|
HC THROMBO EMBO CATHETER LVL 88
|
Facility
|
IP
|
$8,810.00
|
|
|
Service Code
|
HCPCS C1757
|
| Hospital Charge Code |
27200383
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,876.40 |
| Max. Negotiated Rate |
$7,929.00 |
| Rate for Payer: Aetna American Axle |
$5,726.50
|
| Rate for Payer: Aetna Commercial |
$7,488.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,726.50
|
| Rate for Payer: Cash Price |
$7,048.00
|
| Rate for Payer: Cofinity Advantage |
$6,167.00
|
| Rate for Payer: Cofinity Commercial |
$7,576.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,048.00
|
| Rate for Payer: Healthscope Commercial |
$7,929.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$6,167.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,607.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,488.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,607.50
|
| Rate for Payer: PHP Commercial |
$7,488.50
|
| Rate for Payer: Priority Health SBD |
$5,550.30
|
| Rate for Payer: UMR Bronson Commercial |
$3,876.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,607.50
|
|
|
HC THROMBO EMBO LVL 141
|
Facility
|
OP
|
$14,159.85
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
27200225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,239.14 |
| Max. Negotiated Rate |
$12,743.86 |
| Rate for Payer: Aetna American Axle |
$9,203.90
|
| Rate for Payer: Aetna Commercial |
$12,035.87
|
| Rate for Payer: Aetna Medicare |
$7,079.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,203.90
|
| Rate for Payer: BCBS Complete |
$5,663.94
|
| Rate for Payer: Cash Price |
$11,327.88
|
| Rate for Payer: Cofinity Advantage |
$9,911.90
|
| Rate for Payer: Cofinity Commercial |
$12,177.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,327.88
|
| Rate for Payer: Healthscope Commercial |
$12,743.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,911.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,619.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11,327.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,035.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,619.89
|
| Rate for Payer: PHP Commercial |
$12,035.87
|
| Rate for Payer: Priority Health SBD |
$8,920.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,203.90
|
| Rate for Payer: UHC Core |
$7,377.28
|
| Rate for Payer: UHC Exchange |
$5,564.82
|
| Rate for Payer: UMR Bronson Commercial |
$5,239.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,619.89
|
|
|
HC THROMBO EMBO LVL 141
|
Facility
|
IP
|
$14,159.85
|
|
|
Service Code
|
CPT C1757
|
| Hospital Charge Code |
27200225
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6,230.33 |
| Max. Negotiated Rate |
$12,743.86 |
| Rate for Payer: Aetna American Axle |
$9,203.90
|
| Rate for Payer: Aetna Commercial |
$12,035.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9,203.90
|
| Rate for Payer: Cash Price |
$11,327.88
|
| Rate for Payer: Cofinity Advantage |
$9,911.90
|
| Rate for Payer: Cofinity Commercial |
$12,177.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,327.88
|
| Rate for Payer: Healthscope Commercial |
$12,743.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,911.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,619.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,035.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,619.89
|
| Rate for Payer: PHP Commercial |
$12,035.87
|
| Rate for Payer: Priority Health SBD |
$8,920.71
|
| Rate for Payer: UMR Bronson Commercial |
$6,230.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,619.89
|
|
|
HC THROMBOLYSIS CEREBRAL IV INFUSION
|
Facility
|
OP
|
$530.20
|
|
|
Service Code
|
CPT 37195
|
| Hospital Charge Code |
45000101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$1,064.33 |
| Rate for Payer: Aetna American Axle |
$344.63
|
| Rate for Payer: Aetna Commercial |
$450.67
|
| Rate for Payer: Aetna Medicare |
$342.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$411.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$411.40
|
| Rate for Payer: BCBS Complete |
$180.75
|
| Rate for Payer: BCBS MAPPO |
$329.12
|
| Rate for Payer: BCBS Trust/PPO |
$315.32
|
| Rate for Payer: BCN Commercial |
$315.32
|
| Rate for Payer: BCN Medicare Advantage |
$329.12
|
| Rate for Payer: Cash Price |
$424.16
|
| Rate for Payer: Cash Price |
$424.16
|
| Rate for Payer: Cash Price |
$424.16
|
| Rate for Payer: Cofinity Advantage |
$371.14
|
| Rate for Payer: Cofinity Commercial |
$455.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$329.12
|
| Rate for Payer: Healthscope Commercial |
$477.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.65
|
| Rate for Payer: Mclaren Medicaid |
$329.12
|
| Rate for Payer: Mclaren Medicare |
$329.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$345.58
|
| Rate for Payer: Meridian Medicaid |
$345.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$378.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$362.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.67
|
| Rate for Payer: Nomi Health Commercial |
$987.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.65
|
| Rate for Payer: PACE Medicare |
$312.66
|
| Rate for Payer: PACE SWMI |
$329.12
|
| Rate for Payer: PHP Commercial |
$450.67
|
| Rate for Payer: PHP Medicare Advantage |
$329.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$172.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,064.33
|
| Rate for Payer: Priority Health Medicare |
$329.12
|
| Rate for Payer: Priority Health SBD |
$334.03
|
| Rate for Payer: Priority Health Tiered Network |
$851.46
|
| Rate for Payer: Railroad Medicare Medicare |
$329.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$329.12
|
| Rate for Payer: UHC Medicaid |
$172.13
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$196.17
|
| Rate for Payer: VA VA |
$329.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.65
|
|
|
HC THROMBOLYSIS CEREBRAL IV INFUSION
|
Facility
|
IP
|
$530.20
|
|
|
Service Code
|
CPT 37195
|
| Hospital Charge Code |
45000101
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$233.29 |
| Max. Negotiated Rate |
$477.18 |
| Rate for Payer: Aetna American Axle |
$344.63
|
| Rate for Payer: Aetna Commercial |
$450.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.63
|
| Rate for Payer: Cash Price |
$424.16
|
| Rate for Payer: Cofinity Advantage |
$371.14
|
| Rate for Payer: Cofinity Commercial |
$455.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$424.16
|
| Rate for Payer: Healthscope Commercial |
$477.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$371.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$397.65
|
| Rate for Payer: PHP Commercial |
$450.67
|
| Rate for Payer: Priority Health SBD |
$334.03
|
| Rate for Payer: UMR Bronson Commercial |
$233.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.65
|
|
|
HC THROMBOLYSIS CESSATION
|
Facility
|
IP
|
$4,737.42
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
36100374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,084.46 |
| Max. Negotiated Rate |
$4,263.68 |
| Rate for Payer: Aetna American Axle |
$3,079.32
|
| Rate for Payer: Aetna Commercial |
$4,026.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,079.32
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Advantage |
$3,316.19
|
| Rate for Payer: Cofinity Commercial |
$4,074.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Healthscope Commercial |
$4,263.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,316.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,553.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PHP Commercial |
$4,026.81
|
| Rate for Payer: Priority Health SBD |
$2,984.57
|
| Rate for Payer: UMR Bronson Commercial |
$2,084.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,553.07
|
|
|
HC THROMBOLYSIS CESSATION
|
Facility
|
OP
|
$4,737.42
|
|
|
Service Code
|
CPT 37214
|
| Hospital Charge Code |
36100374
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$771.92 |
| Max. Negotiated Rate |
$10,174.29 |
| Rate for Payer: Aetna American Axle |
$3,079.32
|
| Rate for Payer: Aetna Commercial |
$4,026.81
|
| Rate for Payer: Aetna Medicare |
$3,271.98
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,079.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,932.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,932.66
|
| Rate for Payer: BCBS Complete |
$1,727.85
|
| Rate for Payer: BCBS MAPPO |
$3,146.13
|
| Rate for Payer: BCBS Trust/PPO |
$771.92
|
| Rate for Payer: BCN Commercial |
$771.92
|
| Rate for Payer: BCN Medicare Advantage |
$3,146.13
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cash Price |
$3,789.94
|
| Rate for Payer: Cofinity Advantage |
$3,316.19
|
| Rate for Payer: Cofinity Commercial |
$4,074.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,789.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,146.13
|
| Rate for Payer: Healthscope Commercial |
$4,263.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,316.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,553.07
|
| Rate for Payer: Mclaren Medicaid |
$3,146.13
|
| Rate for Payer: Mclaren Medicare |
$3,146.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,303.44
|
| Rate for Payer: Meridian Medicaid |
$3,303.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,618.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,460.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,026.81
|
| Rate for Payer: Nomi Health Commercial |
$9,438.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,553.07
|
| Rate for Payer: PACE Medicare |
$2,988.82
|
| Rate for Payer: PACE SWMI |
$3,146.13
|
| Rate for Payer: PHP Commercial |
$4,026.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,146.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,174.29
|
| Rate for Payer: Priority Health Medicare |
$3,146.13
|
| Rate for Payer: Priority Health SBD |
$2,984.57
|
| Rate for Payer: Priority Health Tiered Network |
$8,139.43
|
| Rate for Payer: Railroad Medicare Medicare |
$3,146.13
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,146.13
|
| Rate for Payer: UHC Medicaid |
$1,645.43
|
| Rate for Payer: UHCCP Medicaid |
$1,645.43
|
| Rate for Payer: UMR Bronson Commercial |
$1,752.85
|
| Rate for Payer: VA VA |
$3,146.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,553.07
|
|
|
HC THSD7
|
Facility
|
OP
|
$387.97
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200493
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.30 |
| Max. Negotiated Rate |
$349.17 |
| Rate for Payer: Aetna American Axle |
$252.18
|
| Rate for Payer: Aetna Commercial |
$329.77
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$6.62
|
| Rate for Payer: BCBS MAPPO |
$12.05
|
| Rate for Payer: BCBS Trust/PPO |
$10.45
|
| Rate for Payer: BCN Commercial |
$10.45
|
| Rate for Payer: BCN Medicare Advantage |
$12.05
|
| Rate for Payer: Cash Price |
$310.38
|
| Rate for Payer: Cash Price |
$310.38
|
| Rate for Payer: Cofinity Advantage |
$271.58
|
| Rate for Payer: Cofinity Commercial |
$333.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.05
|
| Rate for Payer: Healthscope Commercial |
$349.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$271.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.98
|
| Rate for Payer: Mclaren Medicaid |
$12.05
|
| Rate for Payer: Mclaren Medicare |
$12.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$12.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.77
|
| Rate for Payer: Nomi Health Commercial |
$18.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.98
|
| Rate for Payer: PACE Medicare |
$11.45
|
| Rate for Payer: PACE SWMI |
$12.05
|
| Rate for Payer: PHP Commercial |
$329.77
|
| Rate for Payer: PHP Medicare Advantage |
$12.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.05
|
| Rate for Payer: Priority Health Medicare |
$12.05
|
| Rate for Payer: Priority Health SBD |
$244.42
|
| Rate for Payer: Priority Health Tiered Network |
$9.64
|
| Rate for Payer: Railroad Medicare Medicare |
$12.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.08
|
| Rate for Payer: UHC Core |
$18.08
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.05
|
| Rate for Payer: UHC Exchange |
$18.08
|
| Rate for Payer: UHC Medicaid |
$6.30
|
| Rate for Payer: UHCCP Medicaid |
$6.30
|
| Rate for Payer: UMR Bronson Commercial |
$143.55
|
| Rate for Payer: VA VA |
$12.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.98
|
|
|
HC THSD7
|
Facility
|
IP
|
$387.97
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200493
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$170.71 |
| Max. Negotiated Rate |
$349.17 |
| Rate for Payer: Aetna American Axle |
$252.18
|
| Rate for Payer: Aetna Commercial |
$329.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$252.18
|
| Rate for Payer: Cash Price |
$310.38
|
| Rate for Payer: Cofinity Advantage |
$271.58
|
| Rate for Payer: Cofinity Commercial |
$333.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.38
|
| Rate for Payer: Healthscope Commercial |
$349.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$271.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$290.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$290.98
|
| Rate for Payer: PHP Commercial |
$329.77
|
| Rate for Payer: Priority Health SBD |
$244.42
|
| Rate for Payer: UMR Bronson Commercial |
$170.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$290.98
|
|
|
HC THYROGLOBULIN
|
Facility
|
IP
|
$59.05
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
30100434
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.98 |
| Max. Negotiated Rate |
$53.15 |
| Rate for Payer: Aetna American Axle |
$38.38
|
| Rate for Payer: Aetna Commercial |
$50.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.38
|
| Rate for Payer: Cash Price |
$47.24
|
| Rate for Payer: Cofinity Advantage |
$41.34
|
| Rate for Payer: Cofinity Commercial |
$50.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.24
|
| Rate for Payer: Healthscope Commercial |
$53.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.29
|
| Rate for Payer: PHP Commercial |
$50.19
|
| Rate for Payer: Priority Health SBD |
$37.20
|
| Rate for Payer: UMR Bronson Commercial |
$25.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.29
|
|
|
HC THYROGLOBULIN
|
Facility
|
OP
|
$59.05
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
30100434
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$53.15 |
| Rate for Payer: Aetna American Axle |
$38.38
|
| Rate for Payer: Aetna Commercial |
$50.19
|
| Rate for Payer: Aetna Medicare |
$16.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$38.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.07
|
| Rate for Payer: BCBS Complete |
$8.82
|
| Rate for Payer: BCBS MAPPO |
$16.06
|
| Rate for Payer: BCBS Trust/PPO |
$18.57
|
| Rate for Payer: BCN Commercial |
$18.57
|
| Rate for Payer: BCN Medicare Advantage |
$16.06
|
| Rate for Payer: Cash Price |
$47.24
|
| Rate for Payer: Cash Price |
$47.24
|
| Rate for Payer: Cofinity Advantage |
$41.34
|
| Rate for Payer: Cofinity Commercial |
$50.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$53.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$41.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.29
|
| Rate for Payer: Mclaren Medicaid |
$16.06
|
| Rate for Payer: Mclaren Medicare |
$16.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.86
|
| Rate for Payer: Meridian Medicaid |
$16.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.19
|
| Rate for Payer: Nomi Health Commercial |
$24.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.29
|
| Rate for Payer: PACE Medicare |
$15.26
|
| Rate for Payer: PACE SWMI |
$16.06
|
| Rate for Payer: PHP Commercial |
$50.19
|
| Rate for Payer: PHP Medicare Advantage |
$16.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.06
|
| Rate for Payer: Priority Health Medicare |
$16.06
|
| Rate for Payer: Priority Health SBD |
$37.20
|
| Rate for Payer: Priority Health Tiered Network |
$12.85
|
| Rate for Payer: Railroad Medicare Medicare |
$16.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.09
|
| Rate for Payer: UHC Core |
$24.09
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.06
|
| Rate for Payer: UHC Exchange |
$24.09
|
| Rate for Payer: UHC Medicaid |
$8.40
|
| Rate for Payer: UHCCP Medicaid |
$8.40
|
| Rate for Payer: UMR Bronson Commercial |
$21.85
|
| Rate for Payer: VA VA |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.29
|
|
|
HC THYROGLOBULIN CMPT
|
Facility
|
IP
|
$61.44
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.03 |
| Max. Negotiated Rate |
$55.30 |
| Rate for Payer: Aetna American Axle |
$39.94
|
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.94
|
| Rate for Payer: Cash Price |
$49.15
|
| Rate for Payer: Cofinity Advantage |
$43.01
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.15
|
| Rate for Payer: Healthscope Commercial |
$55.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.08
|
| Rate for Payer: PHP Commercial |
$52.22
|
| Rate for Payer: Priority Health SBD |
$38.71
|
| Rate for Payer: UMR Bronson Commercial |
$27.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.08
|
|
|
HC THYROGLOBULIN CMPT
|
Facility
|
OP
|
$61.44
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.32 |
| Max. Negotiated Rate |
$55.30 |
| Rate for Payer: Aetna American Axle |
$39.94
|
| Rate for Payer: Aetna Commercial |
$52.22
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.89
|
| Rate for Payer: BCBS Complete |
$8.74
|
| Rate for Payer: BCBS MAPPO |
$15.91
|
| Rate for Payer: BCBS Trust/PPO |
$18.39
|
| Rate for Payer: BCN Commercial |
$18.39
|
| Rate for Payer: BCN Medicare Advantage |
$15.91
|
| Rate for Payer: Cash Price |
$49.15
|
| Rate for Payer: Cash Price |
$49.15
|
| Rate for Payer: Cofinity Advantage |
$43.01
|
| Rate for Payer: Cofinity Commercial |
$52.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.91
|
| Rate for Payer: Healthscope Commercial |
$55.30
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.08
|
| Rate for Payer: Mclaren Medicaid |
$15.91
|
| Rate for Payer: Mclaren Medicare |
$15.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$16.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.22
|
| Rate for Payer: Nomi Health Commercial |
$23.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.08
|
| Rate for Payer: PACE Medicare |
$15.11
|
| Rate for Payer: PACE SWMI |
$15.91
|
| Rate for Payer: PHP Commercial |
$52.22
|
| Rate for Payer: PHP Medicare Advantage |
$15.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$15.91
|
| Rate for Payer: Priority Health Medicare |
$15.91
|
| Rate for Payer: Priority Health SBD |
$38.71
|
| Rate for Payer: Priority Health Tiered Network |
$12.73
|
| Rate for Payer: Railroad Medicare Medicare |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.87
|
| Rate for Payer: UHC Core |
$23.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$15.91
|
| Rate for Payer: UHC Exchange |
$23.87
|
| Rate for Payer: UHC Medicaid |
$8.32
|
| Rate for Payer: UHCCP Medicaid |
$8.32
|
| Rate for Payer: UMR Bronson Commercial |
$22.73
|
| Rate for Payer: VA VA |
$15.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.08
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
IP
|
$595.08
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$261.84 |
| Max. Negotiated Rate |
$535.57 |
| Rate for Payer: Aetna American Axle |
$386.80
|
| Rate for Payer: Aetna Commercial |
$505.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.80
|
| Rate for Payer: Cash Price |
$476.06
|
| Rate for Payer: Cofinity Advantage |
$416.56
|
| Rate for Payer: Cofinity Commercial |
$511.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.06
|
| Rate for Payer: Healthscope Commercial |
$535.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.31
|
| Rate for Payer: PHP Commercial |
$505.82
|
| Rate for Payer: Priority Health SBD |
$374.90
|
| Rate for Payer: UMR Bronson Commercial |
$261.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.31
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
OP
|
$595.08
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$386.80
|
| Rate for Payer: Aetna Commercial |
$505.82
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$386.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$372.69
|
| Rate for Payer: BCN Commercial |
$372.69
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$476.06
|
| Rate for Payer: Cash Price |
$476.06
|
| Rate for Payer: Cofinity Advantage |
$416.56
|
| Rate for Payer: Cofinity Commercial |
$511.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$476.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$535.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$416.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$446.31
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$505.82
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$446.31
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$505.82
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$374.90
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$386.80
|
| Rate for Payer: UHC Core |
$310.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$233.87
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$220.18
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$446.31
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
OP
|
$1,250.15
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$208.33 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$812.60
|
| Rate for Payer: Aetna Commercial |
$1,062.63
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$469.56
|
| Rate for Payer: BCN Commercial |
$469.56
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$1,000.12
|
| Rate for Payer: Cash Price |
$1,000.12
|
| Rate for Payer: Cofinity Advantage |
$875.11
|
| Rate for Payer: Cofinity Commercial |
$1,075.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$1,125.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$875.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$937.61
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,062.63
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$937.61
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$1,062.63
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$787.59
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$812.60
|
| Rate for Payer: UHC Core |
$651.33
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$491.31
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$462.56
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$937.61
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
IP
|
$1,250.15
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$550.07 |
| Max. Negotiated Rate |
$1,125.13 |
| Rate for Payer: Aetna American Axle |
$812.60
|
| Rate for Payer: Aetna Commercial |
$1,062.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$812.60
|
| Rate for Payer: Cash Price |
$1,000.12
|
| Rate for Payer: Cofinity Advantage |
$875.11
|
| Rate for Payer: Cofinity Commercial |
$1,075.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,000.12
|
| Rate for Payer: Healthscope Commercial |
$1,125.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$875.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$937.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,062.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$937.61
|
| Rate for Payer: PHP Commercial |
$1,062.63
|
| Rate for Payer: Priority Health SBD |
$787.59
|
| Rate for Payer: UMR Bronson Commercial |
$550.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$937.61
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
OP
|
$87.29
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.61 |
| Max. Negotiated Rate |
$78.56 |
| Rate for Payer: Aetna American Axle |
$56.74
|
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna Medicare |
$15.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.19
|
| Rate for Payer: BCBS Complete |
$7.99
|
| Rate for Payer: BCBS MAPPO |
$14.55
|
| Rate for Payer: BCBS Trust/PPO |
$16.82
|
| Rate for Payer: BCN Commercial |
$16.82
|
| Rate for Payer: BCN Medicare Advantage |
$14.55
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cofinity Advantage |
$61.10
|
| Rate for Payer: Cofinity Commercial |
$75.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.55
|
| Rate for Payer: Healthscope Commercial |
$78.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.47
|
| Rate for Payer: Mclaren Medicaid |
$14.55
|
| Rate for Payer: Mclaren Medicare |
$14.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.28
|
| Rate for Payer: Meridian Medicaid |
$15.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Nomi Health Commercial |
$21.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.47
|
| Rate for Payer: PACE Medicare |
$13.82
|
| Rate for Payer: PACE SWMI |
$14.55
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: PHP Medicare Advantage |
$14.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$14.55
|
| Rate for Payer: Priority Health Medicare |
$14.55
|
| Rate for Payer: Priority Health SBD |
$54.99
|
| Rate for Payer: Priority Health Tiered Network |
$11.64
|
| Rate for Payer: Railroad Medicare Medicare |
$14.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.83
|
| Rate for Payer: UHC Core |
$21.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$14.55
|
| Rate for Payer: UHC Exchange |
$21.83
|
| Rate for Payer: UHC Medicaid |
$7.61
|
| Rate for Payer: UHCCP Medicaid |
$7.61
|
| Rate for Payer: UMR Bronson Commercial |
$32.30
|
| Rate for Payer: VA VA |
$14.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.47
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
IP
|
$87.29
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.41 |
| Max. Negotiated Rate |
$78.56 |
| Rate for Payer: Aetna American Axle |
$56.74
|
| Rate for Payer: Aetna Commercial |
$74.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.74
|
| Rate for Payer: Cash Price |
$69.83
|
| Rate for Payer: Cofinity Advantage |
$61.10
|
| Rate for Payer: Cofinity Commercial |
$75.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.83
|
| Rate for Payer: Healthscope Commercial |
$78.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.47
|
| Rate for Payer: PHP Commercial |
$74.20
|
| Rate for Payer: Priority Health SBD |
$54.99
|
| Rate for Payer: UMR Bronson Commercial |
$38.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.47
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
IP
|
$91.06
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.07 |
| Max. Negotiated Rate |
$81.95 |
| Rate for Payer: Aetna American Axle |
$59.19
|
| Rate for Payer: Aetna Commercial |
$77.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.19
|
| Rate for Payer: Cash Price |
$72.85
|
| Rate for Payer: Cofinity Advantage |
$63.74
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.85
|
| Rate for Payer: Healthscope Commercial |
$81.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.30
|
| Rate for Payer: PHP Commercial |
$77.40
|
| Rate for Payer: Priority Health SBD |
$57.37
|
| Rate for Payer: UMR Bronson Commercial |
$40.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.30
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
OP
|
$91.06
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.60 |
| Max. Negotiated Rate |
$81.95 |
| Rate for Payer: Aetna American Axle |
$59.19
|
| Rate for Payer: Aetna Commercial |
$77.40
|
| Rate for Payer: Aetna Medicare |
$52.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.58
|
| Rate for Payer: BCBS Complete |
$27.93
|
| Rate for Payer: BCBS MAPPO |
$50.86
|
| Rate for Payer: BCBS Trust/PPO |
$58.80
|
| Rate for Payer: BCN Commercial |
$58.80
|
| Rate for Payer: BCN Medicare Advantage |
$50.86
|
| Rate for Payer: Cash Price |
$72.85
|
| Rate for Payer: Cash Price |
$72.85
|
| Rate for Payer: Cofinity Advantage |
$63.74
|
| Rate for Payer: Cofinity Commercial |
$78.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$81.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$63.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.30
|
| Rate for Payer: Mclaren Medicaid |
$50.86
|
| Rate for Payer: Mclaren Medicare |
$50.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.40
|
| Rate for Payer: Meridian Medicaid |
$53.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$55.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$77.40
|
| Rate for Payer: Nomi Health Commercial |
$76.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$68.30
|
| Rate for Payer: PACE Medicare |
$48.32
|
| Rate for Payer: PACE SWMI |
$50.86
|
| Rate for Payer: PHP Commercial |
$77.40
|
| Rate for Payer: PHP Medicare Advantage |
$50.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$50.86
|
| Rate for Payer: Priority Health Medicare |
$50.86
|
| Rate for Payer: Priority Health SBD |
$57.37
|
| Rate for Payer: Priority Health Tiered Network |
$40.69
|
| Rate for Payer: Railroad Medicare Medicare |
$50.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.29
|
| Rate for Payer: UHC Core |
$76.29
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$50.86
|
| Rate for Payer: UHC Exchange |
$76.29
|
| Rate for Payer: UHC Medicaid |
$26.60
|
| Rate for Payer: UHCCP Medicaid |
$26.60
|
| Rate for Payer: UMR Bronson Commercial |
$33.69
|
| Rate for Payer: VA VA |
$50.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.30
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
IP
|
$146.06
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$64.27 |
| Max. Negotiated Rate |
$131.45 |
| Rate for Payer: Aetna American Axle |
$94.94
|
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.94
|
| Rate for Payer: Cash Price |
$116.85
|
| Rate for Payer: Cofinity Advantage |
$102.24
|
| Rate for Payer: Cofinity Commercial |
$125.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.85
|
| Rate for Payer: Healthscope Commercial |
$131.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.55
|
| Rate for Payer: PHP Commercial |
$124.15
|
| Rate for Payer: Priority Health SBD |
$92.02
|
| Rate for Payer: UMR Bronson Commercial |
$64.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.55
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
OP
|
$146.06
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$54.04 |
| Max. Negotiated Rate |
$743.46 |
| Rate for Payer: Aetna American Axle |
$94.94
|
| Rate for Payer: Aetna Commercial |
$124.15
|
| Rate for Payer: Aetna Medicare |
$73.03
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.94
|
| Rate for Payer: BCBS Complete |
$58.42
|
| Rate for Payer: BCBS Trust/PPO |
$197.44
|
| Rate for Payer: BCN Commercial |
$197.44
|
| Rate for Payer: Cash Price |
$116.85
|
| Rate for Payer: Cash Price |
$116.85
|
| Rate for Payer: Cofinity Advantage |
$102.24
|
| Rate for Payer: Cofinity Commercial |
$125.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.85
|
| Rate for Payer: Healthscope Commercial |
$131.45
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$102.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$116.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.55
|
| Rate for Payer: PHP Commercial |
$124.15
|
| Rate for Payer: Priority Health SBD |
$92.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$743.46
|
| Rate for Payer: UHC Core |
$743.46
|
| Rate for Payer: UHC Exchange |
$743.46
|
| Rate for Payer: UMR Bronson Commercial |
$54.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.55
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
IP
|
$1,077.76
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$474.21 |
| Max. Negotiated Rate |
$969.98 |
| Rate for Payer: Aetna American Axle |
$700.54
|
| Rate for Payer: Aetna Commercial |
$916.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.54
|
| Rate for Payer: Cash Price |
$862.21
|
| Rate for Payer: Cofinity Advantage |
$754.43
|
| Rate for Payer: Cofinity Commercial |
$926.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$862.21
|
| Rate for Payer: Healthscope Commercial |
$969.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$754.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$808.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$916.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$808.32
|
| Rate for Payer: PHP Commercial |
$916.10
|
| Rate for Payer: Priority Health SBD |
$678.99
|
| Rate for Payer: UMR Bronson Commercial |
$474.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$808.32
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
OP
|
$1,077.76
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$178.13 |
| Max. Negotiated Rate |
$1,288.18 |
| Rate for Payer: Aetna American Axle |
$700.54
|
| Rate for Payer: Aetna Commercial |
$916.10
|
| Rate for Payer: Aetna Medicare |
$414.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$700.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$497.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$497.91
|
| Rate for Payer: BCBS Complete |
$218.76
|
| Rate for Payer: BCBS MAPPO |
$398.33
|
| Rate for Payer: BCBS Trust/PPO |
$178.13
|
| Rate for Payer: BCN Commercial |
$178.13
|
| Rate for Payer: BCN Medicare Advantage |
$398.33
|
| Rate for Payer: Cash Price |
$862.21
|
| Rate for Payer: Cash Price |
$862.21
|
| Rate for Payer: Cofinity Advantage |
$754.43
|
| Rate for Payer: Cofinity Commercial |
$926.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$862.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$398.33
|
| Rate for Payer: Healthscope Commercial |
$969.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$754.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$808.32
|
| Rate for Payer: Mclaren Medicaid |
$398.33
|
| Rate for Payer: Mclaren Medicare |
$398.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$418.25
|
| Rate for Payer: Meridian Medicaid |
$418.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$458.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$438.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$916.10
|
| Rate for Payer: Nomi Health Commercial |
$1,194.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$808.32
|
| Rate for Payer: PACE Medicare |
$378.41
|
| Rate for Payer: PACE SWMI |
$398.33
|
| Rate for Payer: PHP Commercial |
$916.10
|
| Rate for Payer: PHP Medicare Advantage |
$398.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$208.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,288.18
|
| Rate for Payer: Priority Health Medicare |
$398.33
|
| Rate for Payer: Priority Health SBD |
$678.99
|
| Rate for Payer: Priority Health Tiered Network |
$1,030.54
|
| Rate for Payer: Railroad Medicare Medicare |
$398.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$700.54
|
| Rate for Payer: UHC Core |
$561.51
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$398.33
|
| Rate for Payer: UHC Exchange |
$423.56
|
| Rate for Payer: UHC Medicaid |
$208.33
|
| Rate for Payer: UHCCP Medicaid |
$208.33
|
| Rate for Payer: UMR Bronson Commercial |
$398.77
|
| Rate for Payer: VA VA |
$398.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$808.32
|
|
