|
HC TAVR VALVE LVL 40
|
Facility
|
OP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$15,031.25 |
| Max. Negotiated Rate |
$36,562.50 |
| Rate for Payer: Aetna American Axle |
$26,406.25
|
| Rate for Payer: Aetna Commercial |
$34,531.25
|
| Rate for Payer: Aetna Medicare |
$20,312.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26,406.25
|
| Rate for Payer: BCBS Complete |
$16,250.00
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Advantage |
$28,437.50
|
| Rate for Payer: Cofinity Commercial |
$34,937.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Healthscope Commercial |
$36,562.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28,437.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30,468.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32,500.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,531.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30,468.75
|
| Rate for Payer: PHP Commercial |
$34,531.25
|
| Rate for Payer: Priority Health SBD |
$25,593.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26,406.25
|
| Rate for Payer: UHC Core |
$21,165.62
|
| Rate for Payer: UHC Exchange |
$15,965.62
|
| Rate for Payer: UMR Bronson Commercial |
$15,031.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30,468.75
|
|
|
HC TAVR VALVE LVL 40
|
Facility
|
IP
|
$40,625.00
|
|
| Hospital Charge Code |
27800354
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$17,875.00 |
| Max. Negotiated Rate |
$36,562.50 |
| Rate for Payer: Aetna American Axle |
$26,406.25
|
| Rate for Payer: Aetna Commercial |
$34,531.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26,406.25
|
| Rate for Payer: Cash Price |
$32,500.00
|
| Rate for Payer: Cofinity Advantage |
$28,437.50
|
| Rate for Payer: Cofinity Commercial |
$34,937.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32,500.00
|
| Rate for Payer: Healthscope Commercial |
$36,562.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28,437.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30,468.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34,531.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30,468.75
|
| Rate for Payer: PHP Commercial |
$34,531.25
|
| Rate for Payer: Priority Health SBD |
$25,593.75
|
| Rate for Payer: UMR Bronson Commercial |
$17,875.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30,468.75
|
|
|
HC TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK
|
Facility
|
IP
|
$43.70
|
|
|
Service Code
|
CPT 77089
|
| Hospital Charge Code |
32000343
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$19.23 |
| Max. Negotiated Rate |
$39.33 |
| Rate for Payer: Aetna American Axle |
$28.41
|
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.41
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Advantage |
$30.59
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health SBD |
$27.53
|
| Rate for Payer: UMR Bronson Commercial |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK
|
Facility
|
OP
|
$43.70
|
|
|
Service Code
|
CPT 77089
|
| Hospital Charge Code |
32000343
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$16.17 |
| Max. Negotiated Rate |
$41.53 |
| Rate for Payer: Aetna American Axle |
$28.41
|
| Rate for Payer: Aetna Commercial |
$37.15
|
| Rate for Payer: Aetna Medicare |
$21.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$28.41
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cash Price |
$34.96
|
| Rate for Payer: Cofinity Advantage |
$30.59
|
| Rate for Payer: Cofinity Commercial |
$37.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.96
|
| Rate for Payer: Healthscope Commercial |
$39.33
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$30.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.77
|
| Rate for Payer: PHP Commercial |
$37.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$41.53
|
| Rate for Payer: Priority Health SBD |
$27.53
|
| Rate for Payer: Priority Health Tiered Network |
$33.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.41
|
| Rate for Payer: UHC Core |
$22.77
|
| Rate for Payer: UHC Exchange |
$17.17
|
| Rate for Payer: UMR Bronson Commercial |
$16.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.77
|
|
|
HC TBS TECHNICAL CALCULATION ONLY
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 77091
|
| Hospital Charge Code |
32000335
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$112.16 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna American Axle |
$165.69
|
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: UMR Bronson Commercial |
$112.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC TBS TECHNICAL CALCULATION ONLY
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 77091
|
| Hospital Charge Code |
32000335
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$45.35 |
| Max. Negotiated Rate |
$280.42 |
| Rate for Payer: Aetna American Axle |
$165.69
|
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$90.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.39
|
| Rate for Payer: BCBS Complete |
$47.62
|
| Rate for Payer: BCBS MAPPO |
$86.71
|
| Rate for Payer: BCN Medicare Advantage |
$86.71
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Advantage |
$178.43
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.71
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Mclaren Medicaid |
$86.71
|
| Rate for Payer: Mclaren Medicare |
$86.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.05
|
| Rate for Payer: Meridian Medicaid |
$91.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$260.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PACE Medicare |
$82.37
|
| Rate for Payer: PACE SWMI |
$86.71
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$86.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$280.42
|
| Rate for Payer: Priority Health Medicare |
$86.71
|
| Rate for Payer: Priority Health SBD |
$160.59
|
| Rate for Payer: Priority Health Tiered Network |
$224.34
|
| Rate for Payer: Railroad Medicare Medicare |
$86.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$165.69
|
| Rate for Payer: UHC Core |
$132.80
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$86.71
|
| Rate for Payer: UHC Exchange |
$100.18
|
| Rate for Payer: UHC Medicaid |
$45.35
|
| Rate for Payer: UHCCP Medicaid |
$45.35
|
| Rate for Payer: UMR Bronson Commercial |
$94.31
|
| Rate for Payer: VA VA |
$86.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC TB TEST
|
Facility
|
OP
|
$24.97
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
30000069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$93.19 |
| Rate for Payer: Aetna American Axle |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna Medicare |
$29.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.02
|
| Rate for Payer: BCBS Complete |
$15.83
|
| Rate for Payer: BCBS MAPPO |
$28.82
|
| Rate for Payer: BCBS Trust/PPO |
$18.48
|
| Rate for Payer: BCN Commercial |
$18.48
|
| Rate for Payer: BCN Medicare Advantage |
$28.82
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.82
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Mclaren Medicaid |
$28.82
|
| Rate for Payer: Mclaren Medicare |
$28.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.26
|
| Rate for Payer: Meridian Medicaid |
$30.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$31.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Nomi Health Commercial |
$86.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PACE Medicare |
$27.38
|
| Rate for Payer: PACE SWMI |
$28.82
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: PHP Medicare Advantage |
$28.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$93.19
|
| Rate for Payer: Priority Health Medicare |
$28.82
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: Priority Health Tiered Network |
$74.55
|
| Rate for Payer: Railroad Medicare Medicare |
$28.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.74
|
| Rate for Payer: UHC Core |
$36.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$28.82
|
| Rate for Payer: UHC Exchange |
$36.74
|
| Rate for Payer: UHC Medicaid |
$15.07
|
| Rate for Payer: UHCCP Medicaid |
$15.07
|
| Rate for Payer: UMR Bronson Commercial |
$9.24
|
| Rate for Payer: VA VA |
$28.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC TB TEST
|
Facility
|
IP
|
$24.97
|
|
|
Service Code
|
CPT 86580
|
| Hospital Charge Code |
30000069
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna American Axle |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: UMR Bronson Commercial |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC TC 99M ABD PER STUDY
|
Facility
|
OP
|
$160.67
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300019
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$59.45 |
| Max. Negotiated Rate |
$743.46 |
| Rate for Payer: Aetna American Axle |
$104.44
|
| Rate for Payer: Aetna Commercial |
$136.57
|
| Rate for Payer: Aetna Medicare |
$80.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.44
|
| Rate for Payer: BCBS Complete |
$64.27
|
| Rate for Payer: BCBS Trust/PPO |
$197.44
|
| Rate for Payer: BCN Commercial |
$197.44
|
| Rate for Payer: Cash Price |
$128.54
|
| Rate for Payer: Cash Price |
$128.54
|
| Rate for Payer: Cofinity Advantage |
$112.47
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.54
|
| Rate for Payer: Healthscope Commercial |
$144.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.50
|
| Rate for Payer: PHP Commercial |
$136.57
|
| Rate for Payer: Priority Health SBD |
$101.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$743.46
|
| Rate for Payer: UHC Core |
$743.46
|
| Rate for Payer: UHC Exchange |
$743.46
|
| Rate for Payer: UMR Bronson Commercial |
$59.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.50
|
|
|
HC TC 99M ABD PER STUDY
|
Facility
|
IP
|
$160.67
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300019
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$70.69 |
| Max. Negotiated Rate |
$144.60 |
| Rate for Payer: Aetna American Axle |
$104.44
|
| Rate for Payer: Aetna Commercial |
$136.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$104.44
|
| Rate for Payer: Cash Price |
$128.54
|
| Rate for Payer: Cofinity Advantage |
$112.47
|
| Rate for Payer: Cofinity Commercial |
$138.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.54
|
| Rate for Payer: Healthscope Commercial |
$144.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$112.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$120.50
|
| Rate for Payer: PHP Commercial |
$136.57
|
| Rate for Payer: Priority Health SBD |
$101.22
|
| Rate for Payer: UMR Bronson Commercial |
$70.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.50
|
|
|
HC TC-99M AUTOL WBC DIAG PER DOSE
|
Facility
|
OP
|
$2,706.00
|
|
|
Service Code
|
HCPCS A9569
|
| Hospital Charge Code |
34300027
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$488.55 |
| Max. Negotiated Rate |
$2,946.23 |
| Rate for Payer: Aetna American Axle |
$1,758.90
|
| Rate for Payer: Aetna Commercial |
$2,300.10
|
| Rate for Payer: Aetna Medicare |
$971.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,758.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,167.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,167.66
|
| Rate for Payer: BCBS Complete |
$513.02
|
| Rate for Payer: BCBS MAPPO |
$934.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,603.45
|
| Rate for Payer: BCN Commercial |
$1,603.45
|
| Rate for Payer: BCN Medicare Advantage |
$934.13
|
| Rate for Payer: Cash Price |
$2,164.80
|
| Rate for Payer: Cash Price |
$2,164.80
|
| Rate for Payer: Cofinity Advantage |
$1,894.20
|
| Rate for Payer: Cofinity Commercial |
$2,327.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$934.13
|
| Rate for Payer: Healthscope Commercial |
$2,435.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,894.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,029.50
|
| Rate for Payer: Mclaren Medicaid |
$934.13
|
| Rate for Payer: Mclaren Medicare |
$934.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$980.84
|
| Rate for Payer: Meridian Medicaid |
$980.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,074.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,027.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,300.10
|
| Rate for Payer: Nomi Health Commercial |
$2,802.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,029.50
|
| Rate for Payer: PACE Medicare |
$887.42
|
| Rate for Payer: PACE SWMI |
$934.13
|
| Rate for Payer: PHP Commercial |
$2,300.10
|
| Rate for Payer: PHP Medicare Advantage |
$934.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$488.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2,946.23
|
| Rate for Payer: Priority Health Medicare |
$934.13
|
| Rate for Payer: Priority Health SBD |
$1,704.78
|
| Rate for Payer: Priority Health Tiered Network |
$2,356.98
|
| Rate for Payer: Railroad Medicare Medicare |
$934.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,541.31
|
| Rate for Payer: UHC Core |
$1,541.31
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$934.13
|
| Rate for Payer: UHC Exchange |
$1,541.31
|
| Rate for Payer: UHC Medicaid |
$488.55
|
| Rate for Payer: UHCCP Medicaid |
$488.55
|
| Rate for Payer: UMR Bronson Commercial |
$1,001.22
|
| Rate for Payer: VA VA |
$934.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,029.50
|
|
|
HC TC-99M AUTOL WBC DIAG PER DOSE
|
Facility
|
IP
|
$2,706.00
|
|
|
Service Code
|
HCPCS A9569
|
| Hospital Charge Code |
34300027
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,190.64 |
| Max. Negotiated Rate |
$2,435.40 |
| Rate for Payer: Aetna American Axle |
$1,758.90
|
| Rate for Payer: Aetna Commercial |
$2,300.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,758.90
|
| Rate for Payer: Cash Price |
$2,164.80
|
| Rate for Payer: Cofinity Advantage |
$1,894.20
|
| Rate for Payer: Cofinity Commercial |
$2,327.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,164.80
|
| Rate for Payer: Healthscope Commercial |
$2,435.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,894.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,029.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,300.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,029.50
|
| Rate for Payer: PHP Commercial |
$2,300.10
|
| Rate for Payer: Priority Health SBD |
$1,704.78
|
| Rate for Payer: UMR Bronson Commercial |
$1,190.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,029.50
|
|
|
HC TC99M DTPA AEROSOL <=75 MCI
|
Facility
|
OP
|
$136.70
|
|
|
Service Code
|
HCPCS A9567
|
| Hospital Charge Code |
34300030
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$123.03 |
| Rate for Payer: Aetna American Axle |
$88.86
|
| Rate for Payer: Aetna Commercial |
$116.19
|
| Rate for Payer: Aetna Medicare |
$68.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.86
|
| Rate for Payer: BCBS Complete |
$54.68
|
| Rate for Payer: BCBS Trust/PPO |
$99.06
|
| Rate for Payer: BCN Commercial |
$99.06
|
| Rate for Payer: Cash Price |
$109.36
|
| Rate for Payer: Cash Price |
$109.36
|
| Rate for Payer: Cofinity Advantage |
$95.69
|
| Rate for Payer: Cofinity Commercial |
$117.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.36
|
| Rate for Payer: Healthscope Commercial |
$123.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.53
|
| Rate for Payer: PHP Commercial |
$116.19
|
| Rate for Payer: Priority Health SBD |
$86.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.72
|
| Rate for Payer: UHC Core |
$34.72
|
| Rate for Payer: UHC Exchange |
$34.72
|
| Rate for Payer: UMR Bronson Commercial |
$50.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.53
|
|
|
HC TC99M DTPA AEROSOL <=75 MCI
|
Facility
|
IP
|
$136.70
|
|
|
Service Code
|
HCPCS A9567
|
| Hospital Charge Code |
34300030
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$60.15 |
| Max. Negotiated Rate |
$123.03 |
| Rate for Payer: Aetna American Axle |
$88.86
|
| Rate for Payer: Aetna Commercial |
$116.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$88.86
|
| Rate for Payer: Cash Price |
$109.36
|
| Rate for Payer: Cofinity Advantage |
$95.69
|
| Rate for Payer: Cofinity Commercial |
$117.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.36
|
| Rate for Payer: Healthscope Commercial |
$123.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$95.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.53
|
| Rate for Payer: PHP Commercial |
$116.19
|
| Rate for Payer: Priority Health SBD |
$86.12
|
| Rate for Payer: UMR Bronson Commercial |
$60.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.53
|
|
|
HC TC 99M MAA PER STUDY
|
Facility
|
IP
|
$140.39
|
|
|
Service Code
|
HCPCS A9540
|
| Hospital Charge Code |
34300017
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$61.77 |
| Max. Negotiated Rate |
$126.35 |
| Rate for Payer: Aetna American Axle |
$91.25
|
| Rate for Payer: Aetna Commercial |
$119.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.25
|
| Rate for Payer: Cash Price |
$112.31
|
| Rate for Payer: Cofinity Advantage |
$98.27
|
| Rate for Payer: Cofinity Commercial |
$120.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.31
|
| Rate for Payer: Healthscope Commercial |
$126.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.29
|
| Rate for Payer: PHP Commercial |
$119.33
|
| Rate for Payer: Priority Health SBD |
$88.45
|
| Rate for Payer: UMR Bronson Commercial |
$61.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.29
|
|
|
HC TC 99M MAA PER STUDY
|
Facility
|
OP
|
$140.39
|
|
|
Service Code
|
HCPCS A9540
|
| Hospital Charge Code |
34300017
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$50.14 |
| Max. Negotiated Rate |
$126.35 |
| Rate for Payer: Aetna American Axle |
$91.25
|
| Rate for Payer: Aetna Commercial |
$119.33
|
| Rate for Payer: Aetna Medicare |
$70.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$91.25
|
| Rate for Payer: BCBS Complete |
$56.16
|
| Rate for Payer: BCBS Trust/PPO |
$97.27
|
| Rate for Payer: BCN Commercial |
$97.27
|
| Rate for Payer: Cash Price |
$112.31
|
| Rate for Payer: Cash Price |
$112.31
|
| Rate for Payer: Cofinity Advantage |
$98.27
|
| Rate for Payer: Cofinity Commercial |
$120.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.31
|
| Rate for Payer: Healthscope Commercial |
$126.35
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$98.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$105.29
|
| Rate for Payer: PHP Commercial |
$119.33
|
| Rate for Payer: Priority Health SBD |
$88.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.14
|
| Rate for Payer: UHC Core |
$50.14
|
| Rate for Payer: UHC Exchange |
$50.14
|
| Rate for Payer: UMR Bronson Commercial |
$51.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.29
|
|
|
HC TC 99M MDP PER STUDY
|
Facility
|
IP
|
$145.69
|
|
|
Service Code
|
HCPCS A9503
|
| Hospital Charge Code |
34300018
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$64.10 |
| Max. Negotiated Rate |
$131.12 |
| Rate for Payer: Aetna American Axle |
$94.70
|
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.70
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cofinity Advantage |
$101.98
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: Priority Health SBD |
$91.78
|
| Rate for Payer: UMR Bronson Commercial |
$64.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
|
|
HC TC 99M MDP PER STUDY
|
Facility
|
OP
|
$145.69
|
|
|
Service Code
|
HCPCS A9503
|
| Hospital Charge Code |
34300018
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$53.91 |
| Max. Negotiated Rate |
$131.12 |
| Rate for Payer: Aetna American Axle |
$94.70
|
| Rate for Payer: Aetna Commercial |
$123.84
|
| Rate for Payer: Aetna Medicare |
$72.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.70
|
| Rate for Payer: BCBS Complete |
$58.28
|
| Rate for Payer: BCBS Trust/PPO |
$53.95
|
| Rate for Payer: BCN Commercial |
$53.95
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cash Price |
$116.55
|
| Rate for Payer: Cofinity Advantage |
$101.98
|
| Rate for Payer: Cofinity Commercial |
$125.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.55
|
| Rate for Payer: Healthscope Commercial |
$131.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.27
|
| Rate for Payer: PHP Commercial |
$123.84
|
| Rate for Payer: Priority Health SBD |
$91.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.36
|
| Rate for Payer: UHC Core |
$106.36
|
| Rate for Payer: UHC Exchange |
$106.36
|
| Rate for Payer: UMR Bronson Commercial |
$53.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.27
|
|
|
HC TC 99M PERTECHNETATE PER MCI
|
Facility
|
IP
|
$48.56
|
|
|
Service Code
|
HCPCS A9512
|
| Hospital Charge Code |
34300029
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$21.37 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna American Axle |
$31.56
|
| Rate for Payer: Aetna Commercial |
$41.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.56
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: Cofinity Advantage |
$33.99
|
| Rate for Payer: Cofinity Commercial |
$41.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.85
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.42
|
| Rate for Payer: PHP Commercial |
$41.28
|
| Rate for Payer: Priority Health SBD |
$30.59
|
| Rate for Payer: UMR Bronson Commercial |
$21.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.42
|
|
|
HC TC 99M PERTECHNETATE PER MCI
|
Facility
|
OP
|
$48.56
|
|
|
Service Code
|
HCPCS A9512
|
| Hospital Charge Code |
34300029
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$4.62 |
| Max. Negotiated Rate |
$43.70 |
| Rate for Payer: Aetna American Axle |
$31.56
|
| Rate for Payer: Aetna Commercial |
$41.28
|
| Rate for Payer: Aetna Medicare |
$24.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.56
|
| Rate for Payer: BCBS Complete |
$19.42
|
| Rate for Payer: BCBS Trust/PPO |
$4.62
|
| Rate for Payer: BCN Commercial |
$4.62
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: Cash Price |
$38.85
|
| Rate for Payer: Cofinity Advantage |
$33.99
|
| Rate for Payer: Cofinity Commercial |
$41.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.85
|
| Rate for Payer: Healthscope Commercial |
$43.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.42
|
| Rate for Payer: PHP Commercial |
$41.28
|
| Rate for Payer: Priority Health SBD |
$30.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.83
|
| Rate for Payer: UHC Core |
$19.83
|
| Rate for Payer: UHC Exchange |
$19.83
|
| Rate for Payer: UMR Bronson Commercial |
$17.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.42
|
|
|
HC TC 99M PYROPHOSPHATE PER STUDY UP TO 25 MILLICURIES
|
Facility
|
OP
|
$240.89
|
|
|
Service Code
|
CPT A9538
|
| Hospital Charge Code |
34300037
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$53.22 |
| Max. Negotiated Rate |
$216.80 |
| Rate for Payer: Aetna American Axle |
$156.58
|
| Rate for Payer: Aetna Commercial |
$204.76
|
| Rate for Payer: Aetna Medicare |
$120.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.58
|
| Rate for Payer: BCBS Complete |
$96.36
|
| Rate for Payer: BCBS Trust/PPO |
$53.22
|
| Rate for Payer: BCN Commercial |
$53.22
|
| Rate for Payer: Cash Price |
$192.71
|
| Rate for Payer: Cash Price |
$192.71
|
| Rate for Payer: Cofinity Advantage |
$168.62
|
| Rate for Payer: Cofinity Commercial |
$207.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.71
|
| Rate for Payer: Healthscope Commercial |
$216.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.67
|
| Rate for Payer: PHP Commercial |
$204.76
|
| Rate for Payer: Priority Health SBD |
$151.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.59
|
| Rate for Payer: UHC Core |
$65.59
|
| Rate for Payer: UHC Exchange |
$65.59
|
| Rate for Payer: UMR Bronson Commercial |
$89.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.67
|
|
|
HC TC 99M PYROPHOSPHATE PER STUDY UP TO 25 MILLICURIES
|
Facility
|
IP
|
$240.89
|
|
|
Service Code
|
CPT A9538
|
| Hospital Charge Code |
34300037
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$105.99 |
| Max. Negotiated Rate |
$216.80 |
| Rate for Payer: Aetna American Axle |
$156.58
|
| Rate for Payer: Aetna Commercial |
$204.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$156.58
|
| Rate for Payer: Cash Price |
$192.71
|
| Rate for Payer: Cofinity Advantage |
$168.62
|
| Rate for Payer: Cofinity Commercial |
$207.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$192.71
|
| Rate for Payer: Healthscope Commercial |
$216.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$168.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$180.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$204.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$180.67
|
| Rate for Payer: PHP Commercial |
$204.76
|
| Rate for Payer: Priority Health SBD |
$151.76
|
| Rate for Payer: UMR Bronson Commercial |
$105.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$180.67
|
|
|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
OP
|
$255.30
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$94.46 |
| Max. Negotiated Rate |
$1,239.81 |
| Rate for Payer: Aetna American Axle |
$165.94
|
| Rate for Payer: Aetna Commercial |
$217.00
|
| Rate for Payer: Aetna Medicare |
$127.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.94
|
| Rate for Payer: BCBS Complete |
$102.12
|
| Rate for Payer: BCBS Trust/PPO |
$126.03
|
| Rate for Payer: BCN Commercial |
$126.03
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cofinity Advantage |
$178.71
|
| Rate for Payer: Cofinity Commercial |
$219.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.24
|
| Rate for Payer: Healthscope Commercial |
$229.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$204.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.47
|
| Rate for Payer: PHP Commercial |
$217.00
|
| Rate for Payer: Priority Health SBD |
$160.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,239.81
|
| Rate for Payer: UHC Core |
$1,239.81
|
| Rate for Payer: UHC Exchange |
$1,239.81
|
| Rate for Payer: UMR Bronson Commercial |
$94.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.47
|
|
|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
IP
|
$255.30
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$112.33 |
| Max. Negotiated Rate |
$229.77 |
| Rate for Payer: Aetna American Axle |
$165.94
|
| Rate for Payer: Aetna Commercial |
$217.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$165.94
|
| Rate for Payer: Cash Price |
$204.24
|
| Rate for Payer: Cofinity Advantage |
$178.71
|
| Rate for Payer: Cofinity Commercial |
$219.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$204.24
|
| Rate for Payer: Healthscope Commercial |
$229.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$178.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$217.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.47
|
| Rate for Payer: PHP Commercial |
$217.00
|
| Rate for Payer: Priority Health SBD |
$160.84
|
| Rate for Payer: UMR Bronson Commercial |
$112.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.47
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
OP
|
$36.41
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.20 |
| Max. Negotiated Rate |
$32.77 |
| Rate for Payer: Aetna American Axle |
$23.67
|
| Rate for Payer: Aetna Commercial |
$30.95
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.77
|
| Rate for Payer: BCBS Complete |
$11.76
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$24.77
|
| Rate for Payer: BCN Commercial |
$24.77
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cash Price |
$29.13
|
| Rate for Payer: Cofinity Advantage |
$25.49
|
| Rate for Payer: Cofinity Commercial |
$31.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$29.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$32.77
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$25.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.31
|
| Rate for Payer: Mclaren Medicaid |
$21.42
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$22.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$23.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.95
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.31
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$30.95
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health SBD |
$22.94
|
| Rate for Payer: Priority Health Tiered Network |
$17.14
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.13
|
| Rate for Payer: UHC Core |
$32.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$21.42
|
| Rate for Payer: UHC Exchange |
$32.13
|
| Rate for Payer: UHC Medicaid |
$11.20
|
| Rate for Payer: UHCCP Medicaid |
$11.20
|
| Rate for Payer: UMR Bronson Commercial |
$13.47
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.31
|
|
