|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$73.24 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna American Axle |
$108.20
|
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.20
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$116.52
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.20
|
| Rate for Payer: Priority Health SBD |
$104.87
|
| Rate for Payer: UMR Bronson Commercial |
$73.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC TOXICOLOGY SCREEN SALIVA
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100665
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna American Axle |
$108.20
|
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna Medicare |
$64.63
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$108.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.68
|
| Rate for Payer: BCBS Complete |
$34.97
|
| Rate for Payer: BCBS MAPPO |
$62.14
|
| Rate for Payer: BCBS Trust/PPO |
$59.88
|
| Rate for Payer: BCN Commercial |
$59.88
|
| Rate for Payer: BCN Medicare Advantage |
$62.14
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Cofinity Commercial |
$116.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$116.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.14
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$116.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Mclaren Medicaid |
$33.31
|
| Rate for Payer: Mclaren Medicare |
$62.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.25
|
| Rate for Payer: Meridian Medicaid |
$34.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$93.21
|
| Rate for Payer: PACE Medicare |
$59.03
|
| Rate for Payer: PACE SWMI |
$62.14
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: PHP Medicare Advantage |
$62.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$62.14
|
| Rate for Payer: Priority Health Medicare |
$62.14
|
| Rate for Payer: Priority Health Narrow Network |
$49.71
|
| Rate for Payer: Priority Health SBD |
$104.87
|
| Rate for Payer: Railroad Medicare Medicare |
$62.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.14
|
| Rate for Payer: UHC Exchange |
$62.14
|
| Rate for Payer: UHC Medicare Advantage |
$62.14
|
| Rate for Payer: UHCCP Medicaid |
$33.31
|
| Rate for Payer: UMR Bronson Commercial |
$61.59
|
| Rate for Payer: VA VA |
$62.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
IP
|
$115.26
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$50.71 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna American Axle |
$74.92
|
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: UMR Bronson Commercial |
$50.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC TOXOPLASMA AB IGG
|
Facility
|
OP
|
$115.26
|
|
|
Service Code
|
CPT 86777
|
| Hospital Charge Code |
30200321
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$103.73 |
| Rate for Payer: Aetna American Axle |
$74.92
|
| Rate for Payer: Aetna Commercial |
$97.97
|
| Rate for Payer: Aetna Medicare |
$14.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$74.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.99
|
| Rate for Payer: BCBS Complete |
$8.10
|
| Rate for Payer: BCBS MAPPO |
$14.39
|
| Rate for Payer: BCBS Trust/PPO |
$13.86
|
| Rate for Payer: BCN Commercial |
$13.86
|
| Rate for Payer: BCN Medicare Advantage |
$14.39
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cash Price |
$92.21
|
| Rate for Payer: Cofinity Commercial |
$99.12
|
| Rate for Payer: Cofinity Commercial |
$80.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$80.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.39
|
| Rate for Payer: Healthscope Commercial |
$103.73
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$80.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.44
|
| Rate for Payer: Mclaren Medicaid |
$7.71
|
| Rate for Payer: Mclaren Medicare |
$14.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.11
|
| Rate for Payer: Meridian Medicaid |
$8.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$97.97
|
| Rate for Payer: Nomi Health Commercial |
$21.58
|
| Rate for Payer: PACE Medicare |
$13.67
|
| Rate for Payer: PACE SWMI |
$14.39
|
| Rate for Payer: PHP Commercial |
$97.97
|
| Rate for Payer: PHP Medicare Advantage |
$14.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.92
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.39
|
| Rate for Payer: Priority Health Medicare |
$14.39
|
| Rate for Payer: Priority Health Narrow Network |
$11.51
|
| Rate for Payer: Priority Health SBD |
$72.61
|
| Rate for Payer: Railroad Medicare Medicare |
$14.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.27
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.39
|
| Rate for Payer: UHC Exchange |
$14.39
|
| Rate for Payer: UHC Medicare Advantage |
$14.39
|
| Rate for Payer: UHCCP Medicaid |
$7.71
|
| Rate for Payer: UMR Bronson Commercial |
$42.65
|
| Rate for Payer: VA VA |
$14.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.44
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.31 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: UMR Bronson Commercial |
$18.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC TOXOPLASMA AB IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86778
|
| Hospital Charge Code |
30200323
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna American Axle |
$27.05
|
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$14.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$27.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.01
|
| Rate for Payer: BCBS Complete |
$8.11
|
| Rate for Payer: BCBS MAPPO |
$14.41
|
| Rate for Payer: BCBS Trust/PPO |
$13.89
|
| Rate for Payer: BCN Commercial |
$13.89
|
| Rate for Payer: BCN Medicare Advantage |
$14.41
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$29.13
|
| Rate for Payer: Cofinity Medicare Advantage |
$29.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.41
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$29.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$7.72
|
| Rate for Payer: Mclaren Medicare |
$14.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.13
|
| Rate for Payer: Meridian Medicaid |
$8.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$21.62
|
| Rate for Payer: PACE Medicare |
$13.69
|
| Rate for Payer: PACE SWMI |
$14.41
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$14.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.41
|
| Rate for Payer: Priority Health Medicare |
$14.41
|
| Rate for Payer: Priority Health Narrow Network |
$11.53
|
| Rate for Payer: Priority Health SBD |
$26.22
|
| Rate for Payer: Railroad Medicare Medicare |
$14.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.29
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.41
|
| Rate for Payer: UHC Exchange |
$14.41
|
| Rate for Payer: UHC Medicare Advantage |
$14.41
|
| Rate for Payer: UHCCP Medicaid |
$7.72
|
| Rate for Payer: UMR Bronson Commercial |
$15.40
|
| Rate for Payer: VA VA |
$14.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
IP
|
$529.47
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$232.97 |
| Max. Negotiated Rate |
$476.52 |
| Rate for Payer: Aetna American Axle |
$344.16
|
| Rate for Payer: Aetna Commercial |
$450.05
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.16
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cofinity Commercial |
$370.63
|
| Rate for Payer: Cofinity Commercial |
$455.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$370.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.58
|
| Rate for Payer: Healthscope Commercial |
$476.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$370.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.05
|
| Rate for Payer: PHP Commercial |
$450.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.16
|
| Rate for Payer: Priority Health SBD |
$333.57
|
| Rate for Payer: UMR Bronson Commercial |
$232.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.10
|
|
|
HC TPMT AND NUDT15 GENOTYPE
|
Facility
|
OP
|
$529.47
|
|
|
Service Code
|
CPT 0034U
|
| Hospital Charge Code |
31000138
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$195.90 |
| Max. Negotiated Rate |
$1,398.51 |
| Rate for Payer: Aetna American Axle |
$344.16
|
| Rate for Payer: Aetna Commercial |
$450.05
|
| Rate for Payer: Aetna Medicare |
$484.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$344.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$582.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$582.71
|
| Rate for Payer: BCBS Complete |
$262.36
|
| Rate for Payer: BCBS MAPPO |
$466.17
|
| Rate for Payer: BCBS Trust/PPO |
$449.13
|
| Rate for Payer: BCN Commercial |
$449.13
|
| Rate for Payer: BCN Medicare Advantage |
$466.17
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cash Price |
$423.58
|
| Rate for Payer: Cofinity Commercial |
$455.34
|
| Rate for Payer: Cofinity Commercial |
$370.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$370.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$423.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$466.17
|
| Rate for Payer: Healthscope Commercial |
$476.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$370.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$397.10
|
| Rate for Payer: Mclaren Medicaid |
$249.87
|
| Rate for Payer: Mclaren Medicare |
$466.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$489.48
|
| Rate for Payer: Meridian Medicaid |
$262.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$536.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$450.05
|
| Rate for Payer: Nomi Health Commercial |
$1,398.51
|
| Rate for Payer: PACE Medicare |
$442.86
|
| Rate for Payer: PACE SWMI |
$466.17
|
| Rate for Payer: PHP Commercial |
$450.05
|
| Rate for Payer: PHP Medicare Advantage |
$466.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$249.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$344.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$466.17
|
| Rate for Payer: Priority Health Medicare |
$466.17
|
| Rate for Payer: Priority Health Narrow Network |
$372.94
|
| Rate for Payer: Priority Health SBD |
$333.57
|
| Rate for Payer: Railroad Medicare Medicare |
$466.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$559.40
|
| Rate for Payer: UHC Core |
$419.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$466.17
|
| Rate for Payer: UHC Exchange |
$466.17
|
| Rate for Payer: UHC Medicare Advantage |
$466.17
|
| Rate for Payer: UHCCP Medicaid |
$249.87
|
| Rate for Payer: UMR Bronson Commercial |
$195.90
|
| Rate for Payer: VA VA |
$466.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$397.10
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
OP
|
$299.32
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$110.75 |
| Max. Negotiated Rate |
$269.39 |
| Rate for Payer: Aetna American Axle |
$194.56
|
| Rate for Payer: Aetna Commercial |
$254.42
|
| Rate for Payer: Aetna Medicare |
$149.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.56
|
| Rate for Payer: BCBS Complete |
$119.73
|
| Rate for Payer: Cash Price |
$239.46
|
| Rate for Payer: Cofinity Commercial |
$209.52
|
| Rate for Payer: Cofinity Commercial |
$257.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.46
|
| Rate for Payer: Healthscope Commercial |
$269.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.42
|
| Rate for Payer: PHP Commercial |
$254.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.56
|
| Rate for Payer: Priority Health SBD |
$188.57
|
| Rate for Payer: UMR Bronson Commercial |
$110.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.49
|
|
|
HC TRACH BUTTON SUPPLY
|
Facility
|
IP
|
$299.32
|
|
| Hospital Charge Code |
27000159
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$131.70 |
| Max. Negotiated Rate |
$269.39 |
| Rate for Payer: Aetna American Axle |
$194.56
|
| Rate for Payer: Aetna Commercial |
$254.42
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$194.56
|
| Rate for Payer: Cash Price |
$239.46
|
| Rate for Payer: Cofinity Commercial |
$209.52
|
| Rate for Payer: Cofinity Commercial |
$257.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$209.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$239.46
|
| Rate for Payer: Healthscope Commercial |
$269.39
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$209.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$224.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$254.42
|
| Rate for Payer: PHP Commercial |
$254.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$194.56
|
| Rate for Payer: Priority Health SBD |
$188.57
|
| Rate for Payer: UMR Bronson Commercial |
$131.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$224.49
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
IP
|
$1,326.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$583.44 |
| Max. Negotiated Rate |
$1,193.40 |
| Rate for Payer: Aetna American Axle |
$861.90
|
| Rate for Payer: Aetna Commercial |
$1,127.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.90
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$1,140.36
|
| Rate for Payer: Cofinity Commercial |
$928.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$928.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.80
|
| Rate for Payer: Healthscope Commercial |
$1,193.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$928.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$994.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: PHP Commercial |
$1,127.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: Priority Health SBD |
$835.38
|
| Rate for Payer: UMR Bronson Commercial |
$583.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$994.50
|
|
|
HC TRACHEOBRNCHSC THRU EST TRACHS INC
|
Facility
|
OP
|
$1,326.00
|
|
|
Service Code
|
CPT 31615
|
| Hospital Charge Code |
76100389
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$110.72 |
| Max. Negotiated Rate |
$1,568.21 |
| Rate for Payer: Aetna American Axle |
$861.90
|
| Rate for Payer: Aetna Commercial |
$1,127.10
|
| Rate for Payer: Aetna Medicare |
$518.91
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$861.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$623.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$623.69
|
| Rate for Payer: BCBS Complete |
$280.81
|
| Rate for Payer: BCBS MAPPO |
$498.95
|
| Rate for Payer: BCBS Trust/PPO |
$706.85
|
| Rate for Payer: BCN Commercial |
$706.85
|
| Rate for Payer: BCN Medicare Advantage |
$498.95
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cash Price |
$1,060.80
|
| Rate for Payer: Cofinity Commercial |
$928.20
|
| Rate for Payer: Cofinity Commercial |
$1,140.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$928.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,060.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$498.95
|
| Rate for Payer: Healthscope Commercial |
$1,193.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$928.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$994.50
|
| Rate for Payer: Mclaren Medicaid |
$267.44
|
| Rate for Payer: Mclaren Medicare |
$498.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$523.90
|
| Rate for Payer: Meridian Medicaid |
$280.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$573.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,127.10
|
| Rate for Payer: Nomi Health Commercial |
$1,047.80
|
| Rate for Payer: PACE Medicare |
$474.00
|
| Rate for Payer: PACE SWMI |
$498.95
|
| Rate for Payer: PHP Commercial |
$1,127.10
|
| Rate for Payer: PHP Medicare Advantage |
$498.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$267.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,568.21
|
| Rate for Payer: Priority Health Medicare |
$498.95
|
| Rate for Payer: Priority Health Narrow Network |
$1,254.57
|
| Rate for Payer: Priority Health SBD |
$835.38
|
| Rate for Payer: Railroad Medicare Medicare |
$498.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.79
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$498.95
|
| Rate for Payer: UHC Exchange |
$110.72
|
| Rate for Payer: UHC Medicare Advantage |
$498.95
|
| Rate for Payer: UHCCP Medicaid |
$267.44
|
| Rate for Payer: UMR Bronson Commercial |
$490.62
|
| Rate for Payer: VA VA |
$498.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$994.50
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
OP
|
$8,068.20
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$402.16 |
| Max. Negotiated Rate |
$9,986.81 |
| Rate for Payer: Aetna American Axle |
$5,244.33
|
| Rate for Payer: Aetna Commercial |
$6,857.97
|
| Rate for Payer: Aetna Medicare |
$3,304.60
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,244.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,971.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,971.88
|
| Rate for Payer: BCBS Complete |
$1,788.30
|
| Rate for Payer: BCBS MAPPO |
$3,177.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,708.82
|
| Rate for Payer: BCN Commercial |
$1,708.82
|
| Rate for Payer: BCN Medicare Advantage |
$3,177.50
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cofinity Commercial |
$6,938.65
|
| Rate for Payer: Cofinity Commercial |
$5,647.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,647.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,454.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,177.50
|
| Rate for Payer: Healthscope Commercial |
$7,261.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,647.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,051.15
|
| Rate for Payer: Mclaren Medicaid |
$1,703.14
|
| Rate for Payer: Mclaren Medicare |
$3,177.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,336.38
|
| Rate for Payer: Meridian Medicaid |
$1,788.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,654.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,857.97
|
| Rate for Payer: Nomi Health Commercial |
$6,672.75
|
| Rate for Payer: PACE Medicare |
$3,018.62
|
| Rate for Payer: PACE SWMI |
$3,177.50
|
| Rate for Payer: PHP Commercial |
$6,857.97
|
| Rate for Payer: PHP Medicare Advantage |
$3,177.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,703.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,244.33
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,986.81
|
| Rate for Payer: Priority Health Medicare |
$3,177.50
|
| Rate for Payer: Priority Health Narrow Network |
$7,989.45
|
| Rate for Payer: Priority Health SBD |
$5,082.97
|
| Rate for Payer: Railroad Medicare Medicare |
$3,177.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$442.38
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,177.50
|
| Rate for Payer: UHC Exchange |
$402.16
|
| Rate for Payer: UHC Medicare Advantage |
$3,177.50
|
| Rate for Payer: UHCCP Medicaid |
$1,703.14
|
| Rate for Payer: UMR Bronson Commercial |
$2,985.23
|
| Rate for Payer: VA VA |
$3,177.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,051.15
|
|
|
HC TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION
|
Facility
|
IP
|
$8,068.20
|
|
|
Service Code
|
CPT 31613
|
| Hospital Charge Code |
76100404
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,550.01 |
| Max. Negotiated Rate |
$7,261.38 |
| Rate for Payer: Aetna American Axle |
$5,244.33
|
| Rate for Payer: Aetna Commercial |
$6,857.97
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$5,244.33
|
| Rate for Payer: Cash Price |
$6,454.56
|
| Rate for Payer: Cofinity Commercial |
$5,647.74
|
| Rate for Payer: Cofinity Commercial |
$6,938.65
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,647.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,454.56
|
| Rate for Payer: Healthscope Commercial |
$7,261.38
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,647.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,051.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,857.97
|
| Rate for Payer: PHP Commercial |
$6,857.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,244.33
|
| Rate for Payer: Priority Health SBD |
$5,082.97
|
| Rate for Payer: UMR Bronson Commercial |
$3,550.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,051.15
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
OP
|
$507.54
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$187.79 |
| Max. Negotiated Rate |
$456.79 |
| Rate for Payer: Aetna American Axle |
$329.90
|
| Rate for Payer: Aetna Commercial |
$431.41
|
| Rate for Payer: Aetna Medicare |
$253.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.90
|
| Rate for Payer: BCBS Complete |
$203.02
|
| Rate for Payer: Cash Price |
$406.03
|
| Rate for Payer: Cofinity Commercial |
$355.28
|
| Rate for Payer: Cofinity Commercial |
$436.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$355.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.03
|
| Rate for Payer: Healthscope Commercial |
$456.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$355.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.41
|
| Rate for Payer: PHP Commercial |
$431.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.90
|
| Rate for Payer: Priority Health SBD |
$319.75
|
| Rate for Payer: UMR Bronson Commercial |
$187.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.66
|
|
|
HC TRACH TUBE INSERTION
|
Facility
|
IP
|
$507.54
|
|
| Hospital Charge Code |
27000160
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$223.32 |
| Max. Negotiated Rate |
$456.79 |
| Rate for Payer: Aetna American Axle |
$329.90
|
| Rate for Payer: Aetna Commercial |
$431.41
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$329.90
|
| Rate for Payer: Cash Price |
$406.03
|
| Rate for Payer: Cofinity Commercial |
$355.28
|
| Rate for Payer: Cofinity Commercial |
$436.48
|
| Rate for Payer: Cofinity Medicare Advantage |
$355.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$406.03
|
| Rate for Payer: Healthscope Commercial |
$456.79
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$355.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$380.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$431.41
|
| Rate for Payer: PHP Commercial |
$431.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$329.90
|
| Rate for Payer: Priority Health SBD |
$319.75
|
| Rate for Payer: UMR Bronson Commercial |
$223.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$380.66
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
IP
|
$177.56
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$78.13 |
| Max. Negotiated Rate |
$159.80 |
| Rate for Payer: Aetna American Axle |
$115.41
|
| Rate for Payer: Aetna Commercial |
$150.93
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.41
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$124.29
|
| Rate for Payer: Cofinity Commercial |
$152.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$124.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.05
|
| Rate for Payer: Healthscope Commercial |
$159.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.93
|
| Rate for Payer: PHP Commercial |
$150.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.41
|
| Rate for Payer: Priority Health SBD |
$111.86
|
| Rate for Payer: UMR Bronson Commercial |
$78.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.17
|
|
|
HC TRACH TUBE REPLACEMENT
|
Facility
|
OP
|
$177.56
|
|
|
Service Code
|
CPT 31502
|
| Hospital Charge Code |
45000072
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$33.69 |
| Max. Negotiated Rate |
$715.11 |
| Rate for Payer: Aetna American Axle |
$115.41
|
| Rate for Payer: Aetna Commercial |
$150.93
|
| Rate for Payer: Aetna Medicare |
$236.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$115.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$284.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$284.40
|
| Rate for Payer: BCBS Complete |
$128.05
|
| Rate for Payer: BCBS MAPPO |
$227.52
|
| Rate for Payer: BCBS Trust/PPO |
$149.05
|
| Rate for Payer: BCN Commercial |
$149.05
|
| Rate for Payer: BCN Medicare Advantage |
$227.52
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cash Price |
$142.05
|
| Rate for Payer: Cofinity Commercial |
$152.70
|
| Rate for Payer: Cofinity Commercial |
$124.29
|
| Rate for Payer: Cofinity Medicare Advantage |
$124.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$227.52
|
| Rate for Payer: Healthscope Commercial |
$159.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$124.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.17
|
| Rate for Payer: Mclaren Medicaid |
$121.95
|
| Rate for Payer: Mclaren Medicare |
$227.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.90
|
| Rate for Payer: Meridian Medicaid |
$128.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$261.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$150.93
|
| Rate for Payer: Nomi Health Commercial |
$477.79
|
| Rate for Payer: PACE Medicare |
$216.14
|
| Rate for Payer: PACE SWMI |
$227.52
|
| Rate for Payer: PHP Commercial |
$150.93
|
| Rate for Payer: PHP Medicare Advantage |
$227.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$121.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$115.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$715.11
|
| Rate for Payer: Priority Health Medicare |
$227.52
|
| Rate for Payer: Priority Health Narrow Network |
$572.09
|
| Rate for Payer: Priority Health SBD |
$111.86
|
| Rate for Payer: Railroad Medicare Medicare |
$227.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.06
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$227.52
|
| Rate for Payer: UHC Exchange |
$33.69
|
| Rate for Payer: UHC Medicare Advantage |
$227.52
|
| Rate for Payer: UHCCP Medicaid |
$121.95
|
| Rate for Payer: UMR Bronson Commercial |
$65.70
|
| Rate for Payer: VA VA |
$227.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.17
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$11.35 |
| Max. Negotiated Rate |
$294.00 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$59.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: BCBS Complete |
$47.86
|
| Rate for Payer: BCBS Trust/PPO |
$11.35
|
| Rate for Payer: BCN Commercial |
$11.35
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Cofinity Commercial |
$83.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$135.00
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.00
|
| Rate for Payer: Priority Health Narrow Network |
$12.00
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.67
|
| Rate for Payer: UHC Core |
$294.00
|
| Rate for Payer: UHC Exchange |
$13.34
|
| Rate for Payer: UMR Bronson Commercial |
$44.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRACTION MECHANICAL
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 97012
|
| Hospital Charge Code |
42000009
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$107.68 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Cofinity Commercial |
$83.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: UMR Bronson Commercial |
$52.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$396.84 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$131.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.82
|
| Rate for Payer: BCBS Complete |
$71.06
|
| Rate for Payer: BCBS MAPPO |
$126.26
|
| Rate for Payer: BCN Medicare Advantage |
$126.26
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$83.76
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$107.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$67.68
|
| Rate for Payer: Mclaren Medicare |
$126.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.57
|
| Rate for Payer: Meridian Medicaid |
$71.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$378.78
|
| Rate for Payer: PACE Medicare |
$119.95
|
| Rate for Payer: PACE SWMI |
$126.26
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$126.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.84
|
| Rate for Payer: Priority Health Medicare |
$126.26
|
| Rate for Payer: Priority Health Narrow Network |
$317.47
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: Railroad Medicare Medicare |
$126.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.26
|
| Rate for Payer: UHC Exchange |
$133.74
|
| Rate for Payer: UHC Medicare Advantage |
$126.26
|
| Rate for Payer: UHCCP Medicaid |
$67.68
|
| Rate for Payer: UMR Bronson Commercial |
$44.27
|
| Rate for Payer: VA VA |
$126.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANS CARE MGMT 14 DAYS
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 99495
|
| Hospital Charge Code |
51000086
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$107.68 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Cofinity Commercial |
$83.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: UMR Bronson Commercial |
$52.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$52.65 |
| Max. Negotiated Rate |
$107.68 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Cofinity Commercial |
$83.76
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: UMR Bronson Commercial |
$52.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANS CARE MGMT 7 DAYS
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 99496
|
| Hospital Charge Code |
51000087
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$44.27 |
| Max. Negotiated Rate |
$396.84 |
| Rate for Payer: Aetna American Axle |
$77.77
|
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$131.31
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$77.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$157.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$157.82
|
| Rate for Payer: BCBS Complete |
$71.06
|
| Rate for Payer: BCBS MAPPO |
$126.26
|
| Rate for Payer: BCN Medicare Advantage |
$126.26
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$83.76
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Cofinity Medicare Advantage |
$83.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$126.26
|
| Rate for Payer: Healthscope Commercial |
$107.68
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$83.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$67.68
|
| Rate for Payer: Mclaren Medicare |
$126.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$132.57
|
| Rate for Payer: Meridian Medicaid |
$71.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$145.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$378.78
|
| Rate for Payer: PACE Medicare |
$119.95
|
| Rate for Payer: PACE SWMI |
$126.26
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$126.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$77.77
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$396.84
|
| Rate for Payer: Priority Health Medicare |
$126.26
|
| Rate for Payer: Priority Health Narrow Network |
$317.47
|
| Rate for Payer: Priority Health SBD |
$75.38
|
| Rate for Payer: Railroad Medicare Medicare |
$126.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$199.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$126.26
|
| Rate for Payer: UHC Exchange |
$181.64
|
| Rate for Payer: UHC Medicare Advantage |
$126.26
|
| Rate for Payer: UHCCP Medicaid |
$67.68
|
| Rate for Payer: UMR Bronson Commercial |
$44.27
|
| Rate for Payer: VA VA |
$126.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC TRANSCATH INSERT/REPLACE PERM LEADLESS PACEMAKER
|
Facility
|
OP
|
$24,969.60
|
|
|
Service Code
|
CPT 33274
|
| Hospital Charge Code |
48100115
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$457.92 |
| Max. Negotiated Rate |
$58,728.38 |
| Rate for Payer: Aetna American Axle |
$16,230.24
|
| Rate for Payer: Aetna Commercial |
$21,224.16
|
| Rate for Payer: Aetna Medicare |
$19,432.96
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16,230.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23,356.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23,356.92
|
| Rate for Payer: BCBS Complete |
$10,516.22
|
| Rate for Payer: BCBS MAPPO |
$18,685.54
|
| Rate for Payer: BCBS Trust/PPO |
$18,372.64
|
| Rate for Payer: BCN Commercial |
$18,372.64
|
| Rate for Payer: BCN Medicare Advantage |
$18,685.54
|
| Rate for Payer: Cash Price |
$19,975.68
|
| Rate for Payer: Cash Price |
$19,975.68
|
| Rate for Payer: Cash Price |
$19,975.68
|
| Rate for Payer: Cofinity Commercial |
$21,473.86
|
| Rate for Payer: Cofinity Commercial |
$17,478.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$17,478.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19,975.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18,685.54
|
| Rate for Payer: Healthscope Commercial |
$22,472.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17,478.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18,727.20
|
| Rate for Payer: Mclaren Medicaid |
$10,015.45
|
| Rate for Payer: Mclaren Medicare |
$18,685.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19,619.82
|
| Rate for Payer: Meridian Medicaid |
$10,516.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21,488.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21,224.16
|
| Rate for Payer: Nomi Health Commercial |
$39,239.63
|
| Rate for Payer: PACE Medicare |
$17,751.26
|
| Rate for Payer: PACE SWMI |
$18,685.54
|
| Rate for Payer: PHP Commercial |
$21,224.16
|
| Rate for Payer: PHP Medicare Advantage |
$18,685.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$10,015.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16,230.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$58,728.38
|
| Rate for Payer: Priority Health Medicare |
$18,685.54
|
| Rate for Payer: Priority Health Narrow Network |
$46,982.70
|
| Rate for Payer: Priority Health SBD |
$15,730.85
|
| Rate for Payer: Railroad Medicare Medicare |
$18,685.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$503.71
|
| Rate for Payer: UHC Core |
$30,600.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$18,685.54
|
| Rate for Payer: UHC Exchange |
$457.92
|
| Rate for Payer: UHC Medicare Advantage |
$18,685.54
|
| Rate for Payer: UHCCP Medicaid |
$10,015.45
|
| Rate for Payer: UMR Bronson Commercial |
$9,238.75
|
| Rate for Payer: VA VA |
$18,685.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18,727.20
|
|
