|
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 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 |
$95.58 |
| 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 |
$185.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$719.09
|
| 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 |
$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 |
$178.32
|
| 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 |
$95.58
|
| 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 |
$940.35
|
| 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 |
$940.35
|
| 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 |
$719.09
|
| 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 |
$696.96
|
| 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 |
$409.33
|
| Rate for Payer: VA VA |
$178.32
|
| 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 |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| 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: Nomi Health Commercial |
$7.83
|
| 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 HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| 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 REDUCER W/LL ASY 1/4 X 3/8
|
Facility
|
IP
|
$9.18
|
|
| Hospital Charge Code |
27000679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.04 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Aetna American Axle |
$5.97
|
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.97
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$6.43
|
| Rate for Payer: Cofinity Commercial |
$7.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$8.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: PHP Commercial |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.97
|
| Rate for Payer: Priority Health SBD |
$5.78
|
| Rate for Payer: UMR Bronson Commercial |
$4.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.88
|
|
|
HC REDUCER W/LL ASY 1/4 X 3/8
|
Facility
|
OP
|
$9.18
|
|
| Hospital Charge Code |
27000679
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.40 |
| Max. Negotiated Rate |
$8.26 |
| Rate for Payer: Aetna American Axle |
$5.97
|
| Rate for Payer: Aetna Commercial |
$7.80
|
| Rate for Payer: Aetna Medicare |
$4.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5.97
|
| Rate for Payer: BCBS Complete |
$3.67
|
| Rate for Payer: Cash Price |
$7.34
|
| Rate for Payer: Cofinity Commercial |
$6.43
|
| Rate for Payer: Cofinity Commercial |
$7.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$6.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.34
|
| Rate for Payer: Healthscope Commercial |
$8.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.80
|
| Rate for Payer: PHP Commercial |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.97
|
| Rate for Payer: Priority Health SBD |
$5.78
|
| Rate for Payer: UMR Bronson Commercial |
$3.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.88
|
|
|
HC REFILL AND MAINTENANCE OF IMPLANTED PUMP
|
Facility
|
IP
|
$438.65
|
|
|
Service Code
|
HCPCS 96522
|
| Hospital Charge Code |
33500009
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$193.01 |
| Max. Negotiated Rate |
$394.78 |
| Rate for Payer: Aetna American Axle |
$285.12
|
| Rate for Payer: Aetna Commercial |
$372.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.12
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$307.06
|
| Rate for Payer: Cofinity Commercial |
$377.24
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Healthscope Commercial |
$394.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: PHP Commercial |
$372.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health SBD |
$276.35
|
| Rate for Payer: UMR Bronson Commercial |
$193.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.99
|
|
|
HC REFILL AND MAINTENANCE OF IMPLANTED PUMP
|
Facility
|
OP
|
$438.65
|
|
|
Service Code
|
HCPCS 96522
|
| Hospital Charge Code |
33500009
|
|
Hospital Revenue Code
|
335
|
| Min. Negotiated Rate |
$106.51 |
| Max. Negotiated Rate |
$648.80 |
| Rate for Payer: Aetna American Axle |
$285.12
|
| Rate for Payer: Aetna Commercial |
$372.85
|
| Rate for Payer: Aetna Medicare |
$214.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$285.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.04
|
| Rate for Payer: BCBS Complete |
$116.18
|
| Rate for Payer: BCBS MAPPO |
$206.43
|
| Rate for Payer: BCBS Trust/PPO |
$617.20
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: BCN Medicare Advantage |
$206.43
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cash Price |
$350.92
|
| Rate for Payer: Cofinity Commercial |
$377.24
|
| Rate for Payer: Cofinity Commercial |
$307.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$307.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.43
|
| Rate for Payer: Healthscope Commercial |
$394.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$307.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.99
|
| Rate for Payer: Mclaren Medicaid |
$110.65
|
| Rate for Payer: Mclaren Medicare |
$206.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.75
|
| Rate for Payer: Meridian Medicaid |
$116.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.85
|
| Rate for Payer: Nomi Health Commercial |
$619.29
|
| Rate for Payer: PACE Medicare |
$196.11
|
| Rate for Payer: PACE SWMI |
$206.43
|
| Rate for Payer: PHP Commercial |
$372.85
|
| Rate for Payer: PHP Medicare Advantage |
$206.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$285.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$648.80
|
| Rate for Payer: Priority Health Medicare |
$206.43
|
| Rate for Payer: Priority Health Narrow Network |
$519.04
|
| Rate for Payer: Priority Health SBD |
$276.35
|
| Rate for Payer: Railroad Medicare Medicare |
$206.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.16
|
| Rate for Payer: UHC Core |
$284.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.43
|
| Rate for Payer: UHC Exchange |
$106.51
|
| Rate for Payer: UHC Medicare Advantage |
$206.43
|
| Rate for Payer: UHCCP Medicaid |
$110.65
|
| Rate for Payer: UMR Bronson Commercial |
$162.30
|
| Rate for Payer: VA VA |
$206.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.99
|
|
|
HC REFILL AND MAINTENANCE OF PORT PUMP
|
Facility
|
OP
|
$881.99
|
|
|
Service Code
|
CPT 96521
|
| Hospital Charge Code |
33500008
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$110.65 |
| Max. Negotiated Rate |
$793.79 |
| Rate for Payer: Aetna American Axle |
$573.29
|
| Rate for Payer: Aetna Commercial |
$749.69
|
| Rate for Payer: Aetna Medicare |
$214.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$258.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$258.04
|
| Rate for Payer: BCBS Complete |
$116.18
|
| Rate for Payer: BCBS MAPPO |
$206.43
|
| Rate for Payer: BCBS Trust/PPO |
$650.42
|
| Rate for Payer: BCN Commercial |
$650.42
|
| Rate for Payer: BCN Medicare Advantage |
$206.43
|
| Rate for Payer: Cash Price |
$705.59
|
| Rate for Payer: Cash Price |
$705.59
|
| Rate for Payer: Cofinity Commercial |
$758.51
|
| Rate for Payer: Cofinity Commercial |
$617.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$617.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$705.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$206.43
|
| Rate for Payer: Healthscope Commercial |
$793.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$617.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$661.49
|
| Rate for Payer: Mclaren Medicaid |
$110.65
|
| Rate for Payer: Mclaren Medicare |
$206.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$216.75
|
| Rate for Payer: Meridian Medicaid |
$116.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$237.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.69
|
| Rate for Payer: Nomi Health Commercial |
$619.29
|
| Rate for Payer: PACE Medicare |
$196.11
|
| Rate for Payer: PACE SWMI |
$206.43
|
| Rate for Payer: PHP Commercial |
$749.69
|
| Rate for Payer: PHP Medicare Advantage |
$206.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$110.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$648.80
|
| Rate for Payer: Priority Health Medicare |
$206.43
|
| Rate for Payer: Priority Health Narrow Network |
$519.04
|
| Rate for Payer: Priority Health SBD |
$555.65
|
| Rate for Payer: Railroad Medicare Medicare |
$206.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.40
|
| Rate for Payer: UHC Core |
$250.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$206.43
|
| Rate for Payer: UHC Exchange |
$112.18
|
| Rate for Payer: UHC Medicare Advantage |
$206.43
|
| Rate for Payer: UHCCP Medicaid |
$110.65
|
| Rate for Payer: UMR Bronson Commercial |
$326.34
|
| Rate for Payer: VA VA |
$206.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$661.49
|
|
|
HC REFILL AND MAINTENANCE OF PORT PUMP
|
Facility
|
IP
|
$881.99
|
|
|
Service Code
|
CPT 96521
|
| Hospital Charge Code |
33500008
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$388.08 |
| Max. Negotiated Rate |
$793.79 |
| Rate for Payer: Aetna American Axle |
$573.29
|
| Rate for Payer: Aetna Commercial |
$749.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$573.29
|
| Rate for Payer: Cash Price |
$705.59
|
| Rate for Payer: Cofinity Commercial |
$617.39
|
| Rate for Payer: Cofinity Commercial |
$758.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$617.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$705.59
|
| Rate for Payer: Healthscope Commercial |
$793.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$617.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$661.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$749.69
|
| Rate for Payer: PHP Commercial |
$749.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$573.29
|
| Rate for Payer: Priority Health SBD |
$555.65
|
| Rate for Payer: UMR Bronson Commercial |
$388.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$661.49
|
|
|
HC REFILL AND REPROGRAM INTRATHECAL INF PUMP
|
Facility
|
OP
|
$421.57
|
|
|
Service Code
|
CPT 62370
|
| Hospital Charge Code |
36100587
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$44.05 |
| Max. Negotiated Rate |
$923.56 |
| Rate for Payer: Aetna American Axle |
$274.02
|
| Rate for Payer: Aetna Commercial |
$358.33
|
| Rate for Payer: Aetna Medicare |
$305.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$367.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$367.31
|
| Rate for Payer: BCBS Complete |
$165.38
|
| Rate for Payer: BCBS MAPPO |
$293.85
|
| Rate for Payer: BCBS Trust/PPO |
$310.29
|
| Rate for Payer: BCN Commercial |
$310.29
|
| Rate for Payer: BCN Medicare Advantage |
$293.85
|
| Rate for Payer: Cash Price |
$337.26
|
| Rate for Payer: Cash Price |
$337.26
|
| Rate for Payer: Cash Price |
$337.26
|
| Rate for Payer: Cofinity Commercial |
$295.10
|
| Rate for Payer: Cofinity Commercial |
$362.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$295.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$293.85
|
| Rate for Payer: Healthscope Commercial |
$379.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$295.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.18
|
| Rate for Payer: Mclaren Medicaid |
$157.50
|
| Rate for Payer: Mclaren Medicare |
$293.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$308.54
|
| Rate for Payer: Meridian Medicaid |
$165.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$337.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.33
|
| Rate for Payer: Nomi Health Commercial |
$881.55
|
| Rate for Payer: PACE Medicare |
$279.16
|
| Rate for Payer: PACE SWMI |
$293.85
|
| Rate for Payer: PHP Commercial |
$358.33
|
| Rate for Payer: PHP Medicare Advantage |
$293.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$157.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.02
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$923.56
|
| Rate for Payer: Priority Health Medicare |
$293.85
|
| Rate for Payer: Priority Health Narrow Network |
$738.85
|
| Rate for Payer: Priority Health SBD |
$265.59
|
| Rate for Payer: Railroad Medicare Medicare |
$293.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.46
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$293.85
|
| Rate for Payer: UHC Exchange |
$44.05
|
| Rate for Payer: UHC Medicare Advantage |
$293.85
|
| Rate for Payer: UHCCP Medicaid |
$157.50
|
| Rate for Payer: UMR Bronson Commercial |
$155.98
|
| Rate for Payer: VA VA |
$293.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.18
|
|
|
HC REFILL AND REPROGRAM INTRATHECAL INF PUMP
|
Facility
|
IP
|
$421.57
|
|
|
Service Code
|
CPT 62370
|
| Hospital Charge Code |
36100587
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$185.49 |
| Max. Negotiated Rate |
$379.41 |
| Rate for Payer: Aetna American Axle |
$274.02
|
| Rate for Payer: Aetna Commercial |
$358.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.02
|
| Rate for Payer: Cash Price |
$337.26
|
| Rate for Payer: Cofinity Commercial |
$295.10
|
| Rate for Payer: Cofinity Commercial |
$362.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$295.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.26
|
| Rate for Payer: Healthscope Commercial |
$379.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$295.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.33
|
| Rate for Payer: PHP Commercial |
$358.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.02
|
| Rate for Payer: Priority Health SBD |
$265.59
|
| Rate for Payer: UMR Bronson Commercial |
$185.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.18
|
|
|
HC REFLEX BETHESDA UNITS
|
Facility
|
OP
|
$155.02
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$139.52 |
| Rate for Payer: Aetna American Axle |
$100.76
|
| Rate for Payer: Aetna Commercial |
$131.77
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$12.40
|
| Rate for Payer: BCN Commercial |
$12.40
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$124.02
|
| Rate for Payer: Cash Price |
$124.02
|
| Rate for Payer: Cofinity Commercial |
$133.32
|
| Rate for Payer: Cofinity Commercial |
$108.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$139.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.26
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.77
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$131.77
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$10.60
|
| Rate for Payer: Priority Health SBD |
$97.66
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$12.87
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$57.36
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.26
|
|
|
HC REFLEX BETHESDA UNITS
|
Facility
|
IP
|
$155.02
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500042
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$68.21 |
| Max. Negotiated Rate |
$139.52 |
| Rate for Payer: Aetna American Axle |
$100.76
|
| Rate for Payer: Aetna Commercial |
$131.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$100.76
|
| Rate for Payer: Cash Price |
$124.02
|
| Rate for Payer: Cofinity Commercial |
$108.51
|
| Rate for Payer: Cofinity Commercial |
$133.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$108.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.02
|
| Rate for Payer: Healthscope Commercial |
$139.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$108.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.77
|
| Rate for Payer: PHP Commercial |
$131.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.76
|
| Rate for Payer: Priority Health SBD |
$97.66
|
| Rate for Payer: UMR Bronson Commercial |
$68.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.26
|
|
|
HC REFLEX COAG FACTOR VIII INHIBITOR
|
Facility
|
IP
|
$320.44
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500043
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$140.99 |
| Max. Negotiated Rate |
$288.40 |
| Rate for Payer: Aetna American Axle |
$208.29
|
| Rate for Payer: Aetna Commercial |
$272.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.29
|
| Rate for Payer: Cash Price |
$256.35
|
| Rate for Payer: Cofinity Commercial |
$224.31
|
| Rate for Payer: Cofinity Commercial |
$275.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.35
|
| Rate for Payer: Healthscope Commercial |
$288.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.37
|
| Rate for Payer: PHP Commercial |
$272.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.29
|
| Rate for Payer: Priority Health SBD |
$201.88
|
| Rate for Payer: UMR Bronson Commercial |
$140.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.33
|
|
|
HC REFLEX COAG FACTOR VIII INHIBITOR
|
Facility
|
OP
|
$320.44
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30500043
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.90 |
| Max. Negotiated Rate |
$288.40 |
| Rate for Payer: Aetna American Axle |
$208.29
|
| Rate for Payer: Aetna Commercial |
$272.37
|
| Rate for Payer: Aetna Medicare |
$13.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$208.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.09
|
| Rate for Payer: BCBS Complete |
$7.24
|
| Rate for Payer: BCBS MAPPO |
$12.87
|
| Rate for Payer: BCBS Trust/PPO |
$12.40
|
| Rate for Payer: BCN Commercial |
$12.40
|
| Rate for Payer: BCN Medicare Advantage |
$12.87
|
| Rate for Payer: Cash Price |
$256.35
|
| Rate for Payer: Cash Price |
$256.35
|
| Rate for Payer: Cofinity Commercial |
$275.58
|
| Rate for Payer: Cofinity Commercial |
$224.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$224.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$256.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.87
|
| Rate for Payer: Healthscope Commercial |
$288.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$224.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$240.33
|
| Rate for Payer: Mclaren Medicaid |
$6.90
|
| Rate for Payer: Mclaren Medicare |
$12.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.51
|
| Rate for Payer: Meridian Medicaid |
$7.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$272.37
|
| Rate for Payer: Nomi Health Commercial |
$19.30
|
| Rate for Payer: PACE Medicare |
$12.23
|
| Rate for Payer: PACE SWMI |
$12.87
|
| Rate for Payer: PHP Commercial |
$272.37
|
| Rate for Payer: PHP Medicare Advantage |
$12.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$208.29
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.25
|
| Rate for Payer: Priority Health Medicare |
$12.87
|
| Rate for Payer: Priority Health Narrow Network |
$10.60
|
| Rate for Payer: Priority Health SBD |
$201.88
|
| Rate for Payer: Railroad Medicare Medicare |
$12.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.87
|
| Rate for Payer: UHC Exchange |
$12.87
|
| Rate for Payer: UHC Medicare Advantage |
$12.87
|
| Rate for Payer: UHCCP Medicaid |
$6.90
|
| Rate for Payer: UMR Bronson Commercial |
$118.56
|
| Rate for Payer: VA VA |
$12.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$240.33
|
|
|
HC REG/SEDAT ADDL 15 MIN
|
Facility
|
IP
|
$117.78
|
|
| Hospital Charge Code |
37000011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$51.82 |
| Max. Negotiated Rate |
$106.00 |
| Rate for Payer: Aetna American Axle |
$76.56
|
| Rate for Payer: Aetna Commercial |
$100.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.56
|
| Rate for Payer: Cash Price |
$94.22
|
| Rate for Payer: Cofinity Commercial |
$101.29
|
| Rate for Payer: Cofinity Commercial |
$82.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.22
|
| Rate for Payer: Healthscope Commercial |
$106.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.11
|
| Rate for Payer: PHP Commercial |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.56
|
| Rate for Payer: Priority Health SBD |
$74.20
|
| Rate for Payer: UMR Bronson Commercial |
$51.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.34
|
|
|
HC REG/SEDAT ADDL 15 MIN
|
Facility
|
OP
|
$117.78
|
|
| Hospital Charge Code |
37000011
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$43.58 |
| Max. Negotiated Rate |
$106.00 |
| Rate for Payer: Aetna American Axle |
$76.56
|
| Rate for Payer: Aetna Commercial |
$100.11
|
| Rate for Payer: Aetna Medicare |
$58.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$76.56
|
| Rate for Payer: BCBS Complete |
$47.11
|
| Rate for Payer: Cash Price |
$94.22
|
| Rate for Payer: Cofinity Commercial |
$101.29
|
| Rate for Payer: Cofinity Commercial |
$82.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$82.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.22
|
| Rate for Payer: Healthscope Commercial |
$106.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$82.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.11
|
| Rate for Payer: PHP Commercial |
$100.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.56
|
| Rate for Payer: Priority Health SBD |
$74.20
|
| Rate for Payer: UMR Bronson Commercial |
$43.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.34
|
|
|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
OP
|
$595.78
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$220.44 |
| Max. Negotiated Rate |
$536.20 |
| Rate for Payer: Aetna American Axle |
$387.26
|
| Rate for Payer: Aetna Commercial |
$506.41
|
| Rate for Payer: Aetna Medicare |
$297.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.26
|
| Rate for Payer: BCBS Complete |
$238.31
|
| Rate for Payer: Cash Price |
$476.62
|
| Rate for Payer: Cofinity Commercial |
$417.05
|
| Rate for Payer: Cofinity Commercial |
$512.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.62
|
| Rate for Payer: Healthscope Commercial |
$536.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.41
|
| Rate for Payer: PHP Commercial |
$506.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.26
|
| Rate for Payer: Priority Health SBD |
$375.34
|
| Rate for Payer: UMR Bronson Commercial |
$220.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.84
|
|
|
HC REG/SEDAT INIT 30 MIN
|
Facility
|
IP
|
$595.78
|
|
| Hospital Charge Code |
37000012
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$262.14 |
| Max. Negotiated Rate |
$536.20 |
| Rate for Payer: Aetna American Axle |
$387.26
|
| Rate for Payer: Aetna Commercial |
$506.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$387.26
|
| Rate for Payer: Cash Price |
$476.62
|
| Rate for Payer: Cofinity Commercial |
$417.05
|
| Rate for Payer: Cofinity Commercial |
$512.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$417.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.62
|
| Rate for Payer: Healthscope Commercial |
$536.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$417.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$506.41
|
| Rate for Payer: PHP Commercial |
$506.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$387.26
|
| Rate for Payer: Priority Health SBD |
$375.34
|
| Rate for Payer: UMR Bronson Commercial |
$262.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.84
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Facility
|
IP
|
$107.10
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$47.12 |
| Max. Negotiated Rate |
$96.39 |
| Rate for Payer: Aetna American Axle |
$69.62
|
| Rate for Payer: Aetna Commercial |
$91.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.62
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: PHP Commercial |
$91.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: UMR Bronson Commercial |
$47.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.32
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D
|
Facility
|
OP
|
$107.10
|
|
|
Service Code
|
CPT 99454
|
| Hospital Charge Code |
51000110
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$19.59 |
| Max. Negotiated Rate |
$198.74 |
| Rate for Payer: Aetna American Axle |
$69.62
|
| Rate for Payer: Aetna Commercial |
$91.04
|
| Rate for Payer: Aetna Medicare |
$38.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$69.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.68
|
| Rate for Payer: BCBS Complete |
$20.56
|
| Rate for Payer: BCBS MAPPO |
$36.54
|
| Rate for Payer: BCBS Trust/PPO |
$198.74
|
| Rate for Payer: BCN Commercial |
$198.74
|
| Rate for Payer: BCN Medicare Advantage |
$36.54
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cash Price |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$74.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$74.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.54
|
| Rate for Payer: Healthscope Commercial |
$96.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$74.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.32
|
| Rate for Payer: Mclaren Medicaid |
$19.59
|
| Rate for Payer: Mclaren Medicare |
$36.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.37
|
| Rate for Payer: Meridian Medicaid |
$20.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.04
|
| Rate for Payer: Nomi Health Commercial |
$109.62
|
| Rate for Payer: PACE Medicare |
$34.71
|
| Rate for Payer: PACE SWMI |
$36.54
|
| Rate for Payer: PHP Commercial |
$91.04
|
| Rate for Payer: PHP Medicare Advantage |
$36.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$69.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.83
|
| Rate for Payer: Priority Health Medicare |
$36.54
|
| Rate for Payer: Priority Health Narrow Network |
$91.86
|
| Rate for Payer: Priority Health SBD |
$67.47
|
| Rate for Payer: Railroad Medicare Medicare |
$36.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.54
|
| Rate for Payer: UHC Exchange |
$42.44
|
| Rate for Payer: UHC Medicare Advantage |
$36.54
|
| Rate for Payer: UHCCP Medicaid |
$19.59
|
| Rate for Payer: UMR Bronson Commercial |
$39.63
|
| Rate for Payer: VA VA |
$36.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.32
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
OP
|
$346.80
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$18.07 |
| Max. Negotiated Rate |
$396.84 |
| Rate for Payer: Aetna American Axle |
$225.42
|
| Rate for Payer: Aetna Commercial |
$294.78
|
| Rate for Payer: Aetna Medicare |
$131.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.82
|
| Rate for Payer: BCBS Complete |
$71.06
|
| Rate for Payer: BCBS MAPPO |
$126.26
|
| Rate for Payer: BCBS Trust/PPO |
$81.75
|
| Rate for Payer: BCN Commercial |
$81.75
|
| Rate for Payer: BCN Medicare Advantage |
$126.26
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cofinity Commercial |
$298.25
|
| Rate for Payer: Cofinity Commercial |
$242.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$242.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$312.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.10
|
| Rate for Payer: Mclaren Medicaid |
$67.68
|
| Rate for Payer: Mclaren Medicare |
$126.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.57
|
| Rate for Payer: Meridian Medicaid |
$71.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.78
|
| Rate for Payer: Nomi Health Commercial |
$378.78
|
| Rate for Payer: PACE Medicare |
$119.95
|
| Rate for Payer: PACE SWMI |
$126.26
|
| Rate for Payer: PHP Commercial |
$294.78
|
| Rate for Payer: PHP Medicare Advantage |
$126.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.84
|
| Rate for Payer: Priority Health Medicare |
$126.26
|
| Rate for Payer: Priority Health Narrow Network |
$317.47
|
| Rate for Payer: Priority Health SBD |
$218.48
|
| Rate for Payer: Railroad Medicare Medicare |
$126.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.26
|
| Rate for Payer: UHC Exchange |
$18.07
|
| Rate for Payer: UHC Medicare Advantage |
$126.26
|
| Rate for Payer: UHCCP Medicaid |
$67.68
|
| Rate for Payer: UMR Bronson Commercial |
$128.32
|
| Rate for Payer: VA VA |
$126.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.10
|
|
|
HC REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP
|
Facility
|
IP
|
$346.80
|
|
|
Service Code
|
CPT 99453
|
| Hospital Charge Code |
51000111
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$152.59 |
| Max. Negotiated Rate |
$312.12 |
| Rate for Payer: Aetna American Axle |
$225.42
|
| Rate for Payer: Aetna Commercial |
$294.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$225.42
|
| Rate for Payer: Cash Price |
$277.44
|
| Rate for Payer: Cofinity Commercial |
$242.76
|
| Rate for Payer: Cofinity Commercial |
$298.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$242.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$277.44
|
| Rate for Payer: Healthscope Commercial |
$312.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$242.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.78
|
| Rate for Payer: PHP Commercial |
$294.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$225.42
|
| Rate for Payer: Priority Health SBD |
$218.48
|
| Rate for Payer: UMR Bronson Commercial |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.10
|
|
|
HC REMOTE THER MON DEVICE SUPPLY MS EA 30 DAY
|
Facility
|
OP
|
$114.75
|
|
|
Service Code
|
CPT 98977
|
| Hospital Charge Code |
42000063
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.59 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$74.59
|
| Rate for Payer: Aetna Commercial |
$97.54
|
| Rate for Payer: Aetna Medicare |
$38.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.68
|
| Rate for Payer: BCBS Complete |
$20.56
|
| Rate for Payer: BCBS MAPPO |
$36.54
|
| Rate for Payer: BCBS Trust/PPO |
$198.74
|
| Rate for Payer: BCN Commercial |
$198.74
|
| Rate for Payer: BCN Medicare Advantage |
$36.54
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Cofinity Commercial |
$98.68
|
| Rate for Payer: Cofinity Commercial |
$80.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.54
|
| Rate for Payer: Healthscope Commercial |
$103.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.06
|
| Rate for Payer: Mclaren Medicaid |
$19.59
|
| Rate for Payer: Mclaren Medicare |
$36.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.37
|
| Rate for Payer: Meridian Medicaid |
$20.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.54
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PACE Medicare |
$34.71
|
| Rate for Payer: PACE SWMI |
$36.54
|
| Rate for Payer: PHP Commercial |
$97.54
|
| Rate for Payer: PHP Medicare Advantage |
$36.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.83
|
| Rate for Payer: Priority Health Medicare |
$36.54
|
| Rate for Payer: Priority Health Narrow Network |
$91.86
|
| Rate for Payer: Priority Health SBD |
$72.29
|
| Rate for Payer: Railroad Medicare Medicare |
$36.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.68
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.54
|
| Rate for Payer: UHC Exchange |
$42.44
|
| Rate for Payer: UHC Medicare Advantage |
$36.54
|
| Rate for Payer: UHCCP Medicaid |
$19.59
|
| Rate for Payer: UMR Bronson Commercial |
$42.46
|
| Rate for Payer: VA VA |
$36.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.06
|
|
