HC Z BALLOON CATHETER
|
Facility
|
OP
|
$1,522.88
|
|
Service Code
|
HCPCS C1725
|
Hospital Charge Code |
27200083
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$0.03 |
Max. Negotiated Rate |
$1,370.59 |
Rate for Payer: Aetna American Axle |
$989.87
|
Rate for Payer: Aetna Commercial |
$1,294.45
|
Rate for Payer: Aetna New Business (MI Preferred) |
$989.87
|
Rate for Payer: BCBS Complete |
$609.15
|
Rate for Payer: BCBS Trust/PPO |
$0.03
|
Rate for Payer: Cash Price |
$1,218.30
|
Rate for Payer: Cash Price |
$1,218.30
|
Rate for Payer: Cofinity Commercial |
$1,066.02
|
Rate for Payer: Cofinity Commercial |
$1,309.68
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.30
|
Rate for Payer: Healthscope Commercial |
$1,370.59
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,066.02
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,142.16
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,294.45
|
Rate for Payer: PHP Commercial |
$1,294.45
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,066.02
|
Rate for Payer: Priority Health SBD |
$959.41
|
Rate for Payer: UMR Bronson Commercial |
$563.47
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,142.16
|
|
HC Z BALLOON CATHETER
|
Facility
|
IP
|
$1,522.88
|
|
Service Code
|
HCPCS C1725
|
Hospital Charge Code |
27200083
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$670.07 |
Max. Negotiated Rate |
$1,370.59 |
Rate for Payer: Aetna American Axle |
$989.87
|
Rate for Payer: Aetna Commercial |
$1,294.45
|
Rate for Payer: Aetna New Business (MI Preferred) |
$989.87
|
Rate for Payer: Cash Price |
$1,218.30
|
Rate for Payer: Cofinity Commercial |
$1,066.02
|
Rate for Payer: Cofinity Commercial |
$1,309.68
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,218.30
|
Rate for Payer: Healthscope Commercial |
$1,370.59
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,066.02
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,142.16
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,294.45
|
Rate for Payer: PHP Commercial |
$1,294.45
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,066.02
|
Rate for Payer: Priority Health SBD |
$959.41
|
Rate for Payer: UMR Bronson Commercial |
$670.07
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,142.16
|
|
HC Z CORDIS BALLOON STENT
|
Facility
|
IP
|
$5,380.54
|
|
Service Code
|
HCPCS C1876
|
Hospital Charge Code |
27800038
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,367.44 |
Max. Negotiated Rate |
$4,842.49 |
Rate for Payer: Aetna American Axle |
$3,497.35
|
Rate for Payer: Aetna Commercial |
$4,573.46
|
Rate for Payer: Aetna New Business (MI Preferred) |
$3,497.35
|
Rate for Payer: Cash Price |
$4,304.43
|
Rate for Payer: Cofinity Commercial |
$3,766.38
|
Rate for Payer: Cofinity Commercial |
$4,627.26
|
Rate for Payer: Encore Health Key Benefits Commercial |
$4,304.43
|
Rate for Payer: Healthscope Commercial |
$4,842.49
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,766.38
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,035.40
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,573.46
|
Rate for Payer: PHP Commercial |
$4,573.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,766.38
|
Rate for Payer: Priority Health SBD |
$3,389.74
|
Rate for Payer: UMR Bronson Commercial |
$2,367.44
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,035.40
|
|
HC Z CORDIS BALLOON STENT
|
Facility
|
OP
|
$5,380.54
|
|
Service Code
|
HCPCS C1876
|
Hospital Charge Code |
27800038
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,990.80 |
Max. Negotiated Rate |
$4,842.49 |
Rate for Payer: Aetna American Axle |
$3,497.35
|
Rate for Payer: Aetna Commercial |
$4,573.46
|
Rate for Payer: Aetna New Business (MI Preferred) |
$3,497.35
|
Rate for Payer: BCBS Complete |
$2,152.22
|
Rate for Payer: Cash Price |
$4,304.43
|
Rate for Payer: Cofinity Commercial |
$3,766.38
|
Rate for Payer: Cofinity Commercial |
$4,627.26
|
Rate for Payer: Encore Health Key Benefits Commercial |
$4,304.43
|
Rate for Payer: Healthscope Commercial |
$4,842.49
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,766.38
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,035.40
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,573.46
|
Rate for Payer: PHP Commercial |
$4,573.46
|
Rate for Payer: Priority Health Cigna Priority Health |
$3,766.38
|
Rate for Payer: Priority Health SBD |
$3,389.74
|
Rate for Payer: UMR Bronson Commercial |
$1,990.80
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,035.40
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,017.54
|
|
Hospital Charge Code |
27800045
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,767.72 |
Max. Negotiated Rate |
$3,615.79 |
Rate for Payer: Aetna American Axle |
$2,611.40
|
Rate for Payer: Aetna Commercial |
$3,414.91
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,611.40
|
Rate for Payer: Cash Price |
$3,214.03
|
Rate for Payer: Cofinity Commercial |
$2,812.28
|
Rate for Payer: Cofinity Commercial |
$3,455.08
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3,214.03
|
Rate for Payer: Healthscope Commercial |
$3,615.79
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,812.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,013.16
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.91
|
Rate for Payer: PHP Commercial |
$3,414.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,812.28
|
Rate for Payer: Priority Health SBD |
$2,531.05
|
Rate for Payer: UMR Bronson Commercial |
$1,767.72
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,013.16
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,017.54
|
|
Hospital Charge Code |
27800045
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$1,486.49 |
Max. Negotiated Rate |
$3,615.79 |
Rate for Payer: Aetna American Axle |
$2,611.40
|
Rate for Payer: Aetna Commercial |
$3,414.91
|
Rate for Payer: Aetna New Business (MI Preferred) |
$2,611.40
|
Rate for Payer: BCBS Complete |
$1,607.02
|
Rate for Payer: Cash Price |
$3,214.03
|
Rate for Payer: Cofinity Commercial |
$2,812.28
|
Rate for Payer: Cofinity Commercial |
$3,455.08
|
Rate for Payer: Encore Health Key Benefits Commercial |
$3,214.03
|
Rate for Payer: Healthscope Commercial |
$3,615.79
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,812.28
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,013.16
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,414.91
|
Rate for Payer: PHP Commercial |
$3,414.91
|
Rate for Payer: Priority Health Cigna Priority Health |
$2,812.28
|
Rate for Payer: Priority Health SBD |
$2,531.05
|
Rate for Payer: UMR Bronson Commercial |
$1,486.49
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,013.16
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,541.41
|
|
Hospital Charge Code |
27800047
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$2,790.32 |
Max. Negotiated Rate |
$6,787.27 |
Rate for Payer: Aetna American Axle |
$4,901.92
|
Rate for Payer: Aetna Commercial |
$6,410.20
|
Rate for Payer: Aetna New Business (MI Preferred) |
$4,901.92
|
Rate for Payer: BCBS Complete |
$3,016.56
|
Rate for Payer: Cash Price |
$6,033.13
|
Rate for Payer: Cofinity Commercial |
$5,278.99
|
Rate for Payer: Cofinity Commercial |
$6,485.61
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6,033.13
|
Rate for Payer: Healthscope Commercial |
$6,787.27
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,278.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,656.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,410.20
|
Rate for Payer: PHP Commercial |
$6,410.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,278.99
|
Rate for Payer: Priority Health SBD |
$4,751.09
|
Rate for Payer: UMR Bronson Commercial |
$2,790.32
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,656.06
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,541.41
|
|
Hospital Charge Code |
27800047
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$3,318.22 |
Max. Negotiated Rate |
$6,787.27 |
Rate for Payer: Aetna American Axle |
$4,901.92
|
Rate for Payer: Aetna Commercial |
$6,410.20
|
Rate for Payer: Aetna New Business (MI Preferred) |
$4,901.92
|
Rate for Payer: Cash Price |
$6,033.13
|
Rate for Payer: Cofinity Commercial |
$5,278.99
|
Rate for Payer: Cofinity Commercial |
$6,485.61
|
Rate for Payer: Encore Health Key Benefits Commercial |
$6,033.13
|
Rate for Payer: Healthscope Commercial |
$6,787.27
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,278.99
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,656.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,410.20
|
Rate for Payer: PHP Commercial |
$6,410.20
|
Rate for Payer: Priority Health Cigna Priority Health |
$5,278.99
|
Rate for Payer: Priority Health SBD |
$4,751.09
|
Rate for Payer: UMR Bronson Commercial |
$3,318.22
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,656.06
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,185.41
|
|
Service Code
|
HCPCS A9542
|
Hospital Charge Code |
34300025
|
Hospital Revenue Code
|
343
|
Min. Negotiated Rate |
$808.60 |
Max. Negotiated Rate |
$3,321.06 |
Rate for Payer: Aetna American Axle |
$1,420.52
|
Rate for Payer: Aetna Commercial |
$1,857.60
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.52
|
Rate for Payer: BCBS Complete |
$874.16
|
Rate for Payer: BCBS Trust/PPO |
$3,321.06
|
Rate for Payer: Cash Price |
$1,748.33
|
Rate for Payer: Cash Price |
$1,748.33
|
Rate for Payer: Cofinity Commercial |
$1,529.79
|
Rate for Payer: Cofinity Commercial |
$1,879.45
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,748.33
|
Rate for Payer: Healthscope Commercial |
$1,966.87
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,529.79
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,639.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,857.60
|
Rate for Payer: PHP Commercial |
$1,857.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,529.79
|
Rate for Payer: Priority Health SBD |
$1,376.81
|
Rate for Payer: UMR Bronson Commercial |
$808.60
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,639.06
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,185.41
|
|
Service Code
|
HCPCS A9542
|
Hospital Charge Code |
34300025
|
Hospital Revenue Code
|
343
|
Min. Negotiated Rate |
$961.58 |
Max. Negotiated Rate |
$1,966.87 |
Rate for Payer: Aetna American Axle |
$1,420.52
|
Rate for Payer: Aetna Commercial |
$1,857.60
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,420.52
|
Rate for Payer: Cash Price |
$1,748.33
|
Rate for Payer: Cofinity Commercial |
$1,529.79
|
Rate for Payer: Cofinity Commercial |
$1,879.45
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,748.33
|
Rate for Payer: Healthscope Commercial |
$1,966.87
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,529.79
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,639.06
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,857.60
|
Rate for Payer: PHP Commercial |
$1,857.60
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,529.79
|
Rate for Payer: Priority Health SBD |
$1,376.81
|
Rate for Payer: UMR Bronson Commercial |
$961.58
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,639.06
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$60,748.42
|
|
Service Code
|
HCPCS A9543
|
Hospital Charge Code |
34400006
|
Hospital Revenue Code
|
344
|
Min. Negotiated Rate |
$22,476.92 |
Max. Negotiated Rate |
$192,296.53 |
Rate for Payer: Aetna American Axle |
$39,486.47
|
Rate for Payer: Aetna Commercial |
$51,636.16
|
Rate for Payer: Aetna Medicare |
$68,095.65
|
Rate for Payer: Aetna New Business (MI Preferred) |
$39,486.47
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$81,845.73
|
Rate for Payer: Amish Plain Church Group Commercial |
$81,845.73
|
Rate for Payer: BCBS Complete |
$37,609.75
|
Rate for Payer: BCBS MAPPO |
$65,476.58
|
Rate for Payer: BCBS Trust/PPO |
$78,512.97
|
Rate for Payer: BCN Medicare Advantage |
$65,476.58
|
Rate for Payer: Cash Price |
$48,598.74
|
Rate for Payer: Cash Price |
$48,598.74
|
Rate for Payer: Cofinity Commercial |
$52,243.64
|
Rate for Payer: Cofinity Commercial |
$42,523.89
|
Rate for Payer: Encore Health Key Benefits Commercial |
$48,598.74
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$65,476.58
|
Rate for Payer: Healthscope Commercial |
$54,673.58
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42,523.89
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$45,561.32
|
Rate for Payer: Mclaren Medicaid |
$35,815.69
|
Rate for Payer: Mclaren Medicare |
$65,476.58
|
Rate for Payer: Meridian Medicaid |
$37,609.75
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$68,750.41
|
Rate for Payer: MI Amish Medical Board Commercial |
$75,298.07
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51,636.16
|
Rate for Payer: PACE Medicare |
$62,202.75
|
Rate for Payer: PACE SWMI |
$65,476.58
|
Rate for Payer: PHP Commercial |
$51,636.16
|
Rate for Payer: PHP Medicare Advantage |
$65,476.58
|
Rate for Payer: Priority Health Choice Medicaid |
$35,815.69
|
Rate for Payer: Priority Health Cigna Priority Health |
$42,523.89
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$192,296.53
|
Rate for Payer: Priority Health Medicare |
$65,476.58
|
Rate for Payer: Priority Health Narrow Network |
$153,837.22
|
Rate for Payer: Priority Health SBD |
$38,271.50
|
Rate for Payer: Railroad Medicare Medicare |
$65,476.58
|
Rate for Payer: UHC Dual Complete DSNP |
$65,476.58
|
Rate for Payer: UHC Medicare Advantage |
$67,440.88
|
Rate for Payer: UMR Bronson Commercial |
$22,476.92
|
Rate for Payer: VA VA |
$65,476.58
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45,561.32
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$60,748.42
|
|
Service Code
|
HCPCS A9543
|
Hospital Charge Code |
34400006
|
Hospital Revenue Code
|
344
|
Min. Negotiated Rate |
$26,729.30 |
Max. Negotiated Rate |
$54,673.58 |
Rate for Payer: Aetna American Axle |
$39,486.47
|
Rate for Payer: Aetna Commercial |
$51,636.16
|
Rate for Payer: Aetna New Business (MI Preferred) |
$39,486.47
|
Rate for Payer: Cash Price |
$48,598.74
|
Rate for Payer: Cofinity Commercial |
$42,523.89
|
Rate for Payer: Cofinity Commercial |
$52,243.64
|
Rate for Payer: Encore Health Key Benefits Commercial |
$48,598.74
|
Rate for Payer: Healthscope Commercial |
$54,673.58
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42,523.89
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$45,561.32
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$51,636.16
|
Rate for Payer: PHP Commercial |
$51,636.16
|
Rate for Payer: Priority Health Cigna Priority Health |
$42,523.89
|
Rate for Payer: Priority Health SBD |
$38,271.50
|
Rate for Payer: UMR Bronson Commercial |
$26,729.30
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45,561.32
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,500.87
|
|
Hospital Charge Code |
27800048
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$660.38 |
Max. Negotiated Rate |
$1,350.78 |
Rate for Payer: Aetna American Axle |
$975.57
|
Rate for Payer: Aetna Commercial |
$1,275.74
|
Rate for Payer: Aetna New Business (MI Preferred) |
$975.57
|
Rate for Payer: Cash Price |
$1,200.70
|
Rate for Payer: Cofinity Commercial |
$1,050.61
|
Rate for Payer: Cofinity Commercial |
$1,290.75
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.70
|
Rate for Payer: Healthscope Commercial |
$1,350.78
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.61
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.65
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.74
|
Rate for Payer: PHP Commercial |
$1,275.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,050.61
|
Rate for Payer: Priority Health SBD |
$945.55
|
Rate for Payer: UMR Bronson Commercial |
$660.38
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.65
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,500.87
|
|
Hospital Charge Code |
27800048
|
Hospital Revenue Code
|
278
|
Min. Negotiated Rate |
$555.32 |
Max. Negotiated Rate |
$1,350.78 |
Rate for Payer: Aetna American Axle |
$975.57
|
Rate for Payer: Aetna Commercial |
$1,275.74
|
Rate for Payer: Aetna New Business (MI Preferred) |
$975.57
|
Rate for Payer: BCBS Complete |
$600.35
|
Rate for Payer: Cash Price |
$1,200.70
|
Rate for Payer: Cofinity Commercial |
$1,050.61
|
Rate for Payer: Cofinity Commercial |
$1,290.75
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,200.70
|
Rate for Payer: Healthscope Commercial |
$1,350.78
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,050.61
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,125.65
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,275.74
|
Rate for Payer: PHP Commercial |
$1,275.74
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,050.61
|
Rate for Payer: Priority Health SBD |
$945.55
|
Rate for Payer: UMR Bronson Commercial |
$555.32
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,125.65
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,199.35
|
|
Service Code
|
HCPCS C1881
|
Hospital Charge Code |
27200087
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$443.76 |
Max. Negotiated Rate |
$1,079.42 |
Rate for Payer: Aetna American Axle |
$779.58
|
Rate for Payer: Aetna Commercial |
$1,019.45
|
Rate for Payer: Aetna New Business (MI Preferred) |
$779.58
|
Rate for Payer: BCBS Complete |
$479.74
|
Rate for Payer: Cash Price |
$959.48
|
Rate for Payer: Cofinity Commercial |
$1,031.44
|
Rate for Payer: Cofinity Commercial |
$839.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$959.48
|
Rate for Payer: Healthscope Commercial |
$1,079.42
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.51
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,019.45
|
Rate for Payer: PHP Commercial |
$1,019.45
|
Rate for Payer: Priority Health Cigna Priority Health |
$839.54
|
Rate for Payer: Priority Health SBD |
$755.59
|
Rate for Payer: UMR Bronson Commercial |
$443.76
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.51
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
IP
|
$1,199.35
|
|
Service Code
|
HCPCS C1881
|
Hospital Charge Code |
27200087
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$527.71 |
Max. Negotiated Rate |
$1,079.42 |
Rate for Payer: Aetna American Axle |
$779.58
|
Rate for Payer: Aetna Commercial |
$1,019.45
|
Rate for Payer: Aetna New Business (MI Preferred) |
$779.58
|
Rate for Payer: Cash Price |
$959.48
|
Rate for Payer: Cofinity Commercial |
$1,031.44
|
Rate for Payer: Cofinity Commercial |
$839.54
|
Rate for Payer: Encore Health Key Benefits Commercial |
$959.48
|
Rate for Payer: Healthscope Commercial |
$1,079.42
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$839.54
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$899.51
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,019.45
|
Rate for Payer: PHP Commercial |
$1,019.45
|
Rate for Payer: Priority Health Cigna Priority Health |
$839.54
|
Rate for Payer: Priority Health SBD |
$755.59
|
Rate for Payer: UMR Bronson Commercial |
$527.71
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$899.51
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
OP
|
$1,552.09
|
|
Service Code
|
HCPCS C1881
|
Hospital Charge Code |
27200088
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$574.27 |
Max. Negotiated Rate |
$1,396.88 |
Rate for Payer: Aetna American Axle |
$1,008.86
|
Rate for Payer: Aetna Commercial |
$1,319.28
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.86
|
Rate for Payer: BCBS Complete |
$620.84
|
Rate for Payer: Cash Price |
$1,241.67
|
Rate for Payer: Cofinity Commercial |
$1,086.46
|
Rate for Payer: Cofinity Commercial |
$1,334.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.67
|
Rate for Payer: Healthscope Commercial |
$1,396.88
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,086.46
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,164.07
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,319.28
|
Rate for Payer: PHP Commercial |
$1,319.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,086.46
|
Rate for Payer: Priority Health SBD |
$977.82
|
Rate for Payer: UMR Bronson Commercial |
$574.27
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,164.07
|
|
HC Z HEMODIALYSIS BARD
|
Facility
|
IP
|
$1,552.09
|
|
Service Code
|
HCPCS C1881
|
Hospital Charge Code |
27200088
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$682.92 |
Max. Negotiated Rate |
$1,396.88 |
Rate for Payer: Aetna American Axle |
$1,008.86
|
Rate for Payer: Aetna Commercial |
$1,319.28
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,008.86
|
Rate for Payer: Cash Price |
$1,241.67
|
Rate for Payer: Cofinity Commercial |
$1,086.46
|
Rate for Payer: Cofinity Commercial |
$1,334.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,241.67
|
Rate for Payer: Healthscope Commercial |
$1,396.88
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,086.46
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,164.07
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,319.28
|
Rate for Payer: PHP Commercial |
$1,319.28
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,086.46
|
Rate for Payer: Priority Health SBD |
$977.82
|
Rate for Payer: UMR Bronson Commercial |
$682.92
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,164.07
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
OP
|
$2,175.42
|
|
Service Code
|
HCPCS C2628
|
Hospital Charge Code |
27200089
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$804.91 |
Max. Negotiated Rate |
$1,957.88 |
Rate for Payer: Aetna American Axle |
$1,414.02
|
Rate for Payer: Aetna Commercial |
$1,849.11
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,414.02
|
Rate for Payer: BCBS Complete |
$870.17
|
Rate for Payer: Cash Price |
$1,740.34
|
Rate for Payer: Cofinity Commercial |
$1,870.86
|
Rate for Payer: Cofinity Commercial |
$1,522.79
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.34
|
Rate for Payer: Healthscope Commercial |
$1,957.88
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,522.79
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,849.11
|
Rate for Payer: PHP Commercial |
$1,849.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,522.79
|
Rate for Payer: Priority Health SBD |
$1,370.51
|
Rate for Payer: UMR Bronson Commercial |
$804.91
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.56
|
|
HC Z HYPERGLIDE OCCL BALLOON C
|
Facility
|
IP
|
$2,175.42
|
|
Service Code
|
HCPCS C2628
|
Hospital Charge Code |
27200089
|
Hospital Revenue Code
|
272
|
Min. Negotiated Rate |
$957.18 |
Max. Negotiated Rate |
$1,957.88 |
Rate for Payer: Aetna American Axle |
$1,414.02
|
Rate for Payer: Aetna Commercial |
$1,849.11
|
Rate for Payer: Aetna New Business (MI Preferred) |
$1,414.02
|
Rate for Payer: Cash Price |
$1,740.34
|
Rate for Payer: Cofinity Commercial |
$1,522.79
|
Rate for Payer: Cofinity Commercial |
$1,870.86
|
Rate for Payer: Encore Health Key Benefits Commercial |
$1,740.34
|
Rate for Payer: Healthscope Commercial |
$1,957.88
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,522.79
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,631.56
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,849.11
|
Rate for Payer: PHP Commercial |
$1,849.11
|
Rate for Payer: Priority Health Cigna Priority Health |
$1,522.79
|
Rate for Payer: Priority Health SBD |
$1,370.51
|
Rate for Payer: UMR Bronson Commercial |
$957.18
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,631.56
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$184.00
|
|
Service Code
|
CPT 86794
|
Hospital Charge Code |
30000148
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$80.96 |
Max. Negotiated Rate |
$165.60 |
Rate for Payer: Aetna American Axle |
$119.60
|
Rate for Payer: Aetna Commercial |
$156.40
|
Rate for Payer: Aetna New Business (MI Preferred) |
$119.60
|
Rate for Payer: Cash Price |
$147.20
|
Rate for Payer: Cofinity Commercial |
$128.80
|
Rate for Payer: Cofinity Commercial |
$158.24
|
Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
Rate for Payer: Healthscope Commercial |
$165.60
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.00
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.40
|
Rate for Payer: PHP Commercial |
$156.40
|
Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
Rate for Payer: Priority Health SBD |
$115.92
|
Rate for Payer: UMR Bronson Commercial |
$80.96
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.00
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$184.00
|
|
Service Code
|
CPT 86794
|
Hospital Charge Code |
30000148
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$9.22 |
Max. Negotiated Rate |
$165.60 |
Rate for Payer: Aetna American Axle |
$119.60
|
Rate for Payer: Aetna Commercial |
$156.40
|
Rate for Payer: Aetna Medicare |
$17.52
|
Rate for Payer: Aetna New Business (MI Preferred) |
$119.60
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
Rate for Payer: BCBS Complete |
$9.68
|
Rate for Payer: BCBS MAPPO |
$16.85
|
Rate for Payer: BCBS Trust/PPO |
$15.16
|
Rate for Payer: BCN Medicare Advantage |
$16.85
|
Rate for Payer: Cash Price |
$147.20
|
Rate for Payer: Cash Price |
$147.20
|
Rate for Payer: Cofinity Commercial |
$158.24
|
Rate for Payer: Cofinity Commercial |
$128.80
|
Rate for Payer: Encore Health Key Benefits Commercial |
$147.20
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
Rate for Payer: Healthscope Commercial |
$165.60
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$128.80
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.00
|
Rate for Payer: Mclaren Medicaid |
$9.22
|
Rate for Payer: Mclaren Medicare |
$16.85
|
Rate for Payer: Meridian Medicaid |
$9.68
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$17.69
|
Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$156.40
|
Rate for Payer: PACE Medicare |
$16.01
|
Rate for Payer: PACE SWMI |
$16.85
|
Rate for Payer: PHP Commercial |
$156.40
|
Rate for Payer: PHP Medicare Advantage |
$16.85
|
Rate for Payer: Priority Health Choice Medicaid |
$9.22
|
Rate for Payer: Priority Health Cigna Priority Health |
$128.80
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.23
|
Rate for Payer: Priority Health Medicare |
$16.85
|
Rate for Payer: Priority Health Narrow Network |
$14.58
|
Rate for Payer: Priority Health SBD |
$115.92
|
Rate for Payer: Railroad Medicare Medicare |
$16.85
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$20.22
|
Rate for Payer: UHC Core |
$24.96
|
Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
Rate for Payer: UHC Exchange |
$16.85
|
Rate for Payer: UHC Medicare Advantage |
$17.36
|
Rate for Payer: UMR Bronson Commercial |
$68.08
|
Rate for Payer: VA VA |
$16.85
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.00
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
IP
|
$255.00
|
|
Service Code
|
CPT 87662
|
Hospital Charge Code |
30000150
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$112.20 |
Max. Negotiated Rate |
$229.50 |
Rate for Payer: Aetna American Axle |
$165.75
|
Rate for Payer: Aetna Commercial |
$216.75
|
Rate for Payer: Aetna New Business (MI Preferred) |
$165.75
|
Rate for Payer: Cash Price |
$204.00
|
Rate for Payer: Cofinity Commercial |
$219.30
|
Rate for Payer: Cofinity Commercial |
$178.50
|
Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
Rate for Payer: Healthscope Commercial |
$229.50
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
Rate for Payer: PHP Commercial |
$216.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
Rate for Payer: Priority Health SBD |
$160.65
|
Rate for Payer: UMR Bronson Commercial |
$112.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
OP
|
$255.00
|
|
Service Code
|
CPT 87662
|
Hospital Charge Code |
30000150
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$28.07 |
Max. Negotiated Rate |
$229.50 |
Rate for Payer: Aetna American Axle |
$165.75
|
Rate for Payer: Aetna Commercial |
$216.75
|
Rate for Payer: Aetna Medicare |
$53.36
|
Rate for Payer: Aetna New Business (MI Preferred) |
$165.75
|
Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
Rate for Payer: BCBS Complete |
$29.47
|
Rate for Payer: BCBS MAPPO |
$51.31
|
Rate for Payer: BCBS Trust/PPO |
$46.14
|
Rate for Payer: BCN Medicare Advantage |
$51.31
|
Rate for Payer: Cash Price |
$204.00
|
Rate for Payer: Cash Price |
$204.00
|
Rate for Payer: Cofinity Commercial |
$178.50
|
Rate for Payer: Cofinity Commercial |
$219.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
Rate for Payer: Healthscope Commercial |
$229.50
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
Rate for Payer: Mclaren Medicaid |
$28.07
|
Rate for Payer: Mclaren Medicare |
$51.31
|
Rate for Payer: Meridian Medicaid |
$29.47
|
Rate for Payer: Meridian Wellcare - Medicare Advantage |
$53.88
|
Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
Rate for Payer: PACE Medicare |
$48.74
|
Rate for Payer: PACE SWMI |
$51.31
|
Rate for Payer: PHP Commercial |
$216.75
|
Rate for Payer: PHP Medicare Advantage |
$51.31
|
Rate for Payer: Priority Health Choice Medicaid |
$28.07
|
Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$70.39
|
Rate for Payer: Priority Health Medicare |
$51.31
|
Rate for Payer: Priority Health Narrow Network |
$56.31
|
Rate for Payer: Priority Health SBD |
$160.65
|
Rate for Payer: Railroad Medicare Medicare |
$51.31
|
Rate for Payer: UHC All Payor (Choice/PPO) |
$61.57
|
Rate for Payer: UHC Core |
$76.02
|
Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
Rate for Payer: UHC Exchange |
$51.31
|
Rate for Payer: UHC Medicare Advantage |
$52.85
|
Rate for Payer: UMR Bronson Commercial |
$94.35
|
Rate for Payer: VA VA |
$51.31
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
IP
|
$255.00
|
|
Service Code
|
CPT 87662
|
Hospital Charge Code |
30000151
|
Hospital Revenue Code
|
300
|
Min. Negotiated Rate |
$112.20 |
Max. Negotiated Rate |
$229.50 |
Rate for Payer: Aetna American Axle |
$165.75
|
Rate for Payer: Aetna Commercial |
$216.75
|
Rate for Payer: Aetna New Business (MI Preferred) |
$165.75
|
Rate for Payer: Cash Price |
$204.00
|
Rate for Payer: Cofinity Commercial |
$178.50
|
Rate for Payer: Cofinity Commercial |
$219.30
|
Rate for Payer: Encore Health Key Benefits Commercial |
$204.00
|
Rate for Payer: Healthscope Commercial |
$229.50
|
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.50
|
Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.25
|
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$216.75
|
Rate for Payer: PHP Commercial |
$216.75
|
Rate for Payer: Priority Health Cigna Priority Health |
$178.50
|
Rate for Payer: Priority Health SBD |
$160.65
|
Rate for Payer: UMR Bronson Commercial |
$112.20
|
Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.25
|
|