|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
OP
|
$88.43
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.01 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna American Axle |
$57.48
|
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna Medicare |
$15.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.15
|
| Rate for Payer: BCBS Complete |
$8.41
|
| Rate for Payer: BCBS MAPPO |
$15.32
|
| Rate for Payer: BCBS Trust/PPO |
$17.71
|
| Rate for Payer: BCN Commercial |
$17.71
|
| Rate for Payer: BCN Medicare Advantage |
$15.32
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Advantage |
$61.90
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.32
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.32
|
| Rate for Payer: Mclaren Medicaid |
$15.32
|
| Rate for Payer: Mclaren Medicare |
$15.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.09
|
| Rate for Payer: Meridian Medicaid |
$16.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PACE Medicare |
$14.55
|
| Rate for Payer: PACE SWMI |
$15.32
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: PHP Medicare Advantage |
$15.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.32
|
| Rate for Payer: Priority Health Medicare |
$15.32
|
| Rate for Payer: Priority Health SBD |
$55.71
|
| Rate for Payer: Priority Health Tiered Network |
$12.26
|
| Rate for Payer: Railroad Medicare Medicare |
$15.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.98
|
| Rate for Payer: UHC Core |
$22.98
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.32
|
| Rate for Payer: UHC Exchange |
$22.98
|
| Rate for Payer: UHC Medicaid |
$8.01
|
| Rate for Payer: UHCCP Medicaid |
$8.01
|
| Rate for Payer: UMR Bronson Commercial |
$32.72
|
| Rate for Payer: VA VA |
$15.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.32
|
|
|
HC PROTEIN S ANTIGEN FREE
|
Facility
|
IP
|
$88.43
|
|
|
Service Code
|
CPT 85306
|
| Hospital Charge Code |
30500074
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$38.91 |
| Max. Negotiated Rate |
$79.59 |
| Rate for Payer: Aetna American Axle |
$57.48
|
| Rate for Payer: Aetna Commercial |
$75.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.48
|
| Rate for Payer: Cash Price |
$70.74
|
| Rate for Payer: Cofinity Advantage |
$61.90
|
| Rate for Payer: Cofinity Commercial |
$76.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.74
|
| Rate for Payer: Healthscope Commercial |
$79.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$75.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.32
|
| Rate for Payer: PHP Commercial |
$75.17
|
| Rate for Payer: Priority Health SBD |
$55.71
|
| Rate for Payer: UMR Bronson Commercial |
$38.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.32
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$21.97 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: UMR Bronson Commercial |
$21.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC PROTHROMBIN TIME
|
Facility
|
OP
|
$49.94
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500073
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna American Axle |
$32.46
|
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: Aetna Medicare |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$4.96
|
| Rate for Payer: BCN Commercial |
$4.96
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Advantage |
$34.96
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Mclaren Medicaid |
$4.29
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: Meridian Medicaid |
$4.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$6.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.29
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health SBD |
$31.46
|
| Rate for Payer: Priority Health Tiered Network |
$3.43
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.44
|
| Rate for Payer: UHC Core |
$6.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.29
|
| Rate for Payer: UHC Exchange |
$6.44
|
| Rate for Payer: UHC Medicaid |
$2.24
|
| Rate for Payer: UHCCP Medicaid |
$2.24
|
| Rate for Payer: UMR Bronson Commercial |
$18.48
|
| Rate for Payer: VA VA |
$4.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC PROTIME WITH INR
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.07 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna American Axle |
$19.31
|
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: Priority Health SBD |
$18.72
|
| Rate for Payer: UMR Bronson Commercial |
$13.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC PROTIME WITH INR
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500058
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.24 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna American Axle |
$19.31
|
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Medicare |
$4.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.36
|
| Rate for Payer: BCBS Complete |
$2.36
|
| Rate for Payer: BCBS MAPPO |
$4.29
|
| Rate for Payer: BCBS Trust/PPO |
$4.96
|
| Rate for Payer: BCN Commercial |
$4.96
|
| Rate for Payer: BCN Medicare Advantage |
$4.29
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Advantage |
$20.80
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.29
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Mclaren Medicaid |
$4.29
|
| Rate for Payer: Mclaren Medicare |
$4.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.50
|
| Rate for Payer: Meridian Medicaid |
$4.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.93
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$6.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Medicare |
$4.08
|
| Rate for Payer: PACE SWMI |
$4.29
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$4.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.29
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health SBD |
$18.72
|
| Rate for Payer: Priority Health Tiered Network |
$3.43
|
| Rate for Payer: Railroad Medicare Medicare |
$4.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.44
|
| Rate for Payer: UHC Core |
$6.44
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.29
|
| Rate for Payer: UHC Exchange |
$6.44
|
| Rate for Payer: UHC Medicaid |
$2.24
|
| Rate for Payer: UHCCP Medicaid |
$2.24
|
| Rate for Payer: UMR Bronson Commercial |
$10.99
|
| Rate for Payer: VA VA |
$4.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.13 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna American Axle |
$56.13
|
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.19
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$2.51
|
| Rate for Payer: BCN Commercial |
$2.51
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Advantage |
$60.45
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.17
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Mclaren Medicaid |
$2.17
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Medicaid |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$3.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.17
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health SBD |
$54.40
|
| Rate for Payer: Priority Health Tiered Network |
$1.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.26
|
| Rate for Payer: UHC Core |
$3.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.17
|
| Rate for Payer: UHC Exchange |
$3.26
|
| Rate for Payer: UHC Medicaid |
$1.13
|
| Rate for Payer: UHCCP Medicaid |
$1.13
|
| Rate for Payer: UMR Bronson Commercial |
$31.95
|
| Rate for Payer: VA VA |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PROTOPORPHYRIN FREE WB
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30100619
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.99 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna American Axle |
$56.13
|
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Advantage |
$60.45
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$64.76
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health SBD |
$54.40
|
| Rate for Payer: UMR Bronson Commercial |
$37.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PROTOPORPHYRINS, FRACTIONATION, WB
|
Facility
|
OP
|
$88.08
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100692
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.60 |
| Max. Negotiated Rate |
$79.27 |
| Rate for Payer: Aetna American Axle |
$57.25
|
| Rate for Payer: Aetna Commercial |
$74.87
|
| Rate for Payer: Aetna Medicare |
$25.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.11
|
| Rate for Payer: BCBS Complete |
$13.23
|
| Rate for Payer: BCBS MAPPO |
$24.09
|
| Rate for Payer: BCBS Trust/PPO |
$27.85
|
| Rate for Payer: BCN Commercial |
$27.85
|
| Rate for Payer: BCN Medicare Advantage |
$24.09
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Advantage |
$61.66
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.09
|
| Rate for Payer: Healthscope Commercial |
$79.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.06
|
| Rate for Payer: Mclaren Medicaid |
$24.09
|
| Rate for Payer: Mclaren Medicare |
$24.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.29
|
| Rate for Payer: Meridian Medicaid |
$25.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Nomi Health Commercial |
$36.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PACE Medicare |
$22.89
|
| Rate for Payer: PACE SWMI |
$24.09
|
| Rate for Payer: PHP Commercial |
$74.87
|
| Rate for Payer: PHP Medicare Advantage |
$24.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$24.09
|
| Rate for Payer: Priority Health Medicare |
$24.09
|
| Rate for Payer: Priority Health SBD |
$55.49
|
| Rate for Payer: Priority Health Tiered Network |
$19.27
|
| Rate for Payer: Railroad Medicare Medicare |
$24.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.14
|
| Rate for Payer: UHC Core |
$36.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$24.09
|
| Rate for Payer: UHC Exchange |
$36.14
|
| Rate for Payer: UHC Medicaid |
$12.60
|
| Rate for Payer: UHCCP Medicaid |
$12.60
|
| Rate for Payer: UMR Bronson Commercial |
$32.59
|
| Rate for Payer: VA VA |
$24.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.06
|
|
|
HC PROTOPORPHYRINS, FRACTIONATION, WB
|
Facility
|
IP
|
$88.08
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100692
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.76 |
| Max. Negotiated Rate |
$79.27 |
| Rate for Payer: Aetna American Axle |
$57.25
|
| Rate for Payer: Aetna Commercial |
$74.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$57.25
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Advantage |
$61.66
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Healthscope Commercial |
$79.27
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PHP Commercial |
$74.87
|
| Rate for Payer: Priority Health SBD |
$55.49
|
| Rate for Payer: UMR Bronson Commercial |
$38.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.06
|
|
|
HC PSA ANNUAL SCREEN
|
Facility
|
OP
|
$71.07
|
|
|
Service Code
|
HCPCS G0103
|
| Hospital Charge Code |
30000044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.10 |
| Max. Negotiated Rate |
$63.96 |
| Rate for Payer: Aetna American Axle |
$46.20
|
| Rate for Payer: Aetna Commercial |
$60.41
|
| Rate for Payer: Aetna Medicare |
$20.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.14
|
| Rate for Payer: BCBS Complete |
$10.61
|
| Rate for Payer: BCBS MAPPO |
$19.31
|
| Rate for Payer: BCBS Trust/PPO |
$22.32
|
| Rate for Payer: BCN Commercial |
$22.32
|
| Rate for Payer: BCN Medicare Advantage |
$19.31
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cofinity Advantage |
$49.75
|
| Rate for Payer: Cofinity Commercial |
$61.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.31
|
| Rate for Payer: Healthscope Commercial |
$63.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.30
|
| Rate for Payer: Mclaren Medicaid |
$19.31
|
| Rate for Payer: Mclaren Medicare |
$19.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.28
|
| Rate for Payer: Meridian Medicaid |
$20.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.41
|
| Rate for Payer: Nomi Health Commercial |
$57.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.30
|
| Rate for Payer: PACE Medicare |
$18.34
|
| Rate for Payer: PACE SWMI |
$19.31
|
| Rate for Payer: PHP Commercial |
$60.41
|
| Rate for Payer: PHP Medicare Advantage |
$19.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$19.31
|
| Rate for Payer: Priority Health Medicare |
$19.31
|
| Rate for Payer: Priority Health SBD |
$44.77
|
| Rate for Payer: Priority Health Tiered Network |
$15.45
|
| Rate for Payer: Railroad Medicare Medicare |
$19.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.97
|
| Rate for Payer: UHC Core |
$28.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$19.31
|
| Rate for Payer: UHC Exchange |
$28.97
|
| Rate for Payer: UHC Medicaid |
$10.10
|
| Rate for Payer: UHCCP Medicaid |
$10.10
|
| Rate for Payer: UMR Bronson Commercial |
$26.30
|
| Rate for Payer: VA VA |
$19.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.30
|
|
|
HC PSA ANNUAL SCREEN
|
Facility
|
IP
|
$71.07
|
|
|
Service Code
|
HCPCS G0103
|
| Hospital Charge Code |
30000044
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.27 |
| Max. Negotiated Rate |
$63.96 |
| Rate for Payer: Aetna American Axle |
$46.20
|
| Rate for Payer: Aetna Commercial |
$60.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.20
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cofinity Advantage |
$49.75
|
| Rate for Payer: Cofinity Commercial |
$61.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.86
|
| Rate for Payer: Healthscope Commercial |
$63.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.30
|
| Rate for Payer: PHP Commercial |
$60.41
|
| Rate for Payer: Priority Health SBD |
$44.77
|
| Rate for Payer: UMR Bronson Commercial |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.30
|
|
|
HC PSA FREE
|
Facility
|
IP
|
$71.07
|
|
|
Service Code
|
CPT 84154
|
| Hospital Charge Code |
30100405
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.27 |
| Max. Negotiated Rate |
$63.96 |
| Rate for Payer: Aetna American Axle |
$46.20
|
| Rate for Payer: Aetna Commercial |
$60.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.20
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cofinity Advantage |
$49.75
|
| Rate for Payer: Cofinity Commercial |
$61.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.86
|
| Rate for Payer: Healthscope Commercial |
$63.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.30
|
| Rate for Payer: PHP Commercial |
$60.41
|
| Rate for Payer: Priority Health SBD |
$44.77
|
| Rate for Payer: UMR Bronson Commercial |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.30
|
|
|
HC PSA FREE
|
Facility
|
OP
|
$71.07
|
|
|
Service Code
|
CPT 84154
|
| Hospital Charge Code |
30100405
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$63.96 |
| Rate for Payer: Aetna American Axle |
$46.20
|
| Rate for Payer: Aetna Commercial |
$60.41
|
| Rate for Payer: Aetna Medicare |
$19.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.99
|
| Rate for Payer: BCBS Complete |
$10.10
|
| Rate for Payer: BCBS MAPPO |
$18.39
|
| Rate for Payer: BCBS Trust/PPO |
$21.25
|
| Rate for Payer: BCN Commercial |
$21.25
|
| Rate for Payer: BCN Medicare Advantage |
$18.39
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cofinity Advantage |
$49.75
|
| Rate for Payer: Cofinity Commercial |
$61.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.39
|
| Rate for Payer: Healthscope Commercial |
$63.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.30
|
| Rate for Payer: Mclaren Medicaid |
$18.39
|
| Rate for Payer: Mclaren Medicare |
$18.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.31
|
| Rate for Payer: Meridian Medicaid |
$19.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.41
|
| Rate for Payer: Nomi Health Commercial |
$27.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.30
|
| Rate for Payer: PACE Medicare |
$17.47
|
| Rate for Payer: PACE SWMI |
$18.39
|
| Rate for Payer: PHP Commercial |
$60.41
|
| Rate for Payer: PHP Medicare Advantage |
$18.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.39
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health SBD |
$44.77
|
| Rate for Payer: Priority Health Tiered Network |
$14.71
|
| Rate for Payer: Railroad Medicare Medicare |
$18.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.59
|
| Rate for Payer: UHC Core |
$27.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.39
|
| Rate for Payer: UHC Exchange |
$27.59
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UMR Bronson Commercial |
$26.30
|
| Rate for Payer: VA VA |
$18.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.30
|
|
|
HC PSA TOTAL
|
Facility
|
OP
|
$71.07
|
|
|
Service Code
|
CPT 84153
|
| Hospital Charge Code |
30100403
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.62 |
| Max. Negotiated Rate |
$63.96 |
| Rate for Payer: Aetna American Axle |
$46.20
|
| Rate for Payer: Aetna Commercial |
$60.41
|
| Rate for Payer: Aetna Medicare |
$19.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.99
|
| Rate for Payer: BCBS Complete |
$10.10
|
| Rate for Payer: BCBS MAPPO |
$18.39
|
| Rate for Payer: BCBS Trust/PPO |
$21.25
|
| Rate for Payer: BCN Commercial |
$21.25
|
| Rate for Payer: BCN Medicare Advantage |
$18.39
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cofinity Advantage |
$49.75
|
| Rate for Payer: Cofinity Commercial |
$61.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.39
|
| Rate for Payer: Healthscope Commercial |
$63.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.30
|
| Rate for Payer: Mclaren Medicaid |
$18.39
|
| Rate for Payer: Mclaren Medicare |
$18.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.31
|
| Rate for Payer: Meridian Medicaid |
$19.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.41
|
| Rate for Payer: Nomi Health Commercial |
$27.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.30
|
| Rate for Payer: PACE Medicare |
$17.47
|
| Rate for Payer: PACE SWMI |
$18.39
|
| Rate for Payer: PHP Commercial |
$60.41
|
| Rate for Payer: PHP Medicare Advantage |
$18.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.39
|
| Rate for Payer: Priority Health Medicare |
$18.39
|
| Rate for Payer: Priority Health SBD |
$44.77
|
| Rate for Payer: Priority Health Tiered Network |
$14.71
|
| Rate for Payer: Railroad Medicare Medicare |
$18.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.59
|
| Rate for Payer: UHC Core |
$27.59
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.39
|
| Rate for Payer: UHC Exchange |
$27.59
|
| Rate for Payer: UHC Medicaid |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$9.62
|
| Rate for Payer: UMR Bronson Commercial |
$26.30
|
| Rate for Payer: VA VA |
$18.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.30
|
|
|
HC PSA TOTAL
|
Facility
|
IP
|
$71.07
|
|
|
Service Code
|
CPT 84153
|
| Hospital Charge Code |
30100403
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.27 |
| Max. Negotiated Rate |
$63.96 |
| Rate for Payer: Aetna American Axle |
$46.20
|
| Rate for Payer: Aetna Commercial |
$60.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.20
|
| Rate for Payer: Cash Price |
$56.86
|
| Rate for Payer: Cofinity Advantage |
$49.75
|
| Rate for Payer: Cofinity Commercial |
$61.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.86
|
| Rate for Payer: Healthscope Commercial |
$63.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.30
|
| Rate for Payer: PHP Commercial |
$60.41
|
| Rate for Payer: Priority Health SBD |
$44.77
|
| Rate for Payer: UMR Bronson Commercial |
$31.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.30
|
|
|
HC PSEUDOANEURYSM INJECTION
|
Facility
|
IP
|
$1,091.96
|
|
|
Service Code
|
CPT 36002
|
| Hospital Charge Code |
36100094
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$480.46 |
| Max. Negotiated Rate |
$982.76 |
| Rate for Payer: Aetna American Axle |
$709.77
|
| Rate for Payer: Aetna Commercial |
$928.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.77
|
| Rate for Payer: Cash Price |
$873.57
|
| Rate for Payer: Cofinity Advantage |
$764.37
|
| Rate for Payer: Cofinity Commercial |
$939.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.57
|
| Rate for Payer: Healthscope Commercial |
$982.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$764.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$818.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$818.97
|
| Rate for Payer: PHP Commercial |
$928.17
|
| Rate for Payer: Priority Health SBD |
$687.93
|
| Rate for Payer: UMR Bronson Commercial |
$480.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$818.97
|
|
|
HC PSEUDOANEURYSM INJECTION
|
Facility
|
OP
|
$1,091.96
|
|
|
Service Code
|
CPT 36002
|
| Hospital Charge Code |
36100094
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$326.90 |
| Max. Negotiated Rate |
$2,021.35 |
| Rate for Payer: Aetna American Axle |
$709.77
|
| Rate for Payer: Aetna Commercial |
$928.17
|
| Rate for Payer: Aetna Medicare |
$650.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$709.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$781.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$781.31
|
| Rate for Payer: BCBS Complete |
$343.28
|
| Rate for Payer: BCBS MAPPO |
$625.05
|
| Rate for Payer: BCBS Trust/PPO |
$695.62
|
| Rate for Payer: BCN Commercial |
$695.62
|
| Rate for Payer: BCN Medicare Advantage |
$625.05
|
| Rate for Payer: Cash Price |
$873.57
|
| Rate for Payer: Cash Price |
$873.57
|
| Rate for Payer: Cash Price |
$873.57
|
| Rate for Payer: Cofinity Advantage |
$764.37
|
| Rate for Payer: Cofinity Commercial |
$939.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$873.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$625.05
|
| Rate for Payer: Healthscope Commercial |
$982.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$764.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$818.97
|
| Rate for Payer: Mclaren Medicaid |
$625.05
|
| Rate for Payer: Mclaren Medicare |
$625.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$656.30
|
| Rate for Payer: Meridian Medicaid |
$656.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$718.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$687.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$928.17
|
| Rate for Payer: Nomi Health Commercial |
$1,875.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$818.97
|
| Rate for Payer: PACE Medicare |
$593.80
|
| Rate for Payer: PACE SWMI |
$625.05
|
| Rate for Payer: PHP Commercial |
$928.17
|
| Rate for Payer: PHP Medicare Advantage |
$625.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$326.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,021.35
|
| Rate for Payer: Priority Health Medicare |
$625.05
|
| Rate for Payer: Priority Health SBD |
$687.93
|
| Rate for Payer: Priority Health Tiered Network |
$1,617.08
|
| Rate for Payer: Railroad Medicare Medicare |
$625.05
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$625.05
|
| Rate for Payer: UHC Medicaid |
$326.90
|
| Rate for Payer: UHCCP Medicaid |
$326.90
|
| Rate for Payer: UMR Bronson Commercial |
$404.03
|
| Rate for Payer: VA VA |
$625.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$818.97
|
|
|
HC PSEUDOCHOLINESTERASE
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
30100156
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.12 |
| 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 |
$8.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.84
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$7.87
|
| Rate for Payer: BCBS Trust/PPO |
$9.09
|
| Rate for Payer: BCN Commercial |
$9.09
|
| Rate for Payer: BCN Medicare Advantage |
$7.87
|
| 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 |
$7.87
|
| 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 |
$7.87
|
| Rate for Payer: Mclaren Medicare |
$7.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.26
|
| Rate for Payer: Meridian Medicaid |
$8.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$11.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Medicare |
$7.48
|
| Rate for Payer: PACE SWMI |
$7.87
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$7.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$7.87
|
| Rate for Payer: Priority Health Medicare |
$7.87
|
| Rate for Payer: Priority Health SBD |
$33.43
|
| Rate for Payer: Priority Health Tiered Network |
$6.30
|
| Rate for Payer: Railroad Medicare Medicare |
$7.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.81
|
| Rate for Payer: UHC Core |
$11.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7.87
|
| Rate for Payer: UHC Exchange |
$11.81
|
| Rate for Payer: UHC Medicaid |
$4.12
|
| Rate for Payer: UHCCP Medicaid |
$4.12
|
| Rate for Payer: UMR Bronson Commercial |
$19.63
|
| Rate for Payer: VA VA |
$7.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC PSEUDOCHOLINESTERASE
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 82480
|
| Hospital Charge Code |
30100156
|
|
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 PSG PEDS 5 AND UNDER
|
Facility
|
IP
|
$5,910.14
|
|
|
Service Code
|
CPT 95782
|
| Hospital Charge Code |
92000017
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$2,600.46 |
| Max. Negotiated Rate |
$5,319.13 |
| Rate for Payer: Aetna American Axle |
$3,841.59
|
| Rate for Payer: Aetna Commercial |
$5,023.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,841.59
|
| Rate for Payer: Cash Price |
$4,728.11
|
| Rate for Payer: Cofinity Advantage |
$4,137.10
|
| Rate for Payer: Cofinity Commercial |
$5,082.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,728.11
|
| Rate for Payer: Healthscope Commercial |
$5,319.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,137.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,432.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,023.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,432.60
|
| Rate for Payer: PHP Commercial |
$5,023.62
|
| Rate for Payer: Priority Health SBD |
$3,723.39
|
| Rate for Payer: UMR Bronson Commercial |
$2,600.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,432.60
|
|
|
HC PSG PEDS 5 AND UNDER
|
Facility
|
OP
|
$5,910.14
|
|
|
Service Code
|
CPT 95782
|
| Hospital Charge Code |
92000017
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$5,319.13 |
| Rate for Payer: Aetna American Axle |
$3,841.59
|
| Rate for Payer: Aetna Commercial |
$5,023.62
|
| Rate for Payer: Aetna Medicare |
$889.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,841.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,598.30
|
| Rate for Payer: BCN Commercial |
$3,598.30
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$4,728.11
|
| Rate for Payer: Cash Price |
$4,728.11
|
| Rate for Payer: Cofinity Advantage |
$4,137.10
|
| Rate for Payer: Cofinity Commercial |
$5,082.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,728.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$5,319.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,137.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,432.60
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$898.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,023.62
|
| Rate for Payer: Nomi Health Commercial |
$2,566.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,432.60
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$5,023.62
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,767.09
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health SBD |
$3,723.39
|
| Rate for Payer: Priority Health Tiered Network |
$2,213.67
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,841.59
|
| Rate for Payer: UHC Core |
$3,079.18
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$2,322.69
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,186.75
|
| Rate for Payer: VA VA |
$855.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,432.60
|
|
|
HC PSG W CPAP PEDS 5 AND UNDER
|
Facility
|
OP
|
$6,102.68
|
|
|
Service Code
|
CPT 95783
|
| Hospital Charge Code |
92000018
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$447.50 |
| Max. Negotiated Rate |
$5,492.41 |
| Rate for Payer: Aetna American Axle |
$3,966.74
|
| Rate for Payer: Aetna Commercial |
$5,187.28
|
| Rate for Payer: Aetna Medicare |
$889.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,966.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,069.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,069.56
|
| Rate for Payer: BCBS Complete |
$469.92
|
| Rate for Payer: BCBS MAPPO |
$855.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,798.36
|
| Rate for Payer: BCN Commercial |
$3,798.36
|
| Rate for Payer: BCN Medicare Advantage |
$855.65
|
| Rate for Payer: Cash Price |
$4,882.14
|
| Rate for Payer: Cash Price |
$4,882.14
|
| Rate for Payer: Cofinity Advantage |
$4,271.88
|
| Rate for Payer: Cofinity Commercial |
$5,248.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,882.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$855.65
|
| Rate for Payer: Healthscope Commercial |
$5,492.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,271.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,577.01
|
| Rate for Payer: Mclaren Medicaid |
$855.65
|
| Rate for Payer: Mclaren Medicare |
$855.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$898.43
|
| Rate for Payer: Meridian Medicaid |
$898.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$984.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$941.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,187.28
|
| Rate for Payer: Nomi Health Commercial |
$2,566.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,577.01
|
| Rate for Payer: PACE Medicare |
$812.87
|
| Rate for Payer: PACE SWMI |
$855.65
|
| Rate for Payer: PHP Commercial |
$5,187.28
|
| Rate for Payer: PHP Medicare Advantage |
$855.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$447.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,767.09
|
| Rate for Payer: Priority Health Medicare |
$855.65
|
| Rate for Payer: Priority Health SBD |
$3,844.69
|
| Rate for Payer: Priority Health Tiered Network |
$2,213.67
|
| Rate for Payer: Railroad Medicare Medicare |
$855.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,966.74
|
| Rate for Payer: UHC Core |
$3,179.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$855.65
|
| Rate for Payer: UHC Exchange |
$2,398.35
|
| Rate for Payer: UHC Medicaid |
$447.50
|
| Rate for Payer: UHCCP Medicaid |
$447.50
|
| Rate for Payer: UMR Bronson Commercial |
$2,257.99
|
| Rate for Payer: VA VA |
$855.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,577.01
|
|
|
HC PSG W CPAP PEDS 5 AND UNDER
|
Facility
|
IP
|
$6,102.68
|
|
|
Service Code
|
CPT 95783
|
| Hospital Charge Code |
92000018
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$2,685.18 |
| Max. Negotiated Rate |
$5,492.41 |
| Rate for Payer: Aetna American Axle |
$3,966.74
|
| Rate for Payer: Aetna Commercial |
$5,187.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,966.74
|
| Rate for Payer: Cash Price |
$4,882.14
|
| Rate for Payer: Cofinity Advantage |
$4,271.88
|
| Rate for Payer: Cofinity Commercial |
$5,248.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,882.14
|
| Rate for Payer: Healthscope Commercial |
$5,492.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,271.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,577.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,187.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,577.01
|
| Rate for Payer: PHP Commercial |
$5,187.28
|
| Rate for Payer: Priority Health SBD |
$3,844.69
|
| Rate for Payer: UMR Bronson Commercial |
$2,685.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,577.01
|
|
|
HC PSORALEN
|
Facility
|
IP
|
$2,200.05
|
|
|
Service Code
|
HCPCS P9073
|
| Hospital Charge Code |
39000085
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$968.02 |
| Max. Negotiated Rate |
$1,980.05 |
| Rate for Payer: Aetna American Axle |
$1,430.03
|
| Rate for Payer: Aetna Commercial |
$1,870.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,430.03
|
| Rate for Payer: Cash Price |
$1,760.04
|
| Rate for Payer: Cofinity Advantage |
$1,540.04
|
| Rate for Payer: Cofinity Commercial |
$1,892.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,760.04
|
| Rate for Payer: Healthscope Commercial |
$1,980.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,540.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,650.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,870.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,650.04
|
| Rate for Payer: PHP Commercial |
$1,870.04
|
| Rate for Payer: Priority Health SBD |
$1,386.03
|
| Rate for Payer: UMR Bronson Commercial |
$968.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,650.04
|
|
