|
HC PERIPHERAL INTRODUCER
|
Facility
|
IP
|
$684.29
|
|
| Hospital Charge Code |
27200146
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$301.09 |
| Max. Negotiated Rate |
$615.86 |
| Rate for Payer: Aetna American Axle |
$444.79
|
| Rate for Payer: Aetna Commercial |
$581.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$444.79
|
| Rate for Payer: Cash Price |
$547.43
|
| Rate for Payer: Cofinity Commercial |
$479.00
|
| Rate for Payer: Cofinity Commercial |
$588.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$479.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$547.43
|
| Rate for Payer: Healthscope Commercial |
$615.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$479.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$513.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$581.65
|
| Rate for Payer: PHP Commercial |
$581.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$444.79
|
| Rate for Payer: Priority Health SBD |
$431.10
|
| Rate for Payer: UMR Bronson Commercial |
$301.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$513.22
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
OP
|
$957.03
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$222.60 |
| Max. Negotiated Rate |
$1,169.00 |
| Rate for Payer: Aetna American Axle |
$622.07
|
| Rate for Payer: Aetna Commercial |
$813.48
|
| Rate for Payer: Aetna Medicare |
$431.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$519.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$519.11
|
| Rate for Payer: BCBS Complete |
$233.73
|
| Rate for Payer: BCBS MAPPO |
$415.29
|
| Rate for Payer: BCN Medicare Advantage |
$415.29
|
| Rate for Payer: Cash Price |
$765.62
|
| Rate for Payer: Cash Price |
$765.62
|
| Rate for Payer: Cofinity Commercial |
$823.05
|
| Rate for Payer: Cofinity Commercial |
$669.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$669.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$415.29
|
| Rate for Payer: Healthscope Commercial |
$861.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.77
|
| Rate for Payer: Mclaren Medicaid |
$222.60
|
| Rate for Payer: Mclaren Medicare |
$415.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$436.05
|
| Rate for Payer: Meridian Medicaid |
$233.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$477.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$813.48
|
| Rate for Payer: PACE Medicare |
$394.53
|
| Rate for Payer: PACE SWMI |
$415.29
|
| Rate for Payer: PHP Commercial |
$813.48
|
| Rate for Payer: PHP Medicare Advantage |
$415.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$222.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.07
|
| Rate for Payer: Priority Health Medicare |
$415.29
|
| Rate for Payer: Priority Health SBD |
$602.93
|
| Rate for Payer: Railroad Medicare Medicare |
$415.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,169.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$415.29
|
| Rate for Payer: UHC Exchange |
$793.66
|
| Rate for Payer: UHC Medicare Advantage |
$415.29
|
| Rate for Payer: UHCCP Medicaid |
$222.60
|
| Rate for Payer: UMR Bronson Commercial |
$354.10
|
| Rate for Payer: VA VA |
$415.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.77
|
|
|
HC PERITONEAL DIALYSIS
|
Facility
|
IP
|
$957.03
|
|
|
Service Code
|
CPT 90945
|
| Hospital Charge Code |
83000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$421.09 |
| Max. Negotiated Rate |
$861.33 |
| Rate for Payer: Aetna American Axle |
$622.07
|
| Rate for Payer: Aetna Commercial |
$813.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$622.07
|
| Rate for Payer: Cash Price |
$765.62
|
| Rate for Payer: Cofinity Commercial |
$669.92
|
| Rate for Payer: Cofinity Commercial |
$823.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$669.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$765.62
|
| Rate for Payer: Healthscope Commercial |
$861.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$669.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$717.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$813.48
|
| Rate for Payer: PHP Commercial |
$813.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$622.07
|
| Rate for Payer: Priority Health SBD |
$602.93
|
| Rate for Payer: UMR Bronson Commercial |
$421.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$717.77
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
IP
|
$707.40
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$311.26 |
| Max. Negotiated Rate |
$636.66 |
| Rate for Payer: Aetna American Axle |
$459.81
|
| Rate for Payer: Aetna Commercial |
$601.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.81
|
| Rate for Payer: Cash Price |
$565.92
|
| Rate for Payer: Cofinity Commercial |
$495.18
|
| Rate for Payer: Cofinity Commercial |
$608.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$495.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.92
|
| Rate for Payer: Healthscope Commercial |
$636.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$495.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$601.29
|
| Rate for Payer: PHP Commercial |
$601.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.81
|
| Rate for Payer: Priority Health SBD |
$445.66
|
| Rate for Payer: UMR Bronson Commercial |
$311.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.55
|
|
|
HC PERITONEAL LVG TRAY
|
Facility
|
OP
|
$707.40
|
|
| Hospital Charge Code |
27000135
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$261.74 |
| Max. Negotiated Rate |
$636.66 |
| Rate for Payer: Aetna American Axle |
$459.81
|
| Rate for Payer: Aetna Commercial |
$601.29
|
| Rate for Payer: Aetna Medicare |
$353.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$459.81
|
| Rate for Payer: BCBS Complete |
$282.96
|
| Rate for Payer: Cash Price |
$565.92
|
| Rate for Payer: Cofinity Commercial |
$495.18
|
| Rate for Payer: Cofinity Commercial |
$608.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$495.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$565.92
|
| Rate for Payer: Healthscope Commercial |
$636.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$495.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$530.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$601.29
|
| Rate for Payer: PHP Commercial |
$601.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$459.81
|
| Rate for Payer: Priority Health SBD |
$445.66
|
| Rate for Payer: UMR Bronson Commercial |
$261.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$530.55
|
|
|
HC PERITONEOGRAM
|
Facility
|
OP
|
$568.67
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$210.41 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna American Axle |
$369.64
|
| Rate for Payer: Aetna Commercial |
$483.37
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$454.94
|
| Rate for Payer: Cash Price |
$454.94
|
| Rate for Payer: Cofinity Commercial |
$489.06
|
| Rate for Payer: Cofinity Commercial |
$398.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$398.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$454.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$511.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$398.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$426.50
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$483.37
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$483.37
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$369.64
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$358.26
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$1,021.96
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: UMR Bronson Commercial |
$210.41
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$426.50
|
|
|
HC PERITONEOGRAM
|
Facility
|
IP
|
$568.67
|
|
|
Service Code
|
CPT 74190
|
| Hospital Charge Code |
32000294
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$250.21 |
| Max. Negotiated Rate |
$511.80 |
| Rate for Payer: Aetna American Axle |
$369.64
|
| Rate for Payer: Aetna Commercial |
$483.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$369.64
|
| Rate for Payer: Cash Price |
$454.94
|
| Rate for Payer: Cofinity Commercial |
$398.07
|
| Rate for Payer: Cofinity Commercial |
$489.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$398.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$454.94
|
| Rate for Payer: Healthscope Commercial |
$511.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$398.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$426.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$483.37
|
| Rate for Payer: PHP Commercial |
$483.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$369.64
|
| Rate for Payer: Priority Health SBD |
$358.26
|
| Rate for Payer: UMR Bronson Commercial |
$250.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$426.50
|
|
|
HC PERMANENT PACEMAKER INTRODUCER
|
Facility
|
OP
|
$247.07
|
|
|
Service Code
|
HCPCS C1892
|
| Hospital Charge Code |
27200062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$91.42 |
| Max. Negotiated Rate |
$222.36 |
| Rate for Payer: Aetna American Axle |
$160.60
|
| Rate for Payer: Aetna Commercial |
$210.01
|
| Rate for Payer: Aetna Medicare |
$123.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.60
|
| Rate for Payer: BCBS Complete |
$98.83
|
| Rate for Payer: Cash Price |
$197.66
|
| Rate for Payer: Cofinity Commercial |
$172.95
|
| Rate for Payer: Cofinity Commercial |
$212.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$172.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.66
|
| Rate for Payer: Healthscope Commercial |
$222.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$172.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.01
|
| Rate for Payer: PHP Commercial |
$210.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.60
|
| Rate for Payer: Priority Health SBD |
$155.65
|
| Rate for Payer: UMR Bronson Commercial |
$91.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.30
|
|
|
HC PERMANENT PACEMAKER INTRODUCER
|
Facility
|
IP
|
$247.07
|
|
|
Service Code
|
HCPCS C1892
|
| Hospital Charge Code |
27200062
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$108.71 |
| Max. Negotiated Rate |
$222.36 |
| Rate for Payer: Aetna American Axle |
$160.60
|
| Rate for Payer: Aetna Commercial |
$210.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.60
|
| Rate for Payer: Cash Price |
$197.66
|
| Rate for Payer: Cofinity Commercial |
$172.95
|
| Rate for Payer: Cofinity Commercial |
$212.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$172.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.66
|
| Rate for Payer: Healthscope Commercial |
$222.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$172.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.01
|
| Rate for Payer: PHP Commercial |
$210.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$160.60
|
| Rate for Payer: Priority Health SBD |
$155.65
|
| Rate for Payer: UMR Bronson Commercial |
$108.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.30
|
|
|
HC PERMANENT PACEMAKER PACK
|
Facility
|
IP
|
$336.72
|
|
| Hospital Charge Code |
62200010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$148.16 |
| Max. Negotiated Rate |
$303.05 |
| Rate for Payer: Aetna American Axle |
$218.87
|
| Rate for Payer: Aetna Commercial |
$286.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.87
|
| Rate for Payer: Cash Price |
$269.38
|
| Rate for Payer: Cofinity Commercial |
$235.70
|
| Rate for Payer: Cofinity Commercial |
$289.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.38
|
| Rate for Payer: Healthscope Commercial |
$303.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.21
|
| Rate for Payer: PHP Commercial |
$286.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.87
|
| Rate for Payer: Priority Health SBD |
$212.13
|
| Rate for Payer: UMR Bronson Commercial |
$148.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.54
|
|
|
HC PERMANENT PACEMAKER PACK
|
Facility
|
OP
|
$336.72
|
|
| Hospital Charge Code |
62200010
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$124.59 |
| Max. Negotiated Rate |
$303.05 |
| Rate for Payer: Aetna American Axle |
$218.87
|
| Rate for Payer: Aetna Commercial |
$286.21
|
| Rate for Payer: Aetna Medicare |
$168.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$218.87
|
| Rate for Payer: BCBS Complete |
$134.69
|
| Rate for Payer: Cash Price |
$269.38
|
| Rate for Payer: Cofinity Commercial |
$235.70
|
| Rate for Payer: Cofinity Commercial |
$289.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$235.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$269.38
|
| Rate for Payer: Healthscope Commercial |
$303.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$235.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$252.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$286.21
|
| Rate for Payer: PHP Commercial |
$286.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$218.87
|
| Rate for Payer: Priority Health SBD |
$212.13
|
| Rate for Payer: UMR Bronson Commercial |
$124.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$252.54
|
|
|
HC PERNICIOUS ANEMIA EVALUATION
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$42.45 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$8.08
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Exchange |
$28.82
|
| Rate for Payer: UHC Medicare Advantage |
$15.08
|
| Rate for Payer: UHCCP Medicaid |
$8.08
|
| Rate for Payer: UMR Bronson Commercial |
$17.32
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC PERNICIOUS ANEMIA EVALUATION
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100186
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.60 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: UMR Bronson Commercial |
$20.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Facility
|
OP
|
$1,768.68
|
|
|
Service Code
|
CPT 33017
|
| Hospital Charge Code |
36100616
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$654.41 |
| Max. Negotiated Rate |
$1,591.81 |
| Rate for Payer: Aetna American Axle |
$1,149.64
|
| Rate for Payer: Aetna Commercial |
$1,503.38
|
| Rate for Payer: Aetna Medicare |
$884.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,149.64
|
| Rate for Payer: BCBS Complete |
$707.47
|
| Rate for Payer: Cash Price |
$1,414.94
|
| Rate for Payer: Cofinity Commercial |
$1,238.08
|
| Rate for Payer: Cofinity Commercial |
$1,521.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,238.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,414.94
|
| Rate for Payer: Healthscope Commercial |
$1,591.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,238.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,326.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,503.38
|
| Rate for Payer: PHP Commercial |
$1,503.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,149.64
|
| Rate for Payer: Priority Health SBD |
$1,114.27
|
| Rate for Payer: UMR Bronson Commercial |
$654.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,326.51
|
|
|
HC PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY
|
Facility
|
IP
|
$1,768.68
|
|
|
Service Code
|
CPT 33017
|
| Hospital Charge Code |
36100616
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$778.22 |
| Max. Negotiated Rate |
$1,591.81 |
| Rate for Payer: Aetna American Axle |
$1,149.64
|
| Rate for Payer: Aetna Commercial |
$1,503.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,149.64
|
| Rate for Payer: Cash Price |
$1,414.94
|
| Rate for Payer: Cofinity Commercial |
$1,238.08
|
| Rate for Payer: Cofinity Commercial |
$1,521.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,238.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,414.94
|
| Rate for Payer: Healthscope Commercial |
$1,591.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,238.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,326.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,503.38
|
| Rate for Payer: PHP Commercial |
$1,503.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,149.64
|
| Rate for Payer: Priority Health SBD |
$1,114.27
|
| Rate for Payer: UMR Bronson Commercial |
$778.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,326.51
|
|
|
HC PERQ REPLACE GTUBE NOT REQ REV GSTRST TRACT
|
Facility
|
IP
|
$443.03
|
|
|
Service Code
|
CPT 43762
|
| Hospital Charge Code |
76100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$194.93 |
| Max. Negotiated Rate |
$398.73 |
| Rate for Payer: Aetna American Axle |
$287.97
|
| Rate for Payer: Aetna Commercial |
$376.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.97
|
| Rate for Payer: Cash Price |
$354.42
|
| Rate for Payer: Cofinity Commercial |
$310.12
|
| Rate for Payer: Cofinity Commercial |
$381.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$310.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.42
|
| Rate for Payer: Healthscope Commercial |
$398.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$310.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.58
|
| Rate for Payer: PHP Commercial |
$376.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.97
|
| Rate for Payer: Priority Health SBD |
$279.11
|
| Rate for Payer: UMR Bronson Commercial |
$194.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.27
|
|
|
HC PERQ REPLACE GTUBE NOT REQ REV GSTRST TRACT
|
Facility
|
OP
|
$443.03
|
|
|
Service Code
|
CPT 43762
|
| Hospital Charge Code |
76100320
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$127.14 |
| Max. Negotiated Rate |
$667.69 |
| Rate for Payer: Aetna American Axle |
$287.97
|
| Rate for Payer: Aetna Commercial |
$376.58
|
| Rate for Payer: Aetna Medicare |
$246.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$287.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$296.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$296.50
|
| Rate for Payer: BCBS Complete |
$133.50
|
| Rate for Payer: BCBS MAPPO |
$237.20
|
| Rate for Payer: BCN Medicare Advantage |
$237.20
|
| Rate for Payer: Cash Price |
$354.42
|
| Rate for Payer: Cash Price |
$354.42
|
| Rate for Payer: Cofinity Commercial |
$381.01
|
| Rate for Payer: Cofinity Commercial |
$310.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$310.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$354.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.20
|
| Rate for Payer: Healthscope Commercial |
$398.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$310.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.27
|
| Rate for Payer: Mclaren Medicaid |
$127.14
|
| Rate for Payer: Mclaren Medicare |
$237.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.06
|
| Rate for Payer: Meridian Medicaid |
$133.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$272.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$376.58
|
| Rate for Payer: PACE Medicare |
$225.34
|
| Rate for Payer: PACE SWMI |
$237.20
|
| Rate for Payer: PHP Commercial |
$376.58
|
| Rate for Payer: PHP Medicare Advantage |
$237.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$127.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$287.97
|
| Rate for Payer: Priority Health Medicare |
$237.20
|
| Rate for Payer: Priority Health SBD |
$279.11
|
| Rate for Payer: Railroad Medicare Medicare |
$237.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$667.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$237.20
|
| Rate for Payer: UHC Exchange |
$453.31
|
| Rate for Payer: UHC Medicare Advantage |
$237.20
|
| Rate for Payer: UHCCP Medicaid |
$127.14
|
| Rate for Payer: UMR Bronson Commercial |
$163.92
|
| Rate for Payer: VA VA |
$237.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.27
|
|
|
HC PERQ TRLUML ANGIO/ATHERECT ONE ART/BRANCH
|
Facility
|
OP
|
$15,697.20
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
48100096
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$5,807.96 |
| Max. Negotiated Rate |
$31,133.44 |
| Rate for Payer: Aetna American Axle |
$10,203.18
|
| Rate for Payer: Aetna Commercial |
$13,342.62
|
| Rate for Payer: Aetna Medicare |
$11,502.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,203.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,825.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,825.29
|
| Rate for Payer: BCBS Complete |
$6,224.70
|
| Rate for Payer: BCBS MAPPO |
$11,060.23
|
| Rate for Payer: BCN Medicare Advantage |
$11,060.23
|
| Rate for Payer: Cash Price |
$12,557.76
|
| Rate for Payer: Cash Price |
$12,557.76
|
| Rate for Payer: Cofinity Commercial |
$13,499.59
|
| Rate for Payer: Cofinity Commercial |
$10,988.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,988.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,557.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,060.23
|
| Rate for Payer: Healthscope Commercial |
$14,127.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,988.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,772.90
|
| Rate for Payer: Mclaren Medicaid |
$5,928.28
|
| Rate for Payer: Mclaren Medicare |
$11,060.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,613.24
|
| Rate for Payer: Meridian Medicaid |
$6,224.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,719.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,342.62
|
| Rate for Payer: PACE Medicare |
$10,507.22
|
| Rate for Payer: PACE SWMI |
$11,060.23
|
| Rate for Payer: PHP Commercial |
$13,342.62
|
| Rate for Payer: PHP Medicare Advantage |
$11,060.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,928.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,203.18
|
| Rate for Payer: Priority Health Medicare |
$11,060.23
|
| Rate for Payer: Priority Health SBD |
$9,889.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11,060.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31,133.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,060.23
|
| Rate for Payer: UHC Exchange |
$21,137.21
|
| Rate for Payer: UHC Medicare Advantage |
$11,060.23
|
| Rate for Payer: UHCCP Medicaid |
$5,928.28
|
| Rate for Payer: UMR Bronson Commercial |
$5,807.96
|
| Rate for Payer: VA VA |
$11,060.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,772.90
|
|
|
HC PERQ TRLUML ANGIO/ATHERECT ONE ART/BRANCH
|
Facility
|
IP
|
$15,697.20
|
|
|
Service Code
|
CPT 92924
|
| Hospital Charge Code |
48100096
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,906.77 |
| Max. Negotiated Rate |
$14,127.48 |
| Rate for Payer: Aetna American Axle |
$10,203.18
|
| Rate for Payer: Aetna Commercial |
$13,342.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10,203.18
|
| Rate for Payer: Cash Price |
$12,557.76
|
| Rate for Payer: Cofinity Commercial |
$10,988.04
|
| Rate for Payer: Cofinity Commercial |
$13,499.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,988.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,557.76
|
| Rate for Payer: Healthscope Commercial |
$14,127.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,988.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,772.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,342.62
|
| Rate for Payer: PHP Commercial |
$13,342.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10,203.18
|
| Rate for Payer: Priority Health SBD |
$9,889.24
|
| Rate for Payer: UMR Bronson Commercial |
$6,906.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,772.90
|
|
|
HC PERQ TRLUML CORONRY LITHOTRIPSY
|
Facility
|
IP
|
$16,989.00
|
|
|
Service Code
|
CPT 92972
|
| Hospital Charge Code |
48000402
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$7,475.16 |
| Max. Negotiated Rate |
$15,290.10 |
| Rate for Payer: Aetna American Axle |
$11,042.85
|
| Rate for Payer: Aetna Commercial |
$14,440.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,042.85
|
| Rate for Payer: Cash Price |
$13,591.20
|
| Rate for Payer: Cofinity Commercial |
$11,892.30
|
| Rate for Payer: Cofinity Commercial |
$14,610.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,892.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,591.20
|
| Rate for Payer: Healthscope Commercial |
$15,290.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,892.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,741.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,440.65
|
| Rate for Payer: PHP Commercial |
$14,440.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,042.85
|
| Rate for Payer: Priority Health SBD |
$10,703.07
|
| Rate for Payer: UMR Bronson Commercial |
$7,475.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,741.75
|
|
|
HC PERQ TRLUML CORONRY LITHOTRIPSY
|
Facility
|
OP
|
$16,989.00
|
|
|
Service Code
|
CPT 92972
|
| Hospital Charge Code |
48000402
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$816.00 |
| Max. Negotiated Rate |
$15,290.10 |
| Rate for Payer: Aetna American Axle |
$11,042.85
|
| Rate for Payer: Aetna Commercial |
$14,440.65
|
| Rate for Payer: Aetna Medicare |
$8,494.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$11,042.85
|
| Rate for Payer: BCBS Complete |
$6,795.60
|
| Rate for Payer: Cash Price |
$13,591.20
|
| Rate for Payer: Cash Price |
$13,591.20
|
| Rate for Payer: Cofinity Commercial |
$14,610.54
|
| Rate for Payer: Cofinity Commercial |
$11,892.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$11,892.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13,591.20
|
| Rate for Payer: Healthscope Commercial |
$15,290.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11,892.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12,741.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14,440.65
|
| Rate for Payer: PHP Commercial |
$14,440.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11,042.85
|
| Rate for Payer: Priority Health SBD |
$10,703.07
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UMR Bronson Commercial |
$6,285.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12,741.75
|
|
|
HC PESSARY NON RUBBER ANY TYPE
|
Facility
|
OP
|
$85.83
|
|
|
Service Code
|
HCPCS A4562
|
| Hospital Charge Code |
27200305
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.76 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Aetna American Axle |
$55.79
|
| Rate for Payer: Aetna Commercial |
$72.96
|
| Rate for Payer: Aetna Medicare |
$42.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.79
|
| Rate for Payer: BCBS Complete |
$34.33
|
| Rate for Payer: Cash Price |
$68.66
|
| Rate for Payer: Cofinity Commercial |
$60.08
|
| Rate for Payer: Cofinity Commercial |
$73.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.66
|
| Rate for Payer: Healthscope Commercial |
$77.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.96
|
| Rate for Payer: PHP Commercial |
$72.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.79
|
| Rate for Payer: Priority Health SBD |
$54.07
|
| Rate for Payer: UMR Bronson Commercial |
$31.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.37
|
|
|
HC PESSARY NON RUBBER ANY TYPE
|
Facility
|
IP
|
$85.83
|
|
|
Service Code
|
HCPCS A4562
|
| Hospital Charge Code |
27200305
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.77 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Aetna American Axle |
$55.79
|
| Rate for Payer: Aetna Commercial |
$72.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.79
|
| Rate for Payer: Cash Price |
$68.66
|
| Rate for Payer: Cofinity Commercial |
$60.08
|
| Rate for Payer: Cofinity Commercial |
$73.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.66
|
| Rate for Payer: Healthscope Commercial |
$77.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.96
|
| Rate for Payer: PHP Commercial |
$72.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.79
|
| Rate for Payer: Priority Health SBD |
$54.07
|
| Rate for Payer: UMR Bronson Commercial |
$37.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.37
|
|
|
HC PESSARY RUBBER ANY TYPE
|
Facility
|
IP
|
$196.64
|
|
|
Service Code
|
CPT A4561
|
| Hospital Charge Code |
27200345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$86.52 |
| Max. Negotiated Rate |
$176.98 |
| Rate for Payer: Aetna American Axle |
$127.82
|
| Rate for Payer: Aetna Commercial |
$167.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.82
|
| Rate for Payer: Cash Price |
$157.31
|
| Rate for Payer: Cofinity Commercial |
$137.65
|
| Rate for Payer: Cofinity Commercial |
$169.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.31
|
| Rate for Payer: Healthscope Commercial |
$176.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.14
|
| Rate for Payer: PHP Commercial |
$167.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.82
|
| Rate for Payer: Priority Health SBD |
$123.88
|
| Rate for Payer: UMR Bronson Commercial |
$86.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.48
|
|
|
HC PESSARY RUBBER ANY TYPE
|
Facility
|
OP
|
$196.64
|
|
|
Service Code
|
CPT A4561
|
| Hospital Charge Code |
27200345
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$72.76 |
| Max. Negotiated Rate |
$176.98 |
| Rate for Payer: Aetna American Axle |
$127.82
|
| Rate for Payer: Aetna Commercial |
$167.14
|
| Rate for Payer: Aetna Medicare |
$98.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$127.82
|
| Rate for Payer: BCBS Complete |
$78.66
|
| Rate for Payer: Cash Price |
$157.31
|
| Rate for Payer: Cofinity Commercial |
$137.65
|
| Rate for Payer: Cofinity Commercial |
$169.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$137.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.31
|
| Rate for Payer: Healthscope Commercial |
$176.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$137.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$147.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.14
|
| Rate for Payer: PHP Commercial |
$167.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$127.82
|
| Rate for Payer: Priority Health SBD |
$123.88
|
| Rate for Payer: UMR Bronson Commercial |
$72.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$147.48
|
|
