|
HC MNT GROUP 30 MIN
|
Facility
|
IP
|
$60.53
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
94200004
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$26.63 |
| Max. Negotiated Rate |
$54.48 |
| Rate for Payer: Aetna American Axle |
$39.34
|
| Rate for Payer: Aetna Commercial |
$51.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.34
|
| Rate for Payer: Cash Price |
$48.42
|
| Rate for Payer: Cofinity Commercial |
$42.37
|
| Rate for Payer: Cofinity Commercial |
$52.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.42
|
| Rate for Payer: Healthscope Commercial |
$54.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.45
|
| Rate for Payer: PHP Commercial |
$51.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.34
|
| Rate for Payer: Priority Health SBD |
$38.13
|
| Rate for Payer: UMR Bronson Commercial |
$26.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.40
|
|
|
HC MNT GROUP 30 MIN
|
Facility
|
OP
|
$60.53
|
|
|
Service Code
|
CPT 97804
|
| Hospital Charge Code |
94200004
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$22.40 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$39.34
|
| Rate for Payer: Aetna Commercial |
$51.45
|
| Rate for Payer: Aetna Medicare |
$30.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.34
|
| Rate for Payer: BCBS Complete |
$24.21
|
| Rate for Payer: Cash Price |
$48.42
|
| Rate for Payer: Cash Price |
$48.42
|
| Rate for Payer: Cofinity Commercial |
$52.06
|
| Rate for Payer: Cofinity Commercial |
$42.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.42
|
| Rate for Payer: Healthscope Commercial |
$54.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.45
|
| Rate for Payer: PHP Commercial |
$51.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.34
|
| Rate for Payer: Priority Health SBD |
$38.13
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$22.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.40
|
|
|
HC MNT INITIAL 15 MIN
|
Facility
|
OP
|
$138.66
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
94200002
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$51.30 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$90.13
|
| Rate for Payer: Aetna Commercial |
$117.86
|
| Rate for Payer: Aetna Medicare |
$69.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.13
|
| Rate for Payer: BCBS Complete |
$55.46
|
| Rate for Payer: Cash Price |
$110.93
|
| Rate for Payer: Cash Price |
$110.93
|
| Rate for Payer: Cofinity Commercial |
$97.06
|
| Rate for Payer: Cofinity Commercial |
$119.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$97.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.93
|
| Rate for Payer: Healthscope Commercial |
$124.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.86
|
| Rate for Payer: PHP Commercial |
$117.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.13
|
| Rate for Payer: Priority Health SBD |
$87.36
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$51.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.00
|
|
|
HC MNT INITIAL 15 MIN
|
Facility
|
IP
|
$138.66
|
|
|
Service Code
|
CPT 97802
|
| Hospital Charge Code |
94200002
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$61.01 |
| Max. Negotiated Rate |
$124.79 |
| Rate for Payer: Aetna American Axle |
$90.13
|
| Rate for Payer: Aetna Commercial |
$117.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.13
|
| Rate for Payer: Cash Price |
$110.93
|
| Rate for Payer: Cofinity Commercial |
$119.25
|
| Rate for Payer: Cofinity Commercial |
$97.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$97.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.93
|
| Rate for Payer: Healthscope Commercial |
$124.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$117.86
|
| Rate for Payer: PHP Commercial |
$117.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$90.13
|
| Rate for Payer: Priority Health SBD |
$87.36
|
| Rate for Payer: UMR Bronson Commercial |
$61.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.00
|
|
|
HC MNT REASSESS & INTERVENT 15 MIN
|
Facility
|
IP
|
$122.56
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
94200003
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$53.93 |
| Max. Negotiated Rate |
$110.30 |
| Rate for Payer: Aetna American Axle |
$79.66
|
| Rate for Payer: Aetna Commercial |
$104.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.66
|
| Rate for Payer: Cash Price |
$98.05
|
| Rate for Payer: Cofinity Commercial |
$105.40
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.05
|
| Rate for Payer: Healthscope Commercial |
$110.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.18
|
| Rate for Payer: PHP Commercial |
$104.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.66
|
| Rate for Payer: Priority Health SBD |
$77.21
|
| Rate for Payer: UMR Bronson Commercial |
$53.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.92
|
|
|
HC MNT REASSESS & INTERVENT 15 MIN
|
Facility
|
OP
|
$122.56
|
|
|
Service Code
|
CPT 97803
|
| Hospital Charge Code |
94200003
|
|
Hospital Revenue Code
|
942
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$79.66
|
| Rate for Payer: Aetna Commercial |
$104.18
|
| Rate for Payer: Aetna Medicare |
$61.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.66
|
| Rate for Payer: BCBS Complete |
$49.02
|
| Rate for Payer: Cash Price |
$98.05
|
| Rate for Payer: Cash Price |
$98.05
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Cofinity Commercial |
$105.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$98.05
|
| Rate for Payer: Healthscope Commercial |
$110.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.18
|
| Rate for Payer: PHP Commercial |
$104.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.66
|
| Rate for Payer: Priority Health SBD |
$77.21
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$45.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.92
|
|
|
HC MOG FACS, S
|
Facility
|
OP
|
$535.50
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200476
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna American Axle |
$348.07
|
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$460.53
|
| Rate for Payer: Cofinity Commercial |
$374.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$481.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.62
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.07
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$337.37
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$198.13
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.62
|
|
|
HC MOG FACS, S
|
Facility
|
IP
|
$535.50
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200476
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$235.62 |
| Max. Negotiated Rate |
$481.95 |
| Rate for Payer: Aetna American Axle |
$348.07
|
| Rate for Payer: Aetna Commercial |
$455.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$348.07
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cofinity Commercial |
$374.85
|
| Rate for Payer: Cofinity Commercial |
$460.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$374.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.40
|
| Rate for Payer: Healthscope Commercial |
$481.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$374.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.18
|
| Rate for Payer: PHP Commercial |
$455.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$348.07
|
| Rate for Payer: Priority Health SBD |
$337.37
|
| Rate for Payer: UMR Bronson Commercial |
$235.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.62
|
|
|
HC MOG FACS TITER, S
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200477
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.73
|
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC MOG FACS TITER, S
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200477
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.66 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.73
|
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: UMR Bronson Commercial |
$33.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC MONITOR DOWNLOAD
|
Facility
|
IP
|
$755.95
|
|
|
Service Code
|
CPT 94776
|
| Hospital Charge Code |
41000013
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$332.62 |
| Max. Negotiated Rate |
$680.36 |
| Rate for Payer: Aetna American Axle |
$491.37
|
| Rate for Payer: Aetna Commercial |
$642.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.37
|
| Rate for Payer: Cash Price |
$604.76
|
| Rate for Payer: Cofinity Commercial |
$529.16
|
| Rate for Payer: Cofinity Commercial |
$650.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$529.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.76
|
| Rate for Payer: Healthscope Commercial |
$680.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$529.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$566.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.56
|
| Rate for Payer: PHP Commercial |
$642.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.37
|
| Rate for Payer: Priority Health SBD |
$476.25
|
| Rate for Payer: UMR Bronson Commercial |
$332.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$566.96
|
|
|
HC MONITOR DOWNLOAD
|
Facility
|
OP
|
$755.95
|
|
|
Service Code
|
CPT 94776
|
| Hospital Charge Code |
41000013
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$680.36 |
| Rate for Payer: Aetna American Axle |
$491.37
|
| Rate for Payer: Aetna Commercial |
$642.56
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$491.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$604.76
|
| Rate for Payer: Cash Price |
$604.76
|
| Rate for Payer: Cash Price |
$604.76
|
| Rate for Payer: Cofinity Commercial |
$529.16
|
| Rate for Payer: Cofinity Commercial |
$650.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$529.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$604.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$680.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$529.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$566.96
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$642.56
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$642.56
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$491.37
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$476.25
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$291.61
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$279.70
|
| Rate for Payer: VA VA |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$566.96
|
|
|
HC MONITORED EXERCISE
|
Facility
|
IP
|
$244.93
|
|
|
Service Code
|
CPT 93798
|
| Hospital Charge Code |
94300001
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$107.77 |
| Max. Negotiated Rate |
$220.44 |
| Rate for Payer: Aetna American Axle |
$159.20
|
| Rate for Payer: Aetna Commercial |
$208.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.20
|
| Rate for Payer: Cash Price |
$195.94
|
| Rate for Payer: Cofinity Commercial |
$171.45
|
| Rate for Payer: Cofinity Commercial |
$210.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.94
|
| Rate for Payer: Healthscope Commercial |
$220.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.19
|
| Rate for Payer: PHP Commercial |
$208.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.20
|
| Rate for Payer: Priority Health SBD |
$154.31
|
| Rate for Payer: UMR Bronson Commercial |
$107.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.70
|
|
|
HC MONITORED EXERCISE
|
Facility
|
OP
|
$244.93
|
|
|
Service Code
|
CPT 93798
|
| Hospital Charge Code |
94300001
|
|
Hospital Revenue Code
|
943
|
| Min. Negotiated Rate |
$65.82 |
| Max. Negotiated Rate |
$345.67 |
| Rate for Payer: Aetna American Axle |
$159.20
|
| Rate for Payer: Aetna Commercial |
$208.19
|
| Rate for Payer: Aetna Medicare |
$127.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.50
|
| Rate for Payer: BCBS Complete |
$69.11
|
| Rate for Payer: BCBS MAPPO |
$122.80
|
| Rate for Payer: BCN Medicare Advantage |
$122.80
|
| Rate for Payer: Cash Price |
$195.94
|
| Rate for Payer: Cash Price |
$195.94
|
| Rate for Payer: Cash Price |
$195.94
|
| Rate for Payer: Cofinity Commercial |
$171.45
|
| Rate for Payer: Cofinity Commercial |
$210.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.80
|
| Rate for Payer: Healthscope Commercial |
$220.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.70
|
| Rate for Payer: Mclaren Medicaid |
$65.82
|
| Rate for Payer: Mclaren Medicare |
$122.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.94
|
| Rate for Payer: Meridian Medicaid |
$69.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.19
|
| Rate for Payer: PACE Medicare |
$116.66
|
| Rate for Payer: PACE SWMI |
$122.80
|
| Rate for Payer: PHP Commercial |
$208.19
|
| Rate for Payer: PHP Medicare Advantage |
$122.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.20
|
| Rate for Payer: Priority Health Medicare |
$122.80
|
| Rate for Payer: Priority Health SBD |
$154.31
|
| Rate for Payer: Railroad Medicare Medicare |
$122.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.67
|
| Rate for Payer: UHC Core |
$196.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.80
|
| Rate for Payer: UHC Exchange |
$234.68
|
| Rate for Payer: UHC Medicare Advantage |
$122.80
|
| Rate for Payer: UHCCP Medicaid |
$65.82
|
| Rate for Payer: UMR Bronson Commercial |
$90.62
|
| Rate for Payer: VA VA |
$122.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.70
|
|
|
HC MONITOR SET QUICK PRESSURE
|
Facility
|
IP
|
$437.50
|
|
| Hospital Charge Code |
27000707
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$192.50 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna American Axle |
$284.38
|
| Rate for Payer: Aetna Commercial |
$371.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.38
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cofinity Commercial |
$306.25
|
| Rate for Payer: Cofinity Commercial |
$376.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.00
|
| Rate for Payer: Healthscope Commercial |
$393.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.88
|
| Rate for Payer: PHP Commercial |
$371.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.38
|
| Rate for Payer: Priority Health SBD |
$275.62
|
| Rate for Payer: UMR Bronson Commercial |
$192.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.12
|
|
|
HC MONITOR SET QUICK PRESSURE
|
Facility
|
OP
|
$437.50
|
|
| Hospital Charge Code |
27000707
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$161.88 |
| Max. Negotiated Rate |
$393.75 |
| Rate for Payer: Aetna American Axle |
$284.38
|
| Rate for Payer: Aetna Commercial |
$371.88
|
| Rate for Payer: Aetna Medicare |
$218.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.38
|
| Rate for Payer: BCBS Complete |
$175.00
|
| Rate for Payer: Cash Price |
$350.00
|
| Rate for Payer: Cofinity Commercial |
$306.25
|
| Rate for Payer: Cofinity Commercial |
$376.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.00
|
| Rate for Payer: Healthscope Commercial |
$393.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.88
|
| Rate for Payer: PHP Commercial |
$371.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.38
|
| Rate for Payer: Priority Health SBD |
$275.62
|
| Rate for Payer: UMR Bronson Commercial |
$161.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.12
|
|
|
HC MONO SCREENING MONOSPOT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200186
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.78 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.92
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$2.78
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.18
|
| Rate for Payer: UHC Exchange |
$9.90
|
| Rate for Payer: UHC Medicare Advantage |
$5.18
|
| Rate for Payer: UHCCP Medicaid |
$2.78
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC MONO SCREENING MONOSPOT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86308
|
| Hospital Charge Code |
30200186
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC MORPHINE LVL
|
Facility
|
OP
|
$119.34
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100578
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.16 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna American Axle |
$77.57
|
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: Aetna Medicare |
$59.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.57
|
| Rate for Payer: BCBS Complete |
$47.74
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Cofinity Commercial |
$83.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.44
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.57
|
| Rate for Payer: Priority Health SBD |
$75.18
|
| Rate for Payer: UMR Bronson Commercial |
$44.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC MORPHINE LVL
|
Facility
|
IP
|
$119.34
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100578
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.51 |
| Max. Negotiated Rate |
$107.41 |
| Rate for Payer: Aetna American Axle |
$77.57
|
| Rate for Payer: Aetna Commercial |
$101.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.57
|
| Rate for Payer: Cash Price |
$95.47
|
| Rate for Payer: Cofinity Commercial |
$102.63
|
| Rate for Payer: Cofinity Commercial |
$83.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.47
|
| Rate for Payer: Healthscope Commercial |
$107.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.44
|
| Rate for Payer: PHP Commercial |
$101.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.57
|
| Rate for Payer: Priority Health SBD |
$75.18
|
| Rate for Payer: UMR Bronson Commercial |
$52.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.50
|
|
|
HC MOUSE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200048
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MOUSE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200048
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MPCDS CELL SORTING BM
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100048
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$63.19 |
| Max. Negotiated Rate |
$987.55 |
| Rate for Payer: Aetna American Axle |
$111.01
|
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$364.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.09
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health SBD |
$107.59
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Exchange |
$670.47
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$188.04
|
| Rate for Payer: UMR Bronson Commercial |
$63.19
|
| Rate for Payer: VA VA |
$350.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.09
|
|
|
HC MPCDS CELL SORTING BM
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100048
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$75.14 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Aetna American Axle |
$111.01
|
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health SBD |
$107.59
|
| Rate for Payer: UMR Bronson Commercial |
$75.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.09
|
|
|
HC MPCDS CELL SORTING BM CMPT
|
Facility
|
IP
|
$53.78
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100049
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$23.66 |
| Max. Negotiated Rate |
$48.40 |
| Rate for Payer: Aetna American Axle |
$34.96
|
| Rate for Payer: Aetna Commercial |
$45.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.96
|
| Rate for Payer: Cash Price |
$43.02
|
| Rate for Payer: Cofinity Commercial |
$37.65
|
| Rate for Payer: Cofinity Commercial |
$46.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.02
|
| Rate for Payer: Healthscope Commercial |
$48.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.71
|
| Rate for Payer: PHP Commercial |
$45.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.96
|
| Rate for Payer: Priority Health SBD |
$33.88
|
| Rate for Payer: UMR Bronson Commercial |
$23.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.34
|
|
