|
HC TRYPTASE, S
|
Facility
|
OP
|
$67.92
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100602
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna American Axle |
$44.15
|
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.15
|
| 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 |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Advantage |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| 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 |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$42.79
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$25.13
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC TRYPTASE, S
|
Facility
|
IP
|
$67.92
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100602
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.88 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna American Axle |
$44.15
|
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.15
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Advantage |
$47.54
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: Priority Health SBD |
$42.79
|
| Rate for Payer: UMR Bronson Commercial |
$29.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
IP
|
$68.98
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.35 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna American Axle |
$44.84
|
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: UMR Bronson Commercial |
$30.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC TSH RECEPTOR ANTIBODIES
|
Facility
|
OP
|
$68.98
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100256
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$62.08 |
| Rate for Payer: Aetna American Axle |
$44.84
|
| Rate for Payer: Aetna Commercial |
$58.63
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$44.84
|
| 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 |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$19.96
|
| Rate for Payer: BCN Commercial |
$19.96
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cash Price |
$55.18
|
| Rate for Payer: Cofinity Advantage |
$48.29
|
| Rate for Payer: Cofinity Commercial |
$59.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$62.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.73
|
| Rate for Payer: Mclaren Medicaid |
$17.27
|
| 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 |
$18.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.63
|
| Rate for Payer: Nomi Health Commercial |
$25.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.73
|
| Rate for Payer: PACE Medicare |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$58.63
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.27
|
| Rate for Payer: Priority Health Medicare |
$17.27
|
| Rate for Payer: Priority Health SBD |
$43.46
|
| Rate for Payer: Priority Health Tiered Network |
$13.82
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.91
|
| Rate for Payer: UHC Core |
$25.91
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.27
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicaid |
$9.03
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$25.52
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.73
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.01 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna American Axle |
$31.04
|
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: UMR Bronson Commercial |
$21.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC TSH THYROID STIMULATING HORMONE
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 84443
|
| Hospital Charge Code |
30100438
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna American Axle |
$31.04
|
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$17.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.00
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$19.42
|
| Rate for Payer: BCN Commercial |
$19.42
|
| Rate for Payer: BCN Medicare Advantage |
$16.80
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Advantage |
$33.43
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.80
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$16.80
|
| Rate for Payer: Mclaren Medicare |
$16.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.64
|
| Rate for Payer: Meridian Medicaid |
$17.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$25.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Medicare |
$15.96
|
| Rate for Payer: PACE SWMI |
$16.80
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$16.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$16.80
|
| Rate for Payer: Priority Health Medicare |
$16.80
|
| Rate for Payer: Priority Health SBD |
$30.09
|
| Rate for Payer: Priority Health Tiered Network |
$13.44
|
| Rate for Payer: Railroad Medicare Medicare |
$16.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.20
|
| Rate for Payer: UHC Core |
$25.20
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$16.80
|
| Rate for Payer: UHC Exchange |
$25.20
|
| Rate for Payer: UHC Medicaid |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$8.79
|
| Rate for Payer: UMR Bronson Commercial |
$17.67
|
| Rate for Payer: VA VA |
$16.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
IP
|
$409.92
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$180.36 |
| Max. Negotiated Rate |
$368.93 |
| Rate for Payer: Aetna American Axle |
$266.45
|
| Rate for Payer: Aetna Commercial |
$348.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.45
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cofinity Advantage |
$286.94
|
| Rate for Payer: Cofinity Commercial |
$352.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.94
|
| Rate for Payer: Healthscope Commercial |
$368.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$286.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.44
|
| Rate for Payer: PHP Commercial |
$348.43
|
| Rate for Payer: Priority Health SBD |
$258.25
|
| Rate for Payer: UMR Bronson Commercial |
$180.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.44
|
|
|
HC TUBE CHANGE OF CYSTOSTOMY SIMPLE
|
Facility
|
OP
|
$409.92
|
|
|
Service Code
|
CPT 51705
|
| Hospital Charge Code |
36100253
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$130.20 |
| Max. Negotiated Rate |
$805.08 |
| Rate for Payer: Aetna American Axle |
$266.45
|
| Rate for Payer: Aetna Commercial |
$348.43
|
| Rate for Payer: Aetna Medicare |
$258.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$266.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$311.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$311.19
|
| Rate for Payer: BCBS Complete |
$136.72
|
| Rate for Payer: BCBS MAPPO |
$248.95
|
| Rate for Payer: BCBS Trust/PPO |
$291.15
|
| Rate for Payer: BCN Commercial |
$291.15
|
| Rate for Payer: BCN Medicare Advantage |
$248.95
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cash Price |
$327.94
|
| Rate for Payer: Cofinity Advantage |
$286.94
|
| Rate for Payer: Cofinity Commercial |
$352.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$327.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$248.95
|
| Rate for Payer: Healthscope Commercial |
$368.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$286.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.44
|
| Rate for Payer: Mclaren Medicaid |
$248.95
|
| Rate for Payer: Mclaren Medicare |
$248.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$261.40
|
| Rate for Payer: Meridian Medicaid |
$261.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$286.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$273.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.43
|
| Rate for Payer: Nomi Health Commercial |
$746.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.44
|
| Rate for Payer: PACE Medicare |
$236.50
|
| Rate for Payer: PACE SWMI |
$248.95
|
| Rate for Payer: PHP Commercial |
$348.43
|
| Rate for Payer: PHP Medicare Advantage |
$248.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$130.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$805.08
|
| Rate for Payer: Priority Health Medicare |
$248.95
|
| Rate for Payer: Priority Health SBD |
$258.25
|
| Rate for Payer: Priority Health Tiered Network |
$644.06
|
| Rate for Payer: Railroad Medicare Medicare |
$248.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$266.45
|
| Rate for Payer: UHC Core |
$213.57
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$248.95
|
| Rate for Payer: UHC Exchange |
$161.10
|
| Rate for Payer: UHC Medicaid |
$130.20
|
| Rate for Payer: UHCCP Medicaid |
$130.20
|
| Rate for Payer: UMR Bronson Commercial |
$151.67
|
| Rate for Payer: VA VA |
$248.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.44
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
IP
|
$2,116.00
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$931.04 |
| Max. Negotiated Rate |
$1,904.40 |
| Rate for Payer: Aetna American Axle |
$1,375.40
|
| Rate for Payer: Aetna Commercial |
$1,798.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,375.40
|
| Rate for Payer: Cash Price |
$1,692.80
|
| Rate for Payer: Cofinity Advantage |
$1,481.20
|
| Rate for Payer: Cofinity Commercial |
$1,819.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.80
|
| Rate for Payer: Healthscope Commercial |
$1,904.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,481.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,587.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,798.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,587.00
|
| Rate for Payer: PHP Commercial |
$1,798.60
|
| Rate for Payer: Priority Health SBD |
$1,333.08
|
| Rate for Payer: UMR Bronson Commercial |
$931.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,587.00
|
|
|
HC TUBE CHANGE URETERO VIA ILEALO
|
Facility
|
OP
|
$2,116.00
|
|
|
Service Code
|
CPT 50688
|
| Hospital Charge Code |
36100248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$782.92 |
| Max. Negotiated Rate |
$6,735.82 |
| Rate for Payer: Aetna American Axle |
$1,375.40
|
| Rate for Payer: Aetna Commercial |
$1,798.60
|
| Rate for Payer: Aetna Medicare |
$2,166.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,375.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$1,641.42
|
| Rate for Payer: BCN Commercial |
$1,641.42
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$1,692.80
|
| Rate for Payer: Cash Price |
$1,692.80
|
| Rate for Payer: Cash Price |
$1,692.80
|
| Rate for Payer: Cofinity Advantage |
$1,481.20
|
| Rate for Payer: Cofinity Commercial |
$1,819.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,692.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$1,904.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,481.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,587.00
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$2,187.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,798.60
|
| Rate for Payer: Nomi Health Commercial |
$6,248.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,587.00
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$1,798.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$6,735.82
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health SBD |
$1,333.08
|
| Rate for Payer: Priority Health Tiered Network |
$5,388.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: UMR Bronson Commercial |
$782.92
|
| Rate for Payer: VA VA |
$2,082.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,587.00
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
IP
|
$230.02
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$101.21 |
| Max. Negotiated Rate |
$207.02 |
| Rate for Payer: Aetna American Axle |
$149.51
|
| Rate for Payer: Aetna Commercial |
$195.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.51
|
| Rate for Payer: Cash Price |
$184.02
|
| Rate for Payer: Cofinity Advantage |
$161.01
|
| Rate for Payer: Cofinity Commercial |
$197.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.02
|
| Rate for Payer: Healthscope Commercial |
$207.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.51
|
| Rate for Payer: PHP Commercial |
$195.52
|
| Rate for Payer: Priority Health SBD |
$144.91
|
| Rate for Payer: UMR Bronson Commercial |
$101.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.51
|
|
|
HC TUBE CHECK WITH FLUORO
|
Facility
|
OP
|
$230.02
|
|
|
Service Code
|
CPT 49465
|
| Hospital Charge Code |
36100233
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$85.11 |
| Max. Negotiated Rate |
$768.83 |
| Rate for Payer: Aetna American Axle |
$149.51
|
| Rate for Payer: Aetna Commercial |
$195.52
|
| Rate for Payer: Aetna Medicare |
$247.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$149.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.18
|
| Rate for Payer: BCBS Complete |
$130.57
|
| Rate for Payer: BCBS MAPPO |
$237.74
|
| Rate for Payer: BCBS Trust/PPO |
$316.42
|
| Rate for Payer: BCN Commercial |
$316.42
|
| Rate for Payer: BCN Medicare Advantage |
$237.74
|
| Rate for Payer: Cash Price |
$184.02
|
| Rate for Payer: Cash Price |
$184.02
|
| Rate for Payer: Cash Price |
$184.02
|
| Rate for Payer: Cofinity Advantage |
$161.01
|
| Rate for Payer: Cofinity Commercial |
$197.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$184.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.74
|
| Rate for Payer: Healthscope Commercial |
$207.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$161.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$172.51
|
| Rate for Payer: Mclaren Medicaid |
$237.74
|
| Rate for Payer: Mclaren Medicare |
$237.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.63
|
| Rate for Payer: Meridian Medicaid |
$249.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$195.52
|
| Rate for Payer: Nomi Health Commercial |
$713.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$172.51
|
| Rate for Payer: PACE Medicare |
$225.85
|
| Rate for Payer: PACE SWMI |
$237.74
|
| Rate for Payer: PHP Commercial |
$195.52
|
| Rate for Payer: PHP Medicare Advantage |
$237.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$124.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$768.83
|
| Rate for Payer: Priority Health Medicare |
$237.74
|
| Rate for Payer: Priority Health SBD |
$144.91
|
| Rate for Payer: Priority Health Tiered Network |
$615.06
|
| Rate for Payer: Railroad Medicare Medicare |
$237.74
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$237.74
|
| Rate for Payer: UHC Medicaid |
$124.34
|
| Rate for Payer: UHCCP Medicaid |
$124.34
|
| Rate for Payer: UMR Bronson Commercial |
$85.11
|
| Rate for Payer: VA VA |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$172.51
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
IP
|
$490.49
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.82 |
| Max. Negotiated Rate |
$441.44 |
| Rate for Payer: Aetna American Axle |
$318.82
|
| Rate for Payer: Aetna Commercial |
$416.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.82
|
| Rate for Payer: Cash Price |
$392.39
|
| Rate for Payer: Cofinity Advantage |
$343.34
|
| Rate for Payer: Cofinity Commercial |
$421.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.39
|
| Rate for Payer: Healthscope Commercial |
$441.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.87
|
| Rate for Payer: PHP Commercial |
$416.92
|
| Rate for Payer: Priority Health SBD |
$309.01
|
| Rate for Payer: UMR Bronson Commercial |
$215.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.87
|
|
|
HC TUBE PLACEMENT NASOG OR OROG W FLUO
|
Facility
|
OP
|
$490.49
|
|
|
Service Code
|
CPT 43752
|
| Hospital Charge Code |
36100191
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$181.48 |
| Max. Negotiated Rate |
$1,439.47 |
| Rate for Payer: Aetna American Axle |
$318.82
|
| Rate for Payer: Aetna Commercial |
$416.92
|
| Rate for Payer: Aetna Medicare |
$462.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$318.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$556.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$556.40
|
| Rate for Payer: BCBS Complete |
$244.46
|
| Rate for Payer: BCBS MAPPO |
$445.12
|
| Rate for Payer: BCBS Trust/PPO |
$511.61
|
| Rate for Payer: BCN Commercial |
$511.61
|
| Rate for Payer: BCN Medicare Advantage |
$445.12
|
| Rate for Payer: Cash Price |
$392.39
|
| Rate for Payer: Cash Price |
$392.39
|
| Rate for Payer: Cash Price |
$392.39
|
| Rate for Payer: Cofinity Advantage |
$343.34
|
| Rate for Payer: Cofinity Commercial |
$421.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$392.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$445.12
|
| Rate for Payer: Healthscope Commercial |
$441.44
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$343.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$367.87
|
| Rate for Payer: Mclaren Medicaid |
$445.12
|
| Rate for Payer: Mclaren Medicare |
$445.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$467.38
|
| Rate for Payer: Meridian Medicaid |
$467.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$489.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$416.92
|
| Rate for Payer: Nomi Health Commercial |
$1,335.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$367.87
|
| Rate for Payer: PACE Medicare |
$422.86
|
| Rate for Payer: PACE SWMI |
$445.12
|
| Rate for Payer: PHP Commercial |
$416.92
|
| Rate for Payer: PHP Medicare Advantage |
$445.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$232.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,439.47
|
| Rate for Payer: Priority Health Medicare |
$445.12
|
| Rate for Payer: Priority Health SBD |
$309.01
|
| Rate for Payer: Priority Health Tiered Network |
$1,151.58
|
| Rate for Payer: Railroad Medicare Medicare |
$445.12
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$445.12
|
| Rate for Payer: UHC Medicaid |
$232.80
|
| Rate for Payer: UHCCP Medicaid |
$232.80
|
| Rate for Payer: UMR Bronson Commercial |
$181.48
|
| Rate for Payer: VA VA |
$445.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$367.87
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
IP
|
$315.57
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$138.85 |
| Max. Negotiated Rate |
$284.01 |
| Rate for Payer: Aetna American Axle |
$205.12
|
| Rate for Payer: Aetna Commercial |
$268.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.12
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Advantage |
$220.90
|
| Rate for Payer: Cofinity Commercial |
$271.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Healthscope Commercial |
$284.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| Rate for Payer: PHP Commercial |
$268.23
|
| Rate for Payer: Priority Health SBD |
$198.81
|
| Rate for Payer: UMR Bronson Commercial |
$138.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.68
|
|
|
HC TUBE REPLACEMENT BY PHYSICIAN
|
Facility
|
OP
|
$315.57
|
|
| Hospital Charge Code |
45000055
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$116.76 |
| Max. Negotiated Rate |
$284.01 |
| Rate for Payer: Aetna American Axle |
$205.12
|
| Rate for Payer: Aetna Commercial |
$268.23
|
| Rate for Payer: Aetna Medicare |
$157.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.12
|
| Rate for Payer: BCBS Complete |
$126.23
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cash Price |
$252.46
|
| Rate for Payer: Cofinity Advantage |
$220.90
|
| Rate for Payer: Cofinity Commercial |
$271.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.46
|
| Rate for Payer: Healthscope Commercial |
$284.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$220.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$236.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$252.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$236.68
|
| Rate for Payer: PHP Commercial |
$268.23
|
| Rate for Payer: Priority Health SBD |
$198.81
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: UMR Bronson Commercial |
$116.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$236.68
|
|
|
HC TUBING 1/2
|
Facility
|
OP
|
$18.73
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.93 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Aetna American Axle |
$12.17
|
| Rate for Payer: Aetna Commercial |
$15.92
|
| Rate for Payer: Aetna Medicare |
$9.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.17
|
| Rate for Payer: BCBS Complete |
$7.49
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Advantage |
$13.11
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$16.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.05
|
| Rate for Payer: PHP Commercial |
$15.92
|
| Rate for Payer: Priority Health SBD |
$11.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.17
|
| Rate for Payer: UHC Core |
$9.76
|
| Rate for Payer: UHC Exchange |
$7.36
|
| Rate for Payer: UMR Bronson Commercial |
$6.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.05
|
|
|
HC TUBING 1/2
|
Facility
|
IP
|
$18.73
|
|
| Hospital Charge Code |
27000663
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$16.86 |
| Rate for Payer: Aetna American Axle |
$12.17
|
| Rate for Payer: Aetna Commercial |
$15.92
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.17
|
| Rate for Payer: Cash Price |
$14.98
|
| Rate for Payer: Cofinity Advantage |
$13.11
|
| Rate for Payer: Cofinity Commercial |
$16.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.98
|
| Rate for Payer: Healthscope Commercial |
$16.86
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$14.05
|
| Rate for Payer: PHP Commercial |
$15.92
|
| Rate for Payer: Priority Health SBD |
$11.80
|
| Rate for Payer: UMR Bronson Commercial |
$8.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.05
|
|
|
HC TUBING 1/4
|
Facility
|
OP
|
$24.97
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$9.24 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna American Axle |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna Medicare |
$12.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: BCBS Complete |
$9.99
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.23
|
| Rate for Payer: UHC Core |
$13.01
|
| Rate for Payer: UHC Exchange |
$9.81
|
| Rate for Payer: UMR Bronson Commercial |
$9.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC TUBING 1/4
|
Facility
|
IP
|
$24.97
|
|
| Hospital Charge Code |
27000162
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.99 |
| Max. Negotiated Rate |
$22.47 |
| Rate for Payer: Aetna American Axle |
$16.23
|
| Rate for Payer: Aetna Commercial |
$21.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.23
|
| Rate for Payer: Cash Price |
$19.98
|
| Rate for Payer: Cofinity Advantage |
$17.48
|
| Rate for Payer: Cofinity Commercial |
$21.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.98
|
| Rate for Payer: Healthscope Commercial |
$22.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.73
|
| Rate for Payer: PHP Commercial |
$21.22
|
| Rate for Payer: Priority Health SBD |
$15.73
|
| Rate for Payer: UMR Bronson Commercial |
$10.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.73
|
|
|
HC TUBING 3/8
|
Facility
|
IP
|
$29.65
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.05 |
| Max. Negotiated Rate |
$26.68 |
| Rate for Payer: Aetna American Axle |
$19.27
|
| Rate for Payer: Aetna Commercial |
$25.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.27
|
| Rate for Payer: Cash Price |
$23.72
|
| Rate for Payer: Cofinity Advantage |
$20.75
|
| Rate for Payer: Cofinity Commercial |
$25.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.72
|
| Rate for Payer: Healthscope Commercial |
$26.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.24
|
| Rate for Payer: PHP Commercial |
$25.20
|
| Rate for Payer: Priority Health SBD |
$18.68
|
| Rate for Payer: UMR Bronson Commercial |
$13.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.24
|
|
|
HC TUBING 3/8
|
Facility
|
OP
|
$29.65
|
|
| Hospital Charge Code |
27000113
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.97 |
| Max. Negotiated Rate |
$26.68 |
| Rate for Payer: Aetna American Axle |
$19.27
|
| Rate for Payer: Aetna Commercial |
$25.20
|
| Rate for Payer: Aetna Medicare |
$14.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$19.27
|
| Rate for Payer: BCBS Complete |
$11.86
|
| Rate for Payer: Cash Price |
$23.72
|
| Rate for Payer: Cofinity Advantage |
$20.75
|
| Rate for Payer: Cofinity Commercial |
$25.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.72
|
| Rate for Payer: Healthscope Commercial |
$26.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$20.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.24
|
| Rate for Payer: PHP Commercial |
$25.20
|
| Rate for Payer: Priority Health SBD |
$18.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.27
|
| Rate for Payer: UHC Core |
$15.45
|
| Rate for Payer: UHC Exchange |
$11.65
|
| Rate for Payer: UMR Bronson Commercial |
$10.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.24
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
IP
|
$225.96
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$99.42 |
| Max. Negotiated Rate |
$203.36 |
| Rate for Payer: Aetna American Axle |
$146.87
|
| Rate for Payer: Aetna Commercial |
$192.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.87
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cofinity Advantage |
$158.17
|
| Rate for Payer: Cofinity Commercial |
$194.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.77
|
| Rate for Payer: Healthscope Commercial |
$203.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.47
|
| Rate for Payer: PHP Commercial |
$192.07
|
| Rate for Payer: Priority Health SBD |
$142.35
|
| Rate for Payer: UMR Bronson Commercial |
$99.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.47
|
|
|
HC TUMOR IMMUNOHISTOCHEMISTRY
|
Facility
|
OP
|
$225.96
|
|
|
Service Code
|
CPT 88360
|
| Hospital Charge Code |
31200001
|
|
Hospital Revenue Code
|
312
|
| Min. Negotiated Rate |
$83.61 |
| Max. Negotiated Rate |
$548.99 |
| Rate for Payer: Aetna American Axle |
$146.87
|
| Rate for Payer: Aetna Commercial |
$192.07
|
| Rate for Payer: Aetna Medicare |
$176.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$212.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$212.20
|
| Rate for Payer: BCBS Complete |
$93.23
|
| Rate for Payer: BCBS MAPPO |
$169.76
|
| Rate for Payer: BCBS Trust/PPO |
$145.91
|
| Rate for Payer: BCCCP Commercial |
$110.97
|
| Rate for Payer: BCN Commercial |
$145.91
|
| Rate for Payer: BCN Medicare Advantage |
$169.76
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cash Price |
$180.77
|
| Rate for Payer: Cofinity Advantage |
$158.17
|
| Rate for Payer: Cofinity Commercial |
$194.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$169.76
|
| Rate for Payer: Healthscope Commercial |
$203.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$158.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$169.47
|
| Rate for Payer: Mclaren Medicaid |
$169.76
|
| Rate for Payer: Mclaren Medicare |
$169.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$178.25
|
| Rate for Payer: Meridian Medicaid |
$178.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$195.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$186.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$192.07
|
| Rate for Payer: Nomi Health Commercial |
$509.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$169.47
|
| Rate for Payer: PACE Medicare |
$161.27
|
| Rate for Payer: PACE SWMI |
$169.76
|
| Rate for Payer: PHP Commercial |
$192.07
|
| Rate for Payer: PHP Medicare Advantage |
$169.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$548.99
|
| Rate for Payer: Priority Health Medicare |
$169.76
|
| Rate for Payer: Priority Health SBD |
$142.35
|
| Rate for Payer: Priority Health Tiered Network |
$439.19
|
| Rate for Payer: Railroad Medicare Medicare |
$169.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$257.04
|
| Rate for Payer: UHC Core |
$257.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$169.76
|
| Rate for Payer: UHC Exchange |
$257.04
|
| Rate for Payer: UHC Medicaid |
$88.78
|
| Rate for Payer: UHCCP Medicaid |
$88.78
|
| Rate for Payer: UMR Bronson Commercial |
$83.61
|
| Rate for Payer: VA VA |
$169.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$169.47
|
|
|
HC TUNA IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200067
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
