|
HC PANCREATIC AMYLASE
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.21 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna American Axle |
$44.64
|
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.64
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Advantage |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.50
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health SBD |
$43.26
|
| Rate for Payer: UMR Bronson Commercial |
$30.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna American Axle |
$44.64
|
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.56
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$7.49
|
| Rate for Payer: BCN Commercial |
$7.49
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Advantage |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$6.48
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$6.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.50
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.48
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health SBD |
$43.26
|
| Rate for Payer: Priority Health Tiered Network |
$5.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.72
|
| Rate for Payer: UHC Core |
$9.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.48
|
| Rate for Payer: UHC Exchange |
$9.72
|
| Rate for Payer: UHC Medicaid |
$3.39
|
| Rate for Payer: UHCCP Medicaid |
$3.39
|
| Rate for Payer: UMR Bronson Commercial |
$25.41
|
| Rate for Payer: VA VA |
$6.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Advantage |
$83.75
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: UMR Bronson Commercial |
$52.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$23.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.71
|
| Rate for Payer: BCBS Complete |
$12.62
|
| Rate for Payer: BCBS MAPPO |
$22.97
|
| Rate for Payer: BCBS Trust/PPO |
$26.56
|
| Rate for Payer: BCN Commercial |
$26.56
|
| Rate for Payer: BCN Medicare Advantage |
$22.97
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Advantage |
$83.75
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$22.97
|
| Rate for Payer: Mclaren Medicare |
$22.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.12
|
| Rate for Payer: Meridian Medicaid |
$24.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$34.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PACE Medicare |
$21.82
|
| Rate for Payer: PACE SWMI |
$22.97
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$22.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.97
|
| Rate for Payer: Priority Health Medicare |
$22.97
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: Priority Health Tiered Network |
$18.38
|
| Rate for Payer: Railroad Medicare Medicare |
$22.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.46
|
| Rate for Payer: UHC Core |
$34.46
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.97
|
| Rate for Payer: UHC Exchange |
$34.46
|
| Rate for Payer: UHC Medicaid |
$12.01
|
| Rate for Payer: UHCCP Medicaid |
$12.01
|
| Rate for Payer: UMR Bronson Commercial |
$44.27
|
| Rate for Payer: VA VA |
$22.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.37 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna American Axle |
$72.93
|
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Advantage |
$78.54
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.15
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health SBD |
$70.69
|
| Rate for Payer: UMR Bronson Commercial |
$49.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.92 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna American Axle |
$72.93
|
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna Medicare |
$17.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.32
|
| Rate for Payer: BCBS Complete |
$9.37
|
| Rate for Payer: BCBS MAPPO |
$17.06
|
| Rate for Payer: BCBS Trust/PPO |
$19.73
|
| Rate for Payer: BCN Commercial |
$19.73
|
| Rate for Payer: BCN Medicare Advantage |
$17.06
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Advantage |
$78.54
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Mclaren Medicaid |
$17.06
|
| Rate for Payer: Mclaren Medicare |
$17.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.91
|
| Rate for Payer: Meridian Medicaid |
$17.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.15
|
| Rate for Payer: PACE Medicare |
$16.21
|
| Rate for Payer: PACE SWMI |
$17.06
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: PHP Medicare Advantage |
$17.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.06
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health SBD |
$70.69
|
| Rate for Payer: Priority Health Tiered Network |
$13.65
|
| Rate for Payer: Railroad Medicare Medicare |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.59
|
| Rate for Payer: UHC Core |
$25.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.06
|
| Rate for Payer: UHC Exchange |
$25.59
|
| Rate for Payer: UHC Medicaid |
$8.92
|
| Rate for Payer: UHCCP Medicaid |
$8.92
|
| Rate for Payer: UMR Bronson Commercial |
$41.51
|
| Rate for Payer: VA VA |
$17.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC PAPER WASP IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC PAPER WASP IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC PAP NAP
|
Facility
|
IP
|
$2,358.48
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$1,037.73 |
| Max. Negotiated Rate |
$2,122.63 |
| Rate for Payer: Aetna American Axle |
$1,533.01
|
| Rate for Payer: Aetna Commercial |
$2,004.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,533.01
|
| Rate for Payer: Cash Price |
$1,886.78
|
| Rate for Payer: Cofinity Advantage |
$1,650.94
|
| Rate for Payer: Cofinity Commercial |
$2,028.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,886.78
|
| Rate for Payer: Healthscope Commercial |
$2,122.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,650.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,768.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,004.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,768.86
|
| Rate for Payer: PHP Commercial |
$2,004.71
|
| Rate for Payer: Priority Health SBD |
$1,485.84
|
| Rate for Payer: UMR Bronson Commercial |
$1,037.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,768.86
|
|
|
HC PAP NAP
|
Facility
|
OP
|
$2,358.48
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$194.46 |
| Max. Negotiated Rate |
$2,122.63 |
| Rate for Payer: Aetna American Axle |
$1,533.01
|
| Rate for Payer: Aetna Commercial |
$2,004.71
|
| Rate for Payer: Aetna Medicare |
$386.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,533.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$464.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$464.77
|
| Rate for Payer: BCBS Complete |
$204.20
|
| Rate for Payer: BCBS MAPPO |
$371.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,187.69
|
| Rate for Payer: BCN Commercial |
$1,187.69
|
| Rate for Payer: BCN Medicare Advantage |
$371.82
|
| Rate for Payer: Cash Price |
$1,886.78
|
| Rate for Payer: Cash Price |
$1,886.78
|
| Rate for Payer: Cofinity Advantage |
$1,650.94
|
| Rate for Payer: Cofinity Commercial |
$2,028.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,886.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$371.82
|
| Rate for Payer: Healthscope Commercial |
$2,122.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,650.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,768.86
|
| Rate for Payer: Mclaren Medicaid |
$371.82
|
| Rate for Payer: Mclaren Medicare |
$371.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$390.41
|
| Rate for Payer: Meridian Medicaid |
$390.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$427.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$409.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,004.71
|
| Rate for Payer: Nomi Health Commercial |
$1,115.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,768.86
|
| Rate for Payer: PACE Medicare |
$353.23
|
| Rate for Payer: PACE SWMI |
$371.82
|
| Rate for Payer: PHP Commercial |
$2,004.71
|
| Rate for Payer: PHP Medicare Advantage |
$371.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,202.41
|
| Rate for Payer: Priority Health Medicare |
$371.82
|
| Rate for Payer: Priority Health SBD |
$1,485.84
|
| Rate for Payer: Priority Health Tiered Network |
$961.93
|
| Rate for Payer: Railroad Medicare Medicare |
$371.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,533.01
|
| Rate for Payer: UHC Core |
$1,228.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$371.82
|
| Rate for Payer: UHC Exchange |
$926.88
|
| Rate for Payer: UHC Medicaid |
$194.46
|
| Rate for Payer: UHCCP Medicaid |
$194.46
|
| Rate for Payer: UMR Bronson Commercial |
$872.64
|
| Rate for Payer: VA VA |
$371.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,768.86
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$25.18 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Advantage |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: UMR Bronson Commercial |
$25.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC PAP SMEAR, SCREENING
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
HCPCS P3000
|
| Hospital Charge Code |
31100027
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.70 |
| Max. Negotiated Rate |
$55.62 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$19.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.18
|
| Rate for Payer: BCBS Complete |
$10.18
|
| Rate for Payer: BCBS MAPPO |
$18.54
|
| Rate for Payer: BCBS Trust/PPO |
$21.02
|
| Rate for Payer: BCN Commercial |
$21.02
|
| Rate for Payer: BCN Medicare Advantage |
$18.54
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Advantage |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.54
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Mclaren Medicaid |
$18.54
|
| Rate for Payer: Mclaren Medicare |
$18.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.47
|
| Rate for Payer: Meridian Medicaid |
$19.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$55.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PACE Medicare |
$17.61
|
| Rate for Payer: PACE SWMI |
$18.54
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$18.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.19
|
| Rate for Payer: Priority Health Medicare |
$18.54
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: Priority Health Tiered Network |
$14.55
|
| Rate for Payer: Railroad Medicare Medicare |
$18.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.29
|
| Rate for Payer: UHC Core |
$27.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.54
|
| Rate for Payer: UHC Exchange |
$27.29
|
| Rate for Payer: UHC Medicaid |
$9.70
|
| Rate for Payer: UHCCP Medicaid |
$9.70
|
| Rate for Payer: UMR Bronson Commercial |
$21.17
|
| Rate for Payer: VA VA |
$18.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC PARACENTESIS
|
Facility
|
IP
|
$1,015.62
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$446.87 |
| Max. Negotiated Rate |
$914.06 |
| Rate for Payer: Aetna American Axle |
$660.15
|
| Rate for Payer: Aetna Commercial |
$863.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.15
|
| Rate for Payer: Cash Price |
$812.50
|
| Rate for Payer: Cofinity Advantage |
$710.93
|
| Rate for Payer: Cofinity Commercial |
$873.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$812.50
|
| Rate for Payer: Healthscope Commercial |
$914.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$710.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$761.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$863.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$761.72
|
| Rate for Payer: PHP Commercial |
$863.28
|
| Rate for Payer: Priority Health SBD |
$639.84
|
| Rate for Payer: UMR Bronson Commercial |
$446.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$761.72
|
|
|
HC PARACENTESIS
|
Facility
|
OP
|
$1,015.62
|
|
| Hospital Charge Code |
36000078
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$375.78 |
| Max. Negotiated Rate |
$914.06 |
| Rate for Payer: Aetna American Axle |
$660.15
|
| Rate for Payer: Aetna Commercial |
$863.28
|
| Rate for Payer: Aetna Medicare |
$507.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$660.15
|
| Rate for Payer: BCBS Complete |
$406.25
|
| Rate for Payer: Cash Price |
$812.50
|
| Rate for Payer: Cofinity Advantage |
$710.93
|
| Rate for Payer: Cofinity Commercial |
$873.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$812.50
|
| Rate for Payer: Healthscope Commercial |
$914.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$710.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$761.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$812.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$863.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$761.72
|
| Rate for Payer: PHP Commercial |
$863.28
|
| Rate for Payer: Priority Health SBD |
$639.84
|
| Rate for Payer: UMR Bronson Commercial |
$375.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$761.72
|
|
|
HC PARACERVIAL/PUDENDAL ANES
|
Facility
|
IP
|
$387.95
|
|
| Hospital Charge Code |
37000004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$170.70 |
| Max. Negotiated Rate |
$349.15 |
| Rate for Payer: Aetna American Axle |
$252.17
|
| Rate for Payer: Aetna Commercial |
$329.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.17
|
| Rate for Payer: Cash Price |
$310.36
|
| Rate for Payer: Cofinity Advantage |
$271.56
|
| Rate for Payer: Cofinity Commercial |
$333.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.36
|
| Rate for Payer: Healthscope Commercial |
$349.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$271.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.96
|
| Rate for Payer: PHP Commercial |
$329.76
|
| Rate for Payer: Priority Health SBD |
$244.41
|
| Rate for Payer: UMR Bronson Commercial |
$170.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.96
|
|
|
HC PARACERVIAL/PUDENDAL ANES
|
Facility
|
OP
|
$387.95
|
|
| Hospital Charge Code |
37000004
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$143.54 |
| Max. Negotiated Rate |
$349.15 |
| Rate for Payer: Aetna American Axle |
$252.17
|
| Rate for Payer: Aetna Commercial |
$329.76
|
| Rate for Payer: Aetna Medicare |
$193.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.17
|
| Rate for Payer: BCBS Complete |
$155.18
|
| Rate for Payer: Cash Price |
$310.36
|
| Rate for Payer: Cofinity Advantage |
$271.56
|
| Rate for Payer: Cofinity Commercial |
$333.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.36
|
| Rate for Payer: Healthscope Commercial |
$349.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$271.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$310.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.96
|
| Rate for Payer: PHP Commercial |
$329.76
|
| Rate for Payer: Priority Health SBD |
$244.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$252.17
|
| Rate for Payer: UHC Core |
$202.12
|
| Rate for Payer: UHC Exchange |
$152.46
|
| Rate for Payer: UMR Bronson Commercial |
$143.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.96
|
|
|
HC PARAFFIN BATH
|
Facility
|
OP
|
$65.79
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
43000008
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$5.60 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna American Axle |
$42.76
|
| Rate for Payer: Aetna Commercial |
$55.92
|
| Rate for Payer: Aetna Medicare |
$32.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.76
|
| Rate for Payer: BCBS Complete |
$26.32
|
| Rate for Payer: BCBS Trust/PPO |
$5.74
|
| Rate for Payer: BCN Commercial |
$5.74
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cofinity Advantage |
$46.05
|
| Rate for Payer: Cofinity Commercial |
$56.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.63
|
| Rate for Payer: Healthscope Commercial |
$59.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.92
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.34
|
| Rate for Payer: PHP Commercial |
$55.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.00
|
| Rate for Payer: Priority Health SBD |
$41.45
|
| Rate for Payer: Priority Health Tiered Network |
$5.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.76
|
| Rate for Payer: UHC Core |
$34.28
|
| Rate for Payer: UHC Exchange |
$25.86
|
| Rate for Payer: UMR Bronson Commercial |
$24.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.34
|
|
|
HC PARAFFIN BATH
|
Facility
|
IP
|
$65.79
|
|
|
Service Code
|
CPT 97018
|
| Hospital Charge Code |
43000008
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$28.95 |
| Max. Negotiated Rate |
$59.21 |
| Rate for Payer: Aetna American Axle |
$42.76
|
| Rate for Payer: Aetna Commercial |
$55.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$42.76
|
| Rate for Payer: Cash Price |
$52.63
|
| Rate for Payer: Cofinity Advantage |
$46.05
|
| Rate for Payer: Cofinity Commercial |
$56.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$52.63
|
| Rate for Payer: Healthscope Commercial |
$59.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.34
|
| Rate for Payer: PHP Commercial |
$55.92
|
| Rate for Payer: Priority Health SBD |
$41.45
|
| Rate for Payer: UMR Bronson Commercial |
$28.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.34
|
|
|
HC PARANEOPLAS AB EVAL CSF
|
Facility
|
OP
|
$108.20
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200470
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$97.38 |
| Rate for Payer: Aetna American Axle |
$70.33
|
| Rate for Payer: Aetna Commercial |
$91.97
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cofinity Advantage |
$75.74
|
| Rate for Payer: Cofinity Commercial |
$93.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$97.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.15
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.97
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.15
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$91.97
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$68.17
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$40.03
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.15
|
|
|
HC PARANEOPLAS AB EVAL CSF
|
Facility
|
IP
|
$108.20
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200470
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.61 |
| Max. Negotiated Rate |
$97.38 |
| Rate for Payer: Aetna American Axle |
$70.33
|
| Rate for Payer: Aetna Commercial |
$91.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$70.33
|
| Rate for Payer: Cash Price |
$86.56
|
| Rate for Payer: Cofinity Advantage |
$75.74
|
| Rate for Payer: Cofinity Commercial |
$93.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.56
|
| Rate for Payer: Healthscope Commercial |
$97.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.15
|
| Rate for Payer: PHP Commercial |
$91.97
|
| Rate for Payer: Priority Health SBD |
$68.17
|
| Rate for Payer: UMR Bronson Commercial |
$47.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.15
|
|
|
HC PARANEOPLAS AB EVAL CSF CMPT
|
Facility
|
IP
|
$83.83
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200471
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$36.89 |
| Max. Negotiated Rate |
$75.45 |
| Rate for Payer: Aetna American Axle |
$54.49
|
| Rate for Payer: Aetna Commercial |
$71.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.49
|
| Rate for Payer: Cash Price |
$67.06
|
| Rate for Payer: Cofinity Advantage |
$58.68
|
| Rate for Payer: Cofinity Commercial |
$72.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.06
|
| Rate for Payer: Healthscope Commercial |
$75.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.87
|
| Rate for Payer: PHP Commercial |
$71.26
|
| Rate for Payer: Priority Health SBD |
$52.81
|
| Rate for Payer: UMR Bronson Commercial |
$36.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.87
|
|
|
HC PARANEOPLAS AB EVAL CSF CMPT
|
Facility
|
OP
|
$83.83
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200471
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$75.45 |
| Rate for Payer: Aetna American Axle |
$54.49
|
| Rate for Payer: Aetna Commercial |
$71.26
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$67.06
|
| Rate for Payer: Cash Price |
$67.06
|
| Rate for Payer: Cofinity Advantage |
$58.68
|
| Rate for Payer: Cofinity Commercial |
$72.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$75.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.87
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.26
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.87
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$71.26
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$52.81
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$31.02
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.87
|
|
|
HC PARANEOPLASTIC AB CMPT
|
Facility
|
OP
|
$117.57
|
|
|
Service Code
|
CPT 86596
|
| Hospital Charge Code |
30200495
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna American Axle |
$76.42
|
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$13.93
|
| Rate for Payer: BCN Commercial |
$13.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Advantage |
$82.30
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$74.07
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$43.50
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC PARANEOPLASTIC AB CMPT
|
Facility
|
IP
|
$117.57
|
|
|
Service Code
|
CPT 86596
|
| Hospital Charge Code |
30200495
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.73 |
| Max. Negotiated Rate |
$105.81 |
| Rate for Payer: Aetna American Axle |
$76.42
|
| Rate for Payer: Aetna Commercial |
$99.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.42
|
| Rate for Payer: Cash Price |
$94.06
|
| Rate for Payer: Cofinity Advantage |
$82.30
|
| Rate for Payer: Cofinity Commercial |
$101.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.06
|
| Rate for Payer: Healthscope Commercial |
$105.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.18
|
| Rate for Payer: PHP Commercial |
$99.93
|
| Rate for Payer: Priority Health SBD |
$74.07
|
| Rate for Payer: UMR Bronson Commercial |
$51.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.18
|
|
|
HC PARANEOPLASTIC ANTIBODIES
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100263
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.01 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna American Axle |
$41.39
|
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.39
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Advantage |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health SBD |
$40.11
|
| Rate for Payer: UMR Bronson Commercial |
$28.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
