
|
| Rate for Payer: Healthscope Commercial |
$44.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.77
|
| Rate for Payer: PHP Commercial |
$41.67
|
| Rate for Payer: Priority Health SBD |
$30.88
|
| Rate for Payer: UMR Bronson Commercial |
$21.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.77
|
|
|
HC OLIGOCLONAL BANDS CMPT
|
Facility
|
OP
|
$49.02
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100551
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.32 |
| Max. Negotiated Rate |
$44.12 |
| Rate for Payer: Aetna American Axle |
$31.86
|
| Rate for Payer: Aetna Commercial |
$41.67
|
| Rate for Payer: Aetna Medicare |
$28.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.24
|
| Rate for Payer: BCBS Complete |
$15.04
|
| Rate for Payer: BCBS MAPPO |
$27.39
|
| Rate for Payer: BCBS Trust/PPO |
$31.66
|
| Rate for Payer: BCN Commercial |
$31.66
|
| Rate for Payer: BCN Medicare Advantage |
$27.39
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cash Price |
$39.22
|
| Rate for Payer: Cofinity Advantage |
$34.31
|
| Rate for Payer: Cofinity Commercial |
$42.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$44.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.77
|
| Rate for Payer: Mclaren Medicaid |
$27.39
|
| Rate for Payer: Mclaren Medicare |
$27.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.76
|
| Rate for Payer: Meridian Medicaid |
$28.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.67
|
| Rate for Payer: Nomi Health Commercial |
$41.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.77
|
| Rate for Payer: PACE Medicare |
$26.02
|
| Rate for Payer: PACE SWMI |
$27.39
|
| Rate for Payer: PHP Commercial |
$41.67
|
| Rate for Payer: PHP Medicare Advantage |
$27.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.39
|
| Rate for Payer: Priority Health Medicare |
$27.39
|
| Rate for Payer: Priority Health SBD |
$30.88
|
| Rate for Payer: Priority Health Tiered Network |
$21.91
|
| Rate for Payer: Railroad Medicare Medicare |
$27.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.09
|
| Rate for Payer: UHC Core |
$41.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.39
|
| Rate for Payer: UHC Exchange |
$41.09
|
| Rate for Payer: UHC Medicaid |
$14.32
|
| Rate for Payer: UHCCP Medicaid |
$14.32
|
| Rate for Payer: UMR Bronson Commercial |
$18.14
|
| Rate for Payer: VA VA |
$27.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.77
|
|
|
HC OMMAYA
|
Facility
|
OP
|
$392.42
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
33500005
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$145.20 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna American Axle |
$255.07
|
| Rate for Payer: Aetna Commercial |
$333.56
|
| Rate for Payer: Aetna Medicare |
$342.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$411.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$411.40
|
| Rate for Payer: BCBS Complete |
$180.75
|
| Rate for Payer: BCBS MAPPO |
$329.12
|
| Rate for Payer: BCBS Trust/PPO |
$644.13
|
| Rate for Payer: BCN Commercial |
$644.13
|
| Rate for Payer: BCN Medicare Advantage |
$329.12
|
| Rate for Payer: Cash Price |
$313.94
|
| Rate for Payer: Cash Price |
$313.94
|
| Rate for Payer: Cofinity Advantage |
$274.69
|
| Rate for Payer: Cofinity Commercial |
$337.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.12
|
| Rate for Payer: Healthscope Commercial |
$353.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.31
|
| Rate for Payer: Mclaren Medicaid |
$329.12
|
| Rate for Payer: Mclaren Medicare |
$329.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.58
|
| Rate for Payer: Meridian Medicaid |
$345.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$362.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.56
|
| Rate for Payer: Nomi Health Commercial |
$987.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.31
|
| Rate for Payer: PACE Medicare |
$312.66
|
| Rate for Payer: PACE SWMI |
$329.12
|
| Rate for Payer: PHP Commercial |
$333.56
|
| Rate for Payer: PHP Medicare Advantage |
$329.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,064.33
|
| Rate for Payer: Priority Health Medicare |
$329.12
|
| Rate for Payer: Priority Health SBD |
$247.22
|
| Rate for Payer: Priority Health Tiered Network |
$851.46
|
| Rate for Payer: Railroad Medicare Medicare |
$329.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$255.07
|
| Rate for Payer: UHC Core |
$204.45
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$329.12
|
| Rate for Payer: UHC Exchange |
$154.22
|
| Rate for Payer: UHC Medicaid |
$172.13
|
| Rate for Payer: UHCCP Medicaid |
$172.13
|
| Rate for Payer: UMR Bronson Commercial |
$145.20
|
| Rate for Payer: VA VA |
$329.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.31
|
|
|
HC OMMAYA
|
Facility
|
IP
|
$392.42
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
33500005
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$172.66 |
| Max. Negotiated Rate |
$353.18 |
| Rate for Payer: Aetna American Axle |
$255.07
|
| Rate for Payer: Aetna Commercial |
$333.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$255.07
|
| Rate for Payer: Cash Price |
$313.94
|
| Rate for Payer: Cofinity Advantage |
$274.69
|
| Rate for Payer: Cofinity Commercial |
$337.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$313.94
|
| Rate for Payer: Healthscope Commercial |
$353.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$274.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$294.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$333.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$294.31
|
| Rate for Payer: PHP Commercial |
$333.56
|
| Rate for Payer: Priority Health SBD |
$247.22
|
| Rate for Payer: UMR Bronson Commercial |
$172.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$294.31
|
|
|
HC OMNIPAQUE 300 PER ML
|
Facility
|
OP
|
$1.85
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600017
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna American Axle |
$1.20
|
| Rate for Payer: Aetna Commercial |
$1.57
|
| Rate for Payer: Aetna Medicare |
$0.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.20
|
| Rate for Payer: BCBS Complete |
$0.74
|
| Rate for Payer: BCBS Trust/PPO |
$0.48
|
| Rate for Payer: BCN Commercial |
$0.48
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: Cofinity Advantage |
$1.29
|
| Rate for Payer: Cofinity Commercial |
$1.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.48
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.39
|
| Rate for Payer: PHP Commercial |
$1.57
|
| Rate for Payer: Priority Health SBD |
$1.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.25
|
| Rate for Payer: UHC Core |
$0.25
|
| Rate for Payer: UHC Exchange |
$0.25
|
| Rate for Payer: UMR Bronson Commercial |
$0.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.39
|
|
|
HC OMNIPAQUE 300 PER ML
|
Facility
|
IP
|
$1.85
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600017
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$1.67 |
| Rate for Payer: Aetna American Axle |
$1.20
|
| Rate for Payer: Aetna Commercial |
$1.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.20
|
| Rate for Payer: Cash Price |
$1.48
|
| Rate for Payer: Cofinity Advantage |
$1.29
|
| Rate for Payer: Cofinity Commercial |
$1.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.48
|
| Rate for Payer: Healthscope Commercial |
$1.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.39
|
| Rate for Payer: PHP Commercial |
$1.57
|
| Rate for Payer: Priority Health SBD |
$1.17
|
| Rate for Payer: UMR Bronson Commercial |
$0.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.39
|
|
|
HC OPEN HEART OFF BYPASS
|
Facility
|
IP
|
$5,919.88
|
|
| Hospital Charge Code |
27000702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,604.75 |
| Max. Negotiated Rate |
$5,327.89 |
| Rate for Payer: Aetna American Axle |
$3,847.92
|
| Rate for Payer: Aetna Commercial |
$5,031.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,847.92
|
| Rate for Payer: Cash Price |
$4,735.90
|
| Rate for Payer: Cofinity Advantage |
$4,143.92
|
| Rate for Payer: Cofinity Commercial |
$5,091.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,735.90
|
| Rate for Payer: Healthscope Commercial |
$5,327.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,143.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,439.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,031.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,439.91
|
| Rate for Payer: PHP Commercial |
$5,031.90
|
| Rate for Payer: Priority Health SBD |
$3,729.52
|
| Rate for Payer: UMR Bronson Commercial |
$2,604.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,439.91
|
|
|
HC OPEN HEART OFF BYPASS
|
Facility
|
OP
|
$5,919.88
|
|
| Hospital Charge Code |
27000702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,190.36 |
| Max. Negotiated Rate |
$5,327.89 |
| Rate for Payer: Aetna American Axle |
$3,847.92
|
| Rate for Payer: Aetna Commercial |
$5,031.90
|
| Rate for Payer: Aetna Medicare |
$2,959.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,847.92
|
| Rate for Payer: BCBS Complete |
$2,367.95
|
| Rate for Payer: Cash Price |
$4,735.90
|
| Rate for Payer: Cofinity Advantage |
$4,143.92
|
| Rate for Payer: Cofinity Commercial |
$5,091.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,735.90
|
| Rate for Payer: Healthscope Commercial |
$5,327.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,143.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,439.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,735.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,031.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,439.91
|
| Rate for Payer: PHP Commercial |
$5,031.90
|
| Rate for Payer: Priority Health SBD |
$3,729.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,847.92
|
| Rate for Payer: UHC Core |
$3,084.26
|
| Rate for Payer: UHC Exchange |
$2,326.51
|
| Rate for Payer: UMR Bronson Commercial |
$2,190.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,439.91
|
|
|
HC OPEN HEART PLATELET MAPPING
|
Facility
|
OP
|
$962.88
|
|
| Hospital Charge Code |
27000388
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$356.27 |
| Max. Negotiated Rate |
$866.59 |
| Rate for Payer: Aetna American Axle |
$625.87
|
| Rate for Payer: Aetna Commercial |
$818.45
|
| Rate for Payer: Aetna Medicare |
$481.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.87
|
| Rate for Payer: BCBS Complete |
$385.15
|
| Rate for Payer: Cash Price |
$770.30
|
| Rate for Payer: Cofinity Advantage |
$674.02
|
| Rate for Payer: Cofinity Commercial |
$828.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$770.30
|
| Rate for Payer: Healthscope Commercial |
$866.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$674.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$722.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$770.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$818.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.16
|
| Rate for Payer: PHP Commercial |
$818.45
|
| Rate for Payer: Priority Health SBD |
$606.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$625.87
|
| Rate for Payer: UHC Core |
$501.66
|
| Rate for Payer: UHC Exchange |
$378.41
|
| Rate for Payer: UMR Bronson Commercial |
$356.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$722.16
|
|
|
HC OPEN HEART PLATELET MAPPING
|
Facility
|
IP
|
$962.88
|
|
| Hospital Charge Code |
27000388
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$423.67 |
| Max. Negotiated Rate |
$866.59 |
| Rate for Payer: Aetna American Axle |
$625.87
|
| Rate for Payer: Aetna Commercial |
$818.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$625.87
|
| Rate for Payer: Cash Price |
$770.30
|
| Rate for Payer: Cofinity Advantage |
$674.02
|
| Rate for Payer: Cofinity Commercial |
$828.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$770.30
|
| Rate for Payer: Healthscope Commercial |
$866.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$674.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$722.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$818.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$722.16
|
| Rate for Payer: PHP Commercial |
$818.45
|
| Rate for Payer: Priority Health SBD |
$606.61
|
| Rate for Payer: UMR Bronson Commercial |
$423.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$722.16
|
|
|
HC OPEN HEART TEG
|
Facility
|
IP
|
$563.42
|
|
| Hospital Charge Code |
27000199
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$247.90 |
| Max. Negotiated Rate |
$507.08 |
| Rate for Payer: Aetna American Axle |
$366.22
|
| Rate for Payer: Aetna Commercial |
$478.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.22
|
| Rate for Payer: Cash Price |
$450.74
|
| Rate for Payer: Cofinity Advantage |
$394.39
|
| Rate for Payer: Cofinity Commercial |
$484.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.74
|
| Rate for Payer: Healthscope Commercial |
$507.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.56
|
| Rate for Payer: PHP Commercial |
$478.91
|
| Rate for Payer: Priority Health SBD |
$354.95
|
| Rate for Payer: UMR Bronson Commercial |
$247.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.56
|
|
|
HC OPEN HEART TEG
|
Facility
|
OP
|
$563.42
|
|
| Hospital Charge Code |
27000199
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$208.47 |
| Max. Negotiated Rate |
$507.08 |
| Rate for Payer: Aetna American Axle |
$366.22
|
| Rate for Payer: Aetna Commercial |
$478.91
|
| Rate for Payer: Aetna Medicare |
$281.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$366.22
|
| Rate for Payer: BCBS Complete |
$225.37
|
| Rate for Payer: Cash Price |
$450.74
|
| Rate for Payer: Cofinity Advantage |
$394.39
|
| Rate for Payer: Cofinity Commercial |
$484.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$450.74
|
| Rate for Payer: Healthscope Commercial |
$507.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$394.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$422.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$478.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$422.56
|
| Rate for Payer: PHP Commercial |
$478.91
|
| Rate for Payer: Priority Health SBD |
$354.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.22
|
| Rate for Payer: UHC Core |
$293.54
|
| Rate for Payer: UHC Exchange |
$221.42
|
| Rate for Payer: UMR Bronson Commercial |
$208.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$422.56
|
|
|
HC OP FALSE LABOR 1ST HOUR
|
Facility
|
OP
|
$356.21
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900001
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$131.80 |
| Max. Negotiated Rate |
$320.59 |
| Rate for Payer: Aetna American Axle |
$231.54
|
| Rate for Payer: Aetna Commercial |
$302.78
|
| Rate for Payer: Aetna Medicare |
$178.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.54
|
| Rate for Payer: BCBS Complete |
$142.48
|
| Rate for Payer: Cash Price |
$284.97
|
| Rate for Payer: Cofinity Advantage |
$249.35
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.97
|
| Rate for Payer: Healthscope Commercial |
$320.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$249.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.16
|
| Rate for Payer: PHP Commercial |
$302.78
|
| Rate for Payer: Priority Health SBD |
$224.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.54
|
| Rate for Payer: UHC Core |
$185.59
|
| Rate for Payer: UHC Exchange |
$139.99
|
| Rate for Payer: UMR Bronson Commercial |
$131.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.16
|
|
|
HC OP FALSE LABOR 1ST HOUR
|
Facility
|
IP
|
$356.21
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900001
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$156.73 |
| Max. Negotiated Rate |
$320.59 |
| Rate for Payer: Aetna American Axle |
$231.54
|
| Rate for Payer: Aetna Commercial |
$302.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.54
|
| Rate for Payer: Cash Price |
$284.97
|
| Rate for Payer: Cofinity Advantage |
$249.35
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.97
|
| Rate for Payer: Healthscope Commercial |
$320.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$249.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$267.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$267.16
|
| Rate for Payer: PHP Commercial |
$302.78
|
| Rate for Payer: Priority Health SBD |
$224.41
|
| Rate for Payer: UMR Bronson Commercial |
$156.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$267.16
|
|
|
HC OP FALSE LABOR SUB HOURS
|
Facility
|
IP
|
$197.13
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900002
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$86.74 |
| Max. Negotiated Rate |
$177.42 |
| Rate for Payer: Aetna American Axle |
$128.13
|
| Rate for Payer: Aetna Commercial |
$167.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.13
|
| Rate for Payer: Cash Price |
$157.70
|
| Rate for Payer: Cofinity Advantage |
$137.99
|
| Rate for Payer: Cofinity Commercial |
$169.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.70
|
| Rate for Payer: Healthscope Commercial |
$177.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.85
|
| Rate for Payer: PHP Commercial |
$167.56
|
| Rate for Payer: Priority Health SBD |
$124.19
|
| Rate for Payer: UMR Bronson Commercial |
$86.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.85
|
|
|
HC OP FALSE LABOR SUB HOURS
|
Facility
|
OP
|
$197.13
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900002
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$72.94 |
| Max. Negotiated Rate |
$177.42 |
| Rate for Payer: Aetna American Axle |
$128.13
|
| Rate for Payer: Aetna Commercial |
$167.56
|
| Rate for Payer: Aetna Medicare |
$98.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.13
|
| Rate for Payer: BCBS Complete |
$78.85
|
| Rate for Payer: Cash Price |
$157.70
|
| Rate for Payer: Cofinity Advantage |
$137.99
|
| Rate for Payer: Cofinity Commercial |
$169.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.70
|
| Rate for Payer: Healthscope Commercial |
$177.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$147.85
|
| Rate for Payer: PHP Commercial |
$167.56
|
| Rate for Payer: Priority Health SBD |
$124.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.13
|
| Rate for Payer: UHC Core |
$102.70
|
| Rate for Payer: UHC Exchange |
$77.47
|
| Rate for Payer: UMR Bronson Commercial |
$72.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.85
|
|
|
HC OP HEMODIALYSIS
|
Facility
|
OP
|
$988.38
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100001
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$357.65 |
| Max. Negotiated Rate |
$2,211.50 |
| Rate for Payer: Aetna American Axle |
$642.45
|
| Rate for Payer: Aetna Commercial |
$840.12
|
| Rate for Payer: Aetna Medicare |
$711.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$854.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$854.81
|
| Rate for Payer: BCBS Complete |
$375.57
|
| Rate for Payer: BCBS MAPPO |
$683.85
|
| Rate for Payer: BCN Medicare Advantage |
$683.85
|
| Rate for Payer: Cash Price |
$790.70
|
| Rate for Payer: Cash Price |
$790.70
|
| Rate for Payer: Cofinity Advantage |
$691.87
|
| Rate for Payer: Cofinity Commercial |
$850.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$790.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$683.85
|
| Rate for Payer: Healthscope Commercial |
$889.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$691.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.28
|
| Rate for Payer: Mclaren Medicaid |
$683.85
|
| Rate for Payer: Mclaren Medicare |
$683.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$718.04
|
| Rate for Payer: Meridian Medicaid |
$718.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$786.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$752.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.12
|
| Rate for Payer: Nomi Health Commercial |
$2,051.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.28
|
| Rate for Payer: PACE Medicare |
$649.66
|
| Rate for Payer: PACE SWMI |
$683.85
|
| Rate for Payer: PHP Commercial |
$840.12
|
| Rate for Payer: PHP Medicare Advantage |
$683.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$357.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,211.50
|
| Rate for Payer: Priority Health Medicare |
$683.85
|
| Rate for Payer: Priority Health SBD |
$622.68
|
| Rate for Payer: Priority Health Tiered Network |
$1,769.20
|
| Rate for Payer: Railroad Medicare Medicare |
$683.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$642.45
|
| Rate for Payer: UHC Core |
$514.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$683.85
|
| Rate for Payer: UHC Exchange |
$388.43
|
| Rate for Payer: UHC Medicaid |
$357.65
|
| Rate for Payer: UHCCP Medicaid |
$357.65
|
| Rate for Payer: UMR Bronson Commercial |
$365.70
|
| Rate for Payer: VA VA |
$683.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.28
|
|
|
HC OP HEMODIALYSIS
|
Facility
|
IP
|
$988.38
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100001
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$434.89 |
| Max. Negotiated Rate |
$889.54 |
| Rate for Payer: Aetna American Axle |
$642.45
|
| Rate for Payer: Aetna Commercial |
$840.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$642.45
|
| Rate for Payer: Cash Price |
$790.70
|
| Rate for Payer: Cofinity Advantage |
$691.87
|
| Rate for Payer: Cofinity Commercial |
$850.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$790.70
|
| Rate for Payer: Healthscope Commercial |
$889.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$691.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.28
|
| Rate for Payer: PHP Commercial |
$840.12
|
| Rate for Payer: Priority Health SBD |
$622.68
|
| Rate for Payer: UMR Bronson Commercial |
$434.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.28
|
|
