|
HC URINE CULTURE
|
Facility
|
OP
|
$40.88
|
|
|
Service Code
|
CPT 87086
|
| Hospital Charge Code |
30600080
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.22 |
| Max. Negotiated Rate |
$36.79 |
| Rate for Payer: Aetna American Axle |
$26.57
|
| Rate for Payer: Aetna Commercial |
$34.75
|
| Rate for Payer: Aetna Medicare |
$8.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$26.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.09
|
| Rate for Payer: BCBS Complete |
$4.43
|
| Rate for Payer: BCBS MAPPO |
$8.07
|
| Rate for Payer: BCBS Trust/PPO |
$9.32
|
| Rate for Payer: BCN Commercial |
$9.32
|
| Rate for Payer: BCN Medicare Advantage |
$8.07
|
| Rate for Payer: Cash Price |
$32.70
|
| 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: Health Alliance Plan Medicare Advantage |
$8.07
|
| 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: Mclaren Medicaid |
$8.07
|
| Rate for Payer: Mclaren Medicare |
$8.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: Meridian Medicaid |
$8.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.75
|
| Rate for Payer: Nomi Health Commercial |
$12.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.66
|
| Rate for Payer: PACE Medicare |
$7.67
|
| Rate for Payer: PACE SWMI |
$8.07
|
| Rate for Payer: PHP Commercial |
$34.75
|
| Rate for Payer: PHP Medicare Advantage |
$8.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.07
|
| Rate for Payer: Priority Health Medicare |
$8.07
|
| Rate for Payer: Priority Health SBD |
$25.75
|
| Rate for Payer: Priority Health Tiered Network |
$6.46
|
| Rate for Payer: Railroad Medicare Medicare |
$8.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.11
|
| Rate for Payer: UHC Core |
$12.11
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.07
|
| Rate for Payer: UHC Exchange |
$12.11
|
| Rate for Payer: UHC Medicaid |
$4.22
|
| Rate for Payer: UHCCP Medicaid |
$4.22
|
| Rate for Payer: UMR Bronson Commercial |
$15.13
|
| Rate for Payer: VA VA |
$8.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.66
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
IP
|
$25.78
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$11.34 |
| Max. Negotiated Rate |
$23.20 |
| Rate for Payer: Aetna American Axle |
$16.76
|
| Rate for Payer: Aetna Commercial |
$21.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.76
|
| Rate for Payer: Cash Price |
$20.62
|
| Rate for Payer: Cofinity Advantage |
$18.05
|
| Rate for Payer: Cofinity Commercial |
$22.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.62
|
| Rate for Payer: Healthscope Commercial |
$23.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.34
|
| Rate for Payer: PHP Commercial |
$21.91
|
| Rate for Payer: Priority Health SBD |
$16.24
|
| Rate for Payer: UMR Bronson Commercial |
$11.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.34
|
|
|
HC URINE DRUG SCREEN 80306
|
Facility
|
OP
|
$25.78
|
|
|
Service Code
|
CPT 80306
|
| Hospital Charge Code |
30000145
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.96 |
| Max. Negotiated Rate |
$25.71 |
| Rate for Payer: Aetna American Axle |
$16.76
|
| Rate for Payer: Aetna Commercial |
$21.91
|
| Rate for Payer: Aetna Medicare |
$17.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.43
|
| Rate for Payer: BCBS Complete |
$9.41
|
| Rate for Payer: BCBS MAPPO |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$19.82
|
| Rate for Payer: BCN Commercial |
$19.82
|
| Rate for Payer: BCN Medicare Advantage |
$17.14
|
| Rate for Payer: Cash Price |
$20.62
|
| Rate for Payer: Cash Price |
$20.62
|
| Rate for Payer: Cofinity Advantage |
$18.05
|
| Rate for Payer: Cofinity Commercial |
$22.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.14
|
| Rate for Payer: Healthscope Commercial |
$23.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.34
|
| Rate for Payer: Mclaren Medicaid |
$17.14
|
| Rate for Payer: Mclaren Medicare |
$17.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.00
|
| Rate for Payer: Meridian Medicaid |
$18.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.91
|
| Rate for Payer: Nomi Health Commercial |
$25.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.34
|
| Rate for Payer: PACE Medicare |
$16.28
|
| Rate for Payer: PACE SWMI |
$17.14
|
| Rate for Payer: PHP Commercial |
$21.91
|
| Rate for Payer: PHP Medicare Advantage |
$17.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.14
|
| Rate for Payer: Priority Health Medicare |
$17.14
|
| Rate for Payer: Priority Health SBD |
$16.24
|
| Rate for Payer: Priority Health Tiered Network |
$13.71
|
| Rate for Payer: Railroad Medicare Medicare |
$17.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.71
|
| Rate for Payer: UHC Core |
$25.71
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.14
|
| Rate for Payer: UHC Exchange |
$25.71
|
| Rate for Payer: UHC Medicaid |
$8.96
|
| Rate for Payer: UHCCP Medicaid |
$8.96
|
| Rate for Payer: UMR Bronson Commercial |
$9.54
|
| Rate for Payer: VA VA |
$17.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.34
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
OP
|
$64.50
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.14 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna American Axle |
$41.92
|
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna Medicare |
$32.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: BCBS Complete |
$25.80
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Advantage |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$20.17
|
| Rate for Payer: Priority Health SBD |
$40.63
|
| Rate for Payer: Priority Health Tiered Network |
$16.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$53.37
|
| Rate for Payer: UHC Core |
$53.37
|
| Rate for Payer: UHC Exchange |
$53.37
|
| Rate for Payer: UMR Bronson Commercial |
$23.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC URINE PHENCYCLIDINE
|
Facility
|
IP
|
$64.50
|
|
|
Service Code
|
CPT 83992
|
| Hospital Charge Code |
30100386
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.38 |
| Max. Negotiated Rate |
$58.05 |
| Rate for Payer: Aetna American Axle |
$41.92
|
| Rate for Payer: Aetna Commercial |
$54.83
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$41.92
|
| Rate for Payer: Cash Price |
$51.60
|
| Rate for Payer: Cofinity Advantage |
$45.15
|
| Rate for Payer: Cofinity Commercial |
$55.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.60
|
| Rate for Payer: Healthscope Commercial |
$58.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$45.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.38
|
| Rate for Payer: PHP Commercial |
$54.83
|
| Rate for Payer: Priority Health SBD |
$40.63
|
| Rate for Payer: UMR Bronson Commercial |
$28.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.38
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$11.67 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: UMR Bronson Commercial |
$11.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC URINE PREGNANCY TEST
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 81025
|
| Hospital Charge Code |
30700005
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$4.50 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna American Axle |
$17.24
|
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$8.95
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.76
|
| Rate for Payer: BCBS Complete |
$4.73
|
| Rate for Payer: BCBS MAPPO |
$8.61
|
| Rate for Payer: BCBS Trust/PPO |
$9.96
|
| Rate for Payer: BCCCP Commercial |
$8.61
|
| Rate for Payer: BCN Commercial |
$9.96
|
| Rate for Payer: BCN Medicare Advantage |
$8.61
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Advantage |
$18.57
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.61
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$8.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.04
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$12.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Medicare |
$8.18
|
| Rate for Payer: PACE SWMI |
$8.61
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$8.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.61
|
| Rate for Payer: Priority Health Medicare |
$8.61
|
| Rate for Payer: Priority Health SBD |
$16.71
|
| Rate for Payer: Priority Health Tiered Network |
$6.89
|
| Rate for Payer: Railroad Medicare Medicare |
$8.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.92
|
| Rate for Payer: UHC Core |
$12.92
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.61
|
| Rate for Payer: UHC Exchange |
$12.92
|
| Rate for Payer: UHC Medicaid |
$4.50
|
| Rate for Payer: UHCCP Medicaid |
$4.50
|
| Rate for Payer: UMR Bronson Commercial |
$9.82
|
| Rate for Payer: VA VA |
$8.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC URINE PRESUMPTIVE ID
|
Facility
|
IP
|
$66.38
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.21 |
| Max. Negotiated Rate |
$59.74 |
| Rate for Payer: Aetna American Axle |
$43.15
|
| Rate for Payer: Aetna Commercial |
$56.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.15
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cofinity Advantage |
$46.47
|
| Rate for Payer: Cofinity Commercial |
$57.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.10
|
| Rate for Payer: Healthscope Commercial |
$59.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.78
|
| Rate for Payer: PHP Commercial |
$56.42
|
| Rate for Payer: Priority Health SBD |
$41.82
|
| Rate for Payer: UMR Bronson Commercial |
$29.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.78
|
|
|
HC URINE PRESUMPTIVE ID
|
Facility
|
OP
|
$66.38
|
|
|
Service Code
|
CPT 87088
|
| Hospital Charge Code |
30600081
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$59.74 |
| Rate for Payer: Aetna American Axle |
$43.15
|
| Rate for Payer: Aetna Commercial |
$56.42
|
| Rate for Payer: Aetna Medicare |
$8.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.11
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: BCBS MAPPO |
$8.09
|
| Rate for Payer: BCBS Trust/PPO |
$9.36
|
| Rate for Payer: BCN Commercial |
$9.36
|
| Rate for Payer: BCN Medicare Advantage |
$8.09
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cash Price |
$53.10
|
| Rate for Payer: Cofinity Advantage |
$46.47
|
| Rate for Payer: Cofinity Commercial |
$57.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.09
|
| Rate for Payer: Healthscope Commercial |
$59.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.78
|
| Rate for Payer: Mclaren Medicaid |
$8.09
|
| Rate for Payer: Mclaren Medicare |
$8.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.49
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.42
|
| Rate for Payer: Nomi Health Commercial |
$12.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.78
|
| Rate for Payer: PACE Medicare |
$7.69
|
| Rate for Payer: PACE SWMI |
$8.09
|
| Rate for Payer: PHP Commercial |
$56.42
|
| Rate for Payer: PHP Medicare Advantage |
$8.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$8.09
|
| Rate for Payer: Priority Health Medicare |
$8.09
|
| Rate for Payer: Priority Health SBD |
$41.82
|
| Rate for Payer: Priority Health Tiered Network |
$6.47
|
| Rate for Payer: Railroad Medicare Medicare |
$8.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.14
|
| Rate for Payer: UHC Core |
$12.14
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$8.09
|
| Rate for Payer: UHC Exchange |
$12.14
|
| Rate for Payer: UHC Medicaid |
$4.23
|
| Rate for Payer: UHCCP Medicaid |
$4.23
|
| Rate for Payer: UMR Bronson Commercial |
$24.56
|
| Rate for Payer: VA VA |
$8.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.78
|
|
|
HC URINE REDUCING SUBSTANCES
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700003
|
|
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 URINE REDUCING SUBSTANCES
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 81005
|
| Hospital Charge Code |
30700003
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.13 |
| 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 |
$2.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$25.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.71
|
| Rate for Payer: BCBS Complete |
$1.19
|
| Rate for Payer: BCBS MAPPO |
$2.17
|
| Rate for Payer: BCBS Trust/PPO |
$2.51
|
| Rate for Payer: BCN Commercial |
$2.51
|
| Rate for Payer: BCN Medicare Advantage |
$2.17
|
| 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 |
$2.17
|
| 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 |
$2.17
|
| Rate for Payer: Mclaren Medicare |
$2.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.28
|
| Rate for Payer: Meridian Medicaid |
$2.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.50
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$3.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Medicare |
$2.06
|
| Rate for Payer: PACE SWMI |
$2.17
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$2.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.17
|
| Rate for Payer: Priority Health Medicare |
$2.17
|
| Rate for Payer: Priority Health SBD |
$24.84
|
| Rate for Payer: Priority Health Tiered Network |
$1.74
|
| Rate for Payer: Railroad Medicare Medicare |
$2.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.26
|
| Rate for Payer: UHC Core |
$3.26
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.17
|
| Rate for Payer: UHC Exchange |
$3.26
|
| Rate for Payer: UHC Medicaid |
$1.13
|
| Rate for Payer: UHCCP Medicaid |
$1.13
|
| Rate for Payer: UMR Bronson Commercial |
$14.59
|
| Rate for Payer: VA VA |
$2.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC URIN MDMA
|
Facility
|
IP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000133
|
|
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 URIN MDMA
|
Facility
|
OP
|
$96.42
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30000133
|
|
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 URN COTININE.
|
Facility
|
IP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.95 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna American Axle |
$72.31
|
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.31
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Advantage |
$77.88
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PHP Commercial |
$94.56
|
| Rate for Payer: Priority Health SBD |
$70.09
|
| Rate for Payer: UMR Bronson Commercial |
$48.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC URN COTININE.
|
Facility
|
OP
|
$111.25
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100647
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$100.12 |
| Rate for Payer: Aetna American Axle |
$72.31
|
| Rate for Payer: Aetna Commercial |
$94.56
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$72.31
|
| 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 |
$89.00
|
| Rate for Payer: Cash Price |
$89.00
|
| Rate for Payer: Cofinity Advantage |
$77.88
|
| Rate for Payer: Cofinity Commercial |
$95.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$100.12
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.44
|
| 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 |
$94.56
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.44
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$94.56
|
| 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 |
$70.09
|
| 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 |
$41.16
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.44
|
|
|
HC URN MDMA
|
Facility
|
OP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$14.57
|
| Rate for Payer: BCN Commercial |
$14.57
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Mclaren Medicaid |
$12.60
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: Priority Health Tiered Network |
$10.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.90
|
| Rate for Payer: UHC Core |
$18.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicaid |
$6.59
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC URN MDMA
|
Facility
|
IP
|
$42.45
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000132
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$18.68 |
| Max. Negotiated Rate |
$38.20 |
| Rate for Payer: Aetna American Axle |
$27.59
|
| Rate for Payer: Aetna Commercial |
$36.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.59
|
| Rate for Payer: Cash Price |
$33.96
|
| Rate for Payer: Cofinity Advantage |
$29.71
|
| Rate for Payer: Cofinity Commercial |
$36.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.96
|
| Rate for Payer: Healthscope Commercial |
$38.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$31.84
|
| Rate for Payer: PHP Commercial |
$36.08
|
| Rate for Payer: Priority Health SBD |
$26.74
|
| Rate for Payer: UMR Bronson Commercial |
$18.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.84
|
|
|
HC URN TRICYCLIC
|
Facility
|
IP
|
$48.72
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$21.44 |
| Max. Negotiated Rate |
$43.85 |
| Rate for Payer: Aetna American Axle |
$31.67
|
| Rate for Payer: Aetna Commercial |
$41.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.67
|
| Rate for Payer: Cash Price |
$38.98
|
| Rate for Payer: Cofinity Advantage |
$34.10
|
| Rate for Payer: Cofinity Commercial |
$41.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.98
|
| Rate for Payer: Healthscope Commercial |
$43.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.54
|
| Rate for Payer: PHP Commercial |
$41.41
|
| Rate for Payer: Priority Health SBD |
$30.69
|
| Rate for Payer: UMR Bronson Commercial |
$21.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.54
|
|
|
HC URN TRICYCLIC
|
Facility
|
OP
|
$48.72
|
|
|
Service Code
|
CPT 80305
|
| Hospital Charge Code |
30000131
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$43.85 |
| Rate for Payer: Aetna American Axle |
$31.67
|
| Rate for Payer: Aetna Commercial |
$41.41
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$6.92
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$14.57
|
| Rate for Payer: BCN Commercial |
$14.57
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$38.98
|
| Rate for Payer: Cash Price |
$38.98
|
| Rate for Payer: Cofinity Advantage |
$34.10
|
| Rate for Payer: Cofinity Commercial |
$41.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$43.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.54
|
| Rate for Payer: Mclaren Medicaid |
$12.60
|
| Rate for Payer: Mclaren Medicare |
$12.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.41
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.54
|
| Rate for Payer: PACE Medicare |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$41.41
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$12.60
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health SBD |
$30.69
|
| Rate for Payer: Priority Health Tiered Network |
$10.08
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.90
|
| Rate for Payer: UHC Core |
$18.90
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$12.60
|
| Rate for Payer: UHC Exchange |
$18.90
|
| Rate for Payer: UHC Medicaid |
$6.59
|
| Rate for Payer: UHCCP Medicaid |
$6.59
|
| Rate for Payer: UMR Bronson Commercial |
$18.03
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.54
|
|
|
HC UROLIFT PER DEVICE
|
Facility
|
OP
|
$2,003.04
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
27800129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$741.12 |
| Max. Negotiated Rate |
$1,802.74 |
| Rate for Payer: Aetna American Axle |
$1,301.98
|
| Rate for Payer: Aetna Commercial |
$1,702.58
|
| Rate for Payer: Aetna Medicare |
$1,001.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,301.98
|
| Rate for Payer: BCBS Complete |
$801.22
|
| Rate for Payer: Cash Price |
$1,602.43
|
| Rate for Payer: Cofinity Advantage |
$1,402.13
|
| Rate for Payer: Cofinity Commercial |
$1,722.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,602.43
|
| Rate for Payer: Healthscope Commercial |
$1,802.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,402.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,502.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,602.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,702.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,502.28
|
| Rate for Payer: PHP Commercial |
$1,702.58
|
| Rate for Payer: Priority Health SBD |
$1,261.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,301.98
|
| Rate for Payer: UHC Core |
$1,043.58
|
| Rate for Payer: UHC Exchange |
$787.19
|
| Rate for Payer: UMR Bronson Commercial |
$741.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,502.28
|
|
|
HC UROLIFT PER DEVICE
|
Facility
|
IP
|
$2,003.04
|
|
|
Service Code
|
HCPCS L8699
|
| Hospital Charge Code |
27800129
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$881.34 |
| Max. Negotiated Rate |
$1,802.74 |
| Rate for Payer: Aetna American Axle |
$1,301.98
|
| Rate for Payer: Aetna Commercial |
$1,702.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,301.98
|
| Rate for Payer: Cash Price |
$1,602.43
|
| Rate for Payer: Cofinity Advantage |
$1,402.13
|
| Rate for Payer: Cofinity Commercial |
$1,722.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,602.43
|
| Rate for Payer: Healthscope Commercial |
$1,802.74
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,402.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,502.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,702.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,502.28
|
| Rate for Payer: PHP Commercial |
$1,702.58
|
| Rate for Payer: Priority Health SBD |
$1,261.92
|
| Rate for Payer: UMR Bronson Commercial |
$881.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,502.28
|
|
|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
OP
|
$16.70
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Advantage |
$11.69
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.86
|
| Rate for Payer: UHC Core |
$8.70
|
| Rate for Payer: UHC Exchange |
$6.56
|
| Rate for Payer: UMR Bronson Commercial |
$6.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
HC UROSTOMY ADAPTOR TUBE
|
Facility
|
IP
|
$16.70
|
|
| Hospital Charge Code |
27000168
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$15.03 |
| Rate for Payer: Aetna American Axle |
$10.86
|
| Rate for Payer: Aetna Commercial |
$14.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$10.86
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Cofinity Advantage |
$11.69
|
| Rate for Payer: Cofinity Commercial |
$14.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.36
|
| Rate for Payer: Healthscope Commercial |
$15.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$11.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.53
|
| Rate for Payer: PHP Commercial |
$14.20
|
| Rate for Payer: Priority Health SBD |
$10.52
|
| Rate for Payer: UMR Bronson Commercial |
$7.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.53
|
|
|
HC US AAA SCREENING
|
Facility
|
IP
|
$374.36
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$164.72 |
| Max. Negotiated Rate |
$336.92 |
| Rate for Payer: Aetna American Axle |
$243.33
|
| Rate for Payer: Aetna Commercial |
$318.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.33
|
| Rate for Payer: Cash Price |
$299.49
|
| Rate for Payer: Cofinity Advantage |
$262.05
|
| Rate for Payer: Cofinity Commercial |
$321.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.49
|
| Rate for Payer: Healthscope Commercial |
$336.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.77
|
| Rate for Payer: PHP Commercial |
$318.21
|
| Rate for Payer: Priority Health SBD |
$235.85
|
| Rate for Payer: UMR Bronson Commercial |
$164.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.77
|
|
|
HC US AAA SCREENING
|
Facility
|
OP
|
$374.36
|
|
|
Service Code
|
CPT 76706
|
| Hospital Charge Code |
40200073
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$54.48 |
| Max. Negotiated Rate |
$336.92 |
| Rate for Payer: Aetna American Axle |
$243.33
|
| Rate for Payer: Aetna Commercial |
$318.21
|
| Rate for Payer: Aetna Medicare |
$108.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$243.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.21
|
| Rate for Payer: BCBS Complete |
$57.21
|
| Rate for Payer: BCBS MAPPO |
$104.17
|
| Rate for Payer: BCBS Trust/PPO |
$199.48
|
| Rate for Payer: BCN Commercial |
$199.48
|
| Rate for Payer: BCN Medicare Advantage |
$104.17
|
| Rate for Payer: Cash Price |
$299.49
|
| Rate for Payer: Cash Price |
$299.49
|
| Rate for Payer: Cofinity Advantage |
$262.05
|
| Rate for Payer: Cofinity Commercial |
$321.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.17
|
| Rate for Payer: Healthscope Commercial |
$336.92
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$262.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.77
|
| Rate for Payer: Mclaren Medicaid |
$104.17
|
| Rate for Payer: Mclaren Medicare |
$104.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.38
|
| Rate for Payer: Meridian Medicaid |
$109.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.21
|
| Rate for Payer: Nomi Health Commercial |
$312.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.77
|
| Rate for Payer: PACE Medicare |
$98.96
|
| Rate for Payer: PACE SWMI |
$104.17
|
| Rate for Payer: PHP Commercial |
$318.21
|
| Rate for Payer: PHP Medicare Advantage |
$104.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$336.87
|
| Rate for Payer: Priority Health Medicare |
$104.17
|
| Rate for Payer: Priority Health SBD |
$235.85
|
| Rate for Payer: Priority Health Tiered Network |
$269.50
|
| Rate for Payer: Railroad Medicare Medicare |
$104.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$243.33
|
| Rate for Payer: UHC Core |
$195.04
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$104.17
|
| Rate for Payer: UHC Exchange |
$147.12
|
| Rate for Payer: UHC Medicaid |
$54.48
|
| Rate for Payer: UHCCP Medicaid |
$54.48
|
| Rate for Payer: UMR Bronson Commercial |
$138.51
|
| Rate for Payer: VA VA |
$104.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.77
|
|
