|
HC UREA NITROGEN BUN
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100450
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC UREA NITROGEN BUN
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 84520
|
| Hospital Charge Code |
30100450
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.07 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$4.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.94
|
| Rate for Payer: BCBS Complete |
$2.17
|
| Rate for Payer: BCBS MAPPO |
$3.95
|
| Rate for Payer: BCN Medicare Advantage |
$3.95
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.95
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.95
|
| Rate for Payer: Mclaren Medicare |
$3.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.15
|
| Rate for Payer: Meridian Medicaid |
$4.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$5.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$3.75
|
| Rate for Payer: PACE SWMI |
$3.95
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.95
|
| Rate for Payer: Priority Health Medicare |
$3.95
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$3.16
|
| Rate for Payer: Railroad Medicare Medicare |
$3.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5.93
|
| Rate for Payer: UHC Core |
$5.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.95
|
| Rate for Payer: UHC Exchange |
$5.93
|
| Rate for Payer: UHC Medicaid |
$2.07
|
| Rate for Payer: UHCCP Medicaid |
$2.07
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: VA VA |
$3.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC UREA NITROGEN BUN URINE
|
Facility
|
OP
|
$40.22
|
|
|
Service Code
|
CPT 84540
|
| Hospital Charge Code |
30100451
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$36.20 |
| Rate for Payer: Aetna American Axle |
$26.14
|
| Rate for Payer: Aetna Commercial |
$34.19
|
| Rate for Payer: Aetna Medicare |
$5.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.95
|
| Rate for Payer: BCBS Complete |
$3.05
|
| Rate for Payer: BCBS MAPPO |
$5.56
|
| Rate for Payer: BCBS Trust/PPO |
$6.43
|
| Rate for Payer: BCN Commercial |
$6.43
|
| Rate for Payer: BCN Medicare Advantage |
$5.56
|
| Rate for Payer: Cash Price |
$32.18
|
| Rate for Payer: Cash Price |
$32.18
|
| Rate for Payer: Cofinity Advantage |
$28.15
|
| Rate for Payer: Cofinity Commercial |
$34.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.56
|
| Rate for Payer: Healthscope Commercial |
$36.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.16
|
| Rate for Payer: Mclaren Medicaid |
$5.56
|
| Rate for Payer: Mclaren Medicare |
$5.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.84
|
| Rate for Payer: Meridian Medicaid |
$5.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.19
|
| Rate for Payer: Nomi Health Commercial |
$8.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.16
|
| Rate for Payer: PACE Medicare |
$5.28
|
| Rate for Payer: PACE SWMI |
$5.56
|
| Rate for Payer: PHP Commercial |
$34.19
|
| Rate for Payer: PHP Medicare Advantage |
$5.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.56
|
| Rate for Payer: Priority Health Medicare |
$5.56
|
| Rate for Payer: Priority Health SBD |
$25.34
|
| Rate for Payer: Priority Health Tiered Network |
$4.45
|
| Rate for Payer: Railroad Medicare Medicare |
$5.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8.34
|
| Rate for Payer: UHC Core |
$8.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.56
|
| Rate for Payer: UHC Exchange |
$8.34
|
| Rate for Payer: UHC Medicaid |
$2.91
|
| Rate for Payer: UHCCP Medicaid |
$2.91
|
| Rate for Payer: UMR Bronson Commercial |
$14.88
|
| Rate for Payer: VA VA |
$5.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.16
|
|
|
HC UREA NITROGEN BUN URINE
|
Facility
|
IP
|
$40.22
|
|
|
Service Code
|
CPT 84540
|
| Hospital Charge Code |
30100451
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.70 |
| Max. Negotiated Rate |
$36.20 |
| Rate for Payer: Aetna American Axle |
$26.14
|
| Rate for Payer: Aetna Commercial |
$34.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.14
|
| Rate for Payer: Cash Price |
$32.18
|
| Rate for Payer: Cofinity Advantage |
$28.15
|
| Rate for Payer: Cofinity Commercial |
$34.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.18
|
| Rate for Payer: Healthscope Commercial |
$36.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.16
|
| Rate for Payer: PHP Commercial |
$34.19
|
| Rate for Payer: Priority Health SBD |
$25.34
|
| Rate for Payer: UMR Bronson Commercial |
$17.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.16
|
|
|
HC UREAPLASMA PCR
|
Facility
|
IP
|
$87.68
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600301
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$38.58 |
| Max. Negotiated Rate |
$78.91 |
| Rate for Payer: Aetna American Axle |
$56.99
|
| Rate for Payer: Aetna Commercial |
$74.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.99
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cofinity Advantage |
$61.38
|
| Rate for Payer: Cofinity Commercial |
$75.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.14
|
| Rate for Payer: Healthscope Commercial |
$78.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.76
|
| Rate for Payer: PHP Commercial |
$74.53
|
| Rate for Payer: Priority Health SBD |
$55.24
|
| Rate for Payer: UMR Bronson Commercial |
$38.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.76
|
|
|
HC UREAPLASMA PCR
|
Facility
|
OP
|
$87.68
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600301
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$78.91 |
| Rate for Payer: Aetna American Axle |
$56.99
|
| Rate for Payer: Aetna Commercial |
$74.53
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$56.99
|
| 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 |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cash Price |
$70.14
|
| Rate for Payer: Cofinity Advantage |
$61.38
|
| Rate for Payer: Cofinity Commercial |
$75.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$78.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$61.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$65.76
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| 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 |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.53
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$65.76
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$74.53
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$55.24
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$32.44
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$65.76
|
|
|
HC UREAPLASMA PCR CMPT
|
Facility
|
OP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600302
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.35 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna American Axle |
$40.83
|
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.83
|
| 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 |
$19.27
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$40.57
|
| Rate for Payer: BCN Commercial |
$40.57
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Advantage |
$43.97
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Mclaren Medicaid |
$35.09
|
| 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 |
$36.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Nomi Health Commercial |
$52.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.35
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$39.58
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.64
|
| Rate for Payer: UHC Core |
$52.64
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$35.09
|
| Rate for Payer: UHC Exchange |
$52.64
|
| Rate for Payer: UHC Medicaid |
$18.35
|
| Rate for Payer: UHCCP Medicaid |
$18.35
|
| Rate for Payer: UMR Bronson Commercial |
$23.24
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC UREAPLASMA PCR CMPT
|
Facility
|
IP
|
$62.82
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600302
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.64 |
| Max. Negotiated Rate |
$56.54 |
| Rate for Payer: Aetna American Axle |
$40.83
|
| Rate for Payer: Aetna Commercial |
$53.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.83
|
| Rate for Payer: Cash Price |
$50.26
|
| Rate for Payer: Cofinity Advantage |
$43.97
|
| Rate for Payer: Cofinity Commercial |
$54.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.26
|
| Rate for Payer: Healthscope Commercial |
$56.54
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.40
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.12
|
| Rate for Payer: PHP Commercial |
$53.40
|
| Rate for Payer: Priority Health SBD |
$39.58
|
| Rate for Payer: UMR Bronson Commercial |
$27.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.12
|
|
|
HC URETERAL DILITATION CATH
|
Facility
|
OP
|
$363.86
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$327.47 |
| Rate for Payer: Aetna American Axle |
$236.51
|
| Rate for Payer: Aetna Commercial |
$309.28
|
| Rate for Payer: Aetna Medicare |
$181.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.51
|
| Rate for Payer: BCBS Complete |
$145.54
|
| Rate for Payer: BCBS Trust/PPO |
$0.03
|
| Rate for Payer: BCN Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$291.09
|
| Rate for Payer: Cash Price |
$291.09
|
| Rate for Payer: Cofinity Advantage |
$254.70
|
| Rate for Payer: Cofinity Commercial |
$312.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.09
|
| Rate for Payer: Healthscope Commercial |
$327.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$254.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$291.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.89
|
| Rate for Payer: PHP Commercial |
$309.28
|
| Rate for Payer: Priority Health SBD |
$229.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.51
|
| Rate for Payer: UHC Core |
$189.57
|
| Rate for Payer: UHC Exchange |
$143.00
|
| Rate for Payer: UMR Bronson Commercial |
$134.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.89
|
|
|
HC URETERAL DILITATION CATH
|
Facility
|
IP
|
$363.86
|
|
|
Service Code
|
HCPCS C1758
|
| Hospital Charge Code |
27200077
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$160.10 |
| Max. Negotiated Rate |
$327.47 |
| Rate for Payer: Aetna American Axle |
$236.51
|
| Rate for Payer: Aetna Commercial |
$309.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$236.51
|
| Rate for Payer: Cash Price |
$291.09
|
| Rate for Payer: Cofinity Advantage |
$254.70
|
| Rate for Payer: Cofinity Commercial |
$312.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$291.09
|
| Rate for Payer: Healthscope Commercial |
$327.47
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$254.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$272.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$309.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$272.89
|
| Rate for Payer: PHP Commercial |
$309.28
|
| Rate for Payer: Priority Health SBD |
$229.23
|
| Rate for Payer: UMR Bronson Commercial |
$160.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$272.89
|
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
30100453
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.66 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$5.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.35
|
| Rate for Payer: BCBS Complete |
$2.79
|
| Rate for Payer: BCBS MAPPO |
$5.08
|
| Rate for Payer: BCBS Trust/PPO |
$5.87
|
| Rate for Payer: BCN Commercial |
$5.87
|
| Rate for Payer: BCN Medicare Advantage |
$5.08
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.08
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$5.08
|
| Rate for Payer: Mclaren Medicare |
$5.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.33
|
| Rate for Payer: Meridian Medicaid |
$5.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$7.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$4.83
|
| Rate for Payer: PACE SWMI |
$5.08
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$5.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.08
|
| Rate for Payer: Priority Health Medicare |
$5.08
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$4.06
|
| Rate for Payer: Railroad Medicare Medicare |
$5.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.62
|
| Rate for Payer: UHC Core |
$7.62
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.08
|
| Rate for Payer: UHC Exchange |
$7.62
|
| Rate for Payer: UHC Medicaid |
$2.66
|
| Rate for Payer: UHCCP Medicaid |
$2.66
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$5.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URIC ACID OTHER SOURCE
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 84560
|
| Hospital Charge Code |
30100453
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URIC ACID SERUM
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$4.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.65
|
| Rate for Payer: BCBS Complete |
$2.48
|
| Rate for Payer: BCBS MAPPO |
$4.52
|
| Rate for Payer: BCN Medicare Advantage |
$4.52
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.52
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$4.52
|
| Rate for Payer: Mclaren Medicare |
$4.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.75
|
| Rate for Payer: Meridian Medicaid |
$4.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$6.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$4.29
|
| Rate for Payer: PACE SWMI |
$4.52
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$4.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$4.52
|
| Rate for Payer: Priority Health Medicare |
$4.52
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$3.62
|
| Rate for Payer: Railroad Medicare Medicare |
$4.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6.78
|
| Rate for Payer: UHC Core |
$6.78
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.52
|
| Rate for Payer: UHC Exchange |
$6.78
|
| Rate for Payer: UHC Medicaid |
$2.36
|
| Rate for Payer: UHCCP Medicaid |
$2.36
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: VA VA |
$4.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC URIC ACID SERUM
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 84550
|
| Hospital Charge Code |
30100452
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC URINALYSIS
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.66 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$3.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.96
|
| Rate for Payer: BCBS Complete |
$1.74
|
| Rate for Payer: BCBS MAPPO |
$3.17
|
| Rate for Payer: BCBS Trust/PPO |
$3.67
|
| Rate for Payer: BCN Commercial |
$3.67
|
| Rate for Payer: BCN Medicare Advantage |
$3.17
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.17
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.17
|
| Rate for Payer: Mclaren Medicare |
$3.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.33
|
| Rate for Payer: Meridian Medicaid |
$3.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$4.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Medicare |
$3.01
|
| Rate for Payer: PACE SWMI |
$3.17
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$3.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.17
|
| Rate for Payer: Priority Health Medicare |
$3.17
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: Priority Health Tiered Network |
$2.54
|
| Rate for Payer: Railroad Medicare Medicare |
$3.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.76
|
| Rate for Payer: UHC Core |
$4.76
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.17
|
| Rate for Payer: UHC Exchange |
$4.76
|
| Rate for Payer: UHC Medicaid |
$1.66
|
| Rate for Payer: UHCCP Medicaid |
$1.66
|
| Rate for Payer: UMR Bronson Commercial |
$7.86
|
| Rate for Payer: VA VA |
$3.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC URINALYSIS
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 81001
|
| Hospital Charge Code |
30700001
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna American Axle |
$13.80
|
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$13.80
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Advantage |
$14.86
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$14.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health SBD |
$13.37
|
| Rate for Payer: UMR Bronson Commercial |
$9.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$3.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.81
|
| Rate for Payer: BCBS Complete |
$1.68
|
| Rate for Payer: BCBS MAPPO |
$3.05
|
| Rate for Payer: BCBS Trust/PPO |
$3.53
|
| Rate for Payer: BCN Commercial |
$3.53
|
| Rate for Payer: BCN Medicare Advantage |
$3.05
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.05
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$3.05
|
| Rate for Payer: Mclaren Medicare |
$3.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.20
|
| Rate for Payer: Meridian Medicaid |
$3.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$4.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$2.90
|
| Rate for Payer: PACE SWMI |
$3.05
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$3.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$3.05
|
| Rate for Payer: Priority Health Medicare |
$3.05
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$2.44
|
| Rate for Payer: Railroad Medicare Medicare |
$3.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.58
|
| Rate for Payer: UHC Core |
$4.58
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3.05
|
| Rate for Payer: UHC Exchange |
$4.58
|
| Rate for Payer: UHC Medicaid |
$1.60
|
| Rate for Payer: UHCCP Medicaid |
$1.60
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$3.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URINALYSIS, MICROSCOPIC ONLY
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 81015
|
| Hospital Charge Code |
30700004
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$17.35 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna American Axle |
$25.63
|
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Advantage |
$27.60
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$27.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: UMR Bronson Commercial |
$17.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
OP
|
$14.34
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.31 |
| Max. Negotiated Rate |
$12.91 |
| Rate for Payer: Aetna American Axle |
$9.32
|
| Rate for Payer: Aetna Commercial |
$12.19
|
| Rate for Payer: Aetna Medicare |
$7.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.32
|
| Rate for Payer: BCBS Complete |
$5.74
|
| Rate for Payer: Cash Price |
$11.47
|
| Rate for Payer: Cofinity Advantage |
$10.04
|
| Rate for Payer: Cofinity Commercial |
$12.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.47
|
| Rate for Payer: Healthscope Commercial |
$12.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.76
|
| Rate for Payer: PHP Commercial |
$12.19
|
| Rate for Payer: Priority Health SBD |
$9.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.32
|
| Rate for Payer: UHC Core |
$7.47
|
| Rate for Payer: UHC Exchange |
$5.64
|
| Rate for Payer: UMR Bronson Commercial |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.76
|
|
|
HC URINARY 1 PIECE POUCH
|
Facility
|
IP
|
$14.34
|
|
| Hospital Charge Code |
27000167
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$12.91 |
| Rate for Payer: Aetna American Axle |
$9.32
|
| Rate for Payer: Aetna Commercial |
$12.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$9.32
|
| Rate for Payer: Cash Price |
$11.47
|
| Rate for Payer: Cofinity Advantage |
$10.04
|
| Rate for Payer: Cofinity Commercial |
$12.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.47
|
| Rate for Payer: Healthscope Commercial |
$12.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$10.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.76
|
| Rate for Payer: PHP Commercial |
$12.19
|
| Rate for Payer: Priority Health SBD |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$6.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.76
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$42.42 |
| Max. Negotiated Rate |
$86.78 |
| Rate for Payer: Aetna American Axle |
$62.67
|
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.67
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Advantage |
$67.49
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: Priority Health SBD |
$60.74
|
| Rate for Payer: UMR Bronson Commercial |
$42.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC URINE ALCOHOL SCRN
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000122
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$93.21 |
| Rate for Payer: Aetna American Axle |
$62.67
|
| Rate for Payer: Aetna Commercial |
$81.96
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.67
|
| Rate for Payer: BCBS Complete |
$34.13
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$71.84
|
| Rate for Payer: BCN Commercial |
$71.84
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cash Price |
$77.14
|
| Rate for Payer: Cofinity Advantage |
$67.49
|
| Rate for Payer: Cofinity Commercial |
$82.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$86.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.31
|
| Rate for Payer: Mclaren Medicaid |
$62.14
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$65.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$68.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.96
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.31
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$81.96
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health SBD |
$60.74
|
| Rate for Payer: Priority Health Tiered Network |
$49.71
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.21
|
| Rate for Payer: UHC Core |
$93.21
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$62.14
|
| Rate for Payer: UHC Exchange |
$93.21
|
| Rate for Payer: UHC Medicaid |
$32.50
|
| Rate for Payer: UHCCP Medicaid |
$32.50
|
| Rate for Payer: UMR Bronson Commercial |
$35.68
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.31
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.93 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna American Axle |
$20.96
|
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: BCBS Complete |
$12.90
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Advantage |
$22.57
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC URINE AMPHETAMINE CONFIRM
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 80324
|
| Hospital Charge Code |
30100569
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.19 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna American Axle |
$20.96
|
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$20.96
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Advantage |
$22.57
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$22.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health SBD |
$20.32
|
| Rate for Payer: UMR Bronson Commercial |
$14.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC URINE CULTURE
|
Facility
|
IP
|
$40.88
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$17.99 |
| Max. Negotiated Rate |
$36.79 |
| Rate for Payer: Aetna American Axle |
$26.57
|
| Rate for Payer: Aetna Commercial |
$34.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.57
|
| Rate for Payer: Cash Price |
$32.70
|
| Rate for Payer: Cofinity Advantage |
$28.62
|
| Rate for Payer: Cofinity Commercial |
$35.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.70
|
| Rate for Payer: Healthscope Commercial |
$36.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$28.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.66
|
| Rate for Payer: PHP Commercial |
$34.75
|
| Rate for Payer: Priority Health SBD |
$25.75
|
| Rate for Payer: UMR Bronson Commercial |
$17.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.66
|
|
