|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
OP
|
$1,054.61
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$372.19 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$685.50
|
| Rate for Payer: Aetna Commercial |
$896.42
|
| Rate for Payer: Aetna Medicare |
$527.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.50
|
| Rate for Payer: BCBS Complete |
$421.84
|
| Rate for Payer: BCBS Trust/PPO |
$623.97
|
| Rate for Payer: BCN Commercial |
$623.97
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Cofinity Commercial |
$738.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$738.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.69
|
| Rate for Payer: Healthscope Commercial |
$949.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$738.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.42
|
| Rate for Payer: PHP Commercial |
$896.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.50
|
| Rate for Payer: Priority Health SBD |
$664.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$409.41
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Exchange |
$372.19
|
| Rate for Payer: UMR Bronson Commercial |
$390.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.96
|
|
|
HC RESPIRATORY MOTION SIMULATION
|
Facility
|
IP
|
$1,054.61
|
|
|
Service Code
|
CPT 77293
|
| Hospital Charge Code |
33300058
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$464.03 |
| Max. Negotiated Rate |
$949.15 |
| Rate for Payer: Aetna American Axle |
$685.50
|
| Rate for Payer: Aetna Commercial |
$896.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$685.50
|
| Rate for Payer: Cash Price |
$843.69
|
| Rate for Payer: Cofinity Commercial |
$738.23
|
| Rate for Payer: Cofinity Commercial |
$906.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$738.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$843.69
|
| Rate for Payer: Healthscope Commercial |
$949.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$738.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$790.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$896.42
|
| Rate for Payer: PHP Commercial |
$896.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$685.50
|
| Rate for Payer: Priority Health SBD |
$664.40
|
| Rate for Payer: UMR Bronson Commercial |
$464.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$790.96
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
OP
|
$101.59
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$91.43 |
| Rate for Payer: Aetna American Axle |
$66.03
|
| Rate for Payer: Aetna Commercial |
$86.35
|
| Rate for Payer: Aetna Medicare |
$13.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$12.63
|
| Rate for Payer: BCN Commercial |
$12.63
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$87.37
|
| Rate for Payer: Cofinity Commercial |
$71.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$91.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.19
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.35
|
| Rate for Payer: Nomi Health Commercial |
$19.65
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$86.35
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.10
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health Narrow Network |
$10.48
|
| Rate for Payer: Priority Health SBD |
$64.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.10
|
| Rate for Payer: UHC Exchange |
$13.10
|
| Rate for Payer: UHC Medicare Advantage |
$13.10
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: UMR Bronson Commercial |
$37.59
|
| Rate for Payer: VA VA |
$13.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.19
|
|
|
HC RESPIRATORY SYNCYTIAL VIRUS AG
|
Facility
|
IP
|
$101.59
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30600175
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.70 |
| Max. Negotiated Rate |
$91.43 |
| Rate for Payer: Aetna American Axle |
$66.03
|
| Rate for Payer: Aetna Commercial |
$86.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$66.03
|
| Rate for Payer: Cash Price |
$81.27
|
| Rate for Payer: Cofinity Commercial |
$71.11
|
| Rate for Payer: Cofinity Commercial |
$87.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$71.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.27
|
| Rate for Payer: Healthscope Commercial |
$91.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$71.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.35
|
| Rate for Payer: PHP Commercial |
$86.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.03
|
| Rate for Payer: Priority Health SBD |
$64.00
|
| Rate for Payer: UMR Bronson Commercial |
$44.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.19
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
IP
|
$73.24
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.23 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna American Axle |
$47.61
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.61
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$51.27
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.61
|
| Rate for Payer: Priority Health SBD |
$46.14
|
| Rate for Payer: UMR Bronson Commercial |
$32.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC RESPIRATORY VIRAL ID
|
Facility
|
OP
|
$73.24
|
|
|
Service Code
|
CPT 87280
|
| Hospital Charge Code |
30600182
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.19 |
| Max. Negotiated Rate |
$65.92 |
| Rate for Payer: Aetna American Axle |
$47.61
|
| Rate for Payer: Aetna Commercial |
$62.25
|
| Rate for Payer: Aetna Medicare |
$13.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$47.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.78
|
| Rate for Payer: BCBS Complete |
$7.55
|
| Rate for Payer: BCBS MAPPO |
$13.42
|
| Rate for Payer: BCBS Trust/PPO |
$12.94
|
| Rate for Payer: BCN Commercial |
$12.94
|
| Rate for Payer: BCN Medicare Advantage |
$13.42
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cash Price |
$58.59
|
| Rate for Payer: Cofinity Commercial |
$62.99
|
| Rate for Payer: Cofinity Commercial |
$51.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$51.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.42
|
| Rate for Payer: Healthscope Commercial |
$65.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$51.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.93
|
| Rate for Payer: Mclaren Medicaid |
$7.19
|
| Rate for Payer: Mclaren Medicare |
$13.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.09
|
| Rate for Payer: Meridian Medicaid |
$7.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$62.25
|
| Rate for Payer: Nomi Health Commercial |
$20.13
|
| Rate for Payer: PACE Medicare |
$12.75
|
| Rate for Payer: PACE SWMI |
$13.42
|
| Rate for Payer: PHP Commercial |
$62.25
|
| Rate for Payer: PHP Medicare Advantage |
$13.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$47.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.42
|
| Rate for Payer: Priority Health Medicare |
$13.42
|
| Rate for Payer: Priority Health Narrow Network |
$10.74
|
| Rate for Payer: Priority Health SBD |
$46.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.42
|
| Rate for Payer: UHC Exchange |
$13.42
|
| Rate for Payer: UHC Medicare Advantage |
$13.42
|
| Rate for Payer: UHCCP Medicaid |
$7.19
|
| Rate for Payer: UMR Bronson Commercial |
$27.10
|
| Rate for Payer: VA VA |
$13.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.93
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.42 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna American Axle |
$45.75
|
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna Medicare |
$12.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.98
|
| Rate for Payer: BCBS Complete |
$6.74
|
| Rate for Payer: BCBS MAPPO |
$11.98
|
| Rate for Payer: BCBS Trust/PPO |
$11.55
|
| Rate for Payer: BCN Commercial |
$11.55
|
| Rate for Payer: BCN Medicare Advantage |
$11.98
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Cofinity Commercial |
$49.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.98
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Mclaren Medicaid |
$6.42
|
| Rate for Payer: Mclaren Medicare |
$11.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.58
|
| Rate for Payer: Meridian Medicaid |
$6.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$17.97
|
| Rate for Payer: PACE Medicare |
$11.38
|
| Rate for Payer: PACE SWMI |
$11.98
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$11.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12.33
|
| Rate for Payer: Priority Health Medicare |
$11.98
|
| Rate for Payer: Priority Health Narrow Network |
$9.86
|
| Rate for Payer: Priority Health SBD |
$44.34
|
| Rate for Payer: Railroad Medicare Medicare |
$11.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.98
|
| Rate for Payer: UHC Exchange |
$11.98
|
| Rate for Payer: UHC Medicare Advantage |
$11.98
|
| Rate for Payer: UHCCP Medicaid |
$6.42
|
| Rate for Payer: UMR Bronson Commercial |
$26.04
|
| Rate for Payer: VA VA |
$11.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC RESPIRATORY VIRAL PANEL
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 87300
|
| Hospital Charge Code |
30600134
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$30.97 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna American Axle |
$45.75
|
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.75
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$49.27
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health SBD |
$44.34
|
| Rate for Payer: UMR Bronson Commercial |
$30.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
OP
|
$5,030.37
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$385.85 |
| Max. Negotiated Rate |
$4,741.08 |
| Rate for Payer: Aetna American Axle |
$3,269.74
|
| Rate for Payer: Aetna Commercial |
$4,275.81
|
| Rate for Payer: Aetna Medicare |
$748.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,269.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$899.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$899.84
|
| Rate for Payer: BCBS Complete |
$405.14
|
| Rate for Payer: BCBS MAPPO |
$719.87
|
| Rate for Payer: BCBS Trust/PPO |
$4,741.08
|
| Rate for Payer: BCN Commercial |
$4,741.08
|
| Rate for Payer: BCN Medicare Advantage |
$719.87
|
| Rate for Payer: Cash Price |
$4,024.30
|
| Rate for Payer: Cash Price |
$4,024.30
|
| Rate for Payer: Cofinity Commercial |
$4,326.12
|
| Rate for Payer: Cofinity Commercial |
$3,521.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,521.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,024.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$719.87
|
| Rate for Payer: Healthscope Commercial |
$4,527.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,521.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,772.78
|
| Rate for Payer: Mclaren Medicaid |
$385.85
|
| Rate for Payer: Mclaren Medicare |
$719.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$755.86
|
| Rate for Payer: Meridian Medicaid |
$405.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$827.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,275.81
|
| Rate for Payer: Nomi Health Commercial |
$2,159.61
|
| Rate for Payer: PACE Medicare |
$683.88
|
| Rate for Payer: PACE SWMI |
$719.87
|
| Rate for Payer: PHP Commercial |
$4,275.81
|
| Rate for Payer: PHP Medicare Advantage |
$719.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$385.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,269.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,071.80
|
| Rate for Payer: Priority Health Medicare |
$719.87
|
| Rate for Payer: Priority Health Narrow Network |
$1,657.44
|
| Rate for Payer: Priority Health SBD |
$3,169.13
|
| Rate for Payer: Railroad Medicare Medicare |
$719.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,026.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$719.87
|
| Rate for Payer: UHC Exchange |
$1,375.74
|
| Rate for Payer: UHC Medicare Advantage |
$719.87
|
| Rate for Payer: UHCCP Medicaid |
$385.85
|
| Rate for Payer: UMR Bronson Commercial |
$1,861.24
|
| Rate for Payer: VA VA |
$719.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,772.78
|
|
|
HC RESP SYNCTIAL VIRUS IG PER 50 MG
|
Facility
|
IP
|
$5,030.37
|
|
|
Service Code
|
CPT 90378
|
| Hospital Charge Code |
63600156
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,213.36 |
| Max. Negotiated Rate |
$4,527.33 |
| Rate for Payer: Aetna American Axle |
$3,269.74
|
| Rate for Payer: Aetna Commercial |
$4,275.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,269.74
|
| Rate for Payer: Cash Price |
$4,024.30
|
| Rate for Payer: Cofinity Commercial |
$3,521.26
|
| Rate for Payer: Cofinity Commercial |
$4,326.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,521.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,024.30
|
| Rate for Payer: Healthscope Commercial |
$4,527.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,521.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,772.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,275.81
|
| Rate for Payer: PHP Commercial |
$4,275.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,269.74
|
| Rate for Payer: Priority Health SBD |
$3,169.13
|
| Rate for Payer: UMR Bronson Commercial |
$2,213.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,772.78
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.02 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna American Axle |
$14.59
|
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$13.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.38
|
| Rate for Payer: BCBS Complete |
$7.37
|
| Rate for Payer: BCBS MAPPO |
$13.10
|
| Rate for Payer: BCBS Trust/PPO |
$12.63
|
| Rate for Payer: BCN Commercial |
$12.63
|
| Rate for Payer: BCN Medicare Advantage |
$13.10
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.10
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Mclaren Medicaid |
$7.02
|
| Rate for Payer: Mclaren Medicare |
$13.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$7.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.07
|
| Rate for Payer: Nomi Health Commercial |
$19.65
|
| Rate for Payer: PACE Medicare |
$12.44
|
| Rate for Payer: PACE SWMI |
$13.10
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$13.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.59
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.10
|
| Rate for Payer: Priority Health Medicare |
$13.10
|
| Rate for Payer: Priority Health Narrow Network |
$10.48
|
| Rate for Payer: Priority Health SBD |
$14.14
|
| Rate for Payer: Railroad Medicare Medicare |
$13.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.10
|
| Rate for Payer: UHC Exchange |
$13.10
|
| Rate for Payer: UHC Medicare Advantage |
$13.10
|
| Rate for Payer: UHCCP Medicaid |
$7.02
|
| Rate for Payer: UMR Bronson Commercial |
$8.30
|
| Rate for Payer: VA VA |
$13.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC RESP SYNCYTIAL VIRUS W/OPTIC
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 87807
|
| Hospital Charge Code |
30000172
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.87 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna American Axle |
$14.59
|
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$14.59
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$15.71
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$15.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$15.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.59
|
| Rate for Payer: Priority Health SBD |
$14.14
|
| Rate for Payer: UMR Bronson Commercial |
$9.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL BORDETELLA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600189
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| 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 |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| 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 |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| 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 |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| 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 |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL CHLAMYDIA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87486
|
| Hospital Charge Code |
30600186
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| 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 |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| 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 |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.11
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health Narrow Network |
$28.89
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL MYCOPLASMA
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 87581
|
| Hospital Charge Code |
30600185
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
IP
|
$624.24
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$274.67 |
| Max. Negotiated Rate |
$561.82 |
| Rate for Payer: Aetna American Axle |
$405.76
|
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.76
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$436.97
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$436.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$436.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.76
|
| Rate for Payer: Priority Health SBD |
$393.27
|
| Rate for Payer: UMR Bronson Commercial |
$274.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC RESP VIRAL PANEL RP2.1
|
Facility
|
OP
|
$624.24
|
|
|
Service Code
|
HCPCS 0202U
|
| Hospital Charge Code |
30000162
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$192.69 |
| Max. Negotiated Rate |
$1,250.34 |
| Rate for Payer: Aetna Commercial |
$530.60
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna American Axle |
$405.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$405.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$192.69
|
| Rate for Payer: BCN Commercial |
$192.69
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cash Price |
$499.39
|
| Rate for Payer: Cofinity Commercial |
$536.85
|
| Rate for Payer: Cofinity Commercial |
$436.97
|
| Rate for Payer: Cofinity Medicare Advantage |
$436.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$499.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$561.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$436.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$468.18
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$530.60
|
| Rate for Payer: Nomi Health Commercial |
$1,250.34
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$530.60
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$405.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$416.78
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$333.42
|
| Rate for Payer: Priority Health SBD |
$393.27
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$223.39
|
| Rate for Payer: UMR Bronson Commercial |
$230.97
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$468.18
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
IP
|
$18.85
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$8.29 |
| Max. Negotiated Rate |
$16.96 |
| Rate for Payer: Aetna American Axle |
$12.25
|
| Rate for Payer: Aetna Commercial |
$16.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.25
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$13.20
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.02
|
| Rate for Payer: PHP Commercial |
$16.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.25
|
| Rate for Payer: Priority Health SBD |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$8.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.14
|
|
|
HC RESTORE HYDROGEL 3 OZ
|
Facility
|
OP
|
$18.85
|
|
| Hospital Charge Code |
27100015
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$16.96 |
| Rate for Payer: Aetna American Axle |
$12.25
|
| Rate for Payer: Aetna Commercial |
$16.02
|
| Rate for Payer: Aetna Medicare |
$9.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.25
|
| Rate for Payer: BCBS Complete |
$7.54
|
| Rate for Payer: Cash Price |
$15.08
|
| Rate for Payer: Cofinity Commercial |
$13.20
|
| Rate for Payer: Cofinity Commercial |
$16.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$16.96
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.02
|
| Rate for Payer: PHP Commercial |
$16.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.25
|
| Rate for Payer: Priority Health SBD |
$11.88
|
| Rate for Payer: UMR Bronson Commercial |
$6.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.14
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
OP
|
$275.71
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$43.79 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$179.21
|
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna Medicare |
$202.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.35
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$194.68
|
| Rate for Payer: BCBS Trust/PPO |
$139.79
|
| Rate for Payer: BCN Commercial |
$139.79
|
| Rate for Payer: BCN Medicare Advantage |
$194.68
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$193.00
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.68
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.78
|
| Rate for Payer: Mclaren Medicaid |
$104.35
|
| Rate for Payer: Mclaren Medicare |
$194.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.41
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: Nomi Health Commercial |
$584.04
|
| Rate for Payer: PACE Medicare |
$184.95
|
| Rate for Payer: PACE SWMI |
$194.68
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: PHP Medicare Advantage |
$194.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$611.90
|
| Rate for Payer: Priority Health Medicare |
$194.68
|
| Rate for Payer: Priority Health Narrow Network |
$489.52
|
| Rate for Payer: Priority Health SBD |
$173.70
|
| Rate for Payer: Railroad Medicare Medicare |
$194.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.17
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.68
|
| Rate for Payer: UHC Exchange |
$43.79
|
| Rate for Payer: UHC Medicare Advantage |
$194.68
|
| Rate for Payer: UHCCP Medicaid |
$104.35
|
| Rate for Payer: UMR Bronson Commercial |
$102.01
|
| Rate for Payer: VA VA |
$194.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.78
|
|
|
HC RESUPERF WND BODY <2.5 CM
|
Facility
|
IP
|
$275.71
|
|
|
Service Code
|
CPT 12001
|
| Hospital Charge Code |
76100181
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$121.31 |
| Max. Negotiated Rate |
$248.14 |
| Rate for Payer: Aetna American Axle |
$179.21
|
| Rate for Payer: Aetna Commercial |
$234.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$179.21
|
| Rate for Payer: Cash Price |
$220.57
|
| Rate for Payer: Cofinity Commercial |
$193.00
|
| Rate for Payer: Cofinity Commercial |
$237.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$193.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.57
|
| Rate for Payer: Healthscope Commercial |
$248.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$193.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$234.35
|
| Rate for Payer: PHP Commercial |
$234.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$179.21
|
| Rate for Payer: Priority Health SBD |
$173.70
|
| Rate for Payer: UMR Bronson Commercial |
$121.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.78
|
|
|
HC RETICULOCYTE COUNT
|
Facility
|
IP
|
$41.51
|
|
|
Service Code
|
CPT 85046
|
| Hospital Charge Code |
30500010
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.26 |
| Max. Negotiated Rate |
$37.36 |
| Rate for Payer: Aetna American Axle |
$26.98
|
| Rate for Payer: Aetna Commercial |
$35.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.98
|
| Rate for Payer: Cash Price |
$33.21
|
| Rate for Payer: Cofinity Commercial |
$29.06
|
| Rate for Payer: Cofinity Commercial |
$35.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.21
|
| Rate for Payer: Healthscope Commercial |
$37.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.28
|
| Rate for Payer: PHP Commercial |
$35.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.98
|
| Rate for Payer: Priority Health SBD |
$26.15
|
| Rate for Payer: UMR Bronson Commercial |
$18.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.13
|
|
