|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$160.12
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$59.24 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$104.08
|
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna Medicare |
$149.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$179.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$179.57
|
| Rate for Payer: BCBS Complete |
$80.85
|
| Rate for Payer: BCBS MAPPO |
$143.66
|
| Rate for Payer: BCN Medicare Advantage |
$143.66
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cofinity Commercial |
$112.08
|
| Rate for Payer: Cofinity Commercial |
$137.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$112.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$143.66
|
| Rate for Payer: Healthscope Commercial |
$144.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.09
|
| Rate for Payer: Mclaren Medicaid |
$77.00
|
| Rate for Payer: Mclaren Medicare |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$150.84
|
| Rate for Payer: Meridian Medicaid |
$80.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.10
|
| Rate for Payer: PACE Medicare |
$136.48
|
| Rate for Payer: PACE SWMI |
$143.66
|
| Rate for Payer: PHP Commercial |
$136.10
|
| Rate for Payer: PHP Medicare Advantage |
$143.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.08
|
| Rate for Payer: Priority Health Medicare |
$143.66
|
| Rate for Payer: Priority Health SBD |
$100.88
|
| Rate for Payer: Railroad Medicare Medicare |
$143.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$404.39
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$143.66
|
| Rate for Payer: UHC Exchange |
$274.55
|
| Rate for Payer: UHC Medicare Advantage |
$143.66
|
| Rate for Payer: UHCCP Medicaid |
$77.00
|
| Rate for Payer: UMR Bronson Commercial |
$59.24
|
| Rate for Payer: VA VA |
$143.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.09
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$37.99 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna American Axle |
$56.13
|
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$60.45
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.13
|
| Rate for Payer: Priority Health SBD |
$54.40
|
| Rate for Payer: UMR Bronson Commercial |
$37.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.50 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna American Axle |
$56.13
|
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$6.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.16
|
| Rate for Payer: BCBS Complete |
$3.68
|
| Rate for Payer: BCBS MAPPO |
$6.53
|
| Rate for Payer: BCN Medicare Advantage |
$6.53
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Cofinity Commercial |
$60.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.53
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Mclaren Medicaid |
$3.50
|
| Rate for Payer: Mclaren Medicare |
$6.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.86
|
| Rate for Payer: Meridian Medicaid |
$3.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: PACE Medicare |
$6.20
|
| Rate for Payer: PACE SWMI |
$6.53
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: PHP Medicare Advantage |
$6.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.13
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health SBD |
$54.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.53
|
| Rate for Payer: UHC Exchange |
$12.48
|
| Rate for Payer: UHC Medicare Advantage |
$6.53
|
| Rate for Payer: UHCCP Medicaid |
$3.50
|
| Rate for Payer: UMR Bronson Commercial |
$31.95
|
| Rate for Payer: VA VA |
$6.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna American Axle |
$63.23
|
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$14.02
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Cofinity Commercial |
$68.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.96
|
| Rate for Payer: Mclaren Medicaid |
$13.35
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$61.29
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$47.61
|
| Rate for Payer: UHC Medicare Advantage |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$13.35
|
| Rate for Payer: UMR Bronson Commercial |
$35.99
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.96
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna American Axle |
$63.23
|
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.23
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health SBD |
$61.29
|
| Rate for Payer: UMR Bronson Commercial |
$42.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.96
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$99.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$89.89 |
| Rate for Payer: Aetna American Axle |
$64.92
|
| Rate for Payer: Aetna Commercial |
$84.90
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.34
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Cofinity Commercial |
$69.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.91
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.90
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$84.90
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.92
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$62.92
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.71
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$35.11
|
| Rate for Payer: UHC Medicare Advantage |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.85
|
| Rate for Payer: UMR Bronson Commercial |
$36.96
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.91
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$99.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$43.95 |
| Max. Negotiated Rate |
$89.89 |
| Rate for Payer: Aetna American Axle |
$64.92
|
| Rate for Payer: Aetna Commercial |
$84.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.92
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cofinity Commercial |
$69.92
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$69.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.90
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.90
|
| Rate for Payer: PHP Commercial |
$84.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.92
|
| Rate for Payer: Priority Health SBD |
$62.92
|
| Rate for Payer: UMR Bronson Commercial |
$43.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.91
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$279.14
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$65.75 |
| Max. Negotiated Rate |
$446.00 |
| Rate for Payer: Aetna American Axle |
$181.44
|
| Rate for Payer: Aetna Commercial |
$237.27
|
| Rate for Payer: Aetna Medicare |
$127.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$153.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$153.32
|
| Rate for Payer: BCBS Complete |
$69.03
|
| Rate for Payer: BCBS MAPPO |
$122.66
|
| Rate for Payer: BCN Medicare Advantage |
$122.66
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cofinity Commercial |
$195.40
|
| Rate for Payer: Cofinity Commercial |
$240.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$195.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$122.66
|
| Rate for Payer: Healthscope Commercial |
$251.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$195.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.35
|
| Rate for Payer: Mclaren Medicaid |
$65.75
|
| Rate for Payer: Mclaren Medicare |
$122.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$128.79
|
| Rate for Payer: Meridian Medicaid |
$69.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.27
|
| Rate for Payer: PACE Medicare |
$116.53
|
| Rate for Payer: PACE SWMI |
$122.66
|
| Rate for Payer: PHP Commercial |
$237.27
|
| Rate for Payer: PHP Medicare Advantage |
$122.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$65.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.44
|
| Rate for Payer: Priority Health Medicare |
$122.66
|
| Rate for Payer: Priority Health SBD |
$175.86
|
| Rate for Payer: Railroad Medicare Medicare |
$122.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$345.28
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$122.66
|
| Rate for Payer: UHC Exchange |
$234.42
|
| Rate for Payer: UHC Medicare Advantage |
$122.66
|
| Rate for Payer: UHCCP Medicaid |
$65.75
|
| Rate for Payer: UMR Bronson Commercial |
$103.28
|
| Rate for Payer: VA VA |
$122.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.35
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$279.14
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$122.82 |
| Max. Negotiated Rate |
$251.23 |
| Rate for Payer: Aetna American Axle |
$181.44
|
| Rate for Payer: Aetna Commercial |
$237.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.44
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cofinity Commercial |
$195.40
|
| Rate for Payer: Cofinity Commercial |
$240.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$195.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.31
|
| Rate for Payer: Healthscope Commercial |
$251.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$195.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.27
|
| Rate for Payer: PHP Commercial |
$237.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.44
|
| Rate for Payer: Priority Health SBD |
$175.86
|
| Rate for Payer: UMR Bronson Commercial |
$122.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.35
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna American Axle |
$25.13
|
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$4.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.60
|
| Rate for Payer: BCBS Complete |
$2.52
|
| Rate for Payer: BCBS MAPPO |
$4.48
|
| Rate for Payer: BCN Medicare Advantage |
$4.48
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.48
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$2.40
|
| Rate for Payer: Mclaren Medicare |
$4.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.70
|
| Rate for Payer: Meridian Medicaid |
$2.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PACE Medicare |
$4.26
|
| Rate for Payer: PACE SWMI |
$4.48
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$4.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health Medicare |
$4.48
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$4.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.48
|
| Rate for Payer: UHC Exchange |
$8.56
|
| Rate for Payer: UHC Medicare Advantage |
$4.48
|
| Rate for Payer: UHCCP Medicaid |
$2.40
|
| Rate for Payer: UMR Bronson Commercial |
$14.30
|
| Rate for Payer: VA VA |
$4.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna American Axle |
$25.13
|
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.13
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$27.06
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: UMR Bronson Commercial |
$17.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$124.01
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$111.61 |
| Rate for Payer: Aetna American Axle |
$80.61
|
| Rate for Payer: Aetna Commercial |
$105.41
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$14.02
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cofinity Commercial |
$86.81
|
| Rate for Payer: Cofinity Commercial |
$106.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.01
|
| Rate for Payer: Mclaren Medicaid |
$13.35
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.41
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$105.41
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.61
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$78.13
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$47.61
|
| Rate for Payer: UHC Medicare Advantage |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$13.35
|
| Rate for Payer: UMR Bronson Commercial |
$45.88
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.01
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$124.01
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$54.56 |
| Max. Negotiated Rate |
$111.61 |
| Rate for Payer: Aetna American Axle |
$80.61
|
| Rate for Payer: Aetna Commercial |
$105.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$80.61
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cofinity Commercial |
$106.65
|
| Rate for Payer: Cofinity Commercial |
$86.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$86.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.21
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$86.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.41
|
| Rate for Payer: PHP Commercial |
$105.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.61
|
| Rate for Payer: Priority Health SBD |
$78.13
|
| Rate for Payer: UMR Bronson Commercial |
$54.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.01
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$402.53
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$177.11 |
| Max. Negotiated Rate |
$362.28 |
| Rate for Payer: Aetna American Axle |
$261.64
|
| Rate for Payer: Aetna Commercial |
$342.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.64
|
| Rate for Payer: Cash Price |
$322.02
|
| Rate for Payer: Cofinity Commercial |
$281.77
|
| Rate for Payer: Cofinity Commercial |
$346.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$281.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.02
|
| Rate for Payer: Healthscope Commercial |
$362.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$281.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.15
|
| Rate for Payer: PHP Commercial |
$342.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.64
|
| Rate for Payer: Priority Health SBD |
$253.59
|
| Rate for Payer: UMR Bronson Commercial |
$177.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.90
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$402.53
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$107.37 |
| Max. Negotiated Rate |
$563.85 |
| Rate for Payer: Aetna American Axle |
$261.64
|
| Rate for Payer: Aetna Commercial |
$342.15
|
| Rate for Payer: Aetna Medicare |
$208.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.39
|
| Rate for Payer: BCBS Complete |
$112.73
|
| Rate for Payer: BCBS MAPPO |
$200.31
|
| Rate for Payer: BCN Medicare Advantage |
$200.31
|
| Rate for Payer: Cash Price |
$322.02
|
| Rate for Payer: Cash Price |
$322.02
|
| Rate for Payer: Cash Price |
$322.02
|
| Rate for Payer: Cofinity Commercial |
$281.77
|
| Rate for Payer: Cofinity Commercial |
$346.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$281.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.31
|
| Rate for Payer: Healthscope Commercial |
$362.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$281.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.90
|
| Rate for Payer: Mclaren Medicaid |
$107.37
|
| Rate for Payer: Mclaren Medicare |
$200.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.33
|
| Rate for Payer: Meridian Medicaid |
$112.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.15
|
| Rate for Payer: PACE Medicare |
$190.29
|
| Rate for Payer: PACE SWMI |
$200.31
|
| Rate for Payer: PHP Commercial |
$342.15
|
| Rate for Payer: PHP Medicare Advantage |
$200.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.64
|
| Rate for Payer: Priority Health Medicare |
$200.31
|
| Rate for Payer: Priority Health SBD |
$253.59
|
| Rate for Payer: Railroad Medicare Medicare |
$200.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.85
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$200.31
|
| Rate for Payer: UHC Exchange |
$382.81
|
| Rate for Payer: UHC Medicare Advantage |
$200.31
|
| Rate for Payer: UHCCP Medicaid |
$107.37
|
| Rate for Payer: UMR Bronson Commercial |
$148.94
|
| Rate for Payer: VA VA |
$200.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.90
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
IP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna American Axle |
$63.23
|
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.23
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$68.10
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health SBD |
$61.29
|
| Rate for Payer: UMR Bronson Commercial |
$42.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.96
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
OP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna American Axle |
$63.23
|
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$14.02
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Cofinity Commercial |
$68.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.96
|
| Rate for Payer: Mclaren Medicaid |
$13.35
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$61.29
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$47.61
|
| Rate for Payer: UHC Medicare Advantage |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$13.35
|
| Rate for Payer: UMR Bronson Commercial |
$35.99
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.96
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
IP
|
$92.60
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$40.74 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna American Axle |
$60.19
|
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.19
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$64.82
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health SBD |
$58.34
|
| Rate for Payer: UMR Bronson Commercial |
$40.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
OP
|
$92.60
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.35 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna American Axle |
$60.19
|
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna Medicare |
$25.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.14
|
| Rate for Payer: BCBS Complete |
$14.02
|
| Rate for Payer: BCBS MAPPO |
$24.91
|
| Rate for Payer: BCN Medicare Advantage |
$24.91
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Cofinity Commercial |
$64.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.91
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Mclaren Medicaid |
$13.35
|
| Rate for Payer: Mclaren Medicare |
$24.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.16
|
| Rate for Payer: Meridian Medicaid |
$14.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: PACE Medicare |
$23.66
|
| Rate for Payer: PACE SWMI |
$24.91
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: PHP Medicare Advantage |
$24.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health SBD |
$58.34
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$47.61
|
| Rate for Payer: UHC Medicare Advantage |
$24.91
|
| Rate for Payer: UHCCP Medicaid |
$13.35
|
| Rate for Payer: UMR Bronson Commercial |
$34.26
|
| Rate for Payer: VA VA |
$24.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
IP
|
$1,942.43
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$854.67 |
| Max. Negotiated Rate |
$1,748.19 |
| Rate for Payer: Aetna American Axle |
$1,262.58
|
| Rate for Payer: Aetna Commercial |
$1,651.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.58
|
| Rate for Payer: Cash Price |
$1,553.94
|
| Rate for Payer: Cofinity Commercial |
$1,359.70
|
| Rate for Payer: Cofinity Commercial |
$1,670.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,359.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.94
|
| Rate for Payer: Healthscope Commercial |
$1,748.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,359.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,651.07
|
| Rate for Payer: PHP Commercial |
$1,651.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.58
|
| Rate for Payer: Priority Health SBD |
$1,223.73
|
| Rate for Payer: UMR Bronson Commercial |
$854.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.82
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
OP
|
$1,942.43
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$715.26 |
| Max. Negotiated Rate |
$3,756.32 |
| Rate for Payer: Aetna American Axle |
$1,262.58
|
| Rate for Payer: Aetna Commercial |
$1,651.07
|
| Rate for Payer: Aetna Medicare |
$1,387.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,668.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,668.05
|
| Rate for Payer: BCBS Complete |
$751.02
|
| Rate for Payer: BCBS MAPPO |
$1,334.44
|
| Rate for Payer: BCN Medicare Advantage |
$1,334.44
|
| Rate for Payer: Cash Price |
$1,553.94
|
| Rate for Payer: Cash Price |
$1,553.94
|
| Rate for Payer: Cofinity Commercial |
$1,670.49
|
| Rate for Payer: Cofinity Commercial |
$1,359.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,359.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,334.44
|
| Rate for Payer: Healthscope Commercial |
$1,748.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,359.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.82
|
| Rate for Payer: Mclaren Medicaid |
$715.26
|
| Rate for Payer: Mclaren Medicare |
$1,334.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,401.16
|
| Rate for Payer: Meridian Medicaid |
$751.02
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,534.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,651.07
|
| Rate for Payer: PACE Medicare |
$1,267.72
|
| Rate for Payer: PACE SWMI |
$1,334.44
|
| Rate for Payer: PHP Commercial |
$1,651.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,334.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$715.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.58
|
| Rate for Payer: Priority Health Medicare |
$1,334.44
|
| Rate for Payer: Priority Health SBD |
$1,223.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,334.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,756.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,334.44
|
| Rate for Payer: UHC Exchange |
$2,550.25
|
| Rate for Payer: UHC Medicare Advantage |
$1,334.44
|
| Rate for Payer: UHCCP Medicaid |
$715.26
|
| Rate for Payer: UMR Bronson Commercial |
$718.70
|
| Rate for Payer: VA VA |
$1,334.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.82
|
|
|
HC PLT PHER LEUKO REDUCED
|
Facility
|
IP
|
$2,204.30
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000071
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$969.89 |
| Max. Negotiated Rate |
$1,983.87 |
| Rate for Payer: Aetna American Axle |
$1,432.80
|
| Rate for Payer: Aetna Commercial |
$1,873.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,432.80
|
| Rate for Payer: Cash Price |
$1,763.44
|
| Rate for Payer: Cofinity Commercial |
$1,543.01
|
| Rate for Payer: Cofinity Commercial |
$1,895.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,543.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,763.44
|
| Rate for Payer: Healthscope Commercial |
$1,983.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,543.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,653.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,873.65
|
| Rate for Payer: PHP Commercial |
$1,873.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.80
|
| Rate for Payer: Priority Health SBD |
$1,388.71
|
| Rate for Payer: UMR Bronson Commercial |
$969.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,653.22
|
|
|
HC PLT PHER LEUKO REDUCED
|
Facility
|
OP
|
$2,204.30
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000071
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$254.63 |
| Max. Negotiated Rate |
$1,983.87 |
| Rate for Payer: Aetna American Axle |
$1,432.80
|
| Rate for Payer: Aetna Commercial |
$1,873.65
|
| Rate for Payer: Aetna Medicare |
$494.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,432.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$593.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$593.83
|
| Rate for Payer: BCBS Complete |
$267.36
|
| Rate for Payer: BCBS MAPPO |
$475.06
|
| Rate for Payer: BCN Medicare Advantage |
$475.06
|
| Rate for Payer: Cash Price |
$1,763.44
|
| Rate for Payer: Cash Price |
$1,763.44
|
| Rate for Payer: Cash Price |
$1,763.44
|
| Rate for Payer: Cofinity Commercial |
$1,543.01
|
| Rate for Payer: Cofinity Commercial |
$1,895.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,543.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,763.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$475.06
|
| Rate for Payer: Healthscope Commercial |
$1,983.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,543.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,653.22
|
| Rate for Payer: Mclaren Medicaid |
$254.63
|
| Rate for Payer: Mclaren Medicare |
$475.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.81
|
| Rate for Payer: Meridian Medicaid |
$267.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$546.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,873.65
|
| Rate for Payer: PACE Medicare |
$451.31
|
| Rate for Payer: PACE SWMI |
$475.06
|
| Rate for Payer: PHP Commercial |
$1,873.65
|
| Rate for Payer: PHP Medicare Advantage |
$475.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,432.80
|
| Rate for Payer: Priority Health Medicare |
$475.06
|
| Rate for Payer: Priority Health SBD |
$1,388.71
|
| Rate for Payer: Railroad Medicare Medicare |
$475.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,337.25
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$475.06
|
| Rate for Payer: UHC Exchange |
$907.89
|
| Rate for Payer: UHC Medicare Advantage |
$475.06
|
| Rate for Payer: UHCCP Medicaid |
$254.63
|
| Rate for Payer: UMR Bronson Commercial |
$815.59
|
| Rate for Payer: VA VA |
$475.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,653.22
|
|
|
HC PLT PHER LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$2,886.67
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000070
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$353.20 |
| Max. Negotiated Rate |
$2,598.00 |
| Rate for Payer: Aetna American Axle |
$1,876.34
|
| Rate for Payer: Aetna Commercial |
$2,453.67
|
| Rate for Payer: Aetna Medicare |
$685.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,876.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$823.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$823.70
|
| Rate for Payer: BCBS Complete |
$370.86
|
| Rate for Payer: BCBS MAPPO |
$658.96
|
| Rate for Payer: BCN Medicare Advantage |
$658.96
|
| Rate for Payer: Cash Price |
$2,309.34
|
| Rate for Payer: Cash Price |
$2,309.34
|
| Rate for Payer: Cash Price |
$2,309.34
|
| Rate for Payer: Cofinity Commercial |
$2,020.67
|
| Rate for Payer: Cofinity Commercial |
$2,482.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,020.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,309.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.96
|
| Rate for Payer: Healthscope Commercial |
$2,598.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,020.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,165.00
|
| Rate for Payer: Mclaren Medicaid |
$353.20
|
| Rate for Payer: Mclaren Medicare |
$658.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.91
|
| Rate for Payer: Meridian Medicaid |
$370.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$757.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,453.67
|
| Rate for Payer: PACE Medicare |
$626.01
|
| Rate for Payer: PACE SWMI |
$658.96
|
| Rate for Payer: PHP Commercial |
$2,453.67
|
| Rate for Payer: PHP Medicare Advantage |
$658.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$353.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,876.34
|
| Rate for Payer: Priority Health Medicare |
$658.96
|
| Rate for Payer: Priority Health SBD |
$1,818.60
|
| Rate for Payer: Railroad Medicare Medicare |
$658.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,854.91
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$658.96
|
| Rate for Payer: UHC Exchange |
$1,259.34
|
| Rate for Payer: UHC Medicare Advantage |
$658.96
|
| Rate for Payer: UHCCP Medicaid |
$353.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,068.07
|
| Rate for Payer: VA VA |
$658.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,165.00
|
|
|
HC PLT PHER LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$2,886.67
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000070
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,270.13 |
| Max. Negotiated Rate |
$2,598.00 |
| Rate for Payer: Aetna American Axle |
$1,876.34
|
| Rate for Payer: Aetna Commercial |
$2,453.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,876.34
|
| Rate for Payer: Cash Price |
$2,309.34
|
| Rate for Payer: Cofinity Commercial |
$2,020.67
|
| Rate for Payer: Cofinity Commercial |
$2,482.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,020.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,309.34
|
| Rate for Payer: Healthscope Commercial |
$2,598.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,020.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,165.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,453.67
|
| Rate for Payer: PHP Commercial |
$2,453.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,876.34
|
| Rate for Payer: Priority Health SBD |
$1,818.60
|
| Rate for Payer: UMR Bronson Commercial |
$1,270.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,165.00
|
|
