|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
OP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.03 |
| Max. Negotiated Rate |
$168.91 |
| Rate for Payer: Aetna American Axle |
$121.99
|
| Rate for Payer: Aetna Commercial |
$159.53
|
| Rate for Payer: Aetna Medicare |
$17.52
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.06
|
| Rate for Payer: BCBS Complete |
$9.48
|
| Rate for Payer: BCBS MAPPO |
$16.85
|
| Rate for Payer: BCN Medicare Advantage |
$16.85
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$161.40
|
| Rate for Payer: Cofinity Commercial |
$131.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.85
|
| Rate for Payer: Healthscope Commercial |
$168.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.76
|
| Rate for Payer: Mclaren Medicaid |
$9.03
|
| Rate for Payer: Mclaren Medicare |
$16.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.69
|
| Rate for Payer: Meridian Medicaid |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: PACE Medicare |
$16.01
|
| Rate for Payer: PACE SWMI |
$16.85
|
| Rate for Payer: PHP Commercial |
$159.53
|
| Rate for Payer: PHP Medicare Advantage |
$16.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: Priority Health Medicare |
$16.85
|
| Rate for Payer: Priority Health SBD |
$118.24
|
| Rate for Payer: Railroad Medicare Medicare |
$16.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.85
|
| Rate for Payer: UHC Exchange |
$32.20
|
| Rate for Payer: UHC Medicare Advantage |
$16.85
|
| Rate for Payer: UHCCP Medicaid |
$9.03
|
| Rate for Payer: UMR Bronson Commercial |
$69.44
|
| Rate for Payer: VA VA |
$16.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.76
|
|
|
HC ZIKA VIRUS MAC ELISA IGM
|
Facility
|
IP
|
$187.68
|
|
|
Service Code
|
CPT 86794
|
| Hospital Charge Code |
30000148
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$82.58 |
| Max. Negotiated Rate |
$168.91 |
| Rate for Payer: Aetna American Axle |
$121.99
|
| Rate for Payer: Aetna Commercial |
$159.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$121.99
|
| Rate for Payer: Cash Price |
$150.14
|
| Rate for Payer: Cofinity Commercial |
$131.38
|
| Rate for Payer: Cofinity Commercial |
$161.40
|
| Rate for Payer: Cofinity Medicare Advantage |
$131.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$150.14
|
| Rate for Payer: Healthscope Commercial |
$168.91
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$131.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$140.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$159.53
|
| Rate for Payer: PHP Commercial |
$159.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$121.99
|
| Rate for Payer: Priority Health SBD |
$118.24
|
| Rate for Payer: UMR Bronson Commercial |
$82.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$140.76
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$114.44 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: UMR Bronson Commercial |
$114.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC ZIKA VIRUS, PCR, SERUM
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000150
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$98.06
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: UMR Bronson Commercial |
$96.24
|
| Rate for Payer: VA VA |
$51.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
OP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.50 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna Medicare |
$53.36
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.14
|
| Rate for Payer: BCBS Complete |
$28.88
|
| Rate for Payer: BCBS MAPPO |
$51.31
|
| Rate for Payer: BCN Medicare Advantage |
$51.31
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.31
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Mclaren Medicaid |
$27.50
|
| Rate for Payer: Mclaren Medicare |
$51.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.88
|
| Rate for Payer: Meridian Medicaid |
$28.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: PACE Medicare |
$48.74
|
| Rate for Payer: PACE SWMI |
$51.31
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: PHP Medicare Advantage |
$51.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health Medicare |
$51.31
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: Railroad Medicare Medicare |
$51.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.31
|
| Rate for Payer: UHC Exchange |
$98.06
|
| Rate for Payer: UHC Medicare Advantage |
$51.31
|
| Rate for Payer: UHCCP Medicaid |
$27.50
|
| Rate for Payer: UMR Bronson Commercial |
$96.24
|
| Rate for Payer: VA VA |
$51.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC ZIKA VIRUS, PCR, URINE
|
Facility
|
IP
|
$260.10
|
|
|
Service Code
|
CPT 87662
|
| Hospital Charge Code |
30000151
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$114.44 |
| Max. Negotiated Rate |
$234.09 |
| Rate for Payer: Aetna American Axle |
$169.06
|
| Rate for Payer: Aetna Commercial |
$221.09
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$169.06
|
| Rate for Payer: Cash Price |
$208.08
|
| Rate for Payer: Cofinity Commercial |
$182.07
|
| Rate for Payer: Cofinity Commercial |
$223.69
|
| Rate for Payer: Cofinity Medicare Advantage |
$182.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.08
|
| Rate for Payer: Healthscope Commercial |
$234.09
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$182.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.09
|
| Rate for Payer: PHP Commercial |
$221.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$169.06
|
| Rate for Payer: Priority Health SBD |
$163.86
|
| Rate for Payer: UMR Bronson Commercial |
$114.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.07
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
OP
|
$3,098.41
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,146.41 |
| Max. Negotiated Rate |
$2,788.57 |
| Rate for Payer: Aetna American Axle |
$2,013.97
|
| Rate for Payer: Aetna Commercial |
$2,633.65
|
| Rate for Payer: Aetna Medicare |
$1,549.20
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,013.97
|
| Rate for Payer: BCBS Complete |
$1,239.36
|
| Rate for Payer: Cash Price |
$2,478.73
|
| Rate for Payer: Cofinity Commercial |
$2,168.89
|
| Rate for Payer: Cofinity Commercial |
$2,664.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,168.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.73
|
| Rate for Payer: Healthscope Commercial |
$2,788.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,168.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,323.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.65
|
| Rate for Payer: PHP Commercial |
$2,633.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.97
|
| Rate for Payer: Priority Health SBD |
$1,952.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,146.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,323.81
|
|
|
HC Z IMPLANTABLE PORT
|
Facility
|
IP
|
$3,098.41
|
|
|
Service Code
|
HCPCS C1788
|
| Hospital Charge Code |
27800039
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,363.30 |
| Max. Negotiated Rate |
$2,788.57 |
| Rate for Payer: Aetna American Axle |
$2,013.97
|
| Rate for Payer: Aetna Commercial |
$2,633.65
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,013.97
|
| Rate for Payer: Cash Price |
$2,478.73
|
| Rate for Payer: Cofinity Commercial |
$2,168.89
|
| Rate for Payer: Cofinity Commercial |
$2,664.63
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,168.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,478.73
|
| Rate for Payer: Healthscope Commercial |
$2,788.57
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,168.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,323.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,633.65
|
| Rate for Payer: PHP Commercial |
$2,633.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,013.97
|
| Rate for Payer: Priority Health SBD |
$1,952.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,363.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,323.81
|
|
|
HC ZINC LEVEL
|
Facility
|
IP
|
$49.98
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.99 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna American Axle |
$32.49
|
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.48
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.49
|
| Rate for Payer: Priority Health SBD |
$31.49
|
| Rate for Payer: UMR Bronson Commercial |
$21.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC ZINC LEVEL
|
Facility
|
OP
|
$49.98
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100462
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.11 |
| Max. Negotiated Rate |
$44.98 |
| Rate for Payer: Aetna American Axle |
$32.49
|
| Rate for Payer: Aetna Commercial |
$42.48
|
| Rate for Payer: Aetna Medicare |
$11.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$32.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.24
|
| Rate for Payer: BCBS Complete |
$6.41
|
| Rate for Payer: BCBS MAPPO |
$11.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.39
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cash Price |
$39.98
|
| Rate for Payer: Cofinity Commercial |
$42.98
|
| Rate for Payer: Cofinity Commercial |
$34.99
|
| Rate for Payer: Cofinity Medicare Advantage |
$34.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.39
|
| Rate for Payer: Healthscope Commercial |
$44.98
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$34.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.48
|
| Rate for Payer: Mclaren Medicaid |
$6.11
|
| Rate for Payer: Mclaren Medicare |
$11.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.96
|
| Rate for Payer: Meridian Medicaid |
$6.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.48
|
| Rate for Payer: PACE Medicare |
$10.82
|
| Rate for Payer: PACE SWMI |
$11.39
|
| Rate for Payer: PHP Commercial |
$42.48
|
| Rate for Payer: PHP Medicare Advantage |
$11.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.49
|
| Rate for Payer: Priority Health Medicare |
$11.39
|
| Rate for Payer: Priority Health SBD |
$31.49
|
| Rate for Payer: Railroad Medicare Medicare |
$11.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.39
|
| Rate for Payer: UHC Exchange |
$21.77
|
| Rate for Payer: UHC Medicare Advantage |
$11.39
|
| Rate for Payer: UHCCP Medicaid |
$6.11
|
| Rate for Payer: UMR Bronson Commercial |
$18.49
|
| Rate for Payer: VA VA |
$11.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.48
|
|
|
HC ZINC TRANSPORTER T8
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200514
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$198.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna American Axle |
$292.50
|
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.50
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$315.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$315.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$315.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health SBD |
$283.50
|
| Rate for Payer: UMR Bronson Commercial |
$198.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC ZINC TRANSPORTER T8
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200514
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna American Axle |
$292.50
|
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: Aetna Medicare |
$24.51
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$292.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.46
|
| Rate for Payer: BCBS Complete |
$13.27
|
| Rate for Payer: BCBS MAPPO |
$23.57
|
| Rate for Payer: BCN Medicare Advantage |
$23.57
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Cofinity Commercial |
$315.00
|
| Rate for Payer: Cofinity Medicare Advantage |
$315.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.57
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$315.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Mclaren Medicaid |
$12.63
|
| Rate for Payer: Mclaren Medicare |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.75
|
| Rate for Payer: Meridian Medicaid |
$13.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: PACE Medicare |
$22.39
|
| Rate for Payer: PACE SWMI |
$23.57
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: PHP Medicare Advantage |
$23.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$292.50
|
| Rate for Payer: Priority Health Medicare |
$23.57
|
| Rate for Payer: Priority Health SBD |
$283.50
|
| Rate for Payer: Railroad Medicare Medicare |
$23.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.57
|
| Rate for Payer: UHC Exchange |
$45.04
|
| Rate for Payer: UHC Medicare Advantage |
$23.57
|
| Rate for Payer: UHCCP Medicaid |
$12.63
|
| Rate for Payer: UMR Bronson Commercial |
$166.50
|
| Rate for Payer: VA VA |
$23.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC ZINC URINE
|
Facility
|
OP
|
$69.97
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.11 |
| Max. Negotiated Rate |
$62.97 |
| Rate for Payer: Aetna American Axle |
$45.48
|
| Rate for Payer: Aetna Commercial |
$59.47
|
| Rate for Payer: Aetna Medicare |
$11.85
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.24
|
| Rate for Payer: BCBS Complete |
$6.41
|
| Rate for Payer: BCBS MAPPO |
$11.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.39
|
| Rate for Payer: Cash Price |
$55.98
|
| Rate for Payer: Cash Price |
$55.98
|
| Rate for Payer: Cofinity Commercial |
$60.17
|
| Rate for Payer: Cofinity Commercial |
$48.98
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.39
|
| Rate for Payer: Healthscope Commercial |
$62.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.48
|
| Rate for Payer: Mclaren Medicaid |
$6.11
|
| Rate for Payer: Mclaren Medicare |
$11.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.96
|
| Rate for Payer: Meridian Medicaid |
$6.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.47
|
| Rate for Payer: PACE Medicare |
$10.82
|
| Rate for Payer: PACE SWMI |
$11.39
|
| Rate for Payer: PHP Commercial |
$59.47
|
| Rate for Payer: PHP Medicare Advantage |
$11.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.48
|
| Rate for Payer: Priority Health Medicare |
$11.39
|
| Rate for Payer: Priority Health SBD |
$44.08
|
| Rate for Payer: Railroad Medicare Medicare |
$11.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$32.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.39
|
| Rate for Payer: UHC Exchange |
$21.77
|
| Rate for Payer: UHC Medicare Advantage |
$11.39
|
| Rate for Payer: UHCCP Medicaid |
$6.11
|
| Rate for Payer: UMR Bronson Commercial |
$25.89
|
| Rate for Payer: VA VA |
$11.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.48
|
|
|
HC ZINC URINE
|
Facility
|
IP
|
$69.97
|
|
|
Service Code
|
CPT 84630
|
| Hospital Charge Code |
30100463
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.79 |
| Max. Negotiated Rate |
$62.97 |
| Rate for Payer: Aetna American Axle |
$45.48
|
| Rate for Payer: Aetna Commercial |
$59.47
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$45.48
|
| Rate for Payer: Cash Price |
$55.98
|
| Rate for Payer: Cofinity Commercial |
$48.98
|
| Rate for Payer: Cofinity Commercial |
$60.17
|
| Rate for Payer: Cofinity Medicare Advantage |
$48.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.98
|
| Rate for Payer: Healthscope Commercial |
$62.97
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$48.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.47
|
| Rate for Payer: PHP Commercial |
$59.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$45.48
|
| Rate for Payer: Priority Health SBD |
$44.08
|
| Rate for Payer: UMR Bronson Commercial |
$30.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.48
|
|
|
HC Z INFUSION WIRE
|
Facility
|
OP
|
$874.85
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$323.69 |
| Max. Negotiated Rate |
$787.37 |
| Rate for Payer: Aetna American Axle |
$568.65
|
| Rate for Payer: Aetna Commercial |
$743.62
|
| Rate for Payer: Aetna Medicare |
$437.43
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.65
|
| Rate for Payer: BCBS Complete |
$349.94
|
| Rate for Payer: Cash Price |
$699.88
|
| Rate for Payer: Cofinity Commercial |
$612.39
|
| Rate for Payer: Cofinity Commercial |
$752.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$612.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.88
|
| Rate for Payer: Healthscope Commercial |
$787.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$612.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.62
|
| Rate for Payer: PHP Commercial |
$743.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.65
|
| Rate for Payer: Priority Health SBD |
$551.16
|
| Rate for Payer: UMR Bronson Commercial |
$323.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.14
|
|
|
HC Z INFUSION WIRE
|
Facility
|
IP
|
$874.85
|
|
| Hospital Charge Code |
62100001
|
|
Hospital Revenue Code
|
621
|
| Min. Negotiated Rate |
$384.93 |
| Max. Negotiated Rate |
$787.37 |
| Rate for Payer: Aetna American Axle |
$568.65
|
| Rate for Payer: Aetna Commercial |
$743.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$568.65
|
| Rate for Payer: Cash Price |
$699.88
|
| Rate for Payer: Cofinity Commercial |
$612.39
|
| Rate for Payer: Cofinity Commercial |
$752.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$612.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$699.88
|
| Rate for Payer: Healthscope Commercial |
$787.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$612.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$656.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$743.62
|
| Rate for Payer: PHP Commercial |
$743.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$568.65
|
| Rate for Payer: Priority Health SBD |
$551.16
|
| Rate for Payer: UMR Bronson Commercial |
$384.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$656.14
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
OP
|
$13,138.47
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,861.23 |
| Max. Negotiated Rate |
$11,824.62 |
| Rate for Payer: Aetna American Axle |
$8,540.01
|
| Rate for Payer: Aetna Commercial |
$11,167.70
|
| Rate for Payer: Aetna Medicare |
$6,569.23
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,540.01
|
| Rate for Payer: BCBS Complete |
$5,255.39
|
| Rate for Payer: Cash Price |
$10,510.78
|
| Rate for Payer: Cofinity Commercial |
$11,299.08
|
| Rate for Payer: Cofinity Commercial |
$9,196.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,196.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,510.78
|
| Rate for Payer: Healthscope Commercial |
$11,824.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,196.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,853.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,167.70
|
| Rate for Payer: PHP Commercial |
$11,167.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,540.01
|
| Rate for Payer: Priority Health SBD |
$8,277.24
|
| Rate for Payer: UMR Bronson Commercial |
$4,861.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,853.85
|
|
|
HC Z INTRACRANIAL STENT
|
Facility
|
IP
|
$13,138.47
|
|
| Hospital Charge Code |
27800049
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$5,780.93 |
| Max. Negotiated Rate |
$11,824.62 |
| Rate for Payer: Aetna American Axle |
$8,540.01
|
| Rate for Payer: Aetna Commercial |
$11,167.70
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$8,540.01
|
| Rate for Payer: Cash Price |
$10,510.78
|
| Rate for Payer: Cofinity Commercial |
$11,299.08
|
| Rate for Payer: Cofinity Commercial |
$9,196.93
|
| Rate for Payer: Cofinity Medicare Advantage |
$9,196.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,510.78
|
| Rate for Payer: Healthscope Commercial |
$11,824.62
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$9,196.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,853.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,167.70
|
| Rate for Payer: PHP Commercial |
$11,167.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,540.01
|
| Rate for Payer: Priority Health SBD |
$8,277.24
|
| Rate for Payer: UMR Bronson Commercial |
$5,780.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,853.85
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
IP
|
$329.25
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$144.87 |
| Max. Negotiated Rate |
$296.32 |
| Rate for Payer: Aetna American Axle |
$214.01
|
| Rate for Payer: Aetna Commercial |
$279.86
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.01
|
| Rate for Payer: Cash Price |
$263.40
|
| Rate for Payer: Cofinity Commercial |
$230.47
|
| Rate for Payer: Cofinity Commercial |
$283.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$230.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.40
|
| Rate for Payer: Healthscope Commercial |
$296.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.86
|
| Rate for Payer: PHP Commercial |
$279.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.01
|
| Rate for Payer: Priority Health SBD |
$207.43
|
| Rate for Payer: UMR Bronson Commercial |
$144.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.94
|
|
|
HC Z INTRODUCER SHEATH
|
Facility
|
OP
|
$329.25
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200090
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.82 |
| Max. Negotiated Rate |
$296.32 |
| Rate for Payer: Aetna American Axle |
$214.01
|
| Rate for Payer: Aetna Commercial |
$279.86
|
| Rate for Payer: Aetna Medicare |
$164.62
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$214.01
|
| Rate for Payer: BCBS Complete |
$131.70
|
| Rate for Payer: Cash Price |
$263.40
|
| Rate for Payer: Cofinity Commercial |
$230.47
|
| Rate for Payer: Cofinity Commercial |
$283.15
|
| Rate for Payer: Cofinity Medicare Advantage |
$230.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$263.40
|
| Rate for Payer: Healthscope Commercial |
$296.32
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$230.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$279.86
|
| Rate for Payer: PHP Commercial |
$279.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$214.01
|
| Rate for Payer: Priority Health SBD |
$207.43
|
| Rate for Payer: UMR Bronson Commercial |
$121.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.94
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
OP
|
$3,775.49
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$262.00 |
| Max. Negotiated Rate |
$3,397.94 |
| Rate for Payer: Aetna American Axle |
$2,454.07
|
| Rate for Payer: Aetna Commercial |
$3,209.17
|
| Rate for Payer: Aetna Medicare |
$1,887.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,454.07
|
| Rate for Payer: BCBS Complete |
$1,510.20
|
| Rate for Payer: Cash Price |
$3,020.39
|
| Rate for Payer: Cash Price |
$3,020.39
|
| Rate for Payer: Cofinity Commercial |
$3,246.92
|
| Rate for Payer: Cofinity Commercial |
$2,642.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,642.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,020.39
|
| Rate for Payer: Healthscope Commercial |
$3,397.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,642.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,831.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,209.17
|
| Rate for Payer: PHP Commercial |
$3,209.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,454.07
|
| Rate for Payer: Priority Health SBD |
$2,378.56
|
| Rate for Payer: UHC Core |
$262.00
|
| Rate for Payer: UMR Bronson Commercial |
$1,396.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,831.62
|
|
|
HC Z ITERPRET VISCERAL PTRA
|
Facility
|
IP
|
$3,775.49
|
|
| Hospital Charge Code |
32000272
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$1,661.22 |
| Max. Negotiated Rate |
$3,397.94 |
| Rate for Payer: Aetna American Axle |
$2,454.07
|
| Rate for Payer: Aetna Commercial |
$3,209.17
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,454.07
|
| Rate for Payer: Cash Price |
$3,020.39
|
| Rate for Payer: Cofinity Commercial |
$2,642.84
|
| Rate for Payer: Cofinity Commercial |
$3,246.92
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,642.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,020.39
|
| Rate for Payer: Healthscope Commercial |
$3,397.94
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,642.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,831.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,209.17
|
| Rate for Payer: PHP Commercial |
$3,209.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,454.07
|
| Rate for Payer: Priority Health SBD |
$2,378.56
|
| Rate for Payer: UMR Bronson Commercial |
$1,661.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,831.62
|
|
|
HC Z NEPHROSTOMY CATH
|
Facility
|
IP
|
$775.77
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$341.34 |
| Max. Negotiated Rate |
$698.19 |
| Rate for Payer: Aetna American Axle |
$504.25
|
| Rate for Payer: Aetna Commercial |
$659.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.25
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$543.04
|
| Rate for Payer: Cofinity Commercial |
$667.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$543.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Healthscope Commercial |
$698.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$543.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.40
|
| Rate for Payer: PHP Commercial |
$659.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.25
|
| Rate for Payer: Priority Health SBD |
$488.74
|
| Rate for Payer: UMR Bronson Commercial |
$341.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.83
|
|
|
HC Z NEPHROSTOMY CATH
|
Facility
|
OP
|
$775.77
|
|
|
Service Code
|
HCPCS C1729
|
| Hospital Charge Code |
27200092
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$287.03 |
| Max. Negotiated Rate |
$698.19 |
| Rate for Payer: Aetna American Axle |
$504.25
|
| Rate for Payer: Aetna Commercial |
$659.40
|
| Rate for Payer: Aetna Medicare |
$387.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$504.25
|
| Rate for Payer: BCBS Complete |
$310.31
|
| Rate for Payer: Cash Price |
$620.62
|
| Rate for Payer: Cofinity Commercial |
$543.04
|
| Rate for Payer: Cofinity Commercial |
$667.16
|
| Rate for Payer: Cofinity Medicare Advantage |
$543.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$620.62
|
| Rate for Payer: Healthscope Commercial |
$698.19
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$543.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$581.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$659.40
|
| Rate for Payer: PHP Commercial |
$659.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$504.25
|
| Rate for Payer: Priority Health SBD |
$488.74
|
| Rate for Payer: UMR Bronson Commercial |
$287.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$581.83
|
|
|
HC ZONISAMIDE
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 80203
|
| Hospital Charge Code |
30100052
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.10 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna American Axle |
$49.73
|
| Rate for Payer: Aetna Commercial |
$65.03
|
| Rate for Payer: Aetna Medicare |
$13.78
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$49.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.56
|
| Rate for Payer: BCBS Complete |
$7.46
|
| Rate for Payer: BCBS MAPPO |
$13.25
|
| Rate for Payer: BCN Medicare Advantage |
$13.25
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Cofinity Commercial |
$53.55
|
| Rate for Payer: Cofinity Medicare Advantage |
$53.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.25
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$53.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$7.10
|
| Rate for Payer: Mclaren Medicare |
$13.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.91
|
| Rate for Payer: Meridian Medicaid |
$7.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.03
|
| Rate for Payer: PACE Medicare |
$12.59
|
| Rate for Payer: PACE SWMI |
$13.25
|
| Rate for Payer: PHP Commercial |
$65.03
|
| Rate for Payer: PHP Medicare Advantage |
$13.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.73
|
| Rate for Payer: Priority Health Medicare |
$13.25
|
| Rate for Payer: Priority Health SBD |
$48.20
|
| Rate for Payer: Railroad Medicare Medicare |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.30
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.25
|
| Rate for Payer: UHC Exchange |
$25.32
|
| Rate for Payer: UHC Medicare Advantage |
$13.25
|
| Rate for Payer: UHCCP Medicaid |
$7.10
|
| Rate for Payer: UMR Bronson Commercial |
$28.30
|
| Rate for Payer: VA VA |
$13.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
