|
HC SWALLOWING THERAPY
|
Facility
|
IP
|
$247.16
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$108.75 |
| Max. Negotiated Rate |
$222.44 |
| Rate for Payer: Aetna American Axle |
$160.65
|
| Rate for Payer: Aetna Commercial |
$210.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.65
|
| Rate for Payer: Cash Price |
$197.73
|
| Rate for Payer: Cofinity Advantage |
$173.01
|
| Rate for Payer: Cofinity Commercial |
$212.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.73
|
| Rate for Payer: Healthscope Commercial |
$222.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.37
|
| Rate for Payer: PHP Commercial |
$210.09
|
| Rate for Payer: Priority Health SBD |
$155.71
|
| Rate for Payer: UMR Bronson Commercial |
$108.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.37
|
|
|
HC SWALLOWING THERAPY
|
Facility
|
OP
|
$247.16
|
|
|
Service Code
|
CPT 92526
|
| Hospital Charge Code |
43000020
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$84.80 |
| Max. Negotiated Rate |
$222.44 |
| Rate for Payer: Aetna American Axle |
$160.65
|
| Rate for Payer: Aetna Commercial |
$210.09
|
| Rate for Payer: Aetna Medicare |
$123.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$160.65
|
| Rate for Payer: BCBS Complete |
$98.86
|
| Rate for Payer: BCBS Trust/PPO |
$115.47
|
| Rate for Payer: BCN Commercial |
$115.47
|
| Rate for Payer: Cash Price |
$197.73
|
| Rate for Payer: Cash Price |
$197.73
|
| Rate for Payer: Cash Price |
$197.73
|
| Rate for Payer: Cofinity Advantage |
$173.01
|
| Rate for Payer: Cofinity Commercial |
$212.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$197.73
|
| Rate for Payer: Healthscope Commercial |
$222.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$173.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$185.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$197.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$210.09
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$185.37
|
| Rate for Payer: PHP Commercial |
$210.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$106.00
|
| Rate for Payer: Priority Health SBD |
$155.71
|
| Rate for Payer: Priority Health Tiered Network |
$84.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$160.65
|
| Rate for Payer: UHC Core |
$128.77
|
| Rate for Payer: UHC Exchange |
$97.13
|
| Rate for Payer: UMR Bronson Commercial |
$91.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$185.37
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
IP
|
$240.18
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$105.68 |
| Max. Negotiated Rate |
$216.16 |
| Rate for Payer: Aetna American Axle |
$156.12
|
| Rate for Payer: Aetna Commercial |
$204.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.12
|
| Rate for Payer: Cash Price |
$192.14
|
| Rate for Payer: Cofinity Advantage |
$168.13
|
| Rate for Payer: Cofinity Commercial |
$206.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.14
|
| Rate for Payer: Healthscope Commercial |
$216.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.13
|
| Rate for Payer: PHP Commercial |
$204.15
|
| Rate for Payer: Priority Health SBD |
$151.31
|
| Rate for Payer: UMR Bronson Commercial |
$105.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.13
|
|
|
HC SWAN GANZ CATHETER
|
Facility
|
OP
|
$240.18
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200073
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$88.87 |
| Max. Negotiated Rate |
$216.16 |
| Rate for Payer: Aetna American Axle |
$156.12
|
| Rate for Payer: Aetna Commercial |
$204.15
|
| Rate for Payer: Aetna Medicare |
$120.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.12
|
| Rate for Payer: BCBS Complete |
$96.07
|
| Rate for Payer: Cash Price |
$192.14
|
| Rate for Payer: Cofinity Advantage |
$168.13
|
| Rate for Payer: Cofinity Commercial |
$206.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.14
|
| Rate for Payer: Healthscope Commercial |
$216.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.13
|
| Rate for Payer: PHP Commercial |
$204.15
|
| Rate for Payer: Priority Health SBD |
$151.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.12
|
| Rate for Payer: UHC Core |
$125.13
|
| Rate for Payer: UHC Exchange |
$94.39
|
| Rate for Payer: UMR Bronson Commercial |
$88.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.13
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
IP
|
$1,677.77
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$738.22 |
| Max. Negotiated Rate |
$1,509.99 |
| Rate for Payer: Aetna American Axle |
$1,090.55
|
| Rate for Payer: Aetna Commercial |
$1,426.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.55
|
| Rate for Payer: Cash Price |
$1,342.22
|
| Rate for Payer: Cofinity Advantage |
$1,174.44
|
| Rate for Payer: Cofinity Commercial |
$1,442.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.22
|
| Rate for Payer: Healthscope Commercial |
$1,509.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,174.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,258.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,258.33
|
| Rate for Payer: PHP Commercial |
$1,426.10
|
| Rate for Payer: Priority Health SBD |
$1,057.00
|
| Rate for Payer: UMR Bronson Commercial |
$738.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,258.33
|
|
|
HC SWAN GANZ PLACEMENT
|
Facility
|
OP
|
$1,677.77
|
|
|
Service Code
|
CPT 93503
|
| Hospital Charge Code |
48100024
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$57.77 |
| Max. Negotiated Rate |
$5,072.36 |
| Rate for Payer: Aetna American Axle |
$1,090.55
|
| Rate for Payer: Aetna Commercial |
$1,426.10
|
| Rate for Payer: Aetna Medicare |
$1,631.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,090.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.61
|
| Rate for Payer: BCBS Complete |
$861.41
|
| Rate for Payer: BCBS MAPPO |
$1,568.49
|
| Rate for Payer: BCBS Trust/PPO |
$57.77
|
| Rate for Payer: BCN Commercial |
$57.77
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.49
|
| Rate for Payer: Cash Price |
$1,342.22
|
| Rate for Payer: Cash Price |
$1,342.22
|
| Rate for Payer: Cofinity Advantage |
$1,174.44
|
| Rate for Payer: Cofinity Commercial |
$1,442.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,342.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.49
|
| Rate for Payer: Healthscope Commercial |
$1,509.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,174.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,258.33
|
| Rate for Payer: Mclaren Medicaid |
$1,568.49
|
| Rate for Payer: Mclaren Medicare |
$1,568.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.91
|
| Rate for Payer: Meridian Medicaid |
$1,646.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,725.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,426.10
|
| Rate for Payer: Nomi Health Commercial |
$4,705.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,258.33
|
| Rate for Payer: PACE Medicare |
$1,490.07
|
| Rate for Payer: PACE SWMI |
$1,568.49
|
| Rate for Payer: PHP Commercial |
$1,426.10
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$820.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5,072.36
|
| Rate for Payer: Priority Health Medicare |
$1,568.49
|
| Rate for Payer: Priority Health SBD |
$1,057.00
|
| Rate for Payer: Priority Health Tiered Network |
$4,057.89
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$1,568.49
|
| Rate for Payer: UHC Medicaid |
$820.32
|
| Rate for Payer: UHCCP Medicaid |
$820.32
|
| Rate for Payer: UMR Bronson Commercial |
$620.77
|
| Rate for Payer: VA VA |
$1,568.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,258.33
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
IP
|
$80.84
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.57 |
| Max. Negotiated Rate |
$72.76 |
| Rate for Payer: Aetna American Axle |
$52.55
|
| Rate for Payer: Aetna Commercial |
$68.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.55
|
| Rate for Payer: Cash Price |
$64.67
|
| Rate for Payer: Cofinity Advantage |
$56.59
|
| Rate for Payer: Cofinity Commercial |
$69.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.67
|
| Rate for Payer: Healthscope Commercial |
$72.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.63
|
| Rate for Payer: PHP Commercial |
$68.71
|
| Rate for Payer: Priority Health SBD |
$50.93
|
| Rate for Payer: UMR Bronson Commercial |
$35.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.63
|
|
|
HC SWEAT CHLORIDE
|
Facility
|
OP
|
$80.84
|
|
|
Service Code
|
CPT 82438
|
| Hospital Charge Code |
30100154
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$72.76 |
| Rate for Payer: Aetna American Axle |
$52.55
|
| Rate for Payer: Aetna Commercial |
$68.71
|
| Rate for Payer: Aetna Medicare |
$5.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.25
|
| Rate for Payer: BCBS Complete |
$2.75
|
| Rate for Payer: BCBS MAPPO |
$5.00
|
| Rate for Payer: BCBS Trust/PPO |
$5.78
|
| Rate for Payer: BCN Commercial |
$5.78
|
| Rate for Payer: BCN Medicare Advantage |
$5.00
|
| Rate for Payer: Cash Price |
$64.67
|
| Rate for Payer: Cash Price |
$64.67
|
| Rate for Payer: Cofinity Advantage |
$56.59
|
| Rate for Payer: Cofinity Commercial |
$69.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.00
|
| Rate for Payer: Healthscope Commercial |
$72.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.63
|
| Rate for Payer: Mclaren Medicaid |
$5.00
|
| Rate for Payer: Mclaren Medicare |
$5.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.25
|
| Rate for Payer: Meridian Medicaid |
$5.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.71
|
| Rate for Payer: Nomi Health Commercial |
$7.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.63
|
| Rate for Payer: PACE Medicare |
$4.75
|
| Rate for Payer: PACE SWMI |
$5.00
|
| Rate for Payer: PHP Commercial |
$68.71
|
| Rate for Payer: PHP Medicare Advantage |
$5.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.00
|
| Rate for Payer: Priority Health Medicare |
$5.00
|
| Rate for Payer: Priority Health SBD |
$50.93
|
| Rate for Payer: Priority Health Tiered Network |
$4.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.50
|
| Rate for Payer: UHC Core |
$7.50
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.00
|
| Rate for Payer: UHC Exchange |
$7.50
|
| Rate for Payer: UHC Medicaid |
$2.62
|
| Rate for Payer: UHCCP Medicaid |
$2.62
|
| Rate for Payer: UMR Bronson Commercial |
$29.91
|
| Rate for Payer: VA VA |
$5.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.63
|
|
|
HC SWEAT COLLECTION
|
Facility
|
IP
|
$101.12
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$44.49 |
| Max. Negotiated Rate |
$91.01 |
| Rate for Payer: Aetna American Axle |
$65.73
|
| Rate for Payer: Aetna Commercial |
$85.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.73
|
| Rate for Payer: Cash Price |
$80.90
|
| Rate for Payer: Cofinity Advantage |
$70.78
|
| Rate for Payer: Cofinity Commercial |
$86.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.90
|
| Rate for Payer: Healthscope Commercial |
$91.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.84
|
| Rate for Payer: PHP Commercial |
$85.95
|
| Rate for Payer: Priority Health SBD |
$63.71
|
| Rate for Payer: UMR Bronson Commercial |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.84
|
|
|
HC SWEAT COLLECTION
|
Facility
|
OP
|
$101.12
|
|
|
Service Code
|
CPT 89230
|
| Hospital Charge Code |
30000004
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.53 |
| Max. Negotiated Rate |
$167.92 |
| Rate for Payer: Aetna American Axle |
$65.73
|
| Rate for Payer: Aetna Commercial |
$85.95
|
| Rate for Payer: Aetna Medicare |
$54.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$65.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.90
|
| Rate for Payer: BCBS Complete |
$28.51
|
| Rate for Payer: BCBS MAPPO |
$51.92
|
| Rate for Payer: BCBS Trust/PPO |
$5.53
|
| Rate for Payer: BCN Commercial |
$5.53
|
| Rate for Payer: BCN Medicare Advantage |
$51.92
|
| Rate for Payer: Cash Price |
$80.90
|
| Rate for Payer: Cash Price |
$80.90
|
| Rate for Payer: Cofinity Advantage |
$70.78
|
| Rate for Payer: Cofinity Commercial |
$86.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.92
|
| Rate for Payer: Healthscope Commercial |
$91.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$70.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.84
|
| Rate for Payer: Mclaren Medicaid |
$51.92
|
| Rate for Payer: Mclaren Medicare |
$51.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.52
|
| Rate for Payer: Meridian Medicaid |
$54.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.95
|
| Rate for Payer: Nomi Health Commercial |
$155.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.84
|
| Rate for Payer: PACE Medicare |
$49.32
|
| Rate for Payer: PACE SWMI |
$51.92
|
| Rate for Payer: PHP Commercial |
$85.95
|
| Rate for Payer: PHP Medicare Advantage |
$51.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$167.92
|
| Rate for Payer: Priority Health Medicare |
$51.92
|
| Rate for Payer: Priority Health SBD |
$63.71
|
| Rate for Payer: Priority Health Tiered Network |
$134.34
|
| Rate for Payer: Railroad Medicare Medicare |
$51.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.15
|
| Rate for Payer: UHC Core |
$80.15
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$51.92
|
| Rate for Payer: UHC Exchange |
$80.15
|
| Rate for Payer: UHC Medicaid |
$27.15
|
| Rate for Payer: UHCCP Medicaid |
$27.15
|
| Rate for Payer: UMR Bronson Commercial |
$37.41
|
| Rate for Payer: VA VA |
$51.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.84
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SWEET VERNAL IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200103
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SYCAMORE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SYCAMORE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200104
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
OP
|
$32.90
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna American Axle |
$21.39
|
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna Medicare |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.93
|
| Rate for Payer: BCN Commercial |
$4.93
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Advantage |
$23.03
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Mclaren Medicaid |
$4.27
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$4.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Nomi Health Commercial |
$12.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.27
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health SBD |
$20.73
|
| Rate for Payer: Priority Health Tiered Network |
$3.42
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.41
|
| Rate for Payer: UHC Core |
$6.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.41
|
| Rate for Payer: UHC Medicaid |
$2.23
|
| Rate for Payer: UHCCP Medicaid |
$2.23
|
| Rate for Payer: UMR Bronson Commercial |
$12.17
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC SYPHILIS ANTIBODY CMPT
|
Facility
|
IP
|
$32.90
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200215
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$29.61 |
| Rate for Payer: Aetna American Axle |
$21.39
|
| Rate for Payer: Aetna Commercial |
$27.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$21.39
|
| Rate for Payer: Cash Price |
$26.32
|
| Rate for Payer: Cofinity Advantage |
$23.03
|
| Rate for Payer: Cofinity Commercial |
$28.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$26.32
|
| Rate for Payer: Healthscope Commercial |
$29.61
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$23.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.68
|
| Rate for Payer: PHP Commercial |
$27.96
|
| Rate for Payer: Priority Health SBD |
$20.73
|
| Rate for Payer: UMR Bronson Commercial |
$14.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.68
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
OP
|
$83.23
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna American Axle |
$54.10
|
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$15.31
|
| Rate for Payer: BCN Commercial |
$15.31
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Advantage |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Mclaren Medicaid |
$13.24
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$13.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Nomi Health Commercial |
$39.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$13.24
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health SBD |
$52.43
|
| Rate for Payer: Priority Health Tiered Network |
$10.59
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.86
|
| Rate for Payer: UHC Core |
$19.86
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$13.24
|
| Rate for Payer: UHC Exchange |
$19.86
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: UMR Bronson Commercial |
$30.80
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC SYPHILLIS AB TP-PA REFLEX
|
Facility
|
IP
|
$83.23
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000082
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$36.62 |
| Max. Negotiated Rate |
$74.91 |
| Rate for Payer: Aetna American Axle |
$54.10
|
| Rate for Payer: Aetna Commercial |
$70.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$54.10
|
| Rate for Payer: Cash Price |
$66.58
|
| Rate for Payer: Cofinity Advantage |
$58.26
|
| Rate for Payer: Cofinity Commercial |
$71.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.58
|
| Rate for Payer: Healthscope Commercial |
$74.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$58.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.42
|
| Rate for Payer: PHP Commercial |
$70.75
|
| Rate for Payer: Priority Health SBD |
$52.43
|
| Rate for Payer: UMR Bronson Commercial |
$36.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.42
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.46 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$18.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.61
|
| Rate for Payer: BCBS Complete |
$9.94
|
| Rate for Payer: BCBS MAPPO |
$18.09
|
| Rate for Payer: BCBS Trust/PPO |
$20.92
|
| Rate for Payer: BCN Commercial |
$20.92
|
| Rate for Payer: BCN Medicare Advantage |
$18.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Advantage |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.09
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$18.09
|
| Rate for Payer: Mclaren Medicare |
$18.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.99
|
| Rate for Payer: Meridian Medicaid |
$18.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$27.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PACE Medicare |
$17.19
|
| Rate for Payer: PACE SWMI |
$18.09
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$18.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$18.09
|
| Rate for Payer: Priority Health Medicare |
$18.09
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Priority Health Tiered Network |
$14.47
|
| Rate for Payer: Railroad Medicare Medicare |
$18.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.14
|
| Rate for Payer: UHC Core |
$27.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.09
|
| Rate for Payer: UHC Exchange |
$27.14
|
| Rate for Payer: UHC Medicaid |
$9.46
|
| Rate for Payer: UHCCP Medicaid |
$9.46
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$18.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC SYPHYLIS NON-TREPONEMAL AB (RPR)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 0065U
|
| Hospital Charge Code |
30200437
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Advantage |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.02
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC T3 FREE
|
Facility
|
OP
|
$134.83
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.86 |
| Max. Negotiated Rate |
$121.35 |
| Rate for Payer: Aetna American Axle |
$87.64
|
| Rate for Payer: Aetna Commercial |
$114.61
|
| Rate for Payer: Aetna Medicare |
$17.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.18
|
| Rate for Payer: BCBS Complete |
$9.30
|
| Rate for Payer: BCBS MAPPO |
$16.94
|
| Rate for Payer: BCBS Trust/PPO |
$19.59
|
| Rate for Payer: BCN Commercial |
$19.59
|
| Rate for Payer: BCN Medicare Advantage |
$16.94
|
| Rate for Payer: Cash Price |
$107.86
|
| Rate for Payer: Cash Price |
$107.86
|
| Rate for Payer: Cofinity Advantage |
$94.38
|
| Rate for Payer: Cofinity Commercial |
$115.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.94
|
| Rate for Payer: Healthscope Commercial |
$121.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.12
|
| Rate for Payer: Mclaren Medicaid |
$16.94
|
| Rate for Payer: Mclaren Medicare |
$16.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.79
|
| Rate for Payer: Meridian Medicaid |
$17.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.61
|
| Rate for Payer: Nomi Health Commercial |
$25.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.12
|
| Rate for Payer: PACE Medicare |
$16.09
|
| Rate for Payer: PACE SWMI |
$16.94
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: PHP Medicare Advantage |
$16.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.94
|
| Rate for Payer: Priority Health Medicare |
$16.94
|
| Rate for Payer: Priority Health SBD |
$84.94
|
| Rate for Payer: Priority Health Tiered Network |
$13.55
|
| Rate for Payer: Railroad Medicare Medicare |
$16.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.41
|
| Rate for Payer: UHC Core |
$25.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.94
|
| Rate for Payer: UHC Exchange |
$25.41
|
| Rate for Payer: UHC Medicaid |
$8.86
|
| Rate for Payer: UHCCP Medicaid |
$8.86
|
| Rate for Payer: UMR Bronson Commercial |
$49.89
|
| Rate for Payer: VA VA |
$16.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.12
|
|
|
HC T3 FREE
|
Facility
|
IP
|
$134.83
|
|
|
Service Code
|
CPT 84481
|
| Hospital Charge Code |
30100448
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$59.33 |
| Max. Negotiated Rate |
$121.35 |
| Rate for Payer: Aetna American Axle |
$87.64
|
| Rate for Payer: Aetna Commercial |
$114.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$87.64
|
| Rate for Payer: Cash Price |
$107.86
|
| Rate for Payer: Cofinity Advantage |
$94.38
|
| Rate for Payer: Cofinity Commercial |
$115.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.86
|
| Rate for Payer: Healthscope Commercial |
$121.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$94.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$101.12
|
| Rate for Payer: PHP Commercial |
$114.61
|
| Rate for Payer: Priority Health SBD |
$84.94
|
| Rate for Payer: UMR Bronson Commercial |
$59.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.12
|
|
|
HC T3 REVERSE
|
Facility
|
OP
|
$59.30
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna Medicare |
$16.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.70
|
| Rate for Payer: BCBS Complete |
$8.66
|
| Rate for Payer: BCBS MAPPO |
$15.76
|
| Rate for Payer: BCBS Trust/PPO |
$18.22
|
| Rate for Payer: BCN Commercial |
$18.22
|
| Rate for Payer: BCN Medicare Advantage |
$15.76
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Advantage |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.76
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Mclaren Medicaid |
$15.76
|
| Rate for Payer: Mclaren Medicare |
$15.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.55
|
| Rate for Payer: Meridian Medicaid |
$16.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$23.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PACE Medicare |
$14.97
|
| Rate for Payer: PACE SWMI |
$15.76
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$15.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.76
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: Priority Health Tiered Network |
$12.61
|
| Rate for Payer: Railroad Medicare Medicare |
$15.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.64
|
| Rate for Payer: UHC Core |
$23.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.76
|
| Rate for Payer: UHC Exchange |
$23.64
|
| Rate for Payer: UHC Medicaid |
$8.24
|
| Rate for Payer: UHCCP Medicaid |
$8.24
|
| Rate for Payer: UMR Bronson Commercial |
$21.94
|
| Rate for Payer: VA VA |
$15.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC T3 REVERSE
|
Facility
|
IP
|
$59.30
|
|
|
Service Code
|
CPT 84482
|
| Hospital Charge Code |
30100660
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.09 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna American Axle |
$38.55
|
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.55
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Advantage |
$41.51
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health SBD |
$37.36
|
| Rate for Payer: UMR Bronson Commercial |
$26.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC T3 UPTAKE
|
Facility
|
IP
|
$139.41
|
|
|
Service Code
|
CPT 84479
|
| Hospital Charge Code |
30100446
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.34 |
| Max. Negotiated Rate |
$125.47 |
| Rate for Payer: Aetna American Axle |
$90.62
|
| Rate for Payer: Aetna Commercial |
$118.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$90.62
|
| Rate for Payer: Cash Price |
$111.53
|
| Rate for Payer: Cofinity Advantage |
$97.59
|
| Rate for Payer: Cofinity Commercial |
$119.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.53
|
| Rate for Payer: Healthscope Commercial |
$125.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$97.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.56
|
| Rate for Payer: PHP Commercial |
$118.50
|
| Rate for Payer: Priority Health SBD |
$87.83
|
| Rate for Payer: UMR Bronson Commercial |
$61.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.56
|
|
