|
HC OLIGOCLONAL BANDS
|
Facility
|
OP
|
$44.80
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100371
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.68 |
| Max. Negotiated Rate |
$41.08 |
| Rate for Payer: Aetna American Axle |
$29.12
|
| Rate for Payer: Aetna Commercial |
$38.08
|
| Rate for Payer: Aetna Medicare |
$28.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.24
|
| Rate for Payer: BCBS Complete |
$15.42
|
| Rate for Payer: BCBS MAPPO |
$27.39
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$27.39
|
| Rate for Payer: Cash Price |
$35.84
|
| Rate for Payer: Cash Price |
$35.84
|
| Rate for Payer: Cofinity Commercial |
$38.53
|
| Rate for Payer: Cofinity Commercial |
$31.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$40.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.60
|
| Rate for Payer: Mclaren Medicaid |
$14.68
|
| Rate for Payer: Mclaren Medicare |
$27.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.76
|
| Rate for Payer: Meridian Medicaid |
$15.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.08
|
| Rate for Payer: Nomi Health Commercial |
$41.08
|
| Rate for Payer: PACE Medicare |
$26.02
|
| Rate for Payer: PACE SWMI |
$27.39
|
| Rate for Payer: PHP Commercial |
$38.08
|
| Rate for Payer: PHP Medicare Advantage |
$27.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.39
|
| Rate for Payer: Priority Health Medicare |
$27.39
|
| Rate for Payer: Priority Health Narrow Network |
$21.91
|
| Rate for Payer: Priority Health SBD |
$28.22
|
| Rate for Payer: Railroad Medicare Medicare |
$27.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.39
|
| Rate for Payer: UHC Exchange |
$27.39
|
| Rate for Payer: UHC Medicare Advantage |
$27.39
|
| Rate for Payer: UHCCP Medicaid |
$14.68
|
| Rate for Payer: UMR Bronson Commercial |
$16.58
|
| Rate for Payer: VA VA |
$27.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.60
|
|
|
HC OLIGOCLONAL BANDS
|
Facility
|
IP
|
$44.80
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100371
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.71 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: Aetna American Axle |
$29.12
|
| Rate for Payer: Aetna Commercial |
$38.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.12
|
| Rate for Payer: Cash Price |
$35.84
|
| Rate for Payer: Cofinity Commercial |
$31.36
|
| Rate for Payer: Cofinity Commercial |
$38.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.84
|
| Rate for Payer: Healthscope Commercial |
$40.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.08
|
| Rate for Payer: PHP Commercial |
$38.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.12
|
| Rate for Payer: Priority Health SBD |
$28.22
|
| Rate for Payer: UMR Bronson Commercial |
$19.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.60
|
|
|
HC OLIGOCLONAL BANDS CMPT
|
Facility
|
IP
|
$44.80
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100551
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.71 |
| Max. Negotiated Rate |
$40.32 |
| Rate for Payer: Aetna American Axle |
$29.12
|
| Rate for Payer: Aetna Commercial |
$38.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.12
|
| Rate for Payer: Cash Price |
$35.84
|
| Rate for Payer: Cofinity Commercial |
$31.36
|
| Rate for Payer: Cofinity Commercial |
$38.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.84
|
| Rate for Payer: Healthscope Commercial |
$40.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.08
|
| Rate for Payer: PHP Commercial |
$38.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.12
|
| Rate for Payer: Priority Health SBD |
$28.22
|
| Rate for Payer: UMR Bronson Commercial |
$19.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.60
|
|
|
HC OLIGOCLONAL BANDS CMPT
|
Facility
|
OP
|
$44.80
|
|
|
Service Code
|
CPT 83916
|
| Hospital Charge Code |
30100551
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.68 |
| Max. Negotiated Rate |
$41.08 |
| Rate for Payer: Aetna American Axle |
$29.12
|
| Rate for Payer: Aetna Commercial |
$38.08
|
| Rate for Payer: Aetna Medicare |
$28.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$29.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.24
|
| Rate for Payer: BCBS Complete |
$15.42
|
| Rate for Payer: BCBS MAPPO |
$27.39
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$27.39
|
| Rate for Payer: Cash Price |
$35.84
|
| Rate for Payer: Cash Price |
$35.84
|
| Rate for Payer: Cofinity Commercial |
$38.53
|
| Rate for Payer: Cofinity Commercial |
$31.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$31.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.39
|
| Rate for Payer: Healthscope Commercial |
$40.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$31.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.60
|
| Rate for Payer: Mclaren Medicaid |
$14.68
|
| Rate for Payer: Mclaren Medicare |
$27.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.76
|
| Rate for Payer: Meridian Medicaid |
$15.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.08
|
| Rate for Payer: Nomi Health Commercial |
$41.08
|
| Rate for Payer: PACE Medicare |
$26.02
|
| Rate for Payer: PACE SWMI |
$27.39
|
| Rate for Payer: PHP Commercial |
$38.08
|
| Rate for Payer: PHP Medicare Advantage |
$27.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.39
|
| Rate for Payer: Priority Health Medicare |
$27.39
|
| Rate for Payer: Priority Health Narrow Network |
$21.91
|
| Rate for Payer: Priority Health SBD |
$28.22
|
| Rate for Payer: Railroad Medicare Medicare |
$27.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.39
|
| Rate for Payer: UHC Exchange |
$27.39
|
| Rate for Payer: UHC Medicare Advantage |
$27.39
|
| Rate for Payer: UHCCP Medicaid |
$14.68
|
| Rate for Payer: UMR Bronson Commercial |
$16.58
|
| Rate for Payer: VA VA |
$27.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.60
|
|
|
HC OMMAYA
|
Facility
|
OP
|
$384.73
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
33500005
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$39.99 |
| Max. Negotiated Rate |
$1,021.42 |
| Rate for Payer: Aetna American Axle |
$250.07
|
| Rate for Payer: Aetna Commercial |
$327.02
|
| Rate for Payer: Aetna Medicare |
$337.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$406.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$406.22
|
| Rate for Payer: BCBS Complete |
$182.90
|
| Rate for Payer: BCBS MAPPO |
$324.98
|
| Rate for Payer: BCBS Trust/PPO |
$685.38
|
| Rate for Payer: BCN Commercial |
$685.38
|
| Rate for Payer: BCN Medicare Advantage |
$324.98
|
| Rate for Payer: Cash Price |
$307.78
|
| Rate for Payer: Cash Price |
$307.78
|
| Rate for Payer: Cofinity Commercial |
$330.87
|
| Rate for Payer: Cofinity Commercial |
$269.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$324.98
|
| Rate for Payer: Healthscope Commercial |
$346.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.55
|
| Rate for Payer: Mclaren Medicaid |
$174.19
|
| Rate for Payer: Mclaren Medicare |
$324.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$341.23
|
| Rate for Payer: Meridian Medicaid |
$182.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$373.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.02
|
| Rate for Payer: Nomi Health Commercial |
$974.94
|
| Rate for Payer: PACE Medicare |
$308.73
|
| Rate for Payer: PACE SWMI |
$324.98
|
| Rate for Payer: PHP Commercial |
$327.02
|
| Rate for Payer: PHP Medicare Advantage |
$324.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,021.42
|
| Rate for Payer: Priority Health Medicare |
$324.98
|
| Rate for Payer: Priority Health Narrow Network |
$817.14
|
| Rate for Payer: Priority Health SBD |
$242.38
|
| Rate for Payer: Railroad Medicare Medicare |
$324.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.99
|
| Rate for Payer: UHC Core |
$284.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$324.98
|
| Rate for Payer: UHC Exchange |
$39.99
|
| Rate for Payer: UHC Medicare Advantage |
$324.98
|
| Rate for Payer: UHCCP Medicaid |
$174.19
|
| Rate for Payer: UMR Bronson Commercial |
$142.35
|
| Rate for Payer: VA VA |
$324.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.55
|
|
|
HC OMMAYA
|
Facility
|
IP
|
$384.73
|
|
|
Service Code
|
CPT 96542
|
| Hospital Charge Code |
33500005
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$169.28 |
| Max. Negotiated Rate |
$346.26 |
| Rate for Payer: Aetna American Axle |
$250.07
|
| Rate for Payer: Aetna Commercial |
$327.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$250.07
|
| Rate for Payer: Cash Price |
$307.78
|
| Rate for Payer: Cofinity Commercial |
$269.31
|
| Rate for Payer: Cofinity Commercial |
$330.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$269.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.78
|
| Rate for Payer: Healthscope Commercial |
$346.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$269.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$327.02
|
| Rate for Payer: PHP Commercial |
$327.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$250.07
|
| Rate for Payer: Priority Health SBD |
$242.38
|
| Rate for Payer: UMR Bronson Commercial |
$169.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.55
|
|
|
HC OMNIPAQUE 300 PER ML
|
Facility
|
IP
|
$1.81
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600017
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$1.63 |
| Rate for Payer: Aetna American Axle |
$1.18
|
| Rate for Payer: Aetna Commercial |
$1.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.18
|
| Rate for Payer: Cash Price |
$1.45
|
| Rate for Payer: Cofinity Commercial |
$1.27
|
| Rate for Payer: Cofinity Commercial |
$1.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.45
|
| Rate for Payer: Healthscope Commercial |
$1.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.54
|
| Rate for Payer: PHP Commercial |
$1.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.18
|
| Rate for Payer: Priority Health SBD |
$1.14
|
| Rate for Payer: UMR Bronson Commercial |
$0.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.36
|
|
|
HC OMNIPAQUE 300 PER ML
|
Facility
|
OP
|
$1.81
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600017
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$1.63 |
| Rate for Payer: Aetna American Axle |
$1.18
|
| Rate for Payer: Aetna Commercial |
$1.54
|
| Rate for Payer: Aetna Medicare |
$0.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1.18
|
| Rate for Payer: BCBS Complete |
$0.72
|
| Rate for Payer: BCBS Trust/PPO |
$0.17
|
| Rate for Payer: BCN Commercial |
$0.17
|
| Rate for Payer: Cash Price |
$1.45
|
| Rate for Payer: Cash Price |
$1.45
|
| Rate for Payer: Cofinity Commercial |
$1.27
|
| Rate for Payer: Cofinity Commercial |
$1.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$1.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.45
|
| Rate for Payer: Healthscope Commercial |
$1.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.54
|
| Rate for Payer: PHP Commercial |
$1.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1.18
|
| Rate for Payer: Priority Health SBD |
$1.14
|
| Rate for Payer: UMR Bronson Commercial |
$0.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.36
|
|
|
HC OPEN HEART OFF BYPASS
|
Facility
|
IP
|
$5,803.80
|
|
| Hospital Charge Code |
27000702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,553.67 |
| Max. Negotiated Rate |
$5,223.42 |
| Rate for Payer: Aetna American Axle |
$3,772.47
|
| Rate for Payer: Aetna Commercial |
$4,933.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,772.47
|
| Rate for Payer: Cash Price |
$4,643.04
|
| Rate for Payer: Cofinity Commercial |
$4,062.66
|
| Rate for Payer: Cofinity Commercial |
$4,991.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,062.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,643.04
|
| Rate for Payer: Healthscope Commercial |
$5,223.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,062.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,352.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,933.23
|
| Rate for Payer: PHP Commercial |
$4,933.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,772.47
|
| Rate for Payer: Priority Health SBD |
$3,656.39
|
| Rate for Payer: UMR Bronson Commercial |
$2,553.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,352.85
|
|
|
HC OPEN HEART OFF BYPASS
|
Facility
|
OP
|
$5,803.80
|
|
| Hospital Charge Code |
27000702
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2,147.41 |
| Max. Negotiated Rate |
$5,223.42 |
| Rate for Payer: Aetna American Axle |
$3,772.47
|
| Rate for Payer: Aetna Commercial |
$4,933.23
|
| Rate for Payer: Aetna Medicare |
$2,901.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,772.47
|
| Rate for Payer: BCBS Complete |
$2,321.52
|
| Rate for Payer: Cash Price |
$4,643.04
|
| Rate for Payer: Cofinity Commercial |
$4,062.66
|
| Rate for Payer: Cofinity Commercial |
$4,991.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,062.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,643.04
|
| Rate for Payer: Healthscope Commercial |
$5,223.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,062.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,352.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,933.23
|
| Rate for Payer: PHP Commercial |
$4,933.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,772.47
|
| Rate for Payer: Priority Health SBD |
$3,656.39
|
| Rate for Payer: UMR Bronson Commercial |
$2,147.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,352.85
|
|
|
HC OPEN HEART PLATELET MAPPING
|
Facility
|
IP
|
$944.00
|
|
| Hospital Charge Code |
27000388
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$415.36 |
| Max. Negotiated Rate |
$849.60 |
| Rate for Payer: Priority Health SBD |
$594.72
|
| Rate for Payer: UMR Bronson Commercial |
$415.36
|
| Rate for Payer: Aetna American Axle |
$613.60
|
| Rate for Payer: Aetna Commercial |
$802.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.60
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$811.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$660.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$755.20
|
| Rate for Payer: Healthscope Commercial |
$849.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$660.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$708.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.40
|
| Rate for Payer: PHP Commercial |
$802.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$708.00
|
|
|
HC OPEN HEART PLATELET MAPPING
|
Facility
|
OP
|
$944.00
|
|
| Hospital Charge Code |
27000388
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$349.28 |
| Max. Negotiated Rate |
$849.60 |
| Rate for Payer: Aetna American Axle |
$613.60
|
| Rate for Payer: Aetna Commercial |
$802.40
|
| Rate for Payer: Aetna Medicare |
$472.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$613.60
|
| Rate for Payer: BCBS Complete |
$377.60
|
| Rate for Payer: Cash Price |
$755.20
|
| Rate for Payer: Cofinity Commercial |
$660.80
|
| Rate for Payer: Cofinity Commercial |
$811.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$660.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$755.20
|
| Rate for Payer: Healthscope Commercial |
$849.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$660.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$708.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$802.40
|
| Rate for Payer: PHP Commercial |
$802.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$613.60
|
| Rate for Payer: Priority Health SBD |
$594.72
|
| Rate for Payer: UMR Bronson Commercial |
$349.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$708.00
|
|
|
HC OPEN HEART TEG
|
Facility
|
OP
|
$552.37
|
|
| Hospital Charge Code |
27000199
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$204.38 |
| Max. Negotiated Rate |
$497.13 |
| Rate for Payer: Aetna American Axle |
$359.04
|
| Rate for Payer: Aetna Commercial |
$469.51
|
| Rate for Payer: Aetna Medicare |
$276.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.04
|
| Rate for Payer: BCBS Complete |
$220.95
|
| Rate for Payer: Cash Price |
$441.90
|
| Rate for Payer: Cofinity Commercial |
$386.66
|
| Rate for Payer: Cofinity Commercial |
$475.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$386.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.90
|
| Rate for Payer: Healthscope Commercial |
$497.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$386.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.51
|
| Rate for Payer: PHP Commercial |
$469.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.04
|
| Rate for Payer: Priority Health SBD |
$347.99
|
| Rate for Payer: UMR Bronson Commercial |
$204.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.28
|
|
|
HC OPEN HEART TEG
|
Facility
|
IP
|
$552.37
|
|
| Hospital Charge Code |
27000199
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$243.04 |
| Max. Negotiated Rate |
$497.13 |
| Rate for Payer: PHP Commercial |
$469.51
|
| Rate for Payer: Aetna American Axle |
$359.04
|
| Rate for Payer: Aetna Commercial |
$469.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$359.04
|
| Rate for Payer: Cash Price |
$441.90
|
| Rate for Payer: Cofinity Commercial |
$386.66
|
| Rate for Payer: Cofinity Commercial |
$475.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$386.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$441.90
|
| Rate for Payer: Healthscope Commercial |
$497.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$386.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$414.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$469.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.04
|
| Rate for Payer: Priority Health SBD |
$347.99
|
| Rate for Payer: UMR Bronson Commercial |
$243.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$414.28
|
|
|
HC OP FALSE LABOR 1ST HOUR
|
Facility
|
OP
|
$349.23
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900001
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$129.22 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna American Axle |
$227.00
|
| Rate for Payer: Aetna Commercial |
$296.85
|
| Rate for Payer: Aetna Medicare |
$174.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.00
|
| Rate for Payer: BCBS Complete |
$139.69
|
| Rate for Payer: Cash Price |
$279.38
|
| Rate for Payer: Cash Price |
$279.38
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Cofinity Commercial |
$244.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$244.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.38
|
| Rate for Payer: Healthscope Commercial |
$314.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$244.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.85
|
| Rate for Payer: PHP Commercial |
$296.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.00
|
| Rate for Payer: Priority Health SBD |
$220.01
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$129.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.92
|
|
|
HC OP FALSE LABOR 1ST HOUR
|
Facility
|
IP
|
$349.23
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900001
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$153.66 |
| Max. Negotiated Rate |
$314.31 |
| Rate for Payer: Aetna American Axle |
$227.00
|
| Rate for Payer: Aetna Commercial |
$296.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$227.00
|
| Rate for Payer: Cash Price |
$279.38
|
| Rate for Payer: Cofinity Commercial |
$244.46
|
| Rate for Payer: Cofinity Commercial |
$300.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$244.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$279.38
|
| Rate for Payer: Healthscope Commercial |
$314.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$244.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$296.85
|
| Rate for Payer: PHP Commercial |
$296.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$227.00
|
| Rate for Payer: Priority Health SBD |
$220.01
|
| Rate for Payer: UMR Bronson Commercial |
$153.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.92
|
|
|
HC OP FALSE LABOR SUB HOURS
|
Facility
|
IP
|
$193.26
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900002
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$85.03 |
| Max. Negotiated Rate |
$173.93 |
| Rate for Payer: Aetna American Axle |
$125.62
|
| Rate for Payer: Aetna Commercial |
$164.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.62
|
| Rate for Payer: Cash Price |
$154.61
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Cofinity Commercial |
$166.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.61
|
| Rate for Payer: Healthscope Commercial |
$173.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.27
|
| Rate for Payer: PHP Commercial |
$164.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.62
|
| Rate for Payer: Priority Health SBD |
$121.75
|
| Rate for Payer: UMR Bronson Commercial |
$85.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.94
|
|
|
HC OP FALSE LABOR SUB HOURS
|
Facility
|
OP
|
$193.26
|
|
|
Service Code
|
HCPCS S4005
|
| Hospital Charge Code |
72900002
|
|
Hospital Revenue Code
|
729
|
| Min. Negotiated Rate |
$71.51 |
| Max. Negotiated Rate |
$2,286.00 |
| Rate for Payer: Aetna American Axle |
$125.62
|
| Rate for Payer: Aetna Commercial |
$164.27
|
| Rate for Payer: Aetna Medicare |
$96.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$125.62
|
| Rate for Payer: BCBS Complete |
$77.30
|
| Rate for Payer: Cash Price |
$154.61
|
| Rate for Payer: Cash Price |
$154.61
|
| Rate for Payer: Cofinity Commercial |
$166.20
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$154.61
|
| Rate for Payer: Healthscope Commercial |
$173.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$135.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$164.27
|
| Rate for Payer: PHP Commercial |
$164.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$125.62
|
| Rate for Payer: Priority Health SBD |
$121.75
|
| Rate for Payer: UHC Core |
$2,286.00
|
| Rate for Payer: UMR Bronson Commercial |
$71.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.94
|
|
|
HC OP HEMODIALYSIS
|
Facility
|
OP
|
$969.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100001
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$358.53 |
| Max. Negotiated Rate |
$2,154.74 |
| Rate for Payer: Aetna American Axle |
$629.85
|
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna Medicare |
$712.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$856.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$856.96
|
| Rate for Payer: BCBS Complete |
$385.84
|
| Rate for Payer: BCBS MAPPO |
$685.57
|
| Rate for Payer: BCN Medicare Advantage |
$685.57
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$678.30
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$678.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$685.57
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$678.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Mclaren Medicaid |
$367.47
|
| Rate for Payer: Mclaren Medicare |
$685.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$719.85
|
| Rate for Payer: Meridian Medicaid |
$385.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$788.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: Nomi Health Commercial |
$2,056.71
|
| Rate for Payer: PACE Medicare |
$651.29
|
| Rate for Payer: PACE SWMI |
$685.57
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: PHP Medicare Advantage |
$685.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,154.74
|
| Rate for Payer: Priority Health Medicare |
$685.57
|
| Rate for Payer: Priority Health Narrow Network |
$1,723.79
|
| Rate for Payer: Priority Health SBD |
$610.47
|
| Rate for Payer: Railroad Medicare Medicare |
$685.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,929.81
|
| Rate for Payer: UHC Core |
$491.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$685.57
|
| Rate for Payer: UHC Exchange |
$1,310.19
|
| Rate for Payer: UHC Medicare Advantage |
$685.57
|
| Rate for Payer: UHCCP Medicaid |
$367.47
|
| Rate for Payer: UMR Bronson Commercial |
$358.53
|
| Rate for Payer: VA VA |
$685.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC OP HEMODIALYSIS
|
Facility
|
IP
|
$969.00
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100001
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$426.36 |
| Max. Negotiated Rate |
$872.10 |
| Rate for Payer: Cofinity Medicare Advantage |
$678.30
|
| Rate for Payer: Aetna American Axle |
$629.85
|
| Rate for Payer: Aetna Commercial |
$823.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$629.85
|
| Rate for Payer: Cash Price |
$775.20
|
| Rate for Payer: Cofinity Commercial |
$678.30
|
| Rate for Payer: Cofinity Commercial |
$833.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$775.20
|
| Rate for Payer: Healthscope Commercial |
$872.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$678.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$726.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$823.65
|
| Rate for Payer: PHP Commercial |
$823.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$629.85
|
| Rate for Payer: Priority Health SBD |
$610.47
|
| Rate for Payer: UMR Bronson Commercial |
$426.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$726.75
|
|
|
HC OPIATE URIN
|
Facility
|
IP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000129
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.73 |
| Max. Negotiated Rate |
$91.49 |
| Rate for Payer: Aetna American Axle |
$66.08
|
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health SBD |
$64.05
|
| Rate for Payer: UMR Bronson Commercial |
$44.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.24
|
|
|
HC OPIATE URIN
|
Facility
|
OP
|
$101.66
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000129
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$93.21 |
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$37.61
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Aetna American Axle |
$66.08
|
| Rate for Payer: Aetna Commercial |
$86.41
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$59.88
|
| Rate for Payer: BCN Commercial |
$59.88
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cash Price |
$81.33
|
| Rate for Payer: Cofinity Commercial |
$87.43
|
| Rate for Payer: Cofinity Commercial |
$71.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$91.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.24
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.41
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$86.41
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$49.71
|
| Rate for Payer: Priority Health SBD |
$64.05
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.24
|
|
|
HC OPIATE URINE CONFIRM
|
Facility
|
OP
|
$63.24
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100579
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.40 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna American Axle |
$41.11
|
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: Aetna Medicare |
$31.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.11
|
| Rate for Payer: BCBS Complete |
$25.30
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Cofinity Commercial |
$44.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health SBD |
$39.84
|
| Rate for Payer: UHC Core |
$27.78
|
| Rate for Payer: UMR Bronson Commercial |
$23.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC OPIATE URINE CONFIRM
|
Facility
|
IP
|
$63.24
|
|
|
Service Code
|
CPT 80361
|
| Hospital Charge Code |
30100579
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.83 |
| Max. Negotiated Rate |
$56.92 |
| Rate for Payer: Aetna American Axle |
$41.11
|
| Rate for Payer: Aetna Commercial |
$53.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.11
|
| Rate for Payer: Cash Price |
$50.59
|
| Rate for Payer: Cofinity Commercial |
$44.27
|
| Rate for Payer: Cofinity Commercial |
$54.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$44.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.59
|
| Rate for Payer: Healthscope Commercial |
$56.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$44.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.75
|
| Rate for Payer: PHP Commercial |
$53.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.11
|
| Rate for Payer: Priority Health SBD |
$39.84
|
| Rate for Payer: UMR Bronson Commercial |
$27.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.43
|
|
|
HC OPIOID DRUG PANEL URIN
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30100645
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$7.09
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$12.14
|
| Rate for Payer: BCN Commercial |
$12.14
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Cofinity Commercial |
$21.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$21.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$6.75
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$7.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow Network |
$10.08
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Exchange |
$12.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$6.75
|
| Rate for Payer: UMR Bronson Commercial |
$11.55
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
