|
HC PACKED CELLS DIRECT LRIR
|
Facility
|
IP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000080
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$553.12 |
| Max. Negotiated Rate |
$1,131.38 |
| Rate for Payer: Aetna American Axle |
$817.11
|
| Rate for Payer: Aetna Commercial |
$1,068.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$817.11
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,081.10
|
| Rate for Payer: Cofinity Commercial |
$879.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$879.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Healthscope Commercial |
$1,131.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$879.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: PHP Commercial |
$1,068.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: Priority Health SBD |
$791.97
|
| Rate for Payer: UMR Bronson Commercial |
$553.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.82
|
|
|
HC PACKED CELLS DIRECT LRIR
|
Facility
|
OP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000080
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$134.34 |
| Max. Negotiated Rate |
$1,131.38 |
| Rate for Payer: Aetna American Axle |
$817.11
|
| Rate for Payer: Aetna Commercial |
$1,068.53
|
| Rate for Payer: Aetna Medicare |
$260.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$817.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$313.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$313.29
|
| Rate for Payer: BCBS Complete |
$141.05
|
| Rate for Payer: BCBS MAPPO |
$250.63
|
| Rate for Payer: BCBS Trust/PPO |
$668.16
|
| Rate for Payer: BCN Commercial |
$668.16
|
| Rate for Payer: BCN Medicare Advantage |
$250.63
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,081.10
|
| Rate for Payer: Cofinity Commercial |
$879.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$879.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.63
|
| Rate for Payer: Healthscope Commercial |
$1,131.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$879.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.82
|
| Rate for Payer: Mclaren Medicaid |
$134.34
|
| Rate for Payer: Mclaren Medicare |
$250.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.16
|
| Rate for Payer: Meridian Medicaid |
$141.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$288.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: Nomi Health Commercial |
$751.89
|
| Rate for Payer: PACE Medicare |
$238.10
|
| Rate for Payer: PACE SWMI |
$250.63
|
| Rate for Payer: PHP Commercial |
$1,068.53
|
| Rate for Payer: PHP Medicare Advantage |
$250.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$787.72
|
| Rate for Payer: Priority Health Medicare |
$250.63
|
| Rate for Payer: Priority Health Narrow Network |
$630.18
|
| Rate for Payer: Priority Health SBD |
$791.97
|
| Rate for Payer: Railroad Medicare Medicare |
$250.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.50
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.63
|
| Rate for Payer: UHC Exchange |
$478.98
|
| Rate for Payer: UHC Medicare Advantage |
$250.63
|
| Rate for Payer: UHCCP Medicaid |
$134.34
|
| Rate for Payer: UMR Bronson Commercial |
$465.12
|
| Rate for Payer: VA VA |
$250.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.82
|
|
|
HC PACK LEFT HEART BYPASS
|
Facility
|
IP
|
$97.92
|
|
| Hospital Charge Code |
27000654
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$43.08 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna American Axle |
$63.65
|
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.65
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$68.54
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.23
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.65
|
| Rate for Payer: Priority Health SBD |
$61.69
|
| Rate for Payer: UMR Bronson Commercial |
$43.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC PACK LEFT HEART BYPASS
|
Facility
|
OP
|
$97.92
|
|
| Hospital Charge Code |
27000654
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.23 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.54
|
| Rate for Payer: Aetna American Axle |
$63.65
|
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: Aetna Medicare |
$48.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.65
|
| Rate for Payer: BCBS Complete |
$39.17
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$68.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.23
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.65
|
| Rate for Payer: Priority Health SBD |
$61.69
|
| Rate for Payer: UMR Bronson Commercial |
$36.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC PACK QUEST CARDIOPLEGIA
|
Facility
|
IP
|
$688.50
|
|
| Hospital Charge Code |
27000457
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$302.94 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna American Axle |
$447.52
|
| Rate for Payer: Aetna Commercial |
$585.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.52
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$481.95
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.22
|
| Rate for Payer: PHP Commercial |
$585.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: Priority Health SBD |
$433.76
|
| Rate for Payer: UMR Bronson Commercial |
$302.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.38
|
|
|
HC PACK QUEST CARDIOPLEGIA
|
Facility
|
OP
|
$688.50
|
|
| Hospital Charge Code |
27000457
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$254.74 |
| Max. Negotiated Rate |
$619.65 |
| Rate for Payer: Aetna American Axle |
$447.52
|
| Rate for Payer: Aetna Commercial |
$585.22
|
| Rate for Payer: Aetna Medicare |
$344.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$447.52
|
| Rate for Payer: BCBS Complete |
$275.40
|
| Rate for Payer: Cash Price |
$550.80
|
| Rate for Payer: Cofinity Commercial |
$481.95
|
| Rate for Payer: Cofinity Commercial |
$592.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$481.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$550.80
|
| Rate for Payer: Healthscope Commercial |
$619.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$481.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$516.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$585.22
|
| Rate for Payer: PHP Commercial |
$585.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$447.52
|
| Rate for Payer: Priority Health SBD |
$433.76
|
| Rate for Payer: UMR Bronson Commercial |
$254.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$516.38
|
|
|
HC PACK TABLE LINE
|
Facility
|
IP
|
$205.02
|
|
| Hospital Charge Code |
27000676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$90.21 |
| Max. Negotiated Rate |
$184.52 |
| Rate for Payer: Aetna American Axle |
$133.26
|
| Rate for Payer: Aetna Commercial |
$174.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.26
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cofinity Commercial |
$143.51
|
| Rate for Payer: Cofinity Commercial |
$176.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.02
|
| Rate for Payer: Healthscope Commercial |
$184.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.27
|
| Rate for Payer: PHP Commercial |
$174.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.26
|
| Rate for Payer: Priority Health SBD |
$129.16
|
| Rate for Payer: UMR Bronson Commercial |
$90.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.76
|
|
|
HC PACK TABLE LINE
|
Facility
|
OP
|
$205.02
|
|
| Hospital Charge Code |
27000676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$75.86 |
| Max. Negotiated Rate |
$184.52 |
| Rate for Payer: Aetna American Axle |
$133.26
|
| Rate for Payer: Aetna Commercial |
$174.27
|
| Rate for Payer: Aetna Medicare |
$102.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.26
|
| Rate for Payer: BCBS Complete |
$82.01
|
| Rate for Payer: Cash Price |
$164.02
|
| Rate for Payer: Cofinity Commercial |
$143.51
|
| Rate for Payer: Cofinity Commercial |
$176.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.02
|
| Rate for Payer: Healthscope Commercial |
$184.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.27
|
| Rate for Payer: PHP Commercial |
$174.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.26
|
| Rate for Payer: Priority Health SBD |
$129.16
|
| Rate for Payer: UMR Bronson Commercial |
$75.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.76
|
|
|
HC PACK W/O RESERV TERUMO
|
Facility
|
OP
|
$841.50
|
|
| Hospital Charge Code |
27000648
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$311.36 |
| Max. Negotiated Rate |
$757.35 |
| Rate for Payer: Aetna American Axle |
$546.98
|
| Rate for Payer: Aetna Commercial |
$715.28
|
| Rate for Payer: Aetna Medicare |
$420.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.98
|
| Rate for Payer: BCBS Complete |
$336.60
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$589.05
|
| Rate for Payer: Cofinity Commercial |
$723.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$589.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Healthscope Commercial |
$757.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$589.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.28
|
| Rate for Payer: PHP Commercial |
$715.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health SBD |
$530.14
|
| Rate for Payer: UMR Bronson Commercial |
$311.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.12
|
|
|
HC PACK W/O RESERV TERUMO
|
Facility
|
IP
|
$841.50
|
|
| Hospital Charge Code |
27000648
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$370.26 |
| Max. Negotiated Rate |
$757.35 |
| Rate for Payer: Aetna American Axle |
$546.98
|
| Rate for Payer: Aetna Commercial |
$715.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$546.98
|
| Rate for Payer: Cash Price |
$673.20
|
| Rate for Payer: Cofinity Commercial |
$589.05
|
| Rate for Payer: Cofinity Commercial |
$723.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$589.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.20
|
| Rate for Payer: Healthscope Commercial |
$757.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$589.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.28
|
| Rate for Payer: PHP Commercial |
$715.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$546.98
|
| Rate for Payer: Priority Health SBD |
$530.14
|
| Rate for Payer: UMR Bronson Commercial |
$370.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.12
|
|
|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
OP
|
$164.38
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$147.94 |
| Rate for Payer: Aetna American Axle |
$106.85
|
| Rate for Payer: Aetna Commercial |
$139.72
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$59.88
|
| Rate for Payer: BCN Commercial |
$59.88
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Cofinity Commercial |
$115.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$147.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.28
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$139.72
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$49.71
|
| Rate for Payer: Priority Health SBD |
$103.56
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$60.82
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.28
|
|
|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
IP
|
$164.38
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$72.33 |
| Max. Negotiated Rate |
$147.94 |
| Rate for Payer: Aetna American Axle |
$106.85
|
| Rate for Payer: Aetna Commercial |
$139.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.85
|
| Rate for Payer: Cash Price |
$131.50
|
| Rate for Payer: Cofinity Commercial |
$115.07
|
| Rate for Payer: Cofinity Commercial |
$141.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$115.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.50
|
| Rate for Payer: Healthscope Commercial |
$147.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$115.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.72
|
| Rate for Payer: PHP Commercial |
$139.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.85
|
| Rate for Payer: Priority Health SBD |
$103.56
|
| Rate for Payer: UMR Bronson Commercial |
$72.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.28
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
OP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8.37 |
| Max. Negotiated Rate |
$136.61 |
| Rate for Payer: Aetna American Axle |
$98.66
|
| Rate for Payer: Aetna Commercial |
$129.02
|
| Rate for Payer: Aetna Medicare |
$75.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.66
|
| Rate for Payer: BCBS Complete |
$60.72
|
| Rate for Payer: BCBS Trust/PPO |
$47.13
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$47.13
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$130.54
|
| Rate for Payer: Cofinity Commercial |
$106.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$106.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Healthscope Commercial |
$136.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.02
|
| Rate for Payer: PHP Commercial |
$129.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.66
|
| Rate for Payer: Priority Health SBD |
$95.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.21
|
| Rate for Payer: UHC Exchange |
$8.37
|
| Rate for Payer: UMR Bronson Commercial |
$56.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.84
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
IP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$66.79 |
| Max. Negotiated Rate |
$136.61 |
| Rate for Payer: Aetna American Axle |
$98.66
|
| Rate for Payer: Aetna Commercial |
$129.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.66
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$106.25
|
| Rate for Payer: Cofinity Commercial |
$130.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$106.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Healthscope Commercial |
$136.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.02
|
| Rate for Payer: PHP Commercial |
$129.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.66
|
| Rate for Payer: Priority Health SBD |
$95.63
|
| Rate for Payer: UMR Bronson Commercial |
$66.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.84
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
OP
|
$923.62
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$341.74 |
| Max. Negotiated Rate |
$831.26 |
| Rate for Payer: Aetna American Axle |
$600.35
|
| Rate for Payer: Aetna Commercial |
$785.08
|
| Rate for Payer: Aetna Medicare |
$461.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.35
|
| Rate for Payer: BCBS Complete |
$369.45
|
| Rate for Payer: Cash Price |
$738.90
|
| Rate for Payer: Cofinity Commercial |
$646.53
|
| Rate for Payer: Cofinity Commercial |
$794.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$646.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.90
|
| Rate for Payer: Healthscope Commercial |
$831.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$646.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$692.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.08
|
| Rate for Payer: PHP Commercial |
$785.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.35
|
| Rate for Payer: Priority Health SBD |
$581.88
|
| Rate for Payer: UMR Bronson Commercial |
$341.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$692.72
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
IP
|
$923.62
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$406.39 |
| Max. Negotiated Rate |
$831.26 |
| Rate for Payer: Aetna American Axle |
$600.35
|
| Rate for Payer: Aetna Commercial |
$785.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$600.35
|
| Rate for Payer: Cash Price |
$738.90
|
| Rate for Payer: Cofinity Commercial |
$646.53
|
| Rate for Payer: Cofinity Commercial |
$794.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$646.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$738.90
|
| Rate for Payer: Healthscope Commercial |
$831.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$646.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$692.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$785.08
|
| Rate for Payer: PHP Commercial |
$785.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$600.35
|
| Rate for Payer: Priority Health SBD |
$581.88
|
| Rate for Payer: UMR Bronson Commercial |
$406.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$692.72
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
IP
|
$67.32
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.62 |
| Max. Negotiated Rate |
$60.59 |
| Rate for Payer: Aetna American Axle |
$43.76
|
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.76
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$47.12
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: Priority Health SBD |
$42.41
|
| Rate for Payer: UMR Bronson Commercial |
$29.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
OP
|
$67.32
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.47 |
| Max. Negotiated Rate |
$1,076.24 |
| Rate for Payer: Aetna American Axle |
$43.76
|
| Rate for Payer: Aetna Commercial |
$57.22
|
| Rate for Payer: Aetna Medicare |
$6.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.10
|
| Rate for Payer: BCBS Complete |
$3.65
|
| Rate for Payer: BCBS MAPPO |
$6.48
|
| Rate for Payer: BCBS Trust/PPO |
$6.24
|
| Rate for Payer: BCN Commercial |
$6.24
|
| Rate for Payer: BCN Medicare Advantage |
$6.48
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cash Price |
$53.86
|
| Rate for Payer: Cofinity Commercial |
$57.90
|
| Rate for Payer: Cofinity Commercial |
$47.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.48
|
| Rate for Payer: Healthscope Commercial |
$60.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.49
|
| Rate for Payer: Mclaren Medicaid |
$3.47
|
| Rate for Payer: Mclaren Medicare |
$6.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$3.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.22
|
| Rate for Payer: Nomi Health Commercial |
$9.72
|
| Rate for Payer: PACE Medicare |
$6.16
|
| Rate for Payer: PACE SWMI |
$6.48
|
| Rate for Payer: PHP Commercial |
$57.22
|
| Rate for Payer: PHP Medicare Advantage |
$6.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.67
|
| Rate for Payer: Priority Health Medicare |
$6.48
|
| Rate for Payer: Priority Health Narrow Network |
$5.34
|
| Rate for Payer: Priority Health SBD |
$42.41
|
| Rate for Payer: Railroad Medicare Medicare |
$6.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.78
|
| Rate for Payer: UHC Core |
$1,076.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.48
|
| Rate for Payer: UHC Exchange |
$6.48
|
| Rate for Payer: UHC Medicare Advantage |
$6.48
|
| Rate for Payer: UHCCP Medicaid |
$3.47
|
| Rate for Payer: UMR Bronson Commercial |
$24.91
|
| Rate for Payer: VA VA |
$6.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.49
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
OP
|
$117.30
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.31 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Meridian Medicaid |
$12.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: Nomi Health Commercial |
$34.46
|
| Rate for Payer: PACE Medicare |
$21.82
|
| Rate for Payer: PACE SWMI |
$22.97
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: PHP Medicare Advantage |
$22.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.97
|
| Rate for Payer: Priority Health Medicare |
$22.97
|
| Rate for Payer: Priority Health Narrow Network |
$18.38
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: Railroad Medicare Medicare |
$22.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.97
|
| Rate for Payer: UHC Exchange |
$22.97
|
| Rate for Payer: UHC Medicare Advantage |
$22.97
|
| Rate for Payer: UHCCP Medicaid |
$12.31
|
| Rate for Payer: UMR Bronson Commercial |
$43.40
|
| Rate for Payer: VA VA |
$22.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna Medicare |
$23.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.71
|
| Rate for Payer: BCBS Complete |
$12.93
|
| Rate for Payer: BCBS MAPPO |
$22.97
|
| Rate for Payer: BCBS Trust/PPO |
$22.13
|
| Rate for Payer: BCN Commercial |
$22.13
|
| Rate for Payer: BCN Medicare Advantage |
$22.97
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.97
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Mclaren Medicaid |
$12.31
|
| Rate for Payer: Mclaren Medicare |
$22.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.12
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
IP
|
$117.30
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.61 |
| Max. Negotiated Rate |
$105.57 |
| Rate for Payer: Aetna American Axle |
$76.24
|
| Rate for Payer: Aetna Commercial |
$99.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.24
|
| Rate for Payer: Cash Price |
$93.84
|
| Rate for Payer: Cofinity Commercial |
$100.88
|
| Rate for Payer: Cofinity Commercial |
$82.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.84
|
| Rate for Payer: Healthscope Commercial |
$105.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.70
|
| Rate for Payer: PHP Commercial |
$99.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.24
|
| Rate for Payer: Priority Health SBD |
$73.90
|
| Rate for Payer: UMR Bronson Commercial |
$51.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.98
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
IP
|
$110.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: UMR Bronson Commercial |
$48.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
OP
|
$110.00
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Aetna Medicare |
$17.74
|
| Rate for Payer: Aetna American Axle |
$71.50
|
| Rate for Payer: Aetna Commercial |
$93.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.32
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$17.06
|
| Rate for Payer: BCBS Trust/PPO |
$16.44
|
| Rate for Payer: BCN Commercial |
$16.44
|
| Rate for Payer: BCN Medicare Advantage |
$17.06
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cash Price |
$88.00
|
| Rate for Payer: Cofinity Commercial |
$94.60
|
| Rate for Payer: Cofinity Commercial |
$77.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$99.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.50
|
| Rate for Payer: Mclaren Medicaid |
$9.14
|
| Rate for Payer: Mclaren Medicare |
$17.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.91
|
| Rate for Payer: Meridian Medicaid |
$9.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.50
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Medicare |
$16.21
|
| Rate for Payer: PACE SWMI |
$17.06
|
| Rate for Payer: PHP Commercial |
$93.50
|
| Rate for Payer: PHP Medicare Advantage |
$17.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.06
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health Narrow Network |
$13.65
|
| Rate for Payer: Priority Health SBD |
$69.30
|
| Rate for Payer: Railroad Medicare Medicare |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.06
|
| Rate for Payer: UHC Exchange |
$17.06
|
| Rate for Payer: UHC Medicare Advantage |
$17.06
|
| Rate for Payer: UHCCP Medicaid |
$9.14
|
| Rate for Payer: UMR Bronson Commercial |
$40.70
|
| Rate for Payer: VA VA |
$17.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.50
|
|
|
HC PAPER WASP IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PAPER WASP IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PAP NAP
|
Facility
|
OP
|
$2,312.24
|
|
|
Service Code
|
CPT 95807
|
| Hospital Charge Code |
92000019
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$278.65 |
| Max. Negotiated Rate |
$4,571.00 |
| Rate for Payer: Aetna Medicare |
$540.66
|
| Rate for Payer: Aetna American Axle |
$1,502.96
|
| Rate for Payer: Aetna Commercial |
$1,965.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,502.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$649.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$649.84
|
| Rate for Payer: BCBS Complete |
$292.58
|
| Rate for Payer: BCBS MAPPO |
$519.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,173.73
|
| Rate for Payer: BCN Commercial |
$1,173.73
|
| Rate for Payer: BCN Medicare Advantage |
$519.87
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cash Price |
$1,849.79
|
| Rate for Payer: Cofinity Commercial |
$1,618.57
|
| Rate for Payer: Cofinity Commercial |
$1,988.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,618.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,849.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.87
|
| Rate for Payer: Healthscope Commercial |
$2,081.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,618.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,734.18
|
| Rate for Payer: Mclaren Medicaid |
$278.65
|
| Rate for Payer: Mclaren Medicare |
$519.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$545.86
|
| Rate for Payer: Meridian Medicaid |
$292.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$597.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,965.40
|
| Rate for Payer: Nomi Health Commercial |
$1,559.61
|
| Rate for Payer: PACE Medicare |
$493.88
|
| Rate for Payer: PACE SWMI |
$519.87
|
| Rate for Payer: PHP Commercial |
$1,965.40
|
| Rate for Payer: PHP Medicare Advantage |
$519.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$278.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,502.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,633.95
|
| Rate for Payer: Priority Health Medicare |
$519.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,307.16
|
| Rate for Payer: Priority Health SBD |
$1,456.71
|
| Rate for Payer: Railroad Medicare Medicare |
$519.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.21
|
| Rate for Payer: UHC Core |
$4,571.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$519.87
|
| Rate for Payer: UHC Exchange |
$372.01
|
| Rate for Payer: UHC Medicare Advantage |
$519.87
|
| Rate for Payer: UHCCP Medicaid |
$278.65
|
| Rate for Payer: UMR Bronson Commercial |
$855.53
|
| Rate for Payer: VA VA |
$519.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,734.18
|
|
