|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
IP
|
$508.92
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$223.92 |
| Max. Negotiated Rate |
$458.03 |
| Rate for Payer: Aetna American Axle |
$330.80
|
| Rate for Payer: Aetna Commercial |
$432.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.80
|
| Rate for Payer: Cash Price |
$407.14
|
| Rate for Payer: Cofinity Advantage |
$356.24
|
| Rate for Payer: Cofinity Commercial |
$437.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.14
|
| Rate for Payer: Healthscope Commercial |
$458.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$356.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.69
|
| Rate for Payer: PHP Commercial |
$432.58
|
| Rate for Payer: Priority Health SBD |
$320.62
|
| Rate for Payer: UMR Bronson Commercial |
$223.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.69
|
|
|
HC SQ IM CHEMO NON-HORMONAL
|
Facility
|
OP
|
$508.92
|
|
|
Service Code
|
CPT 96401
|
| Hospital Charge Code |
33100001
|
|
Hospital Revenue Code
|
331
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$458.03 |
| Rate for Payer: Aetna American Axle |
$330.80
|
| Rate for Payer: Aetna Commercial |
$432.58
|
| Rate for Payer: Aetna Medicare |
$74.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$330.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.67
|
| Rate for Payer: BCBS Complete |
$39.40
|
| Rate for Payer: BCBS MAPPO |
$71.74
|
| Rate for Payer: BCBS Trust/PPO |
$347.48
|
| Rate for Payer: BCN Commercial |
$347.48
|
| Rate for Payer: BCN Medicare Advantage |
$71.74
|
| Rate for Payer: Cash Price |
$407.14
|
| Rate for Payer: Cash Price |
$407.14
|
| Rate for Payer: Cofinity Advantage |
$356.24
|
| Rate for Payer: Cofinity Commercial |
$437.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$407.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.74
|
| Rate for Payer: Healthscope Commercial |
$458.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$356.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$381.69
|
| Rate for Payer: Mclaren Medicaid |
$71.74
|
| Rate for Payer: Mclaren Medicare |
$71.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.33
|
| Rate for Payer: Meridian Medicaid |
$75.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$432.58
|
| Rate for Payer: Nomi Health Commercial |
$215.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$381.69
|
| Rate for Payer: PACE Medicare |
$68.15
|
| Rate for Payer: PACE SWMI |
$71.74
|
| Rate for Payer: PHP Commercial |
$432.58
|
| Rate for Payer: PHP Medicare Advantage |
$71.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$232.01
|
| Rate for Payer: Priority Health Medicare |
$71.74
|
| Rate for Payer: Priority Health SBD |
$320.62
|
| Rate for Payer: Priority Health Tiered Network |
$185.61
|
| Rate for Payer: Railroad Medicare Medicare |
$71.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.80
|
| Rate for Payer: UHC Core |
$265.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.74
|
| Rate for Payer: UHC Exchange |
$200.01
|
| Rate for Payer: UHC Medicaid |
$37.52
|
| Rate for Payer: UHCCP Medicaid |
$37.52
|
| Rate for Payer: UMR Bronson Commercial |
$188.30
|
| Rate for Payer: VA VA |
$71.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$381.69
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
OP
|
$152.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$37.52 |
| Max. Negotiated Rate |
$232.01 |
| Rate for Payer: Aetna American Axle |
$99.31
|
| Rate for Payer: Aetna Commercial |
$129.87
|
| Rate for Payer: Aetna Medicare |
$74.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.67
|
| Rate for Payer: BCBS Complete |
$39.40
|
| Rate for Payer: BCBS MAPPO |
$71.74
|
| Rate for Payer: BCBS Trust/PPO |
$48.85
|
| Rate for Payer: BCN Commercial |
$48.85
|
| Rate for Payer: BCN Medicare Advantage |
$71.74
|
| Rate for Payer: Cash Price |
$122.23
|
| Rate for Payer: Cash Price |
$122.23
|
| Rate for Payer: Cofinity Advantage |
$106.95
|
| Rate for Payer: Cofinity Commercial |
$131.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.74
|
| Rate for Payer: Healthscope Commercial |
$137.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.59
|
| Rate for Payer: Mclaren Medicaid |
$71.74
|
| Rate for Payer: Mclaren Medicare |
$71.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.33
|
| Rate for Payer: Meridian Medicaid |
$75.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.87
|
| Rate for Payer: Nomi Health Commercial |
$215.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.59
|
| Rate for Payer: PACE Medicare |
$68.15
|
| Rate for Payer: PACE SWMI |
$71.74
|
| Rate for Payer: PHP Commercial |
$129.87
|
| Rate for Payer: PHP Medicare Advantage |
$71.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$232.01
|
| Rate for Payer: Priority Health Medicare |
$71.74
|
| Rate for Payer: Priority Health SBD |
$96.26
|
| Rate for Payer: Priority Health Tiered Network |
$185.61
|
| Rate for Payer: Railroad Medicare Medicare |
$71.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.31
|
| Rate for Payer: UHC Core |
$79.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$71.74
|
| Rate for Payer: UHC Exchange |
$60.05
|
| Rate for Payer: UHC Medicaid |
$37.52
|
| Rate for Payer: UHCCP Medicaid |
$37.52
|
| Rate for Payer: UMR Bronson Commercial |
$56.53
|
| Rate for Payer: VA VA |
$71.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.59
|
|
|
HC SQ OR IM INJECTION
|
Facility
|
IP
|
$152.79
|
|
|
Service Code
|
CPT 96372
|
| Hospital Charge Code |
51000003
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$67.23 |
| Max. Negotiated Rate |
$137.51 |
| Rate for Payer: Aetna American Axle |
$99.31
|
| Rate for Payer: Aetna Commercial |
$129.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$99.31
|
| Rate for Payer: Cash Price |
$122.23
|
| Rate for Payer: Cofinity Advantage |
$106.95
|
| Rate for Payer: Cofinity Commercial |
$131.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$122.23
|
| Rate for Payer: Healthscope Commercial |
$137.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$114.59
|
| Rate for Payer: PHP Commercial |
$129.87
|
| Rate for Payer: Priority Health SBD |
$96.26
|
| Rate for Payer: UMR Bronson Commercial |
$67.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$114.59
|
|
|
HC SRA, LMWH
|
Facility
|
OP
|
$339.59
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$305.63 |
| Rate for Payer: Aetna American Axle |
$220.73
|
| Rate for Payer: Aetna Commercial |
$288.65
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$21.24
|
| Rate for Payer: BCN Commercial |
$21.24
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cofinity Advantage |
$237.71
|
| Rate for Payer: Cofinity Commercial |
$292.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$305.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.69
|
| Rate for Payer: Mclaren Medicaid |
$18.37
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$19.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.65
|
| Rate for Payer: Nomi Health Commercial |
$27.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.69
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$288.65
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health SBD |
$213.94
|
| Rate for Payer: Priority Health Tiered Network |
$14.70
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.56
|
| Rate for Payer: UHC Core |
$27.56
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.37
|
| Rate for Payer: UHC Exchange |
$27.56
|
| Rate for Payer: UHC Medicaid |
$9.61
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$125.65
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.69
|
|
|
HC SRA, LMWH
|
Facility
|
IP
|
$339.59
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200424
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$149.42 |
| Max. Negotiated Rate |
$305.63 |
| Rate for Payer: Aetna American Axle |
$220.73
|
| Rate for Payer: Aetna Commercial |
$288.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$220.73
|
| Rate for Payer: Cash Price |
$271.67
|
| Rate for Payer: Cofinity Advantage |
$237.71
|
| Rate for Payer: Cofinity Commercial |
$292.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.67
|
| Rate for Payer: Healthscope Commercial |
$305.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$237.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$254.69
|
| Rate for Payer: PHP Commercial |
$288.65
|
| Rate for Payer: Priority Health SBD |
$213.94
|
| Rate for Payer: UMR Bronson Commercial |
$149.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.69
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
IP
|
$3,163.46
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,391.92 |
| Max. Negotiated Rate |
$2,847.11 |
| Rate for Payer: Aetna American Axle |
$2,056.25
|
| Rate for Payer: Aetna Commercial |
$2,688.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,056.25
|
| Rate for Payer: Cash Price |
$2,530.77
|
| Rate for Payer: Cofinity Advantage |
$2,214.42
|
| Rate for Payer: Cofinity Commercial |
$2,720.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,530.77
|
| Rate for Payer: Healthscope Commercial |
$2,847.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,214.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,372.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,688.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,372.59
|
| Rate for Payer: PHP Commercial |
$2,688.94
|
| Rate for Payer: Priority Health SBD |
$1,992.98
|
| Rate for Payer: UMR Bronson Commercial |
$1,391.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,372.59
|
|
|
HC SRS CRANIAL LESION LIN ACC
|
Facility
|
OP
|
$3,163.46
|
|
|
Service Code
|
CPT 77372
|
| Hospital Charge Code |
33300032
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$1,170.48 |
| Max. Negotiated Rate |
$23,733.03 |
| Rate for Payer: Aetna American Axle |
$2,056.25
|
| Rate for Payer: Aetna Commercial |
$2,688.94
|
| Rate for Payer: Aetna Medicare |
$7,632.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,056.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9,173.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9,173.51
|
| Rate for Payer: BCBS Complete |
$4,030.47
|
| Rate for Payer: BCBS MAPPO |
$7,338.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,294.41
|
| Rate for Payer: BCN Commercial |
$2,294.41
|
| Rate for Payer: BCN Medicare Advantage |
$7,338.81
|
| Rate for Payer: Cash Price |
$2,530.77
|
| Rate for Payer: Cash Price |
$2,530.77
|
| Rate for Payer: Cofinity Advantage |
$2,214.42
|
| Rate for Payer: Cofinity Commercial |
$2,720.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,530.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7,338.81
|
| Rate for Payer: Healthscope Commercial |
$2,847.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,214.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,372.59
|
| Rate for Payer: Mclaren Medicaid |
$7,338.81
|
| Rate for Payer: Mclaren Medicare |
$7,338.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,705.75
|
| Rate for Payer: Meridian Medicaid |
$7,705.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8,439.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$8,072.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,688.94
|
| Rate for Payer: Nomi Health Commercial |
$22,016.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,372.59
|
| Rate for Payer: PACE Medicare |
$6,971.87
|
| Rate for Payer: PACE SWMI |
$7,338.81
|
| Rate for Payer: PHP Commercial |
$2,688.94
|
| Rate for Payer: PHP Medicare Advantage |
$7,338.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,838.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$23,733.03
|
| Rate for Payer: Priority Health Medicare |
$7,338.81
|
| Rate for Payer: Priority Health SBD |
$1,992.98
|
| Rate for Payer: Priority Health Tiered Network |
$18,986.42
|
| Rate for Payer: Railroad Medicare Medicare |
$7,338.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$7,338.81
|
| Rate for Payer: UHC Medicaid |
$3,838.20
|
| Rate for Payer: UHCCP Medicaid |
$3,838.20
|
| Rate for Payer: UMR Bronson Commercial |
$1,170.48
|
| Rate for Payer: VA VA |
$7,338.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,372.59
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
IP
|
$5,412.16
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,381.35 |
| Max. Negotiated Rate |
$4,870.94 |
| Rate for Payer: Aetna American Axle |
$3,517.90
|
| Rate for Payer: Aetna Commercial |
$4,600.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,517.90
|
| Rate for Payer: Cash Price |
$4,329.73
|
| Rate for Payer: Cofinity Advantage |
$3,788.51
|
| Rate for Payer: Cofinity Commercial |
$4,654.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.73
|
| Rate for Payer: Healthscope Commercial |
$4,870.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,788.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,059.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,600.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,059.12
|
| Rate for Payer: PHP Commercial |
$4,600.34
|
| Rate for Payer: Priority Health SBD |
$3,409.66
|
| Rate for Payer: UMR Bronson Commercial |
$2,381.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,059.12
|
|
|
HC SRT UP TO 5 FRACTIONS
|
Facility
|
OP
|
$5,412.16
|
|
|
Service Code
|
CPT 77373
|
| Hospital Charge Code |
33300018
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$931.79 |
| Max. Negotiated Rate |
$5,761.61 |
| Rate for Payer: Aetna American Axle |
$3,517.90
|
| Rate for Payer: Aetna Commercial |
$4,600.34
|
| Rate for Payer: Aetna Medicare |
$1,852.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,517.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,227.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,227.03
|
| Rate for Payer: BCBS Complete |
$978.47
|
| Rate for Payer: BCBS MAPPO |
$1,781.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,409.33
|
| Rate for Payer: BCN Commercial |
$2,409.33
|
| Rate for Payer: BCN Medicare Advantage |
$1,781.62
|
| Rate for Payer: Cash Price |
$4,329.73
|
| Rate for Payer: Cash Price |
$4,329.73
|
| Rate for Payer: Cofinity Advantage |
$3,788.51
|
| Rate for Payer: Cofinity Commercial |
$4,654.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,329.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,781.62
|
| Rate for Payer: Healthscope Commercial |
$4,870.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,788.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,059.12
|
| Rate for Payer: Mclaren Medicaid |
$1,781.62
|
| Rate for Payer: Mclaren Medicare |
$1,781.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,870.70
|
| Rate for Payer: Meridian Medicaid |
$1,870.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,048.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,959.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,600.34
|
| Rate for Payer: Nomi Health Commercial |
$5,344.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,059.12
|
| Rate for Payer: PACE Medicare |
$1,692.54
|
| Rate for Payer: PACE SWMI |
$1,781.62
|
| Rate for Payer: PHP Commercial |
$4,600.34
|
| Rate for Payer: PHP Medicare Advantage |
$1,781.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$931.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,761.61
|
| Rate for Payer: Priority Health Medicare |
$1,781.62
|
| Rate for Payer: Priority Health SBD |
$3,409.66
|
| Rate for Payer: Priority Health Tiered Network |
$4,609.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,781.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,781.62
|
| Rate for Payer: UHC Medicaid |
$931.79
|
| Rate for Payer: UHCCP Medicaid |
$931.79
|
| Rate for Payer: UMR Bronson Commercial |
$2,002.50
|
| Rate for Payer: VA VA |
$1,781.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,059.12
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
OP
|
$114.44
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$42.34 |
| Max. Negotiated Rate |
$428.73 |
| Rate for Payer: Aetna American Axle |
$74.39
|
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna Medicare |
$137.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$165.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$165.71
|
| Rate for Payer: BCBS Complete |
$72.81
|
| Rate for Payer: BCBS MAPPO |
$132.57
|
| Rate for Payer: BCBS Trust/PPO |
$129.92
|
| Rate for Payer: BCN Commercial |
$129.92
|
| Rate for Payer: BCN Medicare Advantage |
$132.57
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Advantage |
$80.11
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$132.57
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Mclaren Medicaid |
$132.57
|
| Rate for Payer: Mclaren Medicare |
$132.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$139.20
|
| Rate for Payer: Meridian Medicaid |
$139.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$152.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$145.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Nomi Health Commercial |
$397.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PACE Medicare |
$125.94
|
| Rate for Payer: PACE SWMI |
$132.57
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: PHP Medicare Advantage |
$132.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$428.73
|
| Rate for Payer: Priority Health Medicare |
$132.57
|
| Rate for Payer: Priority Health SBD |
$72.10
|
| Rate for Payer: Priority Health Tiered Network |
$342.98
|
| Rate for Payer: Railroad Medicare Medicare |
$132.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$193.35
|
| Rate for Payer: UHC Core |
$193.35
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$132.57
|
| Rate for Payer: UHC Exchange |
$193.35
|
| Rate for Payer: UHC Medicaid |
$69.33
|
| Rate for Payer: UHCCP Medicaid |
$69.33
|
| Rate for Payer: UMR Bronson Commercial |
$42.34
|
| Rate for Payer: VA VA |
$132.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC SS2PC SPECIAL STAIN (BILL ONLY)
|
Facility
|
IP
|
$114.44
|
|
|
Service Code
|
CPT 88313
|
| Hospital Charge Code |
31200007
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$50.35 |
| Max. Negotiated Rate |
$103.00 |
| Rate for Payer: Aetna American Axle |
$74.39
|
| Rate for Payer: Aetna Commercial |
$97.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.39
|
| Rate for Payer: Cash Price |
$91.55
|
| Rate for Payer: Cofinity Advantage |
$80.11
|
| Rate for Payer: Cofinity Commercial |
$98.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$91.55
|
| Rate for Payer: Healthscope Commercial |
$103.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$85.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$85.83
|
| Rate for Payer: PHP Commercial |
$97.27
|
| Rate for Payer: Priority Health SBD |
$72.10
|
| Rate for Payer: UMR Bronson Commercial |
$50.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$85.83
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
OP
|
$951.97
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$352.23 |
| Max. Negotiated Rate |
$856.77 |
| Rate for Payer: Aetna American Axle |
$618.78
|
| Rate for Payer: Aetna Commercial |
$809.17
|
| Rate for Payer: Aetna Medicare |
$475.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.78
|
| Rate for Payer: BCBS Complete |
$380.79
|
| Rate for Payer: Cash Price |
$761.58
|
| Rate for Payer: Cofinity Advantage |
$666.38
|
| Rate for Payer: Cofinity Commercial |
$818.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.58
|
| Rate for Payer: Healthscope Commercial |
$856.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$666.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$761.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.98
|
| Rate for Payer: PHP Commercial |
$809.17
|
| Rate for Payer: Priority Health SBD |
$599.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$618.78
|
| Rate for Payer: UHC Core |
$495.98
|
| Rate for Payer: UHC Exchange |
$374.12
|
| Rate for Payer: UMR Bronson Commercial |
$352.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.98
|
|
|
HC STABILIZERS HEART ESTECH
|
Facility
|
IP
|
$951.97
|
|
| Hospital Charge Code |
27000292
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$418.87 |
| Max. Negotiated Rate |
$856.77 |
| Rate for Payer: Aetna American Axle |
$618.78
|
| Rate for Payer: Aetna Commercial |
$809.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$618.78
|
| Rate for Payer: Cash Price |
$761.58
|
| Rate for Payer: Cofinity Advantage |
$666.38
|
| Rate for Payer: Cofinity Commercial |
$818.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$761.58
|
| Rate for Payer: Healthscope Commercial |
$856.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$666.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$713.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$809.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$713.98
|
| Rate for Payer: PHP Commercial |
$809.17
|
| Rate for Payer: Priority Health SBD |
$599.74
|
| Rate for Payer: UMR Bronson Commercial |
$418.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$713.98
|
|
|
HC STACLOT LA.
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.40 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna American Axle |
$98.73
|
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna Medicare |
$18.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.48
|
| Rate for Payer: BCBS Complete |
$9.87
|
| Rate for Payer: BCBS MAPPO |
$17.98
|
| Rate for Payer: BCBS Trust/PPO |
$20.79
|
| Rate for Payer: BCN Commercial |
$20.79
|
| Rate for Payer: BCN Medicare Advantage |
$17.98
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Advantage |
$106.33
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.98
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Mclaren Medicaid |
$17.98
|
| Rate for Payer: Mclaren Medicare |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.88
|
| Rate for Payer: Meridian Medicaid |
$18.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$26.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PACE Medicare |
$17.08
|
| Rate for Payer: PACE SWMI |
$17.98
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: PHP Medicare Advantage |
$17.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.98
|
| Rate for Payer: Priority Health Medicare |
$17.98
|
| Rate for Payer: Priority Health SBD |
$95.70
|
| Rate for Payer: Priority Health Tiered Network |
$14.38
|
| Rate for Payer: Railroad Medicare Medicare |
$17.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.97
|
| Rate for Payer: UHC Core |
$26.97
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.98
|
| Rate for Payer: UHC Exchange |
$26.97
|
| Rate for Payer: UHC Medicaid |
$9.40
|
| Rate for Payer: UHCCP Medicaid |
$9.40
|
| Rate for Payer: UMR Bronson Commercial |
$56.20
|
| Rate for Payer: VA VA |
$17.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC STACLOT LA.
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 85597
|
| Hospital Charge Code |
30500085
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$66.84 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna American Axle |
$98.73
|
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$98.73
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Advantage |
$106.33
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$106.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: Priority Health SBD |
$95.70
|
| Rate for Payer: UMR Bronson Commercial |
$66.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
OP
|
$2,465.99
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$912.42 |
| Max. Negotiated Rate |
$2,219.39 |
| Rate for Payer: Aetna American Axle |
$1,602.89
|
| Rate for Payer: Aetna Commercial |
$2,096.09
|
| Rate for Payer: Aetna Medicare |
$1,232.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,602.89
|
| Rate for Payer: BCBS Complete |
$986.40
|
| Rate for Payer: Cash Price |
$1,972.79
|
| Rate for Payer: Cofinity Advantage |
$1,726.19
|
| Rate for Payer: Cofinity Commercial |
$2,120.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,972.79
|
| Rate for Payer: Healthscope Commercial |
$2,219.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,726.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,849.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,972.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,096.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,849.49
|
| Rate for Payer: PHP Commercial |
$2,096.09
|
| Rate for Payer: Priority Health SBD |
$1,553.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,602.89
|
| Rate for Payer: UHC Core |
$1,284.78
|
| Rate for Payer: UHC Exchange |
$969.13
|
| Rate for Payer: UMR Bronson Commercial |
$912.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,849.49
|
|
|
HC STANDBY OPEN HEART/TAVR
|
Facility
|
IP
|
$2,465.99
|
|
| Hospital Charge Code |
27000151
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,085.04 |
| Max. Negotiated Rate |
$2,219.39 |
| Rate for Payer: Aetna American Axle |
$1,602.89
|
| Rate for Payer: Aetna Commercial |
$2,096.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,602.89
|
| Rate for Payer: Cash Price |
$1,972.79
|
| Rate for Payer: Cofinity Advantage |
$1,726.19
|
| Rate for Payer: Cofinity Commercial |
$2,120.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,972.79
|
| Rate for Payer: Healthscope Commercial |
$2,219.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,726.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,849.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,096.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,849.49
|
| Rate for Payer: PHP Commercial |
$2,096.09
|
| Rate for Payer: Priority Health SBD |
$1,553.57
|
| Rate for Payer: UMR Bronson Commercial |
$1,085.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,849.49
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.18 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Advantage |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: UMR Bronson Commercial |
$25.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 87640
|
| Hospital Charge Code |
30600263
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$52.64 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Advantage |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.91
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.91
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$21.17
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.91
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.64 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna American Axle |
$40.83
|
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.83
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Advantage |
$43.97
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: Priority Health SBD |
$39.58
|
| Rate for Payer: UMR Bronson Commercial |
$27.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC STAPHYLOCOCCUS AUREUS PCR METHICILLIN RESISTANT
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87641
|
| Hospital Charge Code |
30600264
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna American Axle |
$40.83
|
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Advantage |
$43.97
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$35.09
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$39.58
|
| Rate for Payer: Priority Health Tiered Network |
$28.07
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$23.24
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC STATLOCK
|
Facility
|
IP
|
$146.56
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$64.49 |
| Max. Negotiated Rate |
$131.90 |
| Rate for Payer: Aetna American Axle |
$95.26
|
| Rate for Payer: Aetna Commercial |
$124.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.26
|
| Rate for Payer: Cash Price |
$117.25
|
| Rate for Payer: Cofinity Advantage |
$102.59
|
| Rate for Payer: Cofinity Commercial |
$126.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.25
|
| Rate for Payer: Healthscope Commercial |
$131.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.92
|
| Rate for Payer: PHP Commercial |
$124.58
|
| Rate for Payer: Priority Health SBD |
$92.33
|
| Rate for Payer: UMR Bronson Commercial |
$64.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.92
|
|
|
HC STATLOCK
|
Facility
|
OP
|
$146.56
|
|
| Hospital Charge Code |
27000152
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$54.23 |
| Max. Negotiated Rate |
$131.90 |
| Rate for Payer: Aetna American Axle |
$95.26
|
| Rate for Payer: Aetna Commercial |
$124.58
|
| Rate for Payer: Aetna Medicare |
$73.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$95.26
|
| Rate for Payer: BCBS Complete |
$58.62
|
| Rate for Payer: Cash Price |
$117.25
|
| Rate for Payer: Cofinity Advantage |
$102.59
|
| Rate for Payer: Cofinity Commercial |
$126.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$117.25
|
| Rate for Payer: Healthscope Commercial |
$131.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.92
|
| Rate for Payer: PHP Commercial |
$124.58
|
| Rate for Payer: Priority Health SBD |
$92.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.26
|
| Rate for Payer: UHC Core |
$76.36
|
| Rate for Payer: UHC Exchange |
$57.60
|
| Rate for Payer: UMR Bronson Commercial |
$54.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.92
|
|
|
HC STENGER TEST PURE TONE
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 92565
|
| Hospital Charge Code |
76100500
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$15.56 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna American Axle |
$22.99
|
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.99
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Advantage |
$24.76
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.53
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health SBD |
$22.28
|
| Rate for Payer: UMR Bronson Commercial |
$15.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
