|
HC TIER 2 TRAUMA RESUSCITATION
|
Facility
|
OP
|
$4,592.66
|
|
| Hospital Charge Code |
68200001
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,699.28 |
| 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 Medicare |
$2,296.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,985.23
|
| Rate for Payer: BCBS Complete |
$1,837.06
|
| 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 |
$1,699.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,444.49
|
|
|
HC TIER 3 TRAUMA CONSULT
|
Facility
|
IP
|
$3,503.03
|
|
| Hospital Charge Code |
68100002
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,541.33 |
| Max. Negotiated Rate |
$3,152.73 |
| Rate for Payer: Aetna American Axle |
$2,276.97
|
| Rate for Payer: Aetna Commercial |
$2,977.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,276.97
|
| Rate for Payer: Cash Price |
$2,802.42
|
| Rate for Payer: Cofinity Commercial |
$2,452.12
|
| Rate for Payer: Cofinity Commercial |
$3,012.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,452.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,802.42
|
| Rate for Payer: Healthscope Commercial |
$3,152.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,452.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,627.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,977.58
|
| Rate for Payer: PHP Commercial |
$2,977.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,276.97
|
| Rate for Payer: Priority Health SBD |
$2,206.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,541.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,627.27
|
|
|
HC TIER 3 TRAUMA CONSULT
|
Facility
|
OP
|
$3,503.03
|
|
| Hospital Charge Code |
68100002
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,296.12 |
| Max. Negotiated Rate |
$3,152.73 |
| Rate for Payer: Aetna American Axle |
$2,276.97
|
| Rate for Payer: Aetna Commercial |
$2,977.58
|
| Rate for Payer: Aetna Medicare |
$1,751.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,276.97
|
| Rate for Payer: BCBS Complete |
$1,401.21
|
| Rate for Payer: Cash Price |
$2,802.42
|
| Rate for Payer: Cofinity Commercial |
$2,452.12
|
| Rate for Payer: Cofinity Commercial |
$3,012.61
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,452.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,802.42
|
| Rate for Payer: Healthscope Commercial |
$3,152.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,452.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,627.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,977.58
|
| Rate for Payer: PHP Commercial |
$2,977.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,276.97
|
| Rate for Payer: Priority Health SBD |
$2,206.91
|
| Rate for Payer: UMR Bronson Commercial |
$1,296.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,627.27
|
|
|
HC TIER 4 TRAUMA CONSULT
|
Facility
|
IP
|
$2,672.79
|
|
| Hospital Charge Code |
68100003
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$1,176.03 |
| Max. Negotiated Rate |
$2,405.51 |
| Rate for Payer: Aetna American Axle |
$1,737.31
|
| Rate for Payer: Aetna Commercial |
$2,271.87
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,737.31
|
| Rate for Payer: Cash Price |
$2,138.23
|
| Rate for Payer: Cofinity Commercial |
$1,870.95
|
| Rate for Payer: Cofinity Commercial |
$2,298.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,870.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,138.23
|
| Rate for Payer: Healthscope Commercial |
$2,405.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,870.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,004.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,271.87
|
| Rate for Payer: PHP Commercial |
$2,271.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,737.31
|
| Rate for Payer: Priority Health SBD |
$1,683.86
|
| Rate for Payer: UMR Bronson Commercial |
$1,176.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,004.59
|
|
|
HC TIER 4 TRAUMA CONSULT
|
Facility
|
OP
|
$2,672.79
|
|
| Hospital Charge Code |
68100003
|
|
Hospital Revenue Code
|
681
|
| Min. Negotiated Rate |
$988.93 |
| Max. Negotiated Rate |
$2,405.51 |
| Rate for Payer: Aetna American Axle |
$1,737.31
|
| Rate for Payer: Aetna Commercial |
$2,271.87
|
| Rate for Payer: Aetna Medicare |
$1,336.39
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,737.31
|
| Rate for Payer: BCBS Complete |
$1,069.12
|
| Rate for Payer: Cash Price |
$2,138.23
|
| Rate for Payer: Cofinity Commercial |
$1,870.95
|
| Rate for Payer: Cofinity Commercial |
$2,298.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,870.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,138.23
|
| Rate for Payer: Healthscope Commercial |
$2,405.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,870.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,004.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,271.87
|
| Rate for Payer: PHP Commercial |
$2,271.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,737.31
|
| Rate for Payer: Priority Health SBD |
$1,683.86
|
| Rate for Payer: UMR Bronson Commercial |
$988.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,004.59
|
|
|
HC TILT TABLE STRESS
|
Facility
|
OP
|
$1,122.86
|
|
|
Service Code
|
CPT 93660
|
| Hospital Charge Code |
48200002
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$277.37 |
| Max. Negotiated Rate |
$1,456.65 |
| Rate for Payer: Aetna American Axle |
$729.86
|
| Rate for Payer: Aetna Commercial |
$954.43
|
| Rate for Payer: Aetna Medicare |
$538.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$646.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$646.85
|
| Rate for Payer: BCBS Complete |
$291.24
|
| Rate for Payer: BCBS MAPPO |
$517.48
|
| Rate for Payer: BCN Medicare Advantage |
$517.48
|
| Rate for Payer: Cash Price |
$898.29
|
| Rate for Payer: Cash Price |
$898.29
|
| Rate for Payer: Cash Price |
$898.29
|
| Rate for Payer: Cofinity Commercial |
$786.00
|
| Rate for Payer: Cofinity Commercial |
$965.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$786.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.29
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$517.48
|
| Rate for Payer: Healthscope Commercial |
$1,010.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$786.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.14
|
| Rate for Payer: Mclaren Medicaid |
$277.37
|
| Rate for Payer: Mclaren Medicare |
$517.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$543.35
|
| Rate for Payer: Meridian Medicaid |
$291.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$595.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.43
|
| Rate for Payer: PACE Medicare |
$491.61
|
| Rate for Payer: PACE SWMI |
$517.48
|
| Rate for Payer: PHP Commercial |
$954.43
|
| Rate for Payer: PHP Medicare Advantage |
$517.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$277.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.86
|
| Rate for Payer: Priority Health Medicare |
$517.48
|
| Rate for Payer: Priority Health SBD |
$707.40
|
| Rate for Payer: Railroad Medicare Medicare |
$517.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,456.65
|
| Rate for Payer: UHC Core |
$457.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$517.48
|
| Rate for Payer: UHC Exchange |
$988.96
|
| Rate for Payer: UHC Medicare Advantage |
$517.48
|
| Rate for Payer: UHCCP Medicaid |
$277.37
|
| Rate for Payer: UMR Bronson Commercial |
$415.46
|
| Rate for Payer: VA VA |
$517.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.14
|
|
|
HC TILT TABLE STRESS
|
Facility
|
IP
|
$1,122.86
|
|
|
Service Code
|
CPT 93660
|
| Hospital Charge Code |
48200002
|
|
Hospital Revenue Code
|
482
|
| Min. Negotiated Rate |
$494.06 |
| Max. Negotiated Rate |
$1,010.57 |
| Rate for Payer: Aetna American Axle |
$729.86
|
| Rate for Payer: Aetna Commercial |
$954.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$729.86
|
| Rate for Payer: Cash Price |
$898.29
|
| Rate for Payer: Cofinity Commercial |
$786.00
|
| Rate for Payer: Cofinity Commercial |
$965.66
|
| Rate for Payer: Cofinity Medicare Advantage |
$786.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$898.29
|
| Rate for Payer: Healthscope Commercial |
$1,010.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$786.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$842.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$954.43
|
| Rate for Payer: PHP Commercial |
$954.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$729.86
|
| Rate for Payer: Priority Health SBD |
$707.40
|
| Rate for Payer: UMR Bronson Commercial |
$494.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$842.14
|
|
|
HC TIMOTHY GRASS IGE
|
Facility
|
IP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200063
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.17 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: UMR Bronson Commercial |
$11.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC TIMOTHY GRASS IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200063
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna American Axle |
$16.50
|
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.53
|
| Rate for Payer: BCBS Complete |
$2.94
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Cofinity Commercial |
$17.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$2.80
|
| Rate for Payer: Mclaren Medicare |
$5.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.48
|
| Rate for Payer: Meridian Medicaid |
$2.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.00
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.22
|
| Rate for Payer: UHC Exchange |
$9.98
|
| Rate for Payer: UHC Medicare Advantage |
$5.22
|
| Rate for Payer: UHCCP Medicaid |
$2.80
|
| Rate for Payer: UMR Bronson Commercial |
$9.39
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC TIP PUMP SUCTION
|
Facility
|
IP
|
$42.84
|
|
| Hospital Charge Code |
27000111
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna American Axle |
$27.85
|
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.85
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$29.99
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health SBD |
$26.99
|
| Rate for Payer: UMR Bronson Commercial |
$18.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC TIP PUMP SUCTION
|
Facility
|
OP
|
$42.84
|
|
| Hospital Charge Code |
27000111
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$15.85 |
| Max. Negotiated Rate |
$38.56 |
| Rate for Payer: Aetna American Axle |
$27.85
|
| Rate for Payer: Aetna Commercial |
$36.41
|
| Rate for Payer: Aetna Medicare |
$21.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.85
|
| Rate for Payer: BCBS Complete |
$17.14
|
| Rate for Payer: Cash Price |
$34.27
|
| Rate for Payer: Cofinity Commercial |
$29.99
|
| Rate for Payer: Cofinity Commercial |
$36.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.27
|
| Rate for Payer: Healthscope Commercial |
$38.56
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.41
|
| Rate for Payer: PHP Commercial |
$36.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.85
|
| Rate for Payer: Priority Health SBD |
$26.99
|
| Rate for Payer: UMR Bronson Commercial |
$15.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.13
|
|
|
HC TISSUE IN SITU HYB QUANT EA ADD
|
Facility
|
IP
|
$269.46
|
|
|
Service Code
|
CPT 88369
|
| Hospital Charge Code |
31000123
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$118.56 |
| Max. Negotiated Rate |
$242.51 |
| Rate for Payer: Aetna American Axle |
$175.15
|
| Rate for Payer: Aetna Commercial |
$229.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.15
|
| Rate for Payer: Cash Price |
$215.57
|
| Rate for Payer: Cofinity Commercial |
$188.62
|
| Rate for Payer: Cofinity Commercial |
$231.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$188.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.57
|
| Rate for Payer: Healthscope Commercial |
$242.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.04
|
| Rate for Payer: PHP Commercial |
$229.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.15
|
| Rate for Payer: Priority Health SBD |
$169.76
|
| Rate for Payer: UMR Bronson Commercial |
$118.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.09
|
|
|
HC TISSUE IN SITU HYB QUANT EA ADD
|
Facility
|
OP
|
$269.46
|
|
|
Service Code
|
CPT 88369
|
| Hospital Charge Code |
31000123
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.70 |
| Max. Negotiated Rate |
$242.51 |
| Rate for Payer: Aetna American Axle |
$175.15
|
| Rate for Payer: Aetna Commercial |
$229.04
|
| Rate for Payer: Aetna Medicare |
$134.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.15
|
| Rate for Payer: BCBS Complete |
$107.78
|
| Rate for Payer: Cash Price |
$215.57
|
| Rate for Payer: Cofinity Commercial |
$188.62
|
| Rate for Payer: Cofinity Commercial |
$231.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$188.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.57
|
| Rate for Payer: Healthscope Commercial |
$242.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.04
|
| Rate for Payer: PHP Commercial |
$229.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.15
|
| Rate for Payer: Priority Health SBD |
$169.76
|
| Rate for Payer: UMR Bronson Commercial |
$99.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.09
|
|
|
HC TISSUE IN SITU HYBRIDIZATION
|
Facility
|
OP
|
$355.46
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
31000060
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$89.58 |
| Max. Negotiated Rate |
$470.43 |
| Rate for Payer: Aetna American Axle |
$231.05
|
| Rate for Payer: Aetna Commercial |
$302.14
|
| Rate for Payer: Aetna Medicare |
$173.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$208.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$208.90
|
| Rate for Payer: BCBS Complete |
$94.06
|
| Rate for Payer: BCBS MAPPO |
$167.12
|
| Rate for Payer: BCN Medicare Advantage |
$167.12
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cofinity Commercial |
$305.70
|
| Rate for Payer: Cofinity Commercial |
$248.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$167.12
|
| Rate for Payer: Healthscope Commercial |
$319.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.60
|
| Rate for Payer: Mclaren Medicaid |
$89.58
|
| Rate for Payer: Mclaren Medicare |
$167.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$175.48
|
| Rate for Payer: Meridian Medicaid |
$94.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$192.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.14
|
| Rate for Payer: PACE Medicare |
$158.76
|
| Rate for Payer: PACE SWMI |
$167.12
|
| Rate for Payer: PHP Commercial |
$302.14
|
| Rate for Payer: PHP Medicare Advantage |
$167.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.05
|
| Rate for Payer: Priority Health Medicare |
$167.12
|
| Rate for Payer: Priority Health SBD |
$223.94
|
| Rate for Payer: Railroad Medicare Medicare |
$167.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$470.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$167.12
|
| Rate for Payer: UHC Exchange |
$319.38
|
| Rate for Payer: UHC Medicare Advantage |
$167.12
|
| Rate for Payer: UHCCP Medicaid |
$89.58
|
| Rate for Payer: UMR Bronson Commercial |
$131.52
|
| Rate for Payer: VA VA |
$167.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.60
|
|
|
HC TISSUE IN SITU HYBRIDIZATION
|
Facility
|
IP
|
$355.46
|
|
|
Service Code
|
CPT 88365
|
| Hospital Charge Code |
31000060
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$156.40 |
| Max. Negotiated Rate |
$319.91 |
| Rate for Payer: Aetna American Axle |
$231.05
|
| Rate for Payer: Aetna Commercial |
$302.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$231.05
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cofinity Commercial |
$248.82
|
| Rate for Payer: Cofinity Commercial |
$305.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$248.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.37
|
| Rate for Payer: Healthscope Commercial |
$319.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$248.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.14
|
| Rate for Payer: PHP Commercial |
$302.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.05
|
| Rate for Payer: Priority Health SBD |
$223.94
|
| Rate for Payer: UMR Bronson Commercial |
$156.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.60
|
|
|
HC TISSUE IN SITU HYBRID QUANT
|
Facility
|
OP
|
$269.46
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000122
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$99.70 |
| Max. Negotiated Rate |
$987.55 |
| Rate for Payer: Aetna American Axle |
$175.15
|
| Rate for Payer: Aetna Commercial |
$229.04
|
| Rate for Payer: Aetna Medicare |
$364.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$438.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$438.54
|
| Rate for Payer: BCBS Complete |
$197.45
|
| Rate for Payer: BCBS MAPPO |
$350.83
|
| Rate for Payer: BCN Medicare Advantage |
$350.83
|
| Rate for Payer: Cash Price |
$215.57
|
| Rate for Payer: Cash Price |
$215.57
|
| Rate for Payer: Cofinity Commercial |
$231.74
|
| Rate for Payer: Cofinity Commercial |
$188.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$188.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$350.83
|
| Rate for Payer: Healthscope Commercial |
$242.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.09
|
| Rate for Payer: Mclaren Medicaid |
$188.04
|
| Rate for Payer: Mclaren Medicare |
$350.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$368.37
|
| Rate for Payer: Meridian Medicaid |
$197.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$403.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.04
|
| Rate for Payer: PACE Medicare |
$333.29
|
| Rate for Payer: PACE SWMI |
$350.83
|
| Rate for Payer: PHP Commercial |
$229.04
|
| Rate for Payer: PHP Medicare Advantage |
$350.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.15
|
| Rate for Payer: Priority Health Medicare |
$350.83
|
| Rate for Payer: Priority Health SBD |
$169.76
|
| Rate for Payer: Railroad Medicare Medicare |
$350.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$987.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$350.83
|
| Rate for Payer: UHC Exchange |
$670.47
|
| Rate for Payer: UHC Medicare Advantage |
$350.83
|
| Rate for Payer: UHCCP Medicaid |
$188.04
|
| Rate for Payer: UMR Bronson Commercial |
$99.70
|
| Rate for Payer: VA VA |
$350.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.09
|
|
|
HC TISSUE IN SITU HYBRID QUANT
|
Facility
|
IP
|
$269.46
|
|
|
Service Code
|
CPT 88368
|
| Hospital Charge Code |
31000122
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$118.56 |
| Max. Negotiated Rate |
$242.51 |
| Rate for Payer: Aetna American Axle |
$175.15
|
| Rate for Payer: Aetna Commercial |
$229.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$175.15
|
| Rate for Payer: Cash Price |
$215.57
|
| Rate for Payer: Cofinity Commercial |
$188.62
|
| Rate for Payer: Cofinity Commercial |
$231.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$188.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$215.57
|
| Rate for Payer: Healthscope Commercial |
$242.51
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$188.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$202.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$229.04
|
| Rate for Payer: PHP Commercial |
$229.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$175.15
|
| Rate for Payer: Priority Health SBD |
$169.76
|
| Rate for Payer: UMR Bronson Commercial |
$118.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$202.09
|
|
|
HC TISSUE MARKER IMPLANTABLE
|
Facility
|
IP
|
$1,470.09
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$646.84 |
| Max. Negotiated Rate |
$1,323.08 |
| Rate for Payer: Aetna American Axle |
$955.56
|
| Rate for Payer: Aetna Commercial |
$1,249.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.56
|
| Rate for Payer: Cash Price |
$1,176.07
|
| Rate for Payer: Cofinity Commercial |
$1,029.06
|
| Rate for Payer: Cofinity Commercial |
$1,264.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,029.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.07
|
| Rate for Payer: Healthscope Commercial |
$1,323.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,029.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,102.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.58
|
| Rate for Payer: PHP Commercial |
$1,249.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.56
|
| Rate for Payer: Priority Health SBD |
$926.16
|
| Rate for Payer: UMR Bronson Commercial |
$646.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,102.57
|
|
|
HC TISSUE MARKER IMPLANTABLE
|
Facility
|
OP
|
$1,470.09
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800108
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$543.93 |
| Max. Negotiated Rate |
$1,323.08 |
| Rate for Payer: Aetna American Axle |
$955.56
|
| Rate for Payer: Aetna Commercial |
$1,249.58
|
| Rate for Payer: Aetna Medicare |
$735.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$955.56
|
| Rate for Payer: BCBS Complete |
$588.04
|
| Rate for Payer: Cash Price |
$1,176.07
|
| Rate for Payer: Cofinity Commercial |
$1,029.06
|
| Rate for Payer: Cofinity Commercial |
$1,264.28
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,029.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,176.07
|
| Rate for Payer: Healthscope Commercial |
$1,323.08
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,029.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,102.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,249.58
|
| Rate for Payer: PHP Commercial |
$1,249.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$955.56
|
| Rate for Payer: Priority Health SBD |
$926.16
|
| Rate for Payer: UMR Bronson Commercial |
$543.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,102.57
|
|
|
HC TISSUE MARKER PROSTATE
|
Facility
|
IP
|
$1,331.10
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$585.68 |
| Max. Negotiated Rate |
$1,197.99 |
| Rate for Payer: Aetna American Axle |
$865.22
|
| Rate for Payer: Aetna Commercial |
$1,131.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.22
|
| Rate for Payer: Cash Price |
$1,064.88
|
| Rate for Payer: Cofinity Commercial |
$1,144.75
|
| Rate for Payer: Cofinity Commercial |
$931.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$931.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.88
|
| Rate for Payer: Healthscope Commercial |
$1,197.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$931.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,131.43
|
| Rate for Payer: PHP Commercial |
$1,131.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.22
|
| Rate for Payer: Priority Health SBD |
$838.59
|
| Rate for Payer: UMR Bronson Commercial |
$585.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.33
|
|
|
HC TISSUE MARKER PROSTATE
|
Facility
|
OP
|
$1,331.10
|
|
|
Service Code
|
HCPCS A4648
|
| Hospital Charge Code |
27800130
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$492.51 |
| Max. Negotiated Rate |
$1,197.99 |
| Rate for Payer: Aetna American Axle |
$865.22
|
| Rate for Payer: Aetna Commercial |
$1,131.43
|
| Rate for Payer: Aetna Medicare |
$665.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$865.22
|
| Rate for Payer: BCBS Complete |
$532.44
|
| Rate for Payer: Cash Price |
$1,064.88
|
| Rate for Payer: Cofinity Commercial |
$1,144.75
|
| Rate for Payer: Cofinity Commercial |
$931.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$931.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,064.88
|
| Rate for Payer: Healthscope Commercial |
$1,197.99
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$931.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$998.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,131.43
|
| Rate for Payer: PHP Commercial |
$1,131.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$865.22
|
| Rate for Payer: Priority Health SBD |
$838.59
|
| Rate for Payer: UMR Bronson Commercial |
$492.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$998.33
|
|
|
HC TISSUE PROCESSING
|
Facility
|
IP
|
$51.31
|
|
|
Service Code
|
CPT 87176
|
| Hospital Charge Code |
30600095
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$22.58 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna American Axle |
$33.35
|
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health SBD |
$32.33
|
| Rate for Payer: UMR Bronson Commercial |
$22.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC TISSUE PROCESSING
|
Facility
|
OP
|
$51.31
|
|
|
Service Code
|
CPT 87176
|
| Hospital Charge Code |
30600095
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$46.18 |
| Rate for Payer: Aetna American Axle |
$33.35
|
| Rate for Payer: Aetna Commercial |
$43.61
|
| Rate for Payer: Aetna Medicare |
$6.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.35
|
| Rate for Payer: BCBS Complete |
$3.31
|
| Rate for Payer: BCBS MAPPO |
$5.88
|
| Rate for Payer: BCN Medicare Advantage |
$5.88
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cash Price |
$41.05
|
| Rate for Payer: Cofinity Commercial |
$44.13
|
| Rate for Payer: Cofinity Commercial |
$35.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.88
|
| Rate for Payer: Healthscope Commercial |
$46.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.48
|
| Rate for Payer: Mclaren Medicaid |
$3.15
|
| Rate for Payer: Mclaren Medicare |
$5.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.17
|
| Rate for Payer: Meridian Medicaid |
$3.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.61
|
| Rate for Payer: PACE Medicare |
$5.59
|
| Rate for Payer: PACE SWMI |
$5.88
|
| Rate for Payer: PHP Commercial |
$43.61
|
| Rate for Payer: PHP Medicare Advantage |
$5.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.35
|
| Rate for Payer: Priority Health Medicare |
$5.88
|
| Rate for Payer: Priority Health SBD |
$32.33
|
| Rate for Payer: Railroad Medicare Medicare |
$5.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.88
|
| Rate for Payer: UHC Exchange |
$11.24
|
| Rate for Payer: UHC Medicare Advantage |
$5.88
|
| Rate for Payer: UHCCP Medicaid |
$3.15
|
| Rate for Payer: UMR Bronson Commercial |
$18.98
|
| Rate for Payer: VA VA |
$5.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.48
|
|
|
HC TISSUE TRANSGLT AB IGA OR IGG, S
|
Facility
|
OP
|
$57.12
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
30200510
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.18 |
| Max. Negotiated Rate |
$51.41 |
| Rate for Payer: Aetna American Axle |
$37.13
|
| Rate for Payer: Aetna Commercial |
$48.55
|
| Rate for Payer: Aetna Medicare |
$11.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.41
|
| Rate for Payer: BCBS Complete |
$6.49
|
| Rate for Payer: BCBS MAPPO |
$11.53
|
| Rate for Payer: BCN Medicare Advantage |
$11.53
|
| Rate for Payer: Cash Price |
$45.70
|
| Rate for Payer: Cash Price |
$45.70
|
| Rate for Payer: Cofinity Commercial |
$49.12
|
| Rate for Payer: Cofinity Commercial |
$39.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.53
|
| Rate for Payer: Healthscope Commercial |
$51.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.84
|
| Rate for Payer: Mclaren Medicaid |
$6.18
|
| Rate for Payer: Mclaren Medicare |
$11.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.11
|
| Rate for Payer: Meridian Medicaid |
$6.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.55
|
| Rate for Payer: PACE Medicare |
$10.95
|
| Rate for Payer: PACE SWMI |
$11.53
|
| Rate for Payer: PHP Commercial |
$48.55
|
| Rate for Payer: PHP Medicare Advantage |
$11.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health Medicare |
$11.53
|
| Rate for Payer: Priority Health SBD |
$35.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.53
|
| Rate for Payer: UHC Exchange |
$22.03
|
| Rate for Payer: UHC Medicare Advantage |
$11.53
|
| Rate for Payer: UHCCP Medicaid |
$6.18
|
| Rate for Payer: UMR Bronson Commercial |
$21.13
|
| Rate for Payer: VA VA |
$11.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.84
|
|
|
HC TISSUE TRANSGLT AB IGA OR IGG, S
|
Facility
|
IP
|
$57.12
|
|
|
Service Code
|
CPT 86364
|
| Hospital Charge Code |
30200510
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$51.41 |
| Rate for Payer: Aetna American Axle |
$37.13
|
| Rate for Payer: Aetna Commercial |
$48.55
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.13
|
| Rate for Payer: Cash Price |
$45.70
|
| Rate for Payer: Cofinity Commercial |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$49.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$39.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.70
|
| Rate for Payer: Healthscope Commercial |
$51.41
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$39.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.55
|
| Rate for Payer: PHP Commercial |
$48.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.13
|
| Rate for Payer: Priority Health SBD |
$35.99
|
| Rate for Payer: UMR Bronson Commercial |
$25.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.84
|
|
