|
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 |
$5,859.22 |
| 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 |
$5,598.82
|
| 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 |
$5,859.22
|
| 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
|
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 |
$236.30
|
| 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 |
$236.30
|
|
|
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 |
$236.30
|
| 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 |
$236.30
|
|
|
HC PIFLUFOLASTAT PER MILLICURIE
|
Facility
|
IP
|
$1,560.60
|
|
|
Service Code
|
CPT A9595
|
| Hospital Charge Code |
34300369
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$686.66 |
| 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 New Business (MI Preferred) |
$1,014.39
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,092.42
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,092.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| 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: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,014.39
|
| Rate for Payer: Priority Health SBD |
$983.18
|
| Rate for Payer: UMR Bronson Commercial |
$686.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
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: BCBS Trust/PPO |
$745.52
|
| Rate for Payer: BCN Commercial |
$745.52
|
| 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: Nomi Health Commercial |
$997.32
|
| 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 HMO/PPO/Tiered Network |
$956.77
|
| Rate for Payer: Priority Health Medicare |
$332.44
|
| Rate for Payer: Priority Health Narrow Network |
$765.42
|
| 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
|
|
|
HC PIGWEED IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PIGWEED IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200098
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PI LINKED ANTIGEN
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.14 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Aetna American Axle |
$111.01
|
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health SBD |
$107.59
|
| Rate for Payer: UMR Bronson Commercial |
$75.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC PI LINKED ANTIGEN
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000004
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.19 |
| Max. Negotiated Rate |
$1,107.72 |
| Rate for Payer: Aetna American Axle |
$111.01
|
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$366.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$120.07
|
| Rate for Payer: BCN Commercial |
$120.07
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$1,057.35
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.72
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$886.18
|
| Rate for Payer: Priority Health SBD |
$107.59
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Exchange |
$69.97
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$188.91
|
| Rate for Payer: UMR Bronson Commercial |
$63.19
|
| Rate for Payer: VA VA |
$352.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.19 |
| Max. Negotiated Rate |
$1,107.72 |
| Rate for Payer: Aetna American Axle |
$111.01
|
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$366.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$440.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$440.56
|
| Rate for Payer: BCBS Complete |
$198.36
|
| Rate for Payer: BCBS MAPPO |
$352.45
|
| Rate for Payer: BCBS Trust/PPO |
$120.07
|
| Rate for Payer: BCN Commercial |
$120.07
|
| Rate for Payer: BCN Medicare Advantage |
$352.45
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$352.45
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Mclaren Medicaid |
$188.91
|
| Rate for Payer: Mclaren Medicare |
$352.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.07
|
| Rate for Payer: Meridian Medicaid |
$198.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$405.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$1,057.35
|
| Rate for Payer: PACE Medicare |
$334.83
|
| Rate for Payer: PACE SWMI |
$352.45
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$352.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,107.72
|
| Rate for Payer: Priority Health Medicare |
$352.45
|
| Rate for Payer: Priority Health Narrow Network |
$886.18
|
| Rate for Payer: Priority Health SBD |
$107.59
|
| Rate for Payer: Railroad Medicare Medicare |
$352.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$352.45
|
| Rate for Payer: UHC Exchange |
$69.97
|
| Rate for Payer: UHC Medicare Advantage |
$352.45
|
| Rate for Payer: UHCCP Medicaid |
$188.91
|
| Rate for Payer: UMR Bronson Commercial |
$63.19
|
| Rate for Payer: VA VA |
$352.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC PI LINKED ANTIGEN CMPT
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000005
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$75.14 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Aetna American Axle |
$111.01
|
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$111.01
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$119.55
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$119.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$119.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health SBD |
$107.59
|
| Rate for Payer: UMR Bronson Commercial |
$75.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
OP
|
$61.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$21.18 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna American Axle |
$40.20
|
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: Aetna Medicare |
$30.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.20
|
| Rate for Payer: BCBS Complete |
$24.74
|
| Rate for Payer: BCBS Trust/PPO |
$36.43
|
| Rate for Payer: BCN Commercial |
$36.43
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.57
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.20
|
| Rate for Payer: Priority Health SBD |
$38.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.30
|
| Rate for Payer: UHC Exchange |
$21.18
|
| Rate for Payer: UMR Bronson Commercial |
$22.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC PI LINKED ANTIGEN CMPT2
|
Facility
|
IP
|
$61.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000011
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.21 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna American Axle |
$40.20
|
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.20
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$43.30
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.57
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.20
|
| Rate for Payer: Priority Health SBD |
$38.97
|
| Rate for Payer: UMR Bronson Commercial |
$27.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC PINWORM EXAM
|
Facility
|
OP
|
$55.49
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna American Axle |
$36.07
|
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.11
|
| Rate for Payer: BCN Commercial |
$4.11
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cofinity Commercial |
$47.72
|
| Rate for Payer: Cofinity Commercial |
$38.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.62
|
| Rate for Payer: Mclaren Medicaid |
$2.29
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.17
|
| Rate for Payer: Nomi Health Commercial |
$6.40
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.40
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$3.52
|
| Rate for Payer: Priority Health SBD |
$34.96
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: UMR Bronson Commercial |
$20.53
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.62
|
|
|
HC PINWORM EXAM
|
Facility
|
IP
|
$55.49
|
|
|
Service Code
|
CPT 87172
|
| Hospital Charge Code |
30600094
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.42 |
| Max. Negotiated Rate |
$49.94 |
| Rate for Payer: Aetna American Axle |
$36.07
|
| Rate for Payer: Aetna Commercial |
$47.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$36.07
|
| Rate for Payer: Cash Price |
$44.39
|
| Rate for Payer: Cofinity Commercial |
$38.84
|
| Rate for Payer: Cofinity Commercial |
$47.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$38.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.39
|
| Rate for Payer: Healthscope Commercial |
$49.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$38.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.17
|
| Rate for Payer: PHP Commercial |
$47.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$36.07
|
| Rate for Payer: Priority Health SBD |
$34.96
|
| Rate for Payer: UMR Bronson Commercial |
$24.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.62
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
IP
|
$9,316.79
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,099.39 |
| Max. Negotiated Rate |
$8,385.11 |
| Rate for Payer: Aetna American Axle |
$6,055.91
|
| Rate for Payer: Aetna Commercial |
$7,919.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,055.91
|
| Rate for Payer: Cash Price |
$7,453.43
|
| Rate for Payer: Cofinity Commercial |
$6,521.75
|
| Rate for Payer: Cofinity Commercial |
$8,012.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,521.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,453.43
|
| Rate for Payer: Healthscope Commercial |
$8,385.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,521.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,987.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,919.27
|
| Rate for Payer: PHP Commercial |
$7,919.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,055.91
|
| Rate for Payer: Priority Health SBD |
$5,869.58
|
| Rate for Payer: UMR Bronson Commercial |
$4,099.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,987.59
|
|
|
HC PIONEER RE-ENTRY CATHETER
|
Facility
|
OP
|
$9,316.79
|
|
|
Service Code
|
HCPCS C1753
|
| Hospital Charge Code |
27200063
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,447.21 |
| Max. Negotiated Rate |
$8,385.11 |
| Rate for Payer: Aetna American Axle |
$6,055.91
|
| Rate for Payer: Aetna Commercial |
$7,919.27
|
| Rate for Payer: Aetna Medicare |
$4,658.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,055.91
|
| Rate for Payer: BCBS Complete |
$3,726.72
|
| Rate for Payer: Cash Price |
$7,453.43
|
| Rate for Payer: Cofinity Commercial |
$6,521.75
|
| Rate for Payer: Cofinity Commercial |
$8,012.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$6,521.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,453.43
|
| Rate for Payer: Healthscope Commercial |
$8,385.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,521.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,987.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,919.27
|
| Rate for Payer: PHP Commercial |
$7,919.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,055.91
|
| Rate for Payer: Priority Health SBD |
$5,869.58
|
| Rate for Payer: UMR Bronson Commercial |
$3,447.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,987.59
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
OP
|
$19,571.39
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$7,241.41 |
| Max. Negotiated Rate |
$17,614.25 |
| Rate for Payer: Aetna American Axle |
$12,721.40
|
| Rate for Payer: Aetna Commercial |
$16,635.68
|
| Rate for Payer: Aetna Medicare |
$9,785.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,721.40
|
| Rate for Payer: BCBS Complete |
$7,828.56
|
| Rate for Payer: Cash Price |
$15,657.11
|
| Rate for Payer: Cofinity Commercial |
$13,699.97
|
| Rate for Payer: Cofinity Commercial |
$16,831.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,699.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,657.11
|
| Rate for Payer: Healthscope Commercial |
$17,614.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,699.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,678.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,635.68
|
| Rate for Payer: PHP Commercial |
$16,635.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,721.40
|
| Rate for Payer: Priority Health SBD |
$12,329.98
|
| Rate for Payer: UMR Bronson Commercial |
$7,241.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,678.54
|
|
|
HC PIPELINE EMBOLIZATION DEVICE
|
Facility
|
IP
|
$19,571.39
|
|
| Hospital Charge Code |
27800081
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$8,611.41 |
| Max. Negotiated Rate |
$17,614.25 |
| Rate for Payer: Aetna American Axle |
$12,721.40
|
| Rate for Payer: Aetna Commercial |
$16,635.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12,721.40
|
| Rate for Payer: Cash Price |
$15,657.11
|
| Rate for Payer: Cofinity Commercial |
$13,699.97
|
| Rate for Payer: Cofinity Commercial |
$16,831.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$13,699.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15,657.11
|
| Rate for Payer: Healthscope Commercial |
$17,614.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13,699.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14,678.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16,635.68
|
| Rate for Payer: PHP Commercial |
$16,635.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12,721.40
|
| Rate for Payer: Priority Health SBD |
$12,329.98
|
| Rate for Payer: UMR Bronson Commercial |
$8,611.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14,678.54
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PISTACHIO NUT IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200118
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
OP
|
$475.03
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$175.76 |
| Max. Negotiated Rate |
$427.53 |
| Rate for Payer: Aetna American Axle |
$308.77
|
| Rate for Payer: Aetna Commercial |
$403.78
|
| Rate for Payer: Aetna Medicare |
$237.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.77
|
| Rate for Payer: BCBS Complete |
$190.01
|
| Rate for Payer: Cash Price |
$380.02
|
| Rate for Payer: Cofinity Commercial |
$332.52
|
| Rate for Payer: Cofinity Commercial |
$408.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$332.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.02
|
| Rate for Payer: Healthscope Commercial |
$427.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$332.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.78
|
| Rate for Payer: PHP Commercial |
$403.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.77
|
| Rate for Payer: Priority Health SBD |
$299.27
|
| Rate for Payer: UMR Bronson Commercial |
$175.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.27
|
|
|
HC PITOCIN AUGMENTATION
|
Facility
|
IP
|
$475.03
|
|
| Hospital Charge Code |
25800002
|
|
Hospital Revenue Code
|
258
|
| Min. Negotiated Rate |
$209.01 |
| Max. Negotiated Rate |
$427.53 |
| Rate for Payer: PHP Commercial |
$403.78
|
| Rate for Payer: Aetna American Axle |
$308.77
|
| Rate for Payer: Aetna Commercial |
$403.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$308.77
|
| Rate for Payer: Cash Price |
$380.02
|
| Rate for Payer: Cofinity Commercial |
$332.52
|
| Rate for Payer: Cofinity Commercial |
$408.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$332.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$380.02
|
| Rate for Payer: Healthscope Commercial |
$427.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$332.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$356.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$403.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$308.77
|
| Rate for Payer: Priority Health SBD |
$299.27
|
| Rate for Payer: UMR Bronson Commercial |
$209.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$356.27
|
|
|
HC PKU STATE TESTING
|
Facility
|
IP
|
$21.83
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Aetna American Axle |
$14.19
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$15.28
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.19
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: UMR Bronson Commercial |
$9.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
|
|
HC PKU STATE TESTING
|
Facility
|
OP
|
$21.83
|
|
|
Service Code
|
CPT 84030
|
| Hospital Charge Code |
30100387
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.95 |
| Max. Negotiated Rate |
$19.65 |
| Rate for Payer: Priority Health Medicare |
$5.50
|
| Rate for Payer: Priority Health Narrow Network |
$4.53
|
| Rate for Payer: Priority Health SBD |
$13.75
|
| Rate for Payer: Railroad Medicare Medicare |
$5.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.50
|
| Rate for Payer: UHC Exchange |
$5.50
|
| Rate for Payer: UHC Medicare Advantage |
$5.50
|
| Rate for Payer: UHCCP Medicaid |
$2.95
|
| Rate for Payer: UMR Bronson Commercial |
$8.08
|
| Rate for Payer: VA VA |
$5.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.37
|
| Rate for Payer: Aetna American Axle |
$14.19
|
| Rate for Payer: Aetna Commercial |
$18.56
|
| Rate for Payer: Aetna Medicare |
$5.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.88
|
| Rate for Payer: BCBS Complete |
$3.10
|
| Rate for Payer: BCBS MAPPO |
$5.50
|
| Rate for Payer: BCBS Trust/PPO |
$5.31
|
| Rate for Payer: BCN Commercial |
$5.31
|
| Rate for Payer: BCN Medicare Advantage |
$5.50
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Cofinity Commercial |
$18.77
|
| Rate for Payer: Cofinity Commercial |
$15.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.50
|
| Rate for Payer: Healthscope Commercial |
$19.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.37
|
| Rate for Payer: Mclaren Medicaid |
$2.95
|
| Rate for Payer: Mclaren Medicare |
$5.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.78
|
| Rate for Payer: Meridian Medicaid |
$3.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.56
|
| Rate for Payer: Nomi Health Commercial |
$8.25
|
| Rate for Payer: PACE Medicare |
$5.22
|
| Rate for Payer: PACE SWMI |
$5.50
|
| Rate for Payer: PHP Commercial |
$18.56
|
| Rate for Payer: PHP Medicare Advantage |
$5.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.66
|
|
