|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$131.59
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$57.90 |
| Max. Negotiated Rate |
$118.43 |
| Rate for Payer: Aetna American Axle |
$85.53
|
| Rate for Payer: Aetna Commercial |
$111.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$85.53
|
| Rate for Payer: Cash Price |
$105.27
|
| Rate for Payer: Cofinity Advantage |
$92.11
|
| Rate for Payer: Cofinity Commercial |
$113.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.27
|
| Rate for Payer: Healthscope Commercial |
$118.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$98.69
|
| Rate for Payer: PHP Commercial |
$111.85
|
| Rate for Payer: Priority Health SBD |
$82.90
|
| Rate for Payer: UMR Bronson Commercial |
$57.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.69
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
OP
|
$99.76
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.36 |
| Max. Negotiated Rate |
$89.78 |
| Rate for Payer: Aetna American Axle |
$64.84
|
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: BCBS Complete |
$9.83
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$20.70
|
| Rate for Payer: BCN Commercial |
$20.70
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Advantage |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.82
|
| Rate for Payer: Mclaren Medicaid |
$17.90
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$18.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Nomi Health Commercial |
$26.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.82
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$84.80
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$17.90
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health SBD |
$62.85
|
| Rate for Payer: Priority Health Tiered Network |
$14.32
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.85
|
| Rate for Payer: UHC Core |
$26.85
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$17.90
|
| Rate for Payer: UHC Exchange |
$26.85
|
| Rate for Payer: UHC Medicaid |
$9.36
|
| Rate for Payer: UHCCP Medicaid |
$9.36
|
| Rate for Payer: UMR Bronson Commercial |
$36.91
|
| Rate for Payer: VA VA |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.82
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$99.76
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.89 |
| Max. Negotiated Rate |
$89.78 |
| Rate for Payer: Aetna American Axle |
$64.84
|
| Rate for Payer: Aetna Commercial |
$84.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$64.84
|
| Rate for Payer: Cash Price |
$79.81
|
| Rate for Payer: Cofinity Advantage |
$69.83
|
| Rate for Payer: Cofinity Commercial |
$85.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.81
|
| Rate for Payer: Healthscope Commercial |
$89.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$69.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.82
|
| Rate for Payer: PHP Commercial |
$84.80
|
| Rate for Payer: Priority Health SBD |
$62.85
|
| Rate for Payer: UMR Bronson Commercial |
$43.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.82
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
IP
|
$132.65
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.37 |
| Max. Negotiated Rate |
$119.39 |
| Rate for Payer: Aetna American Axle |
$86.22
|
| Rate for Payer: Aetna Commercial |
$112.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.22
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cofinity Advantage |
$92.86
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: PHP Commercial |
$112.75
|
| Rate for Payer: Priority Health SBD |
$83.57
|
| Rate for Payer: UMR Bronson Commercial |
$58.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.49
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
OP
|
$132.65
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$119.39 |
| Rate for Payer: Aetna American Axle |
$86.22
|
| Rate for Payer: Aetna Commercial |
$112.75
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$86.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$26.53
|
| Rate for Payer: BCN Commercial |
$26.53
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cash Price |
$106.12
|
| Rate for Payer: Cofinity Advantage |
$92.86
|
| Rate for Payer: Cofinity Commercial |
$114.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$119.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$92.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.49
|
| Rate for Payer: Mclaren Medicaid |
$22.94
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$112.75
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.49
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$112.75
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$83.57
|
| Rate for Payer: Priority Health Tiered Network |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.41
|
| Rate for Payer: UHC Core |
$34.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$34.41
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: UMR Bronson Commercial |
$49.08
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.49
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
IP
|
$129.01
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$56.76 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna American Axle |
$83.86
|
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.86
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Advantage |
$90.31
|
| Rate for Payer: Cofinity Commercial |
$110.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: PHP Commercial |
$109.66
|
| Rate for Payer: Priority Health SBD |
$81.28
|
| Rate for Payer: UMR Bronson Commercial |
$56.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.76
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
OP
|
$129.01
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna American Axle |
$83.86
|
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.60
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$26.53
|
| Rate for Payer: BCN Commercial |
$26.53
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Advantage |
$90.31
|
| Rate for Payer: Cofinity Commercial |
$110.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.76
|
| Rate for Payer: Mclaren Medicaid |
$22.94
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$24.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.76
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$109.66
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health SBD |
$81.28
|
| Rate for Payer: Priority Health Tiered Network |
$18.35
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.41
|
| Rate for Payer: UHC Core |
$34.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$22.94
|
| Rate for Payer: UHC Exchange |
$34.41
|
| Rate for Payer: UHC Medicaid |
$12.00
|
| Rate for Payer: UHCCP Medicaid |
$12.00
|
| Rate for Payer: UMR Bronson Commercial |
$47.73
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.76
|
|
|
HC VORICONAZOLE, S
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.18 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$28.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| 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 |
$14.89
|
| Rate for Payer: BCBS MAPPO |
$27.11
|
| Rate for Payer: BCBS Trust/PPO |
$31.33
|
| Rate for Payer: BCN Commercial |
$31.33
|
| Rate for Payer: BCN Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Advantage |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.11
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$27.11
|
| 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 |
$28.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$40.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Medicare |
$25.75
|
| Rate for Payer: PACE SWMI |
$27.11
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$27.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$27.11
|
| Rate for Payer: Priority Health Medicare |
$27.11
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: Priority Health Tiered Network |
$21.69
|
| Rate for Payer: Railroad Medicare Medicare |
$27.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.67
|
| Rate for Payer: UHC Core |
$40.67
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$27.11
|
| Rate for Payer: UHC Exchange |
$40.67
|
| Rate for Payer: UHC Medicaid |
$14.18
|
| Rate for Payer: UHCCP Medicaid |
$14.18
|
| Rate for Payer: UMR Bronson Commercial |
$34.65
|
| Rate for Payer: VA VA |
$27.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC VORICONAZOLE, S
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.20 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Advantage |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$65.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: UMR Bronson Commercial |
$41.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$10,430.93 |
| Rate for Payer: Aetna American Axle |
$5,267.89
|
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna Medicare |
$3,354.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,267.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$3,946.59
|
| Rate for Payer: BCN Commercial |
$3,946.59
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Advantage |
$5,673.11
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,673.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$3,386.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$9,676.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$10,430.93
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health SBD |
$5,105.80
|
| Rate for Payer: Priority Health Tiered Network |
$8,344.74
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,267.89
|
| Rate for Payer: UHC Core |
$4,222.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$3,185.04
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: UMR Bronson Commercial |
$2,998.64
|
| Rate for Payer: VA VA |
$3,225.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC VULVECTOMY SIMPLE PARTIAL
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 56620
|
| Hospital Charge Code |
36100618
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,565.95 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna American Axle |
$5,267.89
|
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,267.89
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Advantage |
$5,673.11
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,673.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: Priority Health SBD |
$5,105.80
|
| Rate for Payer: UMR Bronson Commercial |
$3,565.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC WALNUT IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| 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 |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC WALNUT IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200065
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC WALNUT TREE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.40 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: UMR Bronson Commercial |
$11.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC WALNUT TREE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200116
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.73 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna American Axle |
$16.84
|
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$5.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.84
|
| 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 |
$2.87
|
| Rate for Payer: BCBS MAPPO |
$5.22
|
| Rate for Payer: BCBS Trust/PPO |
$6.04
|
| Rate for Payer: BCN Commercial |
$6.04
|
| Rate for Payer: BCN Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Advantage |
$18.13
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.22
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$18.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$5.22
|
| 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 |
$5.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$7.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Medicare |
$4.96
|
| Rate for Payer: PACE SWMI |
$5.22
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$5.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.22
|
| Rate for Payer: Priority Health Medicare |
$5.22
|
| Rate for Payer: Priority Health SBD |
$16.32
|
| Rate for Payer: Priority Health Tiered Network |
$4.18
|
| Rate for Payer: Railroad Medicare Medicare |
$5.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.83
|
| Rate for Payer: UHC Core |
$7.83
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.22
|
| Rate for Payer: UHC Exchange |
$7.83
|
| Rate for Payer: UHC Medicaid |
$2.73
|
| Rate for Payer: UHCCP Medicaid |
$2.73
|
| Rate for Payer: UMR Bronson Commercial |
$9.58
|
| Rate for Payer: VA VA |
$5.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
OP
|
$846.31
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$188.00 |
| Max. Negotiated Rate |
$1,162.48 |
| Rate for Payer: Aetna American Axle |
$550.10
|
| Rate for Payer: Aetna Commercial |
$719.36
|
| Rate for Payer: Aetna Medicare |
$373.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$449.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$449.34
|
| Rate for Payer: BCBS Complete |
$197.42
|
| Rate for Payer: BCBS MAPPO |
$359.47
|
| Rate for Payer: BCBS Trust/PPO |
$1,049.84
|
| Rate for Payer: BCN Commercial |
$1,049.84
|
| Rate for Payer: BCN Medicare Advantage |
$359.47
|
| Rate for Payer: Cash Price |
$677.05
|
| Rate for Payer: Cash Price |
$677.05
|
| Rate for Payer: Cofinity Advantage |
$592.42
|
| Rate for Payer: Cofinity Commercial |
$727.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$677.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$359.47
|
| Rate for Payer: Healthscope Commercial |
$761.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$592.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$634.73
|
| Rate for Payer: Mclaren Medicaid |
$359.47
|
| Rate for Payer: Mclaren Medicare |
$359.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$377.44
|
| Rate for Payer: Meridian Medicaid |
$377.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$413.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$395.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$719.36
|
| Rate for Payer: Nomi Health Commercial |
$1,078.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$634.73
|
| Rate for Payer: PACE Medicare |
$341.50
|
| Rate for Payer: PACE SWMI |
$359.47
|
| Rate for Payer: PHP Commercial |
$719.36
|
| Rate for Payer: PHP Medicare Advantage |
$359.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$188.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$1,162.48
|
| Rate for Payer: Priority Health Medicare |
$359.47
|
| Rate for Payer: Priority Health SBD |
$533.18
|
| Rate for Payer: Priority Health Tiered Network |
$929.98
|
| Rate for Payer: Railroad Medicare Medicare |
$359.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$550.10
|
| Rate for Payer: UHC Core |
$440.93
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$359.47
|
| Rate for Payer: UHC Exchange |
$332.60
|
| Rate for Payer: UHC Medicaid |
$188.00
|
| Rate for Payer: UHCCP Medicaid |
$188.00
|
| Rate for Payer: UMR Bronson Commercial |
$313.13
|
| Rate for Payer: VA VA |
$359.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$634.73
|
|
|
HC WASHED RED BLOOD CELLS
|
Facility
|
IP
|
$846.31
|
|
|
Service Code
|
HCPCS P9022
|
| Hospital Charge Code |
39000073
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$372.38 |
| Max. Negotiated Rate |
$761.68 |
| Rate for Payer: Aetna American Axle |
$550.10
|
| Rate for Payer: Aetna Commercial |
$719.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$550.10
|
| Rate for Payer: Cash Price |
$677.05
|
| Rate for Payer: Cofinity Advantage |
$592.42
|
| Rate for Payer: Cofinity Commercial |
$727.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$677.05
|
| Rate for Payer: Healthscope Commercial |
$761.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$592.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$634.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$719.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$634.73
|
| Rate for Payer: PHP Commercial |
$719.36
|
| Rate for Payer: Priority Health SBD |
$533.18
|
| Rate for Payer: UMR Bronson Commercial |
$372.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$634.73
|
|
|
HC WBC BUFFY COAT
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
30500004
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.65 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna American Axle |
$30.71
|
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna Medicare |
$5.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.34
|
| Rate for Payer: BCBS Complete |
$2.78
|
| Rate for Payer: BCBS MAPPO |
$5.07
|
| Rate for Payer: BCBS Trust/PPO |
$5.86
|
| Rate for Payer: BCN Commercial |
$5.86
|
| Rate for Payer: BCN Medicare Advantage |
$5.07
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Advantage |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.07
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Mclaren Medicaid |
$5.07
|
| Rate for Payer: Mclaren Medicare |
$5.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.32
|
| Rate for Payer: Meridian Medicaid |
$5.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$7.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PACE Medicare |
$4.82
|
| Rate for Payer: PACE SWMI |
$5.07
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: PHP Medicare Advantage |
$5.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$5.07
|
| Rate for Payer: Priority Health Medicare |
$5.07
|
| Rate for Payer: Priority Health SBD |
$29.76
|
| Rate for Payer: Priority Health Tiered Network |
$4.06
|
| Rate for Payer: Railroad Medicare Medicare |
$5.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.61
|
| Rate for Payer: UHC Core |
$7.61
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$5.07
|
| Rate for Payer: UHC Exchange |
$7.61
|
| Rate for Payer: UHC Medicaid |
$2.65
|
| Rate for Payer: UHCCP Medicaid |
$2.65
|
| Rate for Payer: UMR Bronson Commercial |
$17.48
|
| Rate for Payer: VA VA |
$5.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC WBC BUFFY COAT
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 85009
|
| Hospital Charge Code |
30500004
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.79 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna American Axle |
$30.71
|
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.71
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Advantage |
$33.07
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.43
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: Priority Health SBD |
$29.76
|
| Rate for Payer: UMR Bronson Commercial |
$20.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC WBC COUNT
|
Facility
|
OP
|
$27.59
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
30500011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Aetna American Axle |
$17.93
|
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna Medicare |
$2.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.17
|
| Rate for Payer: BCBS Complete |
$1.39
|
| Rate for Payer: BCBS MAPPO |
$2.54
|
| Rate for Payer: BCBS Trust/PPO |
$2.94
|
| Rate for Payer: BCN Commercial |
$2.94
|
| Rate for Payer: BCN Medicare Advantage |
$2.54
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cofinity Advantage |
$19.31
|
| Rate for Payer: Cofinity Commercial |
$23.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.54
|
| Rate for Payer: Healthscope Commercial |
$24.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.69
|
| Rate for Payer: Mclaren Medicaid |
$2.54
|
| Rate for Payer: Mclaren Medicare |
$2.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.67
|
| Rate for Payer: Meridian Medicaid |
$2.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.45
|
| Rate for Payer: Nomi Health Commercial |
$3.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.69
|
| Rate for Payer: PACE Medicare |
$2.41
|
| Rate for Payer: PACE SWMI |
$2.54
|
| Rate for Payer: PHP Commercial |
$23.45
|
| Rate for Payer: PHP Medicare Advantage |
$2.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Narrow Network |
$2.54
|
| Rate for Payer: Priority Health Medicare |
$2.54
|
| Rate for Payer: Priority Health SBD |
$17.38
|
| Rate for Payer: Priority Health Tiered Network |
$2.03
|
| Rate for Payer: Railroad Medicare Medicare |
$2.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3.81
|
| Rate for Payer: UHC Core |
$3.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2.54
|
| Rate for Payer: UHC Exchange |
$3.81
|
| Rate for Payer: UHC Medicaid |
$1.33
|
| Rate for Payer: UHCCP Medicaid |
$1.33
|
| Rate for Payer: UMR Bronson Commercial |
$10.21
|
| Rate for Payer: VA VA |
$2.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.69
|
|
|
HC WBC COUNT
|
Facility
|
IP
|
$27.59
|
|
|
Service Code
|
CPT 85048
|
| Hospital Charge Code |
30500011
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Aetna American Axle |
$17.93
|
| Rate for Payer: Aetna Commercial |
$23.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$17.93
|
| Rate for Payer: Cash Price |
$22.07
|
| Rate for Payer: Cofinity Advantage |
$19.31
|
| Rate for Payer: Cofinity Commercial |
$23.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.07
|
| Rate for Payer: Healthscope Commercial |
$24.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.69
|
| Rate for Payer: PHP Commercial |
$23.45
|
| Rate for Payer: Priority Health SBD |
$17.38
|
| Rate for Payer: UMR Bronson Commercial |
$12.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.69
|
|
|
HC WC EVAL JOB SITE ANALYSIS EACH 30 MIN
|
Facility
|
IP
|
$224.62
|
|
| Hospital Charge Code |
42000045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$98.83 |
| Max. Negotiated Rate |
$202.16 |
| Rate for Payer: Aetna American Axle |
$146.00
|
| Rate for Payer: Aetna Commercial |
$190.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.00
|
| Rate for Payer: Cash Price |
$179.70
|
| Rate for Payer: Cofinity Advantage |
$157.23
|
| Rate for Payer: Cofinity Commercial |
$193.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.70
|
| Rate for Payer: Healthscope Commercial |
$202.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.47
|
| Rate for Payer: PHP Commercial |
$190.93
|
| Rate for Payer: Priority Health SBD |
$141.51
|
| Rate for Payer: UMR Bronson Commercial |
$98.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.47
|
|
|
HC WC EVAL JOB SITE ANALYSIS EACH 30 MIN
|
Facility
|
OP
|
$224.62
|
|
| Hospital Charge Code |
42000045
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$83.11 |
| Max. Negotiated Rate |
$202.16 |
| Rate for Payer: Aetna American Axle |
$146.00
|
| Rate for Payer: Aetna Commercial |
$190.93
|
| Rate for Payer: Aetna Medicare |
$112.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$146.00
|
| Rate for Payer: BCBS Complete |
$89.85
|
| Rate for Payer: Cash Price |
$179.70
|
| Rate for Payer: Cash Price |
$179.70
|
| Rate for Payer: Cofinity Advantage |
$157.23
|
| Rate for Payer: Cofinity Commercial |
$193.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.70
|
| Rate for Payer: Healthscope Commercial |
$202.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$157.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$179.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.93
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.47
|
| Rate for Payer: PHP Commercial |
$190.93
|
| Rate for Payer: Priority Health SBD |
$141.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.00
|
| Rate for Payer: UHC Core |
$117.03
|
| Rate for Payer: UHC Exchange |
$88.28
|
| Rate for Payer: UMR Bronson Commercial |
$83.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.47
|
|
|
HC WC EVAL JOB SITE ANALYSIS FIRST 60 MIN
|
Facility
|
OP
|
$304.84
|
|
| Hospital Charge Code |
42000044
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$112.79 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna American Axle |
$198.15
|
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna Medicare |
$152.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.15
|
| Rate for Payer: BCBS Complete |
$121.94
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Advantage |
$213.39
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$243.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.63
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health SBD |
$192.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.15
|
| Rate for Payer: UHC Core |
$158.82
|
| Rate for Payer: UHC Exchange |
$119.80
|
| Rate for Payer: UMR Bronson Commercial |
$112.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
|
HC WC EVAL JOB SITE ANALYSIS FIRST 60 MIN
|
Facility
|
IP
|
$304.84
|
|
| Hospital Charge Code |
42000044
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$134.13 |
| Max. Negotiated Rate |
$274.36 |
| Rate for Payer: Aetna American Axle |
$198.15
|
| Rate for Payer: Aetna Commercial |
$259.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$198.15
|
| Rate for Payer: Cash Price |
$243.87
|
| Rate for Payer: Cofinity Advantage |
$213.39
|
| Rate for Payer: Cofinity Commercial |
$262.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$243.87
|
| Rate for Payer: Healthscope Commercial |
$274.36
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$213.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$228.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$259.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$228.63
|
| Rate for Payer: PHP Commercial |
$259.11
|
| Rate for Payer: Priority Health SBD |
$192.05
|
| Rate for Payer: UMR Bronson Commercial |
$134.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$228.63
|
|
