|
HC RO TRTMNT >1 MEV COMPLEX
|
Facility
|
IP
|
$701.23
|
|
|
Service Code
|
CPT 77412
|
| Hospital Charge Code |
33300049
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$308.54 |
| Max. Negotiated Rate |
$631.11 |
| Rate for Payer: Aetna American Axle |
$455.80
|
| Rate for Payer: Aetna Commercial |
$596.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$455.80
|
| Rate for Payer: Cash Price |
$560.98
|
| Rate for Payer: Cofinity Commercial |
$490.86
|
| Rate for Payer: Cofinity Commercial |
$603.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$490.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$560.98
|
| Rate for Payer: Healthscope Commercial |
$631.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$490.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$525.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.05
|
| Rate for Payer: PHP Commercial |
$596.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$455.80
|
| Rate for Payer: Priority Health SBD |
$441.77
|
| Rate for Payer: UMR Bronson Commercial |
$308.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$525.92
|
|
|
HC RO TRTMNT > 1 MEV INTERMEDIATE
|
Facility
|
OP
|
$421.54
|
|
|
Service Code
|
CPT 77407
|
| Hospital Charge Code |
33300052
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$138.11 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$274.00
|
| Rate for Payer: Aetna Commercial |
$358.31
|
| Rate for Payer: Aetna Medicare |
$267.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.08
|
| Rate for Payer: BCBS Complete |
$145.01
|
| Rate for Payer: BCBS MAPPO |
$257.66
|
| Rate for Payer: BCBS Trust/PPO |
$148.19
|
| Rate for Payer: BCN Commercial |
$148.19
|
| Rate for Payer: BCN Medicare Advantage |
$257.66
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$362.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$295.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.66
|
| Rate for Payer: Healthscope Commercial |
$379.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$295.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.16
|
| Rate for Payer: Mclaren Medicaid |
$138.11
|
| Rate for Payer: Mclaren Medicare |
$257.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$270.54
|
| Rate for Payer: Meridian Medicaid |
$145.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.31
|
| Rate for Payer: Nomi Health Commercial |
$772.98
|
| Rate for Payer: PACE Medicare |
$244.78
|
| Rate for Payer: PACE SWMI |
$257.66
|
| Rate for Payer: PHP Commercial |
$358.31
|
| Rate for Payer: PHP Medicare Advantage |
$257.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$809.82
|
| Rate for Payer: Priority Health Medicare |
$257.66
|
| Rate for Payer: Priority Health Narrow Network |
$647.86
|
| Rate for Payer: Priority Health SBD |
$265.57
|
| Rate for Payer: Railroad Medicare Medicare |
$257.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$725.29
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.66
|
| Rate for Payer: UHC Exchange |
$492.41
|
| Rate for Payer: UHC Medicare Advantage |
$257.66
|
| Rate for Payer: UHCCP Medicaid |
$138.11
|
| Rate for Payer: UMR Bronson Commercial |
$155.97
|
| Rate for Payer: VA VA |
$257.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.16
|
|
|
HC RO TRTMNT > 1 MEV INTERMEDIATE
|
Facility
|
IP
|
$421.54
|
|
|
Service Code
|
CPT 77407
|
| Hospital Charge Code |
33300052
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$185.48 |
| Max. Negotiated Rate |
$379.39 |
| Rate for Payer: Aetna American Axle |
$274.00
|
| Rate for Payer: Aetna Commercial |
$358.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$274.00
|
| Rate for Payer: Cash Price |
$337.23
|
| Rate for Payer: Cofinity Commercial |
$295.08
|
| Rate for Payer: Cofinity Commercial |
$362.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$295.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$337.23
|
| Rate for Payer: Healthscope Commercial |
$379.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$295.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$316.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$358.31
|
| Rate for Payer: PHP Commercial |
$358.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$274.00
|
| Rate for Payer: Priority Health SBD |
$265.57
|
| Rate for Payer: UMR Bronson Commercial |
$185.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$316.16
|
|
|
HC RO TRTMNT >1 MEV SIMPLE
|
Facility
|
OP
|
$231.24
|
|
|
Service Code
|
CPT 77402
|
| Hospital Charge Code |
33300048
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$57.51 |
| Max. Negotiated Rate |
$979.00 |
| Rate for Payer: Aetna American Axle |
$150.31
|
| Rate for Payer: Aetna Commercial |
$196.55
|
| Rate for Payer: Aetna Medicare |
$111.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.11
|
| Rate for Payer: BCBS Complete |
$60.38
|
| Rate for Payer: BCBS MAPPO |
$107.29
|
| Rate for Payer: BCBS Trust/PPO |
$148.19
|
| Rate for Payer: BCN Commercial |
$148.19
|
| Rate for Payer: BCN Medicare Advantage |
$107.29
|
| Rate for Payer: Cash Price |
$184.99
|
| Rate for Payer: Cash Price |
$184.99
|
| Rate for Payer: Cash Price |
$184.99
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Cofinity Commercial |
$198.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$161.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.29
|
| Rate for Payer: Healthscope Commercial |
$208.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.43
|
| Rate for Payer: Mclaren Medicaid |
$57.51
|
| Rate for Payer: Mclaren Medicare |
$107.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$112.65
|
| Rate for Payer: Meridian Medicaid |
$60.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$123.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.55
|
| Rate for Payer: Nomi Health Commercial |
$321.87
|
| Rate for Payer: PACE Medicare |
$101.93
|
| Rate for Payer: PACE SWMI |
$107.29
|
| Rate for Payer: PHP Commercial |
$196.55
|
| Rate for Payer: PHP Medicare Advantage |
$107.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$337.20
|
| Rate for Payer: Priority Health Medicare |
$107.29
|
| Rate for Payer: Priority Health Narrow Network |
$269.76
|
| Rate for Payer: Priority Health SBD |
$145.68
|
| Rate for Payer: Railroad Medicare Medicare |
$107.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.01
|
| Rate for Payer: UHC Core |
$979.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.29
|
| Rate for Payer: UHC Exchange |
$205.04
|
| Rate for Payer: UHC Medicare Advantage |
$107.29
|
| Rate for Payer: UHCCP Medicaid |
$57.51
|
| Rate for Payer: UMR Bronson Commercial |
$85.56
|
| Rate for Payer: VA VA |
$107.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.43
|
|
|
HC RO TRTMNT >1 MEV SIMPLE
|
Facility
|
IP
|
$231.24
|
|
|
Service Code
|
CPT 77402
|
| Hospital Charge Code |
33300048
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$101.75 |
| Max. Negotiated Rate |
$208.12 |
| Rate for Payer: Aetna American Axle |
$150.31
|
| Rate for Payer: Aetna Commercial |
$196.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$150.31
|
| Rate for Payer: Cash Price |
$184.99
|
| Rate for Payer: Cofinity Commercial |
$161.87
|
| Rate for Payer: Cofinity Commercial |
$198.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$161.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.99
|
| Rate for Payer: Healthscope Commercial |
$208.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$173.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$196.55
|
| Rate for Payer: PHP Commercial |
$196.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$150.31
|
| Rate for Payer: Priority Health SBD |
$145.68
|
| Rate for Payer: UMR Bronson Commercial |
$101.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$173.43
|
|
|
HC ROUGH MARSH ELDER IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200058
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC ROUGH MARSH ELDER IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200058
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.52
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$5.04
|
| Rate for Payer: BCN Commercial |
$5.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| 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 |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5.37
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health Narrow Network |
$4.30
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$5.22
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY
|
Facility
|
IP
|
$15,380.00
|
|
|
Service Code
|
CPT 35266
|
| Hospital Charge Code |
36000124
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$6,767.20 |
| Max. Negotiated Rate |
$13,842.00 |
| Rate for Payer: Aetna American Axle |
$9,997.00
|
| Rate for Payer: Aetna Commercial |
$13,073.00
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,997.00
|
| Rate for Payer: Cash Price |
$12,304.00
|
| Rate for Payer: Cofinity Commercial |
$10,766.00
|
| Rate for Payer: Cofinity Commercial |
$13,226.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,766.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,304.00
|
| Rate for Payer: Healthscope Commercial |
$13,842.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,766.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,535.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,073.00
|
| Rate for Payer: PHP Commercial |
$13,073.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,997.00
|
| Rate for Payer: Priority Health SBD |
$9,689.40
|
| Rate for Payer: UMR Bronson Commercial |
$6,767.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,535.00
|
|
|
HC RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY
|
Facility
|
OP
|
$15,380.00
|
|
|
Service Code
|
CPT 35266
|
| Hospital Charge Code |
36000124
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$838.55 |
| Max. Negotiated Rate |
$16,646.50 |
| Rate for Payer: Aetna American Axle |
$9,997.00
|
| Rate for Payer: Aetna Commercial |
$13,073.00
|
| Rate for Payer: Aetna Medicare |
$5,508.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,997.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,620.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,620.50
|
| Rate for Payer: BCBS Complete |
$2,980.81
|
| Rate for Payer: BCBS MAPPO |
$5,296.40
|
| Rate for Payer: BCBS Trust/PPO |
$3,665.22
|
| Rate for Payer: BCN Commercial |
$3,665.22
|
| Rate for Payer: BCN Medicare Advantage |
$5,296.40
|
| Rate for Payer: Cash Price |
$12,304.00
|
| Rate for Payer: Cash Price |
$12,304.00
|
| Rate for Payer: Cash Price |
$12,304.00
|
| Rate for Payer: Cofinity Commercial |
$13,226.80
|
| Rate for Payer: Cofinity Commercial |
$10,766.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$10,766.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12,304.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5,296.40
|
| Rate for Payer: Healthscope Commercial |
$13,842.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10,766.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$11,535.00
|
| Rate for Payer: Mclaren Medicaid |
$2,838.87
|
| Rate for Payer: Mclaren Medicare |
$5,296.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,561.22
|
| Rate for Payer: Meridian Medicaid |
$2,980.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6,090.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13,073.00
|
| Rate for Payer: Nomi Health Commercial |
$11,122.44
|
| Rate for Payer: PACE Medicare |
$5,031.58
|
| Rate for Payer: PACE SWMI |
$5,296.40
|
| Rate for Payer: PHP Commercial |
$13,073.00
|
| Rate for Payer: PHP Medicare Advantage |
$5,296.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,838.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,997.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16,646.50
|
| Rate for Payer: Priority Health Medicare |
$5,296.40
|
| Rate for Payer: Priority Health Narrow Network |
$13,317.20
|
| Rate for Payer: Priority Health SBD |
$9,689.40
|
| Rate for Payer: Railroad Medicare Medicare |
$5,296.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$922.40
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$5,296.40
|
| Rate for Payer: UHC Exchange |
$838.55
|
| Rate for Payer: UHC Medicare Advantage |
$5,296.40
|
| Rate for Payer: UHCCP Medicaid |
$2,838.87
|
| Rate for Payer: UMR Bronson Commercial |
$5,690.60
|
| Rate for Payer: VA VA |
$5,296.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$11,535.00
|
|
|
HC RPR (SYPHILIS SEROLOGY) SERUM
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200213
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| 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: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RPR (SYPHILIS SEROLOGY) SERUM
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86592
|
| Hospital Charge Code |
30200213
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.29 |
| 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 |
$4.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| 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 |
$2.40
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$4.11
|
| Rate for Payer: BCN Commercial |
$4.11
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| 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 |
$4.27
|
| 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 |
$2.29
|
| 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 |
$2.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$12.81
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.40
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$3.52
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.12
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.27
|
| Rate for Payer: UHC Exchange |
$4.27
|
| Rate for Payer: UHC Medicare Advantage |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.29
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$4.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RPR TITER
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200425
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.44 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna American Axle |
$16.91
|
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$18.21
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$18.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| 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: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: UMR Bronson Commercial |
$11.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RPR TITER
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 86593
|
| Hospital Charge Code |
30200425
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.36 |
| 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 |
$4.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.50
|
| Rate for Payer: BCBS Complete |
$2.48
|
| Rate for Payer: BCBS MAPPO |
$4.40
|
| Rate for Payer: BCBS Trust/PPO |
$4.24
|
| Rate for Payer: BCN Commercial |
$4.24
|
| Rate for Payer: BCN Medicare Advantage |
$4.40
|
| 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 |
$4.40
|
| 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 |
$2.36
|
| Rate for Payer: Mclaren Medicare |
$4.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.62
|
| Rate for Payer: Meridian Medicaid |
$2.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$13.20
|
| Rate for Payer: PACE Medicare |
$4.18
|
| Rate for Payer: PACE SWMI |
$4.40
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$4.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4.53
|
| Rate for Payer: Priority Health Medicare |
$4.40
|
| Rate for Payer: Priority Health Narrow Network |
$3.62
|
| Rate for Payer: Priority Health SBD |
$16.39
|
| Rate for Payer: Railroad Medicare Medicare |
$4.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.40
|
| Rate for Payer: UHC Exchange |
$4.40
|
| Rate for Payer: UHC Medicare Advantage |
$4.40
|
| Rate for Payer: UHCCP Medicaid |
$2.36
|
| Rate for Payer: UMR Bronson Commercial |
$9.62
|
| Rate for Payer: VA VA |
$4.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC RSV DNA/RNA AMP PROBE
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 87634
|
| Hospital Charge Code |
30600315
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC RSV DNA/RNA AMP PROBE
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 87634
|
| Hospital Charge Code |
30600315
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$28.87 |
| Max. Negotiated Rate |
$105.30 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$73.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.75
|
| Rate for Payer: BCBS Complete |
$39.51
|
| Rate for Payer: BCBS MAPPO |
$70.20
|
| Rate for Payer: BCBS Trust/PPO |
$67.63
|
| Rate for Payer: BCN Commercial |
$67.63
|
| Rate for Payer: BCN Medicare Advantage |
$70.20
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.20
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$37.63
|
| Rate for Payer: Mclaren Medicare |
$70.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.71
|
| Rate for Payer: Meridian Medicaid |
$39.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$105.30
|
| Rate for Payer: PACE Medicare |
$66.69
|
| Rate for Payer: PACE SWMI |
$70.20
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$70.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$72.22
|
| Rate for Payer: Priority Health Medicare |
$70.20
|
| Rate for Payer: Priority Health Narrow Network |
$57.78
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Railroad Medicare Medicare |
$70.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.20
|
| Rate for Payer: UHC Exchange |
$70.20
|
| Rate for Payer: UHC Medicare Advantage |
$70.20
|
| Rate for Payer: UHCCP Medicaid |
$37.63
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$70.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 0.5ML IM
|
Facility
|
OP
|
$1,302.54
|
|
|
Service Code
|
CPT 90380
|
| Hospital Charge Code |
63600232
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$474.02 |
| Max. Negotiated Rate |
$1,389.36 |
| Rate for Payer: Aetna American Axle |
$846.65
|
| Rate for Payer: Aetna Commercial |
$1,107.16
|
| Rate for Payer: Aetna Medicare |
$651.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.65
|
| Rate for Payer: BCBS Complete |
$521.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,389.36
|
| Rate for Payer: BCN Commercial |
$1,389.36
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cofinity Commercial |
$1,120.18
|
| Rate for Payer: Cofinity Commercial |
$911.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$911.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.03
|
| Rate for Payer: Healthscope Commercial |
$1,172.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$911.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.16
|
| Rate for Payer: PHP Commercial |
$1,107.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$592.52
|
| Rate for Payer: Priority Health Narrow Network |
$474.02
|
| Rate for Payer: Priority Health SBD |
$820.60
|
| Rate for Payer: UMR Bronson Commercial |
$481.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.90
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 0.5ML IM
|
Facility
|
IP
|
$1,302.54
|
|
|
Service Code
|
CPT 90380
|
| Hospital Charge Code |
63600232
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$573.12 |
| Max. Negotiated Rate |
$1,172.29 |
| Rate for Payer: Aetna American Axle |
$846.65
|
| Rate for Payer: Aetna Commercial |
$1,107.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.65
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cofinity Commercial |
$1,120.18
|
| Rate for Payer: Cofinity Commercial |
$911.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$911.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.03
|
| Rate for Payer: Healthscope Commercial |
$1,172.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$911.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.16
|
| Rate for Payer: PHP Commercial |
$1,107.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.65
|
| Rate for Payer: Priority Health SBD |
$820.60
|
| Rate for Payer: UMR Bronson Commercial |
$573.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.90
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 1 ML IM
|
Facility
|
OP
|
$1,302.54
|
|
|
Service Code
|
CPT 90381
|
| Hospital Charge Code |
63600233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$474.02 |
| Max. Negotiated Rate |
$1,389.36 |
| Rate for Payer: Aetna American Axle |
$846.65
|
| Rate for Payer: Aetna Commercial |
$1,107.16
|
| Rate for Payer: Aetna Medicare |
$651.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.65
|
| Rate for Payer: BCBS Complete |
$521.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,389.36
|
| Rate for Payer: BCN Commercial |
$1,389.36
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cofinity Commercial |
$1,120.18
|
| Rate for Payer: Cofinity Commercial |
$911.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$911.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.03
|
| Rate for Payer: Healthscope Commercial |
$1,172.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$911.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.16
|
| Rate for Payer: PHP Commercial |
$1,107.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.65
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$592.52
|
| Rate for Payer: Priority Health Narrow Network |
$474.02
|
| Rate for Payer: Priority Health SBD |
$820.60
|
| Rate for Payer: UMR Bronson Commercial |
$481.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.90
|
|
|
HC RSV MONOCLONAL ANTB SEASONAL 1 ML IM
|
Facility
|
IP
|
$1,302.54
|
|
|
Service Code
|
CPT 90381
|
| Hospital Charge Code |
63600233
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$573.12 |
| Max. Negotiated Rate |
$1,172.29 |
| Rate for Payer: Aetna American Axle |
$846.65
|
| Rate for Payer: Aetna Commercial |
$1,107.16
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$846.65
|
| Rate for Payer: Cash Price |
$1,042.03
|
| Rate for Payer: Cofinity Commercial |
$1,120.18
|
| Rate for Payer: Cofinity Commercial |
$911.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$911.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,042.03
|
| Rate for Payer: Healthscope Commercial |
$1,172.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$911.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$976.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,107.16
|
| Rate for Payer: PHP Commercial |
$1,107.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$846.65
|
| Rate for Payer: Priority Health SBD |
$820.60
|
| Rate for Payer: UMR Bronson Commercial |
$573.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$976.90
|
|
|
HC RT ANGLE BALL COR CANN
|
Facility
|
OP
|
$70.69
|
|
| Hospital Charge Code |
27000268
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.16 |
| Max. Negotiated Rate |
$63.62 |
| Rate for Payer: Aetna American Axle |
$45.95
|
| Rate for Payer: Aetna Commercial |
$60.09
|
| Rate for Payer: Aetna Medicare |
$35.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.95
|
| Rate for Payer: BCBS Complete |
$28.28
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$60.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.09
|
| Rate for Payer: PHP Commercial |
$60.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.95
|
| Rate for Payer: Priority Health SBD |
$44.53
|
| Rate for Payer: UMR Bronson Commercial |
$26.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.02
|
|
|
HC RT ANGLE BALL COR CANN
|
Facility
|
IP
|
$70.69
|
|
| Hospital Charge Code |
27000268
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$63.62 |
| Rate for Payer: Aetna American Axle |
$45.95
|
| Rate for Payer: Aetna Commercial |
$60.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.95
|
| Rate for Payer: Cash Price |
$56.55
|
| Rate for Payer: Cofinity Commercial |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$60.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.55
|
| Rate for Payer: Healthscope Commercial |
$63.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.09
|
| Rate for Payer: PHP Commercial |
$60.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.95
|
| Rate for Payer: Priority Health SBD |
$44.53
|
| Rate for Payer: UMR Bronson Commercial |
$31.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.02
|
|
|
HC RUBELLA ANTIBODY IGC
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC RUBELLA ANTIBODY IGC
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200315
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.39
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$11.51
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$14.39
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC RUBELLA ANTIBODY IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.39
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$11.51
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$14.39
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC RUBELLA ANTIBODY IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86762
|
| Hospital Charge Code |
30200423
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
