|
HC RECOVERY 2 INIT 30 MIN
|
Facility
|
IP
|
$331.57
|
|
| Hospital Charge Code |
71000023
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$145.89 |
| Max. Negotiated Rate |
$298.41 |
| Rate for Payer: Aetna American Axle |
$215.52
|
| Rate for Payer: Aetna Commercial |
$281.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$215.52
|
| Rate for Payer: Cash Price |
$265.26
|
| Rate for Payer: Cofinity Commercial |
$232.10
|
| Rate for Payer: Cofinity Commercial |
$285.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$232.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.26
|
| Rate for Payer: Healthscope Commercial |
$298.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$232.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.83
|
| Rate for Payer: PHP Commercial |
$281.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.52
|
| Rate for Payer: Priority Health SBD |
$208.89
|
| Rate for Payer: UMR Bronson Commercial |
$145.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.68
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
OP
|
$102.17
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$37.80 |
| Max. Negotiated Rate |
$91.95 |
| Rate for Payer: Aetna American Axle |
$66.41
|
| Rate for Payer: Aetna Commercial |
$86.84
|
| Rate for Payer: Aetna Medicare |
$51.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.41
|
| Rate for Payer: BCBS Complete |
$40.87
|
| Rate for Payer: Cash Price |
$81.74
|
| Rate for Payer: Cofinity Commercial |
$71.52
|
| Rate for Payer: Cofinity Commercial |
$87.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.74
|
| Rate for Payer: Healthscope Commercial |
$91.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.84
|
| Rate for Payer: PHP Commercial |
$86.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.41
|
| Rate for Payer: Priority Health SBD |
$64.37
|
| Rate for Payer: UMR Bronson Commercial |
$37.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.63
|
|
|
HC RECOVERY 3 ADD'L 15 MIN
|
Facility
|
IP
|
$102.17
|
|
| Hospital Charge Code |
71000024
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$44.95 |
| Max. Negotiated Rate |
$91.95 |
| Rate for Payer: Aetna American Axle |
$66.41
|
| Rate for Payer: Aetna Commercial |
$86.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.41
|
| Rate for Payer: Cash Price |
$81.74
|
| Rate for Payer: Cofinity Commercial |
$71.52
|
| Rate for Payer: Cofinity Commercial |
$87.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.74
|
| Rate for Payer: Healthscope Commercial |
$91.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.84
|
| Rate for Payer: PHP Commercial |
$86.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.41
|
| Rate for Payer: Priority Health SBD |
$64.37
|
| Rate for Payer: UMR Bronson Commercial |
$44.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.63
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
IP
|
$206.43
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$90.83 |
| Max. Negotiated Rate |
$185.79 |
| Rate for Payer: Aetna American Axle |
$134.18
|
| Rate for Payer: Aetna Commercial |
$175.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.18
|
| Rate for Payer: Cash Price |
$165.14
|
| Rate for Payer: Cofinity Commercial |
$144.50
|
| Rate for Payer: Cofinity Commercial |
$177.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.14
|
| Rate for Payer: Healthscope Commercial |
$185.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.47
|
| Rate for Payer: PHP Commercial |
$175.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.18
|
| Rate for Payer: Priority Health SBD |
$130.05
|
| Rate for Payer: UMR Bronson Commercial |
$90.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.82
|
|
|
HC RECOVERY 3 INIT 30 MIN
|
Facility
|
OP
|
$206.43
|
|
| Hospital Charge Code |
71000025
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$76.38 |
| Max. Negotiated Rate |
$185.79 |
| Rate for Payer: Aetna American Axle |
$134.18
|
| Rate for Payer: Aetna Commercial |
$175.47
|
| Rate for Payer: Aetna Medicare |
$103.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$134.18
|
| Rate for Payer: BCBS Complete |
$82.57
|
| Rate for Payer: Cash Price |
$165.14
|
| Rate for Payer: Cofinity Commercial |
$144.50
|
| Rate for Payer: Cofinity Commercial |
$177.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$165.14
|
| Rate for Payer: Healthscope Commercial |
$185.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.47
|
| Rate for Payer: PHP Commercial |
$175.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$134.18
|
| Rate for Payer: Priority Health SBD |
$130.05
|
| Rate for Payer: UMR Bronson Commercial |
$76.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.82
|
|
|
HC RECOVERY PHASE 1 COMPLEX BASE CHARGE
|
Facility
|
IP
|
$116.00
|
|
| Hospital Charge Code |
71000039
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$51.04 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Aetna American Axle |
$75.40
|
| Rate for Payer: Aetna Commercial |
$98.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$81.20
|
| Rate for Payer: Cofinity Commercial |
$99.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$81.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.80
|
| Rate for Payer: Healthscope Commercial |
$104.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.60
|
| Rate for Payer: PHP Commercial |
$98.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
| Rate for Payer: Priority Health SBD |
$73.08
|
| Rate for Payer: UMR Bronson Commercial |
$51.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.00
|
|
|
HC RECOVERY PHASE 1 COMPLEX BASE CHARGE
|
Facility
|
OP
|
$116.00
|
|
| Hospital Charge Code |
71000039
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$42.92 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Aetna American Axle |
$75.40
|
| Rate for Payer: Aetna Commercial |
$98.60
|
| Rate for Payer: Aetna Medicare |
$58.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.40
|
| Rate for Payer: BCBS Complete |
$46.40
|
| Rate for Payer: Cash Price |
$92.80
|
| Rate for Payer: Cofinity Commercial |
$81.20
|
| Rate for Payer: Cofinity Commercial |
$99.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$81.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.80
|
| Rate for Payer: Healthscope Commercial |
$104.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.60
|
| Rate for Payer: PHP Commercial |
$98.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.40
|
| Rate for Payer: Priority Health SBD |
$73.08
|
| Rate for Payer: UMR Bronson Commercial |
$42.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.00
|
|
|
HC RECOVERY PHASE 1 COMPLEX EA MIN CHARGE
|
Facility
|
IP
|
$15.00
|
|
| Hospital Charge Code |
71000034
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna American Axle |
$9.75
|
| Rate for Payer: Aetna Commercial |
$12.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.75
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$10.50
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$13.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.75
|
| Rate for Payer: PHP Commercial |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health SBD |
$9.45
|
| Rate for Payer: UMR Bronson Commercial |
$6.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.25
|
|
|
HC RECOVERY PHASE 1 COMPLEX EA MIN CHARGE
|
Facility
|
OP
|
$15.00
|
|
| Hospital Charge Code |
71000034
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$5.55 |
| Max. Negotiated Rate |
$13.50 |
| Rate for Payer: Aetna American Axle |
$9.75
|
| Rate for Payer: Aetna Commercial |
$12.75
|
| Rate for Payer: Aetna Medicare |
$7.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.75
|
| Rate for Payer: BCBS Complete |
$6.00
|
| Rate for Payer: Cash Price |
$12.00
|
| Rate for Payer: Cofinity Commercial |
$10.50
|
| Rate for Payer: Cofinity Commercial |
$12.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$10.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.00
|
| Rate for Payer: Healthscope Commercial |
$13.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.75
|
| Rate for Payer: PHP Commercial |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9.75
|
| Rate for Payer: Priority Health SBD |
$9.45
|
| Rate for Payer: UMR Bronson Commercial |
$5.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11.25
|
|
|
HC RECOVERY PHASE 1 STANDARD BASE CHARGE
|
Facility
|
IP
|
$97.00
|
|
| Hospital Charge Code |
71000035
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$42.68 |
| Max. Negotiated Rate |
$87.30 |
| Rate for Payer: Aetna American Axle |
$63.05
|
| Rate for Payer: Aetna Commercial |
$82.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.05
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$67.90
|
| Rate for Payer: Cofinity Commercial |
$83.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.60
|
| Rate for Payer: Healthscope Commercial |
$87.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.45
|
| Rate for Payer: PHP Commercial |
$82.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health SBD |
$61.11
|
| Rate for Payer: UMR Bronson Commercial |
$42.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.75
|
|
|
HC RECOVERY PHASE 1 STANDARD BASE CHARGE
|
Facility
|
OP
|
$97.00
|
|
| Hospital Charge Code |
71000035
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$35.89 |
| Max. Negotiated Rate |
$87.30 |
| Rate for Payer: Aetna American Axle |
$63.05
|
| Rate for Payer: Aetna Commercial |
$82.45
|
| Rate for Payer: Aetna Medicare |
$48.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.05
|
| Rate for Payer: BCBS Complete |
$38.80
|
| Rate for Payer: Cash Price |
$77.60
|
| Rate for Payer: Cofinity Commercial |
$67.90
|
| Rate for Payer: Cofinity Commercial |
$83.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.60
|
| Rate for Payer: Healthscope Commercial |
$87.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.45
|
| Rate for Payer: PHP Commercial |
$82.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.05
|
| Rate for Payer: Priority Health SBD |
$61.11
|
| Rate for Payer: UMR Bronson Commercial |
$35.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.75
|
|
|
HC RECOVERY PHASE 1 STANDARD EA MIN CHARGE
|
Facility
|
IP
|
$12.00
|
|
| Hospital Charge Code |
71000036
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Aetna American Axle |
$7.80
|
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$10.32
|
| Rate for Payer: Cofinity Commercial |
$8.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.60
|
| Rate for Payer: Healthscope Commercial |
$10.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.20
|
| Rate for Payer: PHP Commercial |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health SBD |
$7.56
|
| Rate for Payer: UMR Bronson Commercial |
$5.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.00
|
|
|
HC RECOVERY PHASE 1 STANDARD EA MIN CHARGE
|
Facility
|
OP
|
$12.00
|
|
| Hospital Charge Code |
71000036
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$4.44 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Aetna American Axle |
$7.80
|
| Rate for Payer: Aetna Commercial |
$10.20
|
| Rate for Payer: Aetna Medicare |
$6.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7.80
|
| Rate for Payer: BCBS Complete |
$4.80
|
| Rate for Payer: Cash Price |
$9.60
|
| Rate for Payer: Cofinity Commercial |
$10.32
|
| Rate for Payer: Cofinity Commercial |
$8.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$8.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.60
|
| Rate for Payer: Healthscope Commercial |
$10.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$8.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.20
|
| Rate for Payer: PHP Commercial |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.80
|
| Rate for Payer: Priority Health SBD |
$7.56
|
| Rate for Payer: UMR Bronson Commercial |
$4.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.00
|
|
|
HC RECOVERY PHASE 2 EA MIN CHARGE
|
Facility
|
OP
|
$9.00
|
|
| Hospital Charge Code |
71000037
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna American Axle |
$5.85
|
| Rate for Payer: Aetna Commercial |
$7.65
|
| Rate for Payer: Aetna Medicare |
$4.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.85
|
| Rate for Payer: BCBS Complete |
$3.60
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$6.30
|
| Rate for Payer: Cofinity Commercial |
$7.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.20
|
| Rate for Payer: Healthscope Commercial |
$8.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.65
|
| Rate for Payer: PHP Commercial |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.85
|
| Rate for Payer: Priority Health SBD |
$5.67
|
| Rate for Payer: UMR Bronson Commercial |
$3.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.75
|
|
|
HC RECOVERY PHASE 2 EA MIN CHARGE
|
Facility
|
IP
|
$9.00
|
|
| Hospital Charge Code |
71000037
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$3.96 |
| Max. Negotiated Rate |
$8.10 |
| Rate for Payer: Aetna American Axle |
$5.85
|
| Rate for Payer: Aetna Commercial |
$7.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.85
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Cofinity Commercial |
$6.30
|
| Rate for Payer: Cofinity Commercial |
$7.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.20
|
| Rate for Payer: Healthscope Commercial |
$8.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.65
|
| Rate for Payer: PHP Commercial |
$7.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.85
|
| Rate for Payer: Priority Health SBD |
$5.67
|
| Rate for Payer: UMR Bronson Commercial |
$3.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.75
|
|
|
HC RED CEDAR IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RED CEDAR IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200099
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| 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 |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
OP
|
$302.94
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.27 |
| Max. Negotiated Rate |
$521.32 |
| Rate for Payer: Aetna American Axle |
$196.91
|
| Rate for Payer: Aetna Commercial |
$257.50
|
| Rate for Payer: Aetna Medicare |
$192.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$231.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$231.50
|
| Rate for Payer: BCBS Complete |
$104.23
|
| Rate for Payer: BCBS MAPPO |
$185.20
|
| Rate for Payer: BCN Medicare Advantage |
$185.20
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$260.53
|
| Rate for Payer: Cofinity Commercial |
$212.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$212.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$185.20
|
| Rate for Payer: Healthscope Commercial |
$272.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.21
|
| Rate for Payer: Mclaren Medicaid |
$99.27
|
| Rate for Payer: Mclaren Medicare |
$185.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$194.46
|
| Rate for Payer: Meridian Medicaid |
$104.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.50
|
| Rate for Payer: PACE Medicare |
$175.94
|
| Rate for Payer: PACE SWMI |
$185.20
|
| Rate for Payer: PHP Commercial |
$257.50
|
| Rate for Payer: PHP Medicare Advantage |
$185.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.91
|
| Rate for Payer: Priority Health Medicare |
$185.20
|
| Rate for Payer: Priority Health SBD |
$190.85
|
| Rate for Payer: Railroad Medicare Medicare |
$185.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$521.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$185.20
|
| Rate for Payer: UHC Exchange |
$353.94
|
| Rate for Payer: UHC Medicare Advantage |
$185.20
|
| Rate for Payer: UHCCP Medicaid |
$99.27
|
| Rate for Payer: UMR Bronson Commercial |
$112.09
|
| Rate for Payer: VA VA |
$185.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.21
|
|
|
HC RED CELL GENO MI BLD
|
Facility
|
IP
|
$302.94
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
31000135
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$133.29 |
| Max. Negotiated Rate |
$272.65 |
| Rate for Payer: Aetna American Axle |
$196.91
|
| Rate for Payer: Aetna Commercial |
$257.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$196.91
|
| Rate for Payer: Cash Price |
$242.35
|
| Rate for Payer: Cofinity Commercial |
$212.06
|
| Rate for Payer: Cofinity Commercial |
$260.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$212.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$242.35
|
| Rate for Payer: Healthscope Commercial |
$272.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$212.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$227.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$257.50
|
| Rate for Payer: PHP Commercial |
$257.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$196.91
|
| Rate for Payer: Priority Health SBD |
$190.85
|
| Rate for Payer: UMR Bronson Commercial |
$133.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$227.21
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
IP
|
$218.10
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$95.96 |
| Max. Negotiated Rate |
$196.29 |
| Rate for Payer: Aetna American Axle |
$141.76
|
| Rate for Payer: Aetna Commercial |
$185.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.76
|
| Rate for Payer: Cash Price |
$174.48
|
| Rate for Payer: Cofinity Commercial |
$152.67
|
| Rate for Payer: Cofinity Commercial |
$187.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$152.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.48
|
| Rate for Payer: Healthscope Commercial |
$196.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.38
|
| Rate for Payer: PHP Commercial |
$185.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.76
|
| Rate for Payer: Priority Health SBD |
$137.40
|
| Rate for Payer: UMR Bronson Commercial |
$95.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.57
|
|
|
HC RED CELL GENO MI BLD CMPT
|
Facility
|
OP
|
$218.10
|
|
|
Service Code
|
CPT 81479
|
| Hospital Charge Code |
31000136
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$80.70 |
| Max. Negotiated Rate |
$196.29 |
| Rate for Payer: Aetna American Axle |
$141.76
|
| Rate for Payer: Aetna Commercial |
$185.38
|
| Rate for Payer: Aetna Medicare |
$109.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$141.76
|
| Rate for Payer: BCBS Complete |
$87.24
|
| Rate for Payer: Cash Price |
$174.48
|
| Rate for Payer: Cofinity Commercial |
$152.67
|
| Rate for Payer: Cofinity Commercial |
$187.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$152.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.48
|
| Rate for Payer: Healthscope Commercial |
$196.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$152.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.38
|
| Rate for Payer: PHP Commercial |
$185.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$141.76
|
| Rate for Payer: Priority Health SBD |
$137.40
|
| Rate for Payer: UMR Bronson Commercial |
$80.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.57
|
|
|
HC RED CELLS, DIRECTED, LEUKO RED
|
Facility
|
OP
|
$1,106.29
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000061
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$95.14 |
| Max. Negotiated Rate |
$995.66 |
| Rate for Payer: Aetna American Axle |
$719.09
|
| Rate for Payer: Aetna Commercial |
$940.35
|
| Rate for Payer: Aetna Medicare |
$184.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$221.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$221.88
|
| Rate for Payer: BCBS Complete |
$99.90
|
| Rate for Payer: BCBS MAPPO |
$177.50
|
| Rate for Payer: BCN Medicare Advantage |
$177.50
|
| Rate for Payer: Cash Price |
$885.03
|
| Rate for Payer: Cash Price |
$885.03
|
| Rate for Payer: Cash Price |
$885.03
|
| Rate for Payer: Cofinity Commercial |
$774.40
|
| Rate for Payer: Cofinity Commercial |
$951.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$774.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$177.50
|
| Rate for Payer: Healthscope Commercial |
$995.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$829.72
|
| Rate for Payer: Mclaren Medicaid |
$95.14
|
| Rate for Payer: Mclaren Medicare |
$177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$186.38
|
| Rate for Payer: Meridian Medicaid |
$99.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.35
|
| Rate for Payer: PACE Medicare |
$168.62
|
| Rate for Payer: PACE SWMI |
$177.50
|
| Rate for Payer: PHP Commercial |
$940.35
|
| Rate for Payer: PHP Medicare Advantage |
$177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$719.09
|
| Rate for Payer: Priority Health Medicare |
$177.50
|
| Rate for Payer: Priority Health SBD |
$696.96
|
| Rate for Payer: Railroad Medicare Medicare |
$177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$499.64
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$177.50
|
| Rate for Payer: UHC Exchange |
$339.22
|
| Rate for Payer: UHC Medicare Advantage |
$177.50
|
| Rate for Payer: UHCCP Medicaid |
$95.14
|
| Rate for Payer: UMR Bronson Commercial |
$409.33
|
| Rate for Payer: VA VA |
$177.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$829.72
|
|
|
HC RED CELLS, DIRECTED, LEUKO RED
|
Facility
|
IP
|
$1,106.29
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000061
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$486.77 |
| Max. Negotiated Rate |
$995.66 |
| Rate for Payer: Aetna American Axle |
$719.09
|
| Rate for Payer: Aetna Commercial |
$940.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.09
|
| Rate for Payer: Cash Price |
$885.03
|
| Rate for Payer: Cofinity Commercial |
$774.40
|
| Rate for Payer: Cofinity Commercial |
$951.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$774.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$885.03
|
| Rate for Payer: Healthscope Commercial |
$995.66
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$774.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$829.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$940.35
|
| Rate for Payer: PHP Commercial |
$940.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$719.09
|
| Rate for Payer: Priority Health SBD |
$696.96
|
| Rate for Payer: UMR Bronson Commercial |
$486.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$829.72
|
|
|
HC REDTOP BENT GRASS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200057
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC REDTOP BENT GRASS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200057
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| 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 |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
