|
HC OR LEVEL 4 PER MINUTE
|
Facility
|
IP
|
$118.00
|
|
| Hospital Charge Code |
36000133
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$51.92 |
| Max. Negotiated Rate |
$106.20 |
| Rate for Payer: Aetna American Axle |
$76.70
|
| Rate for Payer: Aetna Commercial |
$100.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.70
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Advantage |
$82.60
|
| Rate for Payer: Cofinity Commercial |
$101.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.40
|
| Rate for Payer: Healthscope Commercial |
$106.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.50
|
| Rate for Payer: PHP Commercial |
$100.30
|
| Rate for Payer: Priority Health SBD |
$74.34
|
| Rate for Payer: UMR Bronson Commercial |
$51.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.50
|
|
|
HC OR LEVEL 4 PER MINUTE
|
Facility
|
OP
|
$118.00
|
|
| Hospital Charge Code |
36000133
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$106.20 |
| Rate for Payer: Aetna American Axle |
$76.70
|
| Rate for Payer: Aetna Commercial |
$100.30
|
| Rate for Payer: Aetna Medicare |
$59.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.70
|
| Rate for Payer: BCBS Complete |
$47.20
|
| Rate for Payer: Cash Price |
$94.40
|
| Rate for Payer: Cofinity Advantage |
$82.60
|
| Rate for Payer: Cofinity Commercial |
$101.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.40
|
| Rate for Payer: Healthscope Commercial |
$106.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.50
|
| Rate for Payer: PHP Commercial |
$100.30
|
| Rate for Payer: Priority Health SBD |
$74.34
|
| Rate for Payer: UMR Bronson Commercial |
$43.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.50
|
|
|
HC OR LEVEL 5 BASE CHARGE
|
Facility
|
OP
|
$2,188.00
|
|
| Hospital Charge Code |
36000134
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$809.56 |
| Max. Negotiated Rate |
$1,969.20 |
| Rate for Payer: Aetna American Axle |
$1,422.20
|
| Rate for Payer: Aetna Commercial |
$1,859.80
|
| Rate for Payer: Aetna Medicare |
$1,094.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,422.20
|
| Rate for Payer: BCBS Complete |
$875.20
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cofinity Advantage |
$1,531.60
|
| Rate for Payer: Cofinity Commercial |
$1,881.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,750.40
|
| Rate for Payer: Healthscope Commercial |
$1,969.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,531.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,641.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,750.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,859.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,641.00
|
| Rate for Payer: PHP Commercial |
$1,859.80
|
| Rate for Payer: Priority Health SBD |
$1,378.44
|
| Rate for Payer: UMR Bronson Commercial |
$809.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,641.00
|
|
|
HC OR LEVEL 5 BASE CHARGE
|
Facility
|
IP
|
$2,188.00
|
|
| Hospital Charge Code |
36000134
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$962.72 |
| Max. Negotiated Rate |
$1,969.20 |
| Rate for Payer: Aetna American Axle |
$1,422.20
|
| Rate for Payer: Aetna Commercial |
$1,859.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,422.20
|
| Rate for Payer: Cash Price |
$1,750.40
|
| Rate for Payer: Cofinity Advantage |
$1,531.60
|
| Rate for Payer: Cofinity Commercial |
$1,881.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,750.40
|
| Rate for Payer: Healthscope Commercial |
$1,969.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,531.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,641.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,859.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,641.00
|
| Rate for Payer: PHP Commercial |
$1,859.80
|
| Rate for Payer: Priority Health SBD |
$1,378.44
|
| Rate for Payer: UMR Bronson Commercial |
$962.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,641.00
|
|
|
HC OR LEVEL 5 PER MINUTE
|
Facility
|
IP
|
$150.00
|
|
| Hospital Charge Code |
36000135
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$97.50
|
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Advantage |
$105.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health SBD |
$94.50
|
| Rate for Payer: UMR Bronson Commercial |
$66.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC OR LEVEL 5 PER MINUTE
|
Facility
|
OP
|
$150.00
|
|
| Hospital Charge Code |
36000135
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$55.50 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$97.50
|
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare |
$75.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.50
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Advantage |
$105.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$105.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$120.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health SBD |
$94.50
|
| Rate for Payer: UMR Bronson Commercial |
$55.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC ORPHENADRINE INJECTION, PER 60MG
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
63600143
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.54 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna American Axle |
$20.00
|
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna Medicare |
$15.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: BCBS Complete |
$12.31
|
| Rate for Payer: BCBS Trust/PPO |
$20.72
|
| Rate for Payer: BCN Commercial |
$20.72
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: Priority Health SBD |
$19.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.54
|
| Rate for Payer: UHC Core |
$10.54
|
| Rate for Payer: UHC Exchange |
$10.54
|
| Rate for Payer: UMR Bronson Commercial |
$11.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC ORPHENADRINE INJECTION, PER 60MG
|
Facility
|
IP
|
$30.77
|
|
|
Service Code
|
HCPCS J2360
|
| Hospital Charge Code |
63600143
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.54 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna American Axle |
$20.00
|
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.00
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Advantage |
$21.54
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: Priority Health SBD |
$19.39
|
| Rate for Payer: UMR Bronson Commercial |
$13.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC OR SEDATION PER MINUTE
|
Facility
|
IP
|
$14.28
|
|
| Hospital Charge Code |
37000026
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna American Axle |
$9.28
|
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.28
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Advantage |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health SBD |
$9.00
|
| Rate for Payer: UMR Bronson Commercial |
$6.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC OR SEDATION PER MINUTE
|
Facility
|
OP
|
$14.28
|
|
| Hospital Charge Code |
37000026
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$12.85 |
| Rate for Payer: Aetna American Axle |
$9.28
|
| Rate for Payer: Aetna Commercial |
$12.14
|
| Rate for Payer: Aetna Medicare |
$7.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.28
|
| Rate for Payer: BCBS Complete |
$5.71
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Advantage |
$10.00
|
| Rate for Payer: Cofinity Commercial |
$12.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$12.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: PHP Commercial |
$12.14
|
| Rate for Payer: Priority Health SBD |
$9.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.28
|
| Rate for Payer: UHC Core |
$7.44
|
| Rate for Payer: UHC Exchange |
$5.61
|
| Rate for Payer: UMR Bronson Commercial |
$5.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.71
|
|
|
HC ORTHOPOX (AKA MONKEY)
|
Facility
|
OP
|
$125.74
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600334
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$153.93 |
| Rate for Payer: Aetna American Axle |
$81.73
|
| Rate for Payer: Aetna Commercial |
$106.88
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.73
|
| 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 |
$28.18
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$59.31
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$100.59
|
| Rate for Payer: Cash Price |
$100.59
|
| Rate for Payer: Cofinity Advantage |
$88.02
|
| Rate for Payer: Cofinity Commercial |
$108.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$113.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.31
|
| Rate for Payer: Mclaren Medicaid |
$51.31
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$53.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.88
|
| Rate for Payer: Nomi Health Commercial |
$153.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.31
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$106.88
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.31
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$79.22
|
| Rate for Payer: Priority Health Tiered Network |
$41.05
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.97
|
| Rate for Payer: UHC Core |
$76.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.31
|
| Rate for Payer: UHC Exchange |
$76.97
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
| Rate for Payer: UMR Bronson Commercial |
$46.52
|
| Rate for Payer: VA VA |
$51.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.31
|
|
|
HC ORTHOPOX (AKA MONKEY)
|
Facility
|
IP
|
$125.74
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600334
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$55.33 |
| Max. Negotiated Rate |
$113.17 |
| Rate for Payer: Aetna American Axle |
$81.73
|
| Rate for Payer: Aetna Commercial |
$106.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$81.73
|
| Rate for Payer: Cash Price |
$100.59
|
| Rate for Payer: Cofinity Advantage |
$88.02
|
| Rate for Payer: Cofinity Commercial |
$108.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.59
|
| Rate for Payer: Healthscope Commercial |
$113.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$106.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.31
|
| Rate for Payer: PHP Commercial |
$106.88
|
| Rate for Payer: Priority Health SBD |
$79.22
|
| Rate for Payer: UMR Bronson Commercial |
$55.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.31
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ORTHOPOX DNA, PCR
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 87593
|
| Hospital Charge Code |
30600332
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$153.93 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| 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 |
$28.18
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$59.31
|
| Rate for Payer: BCN Commercial |
$59.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Advantage |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$51.31
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$53.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$153.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.31
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Priority Health Tiered Network |
$41.05
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.97
|
| Rate for Payer: UHC Core |
$76.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.31
|
| Rate for Payer: UHC Exchange |
$76.97
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$51.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
IP
|
$149.64
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.84 |
| Max. Negotiated Rate |
$134.68 |
| Rate for Payer: Aetna American Axle |
$97.27
|
| Rate for Payer: Aetna Commercial |
$127.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.27
|
| Rate for Payer: Cash Price |
$119.71
|
| Rate for Payer: Cofinity Advantage |
$104.75
|
| Rate for Payer: Cofinity Commercial |
$128.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.71
|
| Rate for Payer: Healthscope Commercial |
$134.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.23
|
| Rate for Payer: PHP Commercial |
$127.19
|
| Rate for Payer: Priority Health SBD |
$94.27
|
| Rate for Payer: UMR Bronson Commercial |
$65.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.23
|
|
|
HC ORTHO/PROSTH MGMT SUBSEQ EA 15 MIN
|
Facility
|
OP
|
$149.64
|
|
|
Service Code
|
CPT 97763
|
| Hospital Charge Code |
42000056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.46 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$97.27
|
| Rate for Payer: Aetna Commercial |
$127.19
|
| Rate for Payer: Aetna Medicare |
$74.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$97.27
|
| Rate for Payer: BCBS Complete |
$59.86
|
| Rate for Payer: BCBS Trust/PPO |
$69.91
|
| Rate for Payer: BCN Commercial |
$69.91
|
| Rate for Payer: Cash Price |
$119.71
|
| Rate for Payer: Cash Price |
$119.71
|
| Rate for Payer: Cash Price |
$119.71
|
| Rate for Payer: Cofinity Advantage |
$104.75
|
| Rate for Payer: Cofinity Commercial |
$128.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.71
|
| Rate for Payer: Healthscope Commercial |
$134.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$104.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$127.19
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$112.23
|
| Rate for Payer: PHP Commercial |
$127.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$49.32
|
| Rate for Payer: Priority Health SBD |
$94.27
|
| Rate for Payer: Priority Health Tiered Network |
$39.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.27
|
| Rate for Payer: UHC Core |
$77.96
|
| Rate for Payer: UHC Exchange |
$58.81
|
| Rate for Payer: UMR Bronson Commercial |
$55.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.23
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
OP
|
$137.09
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$28.80 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$89.11
|
| Rate for Payer: Aetna Commercial |
$116.53
|
| Rate for Payer: Aetna Medicare |
$68.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.11
|
| Rate for Payer: BCBS Complete |
$54.84
|
| Rate for Payer: BCBS Trust/PPO |
$64.05
|
| Rate for Payer: BCN Commercial |
$64.05
|
| Rate for Payer: Cash Price |
$109.67
|
| Rate for Payer: Cash Price |
$109.67
|
| Rate for Payer: Cash Price |
$109.67
|
| Rate for Payer: Cofinity Advantage |
$95.96
|
| Rate for Payer: Cofinity Commercial |
$117.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.67
|
| Rate for Payer: Healthscope Commercial |
$123.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.53
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.82
|
| Rate for Payer: PHP Commercial |
$116.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$36.00
|
| Rate for Payer: Priority Health SBD |
$86.37
|
| Rate for Payer: Priority Health Tiered Network |
$28.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.11
|
| Rate for Payer: UHC Core |
$71.42
|
| Rate for Payer: UHC Exchange |
$53.88
|
| Rate for Payer: UMR Bronson Commercial |
$50.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.82
|
|
|
HC ORTHOTIC FIT/TRAIN INITIAL EA 15 MIN
|
Facility
|
IP
|
$137.09
|
|
|
Service Code
|
CPT 97760
|
| Hospital Charge Code |
42000039
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$60.32 |
| Max. Negotiated Rate |
$123.38 |
| Rate for Payer: Aetna American Axle |
$89.11
|
| Rate for Payer: Aetna Commercial |
$116.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$89.11
|
| Rate for Payer: Cash Price |
$109.67
|
| Rate for Payer: Cofinity Advantage |
$95.96
|
| Rate for Payer: Cofinity Commercial |
$117.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.67
|
| Rate for Payer: Healthscope Commercial |
$123.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.82
|
| Rate for Payer: PHP Commercial |
$116.53
|
| Rate for Payer: Priority Health SBD |
$86.37
|
| Rate for Payer: UMR Bronson Commercial |
$60.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.82
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
OP
|
$2,458.59
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$80.31 |
| Max. Negotiated Rate |
$2,212.73 |
| Rate for Payer: Aetna American Axle |
$1,598.08
|
| Rate for Payer: Aetna Commercial |
$2,089.80
|
| Rate for Payer: Aetna Medicare |
$640.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,598.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.46
|
| Rate for Payer: BCBS Complete |
$338.07
|
| Rate for Payer: BCBS MAPPO |
$615.57
|
| Rate for Payer: BCBS Trust/PPO |
$80.31
|
| Rate for Payer: BCN Commercial |
$80.31
|
| Rate for Payer: BCN Medicare Advantage |
$615.57
|
| Rate for Payer: Cash Price |
$1,966.87
|
| Rate for Payer: Cash Price |
$1,966.87
|
| Rate for Payer: Cofinity Advantage |
$1,721.01
|
| Rate for Payer: Cofinity Commercial |
$2,114.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,966.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.57
|
| Rate for Payer: Healthscope Commercial |
$2,212.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,721.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,843.94
|
| Rate for Payer: Mclaren Medicaid |
$615.57
|
| Rate for Payer: Mclaren Medicare |
$615.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.35
|
| Rate for Payer: Meridian Medicaid |
$646.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,089.80
|
| Rate for Payer: Nomi Health Commercial |
$1,846.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,843.94
|
| Rate for Payer: PACE Medicare |
$584.79
|
| Rate for Payer: PACE SWMI |
$615.57
|
| Rate for Payer: PHP Commercial |
$2,089.80
|
| Rate for Payer: PHP Medicare Advantage |
$615.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,990.71
|
| Rate for Payer: Priority Health Medicare |
$615.57
|
| Rate for Payer: Priority Health SBD |
$1,548.91
|
| Rate for Payer: Priority Health Tiered Network |
$1,592.57
|
| Rate for Payer: Railroad Medicare Medicare |
$615.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,598.08
|
| Rate for Payer: UHC Core |
$1,280.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.57
|
| Rate for Payer: UHC Exchange |
$966.23
|
| Rate for Payer: UHC Medicaid |
$321.94
|
| Rate for Payer: UHCCP Medicaid |
$321.94
|
| Rate for Payer: UMR Bronson Commercial |
$909.68
|
| Rate for Payer: VA VA |
$615.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,843.94
|
|
|
HC OSCILLATOR INIT DAY
|
Facility
|
IP
|
$2,458.59
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000039
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,081.78 |
| Max. Negotiated Rate |
$2,212.73 |
| Rate for Payer: Aetna American Axle |
$1,598.08
|
| Rate for Payer: Aetna Commercial |
$2,089.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,598.08
|
| Rate for Payer: Cash Price |
$1,966.87
|
| Rate for Payer: Cofinity Advantage |
$1,721.01
|
| Rate for Payer: Cofinity Commercial |
$2,114.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,966.87
|
| Rate for Payer: Healthscope Commercial |
$2,212.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,721.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,843.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,089.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,843.94
|
| Rate for Payer: PHP Commercial |
$2,089.80
|
| Rate for Payer: Priority Health SBD |
$1,548.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,081.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,843.94
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
IP
|
$1,375.25
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$605.11 |
| Max. Negotiated Rate |
$1,237.72 |
| Rate for Payer: Aetna American Axle |
$893.91
|
| Rate for Payer: Aetna Commercial |
$1,168.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.91
|
| Rate for Payer: Cash Price |
$1,100.20
|
| Rate for Payer: Cofinity Advantage |
$962.67
|
| Rate for Payer: Cofinity Commercial |
$1,182.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,100.20
|
| Rate for Payer: Healthscope Commercial |
$1,237.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$962.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,031.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,168.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,031.44
|
| Rate for Payer: PHP Commercial |
$1,168.96
|
| Rate for Payer: Priority Health SBD |
$866.41
|
| Rate for Payer: UMR Bronson Commercial |
$605.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,031.44
|
|
|
HC OSCILLATOR SUB DAY
|
Facility
|
OP
|
$1,375.25
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000040
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$59.18 |
| Max. Negotiated Rate |
$1,990.71 |
| Rate for Payer: Aetna American Axle |
$893.91
|
| Rate for Payer: Aetna Commercial |
$1,168.96
|
| Rate for Payer: Aetna Medicare |
$640.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$893.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$769.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$769.46
|
| Rate for Payer: BCBS Complete |
$338.07
|
| Rate for Payer: BCBS MAPPO |
$615.57
|
| Rate for Payer: BCBS Trust/PPO |
$59.18
|
| Rate for Payer: BCN Commercial |
$59.18
|
| Rate for Payer: BCN Medicare Advantage |
$615.57
|
| Rate for Payer: Cash Price |
$1,100.20
|
| Rate for Payer: Cash Price |
$1,100.20
|
| Rate for Payer: Cofinity Advantage |
$962.67
|
| Rate for Payer: Cofinity Commercial |
$1,182.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,100.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$615.57
|
| Rate for Payer: Healthscope Commercial |
$1,237.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$962.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,031.44
|
| Rate for Payer: Mclaren Medicaid |
$615.57
|
| Rate for Payer: Mclaren Medicare |
$615.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$646.35
|
| Rate for Payer: Meridian Medicaid |
$646.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$707.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$677.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,168.96
|
| Rate for Payer: Nomi Health Commercial |
$1,846.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,031.44
|
| Rate for Payer: PACE Medicare |
$584.79
|
| Rate for Payer: PACE SWMI |
$615.57
|
| Rate for Payer: PHP Commercial |
$1,168.96
|
| Rate for Payer: PHP Medicare Advantage |
$615.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$321.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,990.71
|
| Rate for Payer: Priority Health Medicare |
$615.57
|
| Rate for Payer: Priority Health SBD |
$866.41
|
| Rate for Payer: Priority Health Tiered Network |
$1,592.57
|
| Rate for Payer: Railroad Medicare Medicare |
$615.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$893.91
|
| Rate for Payer: UHC Core |
$716.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$615.57
|
| Rate for Payer: UHC Exchange |
$540.47
|
| Rate for Payer: UHC Medicaid |
$321.94
|
| Rate for Payer: UHCCP Medicaid |
$321.94
|
| Rate for Payer: UMR Bronson Commercial |
$508.84
|
| Rate for Payer: VA VA |
$615.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,031.44
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
IP
|
$56.04
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.66 |
| Max. Negotiated Rate |
$50.44 |
| Rate for Payer: Aetna American Axle |
$36.43
|
| Rate for Payer: Aetna Commercial |
$47.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.43
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Advantage |
$39.23
|
| Rate for Payer: Cofinity Commercial |
$48.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PHP Commercial |
$47.63
|
| Rate for Payer: Priority Health SBD |
$35.31
|
| Rate for Payer: UMR Bronson Commercial |
$24.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.03
|
|
|
HC OSMOLALITY SERUM
|
Facility
|
OP
|
$56.04
|
|
|
Service Code
|
CPT 83930
|
| Hospital Charge Code |
30100378
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$50.44 |
| Rate for Payer: Aetna American Axle |
$36.43
|
| Rate for Payer: Aetna Commercial |
$47.63
|
| Rate for Payer: Aetna Medicare |
$6.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.26
|
| Rate for Payer: BCBS Complete |
$3.63
|
| Rate for Payer: BCBS MAPPO |
$6.61
|
| Rate for Payer: BCBS Trust/PPO |
$7.64
|
| Rate for Payer: BCN Commercial |
$7.64
|
| Rate for Payer: BCN Medicare Advantage |
$6.61
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cash Price |
$44.83
|
| Rate for Payer: Cofinity Advantage |
$39.23
|
| Rate for Payer: Cofinity Commercial |
$48.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.61
|
| Rate for Payer: Healthscope Commercial |
$50.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.03
|
| Rate for Payer: Mclaren Medicaid |
$6.61
|
| Rate for Payer: Mclaren Medicare |
$6.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.94
|
| Rate for Payer: Meridian Medicaid |
$6.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.63
|
| Rate for Payer: Nomi Health Commercial |
$9.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.03
|
| Rate for Payer: PACE Medicare |
$6.28
|
| Rate for Payer: PACE SWMI |
$6.61
|
| Rate for Payer: PHP Commercial |
$47.63
|
| Rate for Payer: PHP Medicare Advantage |
$6.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.61
|
| Rate for Payer: Priority Health Medicare |
$6.61
|
| Rate for Payer: Priority Health SBD |
$35.31
|
| Rate for Payer: Priority Health Tiered Network |
$5.29
|
| Rate for Payer: Railroad Medicare Medicare |
$6.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.92
|
| Rate for Payer: UHC Core |
$9.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.61
|
| Rate for Payer: UHC Exchange |
$9.92
|
| Rate for Payer: UHC Medicaid |
$3.46
|
| Rate for Payer: UHCCP Medicaid |
$3.46
|
| Rate for Payer: UMR Bronson Commercial |
$20.73
|
| Rate for Payer: VA VA |
$6.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.03
|
|
|
HC OSMOLALITY URINE
|
Facility
|
IP
|
$54.94
|
|
|
Service Code
|
CPT 83935
|
| Hospital Charge Code |
30100379
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$49.45 |
| Rate for Payer: Aetna American Axle |
$35.71
|
| Rate for Payer: Aetna Commercial |
$46.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.71
|
| Rate for Payer: Cash Price |
$43.95
|
| Rate for Payer: Cofinity Advantage |
$38.46
|
| Rate for Payer: Cofinity Commercial |
$47.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.95
|
| Rate for Payer: Healthscope Commercial |
$49.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.20
|
| Rate for Payer: PHP Commercial |
$46.70
|
| Rate for Payer: Priority Health SBD |
$34.61
|
| Rate for Payer: UMR Bronson Commercial |
$24.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.20
|
|
