|
HC STREP PNEUMONIAE ANTIGEN
|
Facility
|
IP
|
$80.53
|
|
|
Service Code
|
CPT 87449
|
| Hospital Charge Code |
30600147
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$35.43 |
| Max. Negotiated Rate |
$72.48 |
| Rate for Payer: Aetna American Axle |
$52.34
|
| Rate for Payer: Aetna Commercial |
$68.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$52.34
|
| Rate for Payer: Cash Price |
$64.42
|
| Rate for Payer: Cofinity Commercial |
$56.37
|
| Rate for Payer: Cofinity Commercial |
$69.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$56.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.42
|
| Rate for Payer: Healthscope Commercial |
$72.48
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$56.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.45
|
| Rate for Payer: PHP Commercial |
$68.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$52.34
|
| Rate for Payer: Priority Health SBD |
$50.73
|
| Rate for Payer: UMR Bronson Commercial |
$35.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.40
|
|
|
HC STREP PNEUMONIAE IGG 7 CMPTS
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200361
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$42.20 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$15.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.74
|
| Rate for Payer: BCBS Complete |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$14.99
|
| Rate for Payer: BCN Medicare Advantage |
$14.99
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$8.03
|
| Rate for Payer: Mclaren Medicare |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.74
|
| Rate for Payer: Meridian Medicaid |
$8.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PACE Medicare |
$14.24
|
| Rate for Payer: PACE SWMI |
$14.99
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$14.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health Medicare |
$14.99
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.99
|
| Rate for Payer: UHC Exchange |
$28.65
|
| Rate for Payer: UHC Medicare Advantage |
$14.99
|
| Rate for Payer: UHCCP Medicaid |
$8.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$14.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC STREP PNEUMONIAE IGG 7 CMPTS
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200361
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: UMR Bronson Commercial |
$9.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC STREP PNEUMONIAE IGG 7 SEROTYP
|
Facility
|
IP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200188
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.16 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: UMR Bronson Commercial |
$9.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC STREP PNEUMONIAE IGG 7 SEROTYP
|
Facility
|
OP
|
$20.81
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200188
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$42.20 |
| Rate for Payer: Aetna American Axle |
$13.53
|
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$15.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.74
|
| Rate for Payer: BCBS Complete |
$8.44
|
| Rate for Payer: BCBS MAPPO |
$14.99
|
| Rate for Payer: BCN Medicare Advantage |
$14.99
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Cofinity Commercial |
$14.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$14.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.99
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Mclaren Medicaid |
$8.03
|
| Rate for Payer: Mclaren Medicare |
$14.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.74
|
| Rate for Payer: Meridian Medicaid |
$8.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: PACE Medicare |
$14.24
|
| Rate for Payer: PACE SWMI |
$14.99
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$14.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health Medicare |
$14.99
|
| Rate for Payer: Priority Health SBD |
$13.11
|
| Rate for Payer: Railroad Medicare Medicare |
$14.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.99
|
| Rate for Payer: UHC Exchange |
$28.65
|
| Rate for Payer: UHC Medicare Advantage |
$14.99
|
| Rate for Payer: UHCCP Medicaid |
$8.03
|
| Rate for Payer: UMR Bronson Commercial |
$7.70
|
| Rate for Payer: VA VA |
$14.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC STREPTOCOCCUS AGALACTIAE
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87653
|
| Hospital Charge Code |
30600276
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC STREPTOCOCCUS PNEUMONIA
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600277
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$98.77 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
IP
|
$355.74
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$156.53 |
| Max. Negotiated Rate |
$320.17 |
| Rate for Payer: Aetna American Axle |
$231.23
|
| Rate for Payer: Aetna Commercial |
$302.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.23
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$249.02
|
| Rate for Payer: Cofinity Commercial |
$305.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$249.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.59
|
| Rate for Payer: Healthscope Commercial |
$320.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$249.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.38
|
| Rate for Payer: PHP Commercial |
$302.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.23
|
| Rate for Payer: Priority Health SBD |
$224.12
|
| Rate for Payer: UMR Bronson Commercial |
$156.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.81
|
|
|
HC STRESS COMPLETE PHYSIOLOGY ARTERIES
|
Facility
|
OP
|
$355.74
|
|
|
Service Code
|
CPT 93924
|
| Hospital Charge Code |
92100021
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$81.79 |
| Max. Negotiated Rate |
$587.00 |
| Rate for Payer: Aetna American Axle |
$231.23
|
| Rate for Payer: Aetna Commercial |
$302.38
|
| Rate for Payer: Aetna Medicare |
$158.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$190.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$190.74
|
| Rate for Payer: BCBS Complete |
$85.88
|
| Rate for Payer: BCBS MAPPO |
$152.59
|
| Rate for Payer: BCN Medicare Advantage |
$152.59
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cash Price |
$284.59
|
| Rate for Payer: Cofinity Commercial |
$249.02
|
| Rate for Payer: Cofinity Commercial |
$305.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$249.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$152.59
|
| Rate for Payer: Healthscope Commercial |
$320.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$249.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.81
|
| Rate for Payer: Mclaren Medicaid |
$81.79
|
| Rate for Payer: Mclaren Medicare |
$152.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.22
|
| Rate for Payer: Meridian Medicaid |
$85.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$175.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.38
|
| Rate for Payer: PACE Medicare |
$144.96
|
| Rate for Payer: PACE SWMI |
$152.59
|
| Rate for Payer: PHP Commercial |
$302.38
|
| Rate for Payer: PHP Medicare Advantage |
$152.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$81.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.23
|
| Rate for Payer: Priority Health Medicare |
$152.59
|
| Rate for Payer: Priority Health SBD |
$224.12
|
| Rate for Payer: Railroad Medicare Medicare |
$152.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$429.53
|
| Rate for Payer: UHC Core |
$587.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$152.59
|
| Rate for Payer: UHC Exchange |
$291.61
|
| Rate for Payer: UHC Medicare Advantage |
$152.59
|
| Rate for Payer: UHCCP Medicaid |
$81.79
|
| Rate for Payer: UMR Bronson Commercial |
$131.62
|
| Rate for Payer: VA VA |
$152.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.81
|
|
|
HC STRESS ECHO
|
Facility
|
OP
|
$1,515.37
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$286.63 |
| Max. Negotiated Rate |
$1,505.27 |
| Rate for Payer: Aetna American Axle |
$984.99
|
| Rate for Payer: Aetna Commercial |
$1,288.06
|
| Rate for Payer: Aetna Medicare |
$556.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.44
|
| Rate for Payer: BCBS Complete |
$300.96
|
| Rate for Payer: BCBS MAPPO |
$534.75
|
| Rate for Payer: BCN Medicare Advantage |
$534.75
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cofinity Commercial |
$1,060.76
|
| Rate for Payer: Cofinity Commercial |
$1,303.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,060.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,212.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.75
|
| Rate for Payer: Healthscope Commercial |
$1,363.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,060.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,136.53
|
| Rate for Payer: Mclaren Medicaid |
$286.63
|
| Rate for Payer: Mclaren Medicare |
$534.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.49
|
| Rate for Payer: Meridian Medicaid |
$300.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.06
|
| Rate for Payer: PACE Medicare |
$508.01
|
| Rate for Payer: PACE SWMI |
$534.75
|
| Rate for Payer: PHP Commercial |
$1,288.06
|
| Rate for Payer: PHP Medicare Advantage |
$534.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$286.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.99
|
| Rate for Payer: Priority Health Medicare |
$534.75
|
| Rate for Payer: Priority Health SBD |
$954.68
|
| Rate for Payer: Railroad Medicare Medicare |
$534.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,505.27
|
| Rate for Payer: UHC Core |
$816.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$534.75
|
| Rate for Payer: UHC Exchange |
$1,021.96
|
| Rate for Payer: UHC Medicare Advantage |
$534.75
|
| Rate for Payer: UHCCP Medicaid |
$286.63
|
| Rate for Payer: UMR Bronson Commercial |
$560.69
|
| Rate for Payer: VA VA |
$534.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,136.53
|
|
|
HC STRESS ECHO
|
Facility
|
IP
|
$1,515.37
|
|
|
Service Code
|
CPT 93350
|
| Hospital Charge Code |
48000008
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$666.76 |
| Max. Negotiated Rate |
$1,363.83 |
| Rate for Payer: Aetna American Axle |
$984.99
|
| Rate for Payer: Aetna Commercial |
$1,288.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$984.99
|
| Rate for Payer: Cash Price |
$1,212.30
|
| Rate for Payer: Cofinity Commercial |
$1,060.76
|
| Rate for Payer: Cofinity Commercial |
$1,303.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,060.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,212.30
|
| Rate for Payer: Healthscope Commercial |
$1,363.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,060.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,136.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,288.06
|
| Rate for Payer: PHP Commercial |
$1,288.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$984.99
|
| Rate for Payer: Priority Health SBD |
$954.68
|
| Rate for Payer: UMR Bronson Commercial |
$666.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,136.53
|
|
|
HC STRESS TEST
|
Facility
|
OP
|
$901.94
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$162.78 |
| Max. Negotiated Rate |
$854.89 |
| Rate for Payer: Aetna American Axle |
$586.26
|
| Rate for Payer: Aetna Commercial |
$766.65
|
| Rate for Payer: Aetna Medicare |
$315.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$379.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$379.62
|
| Rate for Payer: BCBS Complete |
$170.92
|
| Rate for Payer: BCBS MAPPO |
$303.70
|
| Rate for Payer: BCN Medicare Advantage |
$303.70
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cofinity Commercial |
$631.36
|
| Rate for Payer: Cofinity Commercial |
$775.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$631.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$303.70
|
| Rate for Payer: Healthscope Commercial |
$811.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$631.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$676.46
|
| Rate for Payer: Mclaren Medicaid |
$162.78
|
| Rate for Payer: Mclaren Medicare |
$303.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$318.88
|
| Rate for Payer: Meridian Medicaid |
$170.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$349.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.65
|
| Rate for Payer: PACE Medicare |
$288.51
|
| Rate for Payer: PACE SWMI |
$303.70
|
| Rate for Payer: PHP Commercial |
$766.65
|
| Rate for Payer: PHP Medicare Advantage |
$303.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$162.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.26
|
| Rate for Payer: Priority Health Medicare |
$303.70
|
| Rate for Payer: Priority Health SBD |
$568.22
|
| Rate for Payer: Railroad Medicare Medicare |
$303.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$854.89
|
| Rate for Payer: UHC Core |
$457.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$303.70
|
| Rate for Payer: UHC Exchange |
$580.40
|
| Rate for Payer: UHC Medicare Advantage |
$303.70
|
| Rate for Payer: UHCCP Medicaid |
$162.78
|
| Rate for Payer: UMR Bronson Commercial |
$333.72
|
| Rate for Payer: VA VA |
$303.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$676.46
|
|
|
HC STRESS TEST
|
Facility
|
IP
|
$901.94
|
|
|
Service Code
|
CPT 93017
|
| Hospital Charge Code |
48200001
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$396.85 |
| Max. Negotiated Rate |
$811.75 |
| Rate for Payer: Aetna American Axle |
$586.26
|
| Rate for Payer: Aetna Commercial |
$766.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$586.26
|
| Rate for Payer: Cash Price |
$721.55
|
| Rate for Payer: Cofinity Commercial |
$631.36
|
| Rate for Payer: Cofinity Commercial |
$775.67
|
| Rate for Payer: Cofinity Medicare Advantage |
$631.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$721.55
|
| Rate for Payer: Healthscope Commercial |
$811.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$631.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$676.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$766.65
|
| Rate for Payer: PHP Commercial |
$766.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$586.26
|
| Rate for Payer: Priority Health SBD |
$568.22
|
| Rate for Payer: UMR Bronson Commercial |
$396.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$676.46
|
|
|
HC STRIP PASTE
|
Facility
|
OP
|
$4.50
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$4.05 |
| Rate for Payer: Aetna American Axle |
$2.92
|
| Rate for Payer: Aetna Commercial |
$3.83
|
| Rate for Payer: Aetna Medicare |
$2.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.92
|
| Rate for Payer: BCBS Complete |
$1.80
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cofinity Commercial |
$3.15
|
| Rate for Payer: Cofinity Commercial |
$3.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.60
|
| Rate for Payer: Healthscope Commercial |
$4.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.83
|
| Rate for Payer: PHP Commercial |
$3.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.92
|
| Rate for Payer: Priority Health SBD |
$2.83
|
| Rate for Payer: UMR Bronson Commercial |
$1.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.38
|
|
|
HC STRIP PASTE
|
Facility
|
IP
|
$4.50
|
|
| Hospital Charge Code |
27000109
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.98 |
| Max. Negotiated Rate |
$4.05 |
| Rate for Payer: Aetna American Axle |
$2.92
|
| Rate for Payer: Aetna Commercial |
$3.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2.92
|
| Rate for Payer: Cash Price |
$3.60
|
| Rate for Payer: Cofinity Commercial |
$3.15
|
| Rate for Payer: Cofinity Commercial |
$3.87
|
| Rate for Payer: Cofinity Medicare Advantage |
$3.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.60
|
| Rate for Payer: Healthscope Commercial |
$4.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.83
|
| Rate for Payer: PHP Commercial |
$3.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2.92
|
| Rate for Payer: Priority Health SBD |
$2.83
|
| Rate for Payer: UMR Bronson Commercial |
$1.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.38
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
IP
|
$87.31
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$38.42 |
| Max. Negotiated Rate |
$78.58 |
| Rate for Payer: Aetna American Axle |
$56.75
|
| Rate for Payer: Aetna Commercial |
$74.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.75
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cofinity Commercial |
$61.12
|
| Rate for Payer: Cofinity Commercial |
$75.09
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.85
|
| Rate for Payer: Healthscope Commercial |
$78.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.21
|
| Rate for Payer: PHP Commercial |
$74.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.75
|
| Rate for Payer: Priority Health SBD |
$55.01
|
| Rate for Payer: UMR Bronson Commercial |
$38.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.48
|
|
|
HC STRONGYLOIDES ANTIBODY, IGG, SERUM
|
Facility
|
OP
|
$87.31
|
|
|
Service Code
|
CPT 86682
|
| Hospital Charge Code |
30200490
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$78.58 |
| Rate for Payer: Aetna American Axle |
$56.75
|
| Rate for Payer: Aetna Commercial |
$74.21
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$7.32
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cash Price |
$69.85
|
| Rate for Payer: Cofinity Commercial |
$75.09
|
| Rate for Payer: Cofinity Commercial |
$61.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$61.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$78.58
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.48
|
| Rate for Payer: Mclaren Medicaid |
$6.97
|
| Rate for Payer: Mclaren Medicare |
$13.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$7.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.21
|
| Rate for Payer: PACE Medicare |
$12.36
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$74.21
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.75
|
| Rate for Payer: Priority Health Medicare |
$13.01
|
| Rate for Payer: Priority Health SBD |
$55.01
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$24.86
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$6.97
|
| Rate for Payer: UMR Bronson Commercial |
$32.30
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.48
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
IP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$17.16 |
| Max. Negotiated Rate |
$35.10 |
| Rate for Payer: Aetna American Axle |
$25.35
|
| Rate for Payer: Aetna Commercial |
$33.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.35
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$27.30
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Healthscope Commercial |
$35.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: PHP Commercial |
$33.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health SBD |
$24.57
|
| Rate for Payer: UMR Bronson Commercial |
$17.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.25
|
|
|
HC STUDY INSERT NON TUNNELED CENTRAL LINE > 5 YRS
|
Facility
|
OP
|
$39.00
|
|
|
Service Code
|
CPT 36556
|
| Hospital Charge Code |
36100588
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$14.43 |
| Max. Negotiated Rate |
$8,640.87 |
| Rate for Payer: Aetna American Axle |
$25.35
|
| Rate for Payer: Aetna Commercial |
$33.15
|
| Rate for Payer: Aetna Medicare |
$3,192.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,837.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,837.11
|
| Rate for Payer: BCBS Complete |
$1,727.62
|
| Rate for Payer: BCBS MAPPO |
$3,069.69
|
| Rate for Payer: BCN Medicare Advantage |
$3,069.69
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cash Price |
$31.20
|
| Rate for Payer: Cofinity Commercial |
$33.54
|
| Rate for Payer: Cofinity Commercial |
$27.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$27.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,069.69
|
| Rate for Payer: Healthscope Commercial |
$35.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.25
|
| Rate for Payer: Mclaren Medicaid |
$1,645.35
|
| Rate for Payer: Mclaren Medicare |
$3,069.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,223.17
|
| Rate for Payer: Meridian Medicaid |
$1,727.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,530.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.15
|
| Rate for Payer: PACE Medicare |
$2,916.21
|
| Rate for Payer: PACE SWMI |
$3,069.69
|
| Rate for Payer: PHP Commercial |
$33.15
|
| Rate for Payer: PHP Medicare Advantage |
$3,069.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,645.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.35
|
| Rate for Payer: Priority Health Medicare |
$3,069.69
|
| Rate for Payer: Priority Health SBD |
$24.57
|
| Rate for Payer: Railroad Medicare Medicare |
$3,069.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,640.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,069.69
|
| Rate for Payer: UHC Exchange |
$5,866.48
|
| Rate for Payer: UHC Medicare Advantage |
$3,069.69
|
| Rate for Payer: UHCCP Medicaid |
$1,645.35
|
| Rate for Payer: UMR Bronson Commercial |
$14.43
|
| Rate for Payer: VA VA |
$3,069.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.25
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
OP
|
$132.60
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Aetna American Axle |
$86.19
|
| Rate for Payer: Aetna Commercial |
$112.71
|
| Rate for Payer: Aetna Medicare |
$8.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$4.51
|
| Rate for Payer: BCBS MAPPO |
$8.02
|
| Rate for Payer: BCN Medicare Advantage |
$8.02
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cofinity Commercial |
$92.82
|
| Rate for Payer: Cofinity Commercial |
$114.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.02
|
| Rate for Payer: Healthscope Commercial |
$119.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.45
|
| Rate for Payer: Mclaren Medicaid |
$4.30
|
| Rate for Payer: Mclaren Medicare |
$8.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.42
|
| Rate for Payer: Meridian Medicaid |
$4.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.71
|
| Rate for Payer: PACE Medicare |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.02
|
| Rate for Payer: PHP Commercial |
$112.71
|
| Rate for Payer: PHP Medicare Advantage |
$8.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.19
|
| Rate for Payer: Priority Health Medicare |
$8.02
|
| Rate for Payer: Priority Health SBD |
$83.54
|
| Rate for Payer: Railroad Medicare Medicare |
$8.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.02
|
| Rate for Payer: UHC Exchange |
$15.33
|
| Rate for Payer: UHC Medicare Advantage |
$8.02
|
| Rate for Payer: UHCCP Medicaid |
$4.30
|
| Rate for Payer: UMR Bronson Commercial |
$49.06
|
| Rate for Payer: VA VA |
$8.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.45
|
|
|
HC SUBCLASS IGG4, SERUM
|
Facility
|
IP
|
$132.60
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100720
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$58.34 |
| Max. Negotiated Rate |
$119.34 |
| Rate for Payer: Aetna American Axle |
$86.19
|
| Rate for Payer: Aetna Commercial |
$112.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.19
|
| Rate for Payer: Cash Price |
$106.08
|
| Rate for Payer: Cofinity Commercial |
$114.04
|
| Rate for Payer: Cofinity Commercial |
$92.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$92.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.08
|
| Rate for Payer: Healthscope Commercial |
$119.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.71
|
| Rate for Payer: PHP Commercial |
$112.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.19
|
| Rate for Payer: Priority Health SBD |
$83.54
|
| Rate for Payer: UMR Bronson Commercial |
$58.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.45
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
IP
|
$8,109.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,567.96 |
| Max. Negotiated Rate |
$7,298.10 |
| Rate for Payer: Aetna American Axle |
$5,270.85
|
| Rate for Payer: Aetna Commercial |
$6,892.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,270.85
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$5,676.30
|
| Rate for Payer: Cofinity Commercial |
$6,973.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,676.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Healthscope Commercial |
$7,298.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,676.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,081.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: PHP Commercial |
$6,892.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: Priority Health SBD |
$5,108.67
|
| Rate for Payer: UMR Bronson Commercial |
$3,567.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,081.75
|
|
|
HC SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL
|
Facility
|
OP
|
$8,109.00
|
|
|
Service Code
|
CPT 30140
|
| Hospital Charge Code |
76100377
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,695.31 |
| Max. Negotiated Rate |
$8,903.25 |
| Rate for Payer: Aetna American Axle |
$5,270.85
|
| Rate for Payer: Aetna Commercial |
$6,892.65
|
| Rate for Payer: Aetna Medicare |
$3,289.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,270.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,953.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,953.62
|
| Rate for Payer: BCBS Complete |
$1,780.08
|
| Rate for Payer: BCBS MAPPO |
$3,162.90
|
| Rate for Payer: BCN Medicare Advantage |
$3,162.90
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cash Price |
$6,487.20
|
| Rate for Payer: Cofinity Commercial |
$6,973.74
|
| Rate for Payer: Cofinity Commercial |
$5,676.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,676.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,487.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,162.90
|
| Rate for Payer: Healthscope Commercial |
$7,298.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,676.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,081.75
|
| Rate for Payer: Mclaren Medicaid |
$1,695.31
|
| Rate for Payer: Mclaren Medicare |
$3,162.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,321.05
|
| Rate for Payer: Meridian Medicaid |
$1,780.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,637.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,892.65
|
| Rate for Payer: PACE Medicare |
$3,004.76
|
| Rate for Payer: PACE SWMI |
$3,162.90
|
| Rate for Payer: PHP Commercial |
$6,892.65
|
| Rate for Payer: PHP Medicare Advantage |
$3,162.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,695.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,270.85
|
| Rate for Payer: Priority Health Medicare |
$3,162.90
|
| Rate for Payer: Priority Health SBD |
$5,108.67
|
| Rate for Payer: Railroad Medicare Medicare |
$3,162.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,903.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,162.90
|
| Rate for Payer: UHC Exchange |
$6,044.62
|
| Rate for Payer: UHC Medicare Advantage |
$3,162.90
|
| Rate for Payer: UHCCP Medicaid |
$1,695.31
|
| Rate for Payer: UMR Bronson Commercial |
$3,000.33
|
| Rate for Payer: VA VA |
$3,162.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,081.75
|
|
