|
HC RUBEOLA VIRUS IGG
|
Facility
|
OP
|
$89.58
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200318
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.74 |
| Max. Negotiated Rate |
$80.62 |
| Rate for Payer: Aetna American Axle |
$58.23
|
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: Aetna Medicare |
$13.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.10
|
| Rate for Payer: BCBS Complete |
$7.07
|
| Rate for Payer: BCBS MAPPO |
$12.88
|
| Rate for Payer: BCBS Trust/PPO |
$14.89
|
| Rate for Payer: BCN Commercial |
$14.89
|
| Rate for Payer: BCN Medicare Advantage |
$12.88
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Advantage |
$62.71
|
| Rate for Payer: Cofinity Commercial |
$77.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.88
|
| Rate for Payer: Healthscope Commercial |
$80.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.19
|
| Rate for Payer: Mclaren Medicaid |
$12.88
|
| Rate for Payer: Mclaren Medicare |
$12.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.52
|
| Rate for Payer: Meridian Medicaid |
$13.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Nomi Health Commercial |
$19.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PACE Medicare |
$12.24
|
| Rate for Payer: PACE SWMI |
$12.88
|
| Rate for Payer: PHP Commercial |
$76.14
|
| Rate for Payer: PHP Medicare Advantage |
$12.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.88
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health SBD |
$56.44
|
| Rate for Payer: Priority Health Tiered Network |
$10.30
|
| Rate for Payer: Railroad Medicare Medicare |
$12.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.32
|
| Rate for Payer: UHC Core |
$19.32
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.88
|
| Rate for Payer: UHC Exchange |
$19.32
|
| Rate for Payer: UHC Medicaid |
$6.74
|
| Rate for Payer: UHCCP Medicaid |
$6.74
|
| Rate for Payer: UMR Bronson Commercial |
$33.14
|
| Rate for Payer: VA VA |
$12.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.19
|
|
|
HC RUBEOLA VIRUS IGG
|
Facility
|
IP
|
$89.58
|
|
|
Service Code
|
CPT 86765
|
| Hospital Charge Code |
30200318
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.42 |
| Max. Negotiated Rate |
$80.62 |
| Rate for Payer: Aetna American Axle |
$58.23
|
| Rate for Payer: Aetna Commercial |
$76.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.23
|
| Rate for Payer: Cash Price |
$71.66
|
| Rate for Payer: Cofinity Advantage |
$62.71
|
| Rate for Payer: Cofinity Commercial |
$77.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.66
|
| Rate for Payer: Healthscope Commercial |
$80.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$67.19
|
| Rate for Payer: PHP Commercial |
$76.14
|
| Rate for Payer: Priority Health SBD |
$56.44
|
| Rate for Payer: UMR Bronson Commercial |
$39.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.19
|
|
|
HC RUBIDIUM PER STUDY DOSE
|
Facility
|
OP
|
$2,091.00
|
|
|
Service Code
|
HCPCS A9555
|
| Hospital Charge Code |
34300039
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$770.65 |
| Max. Negotiated Rate |
$1,881.90 |
| Rate for Payer: Aetna American Axle |
$1,359.15
|
| Rate for Payer: Aetna Commercial |
$1,777.35
|
| Rate for Payer: Aetna Medicare |
$1,045.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.15
|
| Rate for Payer: BCBS Complete |
$836.40
|
| Rate for Payer: BCBS Trust/PPO |
$770.65
|
| Rate for Payer: BCN Commercial |
$770.65
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cofinity Advantage |
$1,463.70
|
| Rate for Payer: Cofinity Commercial |
$1,798.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.80
|
| Rate for Payer: Healthscope Commercial |
$1,881.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,463.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,568.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,672.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,777.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,568.25
|
| Rate for Payer: PHP Commercial |
$1,777.35
|
| Rate for Payer: Priority Health SBD |
$1,317.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$882.88
|
| Rate for Payer: UHC Core |
$882.88
|
| Rate for Payer: UHC Exchange |
$882.88
|
| Rate for Payer: UMR Bronson Commercial |
$773.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,568.25
|
|
|
HC RUBIDIUM PER STUDY DOSE
|
Facility
|
IP
|
$2,091.00
|
|
|
Service Code
|
HCPCS A9555
|
| Hospital Charge Code |
34300039
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$920.04 |
| Max. Negotiated Rate |
$1,881.90 |
| Rate for Payer: Aetna American Axle |
$1,359.15
|
| Rate for Payer: Aetna Commercial |
$1,777.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,359.15
|
| Rate for Payer: Cash Price |
$1,672.80
|
| Rate for Payer: Cofinity Advantage |
$1,463.70
|
| Rate for Payer: Cofinity Commercial |
$1,798.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,672.80
|
| Rate for Payer: Healthscope Commercial |
$1,881.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,463.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,568.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,777.35
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,568.25
|
| Rate for Payer: PHP Commercial |
$1,777.35
|
| Rate for Payer: Priority Health SBD |
$1,317.33
|
| Rate for Payer: UMR Bronson Commercial |
$920.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,568.25
|
|
|
HC RUSSELL VIPER VENOM TIME DILUTED
|
Facility
|
IP
|
$62.84
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
30500059
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.65 |
| Max. Negotiated Rate |
$56.56 |
| Rate for Payer: Aetna American Axle |
$40.85
|
| Rate for Payer: Aetna Commercial |
$53.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.85
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Advantage |
$43.99
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Healthscope Commercial |
$56.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PHP Commercial |
$53.41
|
| Rate for Payer: Priority Health SBD |
$39.59
|
| Rate for Payer: UMR Bronson Commercial |
$27.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.13
|
|
|
HC RUSSELL VIPER VENOM TIME DILUTED
|
Facility
|
OP
|
$62.84
|
|
|
Service Code
|
CPT 85613
|
| Hospital Charge Code |
30500059
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.01 |
| Max. Negotiated Rate |
$56.56 |
| Rate for Payer: Aetna American Axle |
$40.85
|
| Rate for Payer: Aetna Commercial |
$53.41
|
| Rate for Payer: Aetna Medicare |
$9.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.97
|
| Rate for Payer: BCBS Complete |
$5.26
|
| Rate for Payer: BCBS MAPPO |
$9.58
|
| Rate for Payer: BCBS Trust/PPO |
$11.08
|
| Rate for Payer: BCN Commercial |
$11.08
|
| Rate for Payer: BCN Medicare Advantage |
$9.58
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cash Price |
$50.27
|
| Rate for Payer: Cofinity Advantage |
$43.99
|
| Rate for Payer: Cofinity Commercial |
$54.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.58
|
| Rate for Payer: Healthscope Commercial |
$56.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.13
|
| Rate for Payer: Mclaren Medicaid |
$9.58
|
| Rate for Payer: Mclaren Medicare |
$9.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.06
|
| Rate for Payer: Meridian Medicaid |
$10.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.41
|
| Rate for Payer: Nomi Health Commercial |
$14.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.13
|
| Rate for Payer: PACE Medicare |
$9.10
|
| Rate for Payer: PACE SWMI |
$9.58
|
| Rate for Payer: PHP Commercial |
$53.41
|
| Rate for Payer: PHP Medicare Advantage |
$9.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9.58
|
| Rate for Payer: Priority Health Medicare |
$9.58
|
| Rate for Payer: Priority Health SBD |
$39.59
|
| Rate for Payer: Priority Health Tiered Network |
$7.66
|
| Rate for Payer: Railroad Medicare Medicare |
$9.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.37
|
| Rate for Payer: UHC Core |
$14.37
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$9.58
|
| Rate for Payer: UHC Exchange |
$14.37
|
| Rate for Payer: UHC Medicaid |
$5.01
|
| Rate for Payer: UHCCP Medicaid |
$5.01
|
| Rate for Payer: UMR Bronson Commercial |
$23.25
|
| Rate for Payer: VA VA |
$9.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.13
|
|
|
HC RUSSIAN THISTLE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200100
|
|
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 RUSSIAN THISTLE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200100
|
|
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 SACRAL NERVE STIM, TEST LEAD, EACH
|
Facility
|
IP
|
$1,379.57
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27200315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$607.01 |
| Max. Negotiated Rate |
$1,241.61 |
| Rate for Payer: Aetna American Axle |
$896.72
|
| Rate for Payer: Aetna Commercial |
$1,172.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$896.72
|
| Rate for Payer: Cash Price |
$1,103.66
|
| Rate for Payer: Cofinity Advantage |
$965.70
|
| Rate for Payer: Cofinity Commercial |
$1,186.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,103.66
|
| Rate for Payer: Healthscope Commercial |
$1,241.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$965.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,034.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,172.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,034.68
|
| Rate for Payer: PHP Commercial |
$1,172.63
|
| Rate for Payer: Priority Health SBD |
$869.13
|
| Rate for Payer: UMR Bronson Commercial |
$607.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,034.68
|
|
|
HC SACRAL NERVE STIM, TEST LEAD, EACH
|
Facility
|
OP
|
$1,379.57
|
|
|
Service Code
|
HCPCS C1897
|
| Hospital Charge Code |
27200315
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$510.44 |
| Max. Negotiated Rate |
$1,241.61 |
| Rate for Payer: Aetna American Axle |
$896.72
|
| Rate for Payer: Aetna Commercial |
$1,172.63
|
| Rate for Payer: Aetna Medicare |
$689.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$896.72
|
| Rate for Payer: BCBS Complete |
$551.83
|
| Rate for Payer: Cash Price |
$1,103.66
|
| Rate for Payer: Cofinity Advantage |
$965.70
|
| Rate for Payer: Cofinity Commercial |
$1,186.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,103.66
|
| Rate for Payer: Healthscope Commercial |
$1,241.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$965.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,034.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,103.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,172.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,034.68
|
| Rate for Payer: PHP Commercial |
$1,172.63
|
| Rate for Payer: Priority Health SBD |
$869.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$896.72
|
| Rate for Payer: UHC Core |
$718.76
|
| Rate for Payer: UHC Exchange |
$542.17
|
| Rate for Payer: UMR Bronson Commercial |
$510.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,034.68
|
|
|
HC SAFE SHEATH LEAD INTRODUCER
|
Facility
|
IP
|
$2,000.00
|
|
| Hospital Charge Code |
27200400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$880.00 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna American Axle |
$1,300.00
|
| Rate for Payer: Aetna Commercial |
$1,700.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,300.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Advantage |
$1,400.00
|
| Rate for Payer: Cofinity Commercial |
$1,720.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.00
|
| Rate for Payer: Healthscope Commercial |
$1,800.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,400.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,500.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: PHP Commercial |
$1,700.00
|
| Rate for Payer: Priority Health SBD |
$1,260.00
|
| Rate for Payer: UMR Bronson Commercial |
$880.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,500.00
|
|
|
HC SAFE SHEATH LEAD INTRODUCER
|
Facility
|
OP
|
$2,000.00
|
|
| Hospital Charge Code |
27200400
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$740.00 |
| Max. Negotiated Rate |
$1,800.00 |
| Rate for Payer: Aetna American Axle |
$1,300.00
|
| Rate for Payer: Aetna Commercial |
$1,700.00
|
| Rate for Payer: Aetna Medicare |
$1,000.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,300.00
|
| Rate for Payer: BCBS Complete |
$800.00
|
| Rate for Payer: Cash Price |
$1,600.00
|
| Rate for Payer: Cofinity Advantage |
$1,400.00
|
| Rate for Payer: Cofinity Commercial |
$1,720.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,600.00
|
| Rate for Payer: Healthscope Commercial |
$1,800.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,400.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,500.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,600.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,700.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,500.00
|
| Rate for Payer: PHP Commercial |
$1,700.00
|
| Rate for Payer: Priority Health SBD |
$1,260.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,300.00
|
| Rate for Payer: UHC Core |
$1,042.00
|
| Rate for Payer: UHC Exchange |
$786.00
|
| Rate for Payer: UMR Bronson Commercial |
$740.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,500.00
|
|
|
HC SALICYLATE LVL.
|
Facility
|
OP
|
$104.49
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100649
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$94.04 |
| Rate for Payer: Aetna American Axle |
$67.92
|
| Rate for Payer: Aetna Commercial |
$88.82
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.84
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cofinity Advantage |
$73.14
|
| Rate for Payer: Cofinity Commercial |
$89.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$94.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.37
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.82
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.37
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$88.82
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$65.83
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: UMR Bronson Commercial |
$38.66
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.37
|
|
|
HC SALICYLATE LVL.
|
Facility
|
IP
|
$104.49
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100649
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$45.98 |
| Max. Negotiated Rate |
$94.04 |
| Rate for Payer: Aetna American Axle |
$67.92
|
| Rate for Payer: Aetna Commercial |
$88.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$67.92
|
| Rate for Payer: Cash Price |
$83.59
|
| Rate for Payer: Cofinity Advantage |
$73.14
|
| Rate for Payer: Cofinity Commercial |
$89.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.59
|
| Rate for Payer: Healthscope Commercial |
$94.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.37
|
| Rate for Payer: PHP Commercial |
$88.82
|
| Rate for Payer: Priority Health SBD |
$65.83
|
| Rate for Payer: UMR Bronson Commercial |
$45.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.37
|
|
|
HC SALICYLATE THERAPEUTIC DRUG ASSAY
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80179
|
| Hospital Charge Code |
30100730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC SALICYLATE THERAPEUTIC DRUG ASSAY
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80179
|
| Hospital Charge Code |
30100730
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.75 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$19.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.30
|
| Rate for Payer: BCBS Complete |
$10.24
|
| Rate for Payer: BCBS MAPPO |
$18.64
|
| Rate for Payer: BCBS Trust/PPO |
$21.55
|
| Rate for Payer: BCN Commercial |
$21.55
|
| Rate for Payer: BCN Medicare Advantage |
$18.64
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.64
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| Rate for Payer: Mclaren Medicare |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.57
|
| Rate for Payer: Meridian Medicaid |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$17.71
|
| Rate for Payer: PACE SWMI |
$18.64
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$18.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.64
|
| Rate for Payer: Priority Health Medicare |
$18.64
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$14.91
|
| Rate for Payer: Railroad Medicare Medicare |
$18.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.96
|
| Rate for Payer: UHC Core |
$27.96
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.64
|
| Rate for Payer: UHC Exchange |
$27.96
|
| Rate for Payer: UHC Medicaid |
$9.75
|
| Rate for Payer: UHCCP Medicaid |
$9.75
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC SALMON IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200059
|
|
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 SALMON IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200059
|
|
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 SAMARIUM 153 THERAPEUTIC PER TREATMENT DOSE
|
Facility
|
OP
|
$12,927.24
|
|
|
Service Code
|
HCPCS A9604
|
| Hospital Charge Code |
34400005
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$1,652.58 |
| Max. Negotiated Rate |
$25,096.80 |
| Rate for Payer: Aetna American Axle |
$8,402.71
|
| Rate for Payer: Aetna Commercial |
$10,988.15
|
| Rate for Payer: Aetna Medicare |
$3,286.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,402.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,949.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,949.75
|
| Rate for Payer: BCBS Complete |
$1,735.36
|
| Rate for Payer: BCBS MAPPO |
$3,159.80
|
| Rate for Payer: BCBS Trust/PPO |
$25,096.80
|
| Rate for Payer: BCN Commercial |
$25,096.80
|
| Rate for Payer: BCN Medicare Advantage |
$3,159.80
|
| Rate for Payer: Cash Price |
$10,341.79
|
| Rate for Payer: Cash Price |
$10,341.79
|
| Rate for Payer: Cofinity Advantage |
$9,049.07
|
| Rate for Payer: Cofinity Commercial |
$11,117.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,341.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,159.80
|
| Rate for Payer: Healthscope Commercial |
$11,634.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,049.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,695.43
|
| Rate for Payer: Mclaren Medicaid |
$3,159.80
|
| Rate for Payer: Mclaren Medicare |
$3,159.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,317.79
|
| Rate for Payer: Meridian Medicaid |
$3,317.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,633.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,475.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,988.15
|
| Rate for Payer: Nomi Health Commercial |
$9,479.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,695.43
|
| Rate for Payer: PACE Medicare |
$3,001.81
|
| Rate for Payer: PACE SWMI |
$3,159.80
|
| Rate for Payer: PHP Commercial |
$10,988.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,159.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$9,965.90
|
| Rate for Payer: Priority Health Medicare |
$3,159.80
|
| Rate for Payer: Priority Health SBD |
$8,144.16
|
| Rate for Payer: Priority Health Tiered Network |
$7,972.72
|
| Rate for Payer: Railroad Medicare Medicare |
$3,159.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,213.67
|
| Rate for Payer: UHC Core |
$5,213.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,159.80
|
| Rate for Payer: UHC Exchange |
$5,213.67
|
| Rate for Payer: UHC Medicaid |
$1,652.58
|
| Rate for Payer: UHCCP Medicaid |
$1,652.58
|
| Rate for Payer: UMR Bronson Commercial |
$4,783.08
|
| Rate for Payer: VA VA |
$3,159.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,695.43
|
|
|
HC SAMARIUM 153 THERAPEUTIC PER TREATMENT DOSE
|
Facility
|
IP
|
$12,927.24
|
|
|
Service Code
|
HCPCS A9604
|
| Hospital Charge Code |
34400005
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$5,687.99 |
| Max. Negotiated Rate |
$11,634.52 |
| Rate for Payer: Aetna American Axle |
$8,402.71
|
| Rate for Payer: Aetna Commercial |
$10,988.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,402.71
|
| Rate for Payer: Cash Price |
$10,341.79
|
| Rate for Payer: Cofinity Advantage |
$9,049.07
|
| Rate for Payer: Cofinity Commercial |
$11,117.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,341.79
|
| Rate for Payer: Healthscope Commercial |
$11,634.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,049.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,695.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,988.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,695.43
|
| Rate for Payer: PHP Commercial |
$10,988.15
|
| Rate for Payer: Priority Health SBD |
$8,144.16
|
| Rate for Payer: UMR Bronson Commercial |
$5,687.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,695.43
|
|
|
HC SARS CORONAVIRUS 2 IGG AB,S
|
Facility
|
IP
|
$72.17
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200479
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.75 |
| Max. Negotiated Rate |
$64.95 |
| Rate for Payer: Aetna American Axle |
$46.91
|
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.91
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Advantage |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: Priority Health SBD |
$45.47
|
| Rate for Payer: UMR Bronson Commercial |
$31.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC SARS CORONAVIRUS 2 IGG AB,S
|
Facility
|
OP
|
$72.17
|
|
|
Service Code
|
CPT 86769
|
| Hospital Charge Code |
30200479
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.03 |
| Max. Negotiated Rate |
$126.39 |
| Rate for Payer: Aetna American Axle |
$46.91
|
| Rate for Payer: Aetna Commercial |
$61.34
|
| Rate for Payer: Aetna Medicare |
$43.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.66
|
| Rate for Payer: BCBS Complete |
$23.14
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cash Price |
$57.74
|
| Rate for Payer: Cofinity Advantage |
$50.52
|
| Rate for Payer: Cofinity Commercial |
$62.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$64.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$50.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.13
|
| Rate for Payer: Mclaren Medicaid |
$42.13
|
| Rate for Payer: Mclaren Medicare |
$42.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$44.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$61.34
|
| Rate for Payer: Nomi Health Commercial |
$126.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$54.13
|
| Rate for Payer: PACE Medicare |
$40.02
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$61.34
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$42.13
|
| Rate for Payer: Priority Health Medicare |
$42.13
|
| Rate for Payer: Priority Health SBD |
$45.47
|
| Rate for Payer: Priority Health Tiered Network |
$33.70
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$63.20
|
| Rate for Payer: UHC Core |
$63.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$42.13
|
| Rate for Payer: UHC Exchange |
$63.20
|
| Rate for Payer: UHC Medicaid |
$22.03
|
| Rate for Payer: UHCCP Medicaid |
$22.03
|
| Rate for Payer: UMR Bronson Commercial |
$26.70
|
| Rate for Payer: VA VA |
$42.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.13
|
|
|
HC SARS-COV-2 COVID-19 AMP PRB
|
Facility
|
IP
|
$167.08
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600339
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$73.52 |
| Max. Negotiated Rate |
$150.37 |
| Rate for Payer: Aetna American Axle |
$108.60
|
| Rate for Payer: Aetna Commercial |
$142.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.60
|
| Rate for Payer: Cash Price |
$133.66
|
| Rate for Payer: Cofinity Advantage |
$116.96
|
| Rate for Payer: Cofinity Commercial |
$143.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.66
|
| Rate for Payer: Healthscope Commercial |
$150.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.31
|
| Rate for Payer: PHP Commercial |
$142.02
|
| Rate for Payer: Priority Health SBD |
$105.26
|
| Rate for Payer: UMR Bronson Commercial |
$73.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.31
|
|
|
HC SARS-COV-2 COVID-19 AMP PRB
|
Facility
|
OP
|
$167.08
|
|
|
Service Code
|
CPT 87635
|
| Hospital Charge Code |
30600339
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$26.84 |
| Max. Negotiated Rate |
$153.93 |
| Rate for Payer: Aetna American Axle |
$108.60
|
| Rate for Payer: Aetna Commercial |
$142.02
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.18
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCBS Trust/PPO |
$107.89
|
| Rate for Payer: BCN Commercial |
$107.89
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$133.66
|
| Rate for Payer: Cash Price |
$133.66
|
| Rate for Payer: Cofinity Advantage |
$116.96
|
| Rate for Payer: Cofinity Commercial |
$143.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$150.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.31
|
| Rate for Payer: Mclaren Medicaid |
$51.31
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$53.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$56.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.02
|
| Rate for Payer: Nomi Health Commercial |
$153.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.31
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$142.02
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$51.31
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$105.26
|
| Rate for Payer: Priority Health Tiered Network |
$41.05
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.97
|
| Rate for Payer: UHC Core |
$76.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.31
|
| Rate for Payer: UHC Exchange |
$76.97
|
| Rate for Payer: UHC Medicaid |
$26.84
|
| Rate for Payer: UHCCP Medicaid |
$26.84
|
| Rate for Payer: UMR Bronson Commercial |
$61.82
|
| Rate for Payer: VA VA |
$51.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.31
|
|
|
HC SARS-COV2/FLU A&B
|
Facility
|
IP
|
$222.85
|
|
|
Service Code
|
CPT 87636
|
| Hospital Charge Code |
30600318
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$98.05 |
| Max. Negotiated Rate |
$200.56 |
| Rate for Payer: Aetna American Axle |
$144.85
|
| Rate for Payer: Aetna Commercial |
$189.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$144.85
|
| Rate for Payer: Cash Price |
$178.28
|
| Rate for Payer: Cofinity Advantage |
$156.00
|
| Rate for Payer: Cofinity Commercial |
$191.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$178.28
|
| Rate for Payer: Healthscope Commercial |
$200.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$156.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$189.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$167.14
|
| Rate for Payer: PHP Commercial |
$189.42
|
| Rate for Payer: Priority Health SBD |
$140.40
|
| Rate for Payer: UMR Bronson Commercial |
$98.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.14
|
|
