|
HC RHEUMATOID FACTOR
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86431
|
| Hospital Charge Code |
30200211
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$5.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.09
|
| Rate for Payer: BCBS Complete |
$3.19
|
| Rate for Payer: BCBS MAPPO |
$5.67
|
| Rate for Payer: BCBS Trust/PPO |
$5.46
|
| Rate for Payer: BCN Commercial |
$5.46
|
| Rate for Payer: BCN Medicare Advantage |
$5.67
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.67
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$3.04
|
| Rate for Payer: Mclaren Medicare |
$5.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.95
|
| Rate for Payer: Meridian Medicaid |
$3.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$8.50
|
| Rate for Payer: PACE Medicare |
$5.39
|
| Rate for Payer: PACE SWMI |
$5.67
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$5.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.84
|
| Rate for Payer: Priority Health Medicare |
$5.67
|
| Rate for Payer: Priority Health Narrow Network |
$4.67
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$5.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.67
|
| Rate for Payer: UHC Exchange |
$5.67
|
| Rate for Payer: UHC Medicare Advantage |
$5.67
|
| Rate for Payer: UHCCP Medicaid |
$3.04
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$5.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RHOGAM
|
Facility
|
OP
|
$283.98
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$105.07 |
| Max. Negotiated Rate |
$661.60 |
| Rate for Payer: Aetna American Axle |
$184.59
|
| Rate for Payer: Aetna Commercial |
$241.38
|
| Rate for Payer: Aetna Medicare |
$141.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.59
|
| Rate for Payer: BCBS Complete |
$113.59
|
| Rate for Payer: BCBS Trust/PPO |
$661.60
|
| Rate for Payer: BCN Commercial |
$661.60
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cofinity Commercial |
$198.79
|
| Rate for Payer: Cofinity Commercial |
$244.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.18
|
| Rate for Payer: Healthscope Commercial |
$255.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.38
|
| Rate for Payer: PHP Commercial |
$241.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.59
|
| Rate for Payer: Priority Health SBD |
$178.91
|
| Rate for Payer: UMR Bronson Commercial |
$105.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.98
|
|
|
HC RHOGAM
|
Facility
|
IP
|
$283.98
|
|
|
Service Code
|
HCPCS J2790
|
| Hospital Charge Code |
63600006
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$124.95 |
| Max. Negotiated Rate |
$255.58 |
| Rate for Payer: Aetna American Axle |
$184.59
|
| Rate for Payer: Aetna Commercial |
$241.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$184.59
|
| Rate for Payer: Cash Price |
$227.18
|
| Rate for Payer: Cofinity Commercial |
$198.79
|
| Rate for Payer: Cofinity Commercial |
$244.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$198.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.18
|
| Rate for Payer: Healthscope Commercial |
$255.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$198.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$212.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$241.38
|
| Rate for Payer: PHP Commercial |
$241.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.59
|
| Rate for Payer: Priority Health SBD |
$178.91
|
| Rate for Payer: UMR Bronson Commercial |
$124.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$212.98
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RIBOSOME P AB, IGG
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200433
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RIGHT VENTRICULAR RECORDING
|
Facility
|
IP
|
$3,767.24
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
48100031
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,657.59 |
| Max. Negotiated Rate |
$3,390.52 |
| Rate for Payer: Aetna American Axle |
$2,448.71
|
| Rate for Payer: Aetna Commercial |
$3,202.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,448.71
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cofinity Commercial |
$2,637.07
|
| Rate for Payer: Cofinity Commercial |
$3,239.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,637.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.79
|
| Rate for Payer: Healthscope Commercial |
$3,390.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,637.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.15
|
| Rate for Payer: PHP Commercial |
$3,202.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.71
|
| Rate for Payer: Priority Health SBD |
$2,373.36
|
| Rate for Payer: UMR Bronson Commercial |
$1,657.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.43
|
|
|
HC RIGHT VENTRICULAR RECORDING
|
Facility
|
OP
|
$3,767.24
|
|
|
Service Code
|
CPT 93603
|
| Hospital Charge Code |
48100031
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$637.54 |
| Max. Negotiated Rate |
$3,738.41 |
| Rate for Payer: Aetna American Axle |
$2,448.71
|
| Rate for Payer: Aetna Commercial |
$3,202.15
|
| Rate for Payer: Aetna Medicare |
$1,237.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,448.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,486.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,486.80
|
| Rate for Payer: BCBS Complete |
$669.42
|
| Rate for Payer: BCBS MAPPO |
$1,189.44
|
| Rate for Payer: BCBS Trust/PPO |
$3,000.89
|
| Rate for Payer: BCN Commercial |
$3,000.89
|
| Rate for Payer: BCN Medicare Advantage |
$1,189.44
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cash Price |
$3,013.79
|
| Rate for Payer: Cofinity Commercial |
$3,239.83
|
| Rate for Payer: Cofinity Commercial |
$2,637.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,637.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,013.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,189.44
|
| Rate for Payer: Healthscope Commercial |
$3,390.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,637.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.43
|
| Rate for Payer: Mclaren Medicaid |
$637.54
|
| Rate for Payer: Mclaren Medicare |
$1,189.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,248.91
|
| Rate for Payer: Meridian Medicaid |
$669.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,367.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.15
|
| Rate for Payer: Nomi Health Commercial |
$2,497.82
|
| Rate for Payer: PACE Medicare |
$1,129.97
|
| Rate for Payer: PACE SWMI |
$1,189.44
|
| Rate for Payer: PHP Commercial |
$3,202.15
|
| Rate for Payer: PHP Medicare Advantage |
$1,189.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$637.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,448.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,738.41
|
| Rate for Payer: Priority Health Medicare |
$1,189.44
|
| Rate for Payer: Priority Health Narrow Network |
$2,990.73
|
| Rate for Payer: Priority Health SBD |
$2,373.36
|
| Rate for Payer: Railroad Medicare Medicare |
$1,189.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,348.15
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,189.44
|
| Rate for Payer: UHC Exchange |
$2,273.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,189.44
|
| Rate for Payer: UHCCP Medicaid |
$637.54
|
| Rate for Payer: UMR Bronson Commercial |
$1,393.88
|
| Rate for Payer: VA VA |
$1,189.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.43
|
|
|
HC RISPERIDONE AND METABOLIT
|
Facility
|
OP
|
$113.22
|
|
|
Service Code
|
CPT 80342
|
| Hospital Charge Code |
30100691
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.76 |
| Max. Negotiated Rate |
$101.90 |
| Rate for Payer: Aetna American Axle |
$73.59
|
| Rate for Payer: Aetna Commercial |
$96.24
|
| Rate for Payer: Aetna Medicare |
$56.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.59
|
| Rate for Payer: BCBS Complete |
$45.29
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cofinity Commercial |
$97.37
|
| Rate for Payer: Cofinity Commercial |
$79.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.58
|
| Rate for Payer: Healthscope Commercial |
$101.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.24
|
| Rate for Payer: PHP Commercial |
$96.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.59
|
| Rate for Payer: Priority Health SBD |
$71.33
|
| Rate for Payer: UHC Core |
$14.76
|
| Rate for Payer: UMR Bronson Commercial |
$41.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.92
|
|
|
HC RISPERIDONE AND METABOLIT
|
Facility
|
IP
|
$113.22
|
|
|
Service Code
|
CPT 80342
|
| Hospital Charge Code |
30100691
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.82 |
| Max. Negotiated Rate |
$101.90 |
| Rate for Payer: Aetna American Axle |
$73.59
|
| Rate for Payer: Aetna Commercial |
$96.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$73.59
|
| Rate for Payer: Cash Price |
$90.58
|
| Rate for Payer: Cofinity Commercial |
$79.25
|
| Rate for Payer: Cofinity Commercial |
$97.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$79.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.58
|
| Rate for Payer: Healthscope Commercial |
$101.90
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$79.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$96.24
|
| Rate for Payer: PHP Commercial |
$96.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$73.59
|
| Rate for Payer: Priority Health SBD |
$71.33
|
| Rate for Payer: UMR Bronson Commercial |
$49.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.92
|
|
|
HC RISTOCETIN COFACTOR
|
Facility
|
IP
|
$69.08
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.40 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Aetna American Axle |
$44.90
|
| Rate for Payer: Aetna Commercial |
$58.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.90
|
| Rate for Payer: Cash Price |
$55.26
|
| Rate for Payer: Cofinity Commercial |
$48.36
|
| Rate for Payer: Cofinity Commercial |
$59.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.26
|
| Rate for Payer: Healthscope Commercial |
$62.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.72
|
| Rate for Payer: PHP Commercial |
$58.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.90
|
| Rate for Payer: Priority Health SBD |
$43.52
|
| Rate for Payer: UMR Bronson Commercial |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.81
|
|
|
HC RISTOCETIN COFACTOR
|
Facility
|
OP
|
$69.08
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Aetna American Axle |
$44.90
|
| Rate for Payer: Aetna Commercial |
$58.72
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$22.11
|
| Rate for Payer: BCN Commercial |
$22.11
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$55.26
|
| Rate for Payer: Cash Price |
$55.26
|
| Rate for Payer: Cofinity Commercial |
$59.41
|
| Rate for Payer: Cofinity Commercial |
$48.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$62.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.81
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.72
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$58.72
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$18.35
|
| Rate for Payer: Priority Health SBD |
$43.52
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$25.56
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.81
|
|
|
HC RIV 4 VACC RECOMBINANT DNA PRSRV ABX FREE
|
Facility
|
IP
|
$95.17
|
|
|
Service Code
|
CPT 90682
|
| Hospital Charge Code |
63600171
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.87 |
| Max. Negotiated Rate |
$85.65 |
| Rate for Payer: Aetna American Axle |
$61.86
|
| Rate for Payer: Aetna Commercial |
$80.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.86
|
| Rate for Payer: Cash Price |
$76.14
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Cofinity Commercial |
$81.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.14
|
| Rate for Payer: Healthscope Commercial |
$85.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.89
|
| Rate for Payer: PHP Commercial |
$80.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.86
|
| Rate for Payer: Priority Health SBD |
$59.96
|
| Rate for Payer: UMR Bronson Commercial |
$41.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.38
|
|
|
HC RIV 4 VACC RECOMBINANT DNA PRSRV ABX FREE
|
Facility
|
OP
|
$95.17
|
|
|
Service Code
|
CPT 90682
|
| Hospital Charge Code |
63600171
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$35.21 |
| Max. Negotiated Rate |
$194.83 |
| Rate for Payer: Aetna American Axle |
$61.86
|
| Rate for Payer: Aetna Commercial |
$80.89
|
| Rate for Payer: Aetna Medicare |
$47.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$61.86
|
| Rate for Payer: BCBS Complete |
$38.07
|
| Rate for Payer: BCBS Trust/PPO |
$194.83
|
| Rate for Payer: BCN Commercial |
$194.83
|
| Rate for Payer: Cash Price |
$76.14
|
| Rate for Payer: Cash Price |
$76.14
|
| Rate for Payer: Cofinity Commercial |
$66.62
|
| Rate for Payer: Cofinity Commercial |
$81.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$66.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.14
|
| Rate for Payer: Healthscope Commercial |
$85.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$66.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.89
|
| Rate for Payer: PHP Commercial |
$80.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.40
|
| Rate for Payer: Priority Health Narrow Network |
$58.72
|
| Rate for Payer: Priority Health SBD |
$59.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.58
|
| Rate for Payer: UHC Exchange |
$62.58
|
| Rate for Payer: UMR Bronson Commercial |
$35.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.38
|
|
|
HC RLC W INTERVENTION
|
Facility
|
OP
|
$11,199.49
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100020
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,127.76 |
| Max. Negotiated Rate |
$10,079.54 |
| Rate for Payer: Aetna American Axle |
$7,279.67
|
| Rate for Payer: Aetna Commercial |
$9,519.57
|
| Rate for Payer: Aetna Medicare |
$3,277.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,279.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,939.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,939.21
|
| Rate for Payer: BCBS Complete |
$1,773.59
|
| Rate for Payer: BCBS MAPPO |
$3,151.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,640.68
|
| Rate for Payer: BCN Commercial |
$3,640.68
|
| Rate for Payer: BCN Medicare Advantage |
$3,151.37
|
| Rate for Payer: Cash Price |
$8,959.59
|
| Rate for Payer: Cash Price |
$8,959.59
|
| Rate for Payer: Cash Price |
$8,959.59
|
| Rate for Payer: Cofinity Commercial |
$9,631.56
|
| Rate for Payer: Cofinity Commercial |
$7,839.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,839.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,959.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,151.37
|
| Rate for Payer: Healthscope Commercial |
$10,079.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,839.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,399.62
|
| Rate for Payer: Mclaren Medicaid |
$1,689.13
|
| Rate for Payer: Mclaren Medicare |
$3,151.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,308.94
|
| Rate for Payer: Meridian Medicaid |
$1,773.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,624.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,519.57
|
| Rate for Payer: Nomi Health Commercial |
$6,617.88
|
| Rate for Payer: PACE Medicare |
$2,993.80
|
| Rate for Payer: PACE SWMI |
$3,151.37
|
| Rate for Payer: PHP Commercial |
$9,519.57
|
| Rate for Payer: PHP Medicare Advantage |
$3,151.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,689.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,279.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,904.74
|
| Rate for Payer: Priority Health Medicare |
$3,151.37
|
| Rate for Payer: Priority Health Narrow Network |
$7,923.79
|
| Rate for Payer: Priority Health SBD |
$7,055.68
|
| Rate for Payer: Railroad Medicare Medicare |
$3,151.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,240.54
|
| Rate for Payer: UHC Core |
$6,395.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,151.37
|
| Rate for Payer: UHC Exchange |
$1,127.76
|
| Rate for Payer: UHC Medicare Advantage |
$3,151.37
|
| Rate for Payer: UHCCP Medicaid |
$1,689.13
|
| Rate for Payer: UMR Bronson Commercial |
$4,143.81
|
| Rate for Payer: VA VA |
$3,151.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,399.62
|
|
|
HC RLC W INTERVENTION
|
Facility
|
IP
|
$11,199.49
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100020
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,927.78 |
| Max. Negotiated Rate |
$10,079.54 |
| Rate for Payer: Aetna American Axle |
$7,279.67
|
| Rate for Payer: Aetna Commercial |
$9,519.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$7,279.67
|
| Rate for Payer: Cash Price |
$8,959.59
|
| Rate for Payer: Cofinity Commercial |
$7,839.64
|
| Rate for Payer: Cofinity Commercial |
$9,631.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,839.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,959.59
|
| Rate for Payer: Healthscope Commercial |
$10,079.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,839.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,399.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,519.57
|
| Rate for Payer: PHP Commercial |
$9,519.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,279.67
|
| Rate for Payer: Priority Health SBD |
$7,055.68
|
| Rate for Payer: UMR Bronson Commercial |
$4,927.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,399.62
|
|
|
HC RMVL EMBEDDED FB VESTIBULE MOUTH SMPL
|
Facility
|
OP
|
$2,397.00
|
|
|
Service Code
|
CPT 40804
|
| Hospital Charge Code |
76100458
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$107.69 |
| Max. Negotiated Rate |
$2,887.15 |
| Rate for Payer: Aetna American Axle |
$1,558.05
|
| Rate for Payer: Aetna Commercial |
$2,037.45
|
| Rate for Payer: Aetna Medicare |
$955.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,558.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,148.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,148.25
|
| Rate for Payer: BCBS Complete |
$516.99
|
| Rate for Payer: BCBS MAPPO |
$918.60
|
| Rate for Payer: BCBS Trust/PPO |
$246.22
|
| Rate for Payer: BCN Commercial |
$246.22
|
| Rate for Payer: BCN Medicare Advantage |
$918.60
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cofinity Commercial |
$1,677.90
|
| Rate for Payer: Cofinity Commercial |
$2,061.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,677.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,917.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$918.60
|
| Rate for Payer: Healthscope Commercial |
$2,157.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,677.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,797.75
|
| Rate for Payer: Mclaren Medicaid |
$492.37
|
| Rate for Payer: Mclaren Medicare |
$918.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$964.53
|
| Rate for Payer: Meridian Medicaid |
$516.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,056.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,037.45
|
| Rate for Payer: Nomi Health Commercial |
$2,755.80
|
| Rate for Payer: PACE Medicare |
$872.67
|
| Rate for Payer: PACE SWMI |
$918.60
|
| Rate for Payer: PHP Commercial |
$2,037.45
|
| Rate for Payer: PHP Medicare Advantage |
$918.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$492.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,887.15
|
| Rate for Payer: Priority Health Medicare |
$918.60
|
| Rate for Payer: Priority Health Narrow Network |
$2,309.72
|
| Rate for Payer: Priority Health SBD |
$1,510.11
|
| Rate for Payer: Railroad Medicare Medicare |
$918.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.46
|
| Rate for Payer: UHC Core |
$2,014.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$918.60
|
| Rate for Payer: UHC Exchange |
$107.69
|
| Rate for Payer: UHC Medicare Advantage |
$918.60
|
| Rate for Payer: UHCCP Medicaid |
$492.37
|
| Rate for Payer: UMR Bronson Commercial |
$886.89
|
| Rate for Payer: VA VA |
$918.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,797.75
|
|
|
HC RMVL EMBEDDED FB VESTIBULE MOUTH SMPL
|
Facility
|
IP
|
$2,397.00
|
|
|
Service Code
|
CPT 40804
|
| Hospital Charge Code |
76100458
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,054.68 |
| Max. Negotiated Rate |
$2,157.30 |
| Rate for Payer: Aetna American Axle |
$1,558.05
|
| Rate for Payer: Aetna Commercial |
$2,037.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,558.05
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cofinity Commercial |
$1,677.90
|
| Rate for Payer: Cofinity Commercial |
$2,061.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,677.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,917.60
|
| Rate for Payer: Healthscope Commercial |
$2,157.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,677.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,797.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,037.45
|
| Rate for Payer: PHP Commercial |
$2,037.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.05
|
| Rate for Payer: Priority Health SBD |
$1,510.11
|
| Rate for Payer: UMR Bronson Commercial |
$1,054.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,797.75
|
|
|
HC RMVL FB XTRNL EYE CORNEAL W SLIT LAMP
|
Facility
|
OP
|
$359.00
|
|
|
Service Code
|
CPT 65222
|
| Hospital Charge Code |
76200521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$47.32 |
| Max. Negotiated Rate |
$700.00 |
| Rate for Payer: Aetna American Axle |
$233.35
|
| Rate for Payer: Aetna Commercial |
$305.15
|
| Rate for Payer: Aetna Medicare |
$131.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.86
|
| Rate for Payer: BCBS Complete |
$71.08
|
| Rate for Payer: BCBS MAPPO |
$126.29
|
| Rate for Payer: BCBS Trust/PPO |
$174.96
|
| Rate for Payer: BCN Commercial |
$174.96
|
| Rate for Payer: BCN Medicare Advantage |
$126.29
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$251.30
|
| Rate for Payer: Cofinity Commercial |
$308.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.29
|
| Rate for Payer: Healthscope Commercial |
$323.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.25
|
| Rate for Payer: Mclaren Medicaid |
$67.69
|
| Rate for Payer: Mclaren Medicare |
$126.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.60
|
| Rate for Payer: Meridian Medicaid |
$71.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: Nomi Health Commercial |
$378.87
|
| Rate for Payer: PACE Medicare |
$119.98
|
| Rate for Payer: PACE SWMI |
$126.29
|
| Rate for Payer: PHP Commercial |
$305.15
|
| Rate for Payer: PHP Medicare Advantage |
$126.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.95
|
| Rate for Payer: Priority Health Medicare |
$126.29
|
| Rate for Payer: Priority Health Narrow Network |
$317.56
|
| Rate for Payer: Priority Health SBD |
$226.17
|
| Rate for Payer: Railroad Medicare Medicare |
$126.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.05
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.29
|
| Rate for Payer: UHC Exchange |
$47.32
|
| Rate for Payer: UHC Medicare Advantage |
$126.29
|
| Rate for Payer: UHCCP Medicaid |
$67.69
|
| Rate for Payer: UMR Bronson Commercial |
$132.83
|
| Rate for Payer: VA VA |
$126.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.25
|
|
|
HC RMVL FB XTRNL EYE CORNEAL W SLIT LAMP
|
Facility
|
IP
|
$359.00
|
|
|
Service Code
|
CPT 65222
|
| Hospital Charge Code |
76200521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$157.96 |
| Max. Negotiated Rate |
$323.10 |
| Rate for Payer: Aetna American Axle |
$233.35
|
| Rate for Payer: Aetna Commercial |
$305.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$233.35
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$251.30
|
| Rate for Payer: Cofinity Commercial |
$308.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$251.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Healthscope Commercial |
$323.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$251.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: PHP Commercial |
$305.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health SBD |
$226.17
|
| Rate for Payer: UMR Bronson Commercial |
$157.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.25
|
|
|
HC RNA POLYMERASE III AB IGG
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200413
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$31.42 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: UMR Bronson Commercial |
$31.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC RNA POLYMERASE III AB IGG
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200413
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna American Axle |
$46.41
|
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$46.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCBS Trust/PPO |
$11.11
|
| Rate for Payer: BCN Commercial |
$11.11
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Cofinity Commercial |
$49.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$17.30
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.87
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health Narrow Network |
$9.50
|
| Rate for Payer: Priority Health SBD |
$44.98
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$11.53
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$26.42
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC RNP 70 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200164
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP 70 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200164
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP ANTIBODIES, IGG
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200434
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.47 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: UMR Bronson Commercial |
$15.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP ANTIBODIES, IGG
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200434
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.61 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna American Axle |
$22.86
|
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$18.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$22.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.41
|
| Rate for Payer: BCBS Complete |
$10.09
|
| Rate for Payer: BCBS MAPPO |
$17.93
|
| Rate for Payer: BCBS Trust/PPO |
$17.28
|
| Rate for Payer: BCN Commercial |
$17.28
|
| Rate for Payer: BCN Medicare Advantage |
$17.93
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Cofinity Commercial |
$24.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.93
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$9.61
|
| Rate for Payer: Mclaren Medicare |
$17.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.83
|
| Rate for Payer: Meridian Medicaid |
$10.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$26.90
|
| Rate for Payer: PACE Medicare |
$17.03
|
| Rate for Payer: PACE SWMI |
$17.93
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$17.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.93
|
| Rate for Payer: Priority Health Medicare |
$17.93
|
| Rate for Payer: Priority Health Narrow Network |
$14.34
|
| Rate for Payer: Priority Health SBD |
$22.16
|
| Rate for Payer: Railroad Medicare Medicare |
$17.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.93
|
| Rate for Payer: UHC Exchange |
$17.93
|
| Rate for Payer: UHC Medicare Advantage |
$17.93
|
| Rate for Payer: UHCCP Medicaid |
$9.61
|
| Rate for Payer: UMR Bronson Commercial |
$13.01
|
| Rate for Payer: VA VA |
$17.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
