|
HC VMA URINE
|
Facility
|
OP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
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
|
|
|
HC VMA URINE
|
Facility
|
IP
|
$47.94
|
|
|
Service Code
|
CPT 84585
|
| Hospital Charge Code |
30100488
|
|
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 VNUS ABLATION FIRST VEIN
|
Facility
|
IP
|
$5,127.14
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,255.94 |
| Max. Negotiated Rate |
$4,614.43 |
| Rate for Payer: Aetna American Axle |
$3,332.64
|
| Rate for Payer: Aetna Commercial |
$4,358.07
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,332.64
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cofinity Commercial |
$3,589.00
|
| Rate for Payer: Cofinity Commercial |
$4,409.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,589.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,101.71
|
| Rate for Payer: Healthscope Commercial |
$4,614.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,589.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,845.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,358.07
|
| Rate for Payer: PHP Commercial |
$4,358.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,332.64
|
| Rate for Payer: Priority Health SBD |
$3,230.10
|
| Rate for Payer: UMR Bronson Commercial |
$2,255.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,845.36
|
|
|
HC VNUS ABLATION FIRST VEIN
|
Facility
|
OP
|
$5,127.14
|
|
|
Service Code
|
CPT 36475
|
| Hospital Charge Code |
36100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$268.43 |
| Max. Negotiated Rate |
$9,692.51 |
| Rate for Payer: Aetna American Axle |
$3,332.64
|
| Rate for Payer: Aetna Commercial |
$4,358.07
|
| Rate for Payer: Aetna Medicare |
$3,207.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$3,332.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,854.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,854.82
|
| Rate for Payer: BCBS Complete |
$1,735.60
|
| Rate for Payer: BCBS MAPPO |
$3,083.86
|
| Rate for Payer: BCBS Trust/PPO |
$2,741.94
|
| Rate for Payer: BCN Commercial |
$2,741.94
|
| Rate for Payer: BCN Medicare Advantage |
$3,083.86
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cash Price |
$4,101.71
|
| Rate for Payer: Cofinity Commercial |
$4,409.34
|
| Rate for Payer: Cofinity Commercial |
$3,589.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$3,589.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,101.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,083.86
|
| Rate for Payer: Healthscope Commercial |
$4,614.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$3,589.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,845.36
|
| Rate for Payer: Mclaren Medicaid |
$1,652.95
|
| Rate for Payer: Mclaren Medicare |
$3,083.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,238.05
|
| Rate for Payer: Meridian Medicaid |
$1,735.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,546.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,358.07
|
| Rate for Payer: Nomi Health Commercial |
$6,476.11
|
| Rate for Payer: PACE Medicare |
$2,929.67
|
| Rate for Payer: PACE SWMI |
$3,083.86
|
| Rate for Payer: PHP Commercial |
$4,358.07
|
| Rate for Payer: PHP Medicare Advantage |
$3,083.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,652.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,332.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,692.51
|
| Rate for Payer: Priority Health Medicare |
$3,083.86
|
| Rate for Payer: Priority Health Narrow Network |
$7,754.01
|
| Rate for Payer: Priority Health SBD |
$3,230.10
|
| Rate for Payer: Railroad Medicare Medicare |
$3,083.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$295.27
|
| Rate for Payer: UHC Core |
$5,042.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,083.86
|
| Rate for Payer: UHC Exchange |
$268.43
|
| Rate for Payer: UHC Medicare Advantage |
$3,083.86
|
| Rate for Payer: UHCCP Medicaid |
$1,652.95
|
| Rate for Payer: UMR Bronson Commercial |
$1,897.04
|
| Rate for Payer: VA VA |
$3,083.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,845.36
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
OP
|
$2,505.14
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$128.86 |
| Max. Negotiated Rate |
$2,254.63 |
| Rate for Payer: Aetna American Axle |
$1,628.34
|
| Rate for Payer: Aetna Commercial |
$2,129.37
|
| Rate for Payer: Aetna Medicare |
$1,252.57
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.34
|
| Rate for Payer: BCBS Complete |
$1,002.06
|
| Rate for Payer: BCBS Trust/PPO |
$1,060.06
|
| Rate for Payer: BCN Commercial |
$1,060.06
|
| Rate for Payer: Cash Price |
$2,004.11
|
| Rate for Payer: Cash Price |
$2,004.11
|
| Rate for Payer: Cash Price |
$2,004.11
|
| Rate for Payer: Cofinity Commercial |
$2,154.42
|
| Rate for Payer: Cofinity Commercial |
$1,753.60
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,753.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,004.11
|
| Rate for Payer: Healthscope Commercial |
$2,254.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,753.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,878.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,129.37
|
| Rate for Payer: PHP Commercial |
$2,129.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,628.34
|
| Rate for Payer: Priority Health SBD |
$1,578.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.75
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$128.86
|
| Rate for Payer: UMR Bronson Commercial |
$926.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,878.86
|
|
|
HC VNUS ABLATION SUBSEQ VEINS
|
Facility
|
IP
|
$2,505.14
|
|
|
Service Code
|
CPT 36476
|
| Hospital Charge Code |
36100436
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,102.26 |
| Max. Negotiated Rate |
$2,254.63 |
| Rate for Payer: Aetna American Axle |
$1,628.34
|
| Rate for Payer: Aetna Commercial |
$2,129.37
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,628.34
|
| Rate for Payer: Cash Price |
$2,004.11
|
| Rate for Payer: Cofinity Commercial |
$1,753.60
|
| Rate for Payer: Cofinity Commercial |
$2,154.42
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,753.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,004.11
|
| Rate for Payer: Healthscope Commercial |
$2,254.63
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,753.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,878.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,129.37
|
| Rate for Payer: PHP Commercial |
$2,129.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,628.34
|
| Rate for Payer: Priority Health SBD |
$1,578.24
|
| Rate for Payer: UMR Bronson Commercial |
$1,102.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,878.86
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
OP
|
$262.22
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$97.02 |
| Max. Negotiated Rate |
$863.44 |
| Rate for Payer: Aetna American Axle |
$170.44
|
| Rate for Payer: Aetna Commercial |
$222.89
|
| Rate for Payer: Aetna Medicare |
$131.11
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.44
|
| Rate for Payer: BCBS Complete |
$104.89
|
| Rate for Payer: BCBS Trust/PPO |
$863.44
|
| Rate for Payer: BCN Commercial |
$863.44
|
| Rate for Payer: Cash Price |
$209.78
|
| Rate for Payer: Cash Price |
$209.78
|
| Rate for Payer: Cash Price |
$209.78
|
| Rate for Payer: Cofinity Commercial |
$225.51
|
| Rate for Payer: Cofinity Commercial |
$183.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$183.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.78
|
| Rate for Payer: Healthscope Commercial |
$236.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.89
|
| Rate for Payer: PHP Commercial |
$222.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.44
|
| Rate for Payer: Priority Health SBD |
$165.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$189.36
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Exchange |
$172.15
|
| Rate for Payer: UMR Bronson Commercial |
$97.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.66
|
|
|
HC VOIDING PRESS STUDY INTRA-ABDOMINAL VOID
|
Facility
|
IP
|
$262.22
|
|
|
Service Code
|
CPT 51797
|
| Hospital Charge Code |
76100193
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$115.38 |
| Max. Negotiated Rate |
$236.00 |
| Rate for Payer: Aetna American Axle |
$170.44
|
| Rate for Payer: Aetna Commercial |
$222.89
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$170.44
|
| Rate for Payer: Cash Price |
$209.78
|
| Rate for Payer: Cofinity Commercial |
$183.55
|
| Rate for Payer: Cofinity Commercial |
$225.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$183.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.78
|
| Rate for Payer: Healthscope Commercial |
$236.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$183.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.89
|
| Rate for Payer: PHP Commercial |
$222.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.44
|
| Rate for Payer: Priority Health SBD |
$165.20
|
| Rate for Payer: UMR Bronson Commercial |
$115.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.66
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
OP
|
$19.67
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$1.95 |
| Max. Negotiated Rate |
$33.05 |
| Rate for Payer: Aetna American Axle |
$12.79
|
| Rate for Payer: Aetna Commercial |
$16.72
|
| Rate for Payer: Aetna Medicare |
$3.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.55
|
| Rate for Payer: BCBS Complete |
$2.05
|
| Rate for Payer: BCBS MAPPO |
$3.64
|
| Rate for Payer: BCBS Trust/PPO |
$3.51
|
| Rate for Payer: BCN Commercial |
$3.51
|
| Rate for Payer: BCN Medicare Advantage |
$3.64
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cofinity Commercial |
$16.92
|
| Rate for Payer: Cofinity Commercial |
$13.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$17.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.75
|
| Rate for Payer: Mclaren Medicaid |
$1.95
|
| Rate for Payer: Mclaren Medicare |
$3.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.82
|
| Rate for Payer: Meridian Medicaid |
$2.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.72
|
| Rate for Payer: Nomi Health Commercial |
$5.46
|
| Rate for Payer: PACE Medicare |
$3.46
|
| Rate for Payer: PACE SWMI |
$3.64
|
| Rate for Payer: PHP Commercial |
$16.72
|
| Rate for Payer: PHP Medicare Advantage |
$3.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3.64
|
| Rate for Payer: Priority Health Medicare |
$3.64
|
| Rate for Payer: Priority Health Narrow Network |
$2.91
|
| Rate for Payer: Priority Health SBD |
$12.39
|
| Rate for Payer: Railroad Medicare Medicare |
$3.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.37
|
| Rate for Payer: UHC Core |
$33.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.64
|
| Rate for Payer: UHC Exchange |
$3.64
|
| Rate for Payer: UHC Medicare Advantage |
$3.64
|
| Rate for Payer: UHCCP Medicaid |
$1.95
|
| Rate for Payer: UMR Bronson Commercial |
$7.28
|
| Rate for Payer: VA VA |
$3.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.75
|
|
|
HC VOLUME MEASUREMENT
|
Facility
|
IP
|
$19.67
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
30700006
|
|
Hospital Revenue Code
|
307
|
| Min. Negotiated Rate |
$8.65 |
| Max. Negotiated Rate |
$17.70 |
| Rate for Payer: Aetna American Axle |
$12.79
|
| Rate for Payer: Aetna Commercial |
$16.72
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$12.79
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Cofinity Commercial |
$13.77
|
| Rate for Payer: Cofinity Commercial |
$16.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$13.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.74
|
| Rate for Payer: Healthscope Commercial |
$17.70
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$13.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.72
|
| Rate for Payer: PHP Commercial |
$16.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.79
|
| Rate for Payer: Priority Health SBD |
$12.39
|
| Rate for Payer: UMR Bronson Commercial |
$8.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.75
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
IP
|
$67.63
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$60.87 |
| Rate for Payer: Aetna American Axle |
$43.96
|
| Rate for Payer: Aetna Commercial |
$57.49
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Cash Price |
$54.10
|
| Rate for Payer: Cofinity Commercial |
$47.34
|
| Rate for Payer: Cofinity Commercial |
$58.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$47.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.10
|
| 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: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: UMR Bronson Commercial |
$29.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC VON WILLEBRAND ANTIGEN
|
Facility
|
OP
|
$67.63
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500025
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| 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 |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$43.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$22.11
|
| Rate for Payer: BCN Commercial |
$22.11
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| 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 |
$22.94
|
| 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 |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.49
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$57.49
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.96
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$18.35
|
| Rate for Payer: Priority Health SBD |
$42.61
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$25.02
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.72
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
IP
|
$206.00
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$90.64 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna American Axle |
$133.90
|
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.90
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$144.20
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health SBD |
$129.78
|
| Rate for Payer: UMR Bronson Commercial |
$90.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC VON WILLEBRAND FACTOR ACTIVITY
|
Facility
|
OP
|
$206.00
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30000059
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$185.40 |
| Rate for Payer: Aetna American Axle |
$133.90
|
| Rate for Payer: Aetna Commercial |
$175.10
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$29.74
|
| Rate for Payer: BCN Commercial |
$29.74
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cash Price |
$164.80
|
| Rate for Payer: Cofinity Commercial |
$177.16
|
| Rate for Payer: Cofinity Commercial |
$144.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$144.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$185.40
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$144.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.50
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.10
|
| Rate for Payer: Nomi Health Commercial |
$46.29
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$175.10
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.90
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.86
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$24.69
|
| Rate for Payer: Priority Health SBD |
$129.78
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$30.86
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.54
|
| Rate for Payer: UMR Bronson Commercial |
$76.22
|
| Rate for Payer: VA VA |
$30.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.50
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
OP
|
$95.88
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$86.29 |
| Rate for Payer: Aetna American Axle |
$62.32
|
| Rate for Payer: Aetna Commercial |
$81.50
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$22.11
|
| Rate for Payer: BCN Commercial |
$22.11
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$86.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.91
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.50
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$81.50
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$18.35
|
| Rate for Payer: Priority Health SBD |
$60.40
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$35.48
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.91
|
|
|
HC VON WILLEBRAND MULTIMETRIC ANALYSIS
|
Facility
|
IP
|
$95.88
|
|
|
Service Code
|
CPT 85247
|
| Hospital Charge Code |
30500028
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$42.19 |
| Max. Negotiated Rate |
$86.29 |
| Rate for Payer: Aetna American Axle |
$62.32
|
| Rate for Payer: Aetna Commercial |
$81.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$62.32
|
| Rate for Payer: Cash Price |
$76.70
|
| Rate for Payer: Cofinity Commercial |
$67.12
|
| Rate for Payer: Cofinity Commercial |
$82.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$67.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.70
|
| Rate for Payer: Healthscope Commercial |
$86.29
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$67.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.50
|
| Rate for Payer: PHP Commercial |
$81.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$62.32
|
| Rate for Payer: Priority Health SBD |
$60.40
|
| Rate for Payer: UMR Bronson Commercial |
$42.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.91
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
IP
|
$129.01
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$56.76 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna American Axle |
$83.86
|
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.86
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$110.95
|
| Rate for Payer: Cofinity Commercial |
$90.31
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: PHP Commercial |
$109.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: Priority Health SBD |
$81.28
|
| Rate for Payer: UMR Bronson Commercial |
$56.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.76
|
|
|
HC VON WILLEBRAND PANEL
|
Facility
|
OP
|
$129.01
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
31000001
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$116.11 |
| Rate for Payer: Aetna American Axle |
$83.86
|
| Rate for Payer: Aetna Commercial |
$109.66
|
| Rate for Payer: Aetna Medicare |
$32.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$83.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.58
|
| Rate for Payer: BCBS Complete |
$17.37
|
| Rate for Payer: BCBS MAPPO |
$30.86
|
| Rate for Payer: BCBS Trust/PPO |
$29.74
|
| Rate for Payer: BCN Commercial |
$29.74
|
| Rate for Payer: BCN Medicare Advantage |
$30.86
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cash Price |
$103.21
|
| Rate for Payer: Cofinity Commercial |
$90.31
|
| Rate for Payer: Cofinity Commercial |
$110.95
|
| Rate for Payer: Cofinity Medicare Advantage |
$90.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.86
|
| Rate for Payer: Healthscope Commercial |
$116.11
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$90.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.76
|
| Rate for Payer: Mclaren Medicaid |
$16.54
|
| Rate for Payer: Mclaren Medicare |
$30.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.40
|
| Rate for Payer: Meridian Medicaid |
$17.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.66
|
| Rate for Payer: Nomi Health Commercial |
$46.29
|
| Rate for Payer: PACE Medicare |
$29.32
|
| Rate for Payer: PACE SWMI |
$30.86
|
| Rate for Payer: PHP Commercial |
$109.66
|
| Rate for Payer: PHP Medicare Advantage |
$30.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$83.86
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.86
|
| Rate for Payer: Priority Health Medicare |
$30.86
|
| Rate for Payer: Priority Health Narrow Network |
$24.69
|
| Rate for Payer: Priority Health SBD |
$81.28
|
| Rate for Payer: Railroad Medicare Medicare |
$30.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.86
|
| Rate for Payer: UHC Exchange |
$30.86
|
| Rate for Payer: UHC Medicare Advantage |
$30.86
|
| Rate for Payer: UHCCP Medicaid |
$16.54
|
| Rate for Payer: UMR Bronson Commercial |
$47.73
|
| Rate for Payer: VA VA |
$30.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.76
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
IP
|
$97.80
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.03 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna American Axle |
$63.57
|
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.57
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$68.46
|
| Rate for Payer: Cofinity Commercial |
$84.11
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Healthscope Commercial |
$88.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: PHP Commercial |
$83.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.57
|
| Rate for Payer: Priority Health SBD |
$61.61
|
| Rate for Payer: UMR Bronson Commercial |
$43.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.35
|
|
|
HC VON WILLEBRAND PANEL CMPT1
|
Facility
|
OP
|
$97.80
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500020
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$88.02 |
| Rate for Payer: Aetna American Axle |
$63.57
|
| Rate for Payer: Aetna Commercial |
$83.13
|
| Rate for Payer: Aetna Medicare |
$18.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$63.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.38
|
| Rate for Payer: BCBS Complete |
$10.07
|
| Rate for Payer: BCBS MAPPO |
$17.90
|
| Rate for Payer: BCBS Trust/PPO |
$17.25
|
| Rate for Payer: BCN Commercial |
$17.25
|
| Rate for Payer: BCN Medicare Advantage |
$17.90
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cash Price |
$78.24
|
| Rate for Payer: Cofinity Commercial |
$84.11
|
| Rate for Payer: Cofinity Commercial |
$68.46
|
| Rate for Payer: Cofinity Medicare Advantage |
$68.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.90
|
| Rate for Payer: Healthscope Commercial |
$88.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$68.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.35
|
| Rate for Payer: Mclaren Medicaid |
$9.59
|
| Rate for Payer: Mclaren Medicare |
$17.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.80
|
| Rate for Payer: Meridian Medicaid |
$10.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$83.13
|
| Rate for Payer: Nomi Health Commercial |
$26.85
|
| Rate for Payer: PACE Medicare |
$17.00
|
| Rate for Payer: PACE SWMI |
$17.90
|
| Rate for Payer: PHP Commercial |
$83.13
|
| Rate for Payer: PHP Medicare Advantage |
$17.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$17.90
|
| Rate for Payer: Priority Health Medicare |
$17.90
|
| Rate for Payer: Priority Health Narrow Network |
$14.32
|
| Rate for Payer: Priority Health SBD |
$61.61
|
| Rate for Payer: Railroad Medicare Medicare |
$17.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.90
|
| Rate for Payer: UHC Exchange |
$17.90
|
| Rate for Payer: UHC Medicare Advantage |
$17.90
|
| Rate for Payer: UHCCP Medicaid |
$9.59
|
| Rate for Payer: UMR Bronson Commercial |
$36.19
|
| Rate for Payer: VA VA |
$17.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.35
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
OP
|
$130.05
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$117.04 |
| Rate for Payer: Aetna American Axle |
$84.53
|
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$22.11
|
| Rate for Payer: BCN Commercial |
$22.11
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$91.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$117.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$18.35
|
| Rate for Payer: Priority Health SBD |
$81.93
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$48.12
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC VON WILLEBRAND PANEL CMPT2
|
Facility
|
IP
|
$130.05
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500022
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$57.22 |
| Max. Negotiated Rate |
$117.04 |
| Rate for Payer: Aetna American Axle |
$84.53
|
| Rate for Payer: Aetna Commercial |
$110.54
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$84.53
|
| Rate for Payer: Cash Price |
$104.04
|
| Rate for Payer: Cofinity Commercial |
$111.84
|
| Rate for Payer: Cofinity Commercial |
$91.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$91.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.04
|
| Rate for Payer: Healthscope Commercial |
$117.04
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$91.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.54
|
| Rate for Payer: PHP Commercial |
$110.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.53
|
| Rate for Payer: Priority Health SBD |
$81.93
|
| Rate for Payer: UMR Bronson Commercial |
$57.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.54
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
OP
|
$126.48
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.30 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Aetna American Axle |
$82.21
|
| Rate for Payer: Aetna Commercial |
$107.51
|
| Rate for Payer: Aetna Medicare |
$23.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.68
|
| Rate for Payer: BCBS Complete |
$12.91
|
| Rate for Payer: BCBS MAPPO |
$22.94
|
| Rate for Payer: BCBS Trust/PPO |
$22.11
|
| Rate for Payer: BCN Commercial |
$22.11
|
| Rate for Payer: BCN Medicare Advantage |
$22.94
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$88.54
|
| Rate for Payer: Cofinity Commercial |
$108.77
|
| Rate for Payer: Cofinity Medicare Advantage |
$88.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.94
|
| Rate for Payer: Healthscope Commercial |
$113.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.86
|
| Rate for Payer: Mclaren Medicaid |
$12.30
|
| Rate for Payer: Mclaren Medicare |
$22.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.09
|
| Rate for Payer: Meridian Medicaid |
$12.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.51
|
| Rate for Payer: Nomi Health Commercial |
$34.41
|
| Rate for Payer: PACE Medicare |
$21.79
|
| Rate for Payer: PACE SWMI |
$22.94
|
| Rate for Payer: PHP Commercial |
$107.51
|
| Rate for Payer: PHP Medicare Advantage |
$22.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.21
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$22.94
|
| Rate for Payer: Priority Health Medicare |
$22.94
|
| Rate for Payer: Priority Health Narrow Network |
$18.35
|
| Rate for Payer: Priority Health SBD |
$79.68
|
| Rate for Payer: Railroad Medicare Medicare |
$22.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.94
|
| Rate for Payer: UHC Exchange |
$22.94
|
| Rate for Payer: UHC Medicare Advantage |
$22.94
|
| Rate for Payer: UHCCP Medicaid |
$12.30
|
| Rate for Payer: UMR Bronson Commercial |
$46.80
|
| Rate for Payer: VA VA |
$22.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.86
|
|
|
HC VON WILLEBRAND PANEL CMPT3
|
Facility
|
IP
|
$126.48
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500026
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$55.65 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Aetna American Axle |
$82.21
|
| Rate for Payer: Aetna Commercial |
$107.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$82.21
|
| Rate for Payer: Cash Price |
$101.18
|
| Rate for Payer: Cofinity Commercial |
$108.77
|
| Rate for Payer: Cofinity Commercial |
$88.54
|
| Rate for Payer: Cofinity Medicare Advantage |
$88.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.18
|
| Rate for Payer: Healthscope Commercial |
$113.83
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$88.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.51
|
| Rate for Payer: PHP Commercial |
$107.51
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.21
|
| Rate for Payer: Priority Health SBD |
$79.68
|
| Rate for Payer: UMR Bronson Commercial |
$55.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.86
|
|
|
HC VORICONAZOLE, S
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 80285
|
| Hospital Charge Code |
30100707
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.53 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna American Axle |
$59.67
|
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$28.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$59.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.89
|
| Rate for Payer: BCBS Complete |
$15.26
|
| Rate for Payer: BCBS MAPPO |
$27.11
|
| Rate for Payer: BCBS Trust/PPO |
$26.12
|
| Rate for Payer: BCN Commercial |
$26.12
|
| Rate for Payer: BCN Medicare Advantage |
$27.11
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Cofinity Commercial |
$64.26
|
| Rate for Payer: Cofinity Medicare Advantage |
$64.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.11
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$14.53
|
| Rate for Payer: Mclaren Medicare |
$27.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.47
|
| Rate for Payer: Meridian Medicaid |
$15.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$40.66
|
| Rate for Payer: PACE Medicare |
$25.75
|
| Rate for Payer: PACE SWMI |
$27.11
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$27.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$27.11
|
| Rate for Payer: Priority Health Medicare |
$27.11
|
| Rate for Payer: Priority Health Narrow Network |
$21.69
|
| Rate for Payer: Priority Health SBD |
$57.83
|
| Rate for Payer: Railroad Medicare Medicare |
$27.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.11
|
| Rate for Payer: UHC Exchange |
$27.11
|
| Rate for Payer: UHC Medicare Advantage |
$27.11
|
| Rate for Payer: UHCCP Medicaid |
$14.53
|
| Rate for Payer: UMR Bronson Commercial |
$33.97
|
| Rate for Payer: VA VA |
$27.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
