|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$163.32
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$60.43 |
| Max. Negotiated Rate |
$416.48 |
| Rate for Payer: Aetna American Axle |
$106.16
|
| Rate for Payer: Aetna Commercial |
$138.82
|
| Rate for Payer: Aetna Medicare |
$133.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.99
|
| Rate for Payer: BCBS Complete |
$70.73
|
| Rate for Payer: BCBS MAPPO |
$128.79
|
| Rate for Payer: BCBS Trust/PPO |
$389.65
|
| Rate for Payer: BCN Commercial |
$389.65
|
| Rate for Payer: BCN Medicare Advantage |
$128.79
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cofinity Advantage |
$114.32
|
| Rate for Payer: Cofinity Commercial |
$140.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.79
|
| Rate for Payer: Healthscope Commercial |
$146.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.49
|
| Rate for Payer: Mclaren Medicaid |
$128.79
|
| Rate for Payer: Mclaren Medicare |
$128.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.23
|
| Rate for Payer: Meridian Medicaid |
$135.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.82
|
| Rate for Payer: Nomi Health Commercial |
$386.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.49
|
| Rate for Payer: PACE Medicare |
$122.35
|
| Rate for Payer: PACE SWMI |
$128.79
|
| Rate for Payer: PHP Commercial |
$138.82
|
| Rate for Payer: PHP Medicare Advantage |
$128.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$416.48
|
| Rate for Payer: Priority Health Medicare |
$128.79
|
| Rate for Payer: Priority Health SBD |
$102.89
|
| Rate for Payer: Priority Health Tiered Network |
$333.18
|
| Rate for Payer: Railroad Medicare Medicare |
$128.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.16
|
| Rate for Payer: UHC Core |
$85.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.79
|
| Rate for Payer: UHC Exchange |
$64.18
|
| Rate for Payer: UHC Medicaid |
$67.36
|
| Rate for Payer: UHCCP Medicaid |
$67.36
|
| Rate for Payer: UMR Bronson Commercial |
$60.43
|
| Rate for Payer: VA VA |
$128.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.49
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$163.32
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$71.86 |
| Max. Negotiated Rate |
$146.99 |
| Rate for Payer: Aetna American Axle |
$106.16
|
| Rate for Payer: Aetna Commercial |
$138.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.16
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cofinity Advantage |
$114.32
|
| Rate for Payer: Cofinity Commercial |
$140.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.66
|
| Rate for Payer: Healthscope Commercial |
$146.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.49
|
| Rate for Payer: PHP Commercial |
$138.82
|
| Rate for Payer: Priority Health SBD |
$102.89
|
| Rate for Payer: UMR Bronson Commercial |
$71.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.49
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$88.08
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.42 |
| Max. Negotiated Rate |
$79.27 |
| Rate for Payer: Aetna American Axle |
$57.25
|
| Rate for Payer: Aetna Commercial |
$74.87
|
| Rate for Payer: Aetna Medicare |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.16
|
| Rate for Payer: BCBS Complete |
$3.59
|
| Rate for Payer: BCBS MAPPO |
$6.53
|
| Rate for Payer: BCBS Trust/PPO |
$7.55
|
| Rate for Payer: BCN Commercial |
$7.55
|
| Rate for Payer: BCN Medicare Advantage |
$6.53
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Advantage |
$61.66
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$79.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.06
|
| Rate for Payer: Mclaren Medicaid |
$6.53
|
| Rate for Payer: Mclaren Medicare |
$6.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.86
|
| Rate for Payer: Meridian Medicaid |
$6.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Nomi Health Commercial |
$9.79
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PACE Medicare |
$6.20
|
| Rate for Payer: PACE SWMI |
$6.53
|
| Rate for Payer: PHP Commercial |
$74.87
|
| Rate for Payer: PHP Medicare Advantage |
$6.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6.53
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health SBD |
$55.49
|
| Rate for Payer: Priority Health Tiered Network |
$5.22
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.80
|
| Rate for Payer: UHC Core |
$9.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$6.53
|
| Rate for Payer: UHC Exchange |
$9.80
|
| Rate for Payer: UHC Medicaid |
$3.42
|
| Rate for Payer: UHCCP Medicaid |
$3.42
|
| Rate for Payer: UMR Bronson Commercial |
$32.59
|
| Rate for Payer: VA VA |
$6.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.06
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$88.08
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$79.27 |
| Rate for Payer: Aetna American Axle |
$57.25
|
| Rate for Payer: Aetna Commercial |
$74.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.25
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Advantage |
$61.66
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Healthscope Commercial |
$79.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PHP Commercial |
$74.87
|
| Rate for Payer: Priority Health SBD |
$55.49
|
| Rate for Payer: UMR Bronson Commercial |
$38.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.06
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$89.31 |
| Rate for Payer: Aetna American Axle |
$64.50
|
| Rate for Payer: Aetna Commercial |
$84.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.50
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Advantage |
$69.46
|
| Rate for Payer: Cofinity Commercial |
$85.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Healthscope Commercial |
$89.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PHP Commercial |
$84.35
|
| Rate for Payer: Priority Health SBD |
$62.51
|
| Rate for Payer: UMR Bronson Commercial |
$43.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.42
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$89.31 |
| Rate for Payer: Aetna American Axle |
$64.50
|
| Rate for Payer: Aetna Commercial |
$84.35
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Advantage |
$69.46
|
| Rate for Payer: Cofinity Commercial |
$85.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$89.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.42
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$84.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$62.51
|
| Rate for Payer: Priority Health Tiered Network |
$19.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.37
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$37.37
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: UMR Bronson Commercial |
$36.72
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.42
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$101.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.83 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: Aetna American Axle |
$66.22
|
| Rate for Payer: Aetna Commercial |
$86.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.22
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cofinity Advantage |
$71.32
|
| Rate for Payer: Cofinity Commercial |
$87.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.50
|
| Rate for Payer: Healthscope Commercial |
$91.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.41
|
| Rate for Payer: PHP Commercial |
$86.60
|
| Rate for Payer: Priority Health SBD |
$64.18
|
| Rate for Payer: UMR Bronson Commercial |
$44.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.41
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$101.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: Aetna American Axle |
$66.22
|
| Rate for Payer: Aetna Commercial |
$86.60
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$21.24
|
| Rate for Payer: BCN Commercial |
$21.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cofinity Advantage |
$71.32
|
| Rate for Payer: Cofinity Commercial |
$87.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$91.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.41
|
| Rate for Payer: Mclaren Medicaid |
$18.37
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.60
|
| Rate for Payer: Nomi Health Commercial |
$27.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.41
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$86.60
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$64.18
|
| Rate for Payer: Priority Health Tiered Network |
$14.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Core |
$27.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$27.56
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$37.70
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.41
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$284.72
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$73.58 |
| Max. Negotiated Rate |
$455.00 |
| Rate for Payer: Aetna American Axle |
$185.07
|
| Rate for Payer: Aetna Commercial |
$242.01
|
| Rate for Payer: Aetna Medicare |
$146.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$175.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$175.86
|
| Rate for Payer: BCBS Complete |
$77.27
|
| Rate for Payer: BCBS MAPPO |
$140.69
|
| Rate for Payer: BCBS Trust/PPO |
$332.70
|
| Rate for Payer: BCN Commercial |
$332.70
|
| Rate for Payer: BCN Medicare Advantage |
$140.69
|
| Rate for Payer: Cash Price |
$227.78
|
| Rate for Payer: Cash Price |
$227.78
|
| Rate for Payer: Cofinity Advantage |
$199.30
|
| Rate for Payer: Cofinity Commercial |
$244.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$140.69
|
| Rate for Payer: Healthscope Commercial |
$256.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.54
|
| Rate for Payer: Mclaren Medicaid |
$140.69
|
| Rate for Payer: Mclaren Medicare |
$140.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$147.72
|
| Rate for Payer: Meridian Medicaid |
$147.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$161.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$154.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.01
|
| Rate for Payer: Nomi Health Commercial |
$422.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.54
|
| Rate for Payer: PACE Medicare |
$133.66
|
| Rate for Payer: PACE SWMI |
$140.69
|
| Rate for Payer: PHP Commercial |
$242.01
|
| Rate for Payer: PHP Medicare Advantage |
$140.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$455.00
|
| Rate for Payer: Priority Health Medicare |
$140.69
|
| Rate for Payer: Priority Health SBD |
$179.37
|
| Rate for Payer: Priority Health Tiered Network |
$364.00
|
| Rate for Payer: Railroad Medicare Medicare |
$140.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.07
|
| Rate for Payer: UHC Core |
$148.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$140.69
|
| Rate for Payer: UHC Exchange |
$111.89
|
| Rate for Payer: UHC Medicaid |
$73.58
|
| Rate for Payer: UHCCP Medicaid |
$73.58
|
| Rate for Payer: UMR Bronson Commercial |
$105.35
|
| Rate for Payer: VA VA |
$140.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.54
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$284.72
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$125.28 |
| Max. Negotiated Rate |
$256.25 |
| Rate for Payer: Aetna American Axle |
$185.07
|
| Rate for Payer: Aetna Commercial |
$242.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$185.07
|
| Rate for Payer: Cash Price |
$227.78
|
| Rate for Payer: Cofinity Advantage |
$199.30
|
| Rate for Payer: Cofinity Commercial |
$244.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.78
|
| Rate for Payer: Healthscope Commercial |
$256.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$199.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.54
|
| Rate for Payer: PHP Commercial |
$242.01
|
| Rate for Payer: Priority Health SBD |
$179.37
|
| Rate for Payer: UMR Bronson Commercial |
$125.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.54
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.34 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.60
|
| Rate for Payer: BCBS Complete |
$2.46
|
| Rate for Payer: BCBS MAPPO |
$4.48
|
| Rate for Payer: BCBS Trust/PPO |
$5.18
|
| Rate for Payer: BCN Commercial |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$4.48
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.48
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$4.48
|
| Rate for Payer: Mclaren Medicare |
$4.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.70
|
| Rate for Payer: Meridian Medicaid |
$4.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$6.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$4.26
|
| Rate for Payer: PACE SWMI |
$4.48
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$4.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.48
|
| Rate for Payer: Priority Health Medicare |
$4.48
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$3.58
|
| Rate for Payer: Railroad Medicare Medicare |
$4.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.72
|
| Rate for Payer: UHC Core |
$6.72
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.48
|
| Rate for Payer: UHC Exchange |
$6.72
|
| Rate for Payer: UHC Medicaid |
$2.34
|
| Rate for Payer: UHCCP Medicaid |
$2.34
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$4.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$126.49
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$55.66 |
| Max. Negotiated Rate |
$113.84 |
| Rate for Payer: Aetna American Axle |
$82.22
|
| Rate for Payer: Aetna Commercial |
$107.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.22
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cofinity Advantage |
$88.54
|
| Rate for Payer: Cofinity Commercial |
$108.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.19
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.87
|
| Rate for Payer: PHP Commercial |
$107.52
|
| Rate for Payer: Priority Health SBD |
$79.69
|
| Rate for Payer: UMR Bronson Commercial |
$55.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.87
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$126.49
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$113.84 |
| Rate for Payer: Aetna American Axle |
$82.22
|
| Rate for Payer: Aetna Commercial |
$107.52
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cofinity Advantage |
$88.54
|
| Rate for Payer: Cofinity Commercial |
$108.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.87
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.52
|
| Rate for Payer: Nomi Health Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.87
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$107.52
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$79.69
|
| Rate for Payer: Priority Health Tiered Network |
$19.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.37
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$37.37
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: UMR Bronson Commercial |
$46.80
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.87
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$410.58
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$96.70 |
| Max. Negotiated Rate |
$597.98 |
| Rate for Payer: Aetna American Axle |
$266.88
|
| Rate for Payer: Aetna Commercial |
$348.99
|
| Rate for Payer: Aetna Medicare |
$192.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.12
|
| Rate for Payer: BCBS Complete |
$101.55
|
| Rate for Payer: BCBS MAPPO |
$184.90
|
| Rate for Payer: BCBS Trust/PPO |
$543.32
|
| Rate for Payer: BCN Commercial |
$543.32
|
| Rate for Payer: BCN Medicare Advantage |
$184.90
|
| Rate for Payer: Cash Price |
$328.46
|
| Rate for Payer: Cash Price |
$328.46
|
| Rate for Payer: Cofinity Advantage |
$287.41
|
| Rate for Payer: Cofinity Commercial |
$353.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.90
|
| Rate for Payer: Healthscope Commercial |
$369.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$287.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.94
|
| Rate for Payer: Mclaren Medicaid |
$184.90
|
| Rate for Payer: Mclaren Medicare |
$184.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.15
|
| Rate for Payer: Meridian Medicaid |
$194.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$203.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.99
|
| Rate for Payer: Nomi Health Commercial |
$554.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.94
|
| Rate for Payer: PACE Medicare |
$175.66
|
| Rate for Payer: PACE SWMI |
$184.90
|
| Rate for Payer: PHP Commercial |
$348.99
|
| Rate for Payer: PHP Medicare Advantage |
$184.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$597.98
|
| Rate for Payer: Priority Health Medicare |
$184.90
|
| Rate for Payer: Priority Health SBD |
$258.67
|
| Rate for Payer: Priority Health Tiered Network |
$478.38
|
| Rate for Payer: Railroad Medicare Medicare |
$184.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.88
|
| Rate for Payer: UHC Core |
$213.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$184.90
|
| Rate for Payer: UHC Exchange |
$161.36
|
| Rate for Payer: UHC Medicaid |
$96.70
|
| Rate for Payer: UHCCP Medicaid |
$96.70
|
| Rate for Payer: UMR Bronson Commercial |
$151.91
|
| Rate for Payer: VA VA |
$184.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.94
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$410.58
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$180.66 |
| Max. Negotiated Rate |
$369.52 |
| Rate for Payer: Aetna American Axle |
$266.88
|
| Rate for Payer: Aetna Commercial |
$348.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.88
|
| Rate for Payer: Cash Price |
$328.46
|
| Rate for Payer: Cofinity Advantage |
$287.41
|
| Rate for Payer: Cofinity Commercial |
$353.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.46
|
| Rate for Payer: Healthscope Commercial |
$369.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$287.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.94
|
| Rate for Payer: PHP Commercial |
$348.99
|
| Rate for Payer: Priority Health SBD |
$258.67
|
| Rate for Payer: UMR Bronson Commercial |
$180.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.94
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
OP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$89.31 |
| Rate for Payer: Aetna American Axle |
$64.50
|
| Rate for Payer: Aetna Commercial |
$84.35
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Advantage |
$69.46
|
| Rate for Payer: Cofinity Commercial |
$85.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$89.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.42
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$84.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$62.51
|
| Rate for Payer: Priority Health Tiered Network |
$19.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.37
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$37.37
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: UMR Bronson Commercial |
$36.72
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.42
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
IP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.66 |
| Max. Negotiated Rate |
$89.31 |
| Rate for Payer: Aetna American Axle |
$64.50
|
| Rate for Payer: Aetna Commercial |
$84.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.50
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Advantage |
$69.46
|
| Rate for Payer: Cofinity Commercial |
$85.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Healthscope Commercial |
$89.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PHP Commercial |
$84.35
|
| Rate for Payer: Priority Health SBD |
$62.51
|
| Rate for Payer: UMR Bronson Commercial |
$43.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.42
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
OP
|
$94.45
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.03 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna American Axle |
$61.39
|
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Advantage |
$66.11
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Mclaren Medicaid |
$24.91
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$26.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$37.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$59.50
|
| Rate for Payer: Priority Health Tiered Network |
$19.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.37
|
| Rate for Payer: UHC Core |
$37.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.91
|
| Rate for Payer: UHC Exchange |
$37.37
|
| Rate for Payer: UHC Medicaid |
$13.03
|
| Rate for Payer: UHCCP Medicaid |
$13.03
|
| Rate for Payer: UMR Bronson Commercial |
$34.95
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
IP
|
$94.45
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$41.56 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna American Axle |
$61.39
|
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.39
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Advantage |
$66.11
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: Priority Health SBD |
$59.50
|
| Rate for Payer: UMR Bronson Commercial |
$41.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
OP
|
$1,981.28
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$721.30 |
| Max. Negotiated Rate |
$4,460.05 |
| Rate for Payer: Aetna American Axle |
$1,287.83
|
| Rate for Payer: Aetna Commercial |
$1,684.09
|
| Rate for Payer: Aetna Medicare |
$1,434.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,723.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,723.94
|
| Rate for Payer: BCBS Complete |
$757.43
|
| Rate for Payer: BCBS MAPPO |
$1,379.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,816.61
|
| Rate for Payer: BCN Commercial |
$1,816.61
|
| Rate for Payer: BCN Medicare Advantage |
$1,379.15
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cofinity Advantage |
$1,386.90
|
| Rate for Payer: Cofinity Commercial |
$1,703.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,585.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,379.15
|
| Rate for Payer: Healthscope Commercial |
$1,783.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,386.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.96
|
| Rate for Payer: Mclaren Medicaid |
$1,379.15
|
| Rate for Payer: Mclaren Medicare |
$1,379.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,448.11
|
| Rate for Payer: Meridian Medicaid |
$1,448.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,586.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,517.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.09
|
| Rate for Payer: Nomi Health Commercial |
$4,137.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.96
|
| Rate for Payer: PACE Medicare |
$1,310.19
|
| Rate for Payer: PACE SWMI |
$1,379.15
|
| Rate for Payer: PHP Commercial |
$1,684.09
|
| Rate for Payer: PHP Medicare Advantage |
$1,379.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$721.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4,460.05
|
| Rate for Payer: Priority Health Medicare |
$1,379.15
|
| Rate for Payer: Priority Health SBD |
$1,248.21
|
| Rate for Payer: Priority Health Tiered Network |
$3,568.04
|
| Rate for Payer: Railroad Medicare Medicare |
$1,379.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,287.83
|
| Rate for Payer: UHC Core |
$1,032.25
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,379.15
|
| Rate for Payer: UHC Exchange |
$778.64
|
| Rate for Payer: UHC Medicaid |
$721.30
|
| Rate for Payer: UHCCP Medicaid |
$721.30
|
| Rate for Payer: UMR Bronson Commercial |
$733.07
|
| Rate for Payer: VA VA |
$1,379.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.96
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
IP
|
$1,981.28
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$871.76 |
| Max. Negotiated Rate |
$1,783.15 |
| Rate for Payer: Aetna American Axle |
$1,287.83
|
| Rate for Payer: Aetna Commercial |
$1,684.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,287.83
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cofinity Advantage |
$1,386.90
|
| Rate for Payer: Cofinity Commercial |
$1,703.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,585.02
|
| Rate for Payer: Healthscope Commercial |
$1,783.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,386.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.96
|
| Rate for Payer: PHP Commercial |
$1,684.09
|
| Rate for Payer: Priority Health SBD |
$1,248.21
|
| Rate for Payer: UMR Bronson Commercial |
$871.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.96
|
|
|
HC PLT PHER LEUKO REDUCED
|
Facility
|
IP
|
$2,248.39
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000071
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$989.29 |
| Max. Negotiated Rate |
$2,023.55 |
| Rate for Payer: Aetna American Axle |
$1,461.45
|
| Rate for Payer: Aetna Commercial |
$1,911.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.45
|
| Rate for Payer: Cash Price |
$1,798.71
|
| Rate for Payer: Cofinity Advantage |
$1,573.87
|
| Rate for Payer: Cofinity Commercial |
$1,933.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.71
|
| Rate for Payer: Healthscope Commercial |
$2,023.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,573.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.29
|
| Rate for Payer: PHP Commercial |
$1,911.13
|
| Rate for Payer: Priority Health SBD |
$1,416.49
|
| Rate for Payer: UMR Bronson Commercial |
$989.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.29
|
|
|
HC PLT PHER LEUKO REDUCED
|
Facility
|
OP
|
$2,248.39
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000071
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$260.95 |
| Max. Negotiated Rate |
$2,023.55 |
| Rate for Payer: Aetna American Axle |
$1,461.45
|
| Rate for Payer: Aetna Commercial |
$1,911.13
|
| Rate for Payer: Aetna Medicare |
$518.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,461.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.67
|
| Rate for Payer: BCBS Complete |
$274.02
|
| Rate for Payer: BCBS MAPPO |
$498.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.53
|
| Rate for Payer: BCN Commercial |
$1,288.53
|
| Rate for Payer: BCN Medicare Advantage |
$498.94
|
| Rate for Payer: Cash Price |
$1,798.71
|
| Rate for Payer: Cash Price |
$1,798.71
|
| Rate for Payer: Cofinity Advantage |
$1,573.87
|
| Rate for Payer: Cofinity Commercial |
$1,933.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.94
|
| Rate for Payer: Healthscope Commercial |
$2,023.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,573.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.29
|
| Rate for Payer: Mclaren Medicaid |
$498.94
|
| Rate for Payer: Mclaren Medicare |
$498.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.89
|
| Rate for Payer: Meridian Medicaid |
$523.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$548.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.13
|
| Rate for Payer: Nomi Health Commercial |
$1,496.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.29
|
| Rate for Payer: PACE Medicare |
$473.99
|
| Rate for Payer: PACE SWMI |
$498.94
|
| Rate for Payer: PHP Commercial |
$1,911.13
|
| Rate for Payer: PHP Medicare Advantage |
$498.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,613.55
|
| Rate for Payer: Priority Health Medicare |
$498.94
|
| Rate for Payer: Priority Health SBD |
$1,416.49
|
| Rate for Payer: Priority Health Tiered Network |
$1,290.84
|
| Rate for Payer: Railroad Medicare Medicare |
$498.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,461.45
|
| Rate for Payer: UHC Core |
$1,171.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$498.94
|
| Rate for Payer: UHC Exchange |
$883.62
|
| Rate for Payer: UHC Medicaid |
$260.95
|
| Rate for Payer: UHCCP Medicaid |
$260.95
|
| Rate for Payer: UMR Bronson Commercial |
$831.90
|
| Rate for Payer: VA VA |
$498.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.29
|
|
|
HC PLT PHER LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$2,944.40
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000070
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$347.16 |
| Max. Negotiated Rate |
$2,649.96 |
| Rate for Payer: Aetna American Axle |
$1,913.86
|
| Rate for Payer: Aetna Commercial |
$2,502.74
|
| Rate for Payer: Aetna Medicare |
$690.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,913.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$829.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$829.74
|
| Rate for Payer: BCBS Complete |
$364.55
|
| Rate for Payer: BCBS MAPPO |
$663.79
|
| Rate for Payer: BCBS Trust/PPO |
$1,787.32
|
| Rate for Payer: BCN Commercial |
$1,787.32
|
| Rate for Payer: BCN Medicare Advantage |
$663.79
|
| Rate for Payer: Cash Price |
$2,355.52
|
| Rate for Payer: Cash Price |
$2,355.52
|
| Rate for Payer: Cofinity Advantage |
$2,061.08
|
| Rate for Payer: Cofinity Commercial |
$2,532.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,355.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.79
|
| Rate for Payer: Healthscope Commercial |
$2,649.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,061.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,208.30
|
| Rate for Payer: Mclaren Medicaid |
$663.79
|
| Rate for Payer: Mclaren Medicare |
$663.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$696.98
|
| Rate for Payer: Meridian Medicaid |
$696.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$763.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$730.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,502.74
|
| Rate for Payer: Nomi Health Commercial |
$1,991.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,208.30
|
| Rate for Payer: PACE Medicare |
$630.60
|
| Rate for Payer: PACE SWMI |
$663.79
|
| Rate for Payer: PHP Commercial |
$2,502.74
|
| Rate for Payer: PHP Medicare Advantage |
$663.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$347.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,146.63
|
| Rate for Payer: Priority Health Medicare |
$663.79
|
| Rate for Payer: Priority Health SBD |
$1,854.97
|
| Rate for Payer: Priority Health Tiered Network |
$1,717.30
|
| Rate for Payer: Railroad Medicare Medicare |
$663.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,913.86
|
| Rate for Payer: UHC Core |
$1,534.03
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$663.79
|
| Rate for Payer: UHC Exchange |
$1,157.15
|
| Rate for Payer: UHC Medicaid |
$347.16
|
| Rate for Payer: UHCCP Medicaid |
$347.16
|
| Rate for Payer: UMR Bronson Commercial |
$1,089.43
|
| Rate for Payer: VA VA |
$663.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,208.30
|
|
