|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$30.71
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: UMR Bronson Commercial |
$20.02
|
| Rate for Payer: VA VA |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC PHOSPHATIDYLSERINE AUTOABS CMPT
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 86148
|
| Hospital Charge Code |
30200148
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.80 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna American Axle |
$35.16
|
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$35.16
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$37.87
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health SBD |
$34.08
|
| Rate for Payer: UMR Bronson Commercial |
$23.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
IP
|
$282.13
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$124.14 |
| Max. Negotiated Rate |
$253.92 |
| Rate for Payer: Aetna American Axle |
$183.38
|
| Rate for Payer: Aetna Commercial |
$239.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.38
|
| Rate for Payer: Cash Price |
$225.70
|
| Rate for Payer: Cofinity Commercial |
$197.49
|
| Rate for Payer: Cofinity Commercial |
$242.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$197.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.70
|
| Rate for Payer: Healthscope Commercial |
$253.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$197.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.81
|
| Rate for Payer: PHP Commercial |
$239.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.38
|
| Rate for Payer: Priority Health SBD |
$177.74
|
| Rate for Payer: UMR Bronson Commercial |
$124.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.60
|
|
|
HC PHOSPHOLIPASE A2 RECEPTOR
|
Facility
|
OP
|
$282.13
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200492
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$253.92 |
| Rate for Payer: Aetna American Axle |
$183.38
|
| Rate for Payer: Aetna Commercial |
$239.81
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$183.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$225.70
|
| Rate for Payer: Cash Price |
$225.70
|
| Rate for Payer: Cofinity Commercial |
$242.63
|
| Rate for Payer: Cofinity Commercial |
$197.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$197.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$225.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$253.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$197.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$211.60
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$239.81
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$239.81
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$183.38
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$177.74
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$104.39
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$211.60
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
IP
|
$210.12
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$92.45 |
| Max. Negotiated Rate |
$189.11 |
| Rate for Payer: Aetna American Axle |
$136.58
|
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.58
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$147.08
|
| Rate for Payer: Cofinity Commercial |
$180.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Healthscope Commercial |
$189.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: PHP Commercial |
$178.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.58
|
| Rate for Payer: Priority Health SBD |
$132.38
|
| Rate for Payer: UMR Bronson Commercial |
$92.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.59
|
|
|
HC PHOSPHOLIPASE A2 SCREEN
|
Facility
|
OP
|
$210.12
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200430
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$189.11 |
| Rate for Payer: Aetna American Axle |
$136.58
|
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$180.70
|
| Rate for Payer: Cofinity Commercial |
$147.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$189.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.59
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$178.60
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$132.38
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$77.74
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.59
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
IP
|
$210.12
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$92.45 |
| Max. Negotiated Rate |
$189.11 |
| Rate for Payer: Aetna American Axle |
$136.58
|
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.58
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$147.08
|
| Rate for Payer: Cofinity Commercial |
$180.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Healthscope Commercial |
$189.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: PHP Commercial |
$178.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.58
|
| Rate for Payer: Priority Health SBD |
$132.38
|
| Rate for Payer: UMR Bronson Commercial |
$92.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.59
|
|
|
HC PHOSPHOLIPASE A2 TITER
|
Facility
|
OP
|
$210.12
|
|
|
Service Code
|
CPT 86256
|
| Hospital Charge Code |
30200431
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$189.11 |
| Rate for Payer: Aetna American Axle |
$136.58
|
| Rate for Payer: Aetna Commercial |
$178.60
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$136.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.78
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cash Price |
$168.10
|
| Rate for Payer: Cofinity Commercial |
$180.70
|
| Rate for Payer: Cofinity Commercial |
$147.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$147.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$189.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$147.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.59
|
| Rate for Payer: Mclaren Medicaid |
$6.46
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$6.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.60
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$178.60
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$136.58
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$132.38
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.05
|
| Rate for Payer: UHC Exchange |
$23.03
|
| Rate for Payer: UHC Medicare Advantage |
$12.05
|
| Rate for Payer: UHCCP Medicaid |
$6.46
|
| Rate for Payer: UMR Bronson Commercial |
$77.74
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.59
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.54 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$4.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.92
|
| Rate for Payer: BCBS Complete |
$2.67
|
| Rate for Payer: BCBS MAPPO |
$4.74
|
| Rate for Payer: BCN Medicare Advantage |
$4.74
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.74
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Mclaren Medicare |
$4.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.98
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PACE Medicare |
$4.50
|
| Rate for Payer: PACE SWMI |
$4.74
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$4.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health Medicare |
$4.74
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$4.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.74
|
| Rate for Payer: UHC Exchange |
$9.06
|
| Rate for Payer: UHC Medicare Advantage |
$4.74
|
| Rate for Payer: UHCCP Medicaid |
$2.54
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$4.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC PHOSPHOROUS SERUM
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 84100
|
| Hospital Charge Code |
30100392
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: UMR Bronson Commercial |
$9.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
OP
|
$52.94
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$47.65 |
| Rate for Payer: Aetna American Axle |
$34.41
|
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: Aetna Medicare |
$6.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.22
|
| Rate for Payer: BCBS Complete |
$3.25
|
| Rate for Payer: BCBS MAPPO |
$5.78
|
| Rate for Payer: BCN Medicare Advantage |
$5.78
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cofinity Commercial |
$45.53
|
| Rate for Payer: Cofinity Commercial |
$37.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.78
|
| Rate for Payer: Healthscope Commercial |
$47.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.70
|
| Rate for Payer: Mclaren Medicaid |
$3.10
|
| Rate for Payer: Mclaren Medicare |
$5.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.07
|
| Rate for Payer: Meridian Medicaid |
$3.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.00
|
| Rate for Payer: PACE Medicare |
$5.49
|
| Rate for Payer: PACE SWMI |
$5.78
|
| Rate for Payer: PHP Commercial |
$45.00
|
| Rate for Payer: PHP Medicare Advantage |
$5.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.41
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health SBD |
$33.35
|
| Rate for Payer: Railroad Medicare Medicare |
$5.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.78
|
| Rate for Payer: UHC Exchange |
$11.05
|
| Rate for Payer: UHC Medicare Advantage |
$5.78
|
| Rate for Payer: UHCCP Medicaid |
$3.10
|
| Rate for Payer: UMR Bronson Commercial |
$19.59
|
| Rate for Payer: VA VA |
$5.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.70
|
|
|
HC PHOSPHOROUS URINE
|
Facility
|
IP
|
$52.94
|
|
|
Service Code
|
CPT 84105
|
| Hospital Charge Code |
30100393
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.29 |
| Max. Negotiated Rate |
$47.65 |
| Rate for Payer: Aetna American Axle |
$34.41
|
| Rate for Payer: Aetna Commercial |
$45.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$34.41
|
| Rate for Payer: Cash Price |
$42.35
|
| Rate for Payer: Cofinity Commercial |
$37.06
|
| Rate for Payer: Cofinity Commercial |
$45.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$37.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.35
|
| Rate for Payer: Healthscope Commercial |
$47.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$37.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.00
|
| Rate for Payer: PHP Commercial |
$45.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.41
|
| Rate for Payer: Priority Health SBD |
$33.35
|
| Rate for Payer: UMR Bronson Commercial |
$23.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.70
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$46.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: BCBS Complete |
$37.46
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Cofinity Commercial |
$65.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UMR Bronson Commercial |
$34.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC PHYSICAL PERF TEST EA 15 MIN
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
42000038
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: UMR Bronson Commercial |
$41.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC PICC INTRODUCER
|
Facility
|
IP
|
$98.32
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.26 |
| Max. Negotiated Rate |
$88.49 |
| Rate for Payer: Aetna American Axle |
$63.91
|
| Rate for Payer: Aetna Commercial |
$83.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.91
|
| Rate for Payer: Cash Price |
$78.66
|
| Rate for Payer: Cofinity Commercial |
$68.82
|
| Rate for Payer: Cofinity Commercial |
$84.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.66
|
| Rate for Payer: Healthscope Commercial |
$88.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.57
|
| Rate for Payer: PHP Commercial |
$83.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.91
|
| Rate for Payer: Priority Health SBD |
$61.94
|
| Rate for Payer: UMR Bronson Commercial |
$43.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.74
|
|
|
HC PICC INTRODUCER
|
Facility
|
OP
|
$98.32
|
|
| Hospital Charge Code |
27200147
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.38 |
| Max. Negotiated Rate |
$88.49 |
| Rate for Payer: Aetna American Axle |
$63.91
|
| Rate for Payer: Aetna Commercial |
$83.57
|
| Rate for Payer: Aetna Medicare |
$49.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.91
|
| Rate for Payer: BCBS Complete |
$39.33
|
| Rate for Payer: Cash Price |
$78.66
|
| Rate for Payer: Cofinity Commercial |
$68.82
|
| Rate for Payer: Cofinity Commercial |
$84.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.66
|
| Rate for Payer: Healthscope Commercial |
$88.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.57
|
| Rate for Payer: PHP Commercial |
$83.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.91
|
| Rate for Payer: Priority Health SBD |
$61.94
|
| Rate for Payer: UMR Bronson Commercial |
$36.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.74
|
|
|
HC PICU 30" NITROUS OXIDE SED RECOVERY
|
Facility
|
OP
|
$112.59
|
|
| Hospital Charge Code |
37000019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$41.66 |
| Max. Negotiated Rate |
$101.33 |
| Rate for Payer: Aetna American Axle |
$73.18
|
| Rate for Payer: Aetna Commercial |
$95.70
|
| Rate for Payer: Aetna Medicare |
$56.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.18
|
| Rate for Payer: BCBS Complete |
$45.04
|
| Rate for Payer: Cash Price |
$90.07
|
| Rate for Payer: Cofinity Commercial |
$78.81
|
| Rate for Payer: Cofinity Commercial |
$96.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.07
|
| Rate for Payer: Healthscope Commercial |
$101.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.70
|
| Rate for Payer: PHP Commercial |
$95.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.18
|
| Rate for Payer: Priority Health SBD |
$70.93
|
| Rate for Payer: UMR Bronson Commercial |
$41.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.44
|
|
|
HC PICU 30" NITROUS OXIDE SED RECOVERY
|
Facility
|
IP
|
$112.59
|
|
| Hospital Charge Code |
37000019
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$49.54 |
| Max. Negotiated Rate |
$101.33 |
| Rate for Payer: Aetna American Axle |
$73.18
|
| Rate for Payer: Aetna Commercial |
$95.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.18
|
| Rate for Payer: Cash Price |
$90.07
|
| Rate for Payer: Cofinity Commercial |
$78.81
|
| Rate for Payer: Cofinity Commercial |
$96.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$78.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.07
|
| Rate for Payer: Healthscope Commercial |
$101.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$78.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.70
|
| Rate for Payer: PHP Commercial |
$95.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.18
|
| Rate for Payer: Priority Health SBD |
$70.93
|
| Rate for Payer: UMR Bronson Commercial |
$49.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.44
|
|
|
HC PICU OBSERVATION PER HOUR
|
Facility
|
IP
|
$200.94
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200017
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$88.41 |
| Max. Negotiated Rate |
$180.85 |
| Rate for Payer: Aetna American Axle |
$130.61
|
| Rate for Payer: Aetna Commercial |
$170.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.61
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cofinity Commercial |
$140.66
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.75
|
| Rate for Payer: Healthscope Commercial |
$180.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.80
|
| Rate for Payer: PHP Commercial |
$170.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.61
|
| Rate for Payer: Priority Health SBD |
$126.59
|
| Rate for Payer: UMR Bronson Commercial |
$88.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.71
|
|
|
HC PICU OBSERVATION PER HOUR
|
Facility
|
OP
|
$200.94
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200017
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$74.35 |
| Max. Negotiated Rate |
$4,092.00 |
| Rate for Payer: Aetna American Axle |
$130.61
|
| Rate for Payer: Aetna Commercial |
$170.80
|
| Rate for Payer: Aetna Medicare |
$100.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$130.61
|
| Rate for Payer: BCBS Complete |
$80.38
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cash Price |
$160.75
|
| Rate for Payer: Cofinity Commercial |
$172.81
|
| Rate for Payer: Cofinity Commercial |
$140.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$140.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$160.75
|
| Rate for Payer: Healthscope Commercial |
$180.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$140.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$150.71
|
| Rate for Payer: Meridian Medicaid |
$1,000.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$170.80
|
| Rate for Payer: PHP Commercial |
$170.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$130.61
|
| Rate for Payer: Priority Health SBD |
$126.59
|
| Rate for Payer: UHC Core |
$4,092.00
|
| Rate for Payer: UMR Bronson Commercial |
$74.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$150.71
|
|
|
HC PICU OR PED CRITICAL CARE R&B
|
Facility
|
IP
|
$7,801.90
|
|
| Hospital Charge Code |
20300001
|
|
Hospital Revenue Code
|
203
|
| Min. Negotiated Rate |
$3,432.84 |
| Max. Negotiated Rate |
$7,021.71 |
| Rate for Payer: Aetna American Axle |
$5,071.23
|
| Rate for Payer: Aetna Commercial |
$6,631.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,071.23
|
| Rate for Payer: Cash Price |
$6,241.52
|
| Rate for Payer: Cofinity Commercial |
$5,461.33
|
| Rate for Payer: Cofinity Commercial |
$6,709.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,461.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,241.52
|
| Rate for Payer: Healthscope Commercial |
$7,021.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,461.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,851.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,631.61
|
| Rate for Payer: PHP Commercial |
$6,631.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,071.23
|
| Rate for Payer: Priority Health SBD |
$4,915.20
|
| Rate for Payer: UMR Bronson Commercial |
$3,432.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,851.43
|
|
|
HC PICU OR PED INTERMEDIATE CARE R&B
|
Facility
|
IP
|
$6,510.25
|
|
| Hospital Charge Code |
20600002
|
|
Hospital Revenue Code
|
206
|
| Min. Negotiated Rate |
$2,864.51 |
| Max. Negotiated Rate |
$5,859.23 |
| Rate for Payer: Aetna American Axle |
$4,231.66
|
| Rate for Payer: Aetna Commercial |
$5,533.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,231.66
|
| Rate for Payer: Cash Price |
$5,208.20
|
| Rate for Payer: Cofinity Commercial |
$4,557.18
|
| Rate for Payer: Cofinity Commercial |
$5,598.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,557.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,208.20
|
| Rate for Payer: Healthscope Commercial |
$5,859.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,557.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,882.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,533.71
|
| Rate for Payer: PHP Commercial |
$5,533.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,231.66
|
| Rate for Payer: Priority Health SBD |
$4,101.46
|
| Rate for Payer: UMR Bronson Commercial |
$2,864.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,882.69
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
OP
|
$315.06
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$116.57 |
| Max. Negotiated Rate |
$283.55 |
| Rate for Payer: Aetna American Axle |
$204.79
|
| Rate for Payer: Aetna Commercial |
$267.80
|
| Rate for Payer: Aetna Medicare |
$157.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.79
|
| Rate for Payer: BCBS Complete |
$126.02
|
| Rate for Payer: Cash Price |
$252.05
|
| Rate for Payer: Cofinity Commercial |
$220.54
|
| Rate for Payer: Cofinity Commercial |
$270.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$220.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.05
|
| Rate for Payer: Healthscope Commercial |
$283.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.80
|
| Rate for Payer: PHP Commercial |
$267.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.79
|
| Rate for Payer: Priority Health SBD |
$198.49
|
| Rate for Payer: UMR Bronson Commercial |
$116.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.29
|
|
|
HC PICU/PEDS 30" SEDATION RECOVERY
|
Facility
|
IP
|
$315.06
|
|
| Hospital Charge Code |
71000009
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$138.63 |
| Max. Negotiated Rate |
$283.55 |
| Rate for Payer: Aetna American Axle |
$204.79
|
| Rate for Payer: Aetna Commercial |
$267.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$204.79
|
| Rate for Payer: Cash Price |
$252.05
|
| Rate for Payer: Cofinity Commercial |
$220.54
|
| Rate for Payer: Cofinity Commercial |
$270.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$220.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.05
|
| Rate for Payer: Healthscope Commercial |
$283.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$267.80
|
| Rate for Payer: PHP Commercial |
$267.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$204.79
|
| Rate for Payer: Priority Health SBD |
$198.49
|
| Rate for Payer: UMR Bronson Commercial |
$138.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.29
|
|
|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
OP
|
$1,560.60
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$178.19 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna American Axle |
$1,014.39
|
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: Aetna Medicare |
$345.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,014.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$415.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$415.55
|
| Rate for Payer: BCBS Complete |
$187.10
|
| Rate for Payer: BCBS MAPPO |
$332.44
|
| Rate for Payer: BCN Medicare Advantage |
$332.44
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Cofinity Commercial |
$1,092.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,092.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$332.44
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,092.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Mclaren Medicaid |
$178.19
|
| Rate for Payer: Mclaren Medicare |
$332.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$349.06
|
| Rate for Payer: Meridian Medicaid |
$187.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$382.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: PACE Medicare |
$315.82
|
| Rate for Payer: PACE SWMI |
$332.44
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: PHP Medicare Advantage |
$332.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$178.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: Priority Health Medicare |
$332.44
|
| Rate for Payer: Priority Health SBD |
$983.18
|
| Rate for Payer: Railroad Medicare Medicare |
$332.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$935.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$332.44
|
| Rate for Payer: UHC Exchange |
$635.33
|
| Rate for Payer: UHC Medicare Advantage |
$332.44
|
| Rate for Payer: UHCCP Medicaid |
$178.19
|
| Rate for Payer: UMR Bronson Commercial |
$577.42
|
| Rate for Payer: VA VA |
$332.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
