|
HC SENTINEL NODE INJ NON RADIOACTIVE
|
Facility
|
OP
|
$991.36
|
|
|
Service Code
|
HCPCS 38900
|
| Hospital Charge Code |
36000090
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$134.35 |
| Max. Negotiated Rate |
$892.22 |
| Rate for Payer: Aetna American Axle |
$644.38
|
| Rate for Payer: Aetna Commercial |
$842.66
|
| Rate for Payer: Aetna Medicare |
$495.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.38
|
| Rate for Payer: BCBS Complete |
$396.54
|
| Rate for Payer: BCBS Trust/PPO |
$506.66
|
| Rate for Payer: BCN Commercial |
$506.66
|
| Rate for Payer: Cash Price |
$793.09
|
| Rate for Payer: Cash Price |
$793.09
|
| Rate for Payer: Cash Price |
$793.09
|
| Rate for Payer: Cofinity Commercial |
$852.57
|
| Rate for Payer: Cofinity Commercial |
$693.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$693.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.09
|
| Rate for Payer: Healthscope Commercial |
$892.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.66
|
| Rate for Payer: PHP Commercial |
$842.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.38
|
| Rate for Payer: Priority Health SBD |
$624.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.78
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$134.35
|
| Rate for Payer: UMR Bronson Commercial |
$366.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.52
|
|
|
HC SENTINEL NODE INJ NON RADIOACTIVE
|
Facility
|
IP
|
$991.36
|
|
|
Service Code
|
HCPCS 38900
|
| Hospital Charge Code |
36000090
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$436.20 |
| Max. Negotiated Rate |
$892.22 |
| Rate for Payer: Aetna American Axle |
$644.38
|
| Rate for Payer: Aetna Commercial |
$842.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$644.38
|
| Rate for Payer: Cash Price |
$793.09
|
| Rate for Payer: Cofinity Commercial |
$693.95
|
| Rate for Payer: Cofinity Commercial |
$852.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$693.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$793.09
|
| Rate for Payer: Healthscope Commercial |
$892.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$693.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$743.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$842.66
|
| Rate for Payer: PHP Commercial |
$842.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$644.38
|
| Rate for Payer: Priority Health SBD |
$624.56
|
| Rate for Payer: UMR Bronson Commercial |
$436.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$743.52
|
|
|
HC SEQUENTIAL MATERNAL SCRN PART 1
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100655
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.07 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna American Axle |
$59.67
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$15.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.81
|
| Rate for Payer: BCBS Complete |
$8.47
|
| Rate for Payer: BCBS MAPPO |
$15.05
|
| Rate for Payer: BCBS Trust/PPO |
$14.50
|
| Rate for Payer: BCN Commercial |
$14.50
|
| Rate for Payer: BCN Medicare Advantage |
$15.05
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.05
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$15.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.80
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$22.58
|
| Rate for Payer: PACE Medicare |
$14.30
|
| Rate for Payer: PACE SWMI |
$15.05
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$15.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.05
|
| Rate for Payer: Priority Health Medicare |
$15.05
|
| Rate for Payer: Priority Health Narrow Network |
$12.04
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: Railroad Medicare Medicare |
$15.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.05
|
| Rate for Payer: UHC Exchange |
$15.05
|
| Rate for Payer: UHC Medicare Advantage |
$15.05
|
| Rate for Payer: UHCCP Medicaid |
$8.07
|
| Rate for Payer: UMR Bronson Commercial |
$33.97
|
| Rate for Payer: VA VA |
$15.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC SEQUENTIAL MATERNAL SCRN PART 1
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 84163
|
| Hospital Charge Code |
30100655
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.39 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna American Axle |
$59.67
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: UMR Bronson Commercial |
$40.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC SEQUENTIAL MATERNAL SCRN PART 2
|
Facility
|
OP
|
$251.10
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100656
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.28 |
| Max. Negotiated Rate |
$231.90 |
| Rate for Payer: Aetna American Axle |
$163.22
|
| Rate for Payer: Aetna Commercial |
$213.44
|
| Rate for Payer: Aetna Medicare |
$159.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.88
|
| Rate for Payer: BCBS Complete |
$86.39
|
| Rate for Payer: BCBS MAPPO |
$153.50
|
| Rate for Payer: BCBS Trust/PPO |
$147.90
|
| Rate for Payer: BCN Commercial |
$147.90
|
| Rate for Payer: BCN Medicare Advantage |
$153.50
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cofinity Commercial |
$215.95
|
| Rate for Payer: Cofinity Commercial |
$175.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.50
|
| Rate for Payer: Healthscope Commercial |
$225.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.32
|
| Rate for Payer: Mclaren Medicaid |
$82.28
|
| Rate for Payer: Mclaren Medicare |
$153.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$161.18
|
| Rate for Payer: Meridian Medicaid |
$86.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.44
|
| Rate for Payer: Nomi Health Commercial |
$230.25
|
| Rate for Payer: PACE Medicare |
$145.82
|
| Rate for Payer: PACE SWMI |
$153.50
|
| Rate for Payer: PHP Commercial |
$213.44
|
| Rate for Payer: PHP Medicare Advantage |
$153.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.22
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$153.50
|
| Rate for Payer: Priority Health Medicare |
$153.50
|
| Rate for Payer: Priority Health Narrow Network |
$122.80
|
| Rate for Payer: Priority Health SBD |
$158.19
|
| Rate for Payer: Railroad Medicare Medicare |
$153.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.20
|
| Rate for Payer: UHC Core |
$231.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.50
|
| Rate for Payer: UHC Exchange |
$153.50
|
| Rate for Payer: UHC Medicare Advantage |
$153.50
|
| Rate for Payer: UHCCP Medicaid |
$82.28
|
| Rate for Payer: UMR Bronson Commercial |
$92.91
|
| Rate for Payer: VA VA |
$153.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.32
|
|
|
HC SEQUENTIAL MATERNAL SCRN PART 2
|
Facility
|
IP
|
$251.10
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
30100656
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$110.48 |
| Max. Negotiated Rate |
$225.99 |
| Rate for Payer: Aetna American Axle |
$163.22
|
| Rate for Payer: Aetna Commercial |
$213.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$163.22
|
| Rate for Payer: Cash Price |
$200.88
|
| Rate for Payer: Cofinity Commercial |
$175.77
|
| Rate for Payer: Cofinity Commercial |
$215.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.88
|
| Rate for Payer: Healthscope Commercial |
$225.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$188.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$213.44
|
| Rate for Payer: PHP Commercial |
$213.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$163.22
|
| Rate for Payer: Priority Health SBD |
$158.19
|
| Rate for Payer: UMR Bronson Commercial |
$110.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$188.32
|
|
|
HC SERIAL LOOP EXPLANT
|
Facility
|
OP
|
$2,181.53
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
36100082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$82.46 |
| Max. Negotiated Rate |
$2,166.65 |
| Rate for Payer: Aetna American Axle |
$1,417.99
|
| Rate for Payer: Aetna Commercial |
$1,854.30
|
| Rate for Payer: Aetna Medicare |
$716.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,417.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$861.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$861.70
|
| Rate for Payer: BCBS Complete |
$387.97
|
| Rate for Payer: BCBS MAPPO |
$689.36
|
| Rate for Payer: BCBS Trust/PPO |
$680.96
|
| Rate for Payer: BCN Commercial |
$680.96
|
| Rate for Payer: BCN Medicare Advantage |
$689.36
|
| Rate for Payer: Cash Price |
$1,745.22
|
| Rate for Payer: Cash Price |
$1,745.22
|
| Rate for Payer: Cash Price |
$1,745.22
|
| Rate for Payer: Cofinity Commercial |
$1,527.07
|
| Rate for Payer: Cofinity Commercial |
$1,876.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,527.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$689.36
|
| Rate for Payer: Healthscope Commercial |
$1,963.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,527.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,636.15
|
| Rate for Payer: Mclaren Medicaid |
$369.50
|
| Rate for Payer: Mclaren Medicare |
$689.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$723.83
|
| Rate for Payer: Meridian Medicaid |
$387.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$792.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.30
|
| Rate for Payer: Nomi Health Commercial |
$2,068.08
|
| Rate for Payer: PACE Medicare |
$654.89
|
| Rate for Payer: PACE SWMI |
$689.36
|
| Rate for Payer: PHP Commercial |
$1,854.30
|
| Rate for Payer: PHP Medicare Advantage |
$689.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$369.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,166.65
|
| Rate for Payer: Priority Health Medicare |
$689.36
|
| Rate for Payer: Priority Health Narrow Network |
$1,733.32
|
| Rate for Payer: Priority Health SBD |
$1,374.36
|
| Rate for Payer: Railroad Medicare Medicare |
$689.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.71
|
| Rate for Payer: UHC Core |
$981.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$689.36
|
| Rate for Payer: UHC Exchange |
$82.46
|
| Rate for Payer: UHC Medicare Advantage |
$689.36
|
| Rate for Payer: UHCCP Medicaid |
$369.50
|
| Rate for Payer: UMR Bronson Commercial |
$807.17
|
| Rate for Payer: VA VA |
$689.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,636.15
|
|
|
HC SERIAL LOOP EXPLANT
|
Facility
|
IP
|
$2,181.53
|
|
|
Service Code
|
CPT 33286
|
| Hospital Charge Code |
36100082
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$959.87 |
| Max. Negotiated Rate |
$1,963.38 |
| Rate for Payer: Aetna American Axle |
$1,417.99
|
| Rate for Payer: Aetna Commercial |
$1,854.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,417.99
|
| Rate for Payer: Cash Price |
$1,745.22
|
| Rate for Payer: Cofinity Commercial |
$1,527.07
|
| Rate for Payer: Cofinity Commercial |
$1,876.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,527.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,745.22
|
| Rate for Payer: Healthscope Commercial |
$1,963.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,527.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,636.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,854.30
|
| Rate for Payer: PHP Commercial |
$1,854.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,417.99
|
| Rate for Payer: Priority Health SBD |
$1,374.36
|
| Rate for Payer: UMR Bronson Commercial |
$959.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,636.15
|
|
|
HC SERIAL LOOP IMPLANT
|
Facility
|
OP
|
$4,281.51
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
36100081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$84.12 |
| Max. Negotiated Rate |
$25,485.33 |
| Rate for Payer: Aetna American Axle |
$2,782.98
|
| Rate for Payer: Aetna Commercial |
$3,639.28
|
| Rate for Payer: Aetna Medicare |
$8,432.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,782.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10,135.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10,135.80
|
| Rate for Payer: BCBS Complete |
$4,563.54
|
| Rate for Payer: BCBS MAPPO |
$8,108.64
|
| Rate for Payer: BCBS Trust/PPO |
$6,783.93
|
| Rate for Payer: BCN Commercial |
$6,783.93
|
| Rate for Payer: BCN Medicare Advantage |
$8,108.64
|
| Rate for Payer: Cash Price |
$3,425.21
|
| Rate for Payer: Cash Price |
$3,425.21
|
| Rate for Payer: Cash Price |
$3,425.21
|
| Rate for Payer: Cofinity Commercial |
$3,682.10
|
| Rate for Payer: Cofinity Commercial |
$2,997.06
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,997.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,425.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8,108.64
|
| Rate for Payer: Healthscope Commercial |
$3,853.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,997.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,211.13
|
| Rate for Payer: Mclaren Medicaid |
$4,346.23
|
| Rate for Payer: Mclaren Medicare |
$8,108.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8,514.07
|
| Rate for Payer: Meridian Medicaid |
$4,563.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9,324.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,639.28
|
| Rate for Payer: Nomi Health Commercial |
$17,028.14
|
| Rate for Payer: PACE Medicare |
$7,703.21
|
| Rate for Payer: PACE SWMI |
$8,108.64
|
| Rate for Payer: PHP Commercial |
$3,639.28
|
| Rate for Payer: PHP Medicare Advantage |
$8,108.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,346.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,782.98
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$25,485.33
|
| Rate for Payer: Priority Health Medicare |
$8,108.64
|
| Rate for Payer: Priority Health Narrow Network |
$20,388.26
|
| Rate for Payer: Priority Health SBD |
$2,697.35
|
| Rate for Payer: Railroad Medicare Medicare |
$8,108.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.53
|
| Rate for Payer: UHC Core |
$13,752.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$8,108.64
|
| Rate for Payer: UHC Exchange |
$84.12
|
| Rate for Payer: UHC Medicare Advantage |
$8,108.64
|
| Rate for Payer: UHCCP Medicaid |
$4,346.23
|
| Rate for Payer: UMR Bronson Commercial |
$1,584.16
|
| Rate for Payer: VA VA |
$8,108.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,211.13
|
|
|
HC SERIAL LOOP IMPLANT
|
Facility
|
IP
|
$4,281.51
|
|
|
Service Code
|
CPT 33285
|
| Hospital Charge Code |
36100081
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,883.86 |
| Max. Negotiated Rate |
$3,853.36 |
| Rate for Payer: Aetna American Axle |
$2,782.98
|
| Rate for Payer: Aetna Commercial |
$3,639.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,782.98
|
| Rate for Payer: Cash Price |
$3,425.21
|
| Rate for Payer: Cofinity Commercial |
$2,997.06
|
| Rate for Payer: Cofinity Commercial |
$3,682.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,997.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,425.21
|
| Rate for Payer: Healthscope Commercial |
$3,853.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,997.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,211.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,639.28
|
| Rate for Payer: PHP Commercial |
$3,639.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,782.98
|
| Rate for Payer: Priority Health SBD |
$2,697.35
|
| Rate for Payer: UMR Bronson Commercial |
$1,883.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,211.13
|
|
|
HC SERIAL LOOP RECORDER
|
Facility
|
OP
|
$10,450.82
|
|
|
Service Code
|
HCPCS C1764
|
| Hospital Charge Code |
27800025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,866.80 |
| Max. Negotiated Rate |
$9,405.74 |
| Rate for Payer: Aetna American Axle |
$6,793.03
|
| Rate for Payer: Aetna Commercial |
$8,883.20
|
| Rate for Payer: Aetna Medicare |
$5,225.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,793.03
|
| Rate for Payer: BCBS Complete |
$4,180.33
|
| Rate for Payer: Cash Price |
$8,360.66
|
| Rate for Payer: Cofinity Commercial |
$7,315.57
|
| Rate for Payer: Cofinity Commercial |
$8,987.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,315.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,360.66
|
| Rate for Payer: Healthscope Commercial |
$9,405.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,315.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,838.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,883.20
|
| Rate for Payer: PHP Commercial |
$8,883.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,793.03
|
| Rate for Payer: Priority Health SBD |
$6,584.02
|
| Rate for Payer: UMR Bronson Commercial |
$3,866.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,838.12
|
|
|
HC SERIAL LOOP RECORDER
|
Facility
|
IP
|
$10,450.82
|
|
|
Service Code
|
HCPCS C1764
|
| Hospital Charge Code |
27800025
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,598.36 |
| Max. Negotiated Rate |
$9,405.74 |
| Rate for Payer: Aetna American Axle |
$6,793.03
|
| Rate for Payer: Aetna Commercial |
$8,883.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$6,793.03
|
| Rate for Payer: Cash Price |
$8,360.66
|
| Rate for Payer: Cofinity Commercial |
$7,315.57
|
| Rate for Payer: Cofinity Commercial |
$8,987.71
|
| Rate for Payer: Cofinity Medicare Advantage |
$7,315.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,360.66
|
| Rate for Payer: Healthscope Commercial |
$9,405.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$7,315.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,838.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,883.20
|
| Rate for Payer: PHP Commercial |
$8,883.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,793.03
|
| Rate for Payer: Priority Health SBD |
$6,584.02
|
| Rate for Payer: UMR Bronson Commercial |
$4,598.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,838.12
|
|
|
HC SEROTONIN HIAA BLOOD
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 84260
|
| Hospital Charge Code |
30100421
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.61 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna American Axle |
$43.28
|
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna Medicare |
$32.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.72
|
| Rate for Payer: BCBS Complete |
$17.44
|
| Rate for Payer: BCBS MAPPO |
$30.98
|
| Rate for Payer: BCBS Trust/PPO |
$29.85
|
| Rate for Payer: BCN Commercial |
$29.85
|
| Rate for Payer: BCN Medicare Advantage |
$30.98
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Cofinity Commercial |
$46.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.98
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Mclaren Medicaid |
$16.61
|
| Rate for Payer: Mclaren Medicare |
$30.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.53
|
| Rate for Payer: Meridian Medicaid |
$17.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$46.47
|
| Rate for Payer: PACE Medicare |
$29.43
|
| Rate for Payer: PACE SWMI |
$30.98
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: PHP Medicare Advantage |
$30.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.98
|
| Rate for Payer: Priority Health Medicare |
$30.98
|
| Rate for Payer: Priority Health Narrow Network |
$24.78
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: Railroad Medicare Medicare |
$30.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.98
|
| Rate for Payer: UHC Exchange |
$30.98
|
| Rate for Payer: UHC Medicare Advantage |
$30.98
|
| Rate for Payer: UHCCP Medicaid |
$16.61
|
| Rate for Payer: UMR Bronson Commercial |
$24.64
|
| Rate for Payer: VA VA |
$30.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC SEROTONIN HIAA BLOOD
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 84260
|
| Hospital Charge Code |
30100421
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.30 |
| Max. Negotiated Rate |
$59.93 |
| Rate for Payer: Aetna American Axle |
$43.28
|
| Rate for Payer: Aetna Commercial |
$56.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.28
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$57.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$59.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: PHP Commercial |
$56.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.28
|
| Rate for Payer: Priority Health SBD |
$41.95
|
| Rate for Payer: UMR Bronson Commercial |
$29.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.94
|
|
|
HC SEROTONIN RELEASE ASSAY
|
Facility
|
IP
|
$345.41
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200393
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$151.98 |
| Max. Negotiated Rate |
$310.87 |
| Rate for Payer: Aetna American Axle |
$224.52
|
| Rate for Payer: Aetna Commercial |
$293.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.52
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Commercial |
$241.79
|
| Rate for Payer: Cofinity Commercial |
$297.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Healthscope Commercial |
$310.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: PHP Commercial |
$293.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.52
|
| Rate for Payer: Priority Health SBD |
$217.61
|
| Rate for Payer: UMR Bronson Commercial |
$151.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC SEROTONIN RELEASE ASSAY
|
Facility
|
OP
|
$345.41
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200393
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$310.87 |
| Rate for Payer: Aetna American Axle |
$224.52
|
| Rate for Payer: Aetna Commercial |
$293.60
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$224.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.34
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$17.70
|
| Rate for Payer: BCN Commercial |
$17.70
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cash Price |
$276.33
|
| Rate for Payer: Cofinity Commercial |
$297.05
|
| Rate for Payer: Cofinity Commercial |
$241.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$241.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$310.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$241.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.06
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$293.60
|
| Rate for Payer: Nomi Health Commercial |
$27.56
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$293.60
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$224.52
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$14.70
|
| Rate for Payer: Priority Health SBD |
$217.61
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$18.37
|
| Rate for Payer: UHC Medicare Advantage |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.85
|
| Rate for Payer: UMR Bronson Commercial |
$127.80
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.06
|
|
|
HC SEROTONIN RELEASE ASSAY LOVENOX
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200131
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna American Axle |
$68.30
|
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.30
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$73.56
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health SBD |
$66.20
|
| Rate for Payer: UMR Bronson Commercial |
$46.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC SEROTONIN RELEASE ASSAY LOVENOX
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200131
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna American Axle |
$68.30
|
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.34
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$17.70
|
| Rate for Payer: BCN Commercial |
$17.70
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Cofinity Commercial |
$73.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$27.56
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$14.70
|
| Rate for Payer: Priority Health SBD |
$66.20
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$18.37
|
| Rate for Payer: UHC Medicare Advantage |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.85
|
| Rate for Payer: UMR Bronson Commercial |
$38.88
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
OP
|
$407.84
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.85 |
| Max. Negotiated Rate |
$367.06 |
| Rate for Payer: Aetna American Axle |
$265.10
|
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: Aetna Medicare |
$19.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.96
|
| Rate for Payer: BCBS Complete |
$10.34
|
| Rate for Payer: BCBS MAPPO |
$18.37
|
| Rate for Payer: BCBS Trust/PPO |
$17.70
|
| Rate for Payer: BCN Commercial |
$17.70
|
| Rate for Payer: BCN Medicare Advantage |
$18.37
|
| Rate for Payer: Cash Price |
$326.27
|
| Rate for Payer: Cash Price |
$326.27
|
| Rate for Payer: Cofinity Commercial |
$350.74
|
| Rate for Payer: Cofinity Commercial |
$285.49
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.37
|
| Rate for Payer: Healthscope Commercial |
$367.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.88
|
| Rate for Payer: Mclaren Medicaid |
$9.85
|
| Rate for Payer: Mclaren Medicare |
$18.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.29
|
| Rate for Payer: Meridian Medicaid |
$10.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.66
|
| Rate for Payer: Nomi Health Commercial |
$27.56
|
| Rate for Payer: PACE Medicare |
$17.45
|
| Rate for Payer: PACE SWMI |
$18.37
|
| Rate for Payer: PHP Commercial |
$346.66
|
| Rate for Payer: PHP Medicare Advantage |
$18.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$18.37
|
| Rate for Payer: Priority Health Medicare |
$18.37
|
| Rate for Payer: Priority Health Narrow Network |
$14.70
|
| Rate for Payer: Priority Health SBD |
$256.94
|
| Rate for Payer: Railroad Medicare Medicare |
$18.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.37
|
| Rate for Payer: UHC Exchange |
$18.37
|
| Rate for Payer: UHC Medicare Advantage |
$18.37
|
| Rate for Payer: UHCCP Medicaid |
$9.85
|
| Rate for Payer: UMR Bronson Commercial |
$150.90
|
| Rate for Payer: VA VA |
$18.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.88
|
|
|
HC SEROTONIN RELEASE ASSAY PORCINE
|
Facility
|
IP
|
$407.84
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200132
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$179.45 |
| Max. Negotiated Rate |
$367.06 |
| Rate for Payer: Aetna American Axle |
$265.10
|
| Rate for Payer: Aetna Commercial |
$346.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$265.10
|
| Rate for Payer: Cash Price |
$326.27
|
| Rate for Payer: Cofinity Commercial |
$285.49
|
| Rate for Payer: Cofinity Commercial |
$350.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$285.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.27
|
| Rate for Payer: Healthscope Commercial |
$367.06
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$285.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$305.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$346.66
|
| Rate for Payer: PHP Commercial |
$346.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$265.10
|
| Rate for Payer: Priority Health SBD |
$256.94
|
| Rate for Payer: UMR Bronson Commercial |
$179.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$305.88
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.06 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna American Axle |
$50.32
|
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.32
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$54.19
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health SBD |
$48.77
|
| Rate for Payer: UMR Bronson Commercial |
$34.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC SERUM FREE LIGHT CHAIN
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100305
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna American Axle |
$50.32
|
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$16.64
|
| Rate for Payer: BCN Commercial |
$16.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$54.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$25.90
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$13.82
|
| Rate for Payer: Priority Health SBD |
$48.77
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: UMR Bronson Commercial |
$28.65
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.26 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna American Axle |
$50.32
|
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$9.72
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$16.64
|
| Rate for Payer: BCN Commercial |
$16.64
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Cofinity Commercial |
$54.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Mclaren Medicaid |
$9.26
|
| Rate for Payer: Mclaren Medicare |
$17.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$9.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$25.90
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health Narrow Network |
$13.82
|
| Rate for Payer: Priority Health SBD |
$48.77
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$9.26
|
| Rate for Payer: UMR Bronson Commercial |
$28.65
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC SERUM FREE LIGHT CHAIN CMPT
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100306
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.06 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna American Axle |
$50.32
|
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.32
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$54.19
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health SBD |
$48.77
|
| Rate for Payer: UMR Bronson Commercial |
$34.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC SESAME SEED IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200101
|
|
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
|
|
