|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
IP
|
$39.26
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.27 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna American Axle |
$25.52
|
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.52
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Advantage |
$27.48
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: Priority Health SBD |
$24.73
|
| Rate for Payer: UMR Bronson Commercial |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC PRIMIDONE PHENOBARB CMPT
|
Facility
|
OP
|
$39.26
|
|
|
Service Code
|
CPT 80188
|
| Hospital Charge Code |
30100489
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.68 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna American Axle |
$25.52
|
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna Medicare |
$17.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.74
|
| Rate for Payer: BCBS Complete |
$9.11
|
| Rate for Payer: BCBS MAPPO |
$16.59
|
| Rate for Payer: BCBS Trust/PPO |
$19.17
|
| Rate for Payer: BCN Commercial |
$19.17
|
| Rate for Payer: BCN Medicare Advantage |
$16.59
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Advantage |
$27.48
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.59
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Mclaren Medicaid |
$16.59
|
| Rate for Payer: Mclaren Medicare |
$16.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.42
|
| Rate for Payer: Meridian Medicaid |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$24.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PACE Medicare |
$15.76
|
| Rate for Payer: PACE SWMI |
$16.59
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: PHP Medicare Advantage |
$16.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.59
|
| Rate for Payer: Priority Health Medicare |
$16.59
|
| Rate for Payer: Priority Health SBD |
$24.73
|
| Rate for Payer: Priority Health Tiered Network |
$13.27
|
| Rate for Payer: Railroad Medicare Medicare |
$16.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.89
|
| Rate for Payer: UHC Core |
$24.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.59
|
| Rate for Payer: UHC Exchange |
$24.89
|
| Rate for Payer: UHC Medicaid |
$8.68
|
| Rate for Payer: UHCCP Medicaid |
$8.68
|
| Rate for Payer: UMR Bronson Commercial |
$14.53
|
| Rate for Payer: VA VA |
$16.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$258.02
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$52.94 |
| Max. Negotiated Rate |
$327.36 |
| Rate for Payer: Aetna American Axle |
$167.71
|
| Rate for Payer: Aetna Commercial |
$219.32
|
| Rate for Payer: Aetna Medicare |
$105.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$126.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$126.53
|
| Rate for Payer: BCBS Complete |
$55.59
|
| Rate for Payer: BCBS MAPPO |
$101.22
|
| Rate for Payer: BCN Medicare Advantage |
$101.22
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cofinity Advantage |
$180.61
|
| Rate for Payer: Cofinity Commercial |
$221.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$101.22
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.51
|
| Rate for Payer: Mclaren Medicaid |
$101.22
|
| Rate for Payer: Mclaren Medicare |
$101.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$106.28
|
| Rate for Payer: Meridian Medicaid |
$106.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$111.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.32
|
| Rate for Payer: Nomi Health Commercial |
$303.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.51
|
| Rate for Payer: PACE Medicare |
$96.16
|
| Rate for Payer: PACE SWMI |
$101.22
|
| Rate for Payer: PHP Commercial |
$219.32
|
| Rate for Payer: PHP Medicare Advantage |
$101.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$327.36
|
| Rate for Payer: Priority Health Medicare |
$101.22
|
| Rate for Payer: Priority Health SBD |
$162.55
|
| Rate for Payer: Priority Health Tiered Network |
$261.89
|
| Rate for Payer: Railroad Medicare Medicare |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.71
|
| Rate for Payer: UHC Core |
$134.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$101.22
|
| Rate for Payer: UHC Exchange |
$101.40
|
| Rate for Payer: UHC Medicaid |
$52.94
|
| Rate for Payer: UHCCP Medicaid |
$52.94
|
| Rate for Payer: UMR Bronson Commercial |
$95.47
|
| Rate for Payer: VA VA |
$101.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.51
|
|
|
HC PRINCIPAL CARE MGMT 1ST 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$258.02
|
|
|
Service Code
|
CPT 99426
|
| Hospital Charge Code |
51000112
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$113.53 |
| Max. Negotiated Rate |
$232.22 |
| Rate for Payer: Aetna American Axle |
$167.71
|
| Rate for Payer: Aetna Commercial |
$219.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$167.71
|
| Rate for Payer: Cash Price |
$206.42
|
| Rate for Payer: Cofinity Advantage |
$180.61
|
| Rate for Payer: Cofinity Commercial |
$221.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.42
|
| Rate for Payer: Healthscope Commercial |
$232.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$180.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$219.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$193.51
|
| Rate for Payer: PHP Commercial |
$219.32
|
| Rate for Payer: Priority Health SBD |
$162.55
|
| Rate for Payer: UMR Bronson Commercial |
$113.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.51
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
IP
|
$197.68
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$86.98 |
| Max. Negotiated Rate |
$177.91 |
| Rate for Payer: Aetna American Axle |
$128.49
|
| Rate for Payer: Aetna Commercial |
$168.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.49
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Advantage |
$138.38
|
| Rate for Payer: Cofinity Commercial |
$170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Healthscope Commercial |
$177.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.26
|
| Rate for Payer: PHP Commercial |
$168.03
|
| Rate for Payer: Priority Health SBD |
$124.54
|
| Rate for Payer: UMR Bronson Commercial |
$86.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.26
|
|
|
HC PRINCIPAL CARE MGMT EA ADDL 30 MIN STAFF/CAL MO
|
Facility
|
OP
|
$197.68
|
|
|
Service Code
|
CPT 99427
|
| Hospital Charge Code |
51000113
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$73.14 |
| Max. Negotiated Rate |
$177.91 |
| Rate for Payer: Aetna American Axle |
$128.49
|
| Rate for Payer: Aetna Commercial |
$168.03
|
| Rate for Payer: Aetna Medicare |
$98.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$128.49
|
| Rate for Payer: BCBS Complete |
$79.07
|
| Rate for Payer: Cash Price |
$158.14
|
| Rate for Payer: Cofinity Advantage |
$138.38
|
| Rate for Payer: Cofinity Commercial |
$170.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.14
|
| Rate for Payer: Healthscope Commercial |
$177.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$138.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$158.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.26
|
| Rate for Payer: PHP Commercial |
$168.03
|
| Rate for Payer: Priority Health SBD |
$124.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.49
|
| Rate for Payer: UHC Core |
$102.99
|
| Rate for Payer: UHC Exchange |
$77.69
|
| Rate for Payer: UMR Bronson Commercial |
$73.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.26
|
|
|
HC PRO BNP
|
Facility
|
OP
|
$157.30
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.53 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna American Axle |
$102.25
|
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna Medicare |
$40.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.08
|
| Rate for Payer: BCBS Complete |
$21.56
|
| Rate for Payer: BCBS MAPPO |
$39.26
|
| Rate for Payer: BCBS Trust/PPO |
$45.39
|
| Rate for Payer: BCN Commercial |
$45.39
|
| Rate for Payer: BCN Medicare Advantage |
$39.26
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Advantage |
$110.11
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.26
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.97
|
| Rate for Payer: Mclaren Medicaid |
$39.26
|
| Rate for Payer: Mclaren Medicare |
$39.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$41.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$58.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PACE Medicare |
$37.30
|
| Rate for Payer: PACE SWMI |
$39.26
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: PHP Medicare Advantage |
$39.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$39.26
|
| Rate for Payer: Priority Health Medicare |
$39.26
|
| Rate for Payer: Priority Health SBD |
$99.10
|
| Rate for Payer: Priority Health Tiered Network |
$31.41
|
| Rate for Payer: Railroad Medicare Medicare |
$39.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.89
|
| Rate for Payer: UHC Core |
$58.89
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$39.26
|
| Rate for Payer: UHC Exchange |
$58.89
|
| Rate for Payer: UHC Medicaid |
$20.53
|
| Rate for Payer: UHCCP Medicaid |
$20.53
|
| Rate for Payer: UMR Bronson Commercial |
$58.20
|
| Rate for Payer: VA VA |
$39.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.97
|
|
|
HC PRO BNP
|
Facility
|
IP
|
$157.30
|
|
|
Service Code
|
CPT 83880
|
| Hospital Charge Code |
30100304
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$69.21 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna American Axle |
$102.25
|
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.25
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Advantage |
$110.11
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$110.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: Priority Health SBD |
$99.10
|
| Rate for Payer: UMR Bronson Commercial |
$69.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.97
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
IP
|
$69.71
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.67 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna American Axle |
$45.31
|
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.31
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Advantage |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health SBD |
$43.92
|
| Rate for Payer: UMR Bronson Commercial |
$30.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC PROCAINAMIDE AND NAPA LEVEL
|
Facility
|
OP
|
$69.71
|
|
|
Service Code
|
CPT 80192
|
| Hospital Charge Code |
30100042
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.76 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna American Axle |
$45.31
|
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$17.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.94
|
| Rate for Payer: BCBS Complete |
$9.20
|
| Rate for Payer: BCBS MAPPO |
$16.75
|
| Rate for Payer: BCBS Trust/PPO |
$19.36
|
| Rate for Payer: BCN Commercial |
$19.36
|
| Rate for Payer: BCN Medicare Advantage |
$16.75
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Advantage |
$48.80
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.75
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Mclaren Medicaid |
$16.75
|
| Rate for Payer: Mclaren Medicare |
$16.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.59
|
| Rate for Payer: Meridian Medicaid |
$17.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$25.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PACE Medicare |
$15.91
|
| Rate for Payer: PACE SWMI |
$16.75
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: PHP Medicare Advantage |
$16.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.75
|
| Rate for Payer: Priority Health Medicare |
$16.75
|
| Rate for Payer: Priority Health SBD |
$43.92
|
| Rate for Payer: Priority Health Tiered Network |
$13.40
|
| Rate for Payer: Railroad Medicare Medicare |
$16.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.13
|
| Rate for Payer: UHC Core |
$25.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.75
|
| Rate for Payer: UHC Exchange |
$25.13
|
| Rate for Payer: UHC Medicaid |
$8.76
|
| Rate for Payer: UHCCP Medicaid |
$8.76
|
| Rate for Payer: UMR Bronson Commercial |
$25.79
|
| Rate for Payer: VA VA |
$16.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
IP
|
$7,572.41
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$3,331.86 |
| Max. Negotiated Rate |
$6,815.17 |
| Rate for Payer: Aetna American Axle |
$4,922.07
|
| Rate for Payer: Aetna Commercial |
$6,436.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,922.07
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cofinity Advantage |
$5,300.69
|
| Rate for Payer: Cofinity Commercial |
$6,512.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,057.93
|
| Rate for Payer: Healthscope Commercial |
$6,815.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,300.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,679.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,436.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,679.31
|
| Rate for Payer: PHP Commercial |
$6,436.55
|
| Rate for Payer: Priority Health SBD |
$4,770.62
|
| Rate for Payer: UMR Bronson Commercial |
$3,331.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,679.31
|
|
|
HC PROCAINAMIDE CHALLENGE
|
Facility
|
OP
|
$7,572.41
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100123
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$67.05 |
| Max. Negotiated Rate |
$6,815.17 |
| Rate for Payer: Aetna American Axle |
$4,922.07
|
| Rate for Payer: Aetna Commercial |
$6,436.55
|
| Rate for Payer: Aetna Medicare |
$133.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,922.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$160.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$160.26
|
| Rate for Payer: BCBS Complete |
$70.41
|
| Rate for Payer: BCBS MAPPO |
$128.21
|
| Rate for Payer: BCBS Trust/PPO |
$413.88
|
| Rate for Payer: BCN Commercial |
$413.88
|
| Rate for Payer: BCN Medicare Advantage |
$128.21
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cash Price |
$6,057.93
|
| Rate for Payer: Cofinity Advantage |
$5,300.69
|
| Rate for Payer: Cofinity Commercial |
$6,512.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,057.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$128.21
|
| Rate for Payer: Healthscope Commercial |
$6,815.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,300.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,679.31
|
| Rate for Payer: Mclaren Medicaid |
$128.21
|
| Rate for Payer: Mclaren Medicare |
$128.21
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$134.62
|
| Rate for Payer: Meridian Medicaid |
$134.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$147.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$141.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,436.55
|
| Rate for Payer: Nomi Health Commercial |
$384.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,679.31
|
| Rate for Payer: PACE Medicare |
$121.80
|
| Rate for Payer: PACE SWMI |
$128.21
|
| Rate for Payer: PHP Commercial |
$6,436.55
|
| Rate for Payer: PHP Medicare Advantage |
$128.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$414.63
|
| Rate for Payer: Priority Health Medicare |
$128.21
|
| Rate for Payer: Priority Health SBD |
$4,770.62
|
| Rate for Payer: Priority Health Tiered Network |
$331.70
|
| Rate for Payer: Railroad Medicare Medicare |
$128.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$128.21
|
| Rate for Payer: UHC Medicaid |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$67.05
|
| Rate for Payer: UMR Bronson Commercial |
$2,801.79
|
| Rate for Payer: VA VA |
$128.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,679.31
|
|
|
HC PROCALCITONIN
|
Facility
|
IP
|
$106.12
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.69 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna American Axle |
$68.98
|
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: UMR Bronson Commercial |
$46.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC PROCALCITONIN
|
Facility
|
OP
|
$106.12
|
|
|
Service Code
|
CPT 84145
|
| Hospital Charge Code |
30100480
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.24 |
| Max. Negotiated Rate |
$95.51 |
| Rate for Payer: Aetna American Axle |
$68.98
|
| Rate for Payer: Aetna Commercial |
$90.20
|
| Rate for Payer: Aetna Medicare |
$28.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.02
|
| Rate for Payer: BCBS Complete |
$14.95
|
| Rate for Payer: BCBS MAPPO |
$27.22
|
| Rate for Payer: BCBS Trust/PPO |
$31.47
|
| Rate for Payer: BCN Commercial |
$31.47
|
| Rate for Payer: BCN Medicare Advantage |
$27.22
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cash Price |
$84.90
|
| Rate for Payer: Cofinity Advantage |
$74.28
|
| Rate for Payer: Cofinity Commercial |
$91.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.22
|
| Rate for Payer: Healthscope Commercial |
$95.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.59
|
| Rate for Payer: Mclaren Medicaid |
$27.22
|
| Rate for Payer: Mclaren Medicare |
$27.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.58
|
| Rate for Payer: Meridian Medicaid |
$28.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$90.20
|
| Rate for Payer: Nomi Health Commercial |
$40.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.59
|
| Rate for Payer: PACE Medicare |
$25.86
|
| Rate for Payer: PACE SWMI |
$27.22
|
| Rate for Payer: PHP Commercial |
$90.20
|
| Rate for Payer: PHP Medicare Advantage |
$27.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.22
|
| Rate for Payer: Priority Health Medicare |
$27.22
|
| Rate for Payer: Priority Health SBD |
$66.86
|
| Rate for Payer: Priority Health Tiered Network |
$21.78
|
| Rate for Payer: Railroad Medicare Medicare |
$27.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.83
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.22
|
| Rate for Payer: UHC Exchange |
$40.83
|
| Rate for Payer: UHC Medicaid |
$14.24
|
| Rate for Payer: UHCCP Medicaid |
$14.24
|
| Rate for Payer: UMR Bronson Commercial |
$39.26
|
| Rate for Payer: VA VA |
$27.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.59
|
|
|
HC PROCESS FEE
|
Facility
|
OP
|
$37.45
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$13.86 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna American Axle |
$24.34
|
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna Medicare |
$18.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: BCBS Complete |
$14.98
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Advantage |
$26.21
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.09
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.73
|
| Rate for Payer: UHC Core |
$18.73
|
| Rate for Payer: UHC Exchange |
$18.73
|
| Rate for Payer: UMR Bronson Commercial |
$13.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC PROCESS FEE
|
Facility
|
IP
|
$37.45
|
|
| Hospital Charge Code |
30000106
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.48 |
| Max. Negotiated Rate |
$33.70 |
| Rate for Payer: Aetna American Axle |
$24.34
|
| Rate for Payer: Aetna Commercial |
$31.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$24.34
|
| Rate for Payer: Cash Price |
$29.96
|
| Rate for Payer: Cofinity Advantage |
$26.21
|
| Rate for Payer: Cofinity Commercial |
$32.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.96
|
| Rate for Payer: Healthscope Commercial |
$33.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$26.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$31.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.09
|
| Rate for Payer: PHP Commercial |
$31.83
|
| Rate for Payer: Priority Health SBD |
$23.59
|
| Rate for Payer: UMR Bronson Commercial |
$16.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.09
|
|
|
HC PROCTOSIGMOIDOSCOY RIGID DX
|
Facility
|
IP
|
$1,185.73
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
76100185
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$521.72 |
| Max. Negotiated Rate |
$1,067.16 |
| Rate for Payer: Aetna American Axle |
$770.72
|
| Rate for Payer: Aetna Commercial |
$1,007.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.72
|
| Rate for Payer: Cash Price |
$948.58
|
| Rate for Payer: Cofinity Advantage |
$830.01
|
| Rate for Payer: Cofinity Commercial |
$1,019.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.58
|
| Rate for Payer: Healthscope Commercial |
$1,067.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$830.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$889.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.30
|
| Rate for Payer: PHP Commercial |
$1,007.87
|
| Rate for Payer: Priority Health SBD |
$747.01
|
| Rate for Payer: UMR Bronson Commercial |
$521.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$889.30
|
|
|
HC PROCTOSIGMOIDOSCOY RIGID DX
|
Facility
|
OP
|
$1,185.73
|
|
|
Service Code
|
CPT 45300
|
| Hospital Charge Code |
76100185
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$147.99 |
| Max. Negotiated Rate |
$2,996.60 |
| Rate for Payer: Aetna American Axle |
$770.72
|
| Rate for Payer: Aetna Commercial |
$1,007.87
|
| Rate for Payer: Aetna Medicare |
$963.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$770.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,158.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,158.26
|
| Rate for Payer: BCBS Complete |
$508.89
|
| Rate for Payer: BCBS MAPPO |
$926.61
|
| Rate for Payer: BCBS Trust/PPO |
$147.99
|
| Rate for Payer: BCN Commercial |
$147.99
|
| Rate for Payer: BCN Medicare Advantage |
$926.61
|
| Rate for Payer: Cash Price |
$948.58
|
| Rate for Payer: Cash Price |
$948.58
|
| Rate for Payer: Cash Price |
$948.58
|
| Rate for Payer: Cofinity Advantage |
$830.01
|
| Rate for Payer: Cofinity Commercial |
$1,019.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$948.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$926.61
|
| Rate for Payer: Healthscope Commercial |
$1,067.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$830.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$889.30
|
| Rate for Payer: Mclaren Medicaid |
$926.61
|
| Rate for Payer: Mclaren Medicare |
$926.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$972.94
|
| Rate for Payer: Meridian Medicaid |
$972.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,065.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,019.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,007.87
|
| Rate for Payer: Nomi Health Commercial |
$2,779.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$889.30
|
| Rate for Payer: PACE Medicare |
$880.28
|
| Rate for Payer: PACE SWMI |
$926.61
|
| Rate for Payer: PHP Commercial |
$1,007.87
|
| Rate for Payer: PHP Medicare Advantage |
$926.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$484.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,996.60
|
| Rate for Payer: Priority Health Medicare |
$926.61
|
| Rate for Payer: Priority Health SBD |
$747.01
|
| Rate for Payer: Priority Health Tiered Network |
$2,397.28
|
| Rate for Payer: Railroad Medicare Medicare |
$926.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$770.72
|
| Rate for Payer: UHC Core |
$617.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$926.61
|
| Rate for Payer: UHC Exchange |
$465.99
|
| Rate for Payer: UHC Medicaid |
$484.62
|
| Rate for Payer: UHCCP Medicaid |
$484.62
|
| Rate for Payer: UMR Bronson Commercial |
$438.72
|
| Rate for Payer: VA VA |
$926.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$889.30
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY 2 OR MORE INJECT
|
Facility
|
OP
|
$39.31
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
51000082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$150.88 |
| Rate for Payer: Aetna American Axle |
$25.55
|
| Rate for Payer: Aetna Commercial |
$33.41
|
| Rate for Payer: Aetna Medicare |
$48.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.55
|
| 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 |
$50.71
|
| Rate for Payer: BCN Commercial |
$50.71
|
| Rate for Payer: BCN Medicare Advantage |
$46.66
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cofinity Advantage |
$27.52
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.66
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.48
|
| 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 |
$33.41
|
| Rate for Payer: Nomi Health Commercial |
$139.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.48
|
| Rate for Payer: PACE Medicare |
$44.33
|
| Rate for Payer: PACE SWMI |
$46.66
|
| Rate for Payer: PHP Commercial |
$33.41
|
| 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 |
$24.77
|
| 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) |
$25.55
|
| Rate for Payer: UHC Core |
$20.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.66
|
| Rate for Payer: UHC Exchange |
$15.45
|
| Rate for Payer: UHC Medicaid |
$24.40
|
| Rate for Payer: UHCCP Medicaid |
$24.40
|
| Rate for Payer: UMR Bronson Commercial |
$14.54
|
| Rate for Payer: VA VA |
$46.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.48
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY 2 OR MORE INJECT
|
Facility
|
IP
|
$39.31
|
|
|
Service Code
|
CPT 95117
|
| Hospital Charge Code |
51000082
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.30 |
| Max. Negotiated Rate |
$35.38 |
| Rate for Payer: Aetna American Axle |
$25.55
|
| Rate for Payer: Aetna Commercial |
$33.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.55
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cofinity Advantage |
$27.52
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.45
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.48
|
| Rate for Payer: PHP Commercial |
$33.41
|
| Rate for Payer: Priority Health SBD |
$24.77
|
| Rate for Payer: UMR Bronson Commercial |
$17.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.48
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY SINGLE INJECT
|
Facility
|
IP
|
$39.31
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
51000081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$17.30 |
| Max. Negotiated Rate |
$35.38 |
| Rate for Payer: Aetna American Axle |
$25.55
|
| Rate for Payer: Aetna Commercial |
$33.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.55
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cofinity Advantage |
$27.52
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.45
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.48
|
| Rate for Payer: PHP Commercial |
$33.41
|
| Rate for Payer: Priority Health SBD |
$24.77
|
| Rate for Payer: UMR Bronson Commercial |
$17.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.48
|
|
|
HC PROF SVC ALLERGEN IMMUNOTHERAPY SINGLE INJECT
|
Facility
|
OP
|
$39.31
|
|
|
Service Code
|
CPT 95115
|
| Hospital Charge Code |
51000081
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$14.54 |
| Max. Negotiated Rate |
$150.88 |
| Rate for Payer: Aetna American Axle |
$25.55
|
| Rate for Payer: Aetna Commercial |
$33.41
|
| Rate for Payer: Aetna Medicare |
$48.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.55
|
| 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 |
$43.67
|
| Rate for Payer: BCN Commercial |
$43.67
|
| Rate for Payer: BCN Medicare Advantage |
$46.66
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cash Price |
$31.45
|
| Rate for Payer: Cofinity Advantage |
$27.52
|
| Rate for Payer: Cofinity Commercial |
$33.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.66
|
| Rate for Payer: Healthscope Commercial |
$35.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.48
|
| 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 |
$33.41
|
| Rate for Payer: Nomi Health Commercial |
$139.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.48
|
| Rate for Payer: PACE Medicare |
$44.33
|
| Rate for Payer: PACE SWMI |
$46.66
|
| Rate for Payer: PHP Commercial |
$33.41
|
| 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 |
$24.77
|
| 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) |
$25.55
|
| Rate for Payer: UHC Core |
$20.48
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$46.66
|
| Rate for Payer: UHC Exchange |
$15.45
|
| Rate for Payer: UHC Medicaid |
$24.40
|
| Rate for Payer: UHCCP Medicaid |
$24.40
|
| Rate for Payer: UMR Bronson Commercial |
$14.54
|
| Rate for Payer: VA VA |
$46.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.48
|
|
|
HC PROGESTERONE LEVEL
|
Facility
|
OP
|
$80.08
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
30100400
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.91 |
| Max. Negotiated Rate |
$72.07 |
| Rate for Payer: Aetna American Axle |
$52.05
|
| Rate for Payer: Aetna Commercial |
$68.07
|
| Rate for Payer: Aetna Medicare |
$21.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.07
|
| Rate for Payer: BCBS Complete |
$11.46
|
| Rate for Payer: BCBS MAPPO |
$20.86
|
| Rate for Payer: BCBS Trust/PPO |
$24.12
|
| Rate for Payer: BCN Commercial |
$24.12
|
| Rate for Payer: BCN Medicare Advantage |
$20.86
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cofinity Advantage |
$56.06
|
| Rate for Payer: Cofinity Commercial |
$68.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.86
|
| Rate for Payer: Healthscope Commercial |
$72.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.06
|
| Rate for Payer: Mclaren Medicaid |
$20.86
|
| Rate for Payer: Mclaren Medicare |
$20.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.90
|
| Rate for Payer: Meridian Medicaid |
$21.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.07
|
| Rate for Payer: Nomi Health Commercial |
$31.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.06
|
| Rate for Payer: PACE Medicare |
$19.82
|
| Rate for Payer: PACE SWMI |
$20.86
|
| Rate for Payer: PHP Commercial |
$68.07
|
| Rate for Payer: PHP Medicare Advantage |
$20.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.86
|
| Rate for Payer: Priority Health Medicare |
$20.86
|
| Rate for Payer: Priority Health SBD |
$50.45
|
| Rate for Payer: Priority Health Tiered Network |
$16.69
|
| Rate for Payer: Railroad Medicare Medicare |
$20.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.29
|
| Rate for Payer: UHC Core |
$31.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$20.86
|
| Rate for Payer: UHC Exchange |
$31.29
|
| Rate for Payer: UHC Medicaid |
$10.91
|
| Rate for Payer: UHCCP Medicaid |
$10.91
|
| Rate for Payer: UMR Bronson Commercial |
$29.63
|
| Rate for Payer: VA VA |
$20.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.06
|
|
|
HC PROGESTERONE LEVEL
|
Facility
|
IP
|
$80.08
|
|
|
Service Code
|
CPT 84144
|
| Hospital Charge Code |
30100400
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.24 |
| Max. Negotiated Rate |
$72.07 |
| Rate for Payer: Aetna American Axle |
$52.05
|
| Rate for Payer: Aetna Commercial |
$68.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.05
|
| Rate for Payer: Cash Price |
$64.06
|
| Rate for Payer: Cofinity Advantage |
$56.06
|
| Rate for Payer: Cofinity Commercial |
$68.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.06
|
| Rate for Payer: Healthscope Commercial |
$72.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.06
|
| Rate for Payer: PHP Commercial |
$68.07
|
| Rate for Payer: Priority Health SBD |
$50.45
|
| Rate for Payer: UMR Bronson Commercial |
$35.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.06
|
|
|
HC PROLACTIN
|
Facility
|
IP
|
$75.35
|
|
|
Service Code
|
CPT 84146
|
| Hospital Charge Code |
30100402
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$67.81 |
| Rate for Payer: Aetna American Axle |
$48.98
|
| Rate for Payer: Aetna Commercial |
$64.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.98
|
| Rate for Payer: Cash Price |
$60.28
|
| Rate for Payer: Cofinity Advantage |
$52.74
|
| Rate for Payer: Cofinity Commercial |
$64.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.28
|
| Rate for Payer: Healthscope Commercial |
$67.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.51
|
| Rate for Payer: PHP Commercial |
$64.05
|
| Rate for Payer: Priority Health SBD |
$47.47
|
| Rate for Payer: UMR Bronson Commercial |
$33.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.51
|
|
