|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna American Axle |
$33.96
|
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.96
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$36.57
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health SBD |
$32.91
|
| Rate for Payer: UMR Bronson Commercial |
$22.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$115.57
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$28.06 |
| Max. Negotiated Rate |
$200.11 |
| Rate for Payer: Aetna American Axle |
$75.12
|
| Rate for Payer: Aetna Commercial |
$98.23
|
| Rate for Payer: Aetna Medicare |
$54.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.44
|
| Rate for Payer: BCBS Complete |
$29.46
|
| Rate for Payer: BCBS MAPPO |
$52.35
|
| Rate for Payer: BCBS Trust/PPO |
$200.11
|
| Rate for Payer: BCN Commercial |
$200.11
|
| Rate for Payer: BCN Medicare Advantage |
$52.35
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cofinity Commercial |
$99.39
|
| Rate for Payer: Cofinity Commercial |
$80.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.35
|
| Rate for Payer: Healthscope Commercial |
$104.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.68
|
| Rate for Payer: Mclaren Medicaid |
$28.06
|
| Rate for Payer: Mclaren Medicare |
$52.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.97
|
| Rate for Payer: Meridian Medicaid |
$29.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.23
|
| Rate for Payer: Nomi Health Commercial |
$157.05
|
| Rate for Payer: PACE Medicare |
$49.73
|
| Rate for Payer: PACE SWMI |
$52.35
|
| Rate for Payer: PHP Commercial |
$98.23
|
| Rate for Payer: PHP Medicare Advantage |
$52.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$164.53
|
| Rate for Payer: Priority Health Medicare |
$52.35
|
| Rate for Payer: Priority Health Narrow Network |
$131.62
|
| Rate for Payer: Priority Health SBD |
$72.81
|
| Rate for Payer: Railroad Medicare Medicare |
$52.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.35
|
| Rate for Payer: UHC Exchange |
$152.21
|
| Rate for Payer: UHC Medicare Advantage |
$52.35
|
| Rate for Payer: UHCCP Medicaid |
$28.06
|
| Rate for Payer: UMR Bronson Commercial |
$42.76
|
| Rate for Payer: VA VA |
$52.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.68
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$115.57
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$50.85 |
| Max. Negotiated Rate |
$104.01 |
| Rate for Payer: Aetna American Axle |
$75.12
|
| Rate for Payer: Aetna Commercial |
$98.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.12
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cofinity Commercial |
$80.90
|
| Rate for Payer: Cofinity Commercial |
$99.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.46
|
| Rate for Payer: Healthscope Commercial |
$104.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.23
|
| Rate for Payer: PHP Commercial |
$98.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.12
|
| Rate for Payer: Priority Health SBD |
$72.81
|
| Rate for Payer: UMR Bronson Commercial |
$50.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.68
|
|
|
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 |
$453.60 |
| Rate for Payer: Aetna American Axle |
$104.08
|
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna Medicare |
$150.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$180.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$180.40
|
| Rate for Payer: BCBS Complete |
$81.22
|
| Rate for Payer: BCBS MAPPO |
$144.32
|
| Rate for Payer: BCBS Trust/PPO |
$183.00
|
| Rate for Payer: BCN Commercial |
$183.00
|
| Rate for Payer: BCN Medicare Advantage |
$144.32
|
| 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 |
$144.32
|
| 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 |
$77.36
|
| Rate for Payer: Mclaren Medicare |
$144.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$151.54
|
| Rate for Payer: Meridian Medicaid |
$81.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$165.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.10
|
| Rate for Payer: Nomi Health Commercial |
$432.96
|
| Rate for Payer: PACE Medicare |
$137.10
|
| Rate for Payer: PACE SWMI |
$144.32
|
| Rate for Payer: PHP Commercial |
$136.10
|
| Rate for Payer: PHP Medicare Advantage |
$144.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$453.60
|
| Rate for Payer: Priority Health Medicare |
$144.32
|
| Rate for Payer: Priority Health Narrow Network |
$362.88
|
| Rate for Payer: Priority Health SBD |
$100.88
|
| Rate for Payer: Railroad Medicare Medicare |
$144.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$406.25
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$144.32
|
| Rate for Payer: UHC Exchange |
$275.81
|
| Rate for Payer: UHC Medicare Advantage |
$144.32
|
| Rate for Payer: UHCCP Medicaid |
$77.36
|
| Rate for Payer: UMR Bronson Commercial |
$59.24
|
| Rate for Payer: VA VA |
$144.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.09
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$160.12
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$70.45 |
| Max. Negotiated Rate |
$144.11 |
| Rate for Payer: Aetna American Axle |
$104.08
|
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.08
|
| 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: 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: Multiplan/Beech St/PHCS Commercial |
$136.10
|
| Rate for Payer: PHP Commercial |
$136.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.08
|
| Rate for Payer: Priority Health SBD |
$100.88
|
| Rate for Payer: UMR Bronson Commercial |
$70.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.09
|
|
|
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: BCBS Trust/PPO |
$6.29
|
| Rate for Payer: BCN Commercial |
$6.29
|
| 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 |
$60.44
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.44
|
| 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 |
$60.44
|
| 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: Nomi Health Commercial |
$9.80
|
| 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 HMO/PPO/Tiered Network |
$6.72
|
| Rate for Payer: Priority Health Medicare |
$6.53
|
| Rate for Payer: Priority Health Narrow Network |
$5.38
|
| Rate for Payer: Priority Health SBD |
$54.40
|
| Rate for Payer: Railroad Medicare Medicare |
$6.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.53
|
| Rate for Payer: UHC Exchange |
$6.53
|
| 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 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 |
$60.44
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$60.44
|
| 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 |
$60.44
|
| 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 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 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: BCBS Trust/PPO |
$18.00
|
| Rate for Payer: BCN Commercial |
$18.00
|
| 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: Nomi Health Commercial |
$37.36
|
| 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 HMO/PPO/Tiered Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$19.93
|
| Rate for Payer: Priority Health SBD |
$61.29
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$24.91
|
| 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 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 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: BCBS Trust/PPO |
$17.70
|
| Rate for Payer: BCN Commercial |
$17.70
|
| 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: Nomi Health Commercial |
$27.56
|
| 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 HMO/PPO/Tiered Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$14.70
|
| Rate for Payer: Priority Health SBD |
$62.92
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$18.37
|
| 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 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 |
$209.36
|
| 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 |
$209.36
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$279.14
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$66.05 |
| 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 |
$128.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$181.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$154.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$154.04
|
| Rate for Payer: BCBS Complete |
$69.35
|
| Rate for Payer: BCBS MAPPO |
$123.23
|
| Rate for Payer: BCBS Trust/PPO |
$346.36
|
| Rate for Payer: BCN Commercial |
$346.36
|
| Rate for Payer: BCN Medicare Advantage |
$123.23
|
| 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 |
$123.23
|
| 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 |
$209.36
|
| Rate for Payer: Mclaren Medicaid |
$66.05
|
| Rate for Payer: Mclaren Medicare |
$123.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$129.39
|
| Rate for Payer: Meridian Medicaid |
$69.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$141.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.27
|
| Rate for Payer: Nomi Health Commercial |
$369.69
|
| Rate for Payer: PACE Medicare |
$117.07
|
| Rate for Payer: PACE SWMI |
$123.23
|
| Rate for Payer: PHP Commercial |
$237.27
|
| Rate for Payer: PHP Medicare Advantage |
$123.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.44
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$387.31
|
| Rate for Payer: Priority Health Medicare |
$123.23
|
| Rate for Payer: Priority Health Narrow Network |
$309.85
|
| Rate for Payer: Priority Health SBD |
$175.86
|
| Rate for Payer: Railroad Medicare Medicare |
$123.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$346.88
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$123.23
|
| Rate for Payer: UHC Exchange |
$235.50
|
| Rate for Payer: UHC Medicare Advantage |
$123.23
|
| Rate for Payer: UHCCP Medicaid |
$66.05
|
| Rate for Payer: UMR Bronson Commercial |
$103.28
|
| Rate for Payer: VA VA |
$123.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.36
|
|
|
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: BCBS Trust/PPO |
$4.32
|
| Rate for Payer: BCN Commercial |
$4.32
|
| 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: Nomi Health Commercial |
$6.72
|
| 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 HMO/PPO/Tiered Network |
$4.61
|
| Rate for Payer: Priority Health Medicare |
$4.48
|
| Rate for Payer: Priority Health Narrow Network |
$3.69
|
| Rate for Payer: Priority Health SBD |
$24.36
|
| Rate for Payer: Railroad Medicare Medicare |
$4.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.48
|
| Rate for Payer: UHC Exchange |
$4.48
|
| 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: BCBS Trust/PPO |
$18.00
|
| Rate for Payer: BCN Commercial |
$18.00
|
| 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: Nomi Health Commercial |
$37.36
|
| 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 HMO/PPO/Tiered Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$19.93
|
| Rate for Payer: Priority Health SBD |
$78.13
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$24.91
|
| 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 |
$107.86 |
| Max. Negotiated Rate |
$632.49 |
| Rate for Payer: Aetna American Axle |
$261.64
|
| Rate for Payer: Aetna Commercial |
$342.15
|
| Rate for Payer: Aetna Medicare |
$209.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$261.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$251.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$251.55
|
| Rate for Payer: BCBS Complete |
$113.26
|
| Rate for Payer: BCBS MAPPO |
$201.24
|
| Rate for Payer: BCBS Trust/PPO |
$610.34
|
| Rate for Payer: BCN Commercial |
$610.34
|
| Rate for Payer: BCN Medicare Advantage |
$201.24
|
| 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 |
$201.24
|
| 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 |
$107.86
|
| Rate for Payer: Mclaren Medicare |
$201.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$211.30
|
| Rate for Payer: Meridian Medicaid |
$113.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$231.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.15
|
| Rate for Payer: Nomi Health Commercial |
$603.72
|
| Rate for Payer: PACE Medicare |
$191.18
|
| Rate for Payer: PACE SWMI |
$201.24
|
| Rate for Payer: PHP Commercial |
$342.15
|
| Rate for Payer: PHP Medicare Advantage |
$201.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$107.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$632.49
|
| Rate for Payer: Priority Health Medicare |
$201.24
|
| Rate for Payer: Priority Health Narrow Network |
$505.99
|
| Rate for Payer: Priority Health SBD |
$253.59
|
| Rate for Payer: Railroad Medicare Medicare |
$201.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$566.47
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$201.24
|
| Rate for Payer: UHC Exchange |
$384.59
|
| Rate for Payer: UHC Medicare Advantage |
$201.24
|
| Rate for Payer: UHCCP Medicaid |
$107.86
|
| Rate for Payer: UMR Bronson Commercial |
$148.94
|
| Rate for Payer: VA VA |
$201.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.90
|
|
|
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: BCBS Trust/PPO |
$18.00
|
| Rate for Payer: BCN Commercial |
$18.00
|
| 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: Nomi Health Commercial |
$37.36
|
| 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 HMO/PPO/Tiered Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$19.93
|
| Rate for Payer: Priority Health SBD |
$61.29
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$24.91
|
| 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 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 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: BCBS Trust/PPO |
$18.00
|
| Rate for Payer: BCN Commercial |
$18.00
|
| 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: Nomi Health Commercial |
$37.36
|
| 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 HMO/PPO/Tiered Network |
$24.91
|
| Rate for Payer: Priority Health Medicare |
$24.91
|
| Rate for Payer: Priority Health Narrow Network |
$19.93
|
| Rate for Payer: Priority Health SBD |
$58.34
|
| Rate for Payer: Railroad Medicare Medicare |
$24.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$29.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.91
|
| Rate for Payer: UHC Exchange |
$24.91
|
| 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 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 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 |
$97.65 |
| Max. Negotiated Rate |
$4,213.47 |
| Rate for Payer: Aetna American Axle |
$1,262.58
|
| Rate for Payer: Aetna Commercial |
$1,651.07
|
| Rate for Payer: Aetna Medicare |
$1,394.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,262.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,675.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,675.74
|
| Rate for Payer: BCBS Complete |
$754.48
|
| Rate for Payer: BCBS MAPPO |
$1,340.59
|
| Rate for Payer: BCBS Trust/PPO |
$1,503.70
|
| Rate for Payer: BCN Commercial |
$1,503.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,340.59
|
| Rate for Payer: Cash Price |
$1,553.94
|
| Rate for Payer: Cash Price |
$1,553.94
|
| 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: Health Alliance Plan Medicare Advantage |
$1,340.59
|
| 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 |
$718.56
|
| Rate for Payer: Mclaren Medicare |
$1,340.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,407.62
|
| Rate for Payer: Meridian Medicaid |
$754.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,541.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,651.07
|
| Rate for Payer: Nomi Health Commercial |
$4,021.77
|
| Rate for Payer: PACE Medicare |
$1,273.56
|
| Rate for Payer: PACE SWMI |
$1,340.59
|
| Rate for Payer: PHP Commercial |
$1,651.07
|
| Rate for Payer: PHP Medicare Advantage |
$1,340.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$718.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,213.47
|
| Rate for Payer: Priority Health Medicare |
$1,340.59
|
| Rate for Payer: Priority Health Narrow Network |
$3,370.78
|
| Rate for Payer: Priority Health SBD |
$1,223.73
|
| Rate for Payer: Railroad Medicare Medicare |
$1,340.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.42
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,340.59
|
| Rate for Payer: UHC Exchange |
$97.65
|
| Rate for Payer: UHC Medicare Advantage |
$1,340.59
|
| Rate for Payer: UHCCP Medicaid |
$718.56
|
| Rate for Payer: UMR Bronson Commercial |
$718.70
|
| Rate for Payer: VA VA |
$1,340.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.82
|
|
