|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
OP
|
$540.75
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.93 |
| Max. Negotiated Rate |
$1,228.82 |
| Rate for Payer: Aetna American Axle |
$351.49
|
| Rate for Payer: Aetna Commercial |
$459.64
|
| Rate for Payer: Aetna Medicare |
$406.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$488.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$488.71
|
| Rate for Payer: BCBS Complete |
$220.04
|
| Rate for Payer: BCBS MAPPO |
$390.97
|
| Rate for Payer: BCBS Trust/PPO |
$290.36
|
| Rate for Payer: BCN Commercial |
$290.36
|
| Rate for Payer: BCN Medicare Advantage |
$390.97
|
| Rate for Payer: Cash Price |
$432.60
|
| Rate for Payer: Cash Price |
$432.60
|
| Rate for Payer: Cofinity Commercial |
$465.04
|
| Rate for Payer: Cofinity Commercial |
$378.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$378.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.97
|
| Rate for Payer: Healthscope Commercial |
$486.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$378.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.56
|
| Rate for Payer: Mclaren Medicaid |
$209.56
|
| Rate for Payer: Mclaren Medicare |
$390.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$410.52
|
| Rate for Payer: Meridian Medicaid |
$220.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$449.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.64
|
| Rate for Payer: Nomi Health Commercial |
$1,172.91
|
| Rate for Payer: PACE Medicare |
$371.42
|
| Rate for Payer: PACE SWMI |
$390.97
|
| Rate for Payer: PHP Commercial |
$459.64
|
| Rate for Payer: PHP Medicare Advantage |
$390.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$351.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,228.82
|
| Rate for Payer: Priority Health Medicare |
$390.97
|
| Rate for Payer: Priority Health Narrow Network |
$983.06
|
| Rate for Payer: Priority Health SBD |
$340.67
|
| Rate for Payer: Railroad Medicare Medicare |
$390.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$390.97
|
| Rate for Payer: UHC Exchange |
$96.93
|
| Rate for Payer: UHC Medicare Advantage |
$390.97
|
| Rate for Payer: UHCCP Medicaid |
$209.56
|
| Rate for Payer: UMR Bronson Commercial |
$200.08
|
| Rate for Payer: VA VA |
$390.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.56
|
|
|
HC RAPID DESENSITIZATION PROC EA HOUR
|
Facility
|
IP
|
$540.75
|
|
|
Service Code
|
CPT 95180
|
| Hospital Charge Code |
76100075
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$237.93 |
| Max. Negotiated Rate |
$486.68 |
| Rate for Payer: Aetna American Axle |
$351.49
|
| Rate for Payer: Aetna Commercial |
$459.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$351.49
|
| Rate for Payer: Cash Price |
$432.60
|
| Rate for Payer: Cofinity Commercial |
$378.52
|
| Rate for Payer: Cofinity Commercial |
$465.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$378.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$432.60
|
| Rate for Payer: Healthscope Commercial |
$486.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$378.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$405.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$459.64
|
| Rate for Payer: PHP Commercial |
$459.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$351.49
|
| Rate for Payer: Priority Health SBD |
$340.67
|
| Rate for Payer: UMR Bronson Commercial |
$237.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$405.56
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
OP
|
$153.71
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$138.34 |
| Rate for Payer: Aetna American Axle |
$99.91
|
| Rate for Payer: Aetna Commercial |
$130.65
|
| Rate for Payer: Aetna Medicare |
$9.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.11
|
| Rate for Payer: BCBS Complete |
$5.00
|
| Rate for Payer: BCBS MAPPO |
$8.89
|
| Rate for Payer: BCBS Trust/PPO |
$8.57
|
| Rate for Payer: BCN Commercial |
$8.57
|
| Rate for Payer: BCN Medicare Advantage |
$8.89
|
| Rate for Payer: Cash Price |
$122.97
|
| Rate for Payer: Cash Price |
$122.97
|
| Rate for Payer: Cofinity Commercial |
$132.19
|
| Rate for Payer: Cofinity Commercial |
$107.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$138.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.28
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Mclaren Medicare |
$8.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.33
|
| Rate for Payer: Meridian Medicaid |
$5.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.65
|
| Rate for Payer: Nomi Health Commercial |
$13.34
|
| Rate for Payer: PACE Medicare |
$8.45
|
| Rate for Payer: PACE SWMI |
$8.89
|
| Rate for Payer: PHP Commercial |
$130.65
|
| Rate for Payer: PHP Medicare Advantage |
$8.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.14
|
| Rate for Payer: Priority Health Medicare |
$8.89
|
| Rate for Payer: Priority Health Narrow Network |
$7.31
|
| Rate for Payer: Priority Health SBD |
$96.84
|
| Rate for Payer: Railroad Medicare Medicare |
$8.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.89
|
| Rate for Payer: UHC Exchange |
$8.89
|
| Rate for Payer: UHC Medicare Advantage |
$8.89
|
| Rate for Payer: UHCCP Medicaid |
$4.77
|
| Rate for Payer: UMR Bronson Commercial |
$56.87
|
| Rate for Payer: VA VA |
$8.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.28
|
|
|
HC RAPID HIV ANTIBODY
|
Facility
|
IP
|
$153.71
|
|
|
Service Code
|
CPT 86701
|
| Hospital Charge Code |
30200290
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$67.63 |
| Max. Negotiated Rate |
$138.34 |
| Rate for Payer: Aetna American Axle |
$99.91
|
| Rate for Payer: Aetna Commercial |
$130.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.91
|
| Rate for Payer: Cash Price |
$122.97
|
| Rate for Payer: Cofinity Commercial |
$107.60
|
| Rate for Payer: Cofinity Commercial |
$132.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$107.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.97
|
| Rate for Payer: Healthscope Commercial |
$138.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$107.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$130.65
|
| Rate for Payer: PHP Commercial |
$130.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$99.91
|
| Rate for Payer: Priority Health SBD |
$96.84
|
| Rate for Payer: UMR Bronson Commercial |
$67.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.28
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
IP
|
$77.93
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.29 |
| Max. Negotiated Rate |
$70.14 |
| Rate for Payer: Aetna American Axle |
$50.65
|
| Rate for Payer: Aetna Commercial |
$66.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.65
|
| Rate for Payer: Cash Price |
$62.34
|
| Rate for Payer: Cofinity Commercial |
$54.55
|
| Rate for Payer: Cofinity Commercial |
$67.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.34
|
| Rate for Payer: Healthscope Commercial |
$70.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.24
|
| Rate for Payer: PHP Commercial |
$66.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.65
|
| Rate for Payer: Priority Health SBD |
$49.10
|
| Rate for Payer: UMR Bronson Commercial |
$34.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.45
|
|
|
HC RAPID INFLUENZA A & B SCREEN
|
Facility
|
OP
|
$77.93
|
|
|
Service Code
|
CPT 87804
|
| Hospital Charge Code |
30600174
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.87 |
| Max. Negotiated Rate |
$70.14 |
| Rate for Payer: Aetna American Axle |
$50.65
|
| Rate for Payer: Aetna Commercial |
$66.24
|
| Rate for Payer: Aetna Medicare |
$17.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.69
|
| Rate for Payer: BCBS Complete |
$9.31
|
| Rate for Payer: BCBS MAPPO |
$16.55
|
| Rate for Payer: BCBS Trust/PPO |
$15.94
|
| Rate for Payer: BCN Commercial |
$15.94
|
| Rate for Payer: BCN Medicare Advantage |
$16.55
|
| Rate for Payer: Cash Price |
$62.34
|
| Rate for Payer: Cash Price |
$62.34
|
| Rate for Payer: Cofinity Commercial |
$67.02
|
| Rate for Payer: Cofinity Commercial |
$54.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.55
|
| Rate for Payer: Healthscope Commercial |
$70.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.45
|
| Rate for Payer: Mclaren Medicaid |
$8.87
|
| Rate for Payer: Mclaren Medicare |
$16.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.38
|
| Rate for Payer: Meridian Medicaid |
$9.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.24
|
| Rate for Payer: Nomi Health Commercial |
$24.82
|
| Rate for Payer: PACE Medicare |
$15.72
|
| Rate for Payer: PACE SWMI |
$16.55
|
| Rate for Payer: PHP Commercial |
$66.24
|
| Rate for Payer: PHP Medicare Advantage |
$16.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.55
|
| Rate for Payer: Priority Health Medicare |
$16.55
|
| Rate for Payer: Priority Health Narrow Network |
$13.24
|
| Rate for Payer: Priority Health SBD |
$49.10
|
| Rate for Payer: Railroad Medicare Medicare |
$16.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.55
|
| Rate for Payer: UHC Exchange |
$16.55
|
| Rate for Payer: UHC Medicare Advantage |
$16.55
|
| Rate for Payer: UHCCP Medicaid |
$8.87
|
| Rate for Payer: UMR Bronson Commercial |
$28.83
|
| Rate for Payer: VA VA |
$16.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.45
|
|
|
HC RAPID INFUSER
|
Facility
|
IP
|
$1,432.45
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$630.28 |
| Max. Negotiated Rate |
$1,289.20 |
| Rate for Payer: Aetna American Axle |
$931.09
|
| Rate for Payer: Aetna Commercial |
$1,217.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.09
|
| Rate for Payer: Cash Price |
$1,145.96
|
| Rate for Payer: Cofinity Commercial |
$1,002.72
|
| Rate for Payer: Cofinity Commercial |
$1,231.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,002.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.96
|
| Rate for Payer: Healthscope Commercial |
$1,289.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,002.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,074.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.58
|
| Rate for Payer: PHP Commercial |
$1,217.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$931.09
|
| Rate for Payer: Priority Health SBD |
$902.44
|
| Rate for Payer: UMR Bronson Commercial |
$630.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,074.34
|
|
|
HC RAPID INFUSER
|
Facility
|
OP
|
$1,432.45
|
|
| Hospital Charge Code |
27000294
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$530.01 |
| Max. Negotiated Rate |
$1,289.20 |
| Rate for Payer: Aetna American Axle |
$931.09
|
| Rate for Payer: Aetna Commercial |
$1,217.58
|
| Rate for Payer: Aetna Medicare |
$716.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$931.09
|
| Rate for Payer: BCBS Complete |
$572.98
|
| Rate for Payer: Cash Price |
$1,145.96
|
| Rate for Payer: Cofinity Commercial |
$1,002.72
|
| Rate for Payer: Cofinity Commercial |
$1,231.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,002.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,145.96
|
| Rate for Payer: Healthscope Commercial |
$1,289.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,002.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,074.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,217.58
|
| Rate for Payer: PHP Commercial |
$1,217.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$931.09
|
| Rate for Payer: Priority Health SBD |
$902.44
|
| Rate for Payer: UMR Bronson Commercial |
$530.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,074.34
|
|
|
HC RAPID MALARIA ASSAY
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| 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 RAPID MALARIA ASSAY
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30600298
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$16.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.09
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.07
|
| Rate for Payer: BCBS Trust/PPO |
$15.48
|
| Rate for Payer: BCN Commercial |
$15.48
|
| Rate for Payer: BCN Medicare Advantage |
$16.07
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.07
|
| 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: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.87
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$24.10
|
| Rate for Payer: PACE Medicare |
$15.27
|
| Rate for Payer: PACE SWMI |
$16.07
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$16.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$16.07
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$16.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.07
|
| Rate for Payer: UHC Exchange |
$16.07
|
| Rate for Payer: UHC Medicare Advantage |
$16.07
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$16.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
IP
|
$61.70
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.15 |
| Max. Negotiated Rate |
$55.53 |
| Rate for Payer: Aetna American Axle |
$40.10
|
| Rate for Payer: Aetna Commercial |
$52.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.10
|
| Rate for Payer: Cash Price |
$49.36
|
| Rate for Payer: Cofinity Commercial |
$43.19
|
| Rate for Payer: Cofinity Commercial |
$53.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.36
|
| Rate for Payer: Healthscope Commercial |
$55.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.44
|
| Rate for Payer: PHP Commercial |
$52.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.10
|
| Rate for Payer: Priority Health SBD |
$38.87
|
| Rate for Payer: UMR Bronson Commercial |
$27.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.28
|
|
|
HC RAPID STREP SCREEN.
|
Facility
|
OP
|
$61.70
|
|
|
Service Code
|
CPT 87880
|
| Hospital Charge Code |
30600176
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$55.53 |
| Rate for Payer: Aetna American Axle |
$40.10
|
| Rate for Payer: Aetna Commercial |
$52.44
|
| Rate for Payer: Aetna Medicare |
$17.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.66
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$16.53
|
| Rate for Payer: BCBS Trust/PPO |
$15.93
|
| Rate for Payer: BCN Commercial |
$15.93
|
| Rate for Payer: BCN Medicare Advantage |
$16.53
|
| Rate for Payer: Cash Price |
$49.36
|
| Rate for Payer: Cash Price |
$49.36
|
| Rate for Payer: Cofinity Commercial |
$53.06
|
| Rate for Payer: Cofinity Commercial |
$43.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.53
|
| Rate for Payer: Healthscope Commercial |
$55.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.28
|
| Rate for Payer: Mclaren Medicaid |
$8.86
|
| Rate for Payer: Mclaren Medicare |
$16.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.36
|
| Rate for Payer: Meridian Medicaid |
$9.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.44
|
| Rate for Payer: Nomi Health Commercial |
$24.80
|
| Rate for Payer: PACE Medicare |
$15.70
|
| Rate for Payer: PACE SWMI |
$16.53
|
| Rate for Payer: PHP Commercial |
$52.44
|
| Rate for Payer: PHP Medicare Advantage |
$16.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.53
|
| Rate for Payer: Priority Health Medicare |
$16.53
|
| Rate for Payer: Priority Health Narrow Network |
$13.22
|
| Rate for Payer: Priority Health SBD |
$38.87
|
| Rate for Payer: Railroad Medicare Medicare |
$16.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.53
|
| Rate for Payer: UHC Exchange |
$16.53
|
| Rate for Payer: UHC Medicare Advantage |
$16.53
|
| Rate for Payer: UHCCP Medicaid |
$8.86
|
| Rate for Payer: UMR Bronson Commercial |
$22.83
|
| Rate for Payer: VA VA |
$16.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.28
|
|
|
HC RAVAS CTO/DES
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$9,430.19 |
| Max. Negotiated Rate |
$55,296.52 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna Medicare |
$18,297.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21,992.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21,992.05
|
| Rate for Payer: BCBS Complete |
$9,901.70
|
| Rate for Payer: BCBS MAPPO |
$17,593.64
|
| Rate for Payer: BCBS Trust/PPO |
$15,812.76
|
| Rate for Payer: BCN Commercial |
$15,812.76
|
| Rate for Payer: BCN Medicare Advantage |
$17,593.64
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Commercial |
$20,771.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17,593.64
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Mclaren Medicaid |
$9,430.19
|
| Rate for Payer: Mclaren Medicare |
$17,593.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18,473.32
|
| Rate for Payer: Meridian Medicaid |
$9,901.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20,232.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$36,946.64
|
| Rate for Payer: PACE Medicare |
$16,713.96
|
| Rate for Payer: PACE SWMI |
$17,593.64
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: PHP Medicare Advantage |
$17,593.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$9,430.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$55,296.52
|
| Rate for Payer: Priority Health Medicare |
$17,593.64
|
| Rate for Payer: Priority Health Narrow Network |
$44,237.22
|
| Rate for Payer: Priority Health SBD |
$18,694.21
|
| Rate for Payer: Railroad Medicare Medicare |
$17,593.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49,524.34
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$17,593.64
|
| Rate for Payer: UHC Exchange |
$33,623.21
|
| Rate for Payer: UHC Medicare Advantage |
$17,593.64
|
| Rate for Payer: UHCCP Medicaid |
$9,430.19
|
| Rate for Payer: UMR Bronson Commercial |
$10,979.14
|
| Rate for Payer: VA VA |
$17,593.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC RAVAS CTO/DES
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT C9607
|
| Hospital Charge Code |
48100088
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,056.27 |
| Max. Negotiated Rate |
$26,706.02 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$20,771.34
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health SBD |
$18,694.21
|
| Rate for Payer: UMR Bronson Commercial |
$13,056.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC RAVAS CTO/STENT
|
Facility
|
IP
|
$29,673.35
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
48100087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$13,056.27 |
| Max. Negotiated Rate |
$26,706.02 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$20,771.34
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health SBD |
$18,694.21
|
| Rate for Payer: UMR Bronson Commercial |
$13,056.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC RAVAS CTO/STENT
|
Facility
|
OP
|
$29,673.35
|
|
|
Service Code
|
CPT 92943
|
| Hospital Charge Code |
48100087
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$635.53 |
| Max. Negotiated Rate |
$34,922.52 |
| Rate for Payer: Aetna American Axle |
$19,287.68
|
| Rate for Payer: Aetna Commercial |
$25,222.35
|
| Rate for Payer: Aetna Medicare |
$11,555.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19,287.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13,889.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13,889.08
|
| Rate for Payer: BCBS Complete |
$6,253.42
|
| Rate for Payer: BCBS MAPPO |
$11,111.26
|
| Rate for Payer: BCBS Trust/PPO |
$9,963.41
|
| Rate for Payer: BCN Commercial |
$9,963.41
|
| Rate for Payer: BCN Medicare Advantage |
$11,111.26
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cash Price |
$23,738.68
|
| Rate for Payer: Cofinity Commercial |
$25,519.08
|
| Rate for Payer: Cofinity Commercial |
$20,771.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$20,771.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23,738.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,111.26
|
| Rate for Payer: Healthscope Commercial |
$26,706.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20,771.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22,255.01
|
| Rate for Payer: Mclaren Medicaid |
$5,955.64
|
| Rate for Payer: Mclaren Medicare |
$11,111.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11,666.82
|
| Rate for Payer: Meridian Medicaid |
$6,253.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12,777.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25,222.35
|
| Rate for Payer: Nomi Health Commercial |
$23,333.65
|
| Rate for Payer: PACE Medicare |
$10,555.70
|
| Rate for Payer: PACE SWMI |
$11,111.26
|
| Rate for Payer: PHP Commercial |
$25,222.35
|
| Rate for Payer: PHP Medicare Advantage |
$11,111.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$5,955.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19,287.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$34,922.52
|
| Rate for Payer: Priority Health Medicare |
$11,111.26
|
| Rate for Payer: Priority Health Narrow Network |
$27,938.02
|
| Rate for Payer: Priority Health SBD |
$18,694.21
|
| Rate for Payer: Railroad Medicare Medicare |
$11,111.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$699.08
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,111.26
|
| Rate for Payer: UHC Exchange |
$635.53
|
| Rate for Payer: UHC Medicare Advantage |
$11,111.26
|
| Rate for Payer: UHCCP Medicaid |
$5,955.64
|
| Rate for Payer: UMR Bronson Commercial |
$10,979.14
|
| Rate for Payer: VA VA |
$11,111.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22,255.01
|
|
|
HC RBC LEUKO REDUCED
|
Facility
|
OP
|
$725.60
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000059
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$95.58 |
| Max. Negotiated Rate |
$653.04 |
| Rate for Payer: Aetna American Axle |
$471.64
|
| Rate for Payer: Aetna Commercial |
$616.76
|
| Rate for Payer: Aetna Medicare |
$185.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$222.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$222.90
|
| Rate for Payer: BCBS Complete |
$100.36
|
| Rate for Payer: BCBS MAPPO |
$178.32
|
| Rate for Payer: BCBS Trust/PPO |
$478.52
|
| Rate for Payer: BCN Commercial |
$478.52
|
| Rate for Payer: BCN Medicare Advantage |
$178.32
|
| Rate for Payer: Cash Price |
$580.48
|
| Rate for Payer: Cash Price |
$580.48
|
| Rate for Payer: Cash Price |
$580.48
|
| Rate for Payer: Cofinity Commercial |
$507.92
|
| Rate for Payer: Cofinity Commercial |
$624.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$507.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$580.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$178.32
|
| Rate for Payer: Healthscope Commercial |
$653.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$507.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$544.20
|
| Rate for Payer: Mclaren Medicaid |
$95.58
|
| Rate for Payer: Mclaren Medicare |
$178.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$187.24
|
| Rate for Payer: Meridian Medicaid |
$100.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$205.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616.76
|
| Rate for Payer: Nomi Health Commercial |
$534.96
|
| Rate for Payer: PACE Medicare |
$169.40
|
| Rate for Payer: PACE SWMI |
$178.32
|
| Rate for Payer: PHP Commercial |
$616.76
|
| Rate for Payer: PHP Medicare Advantage |
$178.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$95.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$560.47
|
| Rate for Payer: Priority Health Medicare |
$178.32
|
| Rate for Payer: Priority Health Narrow Network |
$448.38
|
| Rate for Payer: Priority Health SBD |
$457.13
|
| Rate for Payer: Railroad Medicare Medicare |
$178.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$501.95
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$178.32
|
| Rate for Payer: UHC Exchange |
$340.79
|
| Rate for Payer: UHC Medicare Advantage |
$178.32
|
| Rate for Payer: UHCCP Medicaid |
$95.58
|
| Rate for Payer: UMR Bronson Commercial |
$268.47
|
| Rate for Payer: VA VA |
$178.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$544.20
|
|
|
HC RBC LEUKO REDUCED
|
Facility
|
IP
|
$725.60
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000059
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$319.26 |
| Max. Negotiated Rate |
$653.04 |
| Rate for Payer: Aetna American Axle |
$471.64
|
| Rate for Payer: Aetna Commercial |
$616.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$471.64
|
| Rate for Payer: Cash Price |
$580.48
|
| Rate for Payer: Cofinity Commercial |
$507.92
|
| Rate for Payer: Cofinity Commercial |
$624.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$507.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$580.48
|
| Rate for Payer: Healthscope Commercial |
$653.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$507.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$544.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$616.76
|
| Rate for Payer: PHP Commercial |
$616.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$471.64
|
| Rate for Payer: Priority Health SBD |
$457.13
|
| Rate for Payer: UMR Bronson Commercial |
$319.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$544.20
|
|
|
HC RBC LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000072
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$134.34 |
| Max. Negotiated Rate |
$1,131.38 |
| Rate for Payer: Aetna American Axle |
$817.11
|
| Rate for Payer: Aetna Commercial |
$1,068.53
|
| Rate for Payer: Aetna Medicare |
$260.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$817.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$313.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$313.29
|
| Rate for Payer: BCBS Complete |
$141.05
|
| Rate for Payer: BCBS MAPPO |
$250.63
|
| Rate for Payer: BCBS Trust/PPO |
$668.16
|
| Rate for Payer: BCN Commercial |
$668.16
|
| Rate for Payer: BCN Medicare Advantage |
$250.63
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,081.10
|
| Rate for Payer: Cofinity Commercial |
$879.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$879.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$250.63
|
| Rate for Payer: Healthscope Commercial |
$1,131.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$879.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.82
|
| Rate for Payer: Mclaren Medicaid |
$134.34
|
| Rate for Payer: Mclaren Medicare |
$250.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$263.16
|
| Rate for Payer: Meridian Medicaid |
$141.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$288.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: Nomi Health Commercial |
$751.89
|
| Rate for Payer: PACE Medicare |
$238.10
|
| Rate for Payer: PACE SWMI |
$250.63
|
| Rate for Payer: PHP Commercial |
$1,068.53
|
| Rate for Payer: PHP Medicare Advantage |
$250.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$787.72
|
| Rate for Payer: Priority Health Medicare |
$250.63
|
| Rate for Payer: Priority Health Narrow Network |
$630.18
|
| Rate for Payer: Priority Health SBD |
$791.97
|
| Rate for Payer: Railroad Medicare Medicare |
$250.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.50
|
| Rate for Payer: UHC Core |
$446.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$250.63
|
| Rate for Payer: UHC Exchange |
$478.98
|
| Rate for Payer: UHC Medicare Advantage |
$250.63
|
| Rate for Payer: UHCCP Medicaid |
$134.34
|
| Rate for Payer: UMR Bronson Commercial |
$465.12
|
| Rate for Payer: VA VA |
$250.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.82
|
|
|
HC RBC LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$1,257.09
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000072
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$553.12 |
| Max. Negotiated Rate |
$1,131.38 |
| Rate for Payer: Aetna American Axle |
$817.11
|
| Rate for Payer: Aetna Commercial |
$1,068.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$817.11
|
| Rate for Payer: Cash Price |
$1,005.67
|
| Rate for Payer: Cofinity Commercial |
$1,081.10
|
| Rate for Payer: Cofinity Commercial |
$879.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$879.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,005.67
|
| Rate for Payer: Healthscope Commercial |
$1,131.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$879.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$942.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,068.53
|
| Rate for Payer: PHP Commercial |
$1,068.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$817.11
|
| Rate for Payer: Priority Health SBD |
$791.97
|
| Rate for Payer: UMR Bronson Commercial |
$553.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$942.82
|
|
|
HC RECEPTOR ASSAY OTHER ENDOCRINE
|
Facility
|
OP
|
$203.97
|
|
|
Service Code
|
CPT 84235
|
| Hospital Charge Code |
30100418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.18 |
| Max. Negotiated Rate |
$183.57 |
| Rate for Payer: Cofinity Commercial |
$142.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$142.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.23
|
| Rate for Payer: Healthscope Commercial |
$183.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.98
|
| Rate for Payer: Mclaren Medicaid |
$38.18
|
| Rate for Payer: Mclaren Medicare |
$71.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.79
|
| Rate for Payer: Meridian Medicaid |
$40.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.37
|
| Rate for Payer: Nomi Health Commercial |
$106.84
|
| Rate for Payer: PACE Medicare |
$67.67
|
| Rate for Payer: PACE SWMI |
$71.23
|
| Rate for Payer: PHP Commercial |
$173.37
|
| Rate for Payer: PHP Medicare Advantage |
$71.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$71.23
|
| Rate for Payer: Priority Health Medicare |
$71.23
|
| Rate for Payer: Priority Health Narrow Network |
$56.98
|
| Rate for Payer: Priority Health SBD |
$128.50
|
| Rate for Payer: Railroad Medicare Medicare |
$71.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$71.23
|
| Rate for Payer: UHC Exchange |
$71.23
|
| Rate for Payer: UHC Medicare Advantage |
$71.23
|
| Rate for Payer: UHCCP Medicaid |
$38.18
|
| Rate for Payer: UMR Bronson Commercial |
$75.47
|
| Rate for Payer: VA VA |
$71.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.98
|
| Rate for Payer: Aetna American Axle |
$132.58
|
| Rate for Payer: Aetna Commercial |
$173.37
|
| Rate for Payer: Aetna Medicare |
$74.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.04
|
| Rate for Payer: BCBS Complete |
$40.09
|
| Rate for Payer: BCBS MAPPO |
$71.23
|
| Rate for Payer: BCBS Trust/PPO |
$68.62
|
| Rate for Payer: BCN Commercial |
$68.62
|
| Rate for Payer: BCN Medicare Advantage |
$71.23
|
| Rate for Payer: Cash Price |
$163.18
|
| Rate for Payer: Cash Price |
$163.18
|
| Rate for Payer: Cofinity Commercial |
$175.41
|
|
|
HC RECEPTOR ASSAY OTHER ENDOCRINE
|
Facility
|
IP
|
$203.97
|
|
|
Service Code
|
CPT 84235
|
| Hospital Charge Code |
30100418
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$89.75 |
| Max. Negotiated Rate |
$183.57 |
| Rate for Payer: Aetna American Axle |
$132.58
|
| Rate for Payer: Aetna Commercial |
$173.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$132.58
|
| Rate for Payer: Cash Price |
$163.18
|
| Rate for Payer: Cofinity Commercial |
$142.78
|
| Rate for Payer: Cofinity Commercial |
$175.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$142.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.18
|
| Rate for Payer: Healthscope Commercial |
$183.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$142.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.37
|
| Rate for Payer: PHP Commercial |
$173.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.58
|
| Rate for Payer: Priority Health SBD |
$128.50
|
| Rate for Payer: UMR Bronson Commercial |
$89.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.98
|
|
|
HC RECOVERY 1 ADD'L 15 MIN
|
Facility
|
IP
|
$157.01
|
|
| Hospital Charge Code |
71000020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$69.08 |
| Max. Negotiated Rate |
$141.31 |
| Rate for Payer: Aetna American Axle |
$102.06
|
| Rate for Payer: Aetna Commercial |
$133.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.06
|
| Rate for Payer: Cash Price |
$125.61
|
| Rate for Payer: Cofinity Commercial |
$109.91
|
| Rate for Payer: Cofinity Commercial |
$135.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.61
|
| Rate for Payer: Healthscope Commercial |
$141.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.46
|
| Rate for Payer: PHP Commercial |
$133.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.06
|
| Rate for Payer: Priority Health SBD |
$98.92
|
| Rate for Payer: UMR Bronson Commercial |
$69.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.76
|
|
|
HC RECOVERY 1 ADD'L 15 MIN
|
Facility
|
OP
|
$157.01
|
|
| Hospital Charge Code |
71000020
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$58.09 |
| Max. Negotiated Rate |
$141.31 |
| Rate for Payer: Aetna American Axle |
$102.06
|
| Rate for Payer: Aetna Commercial |
$133.46
|
| Rate for Payer: Aetna Medicare |
$78.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$102.06
|
| Rate for Payer: BCBS Complete |
$62.80
|
| Rate for Payer: Cash Price |
$125.61
|
| Rate for Payer: Cofinity Commercial |
$109.91
|
| Rate for Payer: Cofinity Commercial |
$135.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$109.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.61
|
| Rate for Payer: Healthscope Commercial |
$141.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$109.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.46
|
| Rate for Payer: PHP Commercial |
$133.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.06
|
| Rate for Payer: Priority Health SBD |
$98.92
|
| Rate for Payer: UMR Bronson Commercial |
$58.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.76
|
|
|
HC RECOVERY 1 INIT 30 MIN
|
Facility
|
OP
|
$370.68
|
|
| Hospital Charge Code |
71000021
|
|
Hospital Revenue Code
|
710
|
| Min. Negotiated Rate |
$137.15 |
| Max. Negotiated Rate |
$333.61 |
| Rate for Payer: Aetna American Axle |
$240.94
|
| Rate for Payer: Aetna Commercial |
$315.08
|
| Rate for Payer: Aetna Medicare |
$185.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$240.94
|
| Rate for Payer: BCBS Complete |
$148.27
|
| Rate for Payer: Cash Price |
$296.54
|
| Rate for Payer: Cofinity Commercial |
$259.48
|
| Rate for Payer: Cofinity Commercial |
$318.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$259.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$296.54
|
| Rate for Payer: Healthscope Commercial |
$333.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$259.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$278.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$315.08
|
| Rate for Payer: PHP Commercial |
$315.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$240.94
|
| Rate for Payer: Priority Health SBD |
$233.53
|
| Rate for Payer: UMR Bronson Commercial |
$137.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$278.01
|
|
