|
HC PYRUVATE PYRUVIC ACID
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84210
|
| Hospital Charge Code |
30100414
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC Q FEVER AB (COXIELLA BURNETTI)
|
Facility
|
IP
|
$93.89
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200247
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$41.31 |
| Max. Negotiated Rate |
$84.50 |
| Rate for Payer: Aetna American Axle |
$61.03
|
| Rate for Payer: Aetna Commercial |
$79.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.03
|
| Rate for Payer: Cash Price |
$75.11
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Cofinity Commercial |
$80.75
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.11
|
| Rate for Payer: Healthscope Commercial |
$84.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.81
|
| Rate for Payer: PHP Commercial |
$79.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.03
|
| Rate for Payer: Priority Health SBD |
$59.15
|
| Rate for Payer: UMR Bronson Commercial |
$41.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.42
|
|
|
HC Q FEVER AB (COXIELLA BURNETTI)
|
Facility
|
OP
|
$93.89
|
|
|
Service Code
|
CPT 86638
|
| Hospital Charge Code |
30200247
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.50 |
| Max. Negotiated Rate |
$84.50 |
| Rate for Payer: Aetna American Axle |
$61.03
|
| Rate for Payer: Aetna Commercial |
$79.81
|
| Rate for Payer: Aetna Medicare |
$12.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.15
|
| Rate for Payer: BCBS Complete |
$6.82
|
| Rate for Payer: BCBS MAPPO |
$12.12
|
| Rate for Payer: BCN Medicare Advantage |
$12.12
|
| Rate for Payer: Cash Price |
$75.11
|
| Rate for Payer: Cash Price |
$75.11
|
| Rate for Payer: Cofinity Commercial |
$80.75
|
| Rate for Payer: Cofinity Commercial |
$65.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.11
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.12
|
| Rate for Payer: Healthscope Commercial |
$84.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.42
|
| Rate for Payer: Mclaren Medicaid |
$6.50
|
| Rate for Payer: Mclaren Medicare |
$12.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.73
|
| Rate for Payer: Meridian Medicaid |
$6.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.81
|
| Rate for Payer: PACE Medicare |
$11.51
|
| Rate for Payer: PACE SWMI |
$12.12
|
| Rate for Payer: PHP Commercial |
$79.81
|
| Rate for Payer: PHP Medicare Advantage |
$12.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.03
|
| Rate for Payer: Priority Health Medicare |
$12.12
|
| Rate for Payer: Priority Health SBD |
$59.15
|
| Rate for Payer: Railroad Medicare Medicare |
$12.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.12
|
| Rate for Payer: UHC Exchange |
$23.16
|
| Rate for Payer: UHC Medicare Advantage |
$12.12
|
| Rate for Payer: UHCCP Medicaid |
$6.50
|
| Rate for Payer: UMR Bronson Commercial |
$34.74
|
| Rate for Payer: VA VA |
$12.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.42
|
|
|
HC QUAD 16CM CATHETER
|
Facility
|
OP
|
$341.11
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$126.21 |
| Max. Negotiated Rate |
$307.00 |
| Rate for Payer: Aetna American Axle |
$221.72
|
| Rate for Payer: Aetna Commercial |
$289.94
|
| Rate for Payer: Aetna Medicare |
$170.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.72
|
| Rate for Payer: BCBS Complete |
$136.44
|
| Rate for Payer: Cash Price |
$272.89
|
| Rate for Payer: Cofinity Commercial |
$238.78
|
| Rate for Payer: Cofinity Commercial |
$293.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.89
|
| Rate for Payer: Healthscope Commercial |
$307.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.94
|
| Rate for Payer: PHP Commercial |
$289.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.72
|
| Rate for Payer: Priority Health SBD |
$214.90
|
| Rate for Payer: UMR Bronson Commercial |
$126.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.83
|
|
|
HC QUAD 16CM CATHETER
|
Facility
|
IP
|
$341.11
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200067
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$150.09 |
| Max. Negotiated Rate |
$307.00 |
| Rate for Payer: Aetna American Axle |
$221.72
|
| Rate for Payer: Aetna Commercial |
$289.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$221.72
|
| Rate for Payer: Cash Price |
$272.89
|
| Rate for Payer: Cofinity Commercial |
$238.78
|
| Rate for Payer: Cofinity Commercial |
$293.35
|
| Rate for Payer: Cofinity Medicare Advantage |
$238.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.89
|
| Rate for Payer: Healthscope Commercial |
$307.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$238.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.94
|
| Rate for Payer: PHP Commercial |
$289.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.72
|
| Rate for Payer: Priority Health SBD |
$214.90
|
| Rate for Payer: UMR Bronson Commercial |
$150.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.83
|
|
|
HC QUAD 20CM CATHETER
|
Facility
|
OP
|
$347.32
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$128.51 |
| Max. Negotiated Rate |
$312.59 |
| Rate for Payer: Aetna American Axle |
$225.76
|
| Rate for Payer: Aetna Commercial |
$295.22
|
| Rate for Payer: Aetna Medicare |
$173.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.76
|
| Rate for Payer: BCBS Complete |
$138.93
|
| Rate for Payer: Cash Price |
$277.86
|
| Rate for Payer: Cofinity Commercial |
$243.12
|
| Rate for Payer: Cofinity Commercial |
$298.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$243.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.86
|
| Rate for Payer: Healthscope Commercial |
$312.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$243.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.22
|
| Rate for Payer: PHP Commercial |
$295.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.76
|
| Rate for Payer: Priority Health SBD |
$218.81
|
| Rate for Payer: UMR Bronson Commercial |
$128.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.49
|
|
|
HC QUAD 20CM CATHETER
|
Facility
|
IP
|
$347.32
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$152.82 |
| Max. Negotiated Rate |
$312.59 |
| Rate for Payer: Aetna American Axle |
$225.76
|
| Rate for Payer: Aetna Commercial |
$295.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.76
|
| Rate for Payer: Cash Price |
$277.86
|
| Rate for Payer: Cofinity Commercial |
$243.12
|
| Rate for Payer: Cofinity Commercial |
$298.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$243.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.86
|
| Rate for Payer: Healthscope Commercial |
$312.59
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$243.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.22
|
| Rate for Payer: PHP Commercial |
$295.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.76
|
| Rate for Payer: Priority Health SBD |
$218.81
|
| Rate for Payer: UMR Bronson Commercial |
$152.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.49
|
|
|
HC QUAD SCREEN MATERNAL
|
Facility
|
OP
|
$251.10
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
31000104
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$82.28 |
| Max. Negotiated Rate |
$432.09 |
| Rate for Payer: Aetna American Axle |
$163.22
|
| Rate for Payer: Aetna Commercial |
$213.44
|
| Rate for Payer: Aetna Medicare |
$159.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.88
|
| Rate for Payer: BCBS Complete |
$86.39
|
| Rate for Payer: BCBS MAPPO |
$153.50
|
| Rate for Payer: BCN Medicare Advantage |
$153.50
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cofinity Commercial |
$215.95
|
| Rate for Payer: Cofinity Commercial |
$175.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.50
|
| Rate for Payer: Healthscope Commercial |
$225.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.32
|
| Rate for Payer: Mclaren Medicaid |
$82.28
|
| Rate for Payer: Mclaren Medicare |
$153.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.18
|
| Rate for Payer: Meridian Medicaid |
$86.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.44
|
| Rate for Payer: PACE Medicare |
$145.82
|
| Rate for Payer: PACE SWMI |
$153.50
|
| Rate for Payer: PHP Commercial |
$213.44
|
| Rate for Payer: PHP Medicare Advantage |
$153.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.22
|
| Rate for Payer: Priority Health Medicare |
$153.50
|
| Rate for Payer: Priority Health SBD |
$158.19
|
| Rate for Payer: Railroad Medicare Medicare |
$153.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$432.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.50
|
| Rate for Payer: UHC Exchange |
$293.35
|
| Rate for Payer: UHC Medicare Advantage |
$153.50
|
| Rate for Payer: UHCCP Medicaid |
$82.28
|
| Rate for Payer: UMR Bronson Commercial |
$92.91
|
| Rate for Payer: VA VA |
$153.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.32
|
|
|
HC QUAD SCREEN MATERNAL
|
Facility
|
IP
|
$251.10
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
31000104
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$110.48 |
| Max. Negotiated Rate |
$225.99 |
| Rate for Payer: Aetna American Axle |
$163.22
|
| Rate for Payer: Aetna Commercial |
$213.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.22
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cofinity Commercial |
$175.77
|
| Rate for Payer: Cofinity Commercial |
$215.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.88
|
| Rate for Payer: Healthscope Commercial |
$225.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.44
|
| Rate for Payer: PHP Commercial |
$213.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.22
|
| Rate for Payer: Priority Health SBD |
$158.19
|
| Rate for Payer: UMR Bronson Commercial |
$110.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.32
|
|
|
HC QUANTIFERON_TB GOLD
|
Facility
|
IP
|
$164.05
|
|
|
Service Code
|
CPT 86481
|
| Hospital Charge Code |
30200456
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$72.18 |
| Max. Negotiated Rate |
$147.65 |
| Rate for Payer: Aetna American Axle |
$106.63
|
| Rate for Payer: Aetna Commercial |
$139.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.63
|
| Rate for Payer: Cash Price |
$131.24
|
| Rate for Payer: Cofinity Commercial |
$114.83
|
| Rate for Payer: Cofinity Commercial |
$141.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$114.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.24
|
| Rate for Payer: Healthscope Commercial |
$147.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.44
|
| Rate for Payer: PHP Commercial |
$139.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.63
|
| Rate for Payer: Priority Health SBD |
$103.35
|
| Rate for Payer: UMR Bronson Commercial |
$72.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.04
|
|
|
HC QUANTIFERON_TB GOLD
|
Facility
|
OP
|
$164.05
|
|
|
Service Code
|
CPT 86481
|
| Hospital Charge Code |
30200456
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$53.60 |
| Max. Negotiated Rate |
$281.49 |
| Rate for Payer: Aetna American Axle |
$106.63
|
| Rate for Payer: Aetna Commercial |
$139.44
|
| Rate for Payer: Aetna Medicare |
$104.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$106.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.00
|
| Rate for Payer: BCBS Complete |
$56.28
|
| Rate for Payer: BCBS MAPPO |
$100.00
|
| Rate for Payer: BCN Medicare Advantage |
$100.00
|
| Rate for Payer: Cash Price |
$131.24
|
| Rate for Payer: Cash Price |
$131.24
|
| Rate for Payer: Cofinity Commercial |
$141.08
|
| Rate for Payer: Cofinity Commercial |
$114.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$114.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.00
|
| Rate for Payer: Healthscope Commercial |
$147.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$114.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.04
|
| Rate for Payer: Mclaren Medicaid |
$53.60
|
| Rate for Payer: Mclaren Medicare |
$100.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.00
|
| Rate for Payer: Meridian Medicaid |
$56.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.44
|
| Rate for Payer: PACE Medicare |
$95.00
|
| Rate for Payer: PACE SWMI |
$100.00
|
| Rate for Payer: PHP Commercial |
$139.44
|
| Rate for Payer: PHP Medicare Advantage |
$100.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$106.63
|
| Rate for Payer: Priority Health Medicare |
$100.00
|
| Rate for Payer: Priority Health SBD |
$103.35
|
| Rate for Payer: Railroad Medicare Medicare |
$100.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$281.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.00
|
| Rate for Payer: UHC Exchange |
$191.11
|
| Rate for Payer: UHC Medicare Advantage |
$100.00
|
| Rate for Payer: UHCCP Medicaid |
$53.60
|
| Rate for Payer: UMR Bronson Commercial |
$60.70
|
| Rate for Payer: VA VA |
$100.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.04
|
|
|
HC QUANTIFERON - TB GOLD PLUS
|
Facility
|
IP
|
$117.36
|
|
|
Service Code
|
CPT 86480
|
| Hospital Charge Code |
30200414
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$51.64 |
| Max. Negotiated Rate |
$105.62 |
| Rate for Payer: Aetna American Axle |
$76.28
|
| Rate for Payer: Aetna Commercial |
$99.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.28
|
| Rate for Payer: Cash Price |
$93.89
|
| Rate for Payer: Cofinity Commercial |
$100.93
|
| Rate for Payer: Cofinity Commercial |
$82.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.89
|
| Rate for Payer: Healthscope Commercial |
$105.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.76
|
| Rate for Payer: PHP Commercial |
$99.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.28
|
| Rate for Payer: Priority Health SBD |
$73.94
|
| Rate for Payer: UMR Bronson Commercial |
$51.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.02
|
|
|
HC QUANTIFERON - TB GOLD PLUS
|
Facility
|
OP
|
$117.36
|
|
|
Service Code
|
CPT 86480
|
| Hospital Charge Code |
30200414
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.22 |
| Max. Negotiated Rate |
$174.47 |
| Rate for Payer: Aetna American Axle |
$76.28
|
| Rate for Payer: Aetna Commercial |
$99.76
|
| Rate for Payer: Aetna Medicare |
$64.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.47
|
| Rate for Payer: BCBS Complete |
$34.88
|
| Rate for Payer: BCBS MAPPO |
$61.98
|
| Rate for Payer: BCN Medicare Advantage |
$61.98
|
| Rate for Payer: Cash Price |
$93.89
|
| Rate for Payer: Cash Price |
$93.89
|
| Rate for Payer: Cofinity Commercial |
$82.15
|
| Rate for Payer: Cofinity Commercial |
$100.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.98
|
| Rate for Payer: Healthscope Commercial |
$105.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.02
|
| Rate for Payer: Mclaren Medicaid |
$33.22
|
| Rate for Payer: Mclaren Medicare |
$61.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.08
|
| Rate for Payer: Meridian Medicaid |
$34.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.76
|
| Rate for Payer: PACE Medicare |
$58.88
|
| Rate for Payer: PACE SWMI |
$61.98
|
| Rate for Payer: PHP Commercial |
$99.76
|
| Rate for Payer: PHP Medicare Advantage |
$61.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.28
|
| Rate for Payer: Priority Health Medicare |
$61.98
|
| Rate for Payer: Priority Health SBD |
$73.94
|
| Rate for Payer: Railroad Medicare Medicare |
$61.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.98
|
| Rate for Payer: UHC Exchange |
$118.45
|
| Rate for Payer: UHC Medicare Advantage |
$61.98
|
| Rate for Payer: UHCCP Medicaid |
$33.22
|
| Rate for Payer: UMR Bronson Commercial |
$43.42
|
| Rate for Payer: VA VA |
$61.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.02
|
|
|
HC QUINIDINE LEVEL
|
Facility
|
OP
|
$57.12
|
|
|
Service Code
|
CPT 80194
|
| Hospital Charge Code |
30100044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.83 |
| Max. Negotiated Rate |
$51.41 |
| Rate for Payer: Aetna American Axle |
$37.13
|
| Rate for Payer: Aetna Commercial |
$48.55
|
| Rate for Payer: Aetna Medicare |
$15.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.25
|
| Rate for Payer: BCBS Complete |
$8.22
|
| Rate for Payer: BCBS MAPPO |
$14.60
|
| Rate for Payer: BCN Medicare Advantage |
$14.60
|
| Rate for Payer: Cash Price |
$45.70
|
| Rate for Payer: Cash Price |
$45.70
|
| Rate for Payer: Cofinity Commercial |
$49.12
|
| Rate for Payer: Cofinity Commercial |
$39.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.60
|
| Rate for Payer: Healthscope Commercial |
$51.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.84
|
| Rate for Payer: Mclaren Medicaid |
$7.83
|
| Rate for Payer: Mclaren Medicare |
$14.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.33
|
| Rate for Payer: Meridian Medicaid |
$8.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.55
|
| Rate for Payer: PACE Medicare |
$13.87
|
| Rate for Payer: PACE SWMI |
$14.60
|
| Rate for Payer: PHP Commercial |
$48.55
|
| Rate for Payer: PHP Medicare Advantage |
$14.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health Medicare |
$14.60
|
| Rate for Payer: Priority Health SBD |
$35.99
|
| Rate for Payer: Railroad Medicare Medicare |
$14.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.60
|
| Rate for Payer: UHC Exchange |
$27.90
|
| Rate for Payer: UHC Medicare Advantage |
$14.60
|
| Rate for Payer: UHCCP Medicaid |
$7.83
|
| Rate for Payer: UMR Bronson Commercial |
$21.13
|
| Rate for Payer: VA VA |
$14.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.84
|
|
|
HC QUINIDINE LEVEL
|
Facility
|
IP
|
$57.12
|
|
|
Service Code
|
CPT 80194
|
| Hospital Charge Code |
30100044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$51.41 |
| Rate for Payer: Aetna American Axle |
$37.13
|
| Rate for Payer: Aetna Commercial |
$48.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.13
|
| Rate for Payer: Cash Price |
$45.70
|
| Rate for Payer: Cofinity Commercial |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$49.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.70
|
| Rate for Payer: Healthscope Commercial |
$51.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.55
|
| Rate for Payer: PHP Commercial |
$48.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health SBD |
$35.99
|
| Rate for Payer: UMR Bronson Commercial |
$25.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.84
|
|
|
HC RABIES VACCINE IM
|
Facility
|
OP
|
$1,037.24
|
|
|
Service Code
|
CPT 90675
|
| Hospital Charge Code |
63600234
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$168.13 |
| Max. Negotiated Rate |
$933.52 |
| Rate for Payer: Aetna American Axle |
$674.21
|
| Rate for Payer: Aetna Commercial |
$881.65
|
| Rate for Payer: Aetna Medicare |
$326.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$392.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$392.10
|
| Rate for Payer: BCBS Complete |
$176.54
|
| Rate for Payer: BCBS MAPPO |
$313.68
|
| Rate for Payer: BCN Medicare Advantage |
$313.68
|
| Rate for Payer: Cash Price |
$829.79
|
| Rate for Payer: Cash Price |
$829.79
|
| Rate for Payer: Cofinity Commercial |
$892.03
|
| Rate for Payer: Cofinity Commercial |
$726.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$726.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$313.68
|
| Rate for Payer: Healthscope Commercial |
$933.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$726.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$777.93
|
| Rate for Payer: Mclaren Medicaid |
$168.13
|
| Rate for Payer: Mclaren Medicare |
$313.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$329.36
|
| Rate for Payer: Meridian Medicaid |
$176.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$360.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.65
|
| Rate for Payer: PACE Medicare |
$298.00
|
| Rate for Payer: PACE SWMI |
$313.68
|
| Rate for Payer: PHP Commercial |
$881.65
|
| Rate for Payer: PHP Medicare Advantage |
$313.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$168.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.21
|
| Rate for Payer: Priority Health Medicare |
$313.68
|
| Rate for Payer: Priority Health SBD |
$653.46
|
| Rate for Payer: Railroad Medicare Medicare |
$313.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$882.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$313.68
|
| Rate for Payer: UHC Exchange |
$599.47
|
| Rate for Payer: UHC Medicare Advantage |
$313.68
|
| Rate for Payer: UHCCP Medicaid |
$168.13
|
| Rate for Payer: UMR Bronson Commercial |
$383.78
|
| Rate for Payer: VA VA |
$313.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$777.93
|
|
|
HC RABIES VACCINE IM
|
Facility
|
IP
|
$1,037.24
|
|
|
Service Code
|
CPT 90675
|
| Hospital Charge Code |
63600234
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$456.39 |
| Max. Negotiated Rate |
$933.52 |
| Rate for Payer: Aetna American Axle |
$674.21
|
| Rate for Payer: Aetna Commercial |
$881.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$674.21
|
| Rate for Payer: Cash Price |
$829.79
|
| Rate for Payer: Cofinity Commercial |
$726.07
|
| Rate for Payer: Cofinity Commercial |
$892.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$726.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$829.79
|
| Rate for Payer: Healthscope Commercial |
$933.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$726.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$777.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$881.65
|
| Rate for Payer: PHP Commercial |
$881.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$674.21
|
| Rate for Payer: Priority Health SBD |
$653.46
|
| Rate for Payer: UMR Bronson Commercial |
$456.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$777.93
|
|
|
HC RADIAL COMPRESSION DEVICE
|
Facility
|
OP
|
$188.62
|
|
| Hospital Charge Code |
27000157
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.79 |
| Max. Negotiated Rate |
$169.76 |
| Rate for Payer: Aetna American Axle |
$122.60
|
| Rate for Payer: Aetna Commercial |
$160.33
|
| Rate for Payer: Aetna Medicare |
$94.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.60
|
| Rate for Payer: BCBS Complete |
$75.45
|
| Rate for Payer: Cash Price |
$150.90
|
| Rate for Payer: Cofinity Commercial |
$132.03
|
| Rate for Payer: Cofinity Commercial |
$162.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$132.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.90
|
| Rate for Payer: Healthscope Commercial |
$169.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$132.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.33
|
| Rate for Payer: PHP Commercial |
$160.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.60
|
| Rate for Payer: Priority Health SBD |
$118.83
|
| Rate for Payer: UMR Bronson Commercial |
$69.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.47
|
|
|
HC RADIAL COMPRESSION DEVICE
|
Facility
|
IP
|
$188.62
|
|
| Hospital Charge Code |
27000157
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$82.99 |
| Max. Negotiated Rate |
$169.76 |
| Rate for Payer: Aetna American Axle |
$122.60
|
| Rate for Payer: Aetna Commercial |
$160.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.60
|
| Rate for Payer: Cash Price |
$150.90
|
| Rate for Payer: Cofinity Commercial |
$132.03
|
| Rate for Payer: Cofinity Commercial |
$162.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$132.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.90
|
| Rate for Payer: Healthscope Commercial |
$169.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$132.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.33
|
| Rate for Payer: PHP Commercial |
$160.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.60
|
| Rate for Payer: Priority Health SBD |
$118.83
|
| Rate for Payer: UMR Bronson Commercial |
$82.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.47
|
|
|
HC RADIATION PROCEDURE
|
Facility
|
IP
|
$429.69
|
|
|
Service Code
|
CPT 77399
|
| Hospital Charge Code |
33300034
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$189.06 |
| Max. Negotiated Rate |
$386.72 |
| Rate for Payer: Aetna American Axle |
$279.30
|
| Rate for Payer: Aetna Commercial |
$365.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.30
|
| Rate for Payer: Cash Price |
$343.75
|
| Rate for Payer: Cofinity Commercial |
$300.78
|
| Rate for Payer: Cofinity Commercial |
$369.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.75
|
| Rate for Payer: Healthscope Commercial |
$386.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.24
|
| Rate for Payer: PHP Commercial |
$365.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.30
|
| Rate for Payer: Priority Health SBD |
$270.70
|
| Rate for Payer: UMR Bronson Commercial |
$189.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.27
|
|
|
HC RADIATION PROCEDURE
|
Facility
|
OP
|
$429.69
|
|
|
Service Code
|
CPT 77399
|
| Hospital Charge Code |
33300034
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$69.41 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$279.30
|
| Rate for Payer: Aetna Commercial |
$365.24
|
| Rate for Payer: Aetna Medicare |
$134.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$279.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$161.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$161.86
|
| Rate for Payer: BCBS Complete |
$72.88
|
| Rate for Payer: BCBS MAPPO |
$129.49
|
| Rate for Payer: BCN Medicare Advantage |
$129.49
|
| Rate for Payer: Cash Price |
$343.75
|
| Rate for Payer: Cash Price |
$343.75
|
| Rate for Payer: Cash Price |
$343.75
|
| Rate for Payer: Cofinity Commercial |
$300.78
|
| Rate for Payer: Cofinity Commercial |
$369.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$300.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$343.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$129.49
|
| Rate for Payer: Healthscope Commercial |
$386.72
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$300.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$322.27
|
| Rate for Payer: Mclaren Medicaid |
$69.41
|
| Rate for Payer: Mclaren Medicare |
$129.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$135.96
|
| Rate for Payer: Meridian Medicaid |
$72.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$148.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$365.24
|
| Rate for Payer: PACE Medicare |
$123.02
|
| Rate for Payer: PACE SWMI |
$129.49
|
| Rate for Payer: PHP Commercial |
$365.24
|
| Rate for Payer: PHP Medicare Advantage |
$129.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$279.30
|
| Rate for Payer: Priority Health Medicare |
$129.49
|
| Rate for Payer: Priority Health SBD |
$270.70
|
| Rate for Payer: Railroad Medicare Medicare |
$129.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.50
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$129.49
|
| Rate for Payer: UHC Exchange |
$247.47
|
| Rate for Payer: UHC Medicare Advantage |
$129.49
|
| Rate for Payer: UHCCP Medicaid |
$69.41
|
| Rate for Payer: UMR Bronson Commercial |
$158.99
|
| Rate for Payer: VA VA |
$129.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$322.27
|
|
|
HC RADIUM RA223 DICHLORIDE XOFIGO PER MICROCURIE
|
Facility
|
IP
|
$286.19
|
|
|
Service Code
|
HCPCS A9606
|
| Hospital Charge Code |
63600051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$125.92 |
| Max. Negotiated Rate |
$257.57 |
| Rate for Payer: Aetna American Axle |
$186.02
|
| Rate for Payer: Aetna Commercial |
$243.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.02
|
| Rate for Payer: Cash Price |
$228.95
|
| Rate for Payer: Cofinity Commercial |
$200.33
|
| Rate for Payer: Cofinity Commercial |
$246.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$200.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.95
|
| Rate for Payer: Healthscope Commercial |
$257.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.26
|
| Rate for Payer: PHP Commercial |
$243.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.02
|
| Rate for Payer: Priority Health SBD |
$180.30
|
| Rate for Payer: UMR Bronson Commercial |
$125.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.64
|
|
|
HC RADIUM RA223 DICHLORIDE XOFIGO PER MICROCURIE
|
Facility
|
OP
|
$286.19
|
|
|
Service Code
|
HCPCS A9606
|
| Hospital Charge Code |
63600051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$92.31 |
| Max. Negotiated Rate |
$484.78 |
| Rate for Payer: Aetna American Axle |
$186.02
|
| Rate for Payer: Aetna Commercial |
$243.26
|
| Rate for Payer: Aetna Medicare |
$179.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$186.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$215.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$215.28
|
| Rate for Payer: BCBS Complete |
$96.93
|
| Rate for Payer: BCBS MAPPO |
$172.22
|
| Rate for Payer: BCN Medicare Advantage |
$172.22
|
| Rate for Payer: Cash Price |
$228.95
|
| Rate for Payer: Cash Price |
$228.95
|
| Rate for Payer: Cofinity Commercial |
$246.12
|
| Rate for Payer: Cofinity Commercial |
$200.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$200.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$172.22
|
| Rate for Payer: Healthscope Commercial |
$257.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$200.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.64
|
| Rate for Payer: Mclaren Medicaid |
$92.31
|
| Rate for Payer: Mclaren Medicare |
$172.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$180.83
|
| Rate for Payer: Meridian Medicaid |
$96.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$198.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.26
|
| Rate for Payer: PACE Medicare |
$163.61
|
| Rate for Payer: PACE SWMI |
$172.22
|
| Rate for Payer: PHP Commercial |
$243.26
|
| Rate for Payer: PHP Medicare Advantage |
$172.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$92.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$186.02
|
| Rate for Payer: Priority Health Medicare |
$172.22
|
| Rate for Payer: Priority Health SBD |
$180.30
|
| Rate for Payer: Railroad Medicare Medicare |
$172.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$484.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$172.22
|
| Rate for Payer: UHC Exchange |
$329.13
|
| Rate for Payer: UHC Medicare Advantage |
$172.22
|
| Rate for Payer: UHCCP Medicaid |
$92.31
|
| Rate for Payer: UMR Bronson Commercial |
$105.89
|
| Rate for Payer: VA VA |
$172.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.64
|
|
|
HC RAD TX ANAL CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1073
|
| Hospital Charge Code |
33300063
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX ANAL CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1073
|
| Hospital Charge Code |
33300063
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$0.01
|
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$0.01
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$0.01
|
| Rate for Payer: Priority Health SBD |
$0.01
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UMR Bronson Commercial |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
