|
HC PLT PHER LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$2,944.40
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000070
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,295.54 |
| 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 New Business (MI Preferred) |
$1,913.86
|
| 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: 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: Multiplan/Beech St/PHCS Commercial |
$2,502.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,208.30
|
| Rate for Payer: PHP Commercial |
$2,502.74
|
| Rate for Payer: Priority Health SBD |
$1,854.97
|
| Rate for Payer: UMR Bronson Commercial |
$1,295.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,208.30
|
|
|
HC PLT PHER LR IRR WASH
|
Facility
|
IP
|
$1,372.14
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000081
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$603.74 |
| Max. Negotiated Rate |
$1,234.93 |
| Rate for Payer: Aetna American Axle |
$891.89
|
| Rate for Payer: Aetna Commercial |
$1,166.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.89
|
| Rate for Payer: Cash Price |
$1,097.71
|
| Rate for Payer: Cofinity Advantage |
$960.50
|
| Rate for Payer: Cofinity Commercial |
$1,180.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,097.71
|
| Rate for Payer: Healthscope Commercial |
$1,234.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$960.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,029.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,166.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.11
|
| Rate for Payer: PHP Commercial |
$1,166.32
|
| Rate for Payer: Priority Health SBD |
$864.45
|
| Rate for Payer: UMR Bronson Commercial |
$603.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,029.11
|
|
|
HC PLT PHER LR IRR WASH
|
Facility
|
OP
|
$1,372.14
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000081
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$347.16 |
| Max. Negotiated Rate |
$2,146.63 |
| Rate for Payer: Aetna American Axle |
$891.89
|
| Rate for Payer: Aetna Commercial |
$1,166.32
|
| Rate for Payer: Aetna Medicare |
$690.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$891.89
|
| 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 |
$1,097.71
|
| Rate for Payer: Cash Price |
$1,097.71
|
| Rate for Payer: Cofinity Advantage |
$960.50
|
| Rate for Payer: Cofinity Commercial |
$1,180.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,097.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$663.79
|
| Rate for Payer: Healthscope Commercial |
$1,234.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$960.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,029.11
|
| 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 |
$1,166.32
|
| Rate for Payer: Nomi Health Commercial |
$1,991.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.11
|
| Rate for Payer: PACE Medicare |
$630.60
|
| Rate for Payer: PACE SWMI |
$663.79
|
| Rate for Payer: PHP Commercial |
$1,166.32
|
| 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 |
$864.45
|
| 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) |
$891.89
|
| Rate for Payer: UHC Core |
$714.88
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$663.79
|
| Rate for Payer: UHC Exchange |
$539.25
|
| Rate for Payer: UHC Medicaid |
$347.16
|
| Rate for Payer: UHCCP Medicaid |
$347.16
|
| Rate for Payer: UMR Bronson Commercial |
$507.69
|
| Rate for Payer: VA VA |
$663.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,029.11
|
|
|
HC PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13) IM
|
Facility
|
IP
|
$301.38
|
|
|
Service Code
|
CPT 90670
|
| Hospital Charge Code |
63600074
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$132.61 |
| Max. Negotiated Rate |
$271.24 |
| Rate for Payer: Aetna American Axle |
$195.90
|
| Rate for Payer: Aetna Commercial |
$256.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.90
|
| Rate for Payer: Cash Price |
$241.10
|
| Rate for Payer: Cofinity Advantage |
$210.97
|
| Rate for Payer: Cofinity Commercial |
$259.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.10
|
| Rate for Payer: Healthscope Commercial |
$271.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.03
|
| Rate for Payer: PHP Commercial |
$256.17
|
| Rate for Payer: Priority Health SBD |
$189.87
|
| Rate for Payer: UMR Bronson Commercial |
$132.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.03
|
|
|
HC PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13) IM
|
Facility
|
OP
|
$301.38
|
|
|
Service Code
|
CPT 90670
|
| Hospital Charge Code |
63600074
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$111.51 |
| Max. Negotiated Rate |
$720.64 |
| Rate for Payer: Aetna American Axle |
$195.90
|
| Rate for Payer: Aetna Commercial |
$256.17
|
| Rate for Payer: Aetna Medicare |
$150.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$195.90
|
| Rate for Payer: BCBS Complete |
$120.55
|
| Rate for Payer: BCBS Trust/PPO |
$720.64
|
| Rate for Payer: BCN Commercial |
$720.64
|
| Rate for Payer: Cash Price |
$241.10
|
| Rate for Payer: Cash Price |
$241.10
|
| Rate for Payer: Cofinity Advantage |
$210.97
|
| Rate for Payer: Cofinity Commercial |
$259.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.10
|
| Rate for Payer: Healthscope Commercial |
$271.24
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$210.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$241.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.03
|
| Rate for Payer: PHP Commercial |
$256.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$257.99
|
| Rate for Payer: Priority Health SBD |
$189.87
|
| Rate for Payer: Priority Health Tiered Network |
$206.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$425.45
|
| Rate for Payer: UHC Core |
$425.45
|
| Rate for Payer: UHC Exchange |
$425.45
|
| Rate for Payer: UMR Bronson Commercial |
$111.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.03
|
|
|
HC PNEUMOCOCCAL IGG AB CMPTS
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200190
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.81 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Advantage |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HC PNEUMOCOCCAL IGG AB CMPTS
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200190
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna Medicare |
$15.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.74
|
| Rate for Payer: BCBS Complete |
$8.23
|
| Rate for Payer: BCBS MAPPO |
$14.99
|
| Rate for Payer: BCBS Trust/PPO |
$17.32
|
| Rate for Payer: BCN Commercial |
$17.32
|
| Rate for Payer: BCN Medicare Advantage |
$14.99
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Advantage |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Mclaren Medicaid |
$14.99
|
| Rate for Payer: Mclaren Medicare |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.74
|
| Rate for Payer: Meridian Medicaid |
$15.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Nomi Health Commercial |
$22.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PACE Medicare |
$14.24
|
| Rate for Payer: PACE SWMI |
$14.99
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: PHP Medicare Advantage |
$14.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.99
|
| Rate for Payer: Priority Health Medicare |
$14.99
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: Priority Health Tiered Network |
$11.99
|
| Rate for Payer: Railroad Medicare Medicare |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.49
|
| Rate for Payer: UHC Core |
$22.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.99
|
| Rate for Payer: UHC Exchange |
$22.49
|
| Rate for Payer: UHC Medicaid |
$7.84
|
| Rate for Payer: UHCCP Medicaid |
$7.84
|
| Rate for Payer: UMR Bronson Commercial |
$9.93
|
| Rate for Payer: VA VA |
$14.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HC PNEUMOCOCCAL IGG ABS 23 SEROTYPE
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200189
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.81 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Advantage |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: UMR Bronson Commercial |
$11.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HC PNEUMOCOCCAL IGG ABS 23 SEROTYPE
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200189
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.84 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna American Axle |
$17.44
|
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna Medicare |
$15.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.74
|
| Rate for Payer: BCBS Complete |
$8.23
|
| Rate for Payer: BCBS MAPPO |
$14.99
|
| Rate for Payer: BCBS Trust/PPO |
$17.32
|
| Rate for Payer: BCN Commercial |
$17.32
|
| Rate for Payer: BCN Medicare Advantage |
$14.99
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Advantage |
$18.78
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Mclaren Medicaid |
$14.99
|
| Rate for Payer: Mclaren Medicare |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.74
|
| Rate for Payer: Meridian Medicaid |
$15.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Nomi Health Commercial |
$22.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PACE Medicare |
$14.24
|
| Rate for Payer: PACE SWMI |
$14.99
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: PHP Medicare Advantage |
$14.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.99
|
| Rate for Payer: Priority Health Medicare |
$14.99
|
| Rate for Payer: Priority Health SBD |
$16.90
|
| Rate for Payer: Priority Health Tiered Network |
$11.99
|
| Rate for Payer: Railroad Medicare Medicare |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.49
|
| Rate for Payer: UHC Core |
$22.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.99
|
| Rate for Payer: UHC Exchange |
$22.49
|
| Rate for Payer: UHC Medicaid |
$7.84
|
| Rate for Payer: UHCCP Medicaid |
$7.84
|
| Rate for Payer: UMR Bronson Commercial |
$9.93
|
| Rate for Payer: VA VA |
$14.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HC PNEUMOCOCCAL IGG ABS PRE & POST
|
Facility
|
IP
|
$8.49
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
30200226
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$7.64 |
| Rate for Payer: Aetna American Axle |
$5.52
|
| Rate for Payer: Aetna Commercial |
$7.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.52
|
| Rate for Payer: Cash Price |
$6.79
|
| Rate for Payer: Cofinity Advantage |
$5.94
|
| Rate for Payer: Cofinity Commercial |
$7.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.79
|
| Rate for Payer: Healthscope Commercial |
$7.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.37
|
| Rate for Payer: PHP Commercial |
$7.22
|
| Rate for Payer: Priority Health SBD |
$5.35
|
| Rate for Payer: UMR Bronson Commercial |
$3.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.37
|
|
|
HC PNEUMOCOCCAL IGG ABS PRE & POST
|
Facility
|
OP
|
$8.49
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
30200226
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.14 |
| Max. Negotiated Rate |
$19.32 |
| Rate for Payer: Aetna American Axle |
$5.52
|
| Rate for Payer: Aetna Commercial |
$7.22
|
| Rate for Payer: Aetna Medicare |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$14.89
|
| Rate for Payer: BCN Commercial |
$14.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$6.79
|
| Rate for Payer: Cash Price |
$6.79
|
| Rate for Payer: Cofinity Advantage |
$5.94
|
| Rate for Payer: Cofinity Commercial |
$7.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$7.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.37
|
| Rate for Payer: Mclaren Medicaid |
$12.88
|
| Rate for Payer: Mclaren Medicare |
$12.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: Meridian Medicaid |
$13.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.22
|
| Rate for Payer: Nomi Health Commercial |
$19.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.37
|
| Rate for Payer: PACE Medicare |
$12.24
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$7.22
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.88
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health SBD |
$5.35
|
| Rate for Payer: Priority Health Tiered Network |
$10.30
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.32
|
| Rate for Payer: UHC Core |
$19.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.88
|
| Rate for Payer: UHC Exchange |
$19.32
|
| Rate for Payer: UHC Medicaid |
$6.74
|
| Rate for Payer: UHCCP Medicaid |
$6.74
|
| Rate for Payer: UMR Bronson Commercial |
$3.14
|
| Rate for Payer: VA VA |
$12.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.37
|
|
|
HC PNEUMOCOCCAL INJECTION
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
HCPCS G0009
|
| Hospital Charge Code |
77100010
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$13.73 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| 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: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: UMR Bronson Commercial |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC PNEUMOCOCCAL INJECTION
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
HCPCS G0009
|
| Hospital Charge Code |
77100010
|
|
Hospital Revenue Code
|
771
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$150.88 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$48.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.33
|
| Rate for Payer: BCBS Complete |
$25.63
|
| Rate for Payer: BCBS MAPPO |
$46.66
|
| Rate for Payer: BCBS Trust/PPO |
$75.27
|
| Rate for Payer: BCN Commercial |
$75.27
|
| Rate for Payer: BCN Medicare Advantage |
$46.66
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.66
|
| 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 |
$46.66
|
| Rate for Payer: Mclaren Medicare |
$46.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.99
|
| Rate for Payer: Meridian Medicaid |
$48.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$53.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$51.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$139.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PACE Medicare |
$44.33
|
| Rate for Payer: PACE SWMI |
$46.66
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$46.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$150.88
|
| Rate for Payer: Priority Health Medicare |
$46.66
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: Priority Health Tiered Network |
$120.70
|
| Rate for Payer: Railroad Medicare Medicare |
$46.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.29
|
| Rate for Payer: UHC Core |
$16.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.66
|
| Rate for Payer: UHC Exchange |
$12.27
|
| Rate for Payer: UHC Medicaid |
$24.40
|
| Rate for Payer: UHCCP Medicaid |
$24.40
|
| Rate for Payer: UMR Bronson Commercial |
$11.55
|
| Rate for Payer: VA VA |
$46.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC PNEUMOCOCCAL VACCINE
|
Facility
|
IP
|
$151.76
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
63600029
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$66.77 |
| Max. Negotiated Rate |
$136.58 |
| Rate for Payer: Aetna American Axle |
$98.64
|
| Rate for Payer: Aetna Commercial |
$129.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.64
|
| Rate for Payer: Cash Price |
$121.41
|
| Rate for Payer: Cofinity Advantage |
$106.23
|
| Rate for Payer: Cofinity Commercial |
$130.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.41
|
| Rate for Payer: Healthscope Commercial |
$136.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.82
|
| Rate for Payer: PHP Commercial |
$129.00
|
| Rate for Payer: Priority Health SBD |
$95.61
|
| Rate for Payer: UMR Bronson Commercial |
$66.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.82
|
|
|
HC PNEUMOCOCCAL VACCINE
|
Facility
|
OP
|
$151.76
|
|
|
Service Code
|
CPT 90732
|
| Hospital Charge Code |
63600029
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$56.15 |
| Max. Negotiated Rate |
$372.62 |
| Rate for Payer: Aetna American Axle |
$98.64
|
| Rate for Payer: Aetna Commercial |
$129.00
|
| Rate for Payer: Aetna Medicare |
$75.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.64
|
| Rate for Payer: BCBS Complete |
$60.70
|
| Rate for Payer: BCBS Trust/PPO |
$372.62
|
| Rate for Payer: BCN Commercial |
$372.62
|
| Rate for Payer: Cash Price |
$121.41
|
| Rate for Payer: Cash Price |
$121.41
|
| Rate for Payer: Cofinity Advantage |
$106.23
|
| Rate for Payer: Cofinity Commercial |
$130.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.41
|
| Rate for Payer: Healthscope Commercial |
$136.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$121.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.82
|
| Rate for Payer: PHP Commercial |
$129.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$133.47
|
| Rate for Payer: Priority Health SBD |
$95.61
|
| Rate for Payer: Priority Health Tiered Network |
$106.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$220.23
|
| Rate for Payer: UHC Core |
$220.23
|
| Rate for Payer: UHC Exchange |
$220.23
|
| Rate for Payer: UMR Bronson Commercial |
$56.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.82
|
|
|
HC PNEUMOCYSTIS BY RAPID PCR
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600170
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$68.67 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna American Axle |
$101.44
|
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Advantage |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: UMR Bronson Commercial |
$68.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC PNEUMOCYSTIS BY RAPID PCR
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600170
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna American Axle |
$101.44
|
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$101.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Advantage |
$109.24
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$98.32
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$57.74
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC PNEUMONIAE AB IGM BY IFA
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna American Axle |
$98.73
|
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCN Commercial |
$15.31
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Advantage |
$106.33
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Mclaren Medicaid |
$13.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$19.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.24
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$95.70
|
| Rate for Payer: Priority Health Tiered Network |
$10.59
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.86
|
| Rate for Payer: UHC Core |
$19.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.24
|
| Rate for Payer: UHC Exchange |
$19.86
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: UMR Bronson Commercial |
$56.20
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC PNEUMONIAE AB IGM BY IFA
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 86738
|
| Hospital Charge Code |
30200309
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$66.84 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna American Axle |
$98.73
|
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.73
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Advantage |
$106.33
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: Priority Health SBD |
$95.70
|
| Rate for Payer: UMR Bronson Commercial |
$66.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC POC BASIC METABOLIC PANEL W/ICAL
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100696
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: UMR Bronson Commercial |
$23.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC POC BASIC METABOLIC PANEL W/ICAL
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100696
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.18 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna American Axle |
$34.49
|
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$14.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.16
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: BCBS MAPPO |
$13.73
|
| Rate for Payer: BCBS Trust/PPO |
$11.81
|
| Rate for Payer: BCN Commercial |
$11.81
|
| Rate for Payer: BCN Medicare Advantage |
$13.73
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Advantage |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.73
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$13.73
|
| Rate for Payer: Mclaren Medicare |
$13.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.42
|
| Rate for Payer: Meridian Medicaid |
$14.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$20.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$13.04
|
| Rate for Payer: PACE SWMI |
$13.73
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.73
|
| Rate for Payer: Priority Health Medicare |
$13.73
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$10.98
|
| Rate for Payer: Railroad Medicare Medicare |
$13.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.60
|
| Rate for Payer: UHC Core |
$20.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.73
|
| Rate for Payer: UHC Exchange |
$20.60
|
| Rate for Payer: UHC Medicaid |
$7.18
|
| Rate for Payer: UHCCP Medicaid |
$7.18
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC POC BLOOD GAS
|
Facility
|
IP
|
$168.52
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100499
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$74.15 |
| Max. Negotiated Rate |
$151.67 |
| Rate for Payer: Aetna American Axle |
$109.54
|
| Rate for Payer: Aetna Commercial |
$143.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.54
|
| Rate for Payer: Cash Price |
$134.82
|
| Rate for Payer: Cofinity Advantage |
$117.96
|
| Rate for Payer: Cofinity Commercial |
$144.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.82
|
| Rate for Payer: Healthscope Commercial |
$151.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.39
|
| Rate for Payer: PHP Commercial |
$143.24
|
| Rate for Payer: Priority Health SBD |
$106.17
|
| Rate for Payer: UMR Bronson Commercial |
$74.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.39
|
|
|
HC POC BLOOD GAS
|
Facility
|
OP
|
$168.52
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100499
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$151.67 |
| Rate for Payer: Aetna American Axle |
$109.54
|
| Rate for Payer: Aetna Commercial |
$143.24
|
| Rate for Payer: Aetna Medicare |
$81.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$109.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$98.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$98.46
|
| Rate for Payer: BCBS Complete |
$43.26
|
| Rate for Payer: BCBS MAPPO |
$78.77
|
| Rate for Payer: BCBS Trust/PPO |
$91.06
|
| Rate for Payer: BCN Commercial |
$91.06
|
| Rate for Payer: BCN Medicare Advantage |
$78.77
|
| Rate for Payer: Cash Price |
$134.82
|
| Rate for Payer: Cash Price |
$134.82
|
| Rate for Payer: Cofinity Advantage |
$117.96
|
| Rate for Payer: Cofinity Commercial |
$144.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$78.77
|
| Rate for Payer: Healthscope Commercial |
$151.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$117.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.39
|
| Rate for Payer: Mclaren Medicaid |
$78.77
|
| Rate for Payer: Mclaren Medicare |
$78.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$82.71
|
| Rate for Payer: Meridian Medicaid |
$82.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$90.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$86.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.24
|
| Rate for Payer: Nomi Health Commercial |
$118.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$126.39
|
| Rate for Payer: PACE Medicare |
$74.83
|
| Rate for Payer: PACE SWMI |
$78.77
|
| Rate for Payer: PHP Commercial |
$143.24
|
| Rate for Payer: PHP Medicare Advantage |
$78.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$78.77
|
| Rate for Payer: Priority Health Medicare |
$78.77
|
| Rate for Payer: Priority Health SBD |
$106.17
|
| Rate for Payer: Priority Health Tiered Network |
$63.02
|
| Rate for Payer: Railroad Medicare Medicare |
$78.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.16
|
| Rate for Payer: UHC Core |
$118.16
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$78.77
|
| Rate for Payer: UHC Exchange |
$118.16
|
| Rate for Payer: UHC Medicaid |
$41.20
|
| Rate for Payer: UHCCP Medicaid |
$41.20
|
| Rate for Payer: UMR Bronson Commercial |
$62.35
|
| Rate for Payer: VA VA |
$78.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.39
|
|
|
HC POC BLOOD GAS CALC O2 SAT
|
Facility
|
OP
|
$111.85
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100700
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.63 |
| Max. Negotiated Rate |
$100.67 |
| Rate for Payer: Aetna American Axle |
$72.70
|
| Rate for Payer: Aetna Commercial |
$95.07
|
| Rate for Payer: Aetna Medicare |
$27.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.59
|
| Rate for Payer: BCBS Complete |
$14.32
|
| Rate for Payer: BCBS MAPPO |
$26.07
|
| Rate for Payer: BCBS Trust/PPO |
$30.13
|
| Rate for Payer: BCN Commercial |
$30.13
|
| Rate for Payer: BCN Medicare Advantage |
$26.07
|
| Rate for Payer: Cash Price |
$89.48
|
| Rate for Payer: Cash Price |
$89.48
|
| Rate for Payer: Cofinity Advantage |
$78.30
|
| Rate for Payer: Cofinity Commercial |
$96.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.07
|
| Rate for Payer: Healthscope Commercial |
$100.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.89
|
| Rate for Payer: Mclaren Medicaid |
$26.07
|
| Rate for Payer: Mclaren Medicare |
$26.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.37
|
| Rate for Payer: Meridian Medicaid |
$27.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.07
|
| Rate for Payer: Nomi Health Commercial |
$39.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.89
|
| Rate for Payer: PACE Medicare |
$24.77
|
| Rate for Payer: PACE SWMI |
$26.07
|
| Rate for Payer: PHP Commercial |
$95.07
|
| Rate for Payer: PHP Medicare Advantage |
$26.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$26.07
|
| Rate for Payer: Priority Health Medicare |
$26.07
|
| Rate for Payer: Priority Health SBD |
$70.47
|
| Rate for Payer: Priority Health Tiered Network |
$20.86
|
| Rate for Payer: Railroad Medicare Medicare |
$26.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.11
|
| Rate for Payer: UHC Core |
$39.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$26.07
|
| Rate for Payer: UHC Exchange |
$39.11
|
| Rate for Payer: UHC Medicaid |
$13.63
|
| Rate for Payer: UHCCP Medicaid |
$13.63
|
| Rate for Payer: UMR Bronson Commercial |
$41.38
|
| Rate for Payer: VA VA |
$26.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.89
|
|
|
HC POC BLOOD GAS CALC O2 SAT
|
Facility
|
IP
|
$111.85
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100700
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.21 |
| Max. Negotiated Rate |
$100.67 |
| Rate for Payer: Aetna American Axle |
$72.70
|
| Rate for Payer: Aetna Commercial |
$95.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.70
|
| Rate for Payer: Cash Price |
$89.48
|
| Rate for Payer: Cofinity Advantage |
$78.30
|
| Rate for Payer: Cofinity Commercial |
$96.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.48
|
| Rate for Payer: Healthscope Commercial |
$100.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.89
|
| Rate for Payer: PHP Commercial |
$95.07
|
| Rate for Payer: Priority Health SBD |
$70.47
|
| Rate for Payer: UMR Bronson Commercial |
$49.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.89
|
|
