|
HC REPOSITION CVAC
|
Facility
|
IP
|
$2,559.00
|
|
|
Service Code
|
CPT 36597
|
| Hospital Charge Code |
36100144
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,125.96 |
| Max. Negotiated Rate |
$2,303.10 |
| Rate for Payer: Aetna American Axle |
$1,663.35
|
| Rate for Payer: Aetna Commercial |
$2,175.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,663.35
|
| Rate for Payer: Cash Price |
$2,047.20
|
| Rate for Payer: Cofinity Advantage |
$1,791.30
|
| Rate for Payer: Cofinity Commercial |
$2,200.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,047.20
|
| Rate for Payer: Healthscope Commercial |
$2,303.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,791.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,919.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,175.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,919.25
|
| Rate for Payer: PHP Commercial |
$2,175.15
|
| Rate for Payer: Priority Health SBD |
$1,612.17
|
| Rate for Payer: UMR Bronson Commercial |
$1,125.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,919.25
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
IP
|
$3,000.46
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,320.20 |
| Max. Negotiated Rate |
$2,700.41 |
| Rate for Payer: Aetna American Axle |
$1,950.30
|
| Rate for Payer: Aetna Commercial |
$2,550.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,950.30
|
| Rate for Payer: Cash Price |
$2,400.37
|
| Rate for Payer: Cofinity Advantage |
$2,100.32
|
| Rate for Payer: Cofinity Commercial |
$2,580.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,400.37
|
| Rate for Payer: Healthscope Commercial |
$2,700.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,100.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,250.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,550.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,250.34
|
| Rate for Payer: PHP Commercial |
$2,550.39
|
| Rate for Payer: Priority Health SBD |
$1,890.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,320.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,250.34
|
|
|
HC REPOSITION RA/RV ELECTRODE
|
Facility
|
OP
|
$3,000.46
|
|
|
Service Code
|
CPT 33215
|
| Hospital Charge Code |
36100064
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,110.17 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$1,950.30
|
| Rate for Payer: Aetna Commercial |
$2,550.39
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,950.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,360.50
|
| Rate for Payer: BCN Commercial |
$1,360.50
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$2,400.37
|
| Rate for Payer: Cash Price |
$2,400.37
|
| Rate for Payer: Cash Price |
$2,400.37
|
| Rate for Payer: Cofinity Advantage |
$2,100.32
|
| Rate for Payer: Cofinity Commercial |
$2,580.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,400.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$2,700.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,100.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,250.34
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,550.39
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,250.34
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$2,550.39
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$1,890.29
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,110.17
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,250.34
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
IP
|
$109.24
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$48.07 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Advantage |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: UMR Bronson Commercial |
$48.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC RESERVOIR 20 MICRON
|
Facility
|
OP
|
$109.24
|
|
| Hospital Charge Code |
27000039
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$40.42 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna American Axle |
$71.01
|
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$54.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.01
|
| Rate for Payer: BCBS Complete |
$43.70
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Advantage |
$76.47
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$76.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$87.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: Priority Health SBD |
$68.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.01
|
| Rate for Payer: UHC Core |
$56.91
|
| Rate for Payer: UHC Exchange |
$42.93
|
| Rate for Payer: UMR Bronson Commercial |
$40.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
OP
|
$31.21
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$15.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.29
|
| Rate for Payer: UHC Core |
$16.26
|
| Rate for Payer: UHC Exchange |
$12.27
|
| Rate for Payer: UMR Bronson Commercial |
$11.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC RESERVOIR OUTLET Y
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27000668
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.73 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: UMR Bronson Commercial |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
OP
|
$31.21
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.55 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$15.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: BCBS Complete |
$12.48
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.29
|
| Rate for Payer: UHC Core |
$16.26
|
| Rate for Payer: UHC Exchange |
$12.27
|
| Rate for Payer: UMR Bronson Commercial |
$11.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC RESERVOIR TANDEM Y
|
Facility
|
IP
|
$31.21
|
|
| Hospital Charge Code |
27000667
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.73 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna American Axle |
$20.29
|
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.29
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Advantage |
$21.85
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$21.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.41
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health SBD |
$19.66
|
| Rate for Payer: UMR Bronson Commercial |
$13.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
IP
|
$858.33
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$377.67 |
| Max. Negotiated Rate |
$772.50 |
| Rate for Payer: Aetna American Axle |
$557.91
|
| Rate for Payer: Aetna Commercial |
$729.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.91
|
| Rate for Payer: Cash Price |
$686.66
|
| Rate for Payer: Cofinity Advantage |
$600.83
|
| Rate for Payer: Cofinity Commercial |
$738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.66
|
| Rate for Payer: Healthscope Commercial |
$772.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$600.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.75
|
| Rate for Payer: PHP Commercial |
$729.58
|
| Rate for Payer: Priority Health SBD |
$540.75
|
| Rate for Payer: UMR Bronson Commercial |
$377.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.75
|
|
|
HC RESERVOIR VEN STAND ALONE
|
Facility
|
OP
|
$858.33
|
|
| Hospital Charge Code |
27000653
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$317.58 |
| Max. Negotiated Rate |
$772.50 |
| Rate for Payer: Aetna American Axle |
$557.91
|
| Rate for Payer: Aetna Commercial |
$729.58
|
| Rate for Payer: Aetna Medicare |
$429.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$557.91
|
| Rate for Payer: BCBS Complete |
$343.33
|
| Rate for Payer: Cash Price |
$686.66
|
| Rate for Payer: Cofinity Advantage |
$600.83
|
| Rate for Payer: Cofinity Commercial |
$738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.66
|
| Rate for Payer: Healthscope Commercial |
$772.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$600.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$686.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.75
|
| Rate for Payer: PHP Commercial |
$729.58
|
| Rate for Payer: Priority Health SBD |
$540.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$557.91
|
| Rate for Payer: UHC Core |
$447.19
|
| Rate for Payer: UHC Exchange |
$337.32
|
| Rate for Payer: UMR Bronson Commercial |
$317.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.75
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC RESPIRATORY ALLERGEN PROFILE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200121
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
IP
|
$181.98
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$80.07 |
| Max. Negotiated Rate |
$163.78 |
| Rate for Payer: Aetna American Axle |
$118.29
|
| Rate for Payer: Aetna Commercial |
$154.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.29
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cofinity Advantage |
$127.39
|
| Rate for Payer: Cofinity Commercial |
$156.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.58
|
| Rate for Payer: Healthscope Commercial |
$163.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.49
|
| Rate for Payer: PHP Commercial |
$154.68
|
| Rate for Payer: Priority Health SBD |
$114.65
|
| Rate for Payer: UMR Bronson Commercial |
$80.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.49
|
|
|
HC RESPIRATORY FLOW VOLUME
|
Facility
|
OP
|
$181.98
|
|
|
Service Code
|
CPT 94375
|
| Hospital Charge Code |
46000023
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$67.33 |
| Max. Negotiated Rate |
$695.77 |
| Rate for Payer: Aetna American Axle |
$118.29
|
| Rate for Payer: Aetna Commercial |
$154.68
|
| Rate for Payer: Aetna Medicare |
$223.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$118.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.94
|
| Rate for Payer: BCBS Complete |
$118.16
|
| Rate for Payer: BCBS MAPPO |
$215.15
|
| Rate for Payer: BCBS Trust/PPO |
$105.68
|
| Rate for Payer: BCN Commercial |
$105.68
|
| Rate for Payer: BCN Medicare Advantage |
$215.15
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cash Price |
$145.58
|
| Rate for Payer: Cofinity Advantage |
$127.39
|
| Rate for Payer: Cofinity Commercial |
$156.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$145.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$215.15
|
| Rate for Payer: Healthscope Commercial |
$163.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$127.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$136.49
|
| Rate for Payer: Mclaren Medicaid |
$215.15
|
| Rate for Payer: Mclaren Medicare |
$215.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.91
|
| Rate for Payer: Meridian Medicaid |
$225.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$247.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$154.68
|
| Rate for Payer: Nomi Health Commercial |
$645.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$136.49
|
| Rate for Payer: PACE Medicare |
$204.39
|
| Rate for Payer: PACE SWMI |
$215.15
|
| Rate for Payer: PHP Commercial |
$154.68
|
| Rate for Payer: PHP Medicare Advantage |
$215.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$695.77
|
| Rate for Payer: Priority Health Medicare |
$215.15
|
| Rate for Payer: Priority Health SBD |
$114.65
|
| Rate for Payer: Priority Health Tiered Network |
$556.62
|
| Rate for Payer: Railroad Medicare Medicare |
$215.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.29
|
| Rate for Payer: UHC Core |
$94.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$215.15
|
| Rate for Payer: UHC Exchange |
$71.52
|
| Rate for Payer: UHC Medicaid |
$112.52
|
| Rate for Payer: UHCCP Medicaid |
$112.52
|
| Rate for Payer: UMR Bronson Commercial |
$67.33
|
| Rate for Payer: VA VA |
$215.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$136.49
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
OP
|
$1,075.70
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$398.01 |
| Max. Negotiated Rate |
$968.13 |
| Rate for Payer: Aetna American Axle |
$699.21
|
| Rate for Payer: Aetna Commercial |
$914.35
|
| Rate for Payer: Aetna Medicare |
$537.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.21
|
| Rate for Payer: BCBS Complete |
$430.28
|
| Rate for Payer: BCBS Trust/PPO |
$731.42
|
| Rate for Payer: BCN Commercial |
$731.42
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cofinity Advantage |
$752.99
|
| Rate for Payer: Cofinity Commercial |
$925.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.56
|
| Rate for Payer: Healthscope Commercial |
$968.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$752.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$860.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$914.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.77
|
| Rate for Payer: PHP Commercial |
$914.35
|
| Rate for Payer: Priority Health SBD |
$677.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.21
|
| Rate for Payer: UHC Core |
$560.44
|
| Rate for Payer: UHC Exchange |
$422.75
|
| Rate for Payer: UMR Bronson Commercial |
$398.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.77
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$1,075.70
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$473.31 |
| Max. Negotiated Rate |
$968.13 |
| Rate for Payer: Aetna American Axle |
$699.21
|
| Rate for Payer: Aetna Commercial |
$914.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$699.21
|
| Rate for Payer: Cash Price |
$860.56
|
| Rate for Payer: Cofinity Advantage |
$752.99
|
| Rate for Payer: Cofinity Commercial |
$925.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$860.56
|
| Rate for Payer: Healthscope Commercial |
$968.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$752.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$806.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$914.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$806.77
|
| Rate for Payer: PHP Commercial |
$914.35
|
| Rate for Payer: Priority Health SBD |
$677.69
|
| Rate for Payer: UMR Bronson Commercial |
$473.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$806.77
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$103.62
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$45.59 |
| Max. Negotiated Rate |
$93.26 |
| Rate for Payer: Aetna American Axle |
$67.35
|
| Rate for Payer: Aetna Commercial |
$88.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.35
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cofinity Advantage |
$72.53
|
| Rate for Payer: Cofinity Commercial |
$89.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.90
|
| Rate for Payer: Healthscope Commercial |
$93.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.72
|
| Rate for Payer: PHP Commercial |
$88.08
|
| Rate for Payer: Priority Health SBD |
$65.28
|
| Rate for Payer: UMR Bronson Commercial |
$45.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.72
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$103.62
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.85 |
| Max. Negotiated Rate |
$93.26 |
| Rate for Payer: Aetna American Axle |
$67.35
|
| Rate for Payer: Aetna Commercial |
$88.08
|
| Rate for Payer: Aetna Medicare |
$13.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: BCBS Complete |
$7.19
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$15.15
|
| Rate for Payer: BCN Commercial |
$15.15
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cash Price |
$82.90
|
| Rate for Payer: Cofinity Advantage |
$72.53
|
| Rate for Payer: Cofinity Commercial |
$89.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$93.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$72.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.72
|
| Rate for Payer: Mclaren Medicaid |
$13.10
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$13.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.08
|
| Rate for Payer: Nomi Health Commercial |
$19.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$77.72
|
| Rate for Payer: PACE Medicare |
$12.45
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$88.08
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.10
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health SBD |
$65.28
|
| Rate for Payer: Priority Health Tiered Network |
$10.48
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.65
|
| Rate for Payer: UHC Core |
$19.65
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.10
|
| Rate for Payer: UHC Exchange |
$19.65
|
| Rate for Payer: UHC Medicaid |
$6.85
|
| Rate for Payer: UHCCP Medicaid |
$6.85
|
| Rate for Payer: UMR Bronson Commercial |
$38.34
|
| Rate for Payer: VA VA |
$13.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.72
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
OP
|
$74.70
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna American Axle |
$48.55
|
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: Aetna Medicare |
$13.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.77
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$15.52
|
| Rate for Payer: BCN Commercial |
$15.52
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Advantage |
$52.29
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$67.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.02
|
| Rate for Payer: Mclaren Medicaid |
$13.42
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$14.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: Nomi Health Commercial |
$20.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.02
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.42
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health SBD |
$47.06
|
| Rate for Payer: Priority Health Tiered Network |
$10.74
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.13
|
| Rate for Payer: UHC Core |
$20.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.42
|
| Rate for Payer: UHC Exchange |
$20.13
|
| Rate for Payer: UHC Medicaid |
$7.02
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: UMR Bronson Commercial |
$27.64
|
| Rate for Payer: VA VA |
$13.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.02
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
IP
|
$74.70
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.87 |
| Max. Negotiated Rate |
$67.23 |
| Rate for Payer: Aetna American Axle |
$48.55
|
| Rate for Payer: Aetna Commercial |
$63.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$48.55
|
| Rate for Payer: Cash Price |
$59.76
|
| Rate for Payer: Cofinity Advantage |
$52.29
|
| Rate for Payer: Cofinity Commercial |
$64.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.76
|
| Rate for Payer: Healthscope Commercial |
$67.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$52.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.02
|
| Rate for Payer: PHP Commercial |
$63.49
|
| Rate for Payer: Priority Health SBD |
$47.06
|
| Rate for Payer: UMR Bronson Commercial |
$32.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.02
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
IP
|
$71.79
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.59 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna American Axle |
$46.66
|
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Advantage |
$50.25
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: Priority Health SBD |
$45.23
|
| Rate for Payer: UMR Bronson Commercial |
$31.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
OP
|
$71.79
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.27 |
| Max. Negotiated Rate |
$64.61 |
| Rate for Payer: Aetna American Axle |
$46.66
|
| Rate for Payer: Aetna Commercial |
$61.02
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.97
|
| Rate for Payer: BCBS Complete |
$6.58
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cash Price |
$57.43
|
| Rate for Payer: Cofinity Advantage |
$50.25
|
| Rate for Payer: Cofinity Commercial |
$61.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$64.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.84
|
| Rate for Payer: Mclaren Medicaid |
$11.98
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$12.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.02
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.84
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$61.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health SBD |
$45.23
|
| Rate for Payer: Priority Health Tiered Network |
$9.58
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.97
|
| Rate for Payer: UHC Core |
$17.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$11.98
|
| Rate for Payer: UHC Exchange |
$17.97
|
| Rate for Payer: UHC Medicaid |
$6.27
|
| Rate for Payer: UHCCP Medicaid |
$6.27
|
| Rate for Payer: UMR Bronson Commercial |
$26.56
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.84
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
OP
|
$5,130.98
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$228.42 |
| Max. Negotiated Rate |
$5,794.43 |
| Rate for Payer: Aetna American Axle |
$3,335.14
|
| Rate for Payer: Aetna Commercial |
$4,361.33
|
| Rate for Payer: Aetna Medicare |
$454.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,335.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$545.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$545.94
|
| Rate for Payer: BCBS Complete |
$239.86
|
| Rate for Payer: BCBS MAPPO |
$436.75
|
| Rate for Payer: BCBS Trust/PPO |
$5,794.43
|
| Rate for Payer: BCN Commercial |
$5,794.43
|
| Rate for Payer: BCN Medicare Advantage |
$436.75
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cofinity Advantage |
$3,591.69
|
| Rate for Payer: Cofinity Commercial |
$4,412.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,104.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$436.75
|
| Rate for Payer: Healthscope Commercial |
$4,617.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,591.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,848.24
|
| Rate for Payer: Mclaren Medicaid |
$436.75
|
| Rate for Payer: Mclaren Medicare |
$436.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$458.59
|
| Rate for Payer: Meridian Medicaid |
$458.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$502.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$480.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,361.33
|
| Rate for Payer: Nomi Health Commercial |
$1,310.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,848.24
|
| Rate for Payer: PACE Medicare |
$414.91
|
| Rate for Payer: PACE SWMI |
$436.75
|
| Rate for Payer: PHP Commercial |
$4,361.33
|
| Rate for Payer: PHP Medicare Advantage |
$436.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$228.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,377.51
|
| Rate for Payer: Priority Health Medicare |
$436.75
|
| Rate for Payer: Priority Health SBD |
$3,232.52
|
| Rate for Payer: Priority Health Tiered Network |
$1,102.01
|
| Rate for Payer: Railroad Medicare Medicare |
$436.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.43
|
| Rate for Payer: UHC Core |
$480.43
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$436.75
|
| Rate for Payer: UHC Exchange |
$480.43
|
| Rate for Payer: UHC Medicaid |
$228.42
|
| Rate for Payer: UHCCP Medicaid |
$228.42
|
| Rate for Payer: UMR Bronson Commercial |
$1,898.46
|
| Rate for Payer: VA VA |
$436.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,848.24
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
IP
|
$5,130.98
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,257.63 |
| Max. Negotiated Rate |
$4,617.88 |
| Rate for Payer: Aetna American Axle |
$3,335.14
|
| Rate for Payer: Aetna Commercial |
$4,361.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,335.14
|
| Rate for Payer: Cash Price |
$4,104.78
|
| Rate for Payer: Cofinity Advantage |
$3,591.69
|
| Rate for Payer: Cofinity Commercial |
$4,412.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,104.78
|
| Rate for Payer: Healthscope Commercial |
$4,617.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,591.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,848.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,361.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,848.24
|
| Rate for Payer: PHP Commercial |
$4,361.33
|
| Rate for Payer: Priority Health SBD |
$3,232.52
|
| Rate for Payer: UMR Bronson Commercial |
$2,257.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,848.24
|
|
