|
HC NETTLE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC NETTLE IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200049
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
OP
|
$135.25
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$50.04 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$87.91
|
| Rate for Payer: Aetna Commercial |
$114.96
|
| Rate for Payer: Aetna Medicare |
$67.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.91
|
| Rate for Payer: BCBS Complete |
$54.10
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$94.68
|
| Rate for Payer: Cofinity Commercial |
$116.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$94.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Healthscope Commercial |
$121.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: PHP Commercial |
$114.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.91
|
| Rate for Payer: Priority Health SBD |
$85.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.50
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Exchange |
$64.09
|
| Rate for Payer: UMR Bronson Commercial |
$50.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM EA ADDL HR
|
Facility
|
IP
|
$135.25
|
|
|
Service Code
|
CPT 96121
|
| Hospital Charge Code |
91800006
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$59.51 |
| Max. Negotiated Rate |
$121.72 |
| Rate for Payer: Aetna American Axle |
$87.91
|
| Rate for Payer: Aetna Commercial |
$114.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.91
|
| Rate for Payer: Cash Price |
$108.20
|
| Rate for Payer: Cofinity Commercial |
$116.32
|
| Rate for Payer: Cofinity Commercial |
$94.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$94.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.20
|
| Rate for Payer: Healthscope Commercial |
$121.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.96
|
| Rate for Payer: PHP Commercial |
$114.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.91
|
| Rate for Payer: Priority Health SBD |
$85.21
|
| Rate for Payer: UMR Bronson Commercial |
$59.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.44
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
OP
|
$275.10
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$76.80 |
| Max. Negotiated Rate |
$958.92 |
| Rate for Payer: Aetna American Axle |
$178.82
|
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna Medicare |
$317.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$381.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$381.38
|
| Rate for Payer: BCBS Complete |
$171.71
|
| Rate for Payer: BCBS MAPPO |
$305.10
|
| Rate for Payer: BCN Medicare Advantage |
$305.10
|
| Rate for Payer: Cash Price |
$220.08
|
| Rate for Payer: Cash Price |
$220.08
|
| Rate for Payer: Cash Price |
$220.08
|
| Rate for Payer: Cofinity Commercial |
$192.57
|
| Rate for Payer: Cofinity Commercial |
$236.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$192.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$305.10
|
| Rate for Payer: Healthscope Commercial |
$247.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.32
|
| Rate for Payer: Mclaren Medicaid |
$163.53
|
| Rate for Payer: Mclaren Medicare |
$305.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$320.36
|
| Rate for Payer: Meridian Medicaid |
$171.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$350.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.84
|
| Rate for Payer: Nomi Health Commercial |
$915.30
|
| Rate for Payer: PACE Medicare |
$289.84
|
| Rate for Payer: PACE SWMI |
$305.10
|
| Rate for Payer: PHP Commercial |
$233.84
|
| Rate for Payer: PHP Medicare Advantage |
$305.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.82
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$958.92
|
| Rate for Payer: Priority Health Medicare |
$305.10
|
| Rate for Payer: Priority Health Narrow Network |
$767.14
|
| Rate for Payer: Priority Health SBD |
$173.31
|
| Rate for Payer: Railroad Medicare Medicare |
$305.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.48
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$305.10
|
| Rate for Payer: UHC Exchange |
$76.80
|
| Rate for Payer: UHC Medicare Advantage |
$305.10
|
| Rate for Payer: UHCCP Medicaid |
$163.53
|
| Rate for Payer: UMR Bronson Commercial |
$101.79
|
| Rate for Payer: VA VA |
$305.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.32
|
|
|
HC NEUROBEHAVIORAL STATUS EXAM FIRST HOUR
|
Facility
|
IP
|
$275.10
|
|
|
Service Code
|
CPT 96116
|
| Hospital Charge Code |
91800001
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$121.04 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna American Axle |
$178.82
|
| Rate for Payer: Aetna Commercial |
$233.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$178.82
|
| Rate for Payer: Cash Price |
$220.08
|
| Rate for Payer: Cofinity Commercial |
$192.57
|
| Rate for Payer: Cofinity Commercial |
$236.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$192.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.08
|
| Rate for Payer: Healthscope Commercial |
$247.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$192.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.84
|
| Rate for Payer: PHP Commercial |
$233.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$178.82
|
| Rate for Payer: Priority Health SBD |
$173.31
|
| Rate for Payer: UMR Bronson Commercial |
$121.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.32
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
IP
|
$11,880.07
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,227.23 |
| Max. Negotiated Rate |
$10,692.06 |
| Rate for Payer: Aetna American Axle |
$7,722.05
|
| Rate for Payer: Aetna Commercial |
$10,098.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,722.05
|
| Rate for Payer: Cash Price |
$9,504.06
|
| Rate for Payer: Cofinity Commercial |
$10,216.86
|
| Rate for Payer: Cofinity Commercial |
$8,316.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,316.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,504.06
|
| Rate for Payer: Healthscope Commercial |
$10,692.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,316.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,910.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,098.06
|
| Rate for Payer: PHP Commercial |
$10,098.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,722.05
|
| Rate for Payer: Priority Health SBD |
$7,484.44
|
| Rate for Payer: UMR Bronson Commercial |
$5,227.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,910.05
|
|
|
HC NEUROFORM ATLAS STENT
|
Facility
|
OP
|
$11,880.07
|
|
| Hospital Charge Code |
27800118
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,395.63 |
| Max. Negotiated Rate |
$10,692.06 |
| Rate for Payer: Aetna American Axle |
$7,722.05
|
| Rate for Payer: Aetna Commercial |
$10,098.06
|
| Rate for Payer: Aetna Medicare |
$5,940.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,722.05
|
| Rate for Payer: BCBS Complete |
$4,752.03
|
| Rate for Payer: Cash Price |
$9,504.06
|
| Rate for Payer: Cofinity Commercial |
$10,216.86
|
| Rate for Payer: Cofinity Commercial |
$8,316.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,316.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,504.06
|
| Rate for Payer: Healthscope Commercial |
$10,692.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,316.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,910.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,098.06
|
| Rate for Payer: PHP Commercial |
$10,098.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,722.05
|
| Rate for Payer: Priority Health SBD |
$7,484.44
|
| Rate for Payer: UMR Bronson Commercial |
$4,395.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,910.05
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
OP
|
$1,929.94
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$152.90 |
| Max. Negotiated Rate |
$2,741.59 |
| Rate for Payer: Aetna American Axle |
$1,254.46
|
| Rate for Payer: Aetna Commercial |
$1,640.45
|
| Rate for Payer: Aetna Medicare |
$907.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,254.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,090.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,090.36
|
| Rate for Payer: BCBS Complete |
$490.92
|
| Rate for Payer: BCBS MAPPO |
$872.29
|
| Rate for Payer: BCBS Trust/PPO |
$966.07
|
| Rate for Payer: BCN Commercial |
$966.07
|
| Rate for Payer: BCN Medicare Advantage |
$872.29
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cofinity Commercial |
$1,659.75
|
| Rate for Payer: Cofinity Commercial |
$1,350.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,350.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,543.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$872.29
|
| Rate for Payer: Healthscope Commercial |
$1,736.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,350.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,447.46
|
| Rate for Payer: Mclaren Medicaid |
$467.55
|
| Rate for Payer: Mclaren Medicare |
$872.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$915.90
|
| Rate for Payer: Meridian Medicaid |
$490.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,003.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,640.45
|
| Rate for Payer: Nomi Health Commercial |
$1,831.81
|
| Rate for Payer: PACE Medicare |
$828.68
|
| Rate for Payer: PACE SWMI |
$872.29
|
| Rate for Payer: PHP Commercial |
$1,640.45
|
| Rate for Payer: PHP Medicare Advantage |
$872.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$467.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,741.59
|
| Rate for Payer: Priority Health Medicare |
$872.29
|
| Rate for Payer: Priority Health Narrow Network |
$2,193.27
|
| Rate for Payer: Priority Health SBD |
$1,215.86
|
| Rate for Payer: Railroad Medicare Medicare |
$872.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.19
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$872.29
|
| Rate for Payer: UHC Exchange |
$152.90
|
| Rate for Payer: UHC Medicare Advantage |
$872.29
|
| Rate for Payer: UHCCP Medicaid |
$467.55
|
| Rate for Payer: UMR Bronson Commercial |
$714.08
|
| Rate for Payer: VA VA |
$872.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,447.46
|
|
|
HC NEUROLYSIS CELIAC PLEXUS
|
Facility
|
IP
|
$1,929.94
|
|
|
Service Code
|
CPT 64680
|
| Hospital Charge Code |
36100479
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$849.17 |
| Max. Negotiated Rate |
$1,736.95 |
| Rate for Payer: Aetna American Axle |
$1,254.46
|
| Rate for Payer: Aetna Commercial |
$1,640.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,254.46
|
| Rate for Payer: Cash Price |
$1,543.95
|
| Rate for Payer: Cofinity Commercial |
$1,350.96
|
| Rate for Payer: Cofinity Commercial |
$1,659.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,350.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,543.95
|
| Rate for Payer: Healthscope Commercial |
$1,736.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,350.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,447.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,640.45
|
| Rate for Payer: PHP Commercial |
$1,640.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,254.46
|
| Rate for Payer: Priority Health SBD |
$1,215.86
|
| Rate for Payer: UMR Bronson Commercial |
$849.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,447.46
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.86 |
| 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 |
$19.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.00
|
| Rate for Payer: BCBS Complete |
$10.36
|
| Rate for Payer: BCBS MAPPO |
$18.40
|
| Rate for Payer: BCBS Trust/PPO |
$17.73
|
| Rate for Payer: BCN Commercial |
$17.73
|
| Rate for Payer: BCN Medicare Advantage |
$18.40
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Cofinity Commercial |
$48.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.40
|
| 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 |
$9.86
|
| Rate for Payer: Mclaren Medicare |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.32
|
| Rate for Payer: Meridian Medicaid |
$10.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$27.60
|
| Rate for Payer: PACE Medicare |
$17.48
|
| Rate for Payer: PACE SWMI |
$18.40
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$18.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.40
|
| Rate for Payer: Priority Health Medicare |
$18.40
|
| Rate for Payer: Priority Health Narrow Network |
$14.72
|
| Rate for Payer: Priority Health SBD |
$43.26
|
| Rate for Payer: Railroad Medicare Medicare |
$18.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.40
|
| Rate for Payer: UHC Exchange |
$18.40
|
| Rate for Payer: UHC Medicare Advantage |
$18.40
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: UMR Bronson Commercial |
$25.41
|
| Rate for Payer: VA VA |
$18.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC NEURONAL (V-G)K+ CHANNEL AB
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 83519
|
| Hospital Charge Code |
30100607
|
|
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 Commercial |
$48.07
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.07
|
| 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: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.64
|
| 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 NEURON SPECIFIC ENOLASE
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$63.68 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna American Axle |
$45.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$16.64
|
| Rate for Payer: BCN Commercial |
$16.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Commercial |
$49.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$63.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$25.90
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$13.82
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: UMR Bronson Commercial |
$26.18
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC NEURON SPECIFIC ENOLASE
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100260
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$63.68 |
| Rate for Payer: Aetna American Axle |
$45.99
|
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.99
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$49.52
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.99
|
| Rate for Payer: Priority Health SBD |
$44.57
|
| Rate for Payer: UMR Bronson Commercial |
$31.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC NEUROPSYCH TEST EVAL BY PHYS FIRST HR
|
Facility
|
IP
|
$69.71
|
|
|
Service Code
|
CPT 96132
|
| Hospital Charge Code |
91800007
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna American Axle |
$45.31
|
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.31
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.31
|
| Rate for Payer: Priority Health SBD |
$43.92
|
| Rate for Payer: UMR Bronson Commercial |
$30.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC NEUROPSYCH TEST EVAL BY PHYS FIRST HR
|
Facility
|
OP
|
$69.71
|
|
|
Service Code
|
CPT 96132
|
| Hospital Charge Code |
91800007
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$25.79 |
| Max. Negotiated Rate |
$1,633.95 |
| Rate for Payer: Aetna American Axle |
$45.31
|
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$540.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.87
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Mclaren Medicaid |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$1,559.61
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,633.95
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,307.16
|
| Rate for Payer: Priority Health SBD |
$43.92
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.09
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$101.90
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: UMR Bronson Commercial |
$25.79
|
| Rate for Payer: VA VA |
$519.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC NEUROPSYCH TEST EVAL EA ADDL HR
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 96133
|
| Hospital Charge Code |
91800008
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$13.47 |
| Max. Negotiated Rate |
$491.00 |
| Rate for Payer: Aetna American Axle |
$23.67
|
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$18.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: BCBS Complete |
$14.56
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.92
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Exchange |
$73.56
|
| Rate for Payer: UMR Bronson Commercial |
$13.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC NEUROPSYCH TEST EVAL EA ADDL HR
|
Facility
|
IP
|
$36.41
|
|
|
Service Code
|
CPT 96133
|
| Hospital Charge Code |
91800008
|
|
Hospital Revenue Code
|
918
|
| Min. Negotiated Rate |
$16.02 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna American Axle |
$23.67
|
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$25.49
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$25.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.67
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: UMR Bronson Commercial |
$16.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 15
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$566.10 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$765.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: BCBS Complete |
$612.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: UMR Bronson Commercial |
$566.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 15
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27800137
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$673.20 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna American Axle |
$994.50
|
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$994.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,071.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health SBD |
$963.90
|
| Rate for Payer: UMR Bronson Commercial |
$673.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 25
|
Facility
|
OP
|
$2,550.00
|
|
|
Service Code
|
CPT C1897
|
| Hospital Charge Code |
27800138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$943.50 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Aetna American Axle |
$1,657.50
|
| Rate for Payer: Aetna Commercial |
$2,167.50
|
| Rate for Payer: Aetna Medicare |
$1,275.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.50
|
| Rate for Payer: BCBS Complete |
$1,020.00
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$1,785.00
|
| Rate for Payer: Cofinity Commercial |
$2,193.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,785.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.00
|
| Rate for Payer: Healthscope Commercial |
$2,295.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,785.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.50
|
| Rate for Payer: PHP Commercial |
$2,167.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.50
|
| Rate for Payer: Priority Health SBD |
$1,606.50
|
| Rate for Payer: UMR Bronson Commercial |
$943.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.50
|
|
|
HC NEUROSTIMULATOR TEST KIT LVL 25
|
Facility
|
IP
|
$2,550.00
|
|
|
Service Code
|
CPT C1897
|
| Hospital Charge Code |
27800138
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,122.00 |
| Max. Negotiated Rate |
$2,295.00 |
| Rate for Payer: Aetna American Axle |
$1,657.50
|
| Rate for Payer: Aetna Commercial |
$2,167.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,657.50
|
| Rate for Payer: Cash Price |
$2,040.00
|
| Rate for Payer: Cofinity Commercial |
$1,785.00
|
| Rate for Payer: Cofinity Commercial |
$2,193.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,785.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.00
|
| Rate for Payer: Healthscope Commercial |
$2,295.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,785.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.50
|
| Rate for Payer: PHP Commercial |
$2,167.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,657.50
|
| Rate for Payer: Priority Health SBD |
$1,606.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,122.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.50
|
|
|
HC NEUTROPHIL OXIDATIVE BURST
|
Facility
|
IP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.68 |
| Max. Negotiated Rate |
$142.52 |
| Rate for Payer: Aetna American Axle |
$102.93
|
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.93
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$110.85
|
| Rate for Payer: Cofinity Commercial |
$136.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$110.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Healthscope Commercial |
$142.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: Priority Health SBD |
$99.77
|
| Rate for Payer: UMR Bronson Commercial |
$69.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.77
|
|
|
HC NEUTROPHIL OXIDATIVE BURST
|
Facility
|
OP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000003
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$58.59 |
| Max. Negotiated Rate |
$1,107.72 |
| Rate for Payer: Aetna American Axle |
$102.93
|
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: Aetna Medicare |
$366.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.93
|
| 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 |
$126.69
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$136.19
|
| Rate for Payer: Cofinity Commercial |
$110.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$110.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$142.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.77
|
| 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 |
$134.61
|
| 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 |
$134.61
|
| 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 |
$102.93
|
| 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 |
$99.77
|
| 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 |
$58.59
|
| Rate for Payer: VA VA |
$352.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.77
|
|
|
HC NEUTROPHIL OXIDATIVE BURST CMP
|
Facility
|
OP
|
$56.18
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000012
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$50.56 |
| Rate for Payer: Aetna American Axle |
$36.52
|
| Rate for Payer: Aetna Commercial |
$47.75
|
| Rate for Payer: Aetna Medicare |
$28.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.52
|
| Rate for Payer: BCBS Complete |
$22.47
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cash Price |
$44.94
|
| Rate for Payer: Cofinity Commercial |
$39.33
|
| Rate for Payer: Cofinity Commercial |
$48.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.94
|
| Rate for Payer: Healthscope Commercial |
$50.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.75
|
| Rate for Payer: PHP Commercial |
$47.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.52
|
| Rate for Payer: Priority Health SBD |
$35.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$20.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.14
|
|
