|
HC VITAMIN A LEVEL
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 84590
|
| Hospital Charge Code |
30100458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna American Axle |
$30.43
|
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$30.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.51
|
| Rate for Payer: BCBS Complete |
$6.53
|
| Rate for Payer: BCBS MAPPO |
$11.61
|
| Rate for Payer: BCBS Trust/PPO |
$11.19
|
| Rate for Payer: BCN Commercial |
$11.19
|
| Rate for Payer: BCN Medicare Advantage |
$11.61
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Cofinity Commercial |
$32.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$32.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.61
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$32.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$6.22
|
| Rate for Payer: Mclaren Medicare |
$11.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.19
|
| Rate for Payer: Meridian Medicaid |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$17.42
|
| Rate for Payer: PACE Medicare |
$11.03
|
| Rate for Payer: PACE SWMI |
$11.61
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$11.94
|
| Rate for Payer: Priority Health Medicare |
$11.61
|
| Rate for Payer: Priority Health Narrow Network |
$9.55
|
| Rate for Payer: Priority Health SBD |
$29.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$13.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.61
|
| Rate for Payer: UHC Exchange |
$11.61
|
| Rate for Payer: UHC Medicare Advantage |
$11.61
|
| Rate for Payer: UHCCP Medicaid |
$6.22
|
| Rate for Payer: UMR Bronson Commercial |
$17.32
|
| Rate for Payer: VA VA |
$11.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC VITAMIN B12 LEVEL
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100185
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$15.68
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.85
|
| Rate for Payer: BCBS Complete |
$8.49
|
| Rate for Payer: BCBS MAPPO |
$15.08
|
| Rate for Payer: BCBS Trust/PPO |
$14.53
|
| Rate for Payer: BCN Commercial |
$14.53
|
| Rate for Payer: BCN Medicare Advantage |
$15.08
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.08
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Mclaren Medicaid |
$8.08
|
| Rate for Payer: Mclaren Medicare |
$15.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.83
|
| Rate for Payer: Meridian Medicaid |
$8.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$22.62
|
| Rate for Payer: PACE Medicare |
$14.33
|
| Rate for Payer: PACE SWMI |
$15.08
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.51
|
| Rate for Payer: Priority Health Medicare |
$15.08
|
| Rate for Payer: Priority Health Narrow Network |
$12.41
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: Railroad Medicare Medicare |
$15.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.10
|
| Rate for Payer: UHC Core |
$28.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.08
|
| Rate for Payer: UHC Exchange |
$15.08
|
| Rate for Payer: UHC Medicare Advantage |
$15.08
|
| Rate for Payer: UHCCP Medicaid |
$8.08
|
| Rate for Payer: UMR Bronson Commercial |
$23.10
|
| Rate for Payer: VA VA |
$15.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC VITAMIN B12 LEVEL
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 82607
|
| Hospital Charge Code |
30100185
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.46 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna American Axle |
$40.57
|
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40.57
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$43.69
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$43.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.57
|
| Rate for Payer: Priority Health SBD |
$39.32
|
| Rate for Payer: UMR Bronson Commercial |
$27.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.82
|
|
|
HC VITAMIN B3 AND METABOLITES, P
|
Facility
|
IP
|
$188.45
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100754
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$82.92 |
| Max. Negotiated Rate |
$169.60 |
| Rate for Payer: Aetna American Axle |
$122.49
|
| Rate for Payer: Aetna Commercial |
$160.18
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.49
|
| Rate for Payer: Cash Price |
$150.76
|
| Rate for Payer: Cofinity Commercial |
$131.92
|
| Rate for Payer: Cofinity Commercial |
$162.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.76
|
| Rate for Payer: Healthscope Commercial |
$169.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.18
|
| Rate for Payer: PHP Commercial |
$160.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.49
|
| Rate for Payer: Priority Health SBD |
$118.72
|
| Rate for Payer: UMR Bronson Commercial |
$82.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.34
|
|
|
HC VITAMIN B3 AND METABOLITES, P
|
Facility
|
OP
|
$188.45
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100754
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.14 |
| Max. Negotiated Rate |
$169.60 |
| Rate for Payer: Aetna American Axle |
$122.49
|
| Rate for Payer: Aetna Commercial |
$160.18
|
| Rate for Payer: Aetna Medicare |
$17.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$122.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.32
|
| Rate for Payer: BCBS Complete |
$9.60
|
| Rate for Payer: BCBS MAPPO |
$17.06
|
| Rate for Payer: BCBS Trust/PPO |
$16.44
|
| Rate for Payer: BCN Commercial |
$16.44
|
| Rate for Payer: BCN Medicare Advantage |
$17.06
|
| Rate for Payer: Cash Price |
$150.76
|
| Rate for Payer: Cash Price |
$150.76
|
| Rate for Payer: Cofinity Commercial |
$162.07
|
| Rate for Payer: Cofinity Commercial |
$131.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.06
|
| Rate for Payer: Healthscope Commercial |
$169.60
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$141.34
|
| Rate for Payer: Mclaren Medicaid |
$9.14
|
| Rate for Payer: Mclaren Medicare |
$17.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.91
|
| Rate for Payer: Meridian Medicaid |
$9.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$160.18
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Medicare |
$16.21
|
| Rate for Payer: PACE SWMI |
$17.06
|
| Rate for Payer: PHP Commercial |
$160.18
|
| Rate for Payer: PHP Medicare Advantage |
$17.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$122.49
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.06
|
| Rate for Payer: Priority Health Medicare |
$17.06
|
| Rate for Payer: Priority Health Narrow Network |
$13.65
|
| Rate for Payer: Priority Health SBD |
$118.72
|
| Rate for Payer: Railroad Medicare Medicare |
$17.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.06
|
| Rate for Payer: UHC Exchange |
$17.06
|
| Rate for Payer: UHC Medicare Advantage |
$17.06
|
| Rate for Payer: UHCCP Medicaid |
$9.14
|
| Rate for Payer: UMR Bronson Commercial |
$69.73
|
| Rate for Payer: VA VA |
$17.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$141.34
|
|
|
HC VITAMIN B6 LEVEL
|
Facility
|
OP
|
$57.22
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
30100413
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.06 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna Medicare |
$29.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.12
|
| Rate for Payer: BCBS Complete |
$15.81
|
| Rate for Payer: BCBS MAPPO |
$28.10
|
| Rate for Payer: BCBS Trust/PPO |
$27.08
|
| Rate for Payer: BCN Commercial |
$27.08
|
| Rate for Payer: BCN Medicare Advantage |
$28.10
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.10
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.92
|
| Rate for Payer: Mclaren Medicaid |
$15.06
|
| Rate for Payer: Mclaren Medicare |
$28.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.50
|
| Rate for Payer: Meridian Medicaid |
$15.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: Nomi Health Commercial |
$42.15
|
| Rate for Payer: PACE Medicare |
$26.70
|
| Rate for Payer: PACE SWMI |
$28.10
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: PHP Medicare Advantage |
$28.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$28.91
|
| Rate for Payer: Priority Health Medicare |
$28.10
|
| Rate for Payer: Priority Health Narrow Network |
$23.13
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: Railroad Medicare Medicare |
$28.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.10
|
| Rate for Payer: UHC Exchange |
$28.10
|
| Rate for Payer: UHC Medicare Advantage |
$28.10
|
| Rate for Payer: UHCCP Medicaid |
$15.06
|
| Rate for Payer: UMR Bronson Commercial |
$21.17
|
| Rate for Payer: VA VA |
$28.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.92
|
|
|
HC VITAMIN B6 LEVEL
|
Facility
|
IP
|
$57.22
|
|
|
Service Code
|
CPT 84207
|
| Hospital Charge Code |
30100413
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.18 |
| Max. Negotiated Rate |
$51.50 |
| Rate for Payer: Aetna American Axle |
$37.19
|
| Rate for Payer: Aetna Commercial |
$48.64
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$37.19
|
| Rate for Payer: Cash Price |
$45.78
|
| Rate for Payer: Cofinity Commercial |
$40.05
|
| Rate for Payer: Cofinity Commercial |
$49.21
|
| Rate for Payer: Cofinity Medicare Advantage |
$40.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.78
|
| Rate for Payer: Healthscope Commercial |
$51.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$40.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.64
|
| Rate for Payer: PHP Commercial |
$48.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.19
|
| Rate for Payer: Priority Health SBD |
$36.05
|
| Rate for Payer: UMR Bronson Commercial |
$25.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.92
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$1,096.80 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$10.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.36
|
| Rate for Payer: BCBS Complete |
$5.57
|
| Rate for Payer: BCBS MAPPO |
$9.89
|
| Rate for Payer: BCBS Trust/PPO |
$9.53
|
| Rate for Payer: BCN Commercial |
$9.53
|
| Rate for Payer: BCN Medicare Advantage |
$9.89
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.89
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$5.30
|
| Rate for Payer: Mclaren Medicare |
$9.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.38
|
| Rate for Payer: Meridian Medicaid |
$5.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$14.84
|
| Rate for Payer: PACE Medicare |
$9.40
|
| Rate for Payer: PACE SWMI |
$9.89
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$9.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10.17
|
| Rate for Payer: Priority Health Medicare |
$9.89
|
| Rate for Payer: Priority Health Narrow Network |
$8.14
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: Railroad Medicare Medicare |
$9.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11.87
|
| Rate for Payer: UHC Core |
$1,096.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.89
|
| Rate for Payer: UHC Exchange |
$9.89
|
| Rate for Payer: UHC Medicare Advantage |
$9.89
|
| Rate for Payer: UHCCP Medicaid |
$5.30
|
| Rate for Payer: UMR Bronson Commercial |
$24.53
|
| Rate for Payer: VA VA |
$9.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC VITAMIN C LEVEL
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 82180
|
| Hospital Charge Code |
30100112
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.17 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna American Axle |
$43.10
|
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.10
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$46.41
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Cofinity Medicare Advantage |
$46.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$46.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health SBD |
$41.77
|
| Rate for Payer: UMR Bronson Commercial |
$29.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC VITAMIN D
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC VITAMIN D
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100481
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.87 |
| Max. Negotiated Rate |
$211.43 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$30.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.00
|
| Rate for Payer: BCBS Complete |
$16.66
|
| Rate for Payer: BCBS MAPPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$28.52
|
| Rate for Payer: BCN Commercial |
$28.52
|
| Rate for Payer: BCN Medicare Advantage |
$29.60
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$15.87
|
| Rate for Payer: Mclaren Medicare |
$29.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.08
|
| Rate for Payer: Meridian Medicaid |
$16.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$44.40
|
| Rate for Payer: PACE Medicare |
$28.12
|
| Rate for Payer: PACE SWMI |
$29.60
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$29.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.46
|
| Rate for Payer: Priority Health Medicare |
$29.60
|
| Rate for Payer: Priority Health Narrow Network |
$24.37
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Railroad Medicare Medicare |
$29.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Core |
$211.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.60
|
| Rate for Payer: UHC Exchange |
$29.60
|
| Rate for Payer: UHC Medicare Advantage |
$29.60
|
| Rate for Payer: UHCCP Medicaid |
$15.87
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$29.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.64 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Mclaren Medicare |
$38.50
|
| Rate for Payer: Aetna American Axle |
$60.87
|
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$40.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$60.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.12
|
| Rate for Payer: BCBS Complete |
$21.67
|
| Rate for Payer: BCBS MAPPO |
$38.50
|
| Rate for Payer: BCBS Trust/PPO |
$37.10
|
| Rate for Payer: BCN Commercial |
$37.10
|
| Rate for Payer: BCN Medicare Advantage |
$38.50
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Cofinity Commercial |
$65.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.50
|
| 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 |
$20.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.42
|
| Rate for Payer: Meridian Medicaid |
$21.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$57.75
|
| Rate for Payer: PACE Medicare |
$36.58
|
| Rate for Payer: PACE SWMI |
$38.50
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$38.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.61
|
| Rate for Payer: Priority Health Medicare |
$38.50
|
| Rate for Payer: Priority Health Narrow Network |
$31.69
|
| Rate for Payer: Priority Health SBD |
$58.99
|
| Rate for Payer: Railroad Medicare Medicare |
$38.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.50
|
| Rate for Payer: UHC Exchange |
$38.50
|
| Rate for Payer: UHC Medicare Advantage |
$38.50
|
| Rate for Payer: UHCCP Medicaid |
$20.64
|
| Rate for Payer: UMR Bronson Commercial |
$34.65
|
| Rate for Payer: VA VA |
$38.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC VITAMIN D 1-25 DIHYDROXY
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 82652
|
| Hospital Charge Code |
30100190
|
|
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 Commercial |
$65.55
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Cofinity Medicare Advantage |
$65.55
|
| 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: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.87
|
| 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 VITAMIN D LEVEL
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.87 |
| Max. Negotiated Rate |
$211.43 |
| Rate for Payer: UHC Dual Complete DSNP |
$29.60
|
| Rate for Payer: UHC Exchange |
$29.60
|
| Rate for Payer: UHC Medicare Advantage |
$29.60
|
| Rate for Payer: UHCCP Medicaid |
$15.87
|
| Rate for Payer: UMR Bronson Commercial |
$28.87
|
| Rate for Payer: VA VA |
$29.60
|
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$30.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.00
|
| Rate for Payer: BCBS Complete |
$16.66
|
| Rate for Payer: BCBS MAPPO |
$29.60
|
| Rate for Payer: BCBS Trust/PPO |
$28.52
|
| Rate for Payer: BCN Commercial |
$28.52
|
| Rate for Payer: BCN Medicare Advantage |
$29.60
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.60
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$15.87
|
| Rate for Payer: Mclaren Medicare |
$29.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.08
|
| Rate for Payer: Meridian Medicaid |
$16.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$44.40
|
| Rate for Payer: PACE Medicare |
$28.12
|
| Rate for Payer: PACE SWMI |
$29.60
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$29.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.87
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.46
|
| Rate for Payer: Priority Health Medicare |
$29.60
|
| Rate for Payer: Priority Health Narrow Network |
$24.37
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: Railroad Medicare Medicare |
$29.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.52
|
| Rate for Payer: UHC Core |
$211.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC VITAMIN D LEVEL
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82306
|
| Hospital Charge Code |
30100126
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.33 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna American Axle |
$50.72
|
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$50.72
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$54.62
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$54.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$54.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.72
|
| Rate for Payer: Priority Health SBD |
$49.16
|
| Rate for Payer: UMR Bronson Commercial |
$34.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$14.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.72
|
| Rate for Payer: BCBS Complete |
$7.98
|
| Rate for Payer: BCBS MAPPO |
$14.18
|
| Rate for Payer: BCBS Trust/PPO |
$13.67
|
| Rate for Payer: BCN Commercial |
$13.67
|
| Rate for Payer: BCN Medicare Advantage |
$14.18
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.18
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$7.60
|
| Rate for Payer: Mclaren Medicare |
$14.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.89
|
| Rate for Payer: Meridian Medicaid |
$7.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$21.27
|
| Rate for Payer: PACE Medicare |
$13.47
|
| Rate for Payer: PACE SWMI |
$14.18
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$14.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.59
|
| Rate for Payer: Priority Health Medicare |
$14.18
|
| Rate for Payer: Priority Health Narrow Network |
$11.67
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: Railroad Medicare Medicare |
$14.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.18
|
| Rate for Payer: UHC Exchange |
$14.18
|
| Rate for Payer: UHC Medicare Advantage |
$14.18
|
| Rate for Payer: UHCCP Medicaid |
$7.60
|
| Rate for Payer: UMR Bronson Commercial |
$19.25
|
| Rate for Payer: VA VA |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC VITAMIN E LEVEL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 84446
|
| Hospital Charge Code |
30100440
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.89 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna American Axle |
$33.81
|
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.81
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$36.41
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Cofinity Medicare Advantage |
$36.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$36.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health SBD |
$32.77
|
| Rate for Payer: UMR Bronson Commercial |
$22.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
IP
|
$122.40
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.86 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna American Axle |
$79.56
|
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.56
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Cofinity Commercial |
$85.68
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.04
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.56
|
| Rate for Payer: Priority Health SBD |
$77.11
|
| Rate for Payer: UMR Bronson Commercial |
$53.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC VITAMIN K LEVEL
|
Facility
|
OP
|
$122.40
|
|
|
Service Code
|
CPT 84597
|
| Hospital Charge Code |
30100459
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.35 |
| Max. Negotiated Rate |
$110.16 |
| Rate for Payer: Aetna American Axle |
$79.56
|
| Rate for Payer: Aetna Commercial |
$104.04
|
| Rate for Payer: Aetna Medicare |
$14.27
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$79.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.15
|
| Rate for Payer: BCBS Complete |
$7.72
|
| Rate for Payer: BCBS MAPPO |
$13.72
|
| Rate for Payer: BCN Medicare Advantage |
$13.72
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cash Price |
$97.92
|
| Rate for Payer: Cofinity Commercial |
$85.68
|
| Rate for Payer: Cofinity Commercial |
$105.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$85.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.72
|
| Rate for Payer: Healthscope Commercial |
$110.16
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$85.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.80
|
| Rate for Payer: Mclaren Medicaid |
$7.35
|
| Rate for Payer: Mclaren Medicare |
$13.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.41
|
| Rate for Payer: Meridian Medicaid |
$7.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$104.04
|
| Rate for Payer: Nomi Health Commercial |
$20.58
|
| Rate for Payer: PACE Medicare |
$13.03
|
| Rate for Payer: PACE SWMI |
$13.72
|
| Rate for Payer: PHP Commercial |
$104.04
|
| Rate for Payer: PHP Medicare Advantage |
$13.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$14.12
|
| Rate for Payer: Priority Health Medicare |
$13.72
|
| Rate for Payer: Priority Health Narrow Network |
$11.30
|
| Rate for Payer: Priority Health SBD |
$77.11
|
| Rate for Payer: Railroad Medicare Medicare |
$13.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.72
|
| Rate for Payer: UHC Exchange |
$13.72
|
| Rate for Payer: UHC Medicare Advantage |
$13.72
|
| Rate for Payer: UHCCP Medicaid |
$7.35
|
| Rate for Payer: UMR Bronson Commercial |
$45.29
|
| Rate for Payer: VA VA |
$13.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.80
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
OP
|
$89.76
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna American Axle |
$58.34
|
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: BCBS Complete |
$8.72
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$14.94
|
| Rate for Payer: BCN Commercial |
$14.94
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Cofinity Commercial |
$62.83
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Mclaren Medicaid |
$8.31
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: Meridian Medicaid |
$8.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: Nomi Health Commercial |
$23.25
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.95
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$12.76
|
| Rate for Payer: Priority Health SBD |
$56.55
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Exchange |
$15.50
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: UMR Bronson Commercial |
$33.21
|
| Rate for Payer: VA VA |
$15.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC VMA AND HVA 4 HOUR RANDOM URINE
|
Facility
|
IP
|
$89.76
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100455
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.49 |
| Max. Negotiated Rate |
$80.78 |
| Rate for Payer: Aetna American Axle |
$58.34
|
| Rate for Payer: Aetna Commercial |
$76.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$58.34
|
| Rate for Payer: Cash Price |
$71.81
|
| Rate for Payer: Cofinity Commercial |
$62.83
|
| Rate for Payer: Cofinity Commercial |
$77.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$62.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$71.81
|
| Rate for Payer: Healthscope Commercial |
$80.78
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$62.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$76.30
|
| Rate for Payer: PHP Commercial |
$76.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$58.34
|
| Rate for Payer: Priority Health SBD |
$56.55
|
| Rate for Payer: UMR Bronson Commercial |
$39.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.32
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
OP
|
$50.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.01 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna Medicare |
$23.31
|
| Rate for Payer: Aetna American Axle |
$33.14
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.01
|
| Rate for Payer: BCBS Complete |
$12.61
|
| Rate for Payer: BCBS MAPPO |
$22.41
|
| Rate for Payer: BCBS Trust/PPO |
$21.59
|
| Rate for Payer: BCN Commercial |
$21.59
|
| Rate for Payer: BCN Medicare Advantage |
$22.41
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Cofinity Commercial |
$35.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.41
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.24
|
| Rate for Payer: Mclaren Medicaid |
$12.01
|
| Rate for Payer: Mclaren Medicare |
$22.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.53
|
| Rate for Payer: Meridian Medicaid |
$12.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: Nomi Health Commercial |
$33.62
|
| Rate for Payer: PACE Medicare |
$21.29
|
| Rate for Payer: PACE SWMI |
$22.41
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: PHP Medicare Advantage |
$22.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.41
|
| Rate for Payer: Priority Health Medicare |
$22.41
|
| Rate for Payer: Priority Health Narrow Network |
$17.93
|
| Rate for Payer: Priority Health SBD |
$32.12
|
| Rate for Payer: Railroad Medicare Medicare |
$22.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.89
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.41
|
| Rate for Payer: UHC Exchange |
$22.41
|
| Rate for Payer: UHC Medicare Advantage |
$22.41
|
| Rate for Payer: UHCCP Medicaid |
$12.01
|
| Rate for Payer: UMR Bronson Commercial |
$18.86
|
| Rate for Payer: VA VA |
$22.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.24
|
|
|
HC VMA AND HVA 4 HR RANDOM URINE CMPT
|
Facility
|
IP
|
$50.98
|
|
|
Service Code
|
CPT 83150
|
| Hospital Charge Code |
30100217
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.43 |
| Max. Negotiated Rate |
$45.88 |
| Rate for Payer: Aetna American Axle |
$33.14
|
| Rate for Payer: Aetna Commercial |
$43.33
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$33.14
|
| Rate for Payer: Cash Price |
$40.78
|
| Rate for Payer: Cofinity Commercial |
$35.69
|
| Rate for Payer: Cofinity Commercial |
$43.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$35.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.78
|
| Rate for Payer: Healthscope Commercial |
$45.88
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$35.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.33
|
| Rate for Payer: PHP Commercial |
$43.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.14
|
| Rate for Payer: Priority Health SBD |
$32.12
|
| Rate for Payer: UMR Bronson Commercial |
$22.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.24
|
|
|
HC VMA RANDOM URINE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: UMR Bronson Commercial |
$21.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
|
HC VMA RANDOM URINE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100454
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.31 |
| Max. Negotiated Rate |
$43.15 |
| Rate for Payer: Aetna American Axle |
$31.16
|
| Rate for Payer: Aetna Commercial |
$40.75
|
| Rate for Payer: Aetna Medicare |
$16.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$31.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.38
|
| Rate for Payer: BCBS Complete |
$8.72
|
| Rate for Payer: BCBS MAPPO |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$14.94
|
| Rate for Payer: BCN Commercial |
$14.94
|
| Rate for Payer: BCN Medicare Advantage |
$15.50
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cash Price |
$38.35
|
| Rate for Payer: Cofinity Commercial |
$41.23
|
| Rate for Payer: Cofinity Commercial |
$33.56
|
| Rate for Payer: Cofinity Medicare Advantage |
$33.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$43.15
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$33.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.96
|
| Rate for Payer: Mclaren Medicaid |
$8.31
|
| Rate for Payer: Mclaren Medicare |
$15.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.28
|
| Rate for Payer: Meridian Medicaid |
$8.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.75
|
| Rate for Payer: Nomi Health Commercial |
$23.25
|
| Rate for Payer: PACE Medicare |
$14.72
|
| Rate for Payer: PACE SWMI |
$15.50
|
| Rate for Payer: PHP Commercial |
$40.75
|
| Rate for Payer: PHP Medicare Advantage |
$15.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.16
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$15.95
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow Network |
$12.76
|
| Rate for Payer: Priority Health SBD |
$30.20
|
| Rate for Payer: Railroad Medicare Medicare |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.50
|
| Rate for Payer: UHC Exchange |
$15.50
|
| Rate for Payer: UHC Medicare Advantage |
$15.50
|
| Rate for Payer: UHCCP Medicaid |
$8.31
|
| Rate for Payer: UMR Bronson Commercial |
$17.74
|
| Rate for Payer: VA VA |
$15.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.96
|
|
