|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
IP
|
$2,584.25
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,137.07 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna American Axle |
$1,679.76
|
| Rate for Payer: Aetna Commercial |
$2,196.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.76
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$1,808.98
|
| Rate for Payer: Cofinity Commercial |
$2,222.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,808.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,808.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,938.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: PHP Commercial |
$2,196.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: Priority Health SBD |
$1,628.08
|
| Rate for Payer: UMR Bronson Commercial |
$1,137.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,938.19
|
|
|
HC MR UPPER EXTREM BIL NO JOINT WO W CON
|
Facility
|
OP
|
$2,584.25
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000021
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$2,325.82 |
| Rate for Payer: Aetna American Axle |
$1,679.76
|
| Rate for Payer: Aetna Commercial |
$2,196.61
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,679.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$658.86
|
| Rate for Payer: BCN Commercial |
$658.86
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cash Price |
$2,067.40
|
| Rate for Payer: Cofinity Commercial |
$2,222.46
|
| Rate for Payer: Cofinity Commercial |
$1,808.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,808.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,067.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$2,325.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,808.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,938.19
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,196.61
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,196.61
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,679.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$1,628.08
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.30
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$384.82
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$956.17
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,938.19
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
IP
|
$2,329.17
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,024.83 |
| Max. Negotiated Rate |
$2,096.25 |
| Rate for Payer: Aetna American Axle |
$1,513.96
|
| Rate for Payer: Aetna American Axle |
$2,270.94
|
| Rate for Payer: Aetna Commercial |
$1,979.79
|
| Rate for Payer: Aetna Commercial |
$2,969.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,270.94
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cofinity Commercial |
$3,004.62
|
| Rate for Payer: Cofinity Commercial |
$2,445.62
|
| Rate for Payer: Cofinity Commercial |
$1,630.42
|
| Rate for Payer: Cofinity Commercial |
$2,003.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,630.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,445.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Healthscope Commercial |
$2,096.25
|
| Rate for Payer: Healthscope Commercial |
$3,144.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,630.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,445.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,746.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,620.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,969.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.79
|
| Rate for Payer: PHP Commercial |
$2,969.69
|
| Rate for Payer: PHP Commercial |
$1,979.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,270.94
|
| Rate for Payer: Priority Health SBD |
$1,467.38
|
| Rate for Payer: Priority Health SBD |
$2,201.06
|
| Rate for Payer: UMR Bronson Commercial |
$1,024.83
|
| Rate for Payer: UMR Bronson Commercial |
$1,537.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,746.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,620.31
|
|
|
HC MR UPPER EXTREM NO JOINT W CON
|
Facility
|
OP
|
$3,493.75
|
|
|
Service Code
|
CPT 73219
|
| Hospital Charge Code |
61000018
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,144.38 |
| Rate for Payer: Aetna American Axle |
$2,270.94
|
| Rate for Payer: Aetna American Axle |
$1,513.96
|
| Rate for Payer: Aetna Commercial |
$1,979.79
|
| Rate for Payer: Aetna Commercial |
$2,969.69
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,513.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,270.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$543.93
|
| Rate for Payer: BCBS Trust/PPO |
$543.93
|
| Rate for Payer: BCN Commercial |
$543.93
|
| Rate for Payer: BCN Commercial |
$543.93
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cash Price |
$2,795.00
|
| Rate for Payer: Cash Price |
$1,863.34
|
| Rate for Payer: Cofinity Commercial |
$3,004.62
|
| Rate for Payer: Cofinity Commercial |
$2,003.09
|
| Rate for Payer: Cofinity Commercial |
$1,630.42
|
| Rate for Payer: Cofinity Commercial |
$2,445.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,445.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,630.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,795.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,863.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,144.38
|
| Rate for Payer: Healthscope Commercial |
$2,096.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,445.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,630.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,746.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,620.31
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,979.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,969.69
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,969.69
|
| Rate for Payer: PHP Commercial |
$1,979.79
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,270.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,513.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$1,467.38
|
| Rate for Payer: Priority Health SBD |
$2,201.06
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.91
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$310.83
|
| Rate for Payer: UHC Exchange |
$310.83
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$861.79
|
| Rate for Payer: UMR Bronson Commercial |
$1,292.69
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,620.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,746.88
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
IP
|
$1,995.22
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$877.90 |
| Max. Negotiated Rate |
$1,795.70 |
| Rate for Payer: Aetna American Axle |
$1,296.89
|
| Rate for Payer: Aetna American Axle |
$1,945.34
|
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,945.34
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Cofinity Commercial |
$2,094.98
|
| Rate for Payer: Cofinity Commercial |
$1,396.65
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,396.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,094.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,094.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health SBD |
$1,256.99
|
| Rate for Payer: Priority Health SBD |
$1,885.48
|
| Rate for Payer: UMR Bronson Commercial |
$877.90
|
| Rate for Payer: UMR Bronson Commercial |
$1,316.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
|
|
HC MR UPPER EXTREM NO JOINT WO CON
|
Facility
|
OP
|
$2,992.83
|
|
|
Service Code
|
CPT 73218
|
| Hospital Charge Code |
61000016
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$126.94 |
| Max. Negotiated Rate |
$2,693.55 |
| Rate for Payer: Healthscope Commercial |
$2,693.55
|
| Rate for Payer: Aetna American Axle |
$1,945.34
|
| Rate for Payer: Aetna American Axle |
$1,296.89
|
| Rate for Payer: Aetna Commercial |
$1,695.94
|
| Rate for Payer: Aetna Commercial |
$2,543.91
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna Medicare |
$246.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,296.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,945.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.04
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS Complete |
$133.29
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS MAPPO |
$236.83
|
| Rate for Payer: BCBS Trust/PPO |
$510.40
|
| Rate for Payer: BCBS Trust/PPO |
$510.40
|
| Rate for Payer: BCN Commercial |
$510.40
|
| Rate for Payer: BCN Commercial |
$510.40
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: BCN Medicare Advantage |
$236.83
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$2,394.26
|
| Rate for Payer: Cash Price |
$1,596.18
|
| Rate for Payer: Cofinity Commercial |
$2,573.83
|
| Rate for Payer: Cofinity Commercial |
$1,715.89
|
| Rate for Payer: Cofinity Commercial |
$1,396.65
|
| Rate for Payer: Cofinity Commercial |
$2,094.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,094.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,396.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,394.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,596.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$236.83
|
| Rate for Payer: Healthscope Commercial |
$1,795.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,094.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,396.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,496.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,244.62
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicaid |
$126.94
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Mclaren Medicare |
$236.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$248.67
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: Meridian Medicaid |
$133.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,695.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,543.91
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: Nomi Health Commercial |
$710.49
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE Medicare |
$224.99
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PACE SWMI |
$236.83
|
| Rate for Payer: PHP Commercial |
$2,543.91
|
| Rate for Payer: PHP Commercial |
$1,695.94
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: PHP Medicare Advantage |
$236.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$126.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,945.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,296.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$744.36
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Medicare |
$236.83
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health Narrow Network |
$595.49
|
| Rate for Payer: Priority Health SBD |
$1,256.99
|
| Rate for Payer: Priority Health SBD |
$1,885.48
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: Railroad Medicare Medicare |
$236.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.73
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$236.83
|
| Rate for Payer: UHC Exchange |
$284.30
|
| Rate for Payer: UHC Exchange |
$284.30
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHC Medicare Advantage |
$236.83
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UHCCP Medicaid |
$126.94
|
| Rate for Payer: UMR Bronson Commercial |
$738.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,107.35
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: VA VA |
$236.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,244.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,496.42
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
OP
|
$3,436.30
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$187.55 |
| Max. Negotiated Rate |
$3,092.67 |
| Rate for Payer: Aetna American Axle |
$2,233.60
|
| Rate for Payer: Aetna American Axle |
$1,489.06
|
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna Medicare |
$363.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,489.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$437.39
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS Complete |
$196.93
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS MAPPO |
$349.91
|
| Rate for Payer: BCBS Trust/PPO |
$658.86
|
| Rate for Payer: BCBS Trust/PPO |
$658.86
|
| Rate for Payer: BCN Commercial |
$658.86
|
| Rate for Payer: BCN Commercial |
$658.86
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: BCN Medicare Advantage |
$349.91
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Commercial |
$1,603.60
|
| Rate for Payer: Cofinity Commercial |
$2,405.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,405.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,603.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$349.91
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,405.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,603.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicaid |
$187.55
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Mclaren Medicare |
$349.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$367.41
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: Meridian Medicaid |
$196.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$402.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: Nomi Health Commercial |
$1,049.73
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE Medicare |
$332.41
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PACE SWMI |
$349.91
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: PHP Medicare Advantage |
$349.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$187.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,099.76
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Medicare |
$349.91
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health Narrow Network |
$879.81
|
| Rate for Payer: Priority Health SBD |
$1,443.24
|
| Rate for Payer: Priority Health SBD |
$2,164.87
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: Railroad Medicare Medicare |
$349.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$423.30
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Core |
$1,943.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$349.91
|
| Rate for Payer: UHC Exchange |
$384.82
|
| Rate for Payer: UHC Exchange |
$384.82
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHC Medicare Advantage |
$349.91
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UHCCP Medicaid |
$187.55
|
| Rate for Payer: UMR Bronson Commercial |
$847.62
|
| Rate for Payer: UMR Bronson Commercial |
$1,271.43
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: VA VA |
$349.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
|
|
HC MR UPPER EXTREM NO JOINT WO W CON
|
Facility
|
IP
|
$2,290.86
|
|
|
Service Code
|
CPT 73220
|
| Hospital Charge Code |
61000020
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,007.98 |
| Max. Negotiated Rate |
$2,061.77 |
| Rate for Payer: Aetna American Axle |
$1,489.06
|
| Rate for Payer: Aetna American Axle |
$2,233.60
|
| Rate for Payer: Aetna Commercial |
$1,947.23
|
| Rate for Payer: Aetna Commercial |
$2,920.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,489.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,233.60
|
| Rate for Payer: Cash Price |
$1,832.69
|
| Rate for Payer: Cash Price |
$2,749.04
|
| Rate for Payer: Cofinity Commercial |
$2,955.22
|
| Rate for Payer: Cofinity Commercial |
$2,405.41
|
| Rate for Payer: Cofinity Commercial |
$1,603.60
|
| Rate for Payer: Cofinity Commercial |
$1,970.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,603.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,405.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,832.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,749.04
|
| Rate for Payer: Healthscope Commercial |
$2,061.77
|
| Rate for Payer: Healthscope Commercial |
$3,092.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,603.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,405.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,718.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,577.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,920.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,947.23
|
| Rate for Payer: PHP Commercial |
$2,920.86
|
| Rate for Payer: PHP Commercial |
$1,947.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,489.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,233.60
|
| Rate for Payer: Priority Health SBD |
$1,443.24
|
| Rate for Payer: Priority Health SBD |
$2,164.87
|
| Rate for Payer: UMR Bronson Commercial |
$1,007.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,511.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,718.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,577.22
|
|
|
HC MSMART BM CMPT1
|
Facility
|
OP
|
$244.80
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna American Axle |
$159.12
|
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna Medicare |
$54.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.44
|
| Rate for Payer: BCBS Complete |
$29.46
|
| Rate for Payer: BCBS MAPPO |
$52.35
|
| Rate for Payer: BCBS Trust/PPO |
$200.11
|
| Rate for Payer: BCN Commercial |
$200.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.35
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.35
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Mclaren Medicaid |
$28.06
|
| Rate for Payer: Mclaren Medicare |
$52.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.97
|
| Rate for Payer: Meridian Medicaid |
$29.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: Nomi Health Commercial |
$157.05
|
| Rate for Payer: PACE Medicare |
$49.73
|
| Rate for Payer: PACE SWMI |
$52.35
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: PHP Medicare Advantage |
$52.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.53
|
| Rate for Payer: Priority Health Medicare |
$52.35
|
| Rate for Payer: Priority Health Narrow Network |
$131.62
|
| Rate for Payer: Priority Health SBD |
$154.22
|
| Rate for Payer: Railroad Medicare Medicare |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.35
|
| Rate for Payer: UHC Exchange |
$152.21
|
| Rate for Payer: UHC Medicare Advantage |
$52.35
|
| Rate for Payer: UHCCP Medicaid |
$28.06
|
| Rate for Payer: UMR Bronson Commercial |
$90.58
|
| Rate for Payer: VA VA |
$52.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC MSMART BM CMPT1
|
Facility
|
IP
|
$244.80
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100045
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$107.71 |
| Max. Negotiated Rate |
$220.32 |
| Rate for Payer: Aetna American Axle |
$159.12
|
| Rate for Payer: Aetna Commercial |
$208.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$159.12
|
| Rate for Payer: Cash Price |
$195.84
|
| Rate for Payer: Cofinity Commercial |
$171.36
|
| Rate for Payer: Cofinity Commercial |
$210.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$171.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.84
|
| Rate for Payer: Healthscope Commercial |
$220.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$171.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$208.08
|
| Rate for Payer: PHP Commercial |
$208.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$159.12
|
| Rate for Payer: Priority Health SBD |
$154.22
|
| Rate for Payer: UMR Bronson Commercial |
$107.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.60
|
|
|
HC MSMART BM CMPT2
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$63.19 |
| Max. Negotiated Rate |
$1,107.72 |
| Rate for Payer: Aetna American Axle |
$111.01
|
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$366.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$120.07
|
| Rate for Payer: BCN Commercial |
$120.07
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| 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 |
$352.45
|
| 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 |
$128.08
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$1,057.35
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.72
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$886.18
|
| Rate for Payer: Priority Health SBD |
$107.59
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Exchange |
$69.97
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$188.91
|
| Rate for Payer: UMR Bronson Commercial |
$63.19
|
| Rate for Payer: VA VA |
$352.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC MSMART BM CMPT2
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100046
|
|
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 |
$128.08
|
| 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 |
$128.08
|
|
|
HC MSMART BM CMPT3
|
Facility
|
OP
|
$176.46
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.18 |
| Max. Negotiated Rate |
$158.81 |
| Rate for Payer: Aetna American Axle |
$114.70
|
| Rate for Payer: Aetna Commercial |
$149.99
|
| Rate for Payer: Aetna Medicare |
$88.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.70
|
| Rate for Payer: BCBS Complete |
$70.58
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cofinity Commercial |
$123.52
|
| Rate for Payer: Cofinity Commercial |
$151.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.17
|
| Rate for Payer: Healthscope Commercial |
$158.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.99
|
| Rate for Payer: PHP Commercial |
$149.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.70
|
| Rate for Payer: Priority Health SBD |
$111.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$65.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.34
|
|
|
HC MSMART BM CMPT3
|
Facility
|
IP
|
$176.46
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100047
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$77.64 |
| Max. Negotiated Rate |
$158.81 |
| Rate for Payer: Aetna American Axle |
$114.70
|
| Rate for Payer: Aetna Commercial |
$149.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$114.70
|
| Rate for Payer: Cash Price |
$141.17
|
| Rate for Payer: Cofinity Commercial |
$123.52
|
| Rate for Payer: Cofinity Commercial |
$151.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$123.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$141.17
|
| Rate for Payer: Healthscope Commercial |
$158.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$123.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$132.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$149.99
|
| Rate for Payer: PHP Commercial |
$149.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.70
|
| Rate for Payer: Priority Health SBD |
$111.17
|
| Rate for Payer: UMR Bronson Commercial |
$77.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$132.34
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
OP
|
$68.18
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$62.52 |
| Rate for Payer: Aetna American Axle |
$44.32
|
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna Medicare |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.10
|
| Rate for Payer: BCBS Complete |
$23.46
|
| Rate for Payer: BCBS MAPPO |
$41.68
|
| Rate for Payer: BCBS Trust/PPO |
$40.16
|
| Rate for Payer: BCN Commercial |
$40.16
|
| Rate for Payer: BCN Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cofinity Commercial |
$58.63
|
| Rate for Payer: Cofinity Commercial |
$47.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.68
|
| Rate for Payer: Healthscope Commercial |
$61.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.14
|
| Rate for Payer: Mclaren Medicaid |
$22.34
|
| Rate for Payer: Mclaren Medicare |
$41.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.76
|
| Rate for Payer: Meridian Medicaid |
$23.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.95
|
| Rate for Payer: Nomi Health Commercial |
$62.52
|
| Rate for Payer: PACE Medicare |
$39.60
|
| Rate for Payer: PACE SWMI |
$41.68
|
| Rate for Payer: PHP Commercial |
$57.95
|
| Rate for Payer: PHP Medicare Advantage |
$41.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.68
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow Network |
$33.34
|
| Rate for Payer: Priority Health SBD |
$42.95
|
| Rate for Payer: Railroad Medicare Medicare |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.68
|
| Rate for Payer: UHC Exchange |
$41.68
|
| Rate for Payer: UHC Medicare Advantage |
$41.68
|
| Rate for Payer: UHCCP Medicaid |
$22.34
|
| Rate for Payer: UMR Bronson Commercial |
$25.23
|
| Rate for Payer: VA VA |
$41.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.14
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR
|
Facility
|
IP
|
$68.18
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600293
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$61.36 |
| Rate for Payer: Aetna American Axle |
$44.32
|
| Rate for Payer: Aetna Commercial |
$57.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.32
|
| Rate for Payer: Cash Price |
$54.54
|
| Rate for Payer: Cofinity Commercial |
$47.73
|
| Rate for Payer: Cofinity Commercial |
$58.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.54
|
| Rate for Payer: Healthscope Commercial |
$61.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.95
|
| Rate for Payer: PHP Commercial |
$57.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.32
|
| Rate for Payer: Priority Health SBD |
$42.95
|
| Rate for Payer: UMR Bronson Commercial |
$30.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.14
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
OP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.31
|
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Cofinity Commercial |
$40.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.05
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.16
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$21.24
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.05
|
|
|
HC MTB RIFAMPIN RESISTANCE GENE PCR CMPT
|
Facility
|
IP
|
$57.40
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600294
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.26 |
| Max. Negotiated Rate |
$51.66 |
| Rate for Payer: Aetna American Axle |
$37.31
|
| Rate for Payer: Aetna Commercial |
$48.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.31
|
| Rate for Payer: Cash Price |
$45.92
|
| Rate for Payer: Cofinity Commercial |
$40.18
|
| Rate for Payer: Cofinity Commercial |
$49.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.92
|
| Rate for Payer: Healthscope Commercial |
$51.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.79
|
| Rate for Payer: PHP Commercial |
$48.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.31
|
| Rate for Payer: Priority Health SBD |
$36.16
|
| Rate for Payer: UMR Bronson Commercial |
$25.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.05
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
IP
|
$506.94
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$223.05 |
| Max. Negotiated Rate |
$456.25 |
| Rate for Payer: Aetna American Axle |
$329.51
|
| Rate for Payer: Aetna Commercial |
$430.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.51
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cofinity Commercial |
$354.86
|
| Rate for Payer: Cofinity Commercial |
$435.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$354.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.55
|
| Rate for Payer: Healthscope Commercial |
$456.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$354.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.90
|
| Rate for Payer: PHP Commercial |
$430.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.51
|
| Rate for Payer: Priority Health SBD |
$319.37
|
| Rate for Payer: UMR Bronson Commercial |
$223.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.20
|
|
|
HC MTHFR 2 MUTATIONS
|
Facility
|
OP
|
$506.94
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000126
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$456.25 |
| Rate for Payer: Aetna American Axle |
$329.51
|
| Rate for Payer: Aetna Commercial |
$430.90
|
| Rate for Payer: Aetna Medicare |
$67.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.68
|
| Rate for Payer: BCBS Complete |
$36.77
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cash Price |
$405.55
|
| Rate for Payer: Cofinity Commercial |
$435.97
|
| Rate for Payer: Cofinity Commercial |
$354.86
|
| Rate for Payer: Cofinity Medicare Advantage |
$354.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$405.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$456.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$354.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.20
|
| Rate for Payer: Mclaren Medicaid |
$35.02
|
| Rate for Payer: Mclaren Medicare |
$65.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.61
|
| Rate for Payer: Meridian Medicaid |
$36.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$430.90
|
| Rate for Payer: Nomi Health Commercial |
$196.02
|
| Rate for Payer: PACE Medicare |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$430.90
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.51
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.34
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$52.27
|
| Rate for Payer: Priority Health SBD |
$319.37
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.41
|
| Rate for Payer: UHC Core |
$336.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.34
|
| Rate for Payer: UHC Exchange |
$65.34
|
| Rate for Payer: UHC Medicare Advantage |
$65.34
|
| Rate for Payer: UHCCP Medicaid |
$35.02
|
| Rate for Payer: UMR Bronson Commercial |
$187.57
|
| Rate for Payer: VA VA |
$65.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.20
|
|
|
HC MTHFR MUTATION
|
Facility
|
OP
|
$382.50
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$35.02 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna American Axle |
$248.62
|
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna Medicare |
$67.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.68
|
| Rate for Payer: BCBS Complete |
$36.77
|
| Rate for Payer: BCBS MAPPO |
$65.34
|
| Rate for Payer: BCN Medicare Advantage |
$65.34
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Cofinity Commercial |
$267.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Mclaren Medicaid |
$35.02
|
| Rate for Payer: Mclaren Medicare |
$65.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.61
|
| Rate for Payer: Meridian Medicaid |
$36.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: Nomi Health Commercial |
$196.02
|
| Rate for Payer: PACE Medicare |
$62.07
|
| Rate for Payer: PACE SWMI |
$65.34
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: PHP Medicare Advantage |
$65.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.34
|
| Rate for Payer: Priority Health Medicare |
$65.34
|
| Rate for Payer: Priority Health Narrow Network |
$52.27
|
| Rate for Payer: Priority Health SBD |
$240.98
|
| Rate for Payer: Railroad Medicare Medicare |
$65.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.41
|
| Rate for Payer: UHC Core |
$336.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.34
|
| Rate for Payer: UHC Exchange |
$65.34
|
| Rate for Payer: UHC Medicare Advantage |
$65.34
|
| Rate for Payer: UHCCP Medicaid |
$35.02
|
| Rate for Payer: UMR Bronson Commercial |
$141.52
|
| Rate for Payer: VA VA |
$65.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC MTHFR MUTATION
|
Facility
|
IP
|
$382.50
|
|
|
Service Code
|
CPT 81291
|
| Hospital Charge Code |
31000102
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$168.30 |
| Max. Negotiated Rate |
$344.25 |
| Rate for Payer: Aetna American Axle |
$248.62
|
| Rate for Payer: Aetna Commercial |
$325.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$248.62
|
| Rate for Payer: Cash Price |
$306.00
|
| Rate for Payer: Cofinity Commercial |
$267.75
|
| Rate for Payer: Cofinity Commercial |
$328.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$267.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$306.00
|
| Rate for Payer: Healthscope Commercial |
$344.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$267.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$286.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$325.12
|
| Rate for Payer: PHP Commercial |
$325.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$248.62
|
| Rate for Payer: Priority Health SBD |
$240.98
|
| Rate for Payer: UMR Bronson Commercial |
$168.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$286.88
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
IP
|
$197.88
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$87.07 |
| Max. Negotiated Rate |
$178.09 |
| Rate for Payer: Aetna American Axle |
$128.62
|
| Rate for Payer: Aetna Commercial |
$168.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.62
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cofinity Commercial |
$138.52
|
| Rate for Payer: Cofinity Commercial |
$170.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$138.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.30
|
| Rate for Payer: Healthscope Commercial |
$178.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.20
|
| Rate for Payer: PHP Commercial |
$168.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.62
|
| Rate for Payer: Priority Health SBD |
$124.66
|
| Rate for Payer: UMR Bronson Commercial |
$87.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.41
|
|
|
HC M TUBERCULOSIS COMPLEX, PCR
|
Facility
|
OP
|
$197.88
|
|
|
Service Code
|
CPT 87556
|
| Hospital Charge Code |
30600291
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$178.09 |
| Rate for Payer: Aetna American Axle |
$128.62
|
| Rate for Payer: Aetna Commercial |
$168.20
|
| Rate for Payer: Aetna Medicare |
$43.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.10
|
| Rate for Payer: BCBS Complete |
$23.46
|
| Rate for Payer: BCBS MAPPO |
$41.68
|
| Rate for Payer: BCBS Trust/PPO |
$40.16
|
| Rate for Payer: BCN Commercial |
$40.16
|
| Rate for Payer: BCN Medicare Advantage |
$41.68
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cash Price |
$158.30
|
| Rate for Payer: Cofinity Commercial |
$170.18
|
| Rate for Payer: Cofinity Commercial |
$138.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$138.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.68
|
| Rate for Payer: Healthscope Commercial |
$178.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.41
|
| Rate for Payer: Mclaren Medicaid |
$22.34
|
| Rate for Payer: Mclaren Medicare |
$41.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.76
|
| Rate for Payer: Meridian Medicaid |
$23.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.20
|
| Rate for Payer: Nomi Health Commercial |
$62.52
|
| Rate for Payer: PACE Medicare |
$39.60
|
| Rate for Payer: PACE SWMI |
$41.68
|
| Rate for Payer: PHP Commercial |
$168.20
|
| Rate for Payer: PHP Medicare Advantage |
$41.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$128.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$41.68
|
| Rate for Payer: Priority Health Medicare |
$41.68
|
| Rate for Payer: Priority Health Narrow Network |
$33.34
|
| Rate for Payer: Priority Health SBD |
$124.66
|
| Rate for Payer: Railroad Medicare Medicare |
$41.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.68
|
| Rate for Payer: UHC Exchange |
$41.68
|
| Rate for Payer: UHC Medicare Advantage |
$41.68
|
| Rate for Payer: UHCCP Medicaid |
$22.34
|
| Rate for Payer: UMR Bronson Commercial |
$73.22
|
| Rate for Payer: VA VA |
$41.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.41
|
|
|
HC MUCORE RACEMOSUS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200093
|
|
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
|
|
