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Service Code NDC 60687-568-01
Hospital Charge Code 4972
Hospital Revenue Code 637
Min. Negotiated Rate $108.68
Max. Negotiated Rate $222.30
Rate for Payer: Aetna American Axle $160.55
Rate for Payer: Aetna Commercial $209.95
Rate for Payer: Aetna New Business (MI Preferred) $160.55
Rate for Payer: Cash Price $197.60
Rate for Payer: Cofinity Commercial $172.90
Rate for Payer: Cofinity Commercial $212.42
Rate for Payer: Encore Health Key Benefits Commercial $197.60
Rate for Payer: Healthscope Commercial $222.30
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $172.90
Rate for Payer: Lakeland Regional Health Systems Commercial $185.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $209.95
Rate for Payer: PHP Commercial $209.95
Rate for Payer: Priority Health Cigna Priority Health $172.90
Rate for Payer: Priority Health SBD $155.61
Rate for Payer: UMR Bronson Commercial $108.68
Rate for Payer: Van Buren County Sheriff Dept. Commercial $185.25
Service Code NDC 63739-992-10
Hospital Charge Code 4972
Hospital Revenue Code 637
Min. Negotiated Rate $102.41
Max. Negotiated Rate $209.48
Rate for Payer: Aetna American Axle $151.29
Rate for Payer: Aetna Commercial $197.84
Rate for Payer: Aetna New Business (MI Preferred) $151.29
Rate for Payer: Cash Price $186.20
Rate for Payer: Cofinity Commercial $162.92
Rate for Payer: Cofinity Commercial $200.16
Rate for Payer: Encore Health Key Benefits Commercial $186.20
Rate for Payer: Healthscope Commercial $209.48
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $162.92
Rate for Payer: Lakeland Regional Health Systems Commercial $174.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $197.84
Rate for Payer: PHP Commercial $197.84
Rate for Payer: Priority Health Cigna Priority Health $162.92
Rate for Payer: Priority Health SBD $146.63
Rate for Payer: UMR Bronson Commercial $102.41
Rate for Payer: Van Buren County Sheriff Dept. Commercial $174.56
Service Code NDC 42023-105-01
Hospital Charge Code 180402
Hospital Revenue Code 250
Min. Negotiated Rate $166.54
Max. Negotiated Rate $340.64
Rate for Payer: Aetna American Axle $246.02
Rate for Payer: Aetna Commercial $321.72
Rate for Payer: Aetna New Business (MI Preferred) $246.02
Rate for Payer: Cash Price $302.79
Rate for Payer: Cofinity Commercial $264.94
Rate for Payer: Cofinity Commercial $325.50
Rate for Payer: Encore Health Key Benefits Commercial $302.79
Rate for Payer: Healthscope Commercial $340.64
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $264.94
Rate for Payer: Lakeland Regional Health Systems Commercial $283.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $321.72
Rate for Payer: PHP Commercial $321.72
Rate for Payer: Priority Health Cigna Priority Health $264.94
Rate for Payer: Priority Health SBD $238.45
Rate for Payer: UMR Bronson Commercial $166.54
Rate for Payer: Van Buren County Sheriff Dept. Commercial $283.87
Service Code NDC 42023-105-01
Hospital Charge Code 70545
Hospital Revenue Code 250
Min. Negotiated Rate $166.54
Max. Negotiated Rate $340.64
Rate for Payer: Aetna American Axle $246.02
Rate for Payer: Aetna Commercial $321.72
Rate for Payer: Aetna New Business (MI Preferred) $246.02
Rate for Payer: Cash Price $302.79
Rate for Payer: Cofinity Commercial $264.94
Rate for Payer: Cofinity Commercial $325.50
Rate for Payer: Encore Health Key Benefits Commercial $302.79
Rate for Payer: Healthscope Commercial $340.64
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $264.94
Rate for Payer: Lakeland Regional Health Systems Commercial $283.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $321.72
Rate for Payer: PHP Commercial $321.72
Rate for Payer: Priority Health Cigna Priority Health $264.94
Rate for Payer: Priority Health SBD $238.45
Rate for Payer: UMR Bronson Commercial $166.54
Rate for Payer: Van Buren County Sheriff Dept. Commercial $283.87
Service Code HCPCS J8610
Hospital Charge Code 4973
Hospital Revenue Code 636
Min. Negotiated Rate $120.38
Max. Negotiated Rate $246.24
Rate for Payer: Aetna American Axle $177.84
Rate for Payer: Aetna American Axle $99.81
Rate for Payer: Aetna American Axle $197.60
Rate for Payer: Aetna American Axle $118.86
Rate for Payer: Aetna Commercial $232.56
Rate for Payer: Aetna Commercial $130.53
Rate for Payer: Aetna Commercial $155.43
Rate for Payer: Aetna Commercial $258.40
Rate for Payer: Aetna New Business (MI Preferred) $177.84
Rate for Payer: Aetna New Business (MI Preferred) $99.81
Rate for Payer: Aetna New Business (MI Preferred) $118.86
Rate for Payer: Aetna New Business (MI Preferred) $197.60
Rate for Payer: Cash Price $243.20
Rate for Payer: Cash Price $146.29
Rate for Payer: Cash Price $122.85
Rate for Payer: Cash Price $218.88
Rate for Payer: Cofinity Commercial $128.00
Rate for Payer: Cofinity Commercial $157.26
Rate for Payer: Cofinity Commercial $212.80
Rate for Payer: Cofinity Commercial $107.49
Rate for Payer: Cofinity Commercial $235.30
Rate for Payer: Cofinity Commercial $191.52
Rate for Payer: Cofinity Commercial $132.06
Rate for Payer: Cofinity Commercial $261.44
Rate for Payer: Encore Health Key Benefits Commercial $243.20
Rate for Payer: Encore Health Key Benefits Commercial $122.85
Rate for Payer: Encore Health Key Benefits Commercial $146.29
Rate for Payer: Encore Health Key Benefits Commercial $218.88
Rate for Payer: Healthscope Commercial $273.60
Rate for Payer: Healthscope Commercial $164.57
Rate for Payer: Healthscope Commercial $138.20
Rate for Payer: Healthscope Commercial $246.24
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $212.80
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $107.49
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $191.52
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $128.00
Rate for Payer: Lakeland Regional Health Systems Commercial $228.00
Rate for Payer: Lakeland Regional Health Systems Commercial $137.14
Rate for Payer: Lakeland Regional Health Systems Commercial $115.17
Rate for Payer: Lakeland Regional Health Systems Commercial $205.20
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $155.43
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $232.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $130.53
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $258.40
Rate for Payer: PHP Commercial $232.56
Rate for Payer: PHP Commercial $130.53
Rate for Payer: PHP Commercial $155.43
Rate for Payer: PHP Commercial $258.40
Rate for Payer: Priority Health Cigna Priority Health $191.52
Rate for Payer: Priority Health Cigna Priority Health $128.00
Rate for Payer: Priority Health Cigna Priority Health $212.80
Rate for Payer: Priority Health Cigna Priority Health $107.49
Rate for Payer: Priority Health SBD $115.20
Rate for Payer: Priority Health SBD $191.52
Rate for Payer: Priority Health SBD $96.74
Rate for Payer: Priority Health SBD $172.37
Rate for Payer: UMR Bronson Commercial $120.38
Rate for Payer: UMR Bronson Commercial $67.57
Rate for Payer: UMR Bronson Commercial $133.76
Rate for Payer: UMR Bronson Commercial $80.46
Rate for Payer: Van Buren County Sheriff Dept. Commercial $228.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial $205.20
Rate for Payer: Van Buren County Sheriff Dept. Commercial $137.14
Rate for Payer: Van Buren County Sheriff Dept. Commercial $115.17
Service Code HCPCS J9260
Hospital Charge Code 4975
Hospital Revenue Code 636
Min. Negotiated Rate $238.30
Max. Negotiated Rate $487.43
Rate for Payer: Aetna American Axle $352.03
Rate for Payer: Aetna American Axle $270.37
Rate for Payer: Aetna Commercial $353.56
Rate for Payer: Aetna Commercial $460.35
Rate for Payer: Aetna New Business (MI Preferred) $270.37
Rate for Payer: Aetna New Business (MI Preferred) $352.03
Rate for Payer: Cash Price $433.27
Rate for Payer: Cash Price $332.76
Rate for Payer: Cofinity Commercial $291.16
Rate for Payer: Cofinity Commercial $465.77
Rate for Payer: Cofinity Commercial $379.11
Rate for Payer: Cofinity Commercial $357.72
Rate for Payer: Encore Health Key Benefits Commercial $332.76
Rate for Payer: Encore Health Key Benefits Commercial $433.27
Rate for Payer: Healthscope Commercial $374.36
Rate for Payer: Healthscope Commercial $487.43
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $379.11
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $291.16
Rate for Payer: Lakeland Regional Health Systems Commercial $406.19
Rate for Payer: Lakeland Regional Health Systems Commercial $311.96
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $353.56
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $460.35
Rate for Payer: PHP Commercial $353.56
Rate for Payer: PHP Commercial $460.35
Rate for Payer: Priority Health Cigna Priority Health $379.11
Rate for Payer: Priority Health Cigna Priority Health $291.16
Rate for Payer: Priority Health SBD $341.20
Rate for Payer: Priority Health SBD $262.05
Rate for Payer: UMR Bronson Commercial $183.02
Rate for Payer: UMR Bronson Commercial $238.30
Rate for Payer: Van Buren County Sheriff Dept. Commercial $406.19
Rate for Payer: Van Buren County Sheriff Dept. Commercial $311.96
Service Code HCPCS J9255
Hospital Charge Code 96981
Hospital Revenue Code 636
Min. Negotiated Rate $77.30
Max. Negotiated Rate $158.12
Rate for Payer: Aetna American Axle $114.20
Rate for Payer: Aetna Commercial $149.34
Rate for Payer: Aetna New Business (MI Preferred) $114.20
Rate for Payer: Cash Price $140.55
Rate for Payer: Cofinity Commercial $122.98
Rate for Payer: Cofinity Commercial $151.09
Rate for Payer: Encore Health Key Benefits Commercial $140.55
Rate for Payer: Healthscope Commercial $158.12
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $122.98
Rate for Payer: Lakeland Regional Health Systems Commercial $131.77
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $149.34
Rate for Payer: PHP Commercial $149.34
Rate for Payer: Priority Health Cigna Priority Health $122.98
Rate for Payer: Priority Health SBD $110.68
Rate for Payer: UMR Bronson Commercial $77.30
Rate for Payer: Van Buren County Sheriff Dept. Commercial $131.77
Service Code HCPCS J9260
Hospital Charge Code 96981
Hospital Revenue Code 636
Min. Negotiated Rate $101.02
Max. Negotiated Rate $206.64
Rate for Payer: Aetna American Axle $149.24
Rate for Payer: Aetna American Axle $89.81
Rate for Payer: Aetna American Axle $77.71
Rate for Payer: Aetna American Axle $183.95
Rate for Payer: Aetna American Axle $55.80
Rate for Payer: Aetna Commercial $101.63
Rate for Payer: Aetna Commercial $240.55
Rate for Payer: Aetna Commercial $195.16
Rate for Payer: Aetna Commercial $72.97
Rate for Payer: Aetna Commercial $117.44
Rate for Payer: Aetna New Business (MI Preferred) $77.71
Rate for Payer: Aetna New Business (MI Preferred) $183.95
Rate for Payer: Aetna New Business (MI Preferred) $89.81
Rate for Payer: Aetna New Business (MI Preferred) $55.80
Rate for Payer: Aetna New Business (MI Preferred) $149.24
Rate for Payer: Cash Price $110.54
Rate for Payer: Cash Price $95.65
Rate for Payer: Cash Price $68.68
Rate for Payer: Cash Price $183.68
Rate for Payer: Cash Price $226.40
Rate for Payer: Cofinity Commercial $73.83
Rate for Payer: Cofinity Commercial $102.82
Rate for Payer: Cofinity Commercial $83.69
Rate for Payer: Cofinity Commercial $118.83
Rate for Payer: Cofinity Commercial $96.72
Rate for Payer: Cofinity Commercial $60.10
Rate for Payer: Cofinity Commercial $160.72
Rate for Payer: Cofinity Commercial $197.46
Rate for Payer: Cofinity Commercial $198.10
Rate for Payer: Cofinity Commercial $243.38
Rate for Payer: Encore Health Key Benefits Commercial $68.68
Rate for Payer: Encore Health Key Benefits Commercial $110.54
Rate for Payer: Encore Health Key Benefits Commercial $226.40
Rate for Payer: Encore Health Key Benefits Commercial $183.68
Rate for Payer: Encore Health Key Benefits Commercial $95.65
Rate for Payer: Healthscope Commercial $206.64
Rate for Payer: Healthscope Commercial $77.26
Rate for Payer: Healthscope Commercial $107.60
Rate for Payer: Healthscope Commercial $254.70
Rate for Payer: Healthscope Commercial $124.35
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $96.72
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $60.10
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $160.72
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $198.10
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $83.69
Rate for Payer: Lakeland Regional Health Systems Commercial $103.63
Rate for Payer: Lakeland Regional Health Systems Commercial $64.39
Rate for Payer: Lakeland Regional Health Systems Commercial $212.25
Rate for Payer: Lakeland Regional Health Systems Commercial $172.20
Rate for Payer: Lakeland Regional Health Systems Commercial $89.67
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $72.97
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $101.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $195.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $117.44
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $240.55
Rate for Payer: PHP Commercial $72.97
Rate for Payer: PHP Commercial $101.63
Rate for Payer: PHP Commercial $117.44
Rate for Payer: PHP Commercial $195.16
Rate for Payer: PHP Commercial $240.55
Rate for Payer: Priority Health Cigna Priority Health $198.10
Rate for Payer: Priority Health Cigna Priority Health $96.72
Rate for Payer: Priority Health Cigna Priority Health $160.72
Rate for Payer: Priority Health Cigna Priority Health $83.69
Rate for Payer: Priority Health Cigna Priority Health $60.10
Rate for Payer: Priority Health SBD $178.29
Rate for Payer: Priority Health SBD $75.32
Rate for Payer: Priority Health SBD $54.09
Rate for Payer: Priority Health SBD $144.65
Rate for Payer: Priority Health SBD $87.05
Rate for Payer: UMR Bronson Commercial $124.52
Rate for Payer: UMR Bronson Commercial $101.02
Rate for Payer: UMR Bronson Commercial $60.79
Rate for Payer: UMR Bronson Commercial $52.61
Rate for Payer: UMR Bronson Commercial $37.77
Rate for Payer: Van Buren County Sheriff Dept. Commercial $103.63
Rate for Payer: Van Buren County Sheriff Dept. Commercial $172.20
Rate for Payer: Van Buren County Sheriff Dept. Commercial $212.25
Rate for Payer: Van Buren County Sheriff Dept. Commercial $64.39
Rate for Payer: Van Buren County Sheriff Dept. Commercial $89.67
Service Code HCPCS J9260
Hospital Charge Code 96981
Hospital Revenue Code 636
Min. Negotiated Rate $9.80
Max. Negotiated Rate $124.35
Rate for Payer: Aetna American Axle $89.81
Rate for Payer: Aetna American Axle $183.95
Rate for Payer: Aetna American Axle $77.71
Rate for Payer: Aetna American Axle $149.24
Rate for Payer: Aetna American Axle $55.80
Rate for Payer: Aetna Commercial $72.97
Rate for Payer: Aetna Commercial $195.16
Rate for Payer: Aetna Commercial $240.55
Rate for Payer: Aetna Commercial $101.63
Rate for Payer: Aetna Commercial $117.44
Rate for Payer: Aetna New Business (MI Preferred) $77.71
Rate for Payer: Aetna New Business (MI Preferred) $89.81
Rate for Payer: Aetna New Business (MI Preferred) $55.80
Rate for Payer: Aetna New Business (MI Preferred) $183.95
Rate for Payer: Aetna New Business (MI Preferred) $149.24
Rate for Payer: BCBS Complete $55.27
Rate for Payer: BCBS Complete $34.34
Rate for Payer: BCBS Complete $47.82
Rate for Payer: BCBS Complete $113.20
Rate for Payer: BCBS Complete $91.84
Rate for Payer: BCBS Trust/PPO $9.80
Rate for Payer: BCBS Trust/PPO $9.80
Rate for Payer: BCBS Trust/PPO $9.80
Rate for Payer: BCBS Trust/PPO $9.80
Rate for Payer: BCBS Trust/PPO $9.80
Rate for Payer: Cash Price $68.68
Rate for Payer: Cash Price $183.68
Rate for Payer: Cash Price $226.40
Rate for Payer: Cash Price $68.68
Rate for Payer: Cash Price $110.54
Rate for Payer: Cash Price $183.68
Rate for Payer: Cash Price $95.65
Rate for Payer: Cash Price $226.40
Rate for Payer: Cash Price $110.54
Rate for Payer: Cash Price $95.65
Rate for Payer: Cofinity Commercial $198.10
Rate for Payer: Cofinity Commercial $118.83
Rate for Payer: Cofinity Commercial $73.83
Rate for Payer: Cofinity Commercial $60.10
Rate for Payer: Cofinity Commercial $160.72
Rate for Payer: Cofinity Commercial $197.46
Rate for Payer: Cofinity Commercial $102.82
Rate for Payer: Cofinity Commercial $83.69
Rate for Payer: Cofinity Commercial $96.72
Rate for Payer: Cofinity Commercial $243.38
Rate for Payer: Encore Health Key Benefits Commercial $226.40
Rate for Payer: Encore Health Key Benefits Commercial $183.68
Rate for Payer: Encore Health Key Benefits Commercial $110.54
Rate for Payer: Encore Health Key Benefits Commercial $95.65
Rate for Payer: Encore Health Key Benefits Commercial $68.68
Rate for Payer: Healthscope Commercial $254.70
Rate for Payer: Healthscope Commercial $77.26
Rate for Payer: Healthscope Commercial $124.35
Rate for Payer: Healthscope Commercial $107.60
Rate for Payer: Healthscope Commercial $206.64
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $160.72
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $83.69
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $96.72
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $198.10
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $60.10
Rate for Payer: Lakeland Regional Health Systems Commercial $103.63
Rate for Payer: Lakeland Regional Health Systems Commercial $89.67
Rate for Payer: Lakeland Regional Health Systems Commercial $172.20
Rate for Payer: Lakeland Regional Health Systems Commercial $64.39
Rate for Payer: Lakeland Regional Health Systems Commercial $212.25
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $195.16
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $117.44
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $101.63
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $240.55
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $72.97
Rate for Payer: PHP Commercial $195.16
Rate for Payer: PHP Commercial $117.44
Rate for Payer: PHP Commercial $240.55
Rate for Payer: PHP Commercial $72.97
Rate for Payer: PHP Commercial $101.63
Rate for Payer: Priority Health Cigna Priority Health $160.72
Rate for Payer: Priority Health Cigna Priority Health $83.69
Rate for Payer: Priority Health Cigna Priority Health $96.72
Rate for Payer: Priority Health Cigna Priority Health $198.10
Rate for Payer: Priority Health Cigna Priority Health $60.10
Rate for Payer: Priority Health SBD $75.32
Rate for Payer: Priority Health SBD $178.29
Rate for Payer: Priority Health SBD $144.65
Rate for Payer: Priority Health SBD $87.05
Rate for Payer: Priority Health SBD $54.09
Rate for Payer: UMR Bronson Commercial $31.76
Rate for Payer: UMR Bronson Commercial $104.71
Rate for Payer: UMR Bronson Commercial $84.95
Rate for Payer: UMR Bronson Commercial $44.24
Rate for Payer: UMR Bronson Commercial $51.12
Rate for Payer: Van Buren County Sheriff Dept. Commercial $172.20
Rate for Payer: Van Buren County Sheriff Dept. Commercial $89.67
Rate for Payer: Van Buren County Sheriff Dept. Commercial $212.25
Rate for Payer: Van Buren County Sheriff Dept. Commercial $64.39
Rate for Payer: Van Buren County Sheriff Dept. Commercial $103.63
Service Code HCPCS J9255
Hospital Charge Code 96981
Hospital Revenue Code 636
Min. Negotiated Rate $0.03
Max. Negotiated Rate $158.12
Rate for Payer: Aetna American Axle $114.20
Rate for Payer: Aetna American Axle $71.34
Rate for Payer: Aetna Commercial $93.30
Rate for Payer: Aetna Commercial $149.34
Rate for Payer: Aetna New Business (MI Preferred) $71.34
Rate for Payer: Aetna New Business (MI Preferred) $114.20
Rate for Payer: BCBS Complete $70.28
Rate for Payer: BCBS Complete $43.90
Rate for Payer: BCBS Trust/PPO $0.03
Rate for Payer: BCBS Trust/PPO $0.03
Rate for Payer: Cash Price $140.55
Rate for Payer: Cash Price $87.81
Rate for Payer: Cash Price $87.81
Rate for Payer: Cash Price $140.55
Rate for Payer: Cofinity Commercial $151.09
Rate for Payer: Cofinity Commercial $76.83
Rate for Payer: Cofinity Commercial $94.39
Rate for Payer: Cofinity Commercial $122.98
Rate for Payer: Encore Health Key Benefits Commercial $140.55
Rate for Payer: Encore Health Key Benefits Commercial $87.81
Rate for Payer: Healthscope Commercial $98.78
Rate for Payer: Healthscope Commercial $158.12
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $76.83
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $122.98
Rate for Payer: Lakeland Regional Health Systems Commercial $131.77
Rate for Payer: Lakeland Regional Health Systems Commercial $82.32
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $93.30
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $149.34
Rate for Payer: PHP Commercial $149.34
Rate for Payer: PHP Commercial $93.30
Rate for Payer: Priority Health Cigna Priority Health $76.83
Rate for Payer: Priority Health Cigna Priority Health $122.98
Rate for Payer: Priority Health SBD $69.15
Rate for Payer: Priority Health SBD $110.68
Rate for Payer: UMR Bronson Commercial $65.01
Rate for Payer: UMR Bronson Commercial $40.61
Rate for Payer: Van Buren County Sheriff Dept. Commercial $131.77
Rate for Payer: Van Buren County Sheriff Dept. Commercial $82.32
Service Code NDC 3877930608
Hospital Charge Code 82599
Hospital Revenue Code 637
Min. Negotiated Rate $29.26
Max. Negotiated Rate $59.85
Rate for Payer: Aetna American Axle $43.22
Rate for Payer: Aetna Commercial $56.52
Rate for Payer: Aetna New Business (MI Preferred) $43.22
Rate for Payer: Cash Price $53.20
Rate for Payer: Cofinity Commercial $46.55
Rate for Payer: Cofinity Commercial $57.19
Rate for Payer: Encore Health Key Benefits Commercial $53.20
Rate for Payer: Healthscope Commercial $59.85
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $46.55
Rate for Payer: Lakeland Regional Health Systems Commercial $49.88
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $56.52
Rate for Payer: PHP Commercial $56.52
Rate for Payer: Priority Health Cigna Priority Health $46.55
Rate for Payer: Priority Health SBD $41.90
Rate for Payer: UMR Bronson Commercial $29.26
Rate for Payer: Van Buren County Sheriff Dept. Commercial $49.88
Service Code NDC 51079-200-01
Hospital Charge Code 4982
Hospital Revenue Code 637
Min. Negotiated Rate $1.61
Max. Negotiated Rate $3.30
Rate for Payer: Aetna American Axle $2.39
Rate for Payer: Aetna Commercial $3.12
Rate for Payer: Aetna New Business (MI Preferred) $2.39
Rate for Payer: Cash Price $2.94
Rate for Payer: Cofinity Commercial $2.57
Rate for Payer: Cofinity Commercial $3.16
Rate for Payer: Encore Health Key Benefits Commercial $2.94
Rate for Payer: Healthscope Commercial $3.30
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $2.57
Rate for Payer: Lakeland Regional Health Systems Commercial $2.75
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $3.12
Rate for Payer: PHP Commercial $3.12
Rate for Payer: Priority Health Cigna Priority Health $2.57
Rate for Payer: Priority Health SBD $2.31
Rate for Payer: UMR Bronson Commercial $1.61
Rate for Payer: Van Buren County Sheriff Dept. Commercial $2.75
Service Code NDC 16729-030-01
Hospital Charge Code 4982
Hospital Revenue Code 637
Min. Negotiated Rate $109.60
Max. Negotiated Rate $224.19
Rate for Payer: Aetna American Axle $161.92
Rate for Payer: Aetna Commercial $211.74
Rate for Payer: Aetna New Business (MI Preferred) $161.92
Rate for Payer: Cash Price $199.28
Rate for Payer: Cofinity Commercial $174.37
Rate for Payer: Cofinity Commercial $214.23
Rate for Payer: Encore Health Key Benefits Commercial $199.28
Rate for Payer: Healthscope Commercial $224.19
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $174.37
Rate for Payer: Lakeland Regional Health Systems Commercial $186.82
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $211.74
Rate for Payer: PHP Commercial $211.74
Rate for Payer: Priority Health Cigna Priority Health $174.37
Rate for Payer: Priority Health SBD $156.93
Rate for Payer: UMR Bronson Commercial $109.60
Rate for Payer: Van Buren County Sheriff Dept. Commercial $186.82
Service Code NDC 17478-504-10
Hospital Charge Code 4985
Hospital Revenue Code 250
Min. Negotiated Rate $260.00
Max. Negotiated Rate $531.81
Rate for Payer: Aetna American Axle $384.08
Rate for Payer: Aetna Commercial $502.26
Rate for Payer: Aetna New Business (MI Preferred) $384.08
Rate for Payer: Cash Price $472.72
Rate for Payer: Cofinity Commercial $413.63
Rate for Payer: Cofinity Commercial $508.17
Rate for Payer: Encore Health Key Benefits Commercial $472.72
Rate for Payer: Healthscope Commercial $531.81
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $413.63
Rate for Payer: Lakeland Regional Health Systems Commercial $443.18
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $502.26
Rate for Payer: PHP Commercial $502.26
Rate for Payer: Priority Health Cigna Priority Health $413.63
Rate for Payer: Priority Health SBD $372.27
Rate for Payer: UMR Bronson Commercial $260.00
Rate for Payer: Van Buren County Sheriff Dept. Commercial $443.18
Service Code NDC 0517-0374-05
Hospital Charge Code 180747
Hospital Revenue Code 250
Min. Negotiated Rate $291.41
Max. Negotiated Rate $596.06
Rate for Payer: Aetna American Axle $430.49
Rate for Payer: Aetna Commercial $562.95
Rate for Payer: Aetna New Business (MI Preferred) $430.49
Rate for Payer: Cash Price $529.83
Rate for Payer: Cofinity Commercial $463.60
Rate for Payer: Cofinity Commercial $569.57
Rate for Payer: Encore Health Key Benefits Commercial $529.83
Rate for Payer: Healthscope Commercial $596.06
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $463.60
Rate for Payer: Lakeland Regional Health Systems Commercial $496.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $562.95
Rate for Payer: PHP Commercial $562.95
Rate for Payer: Priority Health Cigna Priority Health $463.60
Rate for Payer: Priority Health SBD $417.24
Rate for Payer: UMR Bronson Commercial $291.41
Rate for Payer: Van Buren County Sheriff Dept. Commercial $496.72
Service Code NDC 0517-0374-01
Hospital Charge Code 180747
Hospital Revenue Code 250
Min. Negotiated Rate $291.41
Max. Negotiated Rate $596.06
Rate for Payer: Aetna American Axle $430.49
Rate for Payer: Aetna Commercial $562.95
Rate for Payer: Aetna New Business (MI Preferred) $430.49
Rate for Payer: Cash Price $529.83
Rate for Payer: Cofinity Commercial $463.60
Rate for Payer: Cofinity Commercial $569.57
Rate for Payer: Encore Health Key Benefits Commercial $529.83
Rate for Payer: Healthscope Commercial $596.06
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $463.60
Rate for Payer: Lakeland Regional Health Systems Commercial $496.72
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $562.95
Rate for Payer: PHP Commercial $562.95
Rate for Payer: Priority Health Cigna Priority Health $463.60
Rate for Payer: Priority Health SBD $417.24
Rate for Payer: UMR Bronson Commercial $291.41
Rate for Payer: Van Buren County Sheriff Dept. Commercial $496.72
Service Code HCPCS J2210
Hospital Charge Code 10571
Hospital Revenue Code 636
Min. Negotiated Rate $38.91
Max. Negotiated Rate $79.59
Rate for Payer: Aetna American Axle $57.48
Rate for Payer: Aetna American Axle $44.25
Rate for Payer: Aetna Commercial $57.87
Rate for Payer: Aetna Commercial $75.17
Rate for Payer: Aetna New Business (MI Preferred) $44.25
Rate for Payer: Aetna New Business (MI Preferred) $57.48
Rate for Payer: Cash Price $54.46
Rate for Payer: Cash Price $70.74
Rate for Payer: Cofinity Commercial $76.05
Rate for Payer: Cofinity Commercial $47.66
Rate for Payer: Cofinity Commercial $58.55
Rate for Payer: Cofinity Commercial $61.90
Rate for Payer: Encore Health Key Benefits Commercial $54.46
Rate for Payer: Encore Health Key Benefits Commercial $70.74
Rate for Payer: Healthscope Commercial $79.59
Rate for Payer: Healthscope Commercial $61.27
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $61.90
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $47.66
Rate for Payer: Lakeland Regional Health Systems Commercial $66.32
Rate for Payer: Lakeland Regional Health Systems Commercial $51.06
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $57.87
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $75.17
Rate for Payer: PHP Commercial $75.17
Rate for Payer: PHP Commercial $57.87
Rate for Payer: Priority Health Cigna Priority Health $47.66
Rate for Payer: Priority Health Cigna Priority Health $61.90
Rate for Payer: Priority Health SBD $42.89
Rate for Payer: Priority Health SBD $55.71
Rate for Payer: UMR Bronson Commercial $38.91
Rate for Payer: UMR Bronson Commercial $29.96
Rate for Payer: Van Buren County Sheriff Dept. Commercial $51.06
Rate for Payer: Van Buren County Sheriff Dept. Commercial $66.32
Service Code NDC 69238-1605-8
Hospital Charge Code 10572
Hospital Revenue Code 637
Min. Negotiated Rate $699.49
Max. Negotiated Rate $1,430.78
Rate for Payer: Aetna American Axle $1,033.34
Rate for Payer: Aetna Commercial $1,351.29
Rate for Payer: Aetna New Business (MI Preferred) $1,033.34
Rate for Payer: Cash Price $1,271.80
Rate for Payer: Cofinity Commercial $1,112.82
Rate for Payer: Cofinity Commercial $1,367.18
Rate for Payer: Encore Health Key Benefits Commercial $1,271.80
Rate for Payer: Healthscope Commercial $1,430.78
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $1,112.82
Rate for Payer: Lakeland Regional Health Systems Commercial $1,192.31
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $1,351.29
Rate for Payer: PHP Commercial $1,351.29
Rate for Payer: Priority Health Cigna Priority Health $1,112.82
Rate for Payer: Priority Health SBD $1,001.54
Rate for Payer: UMR Bronson Commercial $699.49
Rate for Payer: Van Buren County Sheriff Dept. Commercial $1,192.31
Service Code NDC 16571-735-21
Hospital Charge Code 10572
Hospital Revenue Code 637
Min. Negotiated Rate $214.37
Max. Negotiated Rate $438.49
Rate for Payer: Aetna American Axle $316.69
Rate for Payer: Aetna Commercial $414.13
Rate for Payer: Aetna New Business (MI Preferred) $316.69
Rate for Payer: Cash Price $389.77
Rate for Payer: Cofinity Commercial $341.05
Rate for Payer: Cofinity Commercial $419.00
Rate for Payer: Encore Health Key Benefits Commercial $389.77
Rate for Payer: Healthscope Commercial $438.49
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $341.05
Rate for Payer: Lakeland Regional Health Systems Commercial $365.41
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $414.13
Rate for Payer: PHP Commercial $414.13
Rate for Payer: Priority Health Cigna Priority Health $341.05
Rate for Payer: Priority Health SBD $306.94
Rate for Payer: UMR Bronson Commercial $214.37
Rate for Payer: Van Buren County Sheriff Dept. Commercial $365.41
Service Code NDC 27437-050-56
Hospital Charge Code 10572
Hospital Revenue Code 637
Min. Negotiated Rate $2,646.24
Max. Negotiated Rate $5,412.77
Rate for Payer: Aetna American Axle $3,909.22
Rate for Payer: Aetna Commercial $5,112.06
Rate for Payer: Aetna New Business (MI Preferred) $3,909.22
Rate for Payer: Cash Price $4,811.35
Rate for Payer: Cofinity Commercial $4,209.93
Rate for Payer: Cofinity Commercial $5,172.20
Rate for Payer: Encore Health Key Benefits Commercial $4,811.35
Rate for Payer: Healthscope Commercial $5,412.77
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $4,209.93
Rate for Payer: Lakeland Regional Health Systems Commercial $4,510.64
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $5,112.06
Rate for Payer: PHP Commercial $5,112.06
Rate for Payer: Priority Health Cigna Priority Health $4,209.93
Rate for Payer: Priority Health SBD $3,788.94
Rate for Payer: UMR Bronson Commercial $2,646.24
Rate for Payer: Van Buren County Sheriff Dept. Commercial $4,510.64
Service Code NDC 43386-140-28
Hospital Charge Code 10572
Hospital Revenue Code 637
Min. Negotiated Rate $2,286.31
Max. Negotiated Rate $4,676.55
Rate for Payer: Aetna American Axle $3,377.51
Rate for Payer: Aetna Commercial $4,416.74
Rate for Payer: Aetna New Business (MI Preferred) $3,377.51
Rate for Payer: Cash Price $4,156.94
Rate for Payer: Cofinity Commercial $3,637.32
Rate for Payer: Cofinity Commercial $4,468.71
Rate for Payer: Encore Health Key Benefits Commercial $4,156.94
Rate for Payer: Healthscope Commercial $4,676.55
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $3,637.32
Rate for Payer: Lakeland Regional Health Systems Commercial $3,897.13
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $4,416.74
Rate for Payer: PHP Commercial $4,416.74
Rate for Payer: Priority Health Cigna Priority Health $3,637.32
Rate for Payer: Priority Health SBD $3,273.59
Rate for Payer: UMR Bronson Commercial $2,286.31
Rate for Payer: Van Buren County Sheriff Dept. Commercial $3,897.13
Service Code NDC 16571-735-28
Hospital Charge Code 10572
Hospital Revenue Code 637
Min. Negotiated Rate $608.59
Max. Negotiated Rate $1,244.85
Rate for Payer: Aetna American Axle $899.06
Rate for Payer: Aetna Commercial $1,175.69
Rate for Payer: Aetna New Business (MI Preferred) $899.06
Rate for Payer: Cash Price $1,106.54
Rate for Payer: Cofinity Commercial $1,189.53
Rate for Payer: Cofinity Commercial $968.22
Rate for Payer: Encore Health Key Benefits Commercial $1,106.54
Rate for Payer: Healthscope Commercial $1,244.85
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $968.22
Rate for Payer: Lakeland Regional Health Systems Commercial $1,037.38
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $1,175.69
Rate for Payer: PHP Commercial $1,175.69
Rate for Payer: Priority Health Cigna Priority Health $968.22
Rate for Payer: Priority Health SBD $871.40
Rate for Payer: UMR Bronson Commercial $608.59
Rate for Payer: Van Buren County Sheriff Dept. Commercial $1,037.38
Service Code HCPCS J2212
Hospital Charge Code 91651
Hospital Revenue Code 636
Min. Negotiated Rate $223.48
Max. Negotiated Rate $457.11
Rate for Payer: Aetna American Axle $330.14
Rate for Payer: Aetna Commercial $431.72
Rate for Payer: Aetna New Business (MI Preferred) $330.14
Rate for Payer: Cash Price $406.32
Rate for Payer: Cofinity Commercial $355.53
Rate for Payer: Cofinity Commercial $436.79
Rate for Payer: Encore Health Key Benefits Commercial $406.32
Rate for Payer: Healthscope Commercial $457.11
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $355.53
Rate for Payer: Lakeland Regional Health Systems Commercial $380.92
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $431.72
Rate for Payer: PHP Commercial $431.72
Rate for Payer: Priority Health Cigna Priority Health $355.53
Rate for Payer: Priority Health SBD $319.98
Rate for Payer: UMR Bronson Commercial $223.48
Rate for Payer: Van Buren County Sheriff Dept. Commercial $380.92
Service Code HCPCS J2212
Hospital Charge Code 159006
Hospital Revenue Code 636
Min. Negotiated Rate $223.49
Max. Negotiated Rate $457.14
Rate for Payer: Aetna American Axle $330.15
Rate for Payer: Aetna American Axle $330.14
Rate for Payer: Aetna Commercial $431.72
Rate for Payer: Aetna Commercial $431.74
Rate for Payer: Aetna New Business (MI Preferred) $330.14
Rate for Payer: Aetna New Business (MI Preferred) $330.15
Rate for Payer: Cash Price $406.34
Rate for Payer: Cash Price $406.32
Rate for Payer: Cofinity Commercial $436.79
Rate for Payer: Cofinity Commercial $436.82
Rate for Payer: Cofinity Commercial $355.55
Rate for Payer: Cofinity Commercial $355.53
Rate for Payer: Encore Health Key Benefits Commercial $406.34
Rate for Payer: Encore Health Key Benefits Commercial $406.32
Rate for Payer: Healthscope Commercial $457.14
Rate for Payer: Healthscope Commercial $457.11
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $355.55
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $355.53
Rate for Payer: Lakeland Regional Health Systems Commercial $380.92
Rate for Payer: Lakeland Regional Health Systems Commercial $380.95
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $431.74
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $431.72
Rate for Payer: PHP Commercial $431.74
Rate for Payer: PHP Commercial $431.72
Rate for Payer: Priority Health Cigna Priority Health $355.55
Rate for Payer: Priority Health Cigna Priority Health $355.53
Rate for Payer: Priority Health SBD $319.98
Rate for Payer: Priority Health SBD $320.00
Rate for Payer: UMR Bronson Commercial $223.48
Rate for Payer: UMR Bronson Commercial $223.49
Rate for Payer: Van Buren County Sheriff Dept. Commercial $380.95
Rate for Payer: Van Buren County Sheriff Dept. Commercial $380.92
Service Code NDC 3877914394
Hospital Charge Code 13296
Hospital Revenue Code 637
Min. Negotiated Rate $47.52
Max. Negotiated Rate $97.20
Rate for Payer: Aetna American Axle $70.20
Rate for Payer: Aetna Commercial $91.80
Rate for Payer: Aetna New Business (MI Preferred) $70.20
Rate for Payer: Cash Price $86.40
Rate for Payer: Cofinity Commercial $75.60
Rate for Payer: Cofinity Commercial $92.88
Rate for Payer: Encore Health Key Benefits Commercial $86.40
Rate for Payer: Healthscope Commercial $97.20
Rate for Payer: Kalamazoo County Sherrif's Dept Commercial $75.60
Rate for Payer: Lakeland Regional Health Systems Commercial $81.00
Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS $91.80
Rate for Payer: PHP Commercial $91.80
Rate for Payer: Priority Health Cigna Priority Health $75.60
Rate for Payer: Priority Health SBD $68.04
Rate for Payer: UMR Bronson Commercial $47.52
Rate for Payer: Van Buren County Sheriff Dept. Commercial $81.00