|
HC Z ACCESS DEVICE
|
Facility
|
IP
|
$204.86
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200082
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$90.14 |
| Max. Negotiated Rate |
$184.37 |
| Rate for Payer: Aetna American Axle |
$133.16
|
| Rate for Payer: Aetna Commercial |
$174.13
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$133.16
|
| Rate for Payer: Cash Price |
$163.89
|
| Rate for Payer: Cofinity Commercial |
$143.40
|
| Rate for Payer: Cofinity Commercial |
$176.18
|
| Rate for Payer: Cofinity Medicare Advantage |
$143.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.89
|
| Rate for Payer: Healthscope Commercial |
$184.37
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$143.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$174.13
|
| Rate for Payer: PHP Commercial |
$174.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.16
|
| Rate for Payer: Priority Health SBD |
$129.06
|
| Rate for Payer: UMR Bronson Commercial |
$90.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.64
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
OP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,355.46 |
| Max. Negotiated Rate |
$5,729.50 |
| Rate for Payer: Aetna American Axle |
$4,137.97
|
| Rate for Payer: Aetna Commercial |
$5,411.19
|
| Rate for Payer: Aetna Medicare |
$3,183.06
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,137.97
|
| Rate for Payer: BCBS Complete |
$2,546.44
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$4,456.28
|
| Rate for Payer: Cofinity Commercial |
$5,474.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,456.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$5,729.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,456.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,774.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: PHP Commercial |
$5,411.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: Priority Health SBD |
$4,010.65
|
| Rate for Payer: UMR Bronson Commercial |
$2,355.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,774.58
|
|
|
HC Z ACCUNET PROTECTIVE SYSTEM
|
Facility
|
IP
|
$6,366.11
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800037
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,801.09 |
| Max. Negotiated Rate |
$5,729.50 |
| Rate for Payer: Aetna American Axle |
$4,137.97
|
| Rate for Payer: Aetna Commercial |
$5,411.19
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,137.97
|
| Rate for Payer: Cash Price |
$5,092.89
|
| Rate for Payer: Cofinity Commercial |
$4,456.28
|
| Rate for Payer: Cofinity Commercial |
$5,474.85
|
| Rate for Payer: Cofinity Medicare Advantage |
$4,456.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,092.89
|
| Rate for Payer: Healthscope Commercial |
$5,729.50
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$4,456.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,774.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,411.19
|
| Rate for Payer: PHP Commercial |
$5,411.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,137.97
|
| Rate for Payer: Priority Health SBD |
$4,010.65
|
| Rate for Payer: UMR Bronson Commercial |
$2,801.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,774.58
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
IP
|
$437.63
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$192.56 |
| Max. Negotiated Rate |
$393.87 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: UMR Bronson Commercial |
$192.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC Z ARTHROCENTESIS SMALL JOINT BIL
|
Facility
|
OP
|
$437.63
|
|
|
Service Code
|
CPT 20600
|
| Hospital Charge Code |
36100023
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$34.61 |
| Max. Negotiated Rate |
$909.03 |
| Rate for Payer: Aetna American Axle |
$284.46
|
| Rate for Payer: Aetna Commercial |
$371.99
|
| Rate for Payer: Aetna Medicare |
$300.79
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$284.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$361.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$361.52
|
| Rate for Payer: BCBS Complete |
$162.77
|
| Rate for Payer: BCBS MAPPO |
$289.22
|
| Rate for Payer: BCBS Trust/PPO |
$304.95
|
| Rate for Payer: BCN Commercial |
$304.95
|
| Rate for Payer: BCN Medicare Advantage |
$289.22
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cash Price |
$350.10
|
| Rate for Payer: Cofinity Commercial |
$376.36
|
| Rate for Payer: Cofinity Commercial |
$306.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$306.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$289.22
|
| Rate for Payer: Healthscope Commercial |
$393.87
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$306.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.22
|
| Rate for Payer: Mclaren Medicaid |
$155.02
|
| Rate for Payer: Mclaren Medicare |
$289.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$303.68
|
| Rate for Payer: Meridian Medicaid |
$162.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$332.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$371.99
|
| Rate for Payer: Nomi Health Commercial |
$607.36
|
| Rate for Payer: PACE Medicare |
$274.76
|
| Rate for Payer: PACE SWMI |
$289.22
|
| Rate for Payer: PHP Commercial |
$371.99
|
| Rate for Payer: PHP Medicare Advantage |
$289.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$284.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$909.03
|
| Rate for Payer: Priority Health Medicare |
$289.22
|
| Rate for Payer: Priority Health Narrow Network |
$727.22
|
| Rate for Payer: Priority Health SBD |
$275.71
|
| Rate for Payer: Railroad Medicare Medicare |
$289.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.07
|
| Rate for Payer: UHC Core |
$700.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$289.22
|
| Rate for Payer: UHC Exchange |
$34.61
|
| Rate for Payer: UHC Medicare Advantage |
$289.22
|
| Rate for Payer: UHCCP Medicaid |
$155.02
|
| Rate for Payer: UMR Bronson Commercial |
$161.92
|
| Rate for Payer: VA VA |
$289.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.22
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
OP
|
$692.70
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$223.39 |
| Max. Negotiated Rate |
$625.17 |
| Rate for Payer: Aetna American Axle |
$450.26
|
| Rate for Payer: Aetna Commercial |
$588.80
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$401.55
|
| Rate for Payer: BCN Commercial |
$401.55
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cofinity Commercial |
$595.72
|
| Rate for Payer: Cofinity Commercial |
$484.89
|
| Rate for Payer: Cofinity Medicare Advantage |
$484.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$623.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$519.52
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.80
|
| Rate for Payer: Nomi Health Commercial |
$625.17
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$588.80
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.79
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$343.03
|
| Rate for Payer: Priority Health SBD |
$436.40
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$223.39
|
| Rate for Payer: UMR Bronson Commercial |
$256.30
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$519.52
|
|
|
HC ZB002 CX ID GI PANEL 12-25 TARGETS
|
Facility
|
IP
|
$692.70
|
|
|
Service Code
|
CPT 87507
|
| Hospital Charge Code |
30600280
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$304.79 |
| Max. Negotiated Rate |
$623.43 |
| Rate for Payer: Aetna American Axle |
$450.26
|
| Rate for Payer: Aetna Commercial |
$588.80
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$450.26
|
| Rate for Payer: Cash Price |
$554.16
|
| Rate for Payer: Cofinity Commercial |
$484.89
|
| Rate for Payer: Cofinity Commercial |
$595.72
|
| Rate for Payer: Cofinity Medicare Advantage |
$484.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$554.16
|
| Rate for Payer: Healthscope Commercial |
$623.43
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$484.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$519.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$588.80
|
| Rate for Payer: PHP Commercial |
$588.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$450.26
|
| Rate for Payer: Priority Health SBD |
$436.40
|
| Rate for Payer: UMR Bronson Commercial |
$304.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$519.52
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
IP
|
$622.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$273.98 |
| Max. Negotiated Rate |
$560.42 |
| Rate for Payer: Aetna American Axle |
$404.75
|
| Rate for Payer: Aetna Commercial |
$529.29
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.75
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cofinity Commercial |
$435.88
|
| Rate for Payer: Cofinity Commercial |
$535.51
|
| Rate for Payer: Cofinity Medicare Advantage |
$435.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.15
|
| Rate for Payer: Healthscope Commercial |
$560.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.29
|
| Rate for Payer: PHP Commercial |
$529.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.75
|
| Rate for Payer: Priority Health SBD |
$392.29
|
| Rate for Payer: UMR Bronson Commercial |
$273.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.02
|
|
|
HC ZB5CG RESPIRATORY VIRAL PANEL 12-25 TARGETS
|
Facility
|
OP
|
$622.69
|
|
|
Service Code
|
CPT 87633
|
| Hospital Charge Code |
30600205
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$223.39 |
| Max. Negotiated Rate |
$625.17 |
| Rate for Payer: Aetna American Axle |
$404.75
|
| Rate for Payer: Aetna Commercial |
$529.29
|
| Rate for Payer: Aetna Medicare |
$433.45
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$404.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$520.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$520.98
|
| Rate for Payer: BCBS Complete |
$234.56
|
| Rate for Payer: BCBS MAPPO |
$416.78
|
| Rate for Payer: BCBS Trust/PPO |
$401.55
|
| Rate for Payer: BCN Commercial |
$401.55
|
| Rate for Payer: BCN Medicare Advantage |
$416.78
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cash Price |
$498.15
|
| Rate for Payer: Cofinity Commercial |
$535.51
|
| Rate for Payer: Cofinity Commercial |
$435.88
|
| Rate for Payer: Cofinity Medicare Advantage |
$435.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$498.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$416.78
|
| Rate for Payer: Healthscope Commercial |
$560.42
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$435.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$467.02
|
| Rate for Payer: Mclaren Medicaid |
$223.39
|
| Rate for Payer: Mclaren Medicare |
$416.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$437.62
|
| Rate for Payer: Meridian Medicaid |
$234.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$479.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$529.29
|
| Rate for Payer: Nomi Health Commercial |
$625.17
|
| Rate for Payer: PACE Medicare |
$395.94
|
| Rate for Payer: PACE SWMI |
$416.78
|
| Rate for Payer: PHP Commercial |
$529.29
|
| Rate for Payer: PHP Medicare Advantage |
$416.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$223.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$404.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$428.79
|
| Rate for Payer: Priority Health Medicare |
$416.78
|
| Rate for Payer: Priority Health Narrow Network |
$343.03
|
| Rate for Payer: Priority Health SBD |
$392.29
|
| Rate for Payer: Railroad Medicare Medicare |
$416.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$500.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$416.78
|
| Rate for Payer: UHC Exchange |
$416.78
|
| Rate for Payer: UHC Medicare Advantage |
$416.78
|
| Rate for Payer: UHCCP Medicaid |
$223.39
|
| Rate for Payer: UMR Bronson Commercial |
$230.40
|
| Rate for Payer: VA VA |
$416.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$467.02
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
OP
|
$110.28
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.10 |
| Max. Negotiated Rate |
$197.07 |
| Rate for Payer: Aetna American Axle |
$71.68
|
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna Medicare |
$68.32
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.11
|
| Rate for Payer: BCBS Complete |
$36.97
|
| Rate for Payer: BCBS MAPPO |
$65.69
|
| Rate for Payer: BCBS Trust/PPO |
$63.29
|
| Rate for Payer: BCN Commercial |
$63.29
|
| Rate for Payer: BCN Medicare Advantage |
$65.69
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.69
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.71
|
| Rate for Payer: Mclaren Medicaid |
$35.21
|
| Rate for Payer: Mclaren Medicare |
$65.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.97
|
| Rate for Payer: Meridian Medicaid |
$36.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Nomi Health Commercial |
$197.07
|
| Rate for Payer: PACE Medicare |
$62.41
|
| Rate for Payer: PACE SWMI |
$65.69
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: PHP Medicare Advantage |
$65.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$65.69
|
| Rate for Payer: Priority Health Medicare |
$65.69
|
| Rate for Payer: Priority Health Narrow Network |
$52.55
|
| Rate for Payer: Priority Health SBD |
$69.48
|
| Rate for Payer: Railroad Medicare Medicare |
$65.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$78.83
|
| Rate for Payer: UHC Core |
$5.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.69
|
| Rate for Payer: UHC Exchange |
$65.69
|
| Rate for Payer: UHC Medicare Advantage |
$65.69
|
| Rate for Payer: UHCCP Medicaid |
$35.21
|
| Rate for Payer: UMR Bronson Commercial |
$40.80
|
| Rate for Payer: VA VA |
$65.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.71
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION
|
Facility
|
IP
|
$110.28
|
|
|
Service Code
|
CPT 81240
|
| Hospital Charge Code |
30100514
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$48.52 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna American Axle |
$71.68
|
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$71.68
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$77.20
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Cofinity Medicare Advantage |
$77.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$77.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$71.68
|
| Rate for Payer: Priority Health SBD |
$69.48
|
| Rate for Payer: UMR Bronson Commercial |
$48.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.71
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
OP
|
$120.02
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$39.33 |
| Max. Negotiated Rate |
$220.11 |
| Rate for Payer: Aetna American Axle |
$78.01
|
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna Medicare |
$76.30
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.71
|
| Rate for Payer: BCBS Complete |
$41.29
|
| Rate for Payer: BCBS MAPPO |
$73.37
|
| Rate for Payer: BCBS Trust/PPO |
$70.69
|
| Rate for Payer: BCN Commercial |
$70.69
|
| Rate for Payer: BCN Medicare Advantage |
$73.37
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$84.01
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.37
|
| Rate for Payer: Healthscope Commercial |
$108.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.02
|
| Rate for Payer: Mclaren Medicaid |
$39.33
|
| Rate for Payer: Mclaren Medicare |
$73.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.04
|
| Rate for Payer: Meridian Medicaid |
$41.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: Nomi Health Commercial |
$220.11
|
| Rate for Payer: PACE Medicare |
$69.70
|
| Rate for Payer: PACE SWMI |
$73.37
|
| Rate for Payer: PHP Commercial |
$102.02
|
| Rate for Payer: PHP Medicare Advantage |
$73.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.01
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.37
|
| Rate for Payer: Priority Health Medicare |
$73.37
|
| Rate for Payer: Priority Health Narrow Network |
$58.70
|
| Rate for Payer: Priority Health SBD |
$75.61
|
| Rate for Payer: Railroad Medicare Medicare |
$73.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$73.37
|
| Rate for Payer: UHC Exchange |
$73.37
|
| Rate for Payer: UHC Medicare Advantage |
$73.37
|
| Rate for Payer: UHCCP Medicaid |
$39.33
|
| Rate for Payer: UMR Bronson Commercial |
$44.41
|
| Rate for Payer: VA VA |
$73.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.02
|
|
|
HC ZB774 FACTOR II (2) & FACTOR V LEIDEN MUTATION CMPT
|
Facility
|
IP
|
$120.02
|
|
|
Service Code
|
CPT 81241
|
| Hospital Charge Code |
30100515
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$52.81 |
| Max. Negotiated Rate |
$108.02 |
| Rate for Payer: Aetna American Axle |
$78.01
|
| Rate for Payer: Aetna Commercial |
$102.02
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$78.01
|
| Rate for Payer: Cash Price |
$96.02
|
| Rate for Payer: Cofinity Commercial |
$103.22
|
| Rate for Payer: Cofinity Commercial |
$84.01
|
| Rate for Payer: Cofinity Medicare Advantage |
$84.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.02
|
| Rate for Payer: Healthscope Commercial |
$108.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$84.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$102.02
|
| Rate for Payer: PHP Commercial |
$102.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$78.01
|
| Rate for Payer: Priority Health SBD |
$75.61
|
| Rate for Payer: UMR Bronson Commercial |
$52.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.02
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
OP
|
$4,097.89
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,516.22 |
| Max. Negotiated Rate |
$3,688.10 |
| Rate for Payer: Aetna American Axle |
$2,663.63
|
| Rate for Payer: Aetna Commercial |
$3,483.21
|
| Rate for Payer: Aetna Medicare |
$2,048.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,663.63
|
| Rate for Payer: BCBS Complete |
$1,639.16
|
| Rate for Payer: Cash Price |
$3,278.31
|
| Rate for Payer: Cofinity Commercial |
$2,868.52
|
| Rate for Payer: Cofinity Commercial |
$3,524.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,868.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,278.31
|
| Rate for Payer: Healthscope Commercial |
$3,688.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,868.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,073.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,483.21
|
| Rate for Payer: PHP Commercial |
$3,483.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.63
|
| Rate for Payer: Priority Health SBD |
$2,581.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,516.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,073.42
|
|
|
HC Z EMBOLIZATION COILS
|
Facility
|
IP
|
$4,097.89
|
|
| Hospital Charge Code |
27800045
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,803.07 |
| Max. Negotiated Rate |
$3,688.10 |
| Rate for Payer: Aetna American Axle |
$2,663.63
|
| Rate for Payer: Aetna Commercial |
$3,483.21
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$2,663.63
|
| Rate for Payer: Cash Price |
$3,278.31
|
| Rate for Payer: Cofinity Commercial |
$2,868.52
|
| Rate for Payer: Cofinity Commercial |
$3,524.19
|
| Rate for Payer: Cofinity Medicare Advantage |
$2,868.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,278.31
|
| Rate for Payer: Healthscope Commercial |
$3,688.10
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$2,868.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,073.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,483.21
|
| Rate for Payer: PHP Commercial |
$3,483.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,663.63
|
| Rate for Payer: Priority Health SBD |
$2,581.67
|
| Rate for Payer: UMR Bronson Commercial |
$1,803.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,073.42
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
OP
|
$7,692.24
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,846.13 |
| Max. Negotiated Rate |
$6,923.02 |
| Rate for Payer: Aetna American Axle |
$4,999.96
|
| Rate for Payer: Aetna Commercial |
$6,538.40
|
| Rate for Payer: Aetna Medicare |
$3,846.12
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,999.96
|
| Rate for Payer: BCBS Complete |
$3,076.90
|
| Rate for Payer: Cash Price |
$6,153.79
|
| Rate for Payer: Cofinity Commercial |
$5,384.57
|
| Rate for Payer: Cofinity Commercial |
$6,615.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,384.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,153.79
|
| Rate for Payer: Healthscope Commercial |
$6,923.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,384.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,769.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,538.40
|
| Rate for Payer: PHP Commercial |
$6,538.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,999.96
|
| Rate for Payer: Priority Health SBD |
$4,846.11
|
| Rate for Payer: UMR Bronson Commercial |
$2,846.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,769.18
|
|
|
HC Z ENTERPRISE DEVICE
|
Facility
|
IP
|
$7,692.24
|
|
| Hospital Charge Code |
27800047
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$3,384.59 |
| Max. Negotiated Rate |
$6,923.02 |
| Rate for Payer: Aetna American Axle |
$4,999.96
|
| Rate for Payer: Aetna Commercial |
$6,538.40
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$4,999.96
|
| Rate for Payer: Cash Price |
$6,153.79
|
| Rate for Payer: Cofinity Commercial |
$5,384.57
|
| Rate for Payer: Cofinity Commercial |
$6,615.33
|
| Rate for Payer: Cofinity Medicare Advantage |
$5,384.57
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,153.79
|
| Rate for Payer: Healthscope Commercial |
$6,923.02
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$5,384.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,769.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,538.40
|
| Rate for Payer: PHP Commercial |
$6,538.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,999.96
|
| Rate for Payer: Priority Health SBD |
$4,846.11
|
| Rate for Payer: UMR Bronson Commercial |
$3,384.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,769.18
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
OP
|
$2,229.12
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$427.74 |
| Max. Negotiated Rate |
$3,557.87 |
| Rate for Payer: Aetna American Axle |
$1,448.93
|
| Rate for Payer: Aetna Commercial |
$1,894.75
|
| Rate for Payer: Aetna Medicare |
$829.94
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$997.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$997.52
|
| Rate for Payer: BCBS Complete |
$449.13
|
| Rate for Payer: BCBS MAPPO |
$798.02
|
| Rate for Payer: BCBS Trust/PPO |
$3,557.87
|
| Rate for Payer: BCN Commercial |
$3,557.87
|
| Rate for Payer: BCN Medicare Advantage |
$798.02
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cofinity Commercial |
$1,917.04
|
| Rate for Payer: Cofinity Commercial |
$1,560.38
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,560.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,783.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$798.02
|
| Rate for Payer: Healthscope Commercial |
$2,006.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,560.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.84
|
| Rate for Payer: Mclaren Medicaid |
$427.74
|
| Rate for Payer: Mclaren Medicare |
$798.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$837.92
|
| Rate for Payer: Meridian Medicaid |
$449.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$917.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,894.75
|
| Rate for Payer: Nomi Health Commercial |
$2,394.06
|
| Rate for Payer: PACE Medicare |
$758.12
|
| Rate for Payer: PACE SWMI |
$798.02
|
| Rate for Payer: PHP Commercial |
$1,894.75
|
| Rate for Payer: PHP Medicare Advantage |
$798.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$427.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,296.71
|
| Rate for Payer: Priority Health Medicare |
$798.02
|
| Rate for Payer: Priority Health Narrow Network |
$1,837.37
|
| Rate for Payer: Priority Health SBD |
$1,404.35
|
| Rate for Payer: Railroad Medicare Medicare |
$798.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,246.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$798.02
|
| Rate for Payer: UHC Exchange |
$1,525.10
|
| Rate for Payer: UHC Medicare Advantage |
$798.02
|
| Rate for Payer: UHCCP Medicaid |
$427.74
|
| Rate for Payer: UMR Bronson Commercial |
$824.77
|
| Rate for Payer: VA VA |
$798.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.84
|
|
|
HC ZEVALIN IN-III PER STUDY
|
Facility
|
IP
|
$2,229.12
|
|
|
Service Code
|
HCPCS A9542
|
| Hospital Charge Code |
34300025
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$980.81 |
| Max. Negotiated Rate |
$2,006.21 |
| Rate for Payer: Aetna American Axle |
$1,448.93
|
| Rate for Payer: Aetna Commercial |
$1,894.75
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$1,448.93
|
| Rate for Payer: Cash Price |
$1,783.30
|
| Rate for Payer: Cofinity Commercial |
$1,560.38
|
| Rate for Payer: Cofinity Commercial |
$1,917.04
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,560.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,783.30
|
| Rate for Payer: Healthscope Commercial |
$2,006.21
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,560.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,671.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,894.75
|
| Rate for Payer: PHP Commercial |
$1,894.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,448.93
|
| Rate for Payer: Priority Health SBD |
$1,404.35
|
| Rate for Payer: UMR Bronson Commercial |
$980.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,671.84
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
OP
|
$61,963.39
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$22,926.45 |
| Max. Negotiated Rate |
$170,473.65 |
| Rate for Payer: Aetna American Axle |
$40,276.20
|
| Rate for Payer: Aetna Commercial |
$52,668.88
|
| Rate for Payer: Aetna Medicare |
$59,097.53
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40,276.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71,030.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71,030.69
|
| Rate for Payer: BCBS Complete |
$31,980.86
|
| Rate for Payer: BCBS MAPPO |
$56,824.55
|
| Rate for Payer: BCBS Trust/PPO |
$84,111.21
|
| Rate for Payer: BCN Commercial |
$84,111.21
|
| Rate for Payer: BCN Medicare Advantage |
$56,824.55
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cofinity Commercial |
$53,288.52
|
| Rate for Payer: Cofinity Commercial |
$43,374.37
|
| Rate for Payer: Cofinity Medicare Advantage |
$43,374.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49,570.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56,824.55
|
| Rate for Payer: Healthscope Commercial |
$55,767.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43,374.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46,472.54
|
| Rate for Payer: Mclaren Medicaid |
$30,457.96
|
| Rate for Payer: Mclaren Medicare |
$56,824.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59,665.78
|
| Rate for Payer: Meridian Medicaid |
$31,980.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65,348.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,668.88
|
| Rate for Payer: Nomi Health Commercial |
$170,473.65
|
| Rate for Payer: PACE Medicare |
$53,983.32
|
| Rate for Payer: PACE SWMI |
$56,824.55
|
| Rate for Payer: PHP Commercial |
$52,668.88
|
| Rate for Payer: PHP Medicare Advantage |
$56,824.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$30,457.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40,276.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$42,521.97
|
| Rate for Payer: Priority Health Medicare |
$56,824.55
|
| Rate for Payer: Priority Health Narrow Network |
$34,017.58
|
| Rate for Payer: Priority Health SBD |
$39,036.94
|
| Rate for Payer: Railroad Medicare Medicare |
$56,824.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$159,955.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$56,824.55
|
| Rate for Payer: UHC Exchange |
$108,597.40
|
| Rate for Payer: UHC Medicare Advantage |
$56,824.55
|
| Rate for Payer: UHCCP Medicaid |
$30,457.96
|
| Rate for Payer: UMR Bronson Commercial |
$22,926.45
|
| Rate for Payer: VA VA |
$56,824.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46,472.54
|
|
|
HC ZEVALIN Y-90 PER STUDY
|
Facility
|
IP
|
$61,963.39
|
|
|
Service Code
|
HCPCS A9543
|
| Hospital Charge Code |
34400006
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$27,263.89 |
| Max. Negotiated Rate |
$55,767.05 |
| Rate for Payer: Aetna American Axle |
$40,276.20
|
| Rate for Payer: Aetna Commercial |
$52,668.88
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$40,276.20
|
| Rate for Payer: Cash Price |
$49,570.71
|
| Rate for Payer: Cofinity Commercial |
$43,374.37
|
| Rate for Payer: Cofinity Commercial |
$53,288.52
|
| Rate for Payer: Cofinity Medicare Advantage |
$43,374.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49,570.71
|
| Rate for Payer: Healthscope Commercial |
$55,767.05
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$43,374.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46,472.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52,668.88
|
| Rate for Payer: PHP Commercial |
$52,668.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40,276.20
|
| Rate for Payer: Priority Health SBD |
$39,036.94
|
| Rate for Payer: UMR Bronson Commercial |
$27,263.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46,472.54
|
|
|
HC Z G J TUBE
|
Facility
|
OP
|
$1,530.89
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$566.43 |
| Max. Negotiated Rate |
$1,377.80 |
| Rate for Payer: Aetna American Axle |
$995.08
|
| Rate for Payer: Aetna Commercial |
$1,301.26
|
| Rate for Payer: Aetna Medicare |
$765.44
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.08
|
| Rate for Payer: BCBS Complete |
$612.36
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cofinity Commercial |
$1,071.62
|
| Rate for Payer: Cofinity Commercial |
$1,316.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.71
|
| Rate for Payer: Healthscope Commercial |
$1,377.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,148.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.26
|
| Rate for Payer: PHP Commercial |
$1,301.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.08
|
| Rate for Payer: Priority Health SBD |
$964.46
|
| Rate for Payer: UMR Bronson Commercial |
$566.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,148.17
|
|
|
HC Z G J TUBE
|
Facility
|
IP
|
$1,530.89
|
|
| Hospital Charge Code |
27800048
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$673.59 |
| Max. Negotiated Rate |
$1,377.80 |
| Rate for Payer: Aetna American Axle |
$995.08
|
| Rate for Payer: Aetna Commercial |
$1,301.26
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$995.08
|
| Rate for Payer: Cash Price |
$1,224.71
|
| Rate for Payer: Cofinity Commercial |
$1,071.62
|
| Rate for Payer: Cofinity Commercial |
$1,316.57
|
| Rate for Payer: Cofinity Medicare Advantage |
$1,071.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.71
|
| Rate for Payer: Healthscope Commercial |
$1,377.80
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$1,071.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,148.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,301.26
|
| Rate for Payer: PHP Commercial |
$1,301.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.08
|
| Rate for Payer: Priority Health SBD |
$964.46
|
| Rate for Payer: UMR Bronson Commercial |
$673.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,148.17
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
IP
|
$1,223.34
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$538.27 |
| Max. Negotiated Rate |
$1,101.01 |
| Rate for Payer: Aetna American Axle |
$795.17
|
| Rate for Payer: Aetna Commercial |
$1,039.84
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.17
|
| Rate for Payer: Cash Price |
$978.67
|
| Rate for Payer: Cofinity Commercial |
$1,052.07
|
| Rate for Payer: Cofinity Commercial |
$856.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$856.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$978.67
|
| Rate for Payer: Healthscope Commercial |
$1,101.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$856.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$917.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,039.84
|
| Rate for Payer: PHP Commercial |
$1,039.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.17
|
| Rate for Payer: Priority Health SBD |
$770.70
|
| Rate for Payer: UMR Bronson Commercial |
$538.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$917.50
|
|
|
HC Z HEMODIALYSIS ANGIODYNAMIC
|
Facility
|
OP
|
$1,223.34
|
|
|
Service Code
|
HCPCS C1881
|
| Hospital Charge Code |
27200087
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$452.64 |
| Max. Negotiated Rate |
$1,101.01 |
| Rate for Payer: Aetna American Axle |
$795.17
|
| Rate for Payer: Aetna Commercial |
$1,039.84
|
| Rate for Payer: Aetna Medicare |
$611.67
|
| Rate for Payer: Aetna New Business (MI Preferred) |
$795.17
|
| Rate for Payer: BCBS Complete |
$489.34
|
| Rate for Payer: Cash Price |
$978.67
|
| Rate for Payer: Cofinity Commercial |
$1,052.07
|
| Rate for Payer: Cofinity Commercial |
$856.34
|
| Rate for Payer: Cofinity Medicare Advantage |
$856.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$978.67
|
| Rate for Payer: Healthscope Commercial |
$1,101.01
|
| Rate for Payer: Kalamazoo County Sherrif's Dept Commercial |
$856.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$917.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,039.84
|
| Rate for Payer: PHP Commercial |
$1,039.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$795.17
|
| Rate for Payer: Priority Health SBD |
$770.70
|
| Rate for Payer: UMR Bronson Commercial |
$452.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$917.50
|
|
