|
HC TC 99M PERTECHNETATE PER MCI
|
Facility
|
OP
|
$47.61
|
|
|
Service Code
|
HCPCS A9512
|
| Hospital Charge Code |
34300029
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$42.85 |
| Rate for Payer: Aetna American Axle |
$30.95
|
| Rate for Payer: Aetna Commercial |
$40.47
|
| Rate for Payer: Aetna Medicare |
$23.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.95
|
| Rate for Payer: BCBS Complete |
$19.04
|
| Rate for Payer: BCBS Trust/PPO |
$3.85
|
| Rate for Payer: BCN Commercial |
$3.85
|
| Rate for Payer: Cash Price |
$38.09
|
| Rate for Payer: Cash Price |
$38.09
|
| Rate for Payer: Cofinity Commercial |
$33.33
|
| Rate for Payer: Cofinity Commercial |
$40.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.09
|
| Rate for Payer: Healthscope Commercial |
$42.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.47
|
| Rate for Payer: PHP Commercial |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.95
|
| Rate for Payer: Priority Health SBD |
$29.99
|
| Rate for Payer: UMR Bronson Commercial |
$17.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.71
|
|
|
HC TC 99M PERTECHNETATE PER MCI
|
Facility
|
IP
|
$47.61
|
|
|
Service Code
|
HCPCS A9512
|
| Hospital Charge Code |
34300029
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$20.95 |
| Max. Negotiated Rate |
$42.85 |
| Rate for Payer: Aetna American Axle |
$30.95
|
| Rate for Payer: Aetna Commercial |
$40.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.95
|
| Rate for Payer: Cash Price |
$38.09
|
| Rate for Payer: Cofinity Commercial |
$33.33
|
| Rate for Payer: Cofinity Commercial |
$40.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.09
|
| Rate for Payer: Healthscope Commercial |
$42.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.47
|
| Rate for Payer: PHP Commercial |
$40.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.95
|
| Rate for Payer: Priority Health SBD |
$29.99
|
| Rate for Payer: UMR Bronson Commercial |
$20.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.71
|
|
|
HC TC 99M PYROPHOSPHATE PER STUDY UP TO 25 MILLICURIES
|
Facility
|
OP
|
$236.17
|
|
|
Service Code
|
CPT A9538
|
| Hospital Charge Code |
34300037
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$44.36 |
| Max. Negotiated Rate |
$212.55 |
| Rate for Payer: Aetna American Axle |
$153.51
|
| Rate for Payer: Aetna Commercial |
$200.74
|
| Rate for Payer: Aetna Medicare |
$118.08
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.51
|
| Rate for Payer: BCBS Complete |
$94.47
|
| Rate for Payer: BCBS Trust/PPO |
$44.36
|
| Rate for Payer: BCN Commercial |
$44.36
|
| Rate for Payer: Cash Price |
$188.94
|
| Rate for Payer: Cash Price |
$188.94
|
| Rate for Payer: Cofinity Commercial |
$165.32
|
| Rate for Payer: Cofinity Commercial |
$203.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.94
|
| Rate for Payer: Healthscope Commercial |
$212.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.74
|
| Rate for Payer: PHP Commercial |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.51
|
| Rate for Payer: Priority Health SBD |
$148.79
|
| Rate for Payer: UMR Bronson Commercial |
$87.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.13
|
|
|
HC TC 99M PYROPHOSPHATE PER STUDY UP TO 25 MILLICURIES
|
Facility
|
IP
|
$236.17
|
|
|
Service Code
|
CPT A9538
|
| Hospital Charge Code |
34300037
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$103.91 |
| Max. Negotiated Rate |
$212.55 |
| Rate for Payer: Aetna American Axle |
$153.51
|
| Rate for Payer: Aetna Commercial |
$200.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$153.51
|
| Rate for Payer: Cash Price |
$188.94
|
| Rate for Payer: Cofinity Commercial |
$165.32
|
| Rate for Payer: Cofinity Commercial |
$203.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$165.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$188.94
|
| Rate for Payer: Healthscope Commercial |
$212.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$165.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$200.74
|
| Rate for Payer: PHP Commercial |
$200.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$153.51
|
| Rate for Payer: Priority Health SBD |
$148.79
|
| Rate for Payer: UMR Bronson Commercial |
$103.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.13
|
|
|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
IP
|
$250.29
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$110.13 |
| Max. Negotiated Rate |
$225.26 |
| Rate for Payer: Aetna American Axle |
$162.69
|
| Rate for Payer: Aetna Commercial |
$212.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.69
|
| Rate for Payer: Cash Price |
$200.23
|
| Rate for Payer: Cofinity Commercial |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$215.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.23
|
| Rate for Payer: Healthscope Commercial |
$225.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.75
|
| Rate for Payer: PHP Commercial |
$212.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.69
|
| Rate for Payer: Priority Health SBD |
$157.68
|
| Rate for Payer: UMR Bronson Commercial |
$110.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.72
|
|
|
HC TC 99M SULFUR COLLOID PER STUDY
|
Facility
|
OP
|
$250.29
|
|
|
Service Code
|
HCPCS A9541
|
| Hospital Charge Code |
34300020
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$92.61 |
| Max. Negotiated Rate |
$225.26 |
| Rate for Payer: Aetna American Axle |
$162.69
|
| Rate for Payer: Aetna Commercial |
$212.75
|
| Rate for Payer: Aetna Medicare |
$125.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$162.69
|
| Rate for Payer: BCBS Complete |
$100.12
|
| Rate for Payer: BCBS Trust/PPO |
$105.04
|
| Rate for Payer: BCN Commercial |
$105.04
|
| Rate for Payer: Cash Price |
$200.23
|
| Rate for Payer: Cash Price |
$200.23
|
| Rate for Payer: Cofinity Commercial |
$175.20
|
| Rate for Payer: Cofinity Commercial |
$215.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$175.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$200.23
|
| Rate for Payer: Healthscope Commercial |
$225.26
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$175.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.75
|
| Rate for Payer: PHP Commercial |
$212.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.69
|
| Rate for Payer: Priority Health SBD |
$157.68
|
| Rate for Payer: UMR Bronson Commercial |
$92.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.72
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna American Axle |
$23.20
|
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$20.64
|
| Rate for Payer: BCN Commercial |
$20.64
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Cofinity Commercial |
$24.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.34
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$17.14
|
| Rate for Payer: Priority Health SBD |
$22.49
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: UMR Bronson Commercial |
$13.21
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC T CELL ACUTE LYMPH LEUK
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000133
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.71 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna American Axle |
$23.20
|
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$23.20
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$24.99
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$24.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$24.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$23.20
|
| Rate for Payer: Priority Health SBD |
$22.49
|
| Rate for Payer: UMR Bronson Commercial |
$15.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
OP
|
$118.61
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$106.75 |
| Rate for Payer: Aetna American Axle |
$77.10
|
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$49.32
|
| Rate for Payer: BCN Commercial |
$49.32
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Commercial |
$83.03
|
| Rate for Payer: Cofinity Commercial |
$102.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$106.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.96
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$100.82
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$40.95
|
| Rate for Payer: Priority Health SBD |
$74.72
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$51.19
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: UMR Bronson Commercial |
$43.89
|
| Rate for Payer: VA VA |
$51.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.96
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$118.61
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000040
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$52.19 |
| Max. Negotiated Rate |
$106.75 |
| Rate for Payer: Aetna American Axle |
$77.10
|
| Rate for Payer: Aetna Commercial |
$100.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.10
|
| Rate for Payer: Cash Price |
$94.89
|
| Rate for Payer: Cofinity Commercial |
$102.00
|
| Rate for Payer: Cofinity Commercial |
$83.03
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.89
|
| Rate for Payer: Healthscope Commercial |
$106.75
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.82
|
| Rate for Payer: PHP Commercial |
$100.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.10
|
| Rate for Payer: Priority Health SBD |
$74.72
|
| Rate for Payer: UMR Bronson Commercial |
$52.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.96
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$46.24 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna American Axle |
$68.30
|
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.30
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$73.56
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health SBD |
$66.20
|
| Rate for Payer: UMR Bronson Commercial |
$46.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC T CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000029
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.48 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna American Axle |
$68.30
|
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna Medicare |
$22.28
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$68.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.78
|
| Rate for Payer: BCBS Complete |
$12.06
|
| Rate for Payer: BCBS MAPPO |
$21.42
|
| Rate for Payer: BCBS Trust/PPO |
$20.64
|
| Rate for Payer: BCN Commercial |
$20.64
|
| Rate for Payer: BCN Medicare Advantage |
$21.42
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Cofinity Commercial |
$73.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$73.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.42
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$73.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Mclaren Medicaid |
$11.48
|
| Rate for Payer: Mclaren Medicare |
$21.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.49
|
| Rate for Payer: Meridian Medicaid |
$12.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$32.13
|
| Rate for Payer: PACE Medicare |
$20.35
|
| Rate for Payer: PACE SWMI |
$21.42
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: PHP Medicare Advantage |
$21.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.42
|
| Rate for Payer: Priority Health Medicare |
$21.42
|
| Rate for Payer: Priority Health Narrow Network |
$17.14
|
| Rate for Payer: Priority Health SBD |
$66.20
|
| Rate for Payer: Railroad Medicare Medicare |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.42
|
| Rate for Payer: UHC Exchange |
$21.42
|
| Rate for Payer: UHC Medicare Advantage |
$21.42
|
| Rate for Payer: UHCCP Medicaid |
$11.48
|
| Rate for Payer: UMR Bronson Commercial |
$38.88
|
| Rate for Payer: VA VA |
$21.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC T CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.25 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna American Axle |
$55.03
|
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.03
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$59.26
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: Priority Health SBD |
$53.34
|
| Rate for Payer: UMR Bronson Commercial |
$37.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC T CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000039
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$76.78 |
| Rate for Payer: Aetna American Axle |
$55.03
|
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna Medicare |
$53.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.99
|
| Rate for Payer: BCBS Complete |
$28.81
|
| Rate for Payer: BCBS MAPPO |
$51.19
|
| Rate for Payer: BCBS Trust/PPO |
$49.32
|
| Rate for Payer: BCN Commercial |
$49.32
|
| Rate for Payer: BCN Medicare Advantage |
$51.19
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Cofinity Commercial |
$59.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.19
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Mclaren Medicaid |
$27.44
|
| Rate for Payer: Mclaren Medicare |
$51.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.75
|
| Rate for Payer: Meridian Medicaid |
$28.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$71.96
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: PACE Medicare |
$48.63
|
| Rate for Payer: PACE SWMI |
$51.19
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: PHP Medicare Advantage |
$51.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.03
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$51.19
|
| Rate for Payer: Priority Health Medicare |
$51.19
|
| Rate for Payer: Priority Health Narrow Network |
$40.95
|
| Rate for Payer: Priority Health SBD |
$53.34
|
| Rate for Payer: Railroad Medicare Medicare |
$51.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.19
|
| Rate for Payer: UHC Exchange |
$51.19
|
| Rate for Payer: UHC Medicare Advantage |
$51.19
|
| Rate for Payer: UHCCP Medicaid |
$27.44
|
| Rate for Payer: UMR Bronson Commercial |
$31.32
|
| Rate for Payer: VA VA |
$51.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC T CELLS CD4 CD8 COUNT
|
Facility
|
OP
|
$76.86
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200207
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.18 |
| Max. Negotiated Rate |
$70.47 |
| Rate for Payer: Aetna American Axle |
$49.96
|
| Rate for Payer: Aetna Commercial |
$65.33
|
| Rate for Payer: Aetna Medicare |
$48.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$58.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$58.72
|
| Rate for Payer: BCBS Complete |
$26.44
|
| Rate for Payer: BCBS MAPPO |
$46.98
|
| Rate for Payer: BCBS Trust/PPO |
$45.27
|
| Rate for Payer: BCN Commercial |
$45.27
|
| Rate for Payer: BCN Medicare Advantage |
$46.98
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$66.10
|
| Rate for Payer: Cofinity Commercial |
$53.80
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.98
|
| Rate for Payer: Healthscope Commercial |
$69.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.64
|
| Rate for Payer: Mclaren Medicaid |
$25.18
|
| Rate for Payer: Mclaren Medicare |
$46.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.33
|
| Rate for Payer: Meridian Medicaid |
$26.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.33
|
| Rate for Payer: Nomi Health Commercial |
$70.47
|
| Rate for Payer: PACE Medicare |
$44.63
|
| Rate for Payer: PACE SWMI |
$46.98
|
| Rate for Payer: PHP Commercial |
$65.33
|
| Rate for Payer: PHP Medicare Advantage |
$46.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$48.34
|
| Rate for Payer: Priority Health Medicare |
$46.98
|
| Rate for Payer: Priority Health Narrow Network |
$38.67
|
| Rate for Payer: Priority Health SBD |
$48.42
|
| Rate for Payer: Railroad Medicare Medicare |
$46.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$46.98
|
| Rate for Payer: UHC Exchange |
$46.98
|
| Rate for Payer: UHC Medicare Advantage |
$46.98
|
| Rate for Payer: UHCCP Medicaid |
$25.18
|
| Rate for Payer: UMR Bronson Commercial |
$28.44
|
| Rate for Payer: VA VA |
$46.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.64
|
|
|
HC T CELLS CD4 CD8 COUNT
|
Facility
|
IP
|
$76.86
|
|
|
Service Code
|
CPT 86360
|
| Hospital Charge Code |
30200207
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.82 |
| Max. Negotiated Rate |
$69.17 |
| Rate for Payer: Aetna American Axle |
$49.96
|
| Rate for Payer: Aetna Commercial |
$65.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.96
|
| Rate for Payer: Cash Price |
$61.49
|
| Rate for Payer: Cofinity Commercial |
$53.80
|
| Rate for Payer: Cofinity Commercial |
$66.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.49
|
| Rate for Payer: Healthscope Commercial |
$69.17
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.33
|
| Rate for Payer: PHP Commercial |
$65.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.96
|
| Rate for Payer: Priority Health SBD |
$48.42
|
| Rate for Payer: UMR Bronson Commercial |
$33.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.64
|
|
|
HC T CELL TOTAL
|
Facility
|
IP
|
$61.72
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200205
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.16 |
| Max. Negotiated Rate |
$55.55 |
| Rate for Payer: Aetna American Axle |
$40.12
|
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.12
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$43.20
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health SBD |
$38.88
|
| Rate for Payer: UMR Bronson Commercial |
$27.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC T CELL TOTAL
|
Facility
|
OP
|
$61.72
|
|
|
Service Code
|
CPT 86359
|
| Hospital Charge Code |
30200205
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$20.22 |
| Max. Negotiated Rate |
$56.60 |
| Rate for Payer: Aetna American Axle |
$40.12
|
| Rate for Payer: Aetna Commercial |
$52.46
|
| Rate for Payer: Aetna Medicare |
$39.24
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.16
|
| Rate for Payer: BCBS Complete |
$21.23
|
| Rate for Payer: BCBS MAPPO |
$37.73
|
| Rate for Payer: BCBS Trust/PPO |
$36.35
|
| Rate for Payer: BCN Commercial |
$36.35
|
| Rate for Payer: BCN Medicare Advantage |
$37.73
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cash Price |
$49.38
|
| Rate for Payer: Cofinity Commercial |
$53.08
|
| Rate for Payer: Cofinity Commercial |
$43.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.73
|
| Rate for Payer: Healthscope Commercial |
$55.55
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.29
|
| Rate for Payer: Mclaren Medicaid |
$20.22
|
| Rate for Payer: Mclaren Medicare |
$37.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.62
|
| Rate for Payer: Meridian Medicaid |
$21.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.46
|
| Rate for Payer: Nomi Health Commercial |
$56.60
|
| Rate for Payer: PACE Medicare |
$35.84
|
| Rate for Payer: PACE SWMI |
$37.73
|
| Rate for Payer: PHP Commercial |
$52.46
|
| Rate for Payer: PHP Medicare Advantage |
$37.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.12
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$38.81
|
| Rate for Payer: Priority Health Medicare |
$37.73
|
| Rate for Payer: Priority Health Narrow Network |
$31.05
|
| Rate for Payer: Priority Health SBD |
$38.88
|
| Rate for Payer: Railroad Medicare Medicare |
$37.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.73
|
| Rate for Payer: UHC Exchange |
$37.73
|
| Rate for Payer: UHC Medicare Advantage |
$37.73
|
| Rate for Payer: UHCCP Medicaid |
$20.22
|
| Rate for Payer: UMR Bronson Commercial |
$22.84
|
| Rate for Payer: VA VA |
$37.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.29
|
|
|
HC TCMEPS UPPER/LOWER EXT. STIM
|
Facility
|
IP
|
$3,570.54
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
92200026
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$1,571.04 |
| Max. Negotiated Rate |
$3,213.49 |
| Rate for Payer: Aetna American Axle |
$2,320.85
|
| Rate for Payer: Aetna Commercial |
$3,034.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.85
|
| Rate for Payer: Cash Price |
$2,856.43
|
| Rate for Payer: Cofinity Commercial |
$2,499.38
|
| Rate for Payer: Cofinity Commercial |
$3,070.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.43
|
| Rate for Payer: Healthscope Commercial |
$3,213.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.96
|
| Rate for Payer: PHP Commercial |
$3,034.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.85
|
| Rate for Payer: Priority Health SBD |
$2,249.44
|
| Rate for Payer: UMR Bronson Commercial |
$1,571.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.90
|
|
|
HC TCMEPS UPPER/LOWER EXT. STIM
|
Facility
|
OP
|
$3,570.54
|
|
|
Service Code
|
CPT 95939
|
| Hospital Charge Code |
92200026
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$507.28 |
| Max. Negotiated Rate |
$3,213.49 |
| Rate for Payer: Aetna American Axle |
$2,320.85
|
| Rate for Payer: Aetna Commercial |
$3,034.96
|
| Rate for Payer: Aetna Medicare |
$1,036.69
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,320.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,246.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,246.02
|
| Rate for Payer: BCBS Complete |
$561.01
|
| Rate for Payer: BCBS MAPPO |
$996.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,870.37
|
| Rate for Payer: BCN Commercial |
$1,870.37
|
| Rate for Payer: BCN Medicare Advantage |
$996.82
|
| Rate for Payer: Cash Price |
$2,856.43
|
| Rate for Payer: Cash Price |
$2,856.43
|
| Rate for Payer: Cash Price |
$2,856.43
|
| Rate for Payer: Cofinity Commercial |
$2,499.38
|
| Rate for Payer: Cofinity Commercial |
$3,070.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,499.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,856.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$996.82
|
| Rate for Payer: Healthscope Commercial |
$3,213.49
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,499.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,677.90
|
| Rate for Payer: Mclaren Medicaid |
$534.30
|
| Rate for Payer: Mclaren Medicare |
$996.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,046.66
|
| Rate for Payer: Meridian Medicaid |
$561.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,146.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,034.96
|
| Rate for Payer: Nomi Health Commercial |
$2,990.46
|
| Rate for Payer: PACE Medicare |
$946.98
|
| Rate for Payer: PACE SWMI |
$996.82
|
| Rate for Payer: PHP Commercial |
$3,034.96
|
| Rate for Payer: PHP Medicare Advantage |
$996.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$534.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,320.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,132.99
|
| Rate for Payer: Priority Health Medicare |
$996.82
|
| Rate for Payer: Priority Health Narrow Network |
$2,506.39
|
| Rate for Payer: Priority Health SBD |
$2,249.44
|
| Rate for Payer: Railroad Medicare Medicare |
$996.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$558.01
|
| Rate for Payer: UHC Core |
$522.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$996.82
|
| Rate for Payer: UHC Exchange |
$507.28
|
| Rate for Payer: UHC Medicare Advantage |
$996.82
|
| Rate for Payer: UHCCP Medicaid |
$534.30
|
| Rate for Payer: UMR Bronson Commercial |
$1,321.10
|
| Rate for Payer: VA VA |
$996.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,677.90
|
|
|
HC TCOM INITIAL DAY
|
Facility
|
OP
|
$411.68
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000011
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$51.44 |
| Max. Negotiated Rate |
$370.51 |
| Rate for Payer: Aetna American Axle |
$267.59
|
| Rate for Payer: Aetna Commercial |
$349.93
|
| Rate for Payer: Aetna Medicare |
$205.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.59
|
| Rate for Payer: BCBS Complete |
$164.67
|
| Rate for Payer: BCBS Trust/PPO |
$202.95
|
| Rate for Payer: BCN Commercial |
$202.95
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$354.04
|
| Rate for Payer: Cofinity Commercial |
$288.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$288.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Healthscope Commercial |
$370.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$288.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: PHP Commercial |
$349.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health SBD |
$259.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.58
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$51.44
|
| Rate for Payer: UMR Bronson Commercial |
$152.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.76
|
|
|
HC TCOM INITIAL DAY
|
Facility
|
IP
|
$411.68
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000011
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$181.14 |
| Max. Negotiated Rate |
$370.51 |
| Rate for Payer: Aetna American Axle |
$267.59
|
| Rate for Payer: Aetna Commercial |
$349.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$267.59
|
| Rate for Payer: Cash Price |
$329.34
|
| Rate for Payer: Cofinity Commercial |
$288.18
|
| Rate for Payer: Cofinity Commercial |
$354.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$288.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.34
|
| Rate for Payer: Healthscope Commercial |
$370.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$288.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$308.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$349.93
|
| Rate for Payer: PHP Commercial |
$349.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.59
|
| Rate for Payer: Priority Health SBD |
$259.36
|
| Rate for Payer: UMR Bronson Commercial |
$181.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$308.76
|
|
|
HC TCOM SUBS DAY
|
Facility
|
IP
|
$316.14
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$139.10 |
| Max. Negotiated Rate |
$284.53 |
| Rate for Payer: Aetna American Axle |
$205.49
|
| Rate for Payer: Aetna Commercial |
$268.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.49
|
| Rate for Payer: Cash Price |
$252.91
|
| Rate for Payer: Cofinity Commercial |
$221.30
|
| Rate for Payer: Cofinity Commercial |
$271.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$221.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.91
|
| Rate for Payer: Healthscope Commercial |
$284.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.72
|
| Rate for Payer: PHP Commercial |
$268.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.49
|
| Rate for Payer: Priority Health SBD |
$199.17
|
| Rate for Payer: UMR Bronson Commercial |
$139.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.10
|
|
|
HC TCOM SUBS DAY
|
Facility
|
OP
|
$316.14
|
|
|
Service Code
|
CPT 94729
|
| Hospital Charge Code |
46000010
|
|
Hospital Revenue Code
|
460
|
| Min. Negotiated Rate |
$51.44 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$205.49
|
| Rate for Payer: Aetna Commercial |
$268.72
|
| Rate for Payer: Aetna Medicare |
$158.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$205.49
|
| Rate for Payer: BCBS Complete |
$126.46
|
| Rate for Payer: BCBS Trust/PPO |
$202.95
|
| Rate for Payer: BCN Commercial |
$202.95
|
| Rate for Payer: Cash Price |
$252.91
|
| Rate for Payer: Cash Price |
$252.91
|
| Rate for Payer: Cash Price |
$252.91
|
| Rate for Payer: Cofinity Commercial |
$271.88
|
| Rate for Payer: Cofinity Commercial |
$221.30
|
| Rate for Payer: Cofinity Medicare Advantage |
$221.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$252.91
|
| Rate for Payer: Healthscope Commercial |
$284.53
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$221.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$268.72
|
| Rate for Payer: PHP Commercial |
$268.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$205.49
|
| Rate for Payer: Priority Health SBD |
$199.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.58
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$51.44
|
| Rate for Payer: UMR Bronson Commercial |
$116.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.10
|
|
|
HC TCU OBSERVATION PER HOUR
|
Facility
|
IP
|
$145.08
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200015
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$63.84 |
| Max. Negotiated Rate |
$130.57 |
| Rate for Payer: Aetna American Axle |
$94.30
|
| Rate for Payer: Aetna Commercial |
$123.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$94.30
|
| Rate for Payer: Cash Price |
$116.06
|
| Rate for Payer: Cofinity Commercial |
$101.56
|
| Rate for Payer: Cofinity Commercial |
$124.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$101.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.06
|
| Rate for Payer: Healthscope Commercial |
$130.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$101.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$108.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$123.32
|
| Rate for Payer: PHP Commercial |
$123.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.30
|
| Rate for Payer: Priority Health SBD |
$91.40
|
| Rate for Payer: UMR Bronson Commercial |
$63.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$108.81
|
|
