|
HC THYROGLOBULIN
|
Facility
|
OP
|
$57.89
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
30100434
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.61 |
| Max. Negotiated Rate |
$52.10 |
| Rate for Payer: Aetna American Axle |
$37.63
|
| Rate for Payer: Aetna Commercial |
$49.21
|
| Rate for Payer: Aetna Medicare |
$16.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.07
|
| Rate for Payer: BCBS Complete |
$9.04
|
| Rate for Payer: BCBS MAPPO |
$16.06
|
| Rate for Payer: BCN Medicare Advantage |
$16.06
|
| Rate for Payer: Cash Price |
$46.31
|
| Rate for Payer: Cash Price |
$46.31
|
| Rate for Payer: Cofinity Commercial |
$49.79
|
| Rate for Payer: Cofinity Commercial |
$40.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.06
|
| Rate for Payer: Healthscope Commercial |
$52.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.42
|
| Rate for Payer: Mclaren Medicaid |
$8.61
|
| Rate for Payer: Mclaren Medicare |
$16.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.86
|
| Rate for Payer: Meridian Medicaid |
$9.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.21
|
| Rate for Payer: PACE Medicare |
$15.26
|
| Rate for Payer: PACE SWMI |
$16.06
|
| Rate for Payer: PHP Commercial |
$49.21
|
| Rate for Payer: PHP Medicare Advantage |
$16.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.63
|
| Rate for Payer: Priority Health Medicare |
$16.06
|
| Rate for Payer: Priority Health SBD |
$36.47
|
| Rate for Payer: Railroad Medicare Medicare |
$16.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.06
|
| Rate for Payer: UHC Exchange |
$30.69
|
| Rate for Payer: UHC Medicare Advantage |
$16.06
|
| Rate for Payer: UHCCP Medicaid |
$8.61
|
| Rate for Payer: UMR Bronson Commercial |
$21.42
|
| Rate for Payer: VA VA |
$16.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.42
|
|
|
HC THYROGLOBULIN
|
Facility
|
IP
|
$57.89
|
|
|
Service Code
|
CPT 84432
|
| Hospital Charge Code |
30100434
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.47 |
| Max. Negotiated Rate |
$52.10 |
| Rate for Payer: Aetna American Axle |
$37.63
|
| Rate for Payer: Aetna Commercial |
$49.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.63
|
| Rate for Payer: Cash Price |
$46.31
|
| Rate for Payer: Cofinity Commercial |
$40.52
|
| Rate for Payer: Cofinity Commercial |
$49.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.31
|
| Rate for Payer: Healthscope Commercial |
$52.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.21
|
| Rate for Payer: PHP Commercial |
$49.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.63
|
| Rate for Payer: Priority Health SBD |
$36.47
|
| Rate for Payer: UMR Bronson Commercial |
$25.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.42
|
|
|
HC THYROGLOBULIN CMPT
|
Facility
|
IP
|
$60.24
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$26.51 |
| Max. Negotiated Rate |
$54.22 |
| Rate for Payer: Aetna American Axle |
$39.16
|
| Rate for Payer: Aetna Commercial |
$51.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.16
|
| Rate for Payer: Cash Price |
$48.19
|
| Rate for Payer: Cofinity Commercial |
$42.17
|
| Rate for Payer: Cofinity Commercial |
$51.81
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.19
|
| Rate for Payer: Healthscope Commercial |
$54.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.20
|
| Rate for Payer: PHP Commercial |
$51.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.16
|
| Rate for Payer: Priority Health SBD |
$37.95
|
| Rate for Payer: UMR Bronson Commercial |
$26.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.18
|
|
|
HC THYROGLOBULIN CMPT
|
Facility
|
OP
|
$60.24
|
|
|
Service Code
|
CPT 86800
|
| Hospital Charge Code |
30200335
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.53 |
| Max. Negotiated Rate |
$54.22 |
| Rate for Payer: Aetna American Axle |
$39.16
|
| Rate for Payer: Aetna Commercial |
$51.20
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$39.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.89
|
| Rate for Payer: BCBS Complete |
$8.95
|
| Rate for Payer: BCBS MAPPO |
$15.91
|
| Rate for Payer: BCN Medicare Advantage |
$15.91
|
| Rate for Payer: Cash Price |
$48.19
|
| Rate for Payer: Cash Price |
$48.19
|
| Rate for Payer: Cofinity Commercial |
$51.81
|
| Rate for Payer: Cofinity Commercial |
$42.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$42.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$48.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.91
|
| Rate for Payer: Healthscope Commercial |
$54.22
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$42.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$45.18
|
| Rate for Payer: Mclaren Medicaid |
$8.53
|
| Rate for Payer: Mclaren Medicare |
$15.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$8.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$51.20
|
| Rate for Payer: PACE Medicare |
$15.11
|
| Rate for Payer: PACE SWMI |
$15.91
|
| Rate for Payer: PHP Commercial |
$51.20
|
| Rate for Payer: PHP Medicare Advantage |
$15.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$39.16
|
| Rate for Payer: Priority Health Medicare |
$15.91
|
| Rate for Payer: Priority Health SBD |
$37.95
|
| Rate for Payer: Railroad Medicare Medicare |
$15.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.91
|
| Rate for Payer: UHC Exchange |
$30.41
|
| Rate for Payer: UHC Medicare Advantage |
$15.91
|
| Rate for Payer: UHCCP Medicaid |
$8.53
|
| Rate for Payer: UMR Bronson Commercial |
$22.29
|
| Rate for Payer: VA VA |
$15.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$45.18
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
OP
|
$583.41
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$379.22
|
| Rate for Payer: Aetna Commercial |
$495.90
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$466.73
|
| Rate for Payer: Cash Price |
$466.73
|
| Rate for Payer: Cofinity Commercial |
$501.73
|
| Rate for Payer: Cofinity Commercial |
$408.39
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$525.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.56
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.90
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$495.90
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.22
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$367.55
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$215.86
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.56
|
|
|
HC THYROID IMAGING W VASC FLOW
|
Facility
|
IP
|
$583.41
|
|
|
Service Code
|
CPT 78013
|
| Hospital Charge Code |
34100075
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$256.70 |
| Max. Negotiated Rate |
$525.07 |
| Rate for Payer: Aetna American Axle |
$379.22
|
| Rate for Payer: Aetna Commercial |
$495.90
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$379.22
|
| Rate for Payer: Cash Price |
$466.73
|
| Rate for Payer: Cofinity Commercial |
$408.39
|
| Rate for Payer: Cofinity Commercial |
$501.73
|
| Rate for Payer: Cofinity Medicare Advantage |
$408.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$466.73
|
| Rate for Payer: Healthscope Commercial |
$525.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$408.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$437.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$495.90
|
| Rate for Payer: PHP Commercial |
$495.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.22
|
| Rate for Payer: Priority Health SBD |
$367.55
|
| Rate for Payer: UMR Bronson Commercial |
$256.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$437.56
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
OP
|
$1,225.64
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$796.67
|
| Rate for Payer: Aetna Commercial |
$1,041.79
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cofinity Commercial |
$857.95
|
| Rate for Payer: Cofinity Commercial |
$1,054.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$857.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$980.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$1,103.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$857.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.23
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.79
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$1,041.79
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.67
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$772.15
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$453.49
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.23
|
|
|
HC THYROID IMAG W VASC FLOW SNGL OR MULTI
|
Facility
|
IP
|
$1,225.64
|
|
|
Service Code
|
CPT 78014
|
| Hospital Charge Code |
34100076
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$539.28 |
| Max. Negotiated Rate |
$1,103.08 |
| Rate for Payer: Aetna American Axle |
$796.67
|
| Rate for Payer: Aetna Commercial |
$1,041.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$796.67
|
| Rate for Payer: Cash Price |
$980.51
|
| Rate for Payer: Cofinity Commercial |
$1,054.05
|
| Rate for Payer: Cofinity Commercial |
$857.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$857.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$980.51
|
| Rate for Payer: Healthscope Commercial |
$1,103.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$857.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$919.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,041.79
|
| Rate for Payer: PHP Commercial |
$1,041.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$796.67
|
| Rate for Payer: Priority Health SBD |
$772.15
|
| Rate for Payer: UMR Bronson Commercial |
$539.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$919.23
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
IP
|
$85.58
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$37.66 |
| Max. Negotiated Rate |
$77.02 |
| Rate for Payer: Aetna American Axle |
$55.63
|
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.63
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$59.91
|
| Rate for Payer: Cofinity Commercial |
$73.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Healthscope Commercial |
$77.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.74
|
| Rate for Payer: PHP Commercial |
$72.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.63
|
| Rate for Payer: Priority Health SBD |
$53.92
|
| Rate for Payer: UMR Bronson Commercial |
$37.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.19
|
|
|
HC THYROID PEROXIDASE ANTIBODY
|
Facility
|
OP
|
$85.58
|
|
|
Service Code
|
CPT 86376
|
| Hospital Charge Code |
30200209
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.80 |
| Max. Negotiated Rate |
$77.02 |
| Rate for Payer: Aetna American Axle |
$55.63
|
| Rate for Payer: Aetna Commercial |
$72.74
|
| Rate for Payer: Aetna Medicare |
$15.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.19
|
| Rate for Payer: BCBS Complete |
$8.19
|
| Rate for Payer: BCBS MAPPO |
$14.55
|
| Rate for Payer: BCN Medicare Advantage |
$14.55
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cash Price |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$73.60
|
| Rate for Payer: Cofinity Commercial |
$59.91
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.55
|
| Rate for Payer: Healthscope Commercial |
$77.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.19
|
| Rate for Payer: Mclaren Medicaid |
$7.80
|
| Rate for Payer: Mclaren Medicare |
$14.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.28
|
| Rate for Payer: Meridian Medicaid |
$8.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.74
|
| Rate for Payer: PACE Medicare |
$13.82
|
| Rate for Payer: PACE SWMI |
$14.55
|
| Rate for Payer: PHP Commercial |
$72.74
|
| Rate for Payer: PHP Medicare Advantage |
$14.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.63
|
| Rate for Payer: Priority Health Medicare |
$14.55
|
| Rate for Payer: Priority Health SBD |
$53.92
|
| Rate for Payer: Railroad Medicare Medicare |
$14.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.55
|
| Rate for Payer: UHC Exchange |
$27.81
|
| Rate for Payer: UHC Medicare Advantage |
$14.55
|
| Rate for Payer: UHCCP Medicaid |
$7.80
|
| Rate for Payer: UMR Bronson Commercial |
$31.66
|
| Rate for Payer: VA VA |
$14.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.19
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
OP
|
$85.63
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.26 |
| Max. Negotiated Rate |
$143.17 |
| Rate for Payer: Aetna American Axle |
$55.66
|
| Rate for Payer: Aetna Commercial |
$72.79
|
| Rate for Payer: Aetna Medicare |
$52.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.58
|
| Rate for Payer: BCBS Complete |
$28.62
|
| Rate for Payer: BCBS MAPPO |
$50.86
|
| Rate for Payer: BCN Medicare Advantage |
$50.86
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cofinity Commercial |
$73.64
|
| Rate for Payer: Cofinity Commercial |
$59.94
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.86
|
| Rate for Payer: Healthscope Commercial |
$77.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.22
|
| Rate for Payer: Mclaren Medicaid |
$27.26
|
| Rate for Payer: Mclaren Medicare |
$50.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.40
|
| Rate for Payer: Meridian Medicaid |
$28.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.79
|
| Rate for Payer: PACE Medicare |
$48.32
|
| Rate for Payer: PACE SWMI |
$50.86
|
| Rate for Payer: PHP Commercial |
$72.79
|
| Rate for Payer: PHP Medicare Advantage |
$50.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.66
|
| Rate for Payer: Priority Health Medicare |
$50.86
|
| Rate for Payer: Priority Health SBD |
$53.95
|
| Rate for Payer: Railroad Medicare Medicare |
$50.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.86
|
| Rate for Payer: UHC Exchange |
$97.20
|
| Rate for Payer: UHC Medicare Advantage |
$50.86
|
| Rate for Payer: UHCCP Medicaid |
$27.26
|
| Rate for Payer: UMR Bronson Commercial |
$31.68
|
| Rate for Payer: VA VA |
$50.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.22
|
|
|
HC THYROID STIMULATING IMMUNOGLOB
|
Facility
|
IP
|
$85.63
|
|
|
Service Code
|
CPT 84445
|
| Hospital Charge Code |
30100439
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.68 |
| Max. Negotiated Rate |
$77.07 |
| Rate for Payer: Aetna American Axle |
$55.66
|
| Rate for Payer: Aetna Commercial |
$72.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$55.66
|
| Rate for Payer: Cash Price |
$68.50
|
| Rate for Payer: Cofinity Commercial |
$59.94
|
| Rate for Payer: Cofinity Commercial |
$73.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$59.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$68.50
|
| Rate for Payer: Healthscope Commercial |
$77.07
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$59.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$72.79
|
| Rate for Payer: PHP Commercial |
$72.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$55.66
|
| Rate for Payer: Priority Health SBD |
$53.95
|
| Rate for Payer: UMR Bronson Commercial |
$37.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.22
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
IP
|
$143.20
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$63.01 |
| Max. Negotiated Rate |
$128.88 |
| Rate for Payer: Aetna American Axle |
$93.08
|
| Rate for Payer: Aetna Commercial |
$121.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.08
|
| Rate for Payer: Cash Price |
$114.56
|
| Rate for Payer: Cofinity Commercial |
$100.24
|
| Rate for Payer: Cofinity Commercial |
$123.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.56
|
| Rate for Payer: Healthscope Commercial |
$128.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.72
|
| Rate for Payer: PHP Commercial |
$121.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.08
|
| Rate for Payer: Priority Health SBD |
$90.22
|
| Rate for Payer: UMR Bronson Commercial |
$63.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.40
|
|
|
HC THYROID TC 99M PER STUDY
|
Facility
|
OP
|
$143.20
|
|
|
Service Code
|
HCPCS A9500
|
| Hospital Charge Code |
34300021
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$52.98 |
| Max. Negotiated Rate |
$128.88 |
| Rate for Payer: Aetna American Axle |
$93.08
|
| Rate for Payer: Aetna Commercial |
$121.72
|
| Rate for Payer: Aetna Medicare |
$71.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$93.08
|
| Rate for Payer: BCBS Complete |
$57.28
|
| Rate for Payer: Cash Price |
$114.56
|
| Rate for Payer: Cofinity Commercial |
$100.24
|
| Rate for Payer: Cofinity Commercial |
$123.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$100.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.56
|
| Rate for Payer: Healthscope Commercial |
$128.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$100.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.72
|
| Rate for Payer: PHP Commercial |
$121.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.08
|
| Rate for Payer: Priority Health SBD |
$90.22
|
| Rate for Payer: UMR Bronson Commercial |
$52.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.40
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
OP
|
$1,056.63
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$210.06 |
| Max. Negotiated Rate |
$1,103.16 |
| Rate for Payer: Aetna American Axle |
$686.81
|
| Rate for Payer: Aetna Commercial |
$898.14
|
| Rate for Payer: Aetna Medicare |
$407.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$686.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$489.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$489.88
|
| Rate for Payer: BCBS Complete |
$220.56
|
| Rate for Payer: BCBS MAPPO |
$391.90
|
| Rate for Payer: BCN Medicare Advantage |
$391.90
|
| Rate for Payer: Cash Price |
$845.30
|
| Rate for Payer: Cash Price |
$845.30
|
| Rate for Payer: Cofinity Commercial |
$908.70
|
| Rate for Payer: Cofinity Commercial |
$739.64
|
| Rate for Payer: Cofinity Medicare Advantage |
$739.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$845.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$391.90
|
| Rate for Payer: Healthscope Commercial |
$950.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$739.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$792.47
|
| Rate for Payer: Mclaren Medicaid |
$210.06
|
| Rate for Payer: Mclaren Medicare |
$391.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$411.50
|
| Rate for Payer: Meridian Medicaid |
$220.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$450.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$898.14
|
| Rate for Payer: PACE Medicare |
$372.31
|
| Rate for Payer: PACE SWMI |
$391.90
|
| Rate for Payer: PHP Commercial |
$898.14
|
| Rate for Payer: PHP Medicare Advantage |
$391.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$210.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$686.81
|
| Rate for Payer: Priority Health Medicare |
$391.90
|
| Rate for Payer: Priority Health SBD |
$665.68
|
| Rate for Payer: Railroad Medicare Medicare |
$391.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,103.16
|
| Rate for Payer: UHC Core |
$832.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$391.90
|
| Rate for Payer: UHC Exchange |
$748.96
|
| Rate for Payer: UHC Medicare Advantage |
$391.90
|
| Rate for Payer: UHCCP Medicaid |
$210.06
|
| Rate for Payer: UMR Bronson Commercial |
$390.95
|
| Rate for Payer: VA VA |
$391.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$792.47
|
|
|
HC THYROID UPTK SNGL OR MULTI DETER
|
Facility
|
IP
|
$1,056.63
|
|
|
Service Code
|
CPT 78012
|
| Hospital Charge Code |
34100074
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$464.92 |
| Max. Negotiated Rate |
$950.97 |
| Rate for Payer: Aetna American Axle |
$686.81
|
| Rate for Payer: Aetna Commercial |
$898.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$686.81
|
| Rate for Payer: Cash Price |
$845.30
|
| Rate for Payer: Cofinity Commercial |
$739.64
|
| Rate for Payer: Cofinity Commercial |
$908.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$739.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$845.30
|
| Rate for Payer: Healthscope Commercial |
$950.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$739.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$792.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$898.14
|
| Rate for Payer: PHP Commercial |
$898.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$686.81
|
| Rate for Payer: Priority Health SBD |
$665.68
|
| Rate for Payer: UMR Bronson Commercial |
$464.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$792.47
|
|
|
HC THYROXINE BINDING GLOBULIN
|
Facility
|
IP
|
$66.40
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
30100437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.22 |
| Max. Negotiated Rate |
$59.76 |
| Rate for Payer: Aetna American Axle |
$43.16
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.16
|
| Rate for Payer: Cash Price |
$53.12
|
| Rate for Payer: Cofinity Commercial |
$46.48
|
| Rate for Payer: Cofinity Commercial |
$57.10
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.12
|
| Rate for Payer: Healthscope Commercial |
$59.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.44
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.16
|
| Rate for Payer: Priority Health SBD |
$41.83
|
| Rate for Payer: UMR Bronson Commercial |
$29.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.80
|
|
|
HC THYROXINE BINDING GLOBULIN
|
Facility
|
OP
|
$66.40
|
|
|
Service Code
|
CPT 84442
|
| Hospital Charge Code |
30100437
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$59.76 |
| Rate for Payer: Aetna American Axle |
$43.16
|
| Rate for Payer: Aetna Commercial |
$56.44
|
| Rate for Payer: Aetna Medicare |
$15.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.48
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS MAPPO |
$14.78
|
| Rate for Payer: BCN Medicare Advantage |
$14.78
|
| Rate for Payer: Cash Price |
$53.12
|
| Rate for Payer: Cash Price |
$53.12
|
| Rate for Payer: Cofinity Commercial |
$57.10
|
| Rate for Payer: Cofinity Commercial |
$46.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.78
|
| Rate for Payer: Healthscope Commercial |
$59.76
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.80
|
| Rate for Payer: Mclaren Medicaid |
$7.92
|
| Rate for Payer: Mclaren Medicare |
$14.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.52
|
| Rate for Payer: Meridian Medicaid |
$8.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.44
|
| Rate for Payer: PACE Medicare |
$14.04
|
| Rate for Payer: PACE SWMI |
$14.78
|
| Rate for Payer: PHP Commercial |
$56.44
|
| Rate for Payer: PHP Medicare Advantage |
$14.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.16
|
| Rate for Payer: Priority Health Medicare |
$14.78
|
| Rate for Payer: Priority Health SBD |
$41.83
|
| Rate for Payer: Railroad Medicare Medicare |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.78
|
| Rate for Payer: UHC Exchange |
$28.25
|
| Rate for Payer: UHC Medicare Advantage |
$14.78
|
| Rate for Payer: UHCCP Medicaid |
$7.92
|
| Rate for Payer: UMR Bronson Commercial |
$24.57
|
| Rate for Payer: VA VA |
$14.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.80
|
|
|
HC THYROXINE FREE T4
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
30100436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.71 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna American Axle |
$74.92
|
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: UMR Bronson Commercial |
$50.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC THYROXINE FREE T4
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 84439
|
| Hospital Charge Code |
30100436
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.83 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna American Axle |
$74.92
|
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$9.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.28
|
| Rate for Payer: BCBS Complete |
$5.08
|
| Rate for Payer: BCBS MAPPO |
$9.02
|
| Rate for Payer: BCN Medicare Advantage |
$9.02
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.02
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Mclaren Medicaid |
$4.83
|
| Rate for Payer: Mclaren Medicare |
$9.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.47
|
| Rate for Payer: Meridian Medicaid |
$5.08
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: PACE Medicare |
$8.57
|
| Rate for Payer: PACE SWMI |
$9.02
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$9.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health Medicare |
$9.02
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: Railroad Medicare Medicare |
$9.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.02
|
| Rate for Payer: UHC Exchange |
$17.24
|
| Rate for Payer: UHC Medicare Advantage |
$9.02
|
| Rate for Payer: UHCCP Medicaid |
$4.83
|
| Rate for Payer: UMR Bronson Commercial |
$42.65
|
| Rate for Payer: VA VA |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC TIAGABINE LEVEL
|
Facility
|
IP
|
$115.93
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
30100058
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.01 |
| Max. Negotiated Rate |
$104.34 |
| Rate for Payer: Aetna American Axle |
$75.35
|
| Rate for Payer: Aetna Commercial |
$98.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.35
|
| Rate for Payer: Cash Price |
$92.74
|
| Rate for Payer: Cofinity Commercial |
$81.15
|
| Rate for Payer: Cofinity Commercial |
$99.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$81.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.74
|
| Rate for Payer: Healthscope Commercial |
$104.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.54
|
| Rate for Payer: PHP Commercial |
$98.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.35
|
| Rate for Payer: Priority Health SBD |
$73.04
|
| Rate for Payer: UMR Bronson Commercial |
$51.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.95
|
|
|
HC TIAGABINE LEVEL
|
Facility
|
OP
|
$115.93
|
|
|
Service Code
|
CPT 80199
|
| Hospital Charge Code |
30100058
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$104.34 |
| Rate for Payer: Aetna American Axle |
$75.35
|
| Rate for Payer: Aetna Commercial |
$98.54
|
| Rate for Payer: Aetna Medicare |
$28.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$75.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.89
|
| Rate for Payer: BCBS Complete |
$15.26
|
| Rate for Payer: BCBS MAPPO |
$27.11
|
| Rate for Payer: BCN Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$92.74
|
| Rate for Payer: Cash Price |
$92.74
|
| Rate for Payer: Cofinity Commercial |
$99.70
|
| Rate for Payer: Cofinity Commercial |
$81.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$81.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.11
|
| Rate for Payer: Healthscope Commercial |
$104.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$81.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.95
|
| Rate for Payer: Mclaren Medicaid |
$14.53
|
| Rate for Payer: Mclaren Medicare |
$27.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.47
|
| Rate for Payer: Meridian Medicaid |
$15.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.54
|
| Rate for Payer: PACE Medicare |
$25.75
|
| Rate for Payer: PACE SWMI |
$27.11
|
| Rate for Payer: PHP Commercial |
$98.54
|
| Rate for Payer: PHP Medicare Advantage |
$27.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.35
|
| Rate for Payer: Priority Health Medicare |
$27.11
|
| Rate for Payer: Priority Health SBD |
$73.04
|
| Rate for Payer: Railroad Medicare Medicare |
$27.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$76.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.11
|
| Rate for Payer: UHC Exchange |
$51.81
|
| Rate for Payer: UHC Medicare Advantage |
$27.11
|
| Rate for Payer: UHCCP Medicaid |
$14.53
|
| Rate for Payer: UMR Bronson Commercial |
$42.89
|
| Rate for Payer: VA VA |
$27.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.95
|
|
|
HC TIER 1 MAJOR TRAUMA RESUSCITATION
|
Facility
|
IP
|
$6,022.01
|
|
| Hospital Charge Code |
68100001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$2,649.68 |
| Max. Negotiated Rate |
$5,419.81 |
| Rate for Payer: Aetna American Axle |
$3,914.31
|
| Rate for Payer: Aetna Commercial |
$5,118.71
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,914.31
|
| Rate for Payer: Cash Price |
$4,817.61
|
| Rate for Payer: Cofinity Commercial |
$4,215.41
|
| Rate for Payer: Cofinity Commercial |
$5,178.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,215.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,817.61
|
| Rate for Payer: Healthscope Commercial |
$5,419.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,215.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,516.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,118.71
|
| Rate for Payer: PHP Commercial |
$5,118.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,914.31
|
| Rate for Payer: Priority Health SBD |
$3,793.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,649.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,516.51
|
|
|
HC TIER 1 MAJOR TRAUMA RESUSCITATION
|
Facility
|
OP
|
$6,022.01
|
|
| Hospital Charge Code |
68100001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$2,228.14 |
| Max. Negotiated Rate |
$5,419.81 |
| Rate for Payer: Aetna American Axle |
$3,914.31
|
| Rate for Payer: Aetna Commercial |
$5,118.71
|
| Rate for Payer: Aetna Medicare |
$3,011.01
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,914.31
|
| Rate for Payer: BCBS Complete |
$2,408.80
|
| Rate for Payer: Cash Price |
$4,817.61
|
| Rate for Payer: Cofinity Commercial |
$4,215.41
|
| Rate for Payer: Cofinity Commercial |
$5,178.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,215.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,817.61
|
| Rate for Payer: Healthscope Commercial |
$5,419.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,215.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,516.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,118.71
|
| Rate for Payer: PHP Commercial |
$5,118.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,914.31
|
| Rate for Payer: Priority Health SBD |
$3,793.87
|
| Rate for Payer: UMR Bronson Commercial |
$2,228.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,516.51
|
|
|
HC TIER 2 TRAUMA RESUSCITATION
|
Facility
|
IP
|
$4,592.66
|
|
| Hospital Charge Code |
68200001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$2,020.77 |
| Max. Negotiated Rate |
$4,133.39 |
| Rate for Payer: Aetna American Axle |
$2,985.23
|
| Rate for Payer: Aetna Commercial |
$3,903.76
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,985.23
|
| Rate for Payer: Cash Price |
$3,674.13
|
| Rate for Payer: Cofinity Commercial |
$3,214.86
|
| Rate for Payer: Cofinity Commercial |
$3,949.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,214.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,674.13
|
| Rate for Payer: Healthscope Commercial |
$4,133.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,214.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,444.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,903.76
|
| Rate for Payer: PHP Commercial |
$3,903.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,985.23
|
| Rate for Payer: Priority Health SBD |
$2,893.38
|
| Rate for Payer: UMR Bronson Commercial |
$2,020.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,444.49
|
|
