|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
OP
|
$6,252.80
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$156.85 |
| Max. Negotiated Rate |
$15,654.68 |
| Rate for Payer: Aetna American Axle |
$4,064.32
|
| Rate for Payer: Aetna Commercial |
$5,314.88
|
| Rate for Payer: Aetna Medicare |
$5,180.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,064.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6,226.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6,226.04
|
| Rate for Payer: BCBS Complete |
$2,803.21
|
| Rate for Payer: BCBS MAPPO |
$4,980.83
|
| Rate for Payer: BCBS Trust/PPO |
$5,915.58
|
| Rate for Payer: BCN Commercial |
$5,915.58
|
| Rate for Payer: BCN Medicare Advantage |
$4,980.83
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cofinity Commercial |
$5,377.41
|
| Rate for Payer: Cofinity Commercial |
$4,376.96
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,376.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,002.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4,980.83
|
| Rate for Payer: Healthscope Commercial |
$5,627.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,376.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,689.60
|
| Rate for Payer: Mclaren Medicaid |
$2,669.72
|
| Rate for Payer: Mclaren Medicare |
$4,980.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5,229.87
|
| Rate for Payer: Meridian Medicaid |
$2,803.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5,727.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,314.88
|
| Rate for Payer: Nomi Health Commercial |
$10,459.74
|
| Rate for Payer: PACE Medicare |
$4,731.79
|
| Rate for Payer: PACE SWMI |
$4,980.83
|
| Rate for Payer: PHP Commercial |
$5,314.88
|
| Rate for Payer: PHP Medicare Advantage |
$4,980.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,669.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,064.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15,654.68
|
| Rate for Payer: Priority Health Medicare |
$4,980.83
|
| Rate for Payer: Priority Health Narrow Network |
$12,523.74
|
| Rate for Payer: Priority Health SBD |
$3,939.26
|
| Rate for Payer: Railroad Medicare Medicare |
$4,980.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$172.54
|
| Rate for Payer: UHC Core |
$8,596.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$4,980.83
|
| Rate for Payer: UHC Exchange |
$156.85
|
| Rate for Payer: UHC Medicare Advantage |
$4,980.83
|
| Rate for Payer: UHCCP Medicaid |
$2,669.72
|
| Rate for Payer: UMR Bronson Commercial |
$2,313.54
|
| Rate for Payer: VA VA |
$4,980.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,689.60
|
|
|
HC TRANSPERINEAL PLMT BIODEGRADABLE MATRL
|
Facility
|
IP
|
$6,252.80
|
|
|
Service Code
|
CPT 55874
|
| Hospital Charge Code |
36100574
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,751.23 |
| Max. Negotiated Rate |
$5,627.52 |
| Rate for Payer: Aetna American Axle |
$4,064.32
|
| Rate for Payer: Aetna Commercial |
$5,314.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,064.32
|
| Rate for Payer: Cash Price |
$5,002.24
|
| Rate for Payer: Cofinity Commercial |
$4,376.96
|
| Rate for Payer: Cofinity Commercial |
$5,377.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,376.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,002.24
|
| Rate for Payer: Healthscope Commercial |
$5,627.52
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,376.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,689.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,314.88
|
| Rate for Payer: PHP Commercial |
$5,314.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,064.32
|
| Rate for Payer: Priority Health SBD |
$3,939.26
|
| Rate for Payer: UMR Bronson Commercial |
$2,751.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,689.60
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
OP
|
$3,693.55
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,366.61 |
| Max. Negotiated Rate |
$3,324.20 |
| Rate for Payer: Aetna American Axle |
$2,400.81
|
| Rate for Payer: Aetna Commercial |
$3,139.52
|
| Rate for Payer: Aetna Medicare |
$1,846.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.81
|
| Rate for Payer: BCBS Complete |
$1,477.42
|
| Rate for Payer: Cash Price |
$2,954.84
|
| Rate for Payer: Cofinity Commercial |
$2,585.48
|
| Rate for Payer: Cofinity Commercial |
$3,176.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,585.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.84
|
| Rate for Payer: Healthscope Commercial |
$3,324.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.52
|
| Rate for Payer: PHP Commercial |
$3,139.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,400.81
|
| Rate for Payer: Priority Health SBD |
$2,326.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,366.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.16
|
|
|
HC TRANSSEP INTRO AGILIS
|
Facility
|
IP
|
$3,693.55
|
|
|
Service Code
|
HCPCS C1766
|
| Hospital Charge Code |
27200075
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,625.16 |
| Max. Negotiated Rate |
$3,324.20 |
| Rate for Payer: Aetna American Axle |
$2,400.81
|
| Rate for Payer: Aetna Commercial |
$3,139.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,400.81
|
| Rate for Payer: Cash Price |
$2,954.84
|
| Rate for Payer: Cofinity Commercial |
$2,585.48
|
| Rate for Payer: Cofinity Commercial |
$3,176.45
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,585.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,954.84
|
| Rate for Payer: Healthscope Commercial |
$3,324.20
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,585.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.52
|
| Rate for Payer: PHP Commercial |
$3,139.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,400.81
|
| Rate for Payer: Priority Health SBD |
$2,326.94
|
| Rate for Payer: UMR Bronson Commercial |
$1,625.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.16
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
IP
|
$4,922.93
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,166.09 |
| Max. Negotiated Rate |
$4,430.64 |
| Rate for Payer: Aetna American Axle |
$3,199.90
|
| Rate for Payer: Aetna Commercial |
$4,184.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,199.90
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cofinity Commercial |
$3,446.05
|
| Rate for Payer: Cofinity Commercial |
$4,233.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,446.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.34
|
| Rate for Payer: Healthscope Commercial |
$4,430.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,446.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,692.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.49
|
| Rate for Payer: PHP Commercial |
$4,184.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.90
|
| Rate for Payer: Priority Health SBD |
$3,101.45
|
| Rate for Payer: UMR Bronson Commercial |
$2,166.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,692.20
|
|
|
HC TRANSSEP PUNCTURE FOR PVI
|
Facility
|
OP
|
$4,922.93
|
|
|
Service Code
|
CPT 93462
|
| Hospital Charge Code |
48100021
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$198.93 |
| Max. Negotiated Rate |
$4,430.64 |
| Rate for Payer: Aetna American Axle |
$3,199.90
|
| Rate for Payer: Aetna Commercial |
$4,184.49
|
| Rate for Payer: Aetna Medicare |
$2,461.46
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,199.90
|
| Rate for Payer: BCBS Complete |
$1,969.17
|
| Rate for Payer: BCBS Trust/PPO |
$208.59
|
| Rate for Payer: BCN Commercial |
$208.59
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cash Price |
$3,938.34
|
| Rate for Payer: Cofinity Commercial |
$4,233.72
|
| Rate for Payer: Cofinity Commercial |
$3,446.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,446.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,938.34
|
| Rate for Payer: Healthscope Commercial |
$4,430.64
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,446.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,692.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,184.49
|
| Rate for Payer: PHP Commercial |
$4,184.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,199.90
|
| Rate for Payer: Priority Health SBD |
$3,101.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.82
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$198.93
|
| Rate for Payer: UMR Bronson Commercial |
$1,821.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,692.20
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
IP
|
$904.39
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$397.93 |
| Max. Negotiated Rate |
$813.95 |
| Rate for Payer: Aetna American Axle |
$587.85
|
| Rate for Payer: Aetna Commercial |
$768.73
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.85
|
| Rate for Payer: Cash Price |
$723.51
|
| Rate for Payer: Cofinity Commercial |
$633.07
|
| Rate for Payer: Cofinity Commercial |
$777.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$633.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.51
|
| Rate for Payer: Healthscope Commercial |
$813.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$633.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.73
|
| Rate for Payer: PHP Commercial |
$768.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.85
|
| Rate for Payer: Priority Health SBD |
$569.77
|
| Rate for Payer: UMR Bronson Commercial |
$397.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.29
|
|
|
HC TRANSSEPTAL INTRODUCER
|
Facility
|
OP
|
$904.39
|
|
| Hospital Charge Code |
27200154
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$334.62 |
| Max. Negotiated Rate |
$813.95 |
| Rate for Payer: Aetna American Axle |
$587.85
|
| Rate for Payer: Aetna Commercial |
$768.73
|
| Rate for Payer: Aetna Medicare |
$452.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$587.85
|
| Rate for Payer: BCBS Complete |
$361.76
|
| Rate for Payer: Cash Price |
$723.51
|
| Rate for Payer: Cofinity Commercial |
$633.07
|
| Rate for Payer: Cofinity Commercial |
$777.78
|
| Rate for Payer: Cofinity Medicare Advantage |
$633.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$723.51
|
| Rate for Payer: Healthscope Commercial |
$813.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$633.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$678.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$768.73
|
| Rate for Payer: PHP Commercial |
$768.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$587.85
|
| Rate for Payer: Priority Health SBD |
$569.77
|
| Rate for Payer: UMR Bronson Commercial |
$334.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$678.29
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
OP
|
$1,606.50
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$66.33 |
| Max. Negotiated Rate |
$1,457.26 |
| Rate for Payer: Aetna American Axle |
$1,044.22
|
| Rate for Payer: Aetna Commercial |
$1,365.52
|
| Rate for Payer: Aetna Medicare |
$803.25
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.22
|
| Rate for Payer: BCBS Complete |
$642.60
|
| Rate for Payer: BCBS Trust/PPO |
$1,457.26
|
| Rate for Payer: BCN Commercial |
$1,457.26
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cofinity Commercial |
$1,381.59
|
| Rate for Payer: Cofinity Commercial |
$1,124.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,124.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.20
|
| Rate for Payer: Healthscope Commercial |
$1,445.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,124.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.52
|
| Rate for Payer: PHP Commercial |
$1,365.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.22
|
| Rate for Payer: Priority Health SBD |
$1,012.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$72.96
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$66.33
|
| Rate for Payer: UMR Bronson Commercial |
$594.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.88
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) BIL
|
Facility
|
IP
|
$1,606.50
|
|
|
Service Code
|
CPT 64488
|
| Hospital Charge Code |
36100576
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$706.86 |
| Max. Negotiated Rate |
$1,445.85 |
| Rate for Payer: Aetna American Axle |
$1,044.22
|
| Rate for Payer: Aetna Commercial |
$1,365.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,044.22
|
| Rate for Payer: Cash Price |
$1,285.20
|
| Rate for Payer: Cofinity Commercial |
$1,124.55
|
| Rate for Payer: Cofinity Commercial |
$1,381.59
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,124.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,285.20
|
| Rate for Payer: Healthscope Commercial |
$1,445.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,124.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,204.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,365.52
|
| Rate for Payer: PHP Commercial |
$1,365.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,044.22
|
| Rate for Payer: Priority Health SBD |
$1,012.10
|
| Rate for Payer: UMR Bronson Commercial |
$706.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,204.88
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
OP
|
$1,194.38
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$53.27 |
| Max. Negotiated Rate |
$1,074.94 |
| Rate for Payer: Aetna American Axle |
$776.35
|
| Rate for Payer: Aetna Commercial |
$1,015.22
|
| Rate for Payer: Aetna Medicare |
$597.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.35
|
| Rate for Payer: BCBS Complete |
$477.75
|
| Rate for Payer: BCBS Trust/PPO |
$435.91
|
| Rate for Payer: BCN Commercial |
$435.91
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cofinity Commercial |
$836.07
|
| Rate for Payer: Cofinity Commercial |
$1,027.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$836.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$955.50
|
| Rate for Payer: Healthscope Commercial |
$1,074.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$836.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$895.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.22
|
| Rate for Payer: PHP Commercial |
$1,015.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.35
|
| Rate for Payer: Priority Health SBD |
$752.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.60
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$53.27
|
| Rate for Payer: UMR Bronson Commercial |
$441.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$895.78
|
|
|
HC TRANSVERSUS ABDOMINIS PLANE (TAP) UNI
|
Facility
|
IP
|
$1,194.38
|
|
|
Service Code
|
CPT 64486
|
| Hospital Charge Code |
36100575
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$525.53 |
| Max. Negotiated Rate |
$1,074.94 |
| Rate for Payer: Aetna American Axle |
$776.35
|
| Rate for Payer: Aetna Commercial |
$1,015.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$776.35
|
| Rate for Payer: Cash Price |
$955.50
|
| Rate for Payer: Cofinity Commercial |
$1,027.17
|
| Rate for Payer: Cofinity Commercial |
$836.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$836.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$955.50
|
| Rate for Payer: Healthscope Commercial |
$1,074.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$836.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$895.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,015.22
|
| Rate for Payer: PHP Commercial |
$1,015.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$776.35
|
| Rate for Payer: Priority Health SBD |
$752.46
|
| Rate for Payer: UMR Bronson Commercial |
$525.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$895.78
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
OP
|
$4,903.14
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$365.99 |
| Max. Negotiated Rate |
$10,620.87 |
| Rate for Payer: Aetna American Axle |
$3,187.04
|
| Rate for Payer: Aetna Commercial |
$4,167.67
|
| Rate for Payer: Aetna Medicare |
$3,514.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,187.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,224.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,224.04
|
| Rate for Payer: BCBS Complete |
$1,901.83
|
| Rate for Payer: BCBS MAPPO |
$3,379.23
|
| Rate for Payer: BCBS Trust/PPO |
$1,359.45
|
| Rate for Payer: BCN Commercial |
$1,359.45
|
| Rate for Payer: BCN Medicare Advantage |
$3,379.23
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cofinity Commercial |
$4,216.70
|
| Rate for Payer: Cofinity Commercial |
$3,432.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,432.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,922.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,379.23
|
| Rate for Payer: Healthscope Commercial |
$4,412.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,432.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,677.36
|
| Rate for Payer: Mclaren Medicaid |
$1,811.27
|
| Rate for Payer: Mclaren Medicare |
$3,379.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,548.19
|
| Rate for Payer: Meridian Medicaid |
$1,901.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,886.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,167.67
|
| Rate for Payer: Nomi Health Commercial |
$7,096.38
|
| Rate for Payer: PACE Medicare |
$3,210.27
|
| Rate for Payer: PACE SWMI |
$3,379.23
|
| Rate for Payer: PHP Commercial |
$4,167.67
|
| Rate for Payer: PHP Medicare Advantage |
$3,379.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,811.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.04
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,620.87
|
| Rate for Payer: Priority Health Medicare |
$3,379.23
|
| Rate for Payer: Priority Health Narrow Network |
$8,496.70
|
| Rate for Payer: Priority Health SBD |
$3,088.98
|
| Rate for Payer: Railroad Medicare Medicare |
$3,379.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.59
|
| Rate for Payer: UHC Core |
$3,604.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,379.23
|
| Rate for Payer: UHC Exchange |
$365.99
|
| Rate for Payer: UHC Medicare Advantage |
$3,379.23
|
| Rate for Payer: UHCCP Medicaid |
$1,811.27
|
| Rate for Payer: UMR Bronson Commercial |
$1,814.16
|
| Rate for Payer: VA VA |
$3,379.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,677.36
|
|
|
HC TRANURETH DESTR PROST TISS RF WVT
|
Facility
|
IP
|
$4,903.14
|
|
|
Service Code
|
CPT 53854
|
| Hospital Charge Code |
76100306
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,157.38 |
| Max. Negotiated Rate |
$4,412.83 |
| Rate for Payer: Aetna American Axle |
$3,187.04
|
| Rate for Payer: Aetna Commercial |
$4,167.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,187.04
|
| Rate for Payer: Cash Price |
$3,922.51
|
| Rate for Payer: Cofinity Commercial |
$3,432.20
|
| Rate for Payer: Cofinity Commercial |
$4,216.70
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,432.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,922.51
|
| Rate for Payer: Healthscope Commercial |
$4,412.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,432.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,677.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,167.67
|
| Rate for Payer: PHP Commercial |
$4,167.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,187.04
|
| Rate for Payer: Priority Health SBD |
$3,088.98
|
| Rate for Payer: UMR Bronson Commercial |
$2,157.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,677.36
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
IP
|
$4,243.31
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,867.06 |
| Max. Negotiated Rate |
$3,818.98 |
| Rate for Payer: Aetna American Axle |
$2,758.15
|
| Rate for Payer: Aetna Commercial |
$3,606.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,758.15
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cofinity Commercial |
$2,970.32
|
| Rate for Payer: Cofinity Commercial |
$3,649.25
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,970.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,394.65
|
| Rate for Payer: Healthscope Commercial |
$3,818.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,970.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,182.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,606.81
|
| Rate for Payer: PHP Commercial |
$3,606.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,758.15
|
| Rate for Payer: Priority Health SBD |
$2,673.29
|
| Rate for Payer: UMR Bronson Commercial |
$1,867.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,182.48
|
|
|
HC TREAT FINGER FRACTURE WITH MANIP EA
|
Facility
|
OP
|
$4,243.31
|
|
|
Service Code
|
CPT 26742
|
| Hospital Charge Code |
76100386
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$329.74 |
| Max. Negotiated Rate |
$4,928.37 |
| Rate for Payer: Aetna American Axle |
$2,758.15
|
| Rate for Payer: Aetna Commercial |
$3,606.81
|
| Rate for Payer: Aetna Medicare |
$1,630.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,758.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,960.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,960.06
|
| Rate for Payer: BCBS Complete |
$882.50
|
| Rate for Payer: BCBS MAPPO |
$1,568.05
|
| Rate for Payer: BCBS Trust/PPO |
$988.70
|
| Rate for Payer: BCN Commercial |
$988.70
|
| Rate for Payer: BCN Medicare Advantage |
$1,568.05
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cash Price |
$3,394.65
|
| Rate for Payer: Cofinity Commercial |
$3,649.25
|
| Rate for Payer: Cofinity Commercial |
$2,970.32
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,970.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,394.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,568.05
|
| Rate for Payer: Healthscope Commercial |
$3,818.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,970.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,182.48
|
| Rate for Payer: Mclaren Medicaid |
$840.47
|
| Rate for Payer: Mclaren Medicare |
$1,568.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,646.45
|
| Rate for Payer: Meridian Medicaid |
$882.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,803.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,606.81
|
| Rate for Payer: Nomi Health Commercial |
$3,292.90
|
| Rate for Payer: PACE Medicare |
$1,489.65
|
| Rate for Payer: PACE SWMI |
$1,568.05
|
| Rate for Payer: PHP Commercial |
$3,606.81
|
| Rate for Payer: PHP Medicare Advantage |
$1,568.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$840.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,758.15
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$4,928.37
|
| Rate for Payer: Priority Health Medicare |
$1,568.05
|
| Rate for Payer: Priority Health Narrow Network |
$3,942.70
|
| Rate for Payer: Priority Health SBD |
$2,673.29
|
| Rate for Payer: Railroad Medicare Medicare |
$1,568.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.71
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,568.05
|
| Rate for Payer: UHC Exchange |
$329.74
|
| Rate for Payer: UHC Medicare Advantage |
$1,568.05
|
| Rate for Payer: UHCCP Medicaid |
$840.47
|
| Rate for Payer: UMR Bronson Commercial |
$1,570.02
|
| Rate for Payer: VA VA |
$1,568.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,182.48
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
IP
|
$25.50
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.22 |
| Max. Negotiated Rate |
$22.95 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: UMR Bronson Commercial |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC TREPONEMA PALLIDUM AB TOTAL AND RPR
|
Facility
|
OP
|
$25.50
|
|
|
Service Code
|
CPT 0064U
|
| Hospital Charge Code |
30200436
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.44 |
| Max. Negotiated Rate |
$47.00 |
| Rate for Payer: Aetna American Axle |
$16.58
|
| Rate for Payer: Aetna Commercial |
$21.68
|
| Rate for Payer: Aetna Medicare |
$32.58
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$16.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.16
|
| Rate for Payer: BCBS Complete |
$17.63
|
| Rate for Payer: BCBS MAPPO |
$31.33
|
| Rate for Payer: BCBS Trust/PPO |
$30.19
|
| Rate for Payer: BCN Commercial |
$30.19
|
| Rate for Payer: BCN Medicare Advantage |
$31.33
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cash Price |
$20.40
|
| Rate for Payer: Cofinity Commercial |
$21.93
|
| Rate for Payer: Cofinity Commercial |
$17.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.33
|
| Rate for Payer: Healthscope Commercial |
$22.95
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.12
|
| Rate for Payer: Mclaren Medicaid |
$16.79
|
| Rate for Payer: Mclaren Medicare |
$31.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.90
|
| Rate for Payer: Meridian Medicaid |
$17.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.68
|
| Rate for Payer: Nomi Health Commercial |
$47.00
|
| Rate for Payer: PACE Medicare |
$29.76
|
| Rate for Payer: PACE SWMI |
$31.33
|
| Rate for Payer: PHP Commercial |
$21.68
|
| Rate for Payer: PHP Medicare Advantage |
$31.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.58
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.33
|
| Rate for Payer: Priority Health Medicare |
$31.33
|
| Rate for Payer: Priority Health Narrow Network |
$25.06
|
| Rate for Payer: Priority Health SBD |
$16.06
|
| Rate for Payer: Railroad Medicare Medicare |
$31.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.33
|
| Rate for Payer: UHC Exchange |
$31.33
|
| Rate for Payer: UHC Medicare Advantage |
$31.33
|
| Rate for Payer: UHCCP Medicaid |
$16.79
|
| Rate for Payer: UMR Bronson Commercial |
$9.44
|
| Rate for Payer: VA VA |
$31.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.12
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
OP
|
$24.48
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$39.72 |
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: UMR Bronson Commercial |
$9.06
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Aetna American Axle |
$15.91
|
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.76
|
| Rate for Payer: BCN Commercial |
$12.76
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: Nomi Health Commercial |
$39.72
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.24
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$10.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY
|
Facility
|
IP
|
$24.48
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30000057
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.77 |
| Max. Negotiated Rate |
$22.03 |
| Rate for Payer: Aetna American Axle |
$15.91
|
| Rate for Payer: Aetna Commercial |
$20.81
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$15.91
|
| Rate for Payer: Cash Price |
$19.58
|
| Rate for Payer: Cofinity Commercial |
$17.14
|
| Rate for Payer: Cofinity Commercial |
$21.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$17.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.58
|
| Rate for Payer: Healthscope Commercial |
$22.03
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$17.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$20.81
|
| Rate for Payer: PHP Commercial |
$20.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.91
|
| Rate for Payer: Priority Health SBD |
$15.42
|
| Rate for Payer: UMR Bronson Commercial |
$10.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.36
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
IP
|
$70.38
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.97 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna American Axle |
$45.75
|
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.75
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$49.27
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health SBD |
$44.34
|
| Rate for Payer: UMR Bronson Commercial |
$30.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC TREPONEMA PALLIDUM ANTIBODY FT
|
Facility
|
OP
|
$70.38
|
|
|
Service Code
|
CPT 86780
|
| Hospital Charge Code |
30200325
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$63.34 |
| Rate for Payer: Aetna American Axle |
$45.75
|
| Rate for Payer: Aetna Commercial |
$59.82
|
| Rate for Payer: Aetna Medicare |
$13.77
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.55
|
| Rate for Payer: BCBS Complete |
$7.45
|
| Rate for Payer: BCBS MAPPO |
$13.24
|
| Rate for Payer: BCBS Trust/PPO |
$12.76
|
| Rate for Payer: BCN Commercial |
$12.76
|
| Rate for Payer: BCN Medicare Advantage |
$13.24
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cash Price |
$56.30
|
| Rate for Payer: Cofinity Commercial |
$60.53
|
| Rate for Payer: Cofinity Commercial |
$49.27
|
| Rate for Payer: Cofinity Medicare Advantage |
$49.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.24
|
| Rate for Payer: Healthscope Commercial |
$63.34
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$49.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.78
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.90
|
| Rate for Payer: Meridian Medicaid |
$7.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.82
|
| Rate for Payer: Nomi Health Commercial |
$39.72
|
| Rate for Payer: PACE Medicare |
$12.58
|
| Rate for Payer: PACE SWMI |
$13.24
|
| Rate for Payer: PHP Commercial |
$59.82
|
| Rate for Payer: PHP Medicare Advantage |
$13.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$13.24
|
| Rate for Payer: Priority Health Medicare |
$13.24
|
| Rate for Payer: Priority Health Narrow Network |
$10.59
|
| Rate for Payer: Priority Health SBD |
$44.34
|
| Rate for Payer: Railroad Medicare Medicare |
$13.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.24
|
| Rate for Payer: UHC Exchange |
$13.24
|
| Rate for Payer: UHC Medicare Advantage |
$13.24
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: UMR Bronson Commercial |
$26.04
|
| Rate for Payer: VA VA |
$13.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.78
|
|
|
HC TRIAD CREAM
|
Facility
|
OP
|
$27.70
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.25 |
| Max. Negotiated Rate |
$24.93 |
| Rate for Payer: Aetna American Axle |
$18.00
|
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.00
|
| Rate for Payer: BCBS Complete |
$11.08
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$19.39
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.54
|
| Rate for Payer: PHP Commercial |
$23.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.00
|
| Rate for Payer: Priority Health SBD |
$17.45
|
| Rate for Payer: UMR Bronson Commercial |
$10.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.78
|
|
|
HC TRIAD CREAM
|
Facility
|
IP
|
$27.70
|
|
| Hospital Charge Code |
27000605
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$12.19 |
| Max. Negotiated Rate |
$24.93 |
| Rate for Payer: Aetna American Axle |
$18.00
|
| Rate for Payer: Aetna Commercial |
$23.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$18.00
|
| Rate for Payer: Cash Price |
$22.16
|
| Rate for Payer: Cofinity Commercial |
$19.39
|
| Rate for Payer: Cofinity Commercial |
$23.82
|
| Rate for Payer: Cofinity Medicare Advantage |
$19.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.16
|
| Rate for Payer: Healthscope Commercial |
$24.93
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$19.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.54
|
| Rate for Payer: PHP Commercial |
$23.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.00
|
| Rate for Payer: Priority Health SBD |
$17.45
|
| Rate for Payer: UMR Bronson Commercial |
$12.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.78
|
|
|
HC TRICHOMONAS VAGINALIS AMPLIFIED DNA PROBE
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
HCPCS 87798
|
| Hospital Charge Code |
30600206
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$18.81 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna Medicare |
$36.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.86
|
| Rate for Payer: BCBS Complete |
$19.75
|
| Rate for Payer: BCBS MAPPO |
$35.09
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$35.09
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$60.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$47.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.72
|
| Rate for Payer: Mclaren Medicaid |
$18.81
|
| Rate for Payer: Mclaren Medicare |
$35.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.84
|
| Rate for Payer: Meridian Medicaid |
$19.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$52.64
|
| Rate for Payer: PACE Medicare |
$33.34
|
| Rate for Payer: PACE SWMI |
$35.09
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$35.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health Medicare |
$35.09
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$35.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.09
|
| Rate for Payer: UHC Exchange |
$35.09
|
| Rate for Payer: UHC Medicare Advantage |
$35.09
|
| Rate for Payer: UHCCP Medicaid |
$18.81
|
| Rate for Payer: UMR Bronson Commercial |
$25.02
|
| Rate for Payer: VA VA |
$35.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
