|
HC PET WMC CT WHOLE BODY
|
Facility
|
OP
|
$7,236.90
|
|
|
Service Code
|
CPT 78816
|
| Hospital Charge Code |
40400008
|
|
Hospital Revenue Code
|
404
|
| Min. Negotiated Rate |
$766.00 |
| Max. Negotiated Rate |
$6,513.21 |
| Rate for Payer: Aetna American Axle |
$4,703.98
|
| Rate for Payer: Aetna Commercial |
$6,151.36
|
| Rate for Payer: Aetna Medicare |
$1,486.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,703.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,786.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,786.38
|
| Rate for Payer: BCBS Complete |
$804.30
|
| Rate for Payer: BCBS MAPPO |
$1,429.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,914.82
|
| Rate for Payer: BCN Commercial |
$1,914.82
|
| Rate for Payer: BCN Medicare Advantage |
$1,429.10
|
| Rate for Payer: Cash Price |
$5,789.52
|
| Rate for Payer: Cash Price |
$5,789.52
|
| Rate for Payer: Cash Price |
$5,789.52
|
| Rate for Payer: Cofinity Commercial |
$5,065.83
|
| Rate for Payer: Cofinity Commercial |
$6,223.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,065.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,789.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,429.10
|
| Rate for Payer: Healthscope Commercial |
$6,513.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,065.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,427.68
|
| Rate for Payer: Mclaren Medicaid |
$766.00
|
| Rate for Payer: Mclaren Medicare |
$1,429.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,500.56
|
| Rate for Payer: Meridian Medicaid |
$804.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,643.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,151.36
|
| Rate for Payer: Nomi Health Commercial |
$4,287.30
|
| Rate for Payer: PACE Medicare |
$1,357.64
|
| Rate for Payer: PACE SWMI |
$1,429.10
|
| Rate for Payer: PHP Commercial |
$6,151.36
|
| Rate for Payer: PHP Medicare Advantage |
$1,429.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$766.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,703.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,491.63
|
| Rate for Payer: Priority Health Medicare |
$1,429.10
|
| Rate for Payer: Priority Health Narrow Network |
$3,593.30
|
| Rate for Payer: Priority Health SBD |
$4,559.25
|
| Rate for Payer: Railroad Medicare Medicare |
$1,429.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4,022.77
|
| Rate for Payer: UHC Core |
$3,590.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,429.10
|
| Rate for Payer: UHC Exchange |
$2,731.15
|
| Rate for Payer: UHC Medicare Advantage |
$1,429.10
|
| Rate for Payer: UHCCP Medicaid |
$766.00
|
| Rate for Payer: UMR Bronson Commercial |
$2,677.65
|
| Rate for Payer: VA VA |
$1,429.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,427.68
|
|
|
HC PFO
|
Facility
|
OP
|
$27,024.06
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
48100111
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$937.78 |
| Max. Negotiated Rate |
$55,296.52 |
| Rate for Payer: Aetna American Axle |
$17,565.64
|
| Rate for Payer: Aetna Commercial |
$22,970.45
|
| Rate for Payer: Aetna Medicare |
$18,297.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,565.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$15,930.52
|
| Rate for Payer: BCN Commercial |
$15,930.52
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$21,619.25
|
| Rate for Payer: Cash Price |
$21,619.25
|
| Rate for Payer: Cash Price |
$21,619.25
|
| Rate for Payer: Cofinity Commercial |
$23,240.69
|
| Rate for Payer: Cofinity Commercial |
$18,916.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$18,916.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,619.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$24,321.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,916.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,268.04
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,970.45
|
| Rate for Payer: Nomi Health Commercial |
$36,946.64
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$22,970.45
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,565.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55,296.52
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$44,237.22
|
| Rate for Payer: Priority Health SBD |
$17,025.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,031.56
|
| Rate for Payer: UHC Core |
$18,337.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$937.78
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: UMR Bronson Commercial |
$9,998.90
|
| Rate for Payer: VA VA |
$17,593.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,268.04
|
|
|
HC PFO
|
Facility
|
IP
|
$27,024.06
|
|
|
Service Code
|
CPT 93580
|
| Hospital Charge Code |
48100111
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$11,890.59 |
| Max. Negotiated Rate |
$24,321.65 |
| Rate for Payer: Aetna American Axle |
$17,565.64
|
| Rate for Payer: Aetna Commercial |
$22,970.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17,565.64
|
| Rate for Payer: Cash Price |
$21,619.25
|
| Rate for Payer: Cofinity Commercial |
$18,916.84
|
| Rate for Payer: Cofinity Commercial |
$23,240.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$18,916.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,619.25
|
| Rate for Payer: Healthscope Commercial |
$24,321.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18,916.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,268.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,970.45
|
| Rate for Payer: PHP Commercial |
$22,970.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17,565.64
|
| Rate for Payer: Priority Health SBD |
$17,025.16
|
| Rate for Payer: UMR Bronson Commercial |
$11,890.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,268.04
|
|
|
HC PFO OCCLUDER
|
Facility
|
OP
|
$11,470.41
|
|
|
Service Code
|
HCPCS C1817
|
| Hospital Charge Code |
27800116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,244.05 |
| Max. Negotiated Rate |
$10,323.37 |
| Rate for Payer: Aetna American Axle |
$7,455.77
|
| Rate for Payer: Aetna Commercial |
$9,749.85
|
| Rate for Payer: Aetna Medicare |
$5,735.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,455.77
|
| Rate for Payer: BCBS Complete |
$4,588.16
|
| Rate for Payer: Cash Price |
$9,176.33
|
| Rate for Payer: Cofinity Commercial |
$8,029.29
|
| Rate for Payer: Cofinity Commercial |
$9,864.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,029.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,176.33
|
| Rate for Payer: Healthscope Commercial |
$10,323.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,029.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,602.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,749.85
|
| Rate for Payer: PHP Commercial |
$9,749.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,455.77
|
| Rate for Payer: Priority Health SBD |
$7,226.36
|
| Rate for Payer: UMR Bronson Commercial |
$4,244.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,602.81
|
|
|
HC PFO OCCLUDER
|
Facility
|
IP
|
$11,470.41
|
|
|
Service Code
|
HCPCS C1817
|
| Hospital Charge Code |
27800116
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,046.98 |
| Max. Negotiated Rate |
$10,323.37 |
| Rate for Payer: Aetna American Axle |
$7,455.77
|
| Rate for Payer: Aetna Commercial |
$9,749.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,455.77
|
| Rate for Payer: Cash Price |
$9,176.33
|
| Rate for Payer: Cofinity Commercial |
$8,029.29
|
| Rate for Payer: Cofinity Commercial |
$9,864.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$8,029.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,176.33
|
| Rate for Payer: Healthscope Commercial |
$10,323.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8,029.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,602.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,749.85
|
| Rate for Payer: PHP Commercial |
$9,749.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,455.77
|
| Rate for Payer: Priority Health SBD |
$7,226.36
|
| Rate for Payer: UMR Bronson Commercial |
$5,046.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,602.81
|
|
|
HC PHARMA AGENT CHALLENGE
|
Facility
|
IP
|
$3,878.57
|
|
|
Service Code
|
CPT 93463
|
| Hospital Charge Code |
48100022
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,706.57 |
| Max. Negotiated Rate |
$3,490.71 |
| Rate for Payer: Aetna American Axle |
$2,521.07
|
| Rate for Payer: Aetna Commercial |
$3,296.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,521.07
|
| Rate for Payer: Cash Price |
$3,102.86
|
| Rate for Payer: Cofinity Commercial |
$2,715.00
|
| Rate for Payer: Cofinity Commercial |
$3,335.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,715.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.86
|
| Rate for Payer: Healthscope Commercial |
$3,490.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,715.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.78
|
| Rate for Payer: PHP Commercial |
$3,296.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.07
|
| Rate for Payer: Priority Health SBD |
$2,443.50
|
| Rate for Payer: UMR Bronson Commercial |
$1,706.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.93
|
|
|
HC PHARMA AGENT CHALLENGE
|
Facility
|
OP
|
$3,878.57
|
|
|
Service Code
|
CPT 93463
|
| Hospital Charge Code |
48100022
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$92.51 |
| Max. Negotiated Rate |
$3,490.71 |
| Rate for Payer: Aetna American Axle |
$2,521.07
|
| Rate for Payer: Aetna Commercial |
$3,296.78
|
| Rate for Payer: Aetna Medicare |
$1,939.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,521.07
|
| Rate for Payer: BCBS Complete |
$1,551.43
|
| Rate for Payer: BCBS Trust/PPO |
$500.04
|
| Rate for Payer: BCN Commercial |
$500.04
|
| Rate for Payer: Cash Price |
$3,102.86
|
| Rate for Payer: Cash Price |
$3,102.86
|
| Rate for Payer: Cash Price |
$3,102.86
|
| Rate for Payer: Cofinity Commercial |
$3,335.57
|
| Rate for Payer: Cofinity Commercial |
$2,715.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,715.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,102.86
|
| Rate for Payer: Healthscope Commercial |
$3,490.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,715.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,908.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,296.78
|
| Rate for Payer: PHP Commercial |
$3,296.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,521.07
|
| Rate for Payer: Priority Health SBD |
$2,443.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.76
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$92.51
|
| Rate for Payer: UMR Bronson Commercial |
$1,435.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,908.93
|
|
|
HC PHARYNX AND OR CERVICAL ESOPHAGUS
|
Facility
|
OP
|
$276.82
|
|
|
Service Code
|
CPT 74210
|
| Hospital Charge Code |
32000295
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$86.78 |
| Max. Negotiated Rate |
$548.19 |
| Rate for Payer: Aetna American Axle |
$179.93
|
| Rate for Payer: Aetna Commercial |
$235.30
|
| Rate for Payer: Aetna Medicare |
$181.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$218.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$218.02
|
| Rate for Payer: BCBS Complete |
$98.16
|
| Rate for Payer: BCBS MAPPO |
$174.42
|
| Rate for Payer: BCBS Trust/PPO |
$138.21
|
| Rate for Payer: BCN Commercial |
$138.21
|
| Rate for Payer: BCN Medicare Advantage |
$174.42
|
| Rate for Payer: Cash Price |
$221.46
|
| Rate for Payer: Cash Price |
$221.46
|
| Rate for Payer: Cofinity Commercial |
$238.07
|
| Rate for Payer: Cofinity Commercial |
$193.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$174.42
|
| Rate for Payer: Healthscope Commercial |
$249.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.62
|
| Rate for Payer: Mclaren Medicaid |
$93.49
|
| Rate for Payer: Mclaren Medicare |
$174.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$183.14
|
| Rate for Payer: Meridian Medicaid |
$98.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$200.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.30
|
| Rate for Payer: Nomi Health Commercial |
$523.26
|
| Rate for Payer: PACE Medicare |
$165.70
|
| Rate for Payer: PACE SWMI |
$174.42
|
| Rate for Payer: PHP Commercial |
$235.30
|
| Rate for Payer: PHP Medicare Advantage |
$174.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$548.19
|
| Rate for Payer: Priority Health Medicare |
$174.42
|
| Rate for Payer: Priority Health Narrow Network |
$438.55
|
| Rate for Payer: Priority Health SBD |
$174.40
|
| Rate for Payer: Railroad Medicare Medicare |
$174.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.46
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$174.42
|
| Rate for Payer: UHC Exchange |
$86.78
|
| Rate for Payer: UHC Medicare Advantage |
$174.42
|
| Rate for Payer: UHCCP Medicaid |
$93.49
|
| Rate for Payer: UMR Bronson Commercial |
$102.42
|
| Rate for Payer: VA VA |
$174.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.62
|
|
|
HC PHARYNX AND OR CERVICAL ESOPHAGUS
|
Facility
|
IP
|
$276.82
|
|
|
Service Code
|
CPT 74210
|
| Hospital Charge Code |
32000295
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$121.80 |
| Max. Negotiated Rate |
$249.14 |
| Rate for Payer: Aetna American Axle |
$179.93
|
| Rate for Payer: Aetna Commercial |
$235.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.93
|
| Rate for Payer: Cash Price |
$221.46
|
| Rate for Payer: Cofinity Commercial |
$193.77
|
| Rate for Payer: Cofinity Commercial |
$238.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$221.46
|
| Rate for Payer: Healthscope Commercial |
$249.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$207.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$235.30
|
| Rate for Payer: PHP Commercial |
$235.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.93
|
| Rate for Payer: Priority Health SBD |
$174.40
|
| Rate for Payer: UMR Bronson Commercial |
$121.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$207.62
|
|
|
HC PHASE III REHAB FULL MONTH
|
Facility
|
IP
|
$50.00
|
|
| Hospital Charge Code |
99000048
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna American Axle |
$32.50
|
| Rate for Payer: Aetna Commercial |
$42.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.50
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$45.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.50
|
| Rate for Payer: PHP Commercial |
$42.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health SBD |
$31.50
|
| Rate for Payer: UMR Bronson Commercial |
$22.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.50
|
|
|
HC PHASE III REHAB FULL MONTH
|
Facility
|
OP
|
$50.00
|
|
| Hospital Charge Code |
99000048
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$18.50 |
| Max. Negotiated Rate |
$45.00 |
| Rate for Payer: Aetna American Axle |
$32.50
|
| Rate for Payer: Aetna Commercial |
$42.50
|
| Rate for Payer: Aetna Medicare |
$25.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.50
|
| Rate for Payer: BCBS Complete |
$20.00
|
| Rate for Payer: Cash Price |
$40.00
|
| Rate for Payer: Cofinity Commercial |
$35.00
|
| Rate for Payer: Cofinity Commercial |
$43.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.00
|
| Rate for Payer: Healthscope Commercial |
$45.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.50
|
| Rate for Payer: PHP Commercial |
$42.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.50
|
| Rate for Payer: Priority Health SBD |
$31.50
|
| Rate for Payer: UMR Bronson Commercial |
$18.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.50
|
|
|
HC PHASE III REHAB PARTIAL MONTH
|
Facility
|
OP
|
$25.00
|
|
| Hospital Charge Code |
99000049
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$9.25 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna American Axle |
$16.25
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna Medicare |
$12.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: BCBS Complete |
$10.00
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.25
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$9.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC PHASE III REHAB PARTIAL MONTH
|
Facility
|
IP
|
$25.00
|
|
| Hospital Charge Code |
99000049
|
|
Hospital Revenue Code
|
990
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$22.50 |
| Rate for Payer: Aetna American Axle |
$16.25
|
| Rate for Payer: Aetna Commercial |
$21.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.25
|
| Rate for Payer: Cash Price |
$20.00
|
| Rate for Payer: Cofinity Commercial |
$17.50
|
| Rate for Payer: Cofinity Commercial |
$21.50
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.00
|
| Rate for Payer: Healthscope Commercial |
$22.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.25
|
| Rate for Payer: PHP Commercial |
$21.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.25
|
| Rate for Payer: Priority Health SBD |
$15.75
|
| Rate for Payer: UMR Bronson Commercial |
$11.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.75
|
|
|
HC PH BLOOD
|
Facility
|
IP
|
$69.36
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
30100215
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.52 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: UMR Bronson Commercial |
$30.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC PH BLOOD
|
Facility
|
OP
|
$69.36
|
|
|
Service Code
|
CPT 82800
|
| Hospital Charge Code |
30100215
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$62.42 |
| Rate for Payer: UHC Medicare Advantage |
$11.00
|
| Rate for Payer: UHCCP Medicaid |
$5.90
|
| Rate for Payer: UMR Bronson Commercial |
$25.66
|
| Rate for Payer: VA VA |
$11.00
|
| Rate for Payer: Aetna American Axle |
$45.08
|
| Rate for Payer: Aetna Commercial |
$58.96
|
| Rate for Payer: Aetna Medicare |
$11.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.75
|
| Rate for Payer: BCBS Complete |
$6.19
|
| Rate for Payer: BCBS MAPPO |
$11.00
|
| Rate for Payer: BCBS Trust/PPO |
$10.60
|
| Rate for Payer: BCN Commercial |
$10.60
|
| Rate for Payer: BCN Medicare Advantage |
$11.00
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cash Price |
$55.49
|
| Rate for Payer: Cofinity Commercial |
$59.65
|
| Rate for Payer: Cofinity Commercial |
$48.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.00
|
| Rate for Payer: Healthscope Commercial |
$62.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.02
|
| Rate for Payer: Mclaren Medicaid |
$5.90
|
| Rate for Payer: Mclaren Medicare |
$11.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.55
|
| Rate for Payer: Meridian Medicaid |
$6.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.96
|
| Rate for Payer: Nomi Health Commercial |
$16.50
|
| Rate for Payer: PACE Medicare |
$10.45
|
| Rate for Payer: PACE SWMI |
$11.00
|
| Rate for Payer: PHP Commercial |
$58.96
|
| Rate for Payer: PHP Medicare Advantage |
$11.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.00
|
| Rate for Payer: Priority Health Medicare |
$11.00
|
| Rate for Payer: Priority Health Narrow Network |
$8.80
|
| Rate for Payer: Priority Health SBD |
$43.70
|
| Rate for Payer: Railroad Medicare Medicare |
$11.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.00
|
| Rate for Payer: UHC Exchange |
$11.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.02
|
|
|
HC PH BODY FLUID
|
Facility
|
OP
|
$25.17
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100384
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna American Axle |
$16.36
|
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: Aetna Medicare |
$3.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.48
|
| Rate for Payer: BCBS Complete |
$2.01
|
| Rate for Payer: BCBS MAPPO |
$3.58
|
| Rate for Payer: BCBS Trust/PPO |
$3.46
|
| Rate for Payer: BCN Commercial |
$3.46
|
| Rate for Payer: BCN Medicare Advantage |
$3.58
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$21.65
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.58
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.88
|
| Rate for Payer: Mclaren Medicaid |
$1.92
|
| Rate for Payer: Mclaren Medicare |
$3.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.76
|
| Rate for Payer: Meridian Medicaid |
$2.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: Nomi Health Commercial |
$5.37
|
| Rate for Payer: PACE Medicare |
$3.40
|
| Rate for Payer: PACE SWMI |
$3.58
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: PHP Medicare Advantage |
$3.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.36
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.58
|
| Rate for Payer: Priority Health Medicare |
$3.58
|
| Rate for Payer: Priority Health Narrow Network |
$2.86
|
| Rate for Payer: Priority Health SBD |
$15.86
|
| Rate for Payer: Railroad Medicare Medicare |
$3.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.58
|
| Rate for Payer: UHC Exchange |
$3.58
|
| Rate for Payer: UHC Medicare Advantage |
$3.58
|
| Rate for Payer: UHCCP Medicaid |
$1.92
|
| Rate for Payer: UMR Bronson Commercial |
$9.31
|
| Rate for Payer: VA VA |
$3.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.88
|
|
|
HC PH BODY FLUID
|
Facility
|
IP
|
$25.17
|
|
|
Service Code
|
CPT 83986
|
| Hospital Charge Code |
30100384
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.07 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna American Axle |
$16.36
|
| Rate for Payer: Aetna Commercial |
$21.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.36
|
| Rate for Payer: Cash Price |
$20.14
|
| Rate for Payer: Cofinity Commercial |
$17.62
|
| Rate for Payer: Cofinity Commercial |
$21.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.14
|
| Rate for Payer: Healthscope Commercial |
$22.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.39
|
| Rate for Payer: PHP Commercial |
$21.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.36
|
| Rate for Payer: Priority Health SBD |
$15.86
|
| Rate for Payer: UMR Bronson Commercial |
$11.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.88
|
|
|
HC PHENOBARB LVL
|
Facility
|
IP
|
$100.57
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.25 |
| Max. Negotiated Rate |
$90.51 |
| Rate for Payer: Aetna American Axle |
$65.37
|
| Rate for Payer: Aetna Commercial |
$85.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.37
|
| Rate for Payer: Cash Price |
$80.46
|
| Rate for Payer: Cofinity Commercial |
$70.40
|
| Rate for Payer: Cofinity Commercial |
$86.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.46
|
| Rate for Payer: Healthscope Commercial |
$90.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.48
|
| Rate for Payer: PHP Commercial |
$85.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.37
|
| Rate for Payer: Priority Health SBD |
$63.36
|
| Rate for Payer: UMR Bronson Commercial |
$44.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.43
|
|
|
HC PHENOBARB LVL
|
Facility
|
OP
|
$100.57
|
|
|
Service Code
|
CPT 80184
|
| Hospital Charge Code |
30100587
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.20 |
| Max. Negotiated Rate |
$90.51 |
| Rate for Payer: Cofinity Commercial |
$70.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$70.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.30
|
| Rate for Payer: Healthscope Commercial |
$90.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.43
|
| Rate for Payer: Mclaren Medicaid |
$8.20
|
| Rate for Payer: Mclaren Medicare |
$15.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.06
|
| Rate for Payer: Meridian Medicaid |
$8.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.48
|
| Rate for Payer: Nomi Health Commercial |
$22.95
|
| Rate for Payer: PACE Medicare |
$14.54
|
| Rate for Payer: PACE SWMI |
$15.30
|
| Rate for Payer: PHP Commercial |
$85.48
|
| Rate for Payer: PHP Medicare Advantage |
$15.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.37
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.30
|
| Rate for Payer: Priority Health Medicare |
$15.30
|
| Rate for Payer: Priority Health Narrow Network |
$12.24
|
| Rate for Payer: Priority Health SBD |
$63.36
|
| Rate for Payer: Railroad Medicare Medicare |
$15.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.30
|
| Rate for Payer: UHC Exchange |
$15.30
|
| Rate for Payer: UHC Medicare Advantage |
$15.30
|
| Rate for Payer: UHCCP Medicaid |
$8.20
|
| Rate for Payer: UMR Bronson Commercial |
$37.21
|
| Rate for Payer: VA VA |
$15.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.43
|
| Rate for Payer: Cofinity Commercial |
$86.49
|
| Rate for Payer: Aetna American Axle |
$65.37
|
| Rate for Payer: Aetna Commercial |
$85.48
|
| Rate for Payer: Aetna Medicare |
$15.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.12
|
| Rate for Payer: BCBS Complete |
$8.61
|
| Rate for Payer: BCBS MAPPO |
$15.30
|
| Rate for Payer: BCBS Trust/PPO |
$14.75
|
| Rate for Payer: BCN Commercial |
$14.75
|
| Rate for Payer: BCN Medicare Advantage |
$15.30
|
| Rate for Payer: Cash Price |
$80.46
|
| Rate for Payer: Cash Price |
$80.46
|
|
|
HC PH GASTRIC
|
Facility
|
IP
|
$24.68
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.86 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: Aetna American Axle |
$16.04
|
| Rate for Payer: Aetna Commercial |
$20.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.04
|
| Rate for Payer: Cash Price |
$19.74
|
| Rate for Payer: Cofinity Commercial |
$17.28
|
| Rate for Payer: Cofinity Commercial |
$21.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.74
|
| Rate for Payer: Healthscope Commercial |
$22.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.98
|
| Rate for Payer: PHP Commercial |
$20.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.04
|
| Rate for Payer: Priority Health SBD |
$15.55
|
| Rate for Payer: UMR Bronson Commercial |
$10.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.51
|
|
|
HC PH GASTRIC
|
Facility
|
OP
|
$24.68
|
|
|
Service Code
|
CPT 82930
|
| Hospital Charge Code |
30100219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$22.21 |
| Rate for Payer: UHC Medicare Advantage |
$6.71
|
| Rate for Payer: UHCCP Medicaid |
$3.60
|
| Rate for Payer: UMR Bronson Commercial |
$9.13
|
| Rate for Payer: VA VA |
$6.71
|
| Rate for Payer: Aetna American Axle |
$16.04
|
| Rate for Payer: Aetna Commercial |
$20.98
|
| Rate for Payer: Aetna Medicare |
$6.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.39
|
| Rate for Payer: BCBS Complete |
$3.78
|
| Rate for Payer: BCBS MAPPO |
$6.71
|
| Rate for Payer: BCBS Trust/PPO |
$6.46
|
| Rate for Payer: BCN Commercial |
$6.46
|
| Rate for Payer: BCN Medicare Advantage |
$6.71
|
| Rate for Payer: Cash Price |
$19.74
|
| Rate for Payer: Cash Price |
$19.74
|
| Rate for Payer: Cofinity Commercial |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$17.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.71
|
| Rate for Payer: Healthscope Commercial |
$22.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.51
|
| Rate for Payer: Mclaren Medicaid |
$3.60
|
| Rate for Payer: Mclaren Medicare |
$6.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.05
|
| Rate for Payer: Meridian Medicaid |
$3.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.98
|
| Rate for Payer: Nomi Health Commercial |
$10.06
|
| Rate for Payer: PACE Medicare |
$6.37
|
| Rate for Payer: PACE SWMI |
$6.71
|
| Rate for Payer: PHP Commercial |
$20.98
|
| Rate for Payer: PHP Medicare Advantage |
$6.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6.71
|
| Rate for Payer: Priority Health Medicare |
$6.71
|
| Rate for Payer: Priority Health Narrow Network |
$5.37
|
| Rate for Payer: Priority Health SBD |
$15.55
|
| Rate for Payer: Railroad Medicare Medicare |
$6.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.71
|
| Rate for Payer: UHC Exchange |
$6.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.51
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
OP
|
$96.90
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.85 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna American Axle |
$62.98
|
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna Medicare |
$48.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.98
|
| Rate for Payer: BCBS Complete |
$38.76
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$67.83
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: Priority Health SBD |
$61.05
|
| Rate for Payer: UMR Bronson Commercial |
$35.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC PHOSPHATIDYLETHANOL CONFIRMATION, BLOOD
|
Facility
|
IP
|
$96.90
|
|
|
Service Code
|
CPT 80321
|
| Hospital Charge Code |
30100743
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.64 |
| Max. Negotiated Rate |
$87.21 |
| Rate for Payer: Aetna American Axle |
$62.98
|
| Rate for Payer: Aetna Commercial |
$82.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.98
|
| Rate for Payer: Cash Price |
$77.52
|
| Rate for Payer: Cofinity Commercial |
$67.83
|
| Rate for Payer: Cofinity Commercial |
$83.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.52
|
| Rate for Payer: Healthscope Commercial |
$87.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.36
|
| Rate for Payer: PHP Commercial |
$82.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.98
|
| Rate for Payer: Priority Health SBD |
$61.05
|
| Rate for Payer: UMR Bronson Commercial |
$42.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.68
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
IP
|
$75.48
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.21 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna American Axle |
$49.06
|
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.06
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Cofinity Commercial |
$64.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Healthscope Commercial |
$67.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: PHP Commercial |
$64.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health SBD |
$47.55
|
| Rate for Payer: UMR Bronson Commercial |
$33.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.61
|
|
|
HC PHOSPHATIDYLGLYCEROL
|
Facility
|
OP
|
$75.48
|
|
|
Service Code
|
CPT 84081
|
| Hospital Charge Code |
30100635
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.85 |
| Max. Negotiated Rate |
$67.93 |
| Rate for Payer: Aetna American Axle |
$49.06
|
| Rate for Payer: Aetna Commercial |
$64.16
|
| Rate for Payer: Aetna Medicare |
$17.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.65
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$16.52
|
| Rate for Payer: BCBS Trust/PPO |
$15.92
|
| Rate for Payer: BCN Commercial |
$15.92
|
| Rate for Payer: BCN Medicare Advantage |
$16.52
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cash Price |
$60.38
|
| Rate for Payer: Cofinity Commercial |
$64.91
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$67.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.61
|
| Rate for Payer: Mclaren Medicaid |
$8.85
|
| Rate for Payer: Mclaren Medicare |
$16.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.35
|
| Rate for Payer: Meridian Medicaid |
$9.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.16
|
| Rate for Payer: Nomi Health Commercial |
$24.78
|
| Rate for Payer: PACE Medicare |
$15.69
|
| Rate for Payer: PACE SWMI |
$16.52
|
| Rate for Payer: PHP Commercial |
$64.16
|
| Rate for Payer: PHP Medicare Advantage |
$16.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.06
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.00
|
| Rate for Payer: Priority Health Medicare |
$16.52
|
| Rate for Payer: Priority Health Narrow Network |
$13.60
|
| Rate for Payer: Priority Health SBD |
$47.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.52
|
| Rate for Payer: UHC Exchange |
$16.52
|
| Rate for Payer: UHC Medicare Advantage |
$16.52
|
| Rate for Payer: UHCCP Medicaid |
$8.85
|
| Rate for Payer: UMR Bronson Commercial |
$27.93
|
| Rate for Payer: VA VA |
$16.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.61
|
|
