|
HC YELLOW HORNET IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200113
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$3.00
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$4.70
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$2.86
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Medicaid |
$3.00
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$7.16
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$5.73
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Core |
$8.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.38
|
| Rate for Payer: UMR Bronson Commercial |
$9.21
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC YELLOW JACKET IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200114
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.95 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna American Axle |
$16.18
|
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.18
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$17.42
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health SBD |
$15.68
|
| Rate for Payer: UMR Bronson Commercial |
$10.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
OP
|
$41.25
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.26 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Aetna American Axle |
$26.81
|
| Rate for Payer: Aetna Commercial |
$35.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.81
|
| Rate for Payer: BCBS Complete |
$16.50
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cofinity Commercial |
$28.88
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.00
|
| Rate for Payer: Healthscope Commercial |
$37.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.06
|
| Rate for Payer: PHP Commercial |
$35.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.88
|
| Rate for Payer: Priority Health SBD |
$25.99
|
| Rate for Payer: UMR Bronson Commercial |
$15.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.94
|
|
|
HC Y SET ANTE/RETRO
|
Facility
|
IP
|
$41.25
|
|
| Hospital Charge Code |
27000661
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.15 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Aetna American Axle |
$26.81
|
| Rate for Payer: Aetna Commercial |
$35.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.81
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cofinity Commercial |
$28.88
|
| Rate for Payer: Cofinity Commercial |
$35.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.00
|
| Rate for Payer: Healthscope Commercial |
$37.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.06
|
| Rate for Payer: PHP Commercial |
$35.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.88
|
| Rate for Payer: Priority Health SBD |
$25.99
|
| Rate for Payer: UMR Bronson Commercial |
$18.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.94
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
IP
|
$49,783.83
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$21,904.89 |
| Max. Negotiated Rate |
$44,805.45 |
| Rate for Payer: Aetna American Axle |
$32,359.49
|
| Rate for Payer: Aetna Commercial |
$42,316.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32,359.49
|
| Rate for Payer: Cash Price |
$39,827.06
|
| Rate for Payer: Cofinity Commercial |
$34,848.68
|
| Rate for Payer: Cofinity Commercial |
$42,814.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39,827.06
|
| Rate for Payer: Healthscope Commercial |
$44,805.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34,848.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,337.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42,316.26
|
| Rate for Payer: PHP Commercial |
$42,316.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34,848.68
|
| Rate for Payer: Priority Health SBD |
$31,363.81
|
| Rate for Payer: UMR Bronson Commercial |
$21,904.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,337.87
|
|
|
HC YTTRIUM 90 MICROSPHERES
|
Facility
|
OP
|
$49,783.83
|
|
|
Service Code
|
HCPCS C2616
|
| Hospital Charge Code |
27800106
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,765.55 |
| Max. Negotiated Rate |
$50,446.73 |
| Rate for Payer: Aetna American Axle |
$32,359.49
|
| Rate for Payer: Aetna Commercial |
$42,316.26
|
| Rate for Payer: Aetna Medicare |
$16,665.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32,359.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20,030.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20,030.98
|
| Rate for Payer: BCBS Complete |
$9,204.63
|
| Rate for Payer: BCBS MAPPO |
$16,024.78
|
| Rate for Payer: BCN Medicare Advantage |
$16,024.78
|
| Rate for Payer: Cash Price |
$39,827.06
|
| Rate for Payer: Cash Price |
$39,827.06
|
| Rate for Payer: Cofinity Commercial |
$34,848.68
|
| Rate for Payer: Cofinity Commercial |
$42,814.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39,827.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16,024.78
|
| Rate for Payer: Healthscope Commercial |
$44,805.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34,848.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37,337.87
|
| Rate for Payer: Mclaren Medicaid |
$8,765.55
|
| Rate for Payer: Mclaren Medicare |
$16,024.78
|
| Rate for Payer: Meridian Medicaid |
$9,204.63
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$16,826.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18,428.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42,316.26
|
| Rate for Payer: PACE Medicare |
$15,223.54
|
| Rate for Payer: PACE SWMI |
$16,024.78
|
| Rate for Payer: PHP Commercial |
$42,316.26
|
| Rate for Payer: PHP Medicare Advantage |
$16,024.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,765.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34,848.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$50,446.73
|
| Rate for Payer: Priority Health Medicare |
$16,024.78
|
| Rate for Payer: Priority Health Narrow Network |
$40,357.38
|
| Rate for Payer: Priority Health SBD |
$31,363.81
|
| Rate for Payer: Railroad Medicare Medicare |
$16,024.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44,928.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$16,024.78
|
| Rate for Payer: UHC Exchange |
$30,624.96
|
| Rate for Payer: UHC Medicare Advantage |
$16,505.52
|
| Rate for Payer: UMR Bronson Commercial |
$18,420.02
|
| Rate for Payer: VA VA |
$16,024.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37,337.87
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
IP
|
$41.00
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.04 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Aetna American Axle |
$26.65
|
| Rate for Payer: Aetna Commercial |
$34.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.65
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$35.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.80
|
| Rate for Payer: Healthscope Commercial |
$36.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.85
|
| Rate for Payer: PHP Commercial |
$34.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.70
|
| Rate for Payer: Priority Health SBD |
$25.83
|
| Rate for Payer: UMR Bronson Commercial |
$18.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.75
|
|
|
HC Y VENOUS BICAVAL
|
Facility
|
OP
|
$41.00
|
|
| Hospital Charge Code |
27000279
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.17 |
| Max. Negotiated Rate |
$36.90 |
| Rate for Payer: Aetna American Axle |
$26.65
|
| Rate for Payer: Aetna Commercial |
$34.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.65
|
| Rate for Payer: BCBS Complete |
$16.40
|
| Rate for Payer: Cash Price |
$32.80
|
| Rate for Payer: Cofinity Commercial |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$35.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.80
|
| Rate for Payer: Healthscope Commercial |
$36.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.85
|
| Rate for Payer: PHP Commercial |
$34.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.70
|
| Rate for Payer: Priority Health SBD |
$25.83
|
| Rate for Payer: UMR Bronson Commercial |
$15.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.75
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
OP
|
$200.84
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$74.31 |
| Max. Negotiated Rate |
$180.76 |
| Rate for Payer: Aetna American Axle |
$130.55
|
| Rate for Payer: Aetna Commercial |
$170.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.55
|
| Rate for Payer: BCBS Complete |
$80.34
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Cofinity Commercial |
$140.59
|
| Rate for Payer: Cofinity Commercial |
$172.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.67
|
| Rate for Payer: Healthscope Commercial |
$180.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.71
|
| Rate for Payer: PHP Commercial |
$170.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.59
|
| Rate for Payer: Priority Health SBD |
$126.53
|
| Rate for Payer: UMR Bronson Commercial |
$74.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.63
|
|
|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$200.84
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.37 |
| Max. Negotiated Rate |
$180.76 |
| Rate for Payer: Aetna American Axle |
$130.55
|
| Rate for Payer: Aetna Commercial |
$170.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.55
|
| Rate for Payer: Cash Price |
$160.67
|
| Rate for Payer: Cofinity Commercial |
$140.59
|
| Rate for Payer: Cofinity Commercial |
$172.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.67
|
| Rate for Payer: Healthscope Commercial |
$180.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$170.71
|
| Rate for Payer: PHP Commercial |
$170.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$140.59
|
| Rate for Payer: Priority Health SBD |
$126.53
|
| Rate for Payer: UMR Bronson Commercial |
$88.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.63
|
|
|
HC Z ACCULINK CAROTID STENT
|
Facility
|
IP
|
$6,779.33
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,982.91 |
| Max. Negotiated Rate |
$6,101.40 |
| Rate for Payer: Aetna American Axle |
$4,406.56
|
| Rate for Payer: Aetna Commercial |
$5,762.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,406.56
|
| Rate for Payer: Cash Price |
$5,423.46
|
| Rate for Payer: Cofinity Commercial |
$4,745.53
|
| Rate for Payer: Cofinity Commercial |
$5,830.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,423.46
|
| Rate for Payer: Healthscope Commercial |
$6,101.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,745.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,084.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,762.43
|
| Rate for Payer: PHP Commercial |
$5,762.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,745.53
|
| Rate for Payer: Priority Health SBD |
$4,270.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,982.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,084.50
|
|
|
HC Z ACCULINK CAROTID STENT
|
Facility
|
OP
|
$6,779.33
|
|
|
Service Code
|
HCPCS C1876
|
| Hospital Charge Code |
27800036
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,508.35 |
| Max. Negotiated Rate |
$6,101.40 |
| Rate for Payer: Aetna American Axle |
$4,406.56
|
| Rate for Payer: Aetna Commercial |
$5,762.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,406.56
|
| Rate for Payer: BCBS Complete |
$2,711.73
|
| Rate for Payer: Cash Price |
$5,423.46
|
| Rate for Payer: Cofinity Commercial |
$4,745.53
|
| Rate for Payer: Cofinity Commercial |
$5,830.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,423.46
|
| Rate for Payer: Healthscope Commercial |
$6,101.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,745.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,084.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,762.43
|
| Rate for Payer: PHP Commercial |
$5,762.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,745.53
|
| Rate for Payer: Priority Health SBD |
$4,270.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,508.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,084.50
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,241.28
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,746.16 |
| Max. Negotiated Rate |
$5,617.15 |
| Rate for Payer: Aetna American Axle |
$4,056.83
|
| Rate for Payer: Aetna Commercial |
$5,305.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,056.83
|
| Rate for Payer: Cash Price |
$4,993.02
|
| Rate for Payer: Cofinity Commercial |
$4,368.90
|
| Rate for Payer: Cofinity Commercial |
$5,367.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,993.02
|
| Rate for Payer: Healthscope Commercial |
$5,617.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,368.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,680.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,305.09
|
| Rate for Payer: PHP Commercial |
$5,305.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,368.90
|
| Rate for Payer: Priority Health SBD |
$3,932.01
|
| Rate for Payer: UMR Bronson Commercial |
$2,746.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,680.96
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,241.28
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,309.27 |
| Max. Negotiated Rate |
$5,617.15 |
| Rate for Payer: Aetna American Axle |
$4,056.83
|
| Rate for Payer: Aetna Commercial |
$5,305.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,056.83
|
| Rate for Payer: BCBS Complete |
$2,496.51
|
| Rate for Payer: Cash Price |
$4,993.02
|
| Rate for Payer: Cofinity Commercial |
$4,368.90
|
| Rate for Payer: Cofinity Commercial |
$5,367.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,993.02
|
| Rate for Payer: Healthscope Commercial |
$5,617.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,368.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,680.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$5,305.09
|
| Rate for Payer: PHP Commercial |
$5,305.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,368.90
|
| Rate for Payer: Priority Health SBD |
$3,932.01
|
| Rate for Payer: UMR Bronson Commercial |
$2,309.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,680.96
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
OP
|
$429.05
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$35.04 |
| Max. Negotiated Rate |
$828.79 |
| Rate for Payer: Aetna American Axle |
$278.88
|
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna Medicare |
$273.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$329.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$329.09
|
| Rate for Payer: BCBS Complete |
$151.22
|
| Rate for Payer: BCBS MAPPO |
$263.27
|
| Rate for Payer: BCBS Trust/PPO |
$290.76
|
| Rate for Payer: BCN Medicare Advantage |
$263.27
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$263.27
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Mclaren Medicaid |
$144.01
|
| Rate for Payer: Mclaren Medicare |
$263.27
|
| Rate for Payer: Meridian Medicaid |
$151.22
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$276.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PACE Medicare |
$250.11
|
| Rate for Payer: PACE SWMI |
$263.27
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: PHP Medicare Advantage |
$263.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$144.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$828.79
|
| Rate for Payer: Priority Health Medicare |
$263.27
|
| Rate for Payer: Priority Health Narrow Network |
$663.03
|
| Rate for Payer: Priority Health SBD |
$270.30
|
| Rate for Payer: Railroad Medicare Medicare |
$263.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$263.27
|
| Rate for Payer: UHC Exchange |
$35.04
|
| Rate for Payer: UHC Medicare Advantage |
$271.17
|
| Rate for Payer: UMR Bronson Commercial |
$158.75
|
| Rate for Payer: VA VA |
$263.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$429.05
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$188.78 |
| Max. Negotiated Rate |
$386.14 |
| Rate for Payer: Aetna American Axle |
$278.88
|
| Rate for Payer: Aetna Commercial |
$364.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$278.88
|
| Rate for Payer: Cash Price |
$343.24
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Cofinity Commercial |
$368.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.24
|
| Rate for Payer: Healthscope Commercial |
$386.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$321.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$364.69
|
| Rate for Payer: PHP Commercial |
$364.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$300.34
|
| Rate for Payer: Priority Health SBD |
$270.30
|
| Rate for Payer: UMR Bronson Commercial |
$188.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$321.79
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
OP
|
$679.12
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$227.98 |
| Max. Negotiated Rate |
$680.62 |
| Rate for Payer: Aetna American Axle |
$441.43
|
| Rate for Payer: Aetna Commercial |
$577.25
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.43
|
| 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 |
$239.40
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$374.83
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cofinity Commercial |
$475.38
|
| Rate for Payer: Cofinity Commercial |
$584.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$611.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$475.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$509.34
|
| Rate for Payer: Mclaren Medicaid |
$227.98
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Medicaid |
$239.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$577.25
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$577.25
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$571.72
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$457.38
|
| Rate for Payer: Priority Health SBD |
$427.85
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.14
|
| Rate for Payer: UHC Core |
$680.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$429.28
|
| Rate for Payer: UMR Bronson Commercial |
$251.27
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$509.34
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
IP
|
$679.12
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$298.81 |
| Max. Negotiated Rate |
$611.21 |
| Rate for Payer: Aetna American Axle |
$441.43
|
| Rate for Payer: Aetna Commercial |
$577.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$441.43
|
| Rate for Payer: Cash Price |
$543.30
|
| Rate for Payer: Cofinity Commercial |
$475.38
|
| Rate for Payer: Cofinity Commercial |
$584.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$543.30
|
| Rate for Payer: Healthscope Commercial |
$611.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$475.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$509.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$577.25
|
| Rate for Payer: PHP Commercial |
$577.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$475.38
|
| Rate for Payer: Priority Health SBD |
$427.85
|
| Rate for Payer: UMR Bronson Commercial |
$298.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$509.34
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
OP
|
$610.48
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$225.88 |
| Max. Negotiated Rate |
$687.49 |
| Rate for Payer: Aetna American Axle |
$396.81
|
| Rate for Payer: Aetna Commercial |
$518.91
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.81
|
| 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 |
$239.40
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$374.83
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cofinity Commercial |
$427.34
|
| Rate for Payer: Cofinity Commercial |
$525.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$549.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$427.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.86
|
| Rate for Payer: Mclaren Medicaid |
$227.98
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Medicaid |
$239.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.91
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$518.91
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$227.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$571.72
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$457.38
|
| Rate for Payer: Priority Health SBD |
$384.60
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.14
|
| Rate for Payer: UHC Core |
$687.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$429.28
|
| Rate for Payer: UMR Bronson Commercial |
$225.88
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.86
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
IP
|
$610.48
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$268.61 |
| Max. Negotiated Rate |
$549.43 |
| Rate for Payer: Aetna American Axle |
$396.81
|
| Rate for Payer: Aetna Commercial |
$518.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$396.81
|
| Rate for Payer: Cash Price |
$488.38
|
| Rate for Payer: Cofinity Commercial |
$427.34
|
| Rate for Payer: Cofinity Commercial |
$525.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$488.38
|
| Rate for Payer: Healthscope Commercial |
$549.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$427.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$457.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$518.91
|
| Rate for Payer: PHP Commercial |
$518.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$427.34
|
| Rate for Payer: Priority Health SBD |
$384.60
|
| Rate for Payer: UMR Bronson Commercial |
$268.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$457.86
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.57 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna American Axle |
$70.28
|
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.28
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.90
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.68
|
| Rate for Payer: Priority Health SBD |
$68.12
|
| Rate for Payer: UMR Bronson Commercial |
$47.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.93 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna American Axle |
$70.28
|
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$68.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.11
|
| Rate for Payer: BCBS Complete |
$37.73
|
| Rate for Payer: BCBS MAPPO |
$65.69
|
| Rate for Payer: BCBS Trust/PPO |
$59.08
|
| Rate for Payer: BCN Medicare Advantage |
$65.69
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Cofinity Commercial |
$75.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.69
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Mclaren Medicaid |
$35.93
|
| Rate for Payer: Mclaren Medicare |
$65.69
|
| Rate for Payer: Meridian Medicaid |
$37.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$91.90
|
| Rate for Payer: PACE Medicare |
$62.41
|
| Rate for Payer: PACE SWMI |
$65.69
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: PHP Medicare Advantage |
$65.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$67.50
|
| Rate for Payer: Priority Health Medicare |
$65.69
|
| Rate for Payer: Priority Health Narrow Network |
$54.00
|
| Rate for Payer: Priority Health SBD |
$68.12
|
| Rate for Payer: Railroad Medicare Medicare |
$65.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Core |
$80.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.69
|
| Rate for Payer: UHC Exchange |
$65.69
|
| Rate for Payer: UHC Medicare Advantage |
$67.66
|
| Rate for Payer: UMR Bronson Commercial |
$40.00
|
| Rate for Payer: VA VA |
$65.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$116.60
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.13 |
| Max. Negotiated Rate |
$104.94 |
| Rate for Payer: Aetna American Axle |
$75.79
|
| Rate for Payer: Aetna Commercial |
$99.11
|
| Rate for Payer: Aetna Medicare |
$76.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.71
|
| Rate for Payer: BCBS Complete |
$42.14
|
| Rate for Payer: BCBS MAPPO |
$73.37
|
| Rate for Payer: BCBS Trust/PPO |
$65.99
|
| Rate for Payer: BCN Medicare Advantage |
$73.37
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$100.28
|
| Rate for Payer: Cofinity Commercial |
$81.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.37
|
| Rate for Payer: Healthscope Commercial |
$104.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.45
|
| Rate for Payer: Mclaren Medicaid |
$40.13
|
| Rate for Payer: Mclaren Medicare |
$73.37
|
| Rate for Payer: Meridian Medicaid |
$42.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$77.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.11
|
| Rate for Payer: PACE Medicare |
$69.70
|
| Rate for Payer: PACE SWMI |
$73.37
|
| Rate for Payer: PHP Commercial |
$99.11
|
| Rate for Payer: PHP Medicare Advantage |
$73.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$83.82
|
| Rate for Payer: Priority Health Medicare |
$73.37
|
| Rate for Payer: Priority Health Narrow Network |
$67.06
|
| Rate for Payer: Priority Health SBD |
$73.46
|
| Rate for Payer: Railroad Medicare Medicare |
$73.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.04
|
| Rate for Payer: UHC Core |
$100.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.37
|
| Rate for Payer: UHC Exchange |
$73.37
|
| Rate for Payer: UHC Medicare Advantage |
$75.57
|
| Rate for Payer: UMR Bronson Commercial |
$43.14
|
| Rate for Payer: VA VA |
$73.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.45
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$116.60
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.30 |
| Max. Negotiated Rate |
$104.94 |
| Rate for Payer: Aetna American Axle |
$75.79
|
| Rate for Payer: Aetna Commercial |
$99.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.79
|
| Rate for Payer: Cash Price |
$93.28
|
| Rate for Payer: Cofinity Commercial |
$100.28
|
| Rate for Payer: Cofinity Commercial |
$81.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.28
|
| Rate for Payer: Healthscope Commercial |
$104.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$99.11
|
| Rate for Payer: PHP Commercial |
$99.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$81.62
|
| Rate for Payer: Priority Health SBD |
$73.46
|
| Rate for Payer: UMR Bronson Commercial |
$51.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.45
|
|
