|
HC SEROTONIN RELEASE ASSAY LOVENOX
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200131
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna American Axle |
$69.67
|
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.67
|
| 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 |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$21.24
|
| Rate for Payer: BCN Commercial |
$21.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Advantage |
$75.03
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$75.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.39
|
| Rate for Payer: Mclaren Medicaid |
$18.37
|
| 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 |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$27.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$67.52
|
| Rate for Payer: Priority Health Tiered Network |
$14.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Core |
$27.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$27.56
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$39.66
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.39
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
OP
|
$416.00
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$374.40 |
| Rate for Payer: Aetna American Axle |
$270.40
|
| Rate for Payer: Aetna Commercial |
$353.60
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.40
|
| 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 |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$21.24
|
| Rate for Payer: BCN Commercial |
$21.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cofinity Advantage |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$357.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$374.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.00
|
| Rate for Payer: Mclaren Medicaid |
$18.37
|
| 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 |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.60
|
| Rate for Payer: Nomi Health Commercial |
$27.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.00
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$353.60
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$262.08
|
| Rate for Payer: Priority Health Tiered Network |
$14.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Core |
$27.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$27.56
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$153.92
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.00
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
IP
|
$416.00
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$183.04 |
| Max. Negotiated Rate |
$374.40 |
| Rate for Payer: Aetna American Axle |
$270.40
|
| Rate for Payer: Aetna Commercial |
$353.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$270.40
|
| Rate for Payer: Cash Price |
$332.80
|
| Rate for Payer: Cofinity Advantage |
$291.20
|
| Rate for Payer: Cofinity Commercial |
$357.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$332.80
|
| Rate for Payer: Healthscope Commercial |
$374.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$291.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$353.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.00
|
| Rate for Payer: PHP Commercial |
$353.60
|
| Rate for Payer: Priority Health SBD |
$262.08
|
| Rate for Payer: UMR Bronson Commercial |
$183.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.00
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
IP
|
$78.97
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.75 |
| Max. Negotiated Rate |
$71.07 |
| Rate for Payer: Aetna American Axle |
$51.33
|
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.33
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cofinity Advantage |
$55.28
|
| Rate for Payer: Cofinity Commercial |
$67.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.18
|
| Rate for Payer: Healthscope Commercial |
$71.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.23
|
| Rate for Payer: PHP Commercial |
$67.12
|
| Rate for Payer: Priority Health SBD |
$49.75
|
| Rate for Payer: UMR Bronson Commercial |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.23
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
OP
|
$78.97
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$71.07 |
| Rate for Payer: Aetna American Axle |
$51.33
|
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cofinity Advantage |
$55.28
|
| Rate for Payer: Cofinity Commercial |
$67.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$71.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.23
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.12
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.23
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$67.12
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$49.75
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$29.22
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.23
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
OP
|
$78.97
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$71.07 |
| Rate for Payer: Aetna American Axle |
$51.33
|
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cofinity Advantage |
$55.28
|
| Rate for Payer: Cofinity Commercial |
$67.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$71.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.23
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.12
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.23
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$67.12
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$49.75
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$29.22
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.23
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
IP
|
$78.97
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.75 |
| Max. Negotiated Rate |
$71.07 |
| Rate for Payer: Aetna American Axle |
$51.33
|
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$51.33
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cofinity Advantage |
$55.28
|
| Rate for Payer: Cofinity Commercial |
$67.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.18
|
| Rate for Payer: Healthscope Commercial |
$71.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$55.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.23
|
| Rate for Payer: PHP Commercial |
$67.12
|
| Rate for Payer: Priority Health SBD |
$49.75
|
| Rate for Payer: UMR Bronson Commercial |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.23
|
|
|
HC SESAME SEED IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
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 SESAME SEED IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
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 SETUP 1
|
Facility
|
OP
|
$34.21
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.66 |
| Max. Negotiated Rate |
$30.79 |
| Rate for Payer: Aetna American Axle |
$22.24
|
| Rate for Payer: Aetna Commercial |
$29.08
|
| Rate for Payer: Aetna Medicare |
$17.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.24
|
| Rate for Payer: BCBS Complete |
$13.68
|
| Rate for Payer: Cash Price |
$27.37
|
| Rate for Payer: Cofinity Advantage |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$29.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.37
|
| Rate for Payer: Healthscope Commercial |
$30.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.66
|
| Rate for Payer: PHP Commercial |
$29.08
|
| Rate for Payer: Priority Health SBD |
$21.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.24
|
| Rate for Payer: UHC Core |
$17.82
|
| Rate for Payer: UHC Exchange |
$13.44
|
| Rate for Payer: UMR Bronson Commercial |
$12.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.66
|
|
|
HC SETUP 1
|
Facility
|
IP
|
$34.21
|
|
| Hospital Charge Code |
27000145
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.05 |
| Max. Negotiated Rate |
$30.79 |
| Rate for Payer: Aetna American Axle |
$22.24
|
| Rate for Payer: Aetna Commercial |
$29.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.24
|
| Rate for Payer: Cash Price |
$27.37
|
| Rate for Payer: Cofinity Advantage |
$23.95
|
| Rate for Payer: Cofinity Commercial |
$29.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.37
|
| Rate for Payer: Healthscope Commercial |
$30.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$25.66
|
| Rate for Payer: PHP Commercial |
$29.08
|
| Rate for Payer: Priority Health SBD |
$21.55
|
| Rate for Payer: UMR Bronson Commercial |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.66
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
IP
|
$61.55
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.08 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna American Axle |
$40.01
|
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.01
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Advantage |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.16
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: Priority Health SBD |
$38.78
|
| Rate for Payer: UMR Bronson Commercial |
$27.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC SEX HORMONE BINDING GLOBULIN
|
Facility
|
OP
|
$61.55
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100422
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$55.40 |
| Rate for Payer: Aetna American Axle |
$40.01
|
| Rate for Payer: Aetna Commercial |
$52.32
|
| Rate for Payer: Aetna Medicare |
$22.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.16
|
| Rate for Payer: BCBS Complete |
$11.93
|
| Rate for Payer: BCBS MAPPO |
$21.73
|
| Rate for Payer: BCBS Trust/PPO |
$25.12
|
| Rate for Payer: BCN Commercial |
$25.12
|
| Rate for Payer: BCN Medicare Advantage |
$21.73
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cash Price |
$49.24
|
| Rate for Payer: Cofinity Advantage |
$43.09
|
| Rate for Payer: Cofinity Commercial |
$52.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$55.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.16
|
| Rate for Payer: Mclaren Medicaid |
$21.73
|
| Rate for Payer: Mclaren Medicare |
$21.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.82
|
| Rate for Payer: Meridian Medicaid |
$22.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.32
|
| Rate for Payer: Nomi Health Commercial |
$32.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.16
|
| Rate for Payer: PACE Medicare |
$20.64
|
| Rate for Payer: PACE SWMI |
$21.73
|
| Rate for Payer: PHP Commercial |
$52.32
|
| Rate for Payer: PHP Medicare Advantage |
$21.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.73
|
| Rate for Payer: Priority Health Medicare |
$21.73
|
| Rate for Payer: Priority Health SBD |
$38.78
|
| Rate for Payer: Priority Health Tiered Network |
$17.38
|
| Rate for Payer: Railroad Medicare Medicare |
$21.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.60
|
| Rate for Payer: UHC Core |
$32.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.73
|
| Rate for Payer: UHC Exchange |
$32.60
|
| Rate for Payer: UHC Medicaid |
$11.36
|
| Rate for Payer: UHCCP Medicaid |
$11.36
|
| Rate for Payer: UMR Bronson Commercial |
$22.77
|
| Rate for Payer: VA VA |
$21.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.16
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
OP
|
$86.83
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.36 |
| Max. Negotiated Rate |
$78.15 |
| Rate for Payer: Aetna American Axle |
$56.44
|
| Rate for Payer: Aetna Commercial |
$73.81
|
| Rate for Payer: Aetna Medicare |
$22.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.16
|
| Rate for Payer: BCBS Complete |
$11.93
|
| Rate for Payer: BCBS MAPPO |
$21.73
|
| Rate for Payer: BCBS Trust/PPO |
$25.12
|
| Rate for Payer: BCN Commercial |
$25.12
|
| Rate for Payer: BCN Medicare Advantage |
$21.73
|
| Rate for Payer: Cash Price |
$69.46
|
| Rate for Payer: Cash Price |
$69.46
|
| Rate for Payer: Cofinity Advantage |
$60.78
|
| Rate for Payer: Cofinity Commercial |
$74.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.73
|
| Rate for Payer: Healthscope Commercial |
$78.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.12
|
| Rate for Payer: Mclaren Medicaid |
$21.73
|
| Rate for Payer: Mclaren Medicare |
$21.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.82
|
| Rate for Payer: Meridian Medicaid |
$22.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.81
|
| Rate for Payer: Nomi Health Commercial |
$32.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.12
|
| Rate for Payer: PACE Medicare |
$20.64
|
| Rate for Payer: PACE SWMI |
$21.73
|
| Rate for Payer: PHP Commercial |
$73.81
|
| Rate for Payer: PHP Medicare Advantage |
$21.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.73
|
| Rate for Payer: Priority Health Medicare |
$21.73
|
| Rate for Payer: Priority Health SBD |
$54.70
|
| Rate for Payer: Priority Health Tiered Network |
$17.38
|
| Rate for Payer: Railroad Medicare Medicare |
$21.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.60
|
| Rate for Payer: UHC Core |
$32.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.73
|
| Rate for Payer: UHC Exchange |
$32.60
|
| Rate for Payer: UHC Medicaid |
$11.36
|
| Rate for Payer: UHCCP Medicaid |
$11.36
|
| Rate for Payer: UMR Bronson Commercial |
$32.13
|
| Rate for Payer: VA VA |
$21.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.12
|
|
|
HC SEX HORMONE GLOBULIN BMH
|
Facility
|
IP
|
$86.83
|
|
|
Service Code
|
CPT 84270
|
| Hospital Charge Code |
30100718
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.21 |
| Max. Negotiated Rate |
$78.15 |
| Rate for Payer: Aetna American Axle |
$56.44
|
| Rate for Payer: Aetna Commercial |
$73.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.44
|
| Rate for Payer: Cash Price |
$69.46
|
| Rate for Payer: Cofinity Advantage |
$60.78
|
| Rate for Payer: Cofinity Commercial |
$74.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.46
|
| Rate for Payer: Healthscope Commercial |
$78.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$60.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.12
|
| Rate for Payer: PHP Commercial |
$73.81
|
| Rate for Payer: Priority Health SBD |
$54.70
|
| Rate for Payer: UMR Bronson Commercial |
$38.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.12
|
|
|
HC SGOT AST
|
Facility
|
IP
|
$19.85
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.73 |
| Max. Negotiated Rate |
$17.86 |
| Rate for Payer: Aetna American Axle |
$12.90
|
| Rate for Payer: Aetna Commercial |
$16.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.90
|
| Rate for Payer: Cash Price |
$15.88
|
| Rate for Payer: Cofinity Advantage |
$13.89
|
| Rate for Payer: Cofinity Commercial |
$17.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.88
|
| Rate for Payer: Healthscope Commercial |
$17.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.89
|
| Rate for Payer: PHP Commercial |
$16.87
|
| Rate for Payer: Priority Health SBD |
$12.51
|
| Rate for Payer: UMR Bronson Commercial |
$8.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.89
|
|
|
HC SGOT AST
|
Facility
|
OP
|
$19.85
|
|
|
Service Code
|
CPT 84450
|
| Hospital Charge Code |
30100441
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$17.86 |
| Rate for Payer: Aetna American Axle |
$12.90
|
| Rate for Payer: Aetna Commercial |
$16.87
|
| Rate for Payer: Aetna Medicare |
$5.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.47
|
| Rate for Payer: BCBS Complete |
$2.84
|
| Rate for Payer: BCBS MAPPO |
$5.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.18
|
| Rate for Payer: Cash Price |
$15.88
|
| Rate for Payer: Cash Price |
$15.88
|
| Rate for Payer: Cofinity Advantage |
$13.89
|
| Rate for Payer: Cofinity Commercial |
$17.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.18
|
| Rate for Payer: Healthscope Commercial |
$17.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.89
|
| Rate for Payer: Mclaren Medicaid |
$5.18
|
| Rate for Payer: Mclaren Medicare |
$5.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.44
|
| Rate for Payer: Meridian Medicaid |
$5.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.87
|
| Rate for Payer: Nomi Health Commercial |
$7.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.89
|
| Rate for Payer: PACE Medicare |
$4.92
|
| Rate for Payer: PACE SWMI |
$5.18
|
| Rate for Payer: PHP Commercial |
$16.87
|
| Rate for Payer: PHP Medicare Advantage |
$5.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.18
|
| Rate for Payer: Priority Health Medicare |
$5.18
|
| Rate for Payer: Priority Health SBD |
$12.51
|
| Rate for Payer: Priority Health Tiered Network |
$4.14
|
| Rate for Payer: Railroad Medicare Medicare |
$5.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.77
|
| Rate for Payer: UHC Core |
$7.77
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.18
|
| Rate for Payer: UHC Exchange |
$7.77
|
| Rate for Payer: UHC Medicaid |
$2.71
|
| Rate for Payer: UHCCP Medicaid |
$2.71
|
| Rate for Payer: UMR Bronson Commercial |
$7.34
|
| Rate for Payer: VA VA |
$5.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.89
|
|
|
HC SGPT ALT
|
Facility
|
IP
|
$20.01
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.80 |
| Max. Negotiated Rate |
$18.01 |
| Rate for Payer: Aetna American Axle |
$13.01
|
| Rate for Payer: Aetna Commercial |
$17.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.01
|
| Rate for Payer: Cash Price |
$16.01
|
| Rate for Payer: Cofinity Advantage |
$14.01
|
| Rate for Payer: Cofinity Commercial |
$17.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.01
|
| Rate for Payer: Healthscope Commercial |
$18.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.01
|
| Rate for Payer: PHP Commercial |
$17.01
|
| Rate for Payer: Priority Health SBD |
$12.61
|
| Rate for Payer: UMR Bronson Commercial |
$8.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.01
|
|
|
HC SGPT ALT
|
Facility
|
OP
|
$20.01
|
|
|
Service Code
|
CPT 84460
|
| Hospital Charge Code |
30100442
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.77 |
| Max. Negotiated Rate |
$18.01 |
| Rate for Payer: Aetna American Axle |
$13.01
|
| Rate for Payer: Aetna Commercial |
$17.01
|
| Rate for Payer: Aetna Medicare |
$5.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.62
|
| Rate for Payer: BCBS Complete |
$2.91
|
| Rate for Payer: BCBS MAPPO |
$5.30
|
| Rate for Payer: BCN Medicare Advantage |
$5.30
|
| Rate for Payer: Cash Price |
$16.01
|
| Rate for Payer: Cash Price |
$16.01
|
| Rate for Payer: Cofinity Advantage |
$14.01
|
| Rate for Payer: Cofinity Commercial |
$17.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.30
|
| Rate for Payer: Healthscope Commercial |
$18.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.01
|
| Rate for Payer: Mclaren Medicaid |
$5.30
|
| Rate for Payer: Mclaren Medicare |
$5.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$5.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.09
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.01
|
| Rate for Payer: Nomi Health Commercial |
$7.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.01
|
| Rate for Payer: PACE Medicare |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.30
|
| Rate for Payer: PHP Commercial |
$17.01
|
| Rate for Payer: PHP Medicare Advantage |
$5.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.30
|
| Rate for Payer: Priority Health Medicare |
$5.30
|
| Rate for Payer: Priority Health SBD |
$12.61
|
| Rate for Payer: Priority Health Tiered Network |
$4.24
|
| Rate for Payer: Railroad Medicare Medicare |
$5.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.95
|
| Rate for Payer: UHC Core |
$7.95
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.30
|
| Rate for Payer: UHC Exchange |
$7.95
|
| Rate for Payer: UHC Medicaid |
$2.77
|
| Rate for Payer: UHCCP Medicaid |
$2.77
|
| Rate for Payer: UMR Bronson Commercial |
$7.40
|
| Rate for Payer: VA VA |
$5.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.01
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
IP
|
$310.94
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$136.81 |
| Max. Negotiated Rate |
$279.85 |
| Rate for Payer: Aetna American Axle |
$202.11
|
| Rate for Payer: Aetna Commercial |
$264.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.11
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cofinity Advantage |
$217.66
|
| Rate for Payer: Cofinity Commercial |
$267.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.75
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.21
|
| Rate for Payer: PHP Commercial |
$264.30
|
| Rate for Payer: Priority Health SBD |
$195.89
|
| Rate for Payer: UMR Bronson Commercial |
$136.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.21
|
|
|
HC SHAVE EPIDURAL SKIN LESION 1.1-2.0 CM
|
Facility
|
OP
|
$310.94
|
|
|
Service Code
|
CPT 11312
|
| Hospital Charge Code |
76100073
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$115.05 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$202.11
|
| Rate for Payer: Aetna Commercial |
$264.30
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$176.69
|
| Rate for Payer: BCN Commercial |
$176.69
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cofinity Advantage |
$217.66
|
| Rate for Payer: Cofinity Commercial |
$267.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.21
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.30
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.21
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$264.30
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$195.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.11
|
| Rate for Payer: UHC Core |
$162.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$122.20
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$115.05
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.21
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
IP
|
$310.94
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$136.81 |
| Max. Negotiated Rate |
$279.85 |
| Rate for Payer: Aetna American Axle |
$202.11
|
| Rate for Payer: Aetna Commercial |
$264.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.11
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cofinity Advantage |
$217.66
|
| Rate for Payer: Cofinity Commercial |
$267.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.75
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.30
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.21
|
| Rate for Payer: PHP Commercial |
$264.30
|
| Rate for Payer: Priority Health SBD |
$195.89
|
| Rate for Payer: UMR Bronson Commercial |
$136.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.21
|
|
|
HC SHAVE EPIDURAL SKIN LESION > 2.0 CM
|
Facility
|
OP
|
$310.94
|
|
|
Service Code
|
CPT 11313
|
| Hospital Charge Code |
76100074
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$115.05 |
| Max. Negotiated Rate |
$1,309.90 |
| Rate for Payer: Aetna American Axle |
$202.11
|
| Rate for Payer: Aetna Commercial |
$264.30
|
| Rate for Payer: Aetna Medicare |
$421.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$202.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$506.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$506.31
|
| Rate for Payer: BCBS Complete |
$222.45
|
| Rate for Payer: BCBS MAPPO |
$405.05
|
| Rate for Payer: BCBS Trust/PPO |
$193.33
|
| Rate for Payer: BCN Commercial |
$193.33
|
| Rate for Payer: BCN Medicare Advantage |
$405.05
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cash Price |
$248.75
|
| Rate for Payer: Cofinity Advantage |
$217.66
|
| Rate for Payer: Cofinity Commercial |
$267.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$248.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$405.05
|
| Rate for Payer: Healthscope Commercial |
$279.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$217.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.21
|
| Rate for Payer: Mclaren Medicaid |
$405.05
|
| Rate for Payer: Mclaren Medicare |
$405.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$425.30
|
| Rate for Payer: Meridian Medicaid |
$425.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$465.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$445.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.30
|
| Rate for Payer: Nomi Health Commercial |
$1,215.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.21
|
| Rate for Payer: PACE Medicare |
$384.80
|
| Rate for Payer: PACE SWMI |
$405.05
|
| Rate for Payer: PHP Commercial |
$264.30
|
| Rate for Payer: PHP Medicare Advantage |
$405.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$211.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,309.90
|
| Rate for Payer: Priority Health Medicare |
$405.05
|
| Rate for Payer: Priority Health SBD |
$195.89
|
| Rate for Payer: Priority Health Tiered Network |
$1,047.92
|
| Rate for Payer: Railroad Medicare Medicare |
$405.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$202.11
|
| Rate for Payer: UHC Core |
$162.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$405.05
|
| Rate for Payer: UHC Exchange |
$122.20
|
| Rate for Payer: UHC Medicaid |
$211.84
|
| Rate for Payer: UHCCP Medicaid |
$211.84
|
| Rate for Payer: UMR Bronson Commercial |
$115.05
|
| Rate for Payer: VA VA |
$405.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.21
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
IP
|
$287.22
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$126.38 |
| Max. Negotiated Rate |
$258.50 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: Priority Health SBD |
$180.95
|
| Rate for Payer: UMR Bronson Commercial |
$126.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
|
HC SHAVE LESION FACE, EARS,EYELIDS, NOSE, LIPS, MUC MEMB 0.5 CM OR LESS
|
Facility
|
OP
|
$287.22
|
|
|
Service Code
|
CPT 11310
|
| Hospital Charge Code |
76100087
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$104.55 |
| Max. Negotiated Rate |
$646.50 |
| Rate for Payer: Aetna American Axle |
$186.69
|
| Rate for Payer: Aetna Commercial |
$244.14
|
| Rate for Payer: Aetna Medicare |
$207.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.89
|
| Rate for Payer: BCBS Complete |
$109.79
|
| Rate for Payer: BCBS MAPPO |
$199.91
|
| Rate for Payer: BCBS Trust/PPO |
$135.00
|
| Rate for Payer: BCN Commercial |
$135.00
|
| Rate for Payer: BCN Medicare Advantage |
$199.91
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cash Price |
$229.78
|
| Rate for Payer: Cofinity Advantage |
$201.05
|
| Rate for Payer: Cofinity Commercial |
$247.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$229.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.91
|
| Rate for Payer: Healthscope Commercial |
$258.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$201.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$215.41
|
| Rate for Payer: Mclaren Medicaid |
$199.91
|
| Rate for Payer: Mclaren Medicare |
$199.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.91
|
| Rate for Payer: Meridian Medicaid |
$209.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$244.14
|
| Rate for Payer: Nomi Health Commercial |
$599.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$215.41
|
| Rate for Payer: PACE Medicare |
$189.91
|
| Rate for Payer: PACE SWMI |
$199.91
|
| Rate for Payer: PHP Commercial |
$244.14
|
| Rate for Payer: PHP Medicare Advantage |
$199.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$646.50
|
| Rate for Payer: Priority Health Medicare |
$199.91
|
| Rate for Payer: Priority Health SBD |
$180.95
|
| Rate for Payer: Priority Health Tiered Network |
$517.20
|
| Rate for Payer: Railroad Medicare Medicare |
$199.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$186.69
|
| Rate for Payer: UHC Core |
$149.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$199.91
|
| Rate for Payer: UHC Exchange |
$112.88
|
| Rate for Payer: UHC Medicaid |
$104.55
|
| Rate for Payer: UHCCP Medicaid |
$104.55
|
| Rate for Payer: UMR Bronson Commercial |
$106.27
|
| Rate for Payer: VA VA |
$199.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$215.41
|
|
