|
HC BETA 2 GLYCOPROTEIN I IGM M A
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200443
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC BETA 2 GP1 AB IGA
|
Facility
|
IP
|
$35.70
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200143
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.77 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: BCBS Trust/PPO |
$27.59
|
| Rate for Payer: BCN Commercial |
$27.59
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC BETA 2 GP1 AB IGA
|
Facility
|
OP
|
$35.70
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200143
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$32.13 |
| Rate for Payer: Aetna Commercial |
$30.34
|
| Rate for Payer: Aetna Medicare |
$9.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.16
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$8.92
|
| Rate for Payer: BCBS Trust/PPO |
$27.76
|
| Rate for Payer: BCN Commercial |
$27.76
|
| Rate for Payer: BCN Medicare Advantage |
$8.92
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cofinity Commercial |
$30.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.92
|
| Rate for Payer: Healthscope Commercial |
$32.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.78
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.34
|
| Rate for Payer: PACE Senior Care Partners |
$8.48
|
| Rate for Payer: PACE SWMI |
$8.92
|
| Rate for Payer: PHP Commercial |
$30.34
|
| Rate for Payer: PHP Medicare Advantage |
$8.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.99
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.06
|
| Rate for Payer: Priority Health Medicare |
$8.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.77
|
| Rate for Payer: Railroad Medicare Medicare |
$8.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.42
|
| Rate for Payer: UHC Core |
$29.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.19
|
| Rate for Payer: VA VA |
$8.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.78
|
|
|
HC BETA 2 GP1 AB IGG
|
Facility
|
IP
|
$42.35
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200142
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.83 |
| Max. Negotiated Rate |
$38.12 |
| Rate for Payer: Aetna Commercial |
$36.00
|
| Rate for Payer: BCBS Trust/PPO |
$32.73
|
| Rate for Payer: BCN Commercial |
$32.73
|
| Rate for Payer: Cash Price |
$33.88
|
| Rate for Payer: Cofinity Commercial |
$36.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.88
|
| Rate for Payer: Healthscope Commercial |
$38.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.00
|
| Rate for Payer: PHP Commercial |
$36.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.27
|
| Rate for Payer: UHC Core |
$35.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.76
|
|
|
HC BETA 2 GP1 AB IGG
|
Facility
|
OP
|
$42.35
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200142
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.06 |
| Max. Negotiated Rate |
$38.12 |
| Rate for Payer: Aetna Commercial |
$36.00
|
| Rate for Payer: Aetna Medicare |
$11.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.23
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$10.59
|
| Rate for Payer: BCBS Trust/PPO |
$32.93
|
| Rate for Payer: BCN Commercial |
$32.93
|
| Rate for Payer: BCN Medicare Advantage |
$10.59
|
| Rate for Payer: Cash Price |
$33.88
|
| Rate for Payer: Cash Price |
$33.88
|
| Rate for Payer: Cofinity Commercial |
$36.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.59
|
| Rate for Payer: Healthscope Commercial |
$38.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.76
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.00
|
| Rate for Payer: PACE Senior Care Partners |
$10.06
|
| Rate for Payer: PACE SWMI |
$10.59
|
| Rate for Payer: PHP Commercial |
$36.00
|
| Rate for Payer: PHP Medicare Advantage |
$10.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.84
|
| Rate for Payer: Priority Health Medicare |
$10.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.83
|
| Rate for Payer: Railroad Medicare Medicare |
$10.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.27
|
| Rate for Payer: UHC Core |
$35.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.59
|
| Rate for Payer: UHC Medicare Advantage |
$10.91
|
| Rate for Payer: VA VA |
$10.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.76
|
|
|
HC BETA 2 GP1 AB IGM
|
Facility
|
IP
|
$50.39
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.73 |
| Max. Negotiated Rate |
$45.35 |
| Rate for Payer: Aetna Commercial |
$42.83
|
| Rate for Payer: BCBS Trust/PPO |
$38.94
|
| Rate for Payer: BCN Commercial |
$38.94
|
| Rate for Payer: Cash Price |
$40.31
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.31
|
| Rate for Payer: Healthscope Commercial |
$45.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.83
|
| Rate for Payer: PHP Commercial |
$42.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.34
|
| Rate for Payer: UHC Core |
$42.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.79
|
|
|
HC BETA 2 GP1 AB IGM
|
Facility
|
OP
|
$50.39
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$45.35 |
| Rate for Payer: Aetna Commercial |
$42.83
|
| Rate for Payer: Aetna Medicare |
$13.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.75
|
| Rate for Payer: BCBS Complete |
$19.72
|
| Rate for Payer: BCBS MAPPO |
$12.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.18
|
| Rate for Payer: BCN Commercial |
$39.18
|
| Rate for Payer: BCN Medicare Advantage |
$12.60
|
| Rate for Payer: Cash Price |
$40.31
|
| Rate for Payer: Cash Price |
$40.31
|
| Rate for Payer: Cofinity Commercial |
$43.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.60
|
| Rate for Payer: Healthscope Commercial |
$45.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.79
|
| Rate for Payer: Mclaren Medicaid |
$18.78
|
| Rate for Payer: Meridian Medicaid |
$19.72
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$42.83
|
| Rate for Payer: PACE Senior Care Partners |
$11.97
|
| Rate for Payer: PACE SWMI |
$12.60
|
| Rate for Payer: PHP Commercial |
$42.83
|
| Rate for Payer: PHP Medicare Advantage |
$12.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$43.84
|
| Rate for Payer: Priority Health Medicare |
$12.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.73
|
| Rate for Payer: Railroad Medicare Medicare |
$12.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.34
|
| Rate for Payer: UHC Core |
$42.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.60
|
| Rate for Payer: UHC Medicare Advantage |
$12.98
|
| Rate for Payer: VA VA |
$12.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.79
|
|
|
HC BETA-2 MICROGLOBULIN
|
Facility
|
IP
|
$41.82
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
30100115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.51 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: BCBS Trust/PPO |
$32.32
|
| Rate for Payer: BCN Commercial |
$32.32
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.80
|
| Rate for Payer: UHC Core |
$34.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC BETA-2 MICROGLOBULIN
|
Facility
|
OP
|
$41.82
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
30100115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Aetna Commercial |
$35.55
|
| Rate for Payer: Aetna Medicare |
$10.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.07
|
| Rate for Payer: BCBS Complete |
$12.54
|
| Rate for Payer: BCBS MAPPO |
$10.46
|
| Rate for Payer: BCBS Trust/PPO |
$32.52
|
| Rate for Payer: BCN Commercial |
$32.52
|
| Rate for Payer: BCN Medicare Advantage |
$10.46
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Cofinity Commercial |
$35.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.46
|
| Rate for Payer: Healthscope Commercial |
$37.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.36
|
| Rate for Payer: Mclaren Medicaid |
$11.94
|
| Rate for Payer: Meridian Medicaid |
$12.54
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$35.55
|
| Rate for Payer: PACE Senior Care Partners |
$9.93
|
| Rate for Payer: PACE SWMI |
$10.46
|
| Rate for Payer: PHP Commercial |
$35.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$36.38
|
| Rate for Payer: Priority Health Medicare |
$10.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.51
|
| Rate for Payer: Railroad Medicare Medicare |
$10.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.80
|
| Rate for Payer: UHC Core |
$34.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.46
|
| Rate for Payer: UHC Medicare Advantage |
$10.77
|
| Rate for Payer: VA VA |
$10.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.36
|
|
|
HC BETA HYDROXY BUTYRATE KETONE
|
Facility
|
IP
|
$27.85
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
30100068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.99 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$21.52
|
| Rate for Payer: BCN Commercial |
$21.52
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.51
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC BETA HYDROXY BUTYRATE KETONE
|
Facility
|
OP
|
$27.85
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
30100068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.03 |
| Max. Negotiated Rate |
$25.06 |
| Rate for Payer: Aetna Commercial |
$23.67
|
| Rate for Payer: Aetna Medicare |
$7.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.70
|
| Rate for Payer: BCBS Complete |
$6.33
|
| Rate for Payer: BCBS MAPPO |
$6.96
|
| Rate for Payer: BCBS Trust/PPO |
$21.65
|
| Rate for Payer: BCN Commercial |
$21.65
|
| Rate for Payer: BCN Medicare Advantage |
$6.96
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cash Price |
$22.28
|
| Rate for Payer: Cofinity Commercial |
$23.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.96
|
| Rate for Payer: Healthscope Commercial |
$25.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.89
|
| Rate for Payer: Mclaren Medicaid |
$6.03
|
| Rate for Payer: Meridian Medicaid |
$6.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$7.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$23.67
|
| Rate for Payer: PACE Senior Care Partners |
$6.61
|
| Rate for Payer: PACE SWMI |
$6.96
|
| Rate for Payer: PHP Commercial |
$23.67
|
| Rate for Payer: PHP Medicare Advantage |
$6.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$24.23
|
| Rate for Payer: Priority Health Medicare |
$6.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.99
|
| Rate for Payer: Railroad Medicare Medicare |
$6.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.51
|
| Rate for Payer: UHC Core |
$23.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.96
|
| Rate for Payer: UHC Medicare Advantage |
$7.17
|
| Rate for Payer: VA VA |
$6.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.89
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
OP
|
$600.76
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$142.68 |
| Max. Negotiated Rate |
$540.68 |
| Rate for Payer: Aetna Commercial |
$510.65
|
| Rate for Payer: Aetna Medicare |
$156.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.74
|
| Rate for Payer: BCBS Complete |
$204.01
|
| Rate for Payer: BCBS MAPPO |
$150.19
|
| Rate for Payer: BCBS Trust/PPO |
$467.09
|
| Rate for Payer: BCN Commercial |
$467.09
|
| Rate for Payer: BCN Medicare Advantage |
$150.19
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cofinity Commercial |
$516.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.19
|
| Rate for Payer: Healthscope Commercial |
$540.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.57
|
| Rate for Payer: Mclaren Medicaid |
$194.29
|
| Rate for Payer: Meridian Medicaid |
$204.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$157.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.65
|
| Rate for Payer: PACE Senior Care Partners |
$142.68
|
| Rate for Payer: PACE SWMI |
$150.19
|
| Rate for Payer: PHP Commercial |
$510.65
|
| Rate for Payer: PHP Medicare Advantage |
$150.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$194.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.66
|
| Rate for Payer: Priority Health Medicare |
$150.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.40
|
| Rate for Payer: Railroad Medicare Medicare |
$150.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.67
|
| Rate for Payer: UHC Core |
$501.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.19
|
| Rate for Payer: UHC Medicare Advantage |
$154.70
|
| Rate for Payer: VA VA |
$150.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.57
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
IP
|
$600.76
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$366.40 |
| Max. Negotiated Rate |
$540.68 |
| Rate for Payer: Aetna Commercial |
$510.65
|
| Rate for Payer: BCBS Trust/PPO |
$464.27
|
| Rate for Payer: BCN Commercial |
$464.27
|
| Rate for Payer: Cash Price |
$480.61
|
| Rate for Payer: Cofinity Commercial |
$516.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.61
|
| Rate for Payer: Healthscope Commercial |
$540.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$510.65
|
| Rate for Payer: PHP Commercial |
$510.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$420.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$522.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$366.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.67
|
| Rate for Payer: UHC Core |
$501.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.57
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$724.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$441.57 |
| Max. Negotiated Rate |
$651.60 |
| Rate for Payer: Aetna Commercial |
$615.40
|
| Rate for Payer: BCBS Trust/PPO |
$559.51
|
| Rate for Payer: BCN Commercial |
$559.51
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$622.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.20
|
| Rate for Payer: Healthscope Commercial |
$651.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$543.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$615.40
|
| Rate for Payer: PHP Commercial |
$615.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$441.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.12
|
| Rate for Payer: UHC Core |
$604.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$543.00
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$724.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.36 |
| Max. Negotiated Rate |
$651.60 |
| Rate for Payer: Aetna Commercial |
$615.40
|
| Rate for Payer: Aetna Medicare |
$188.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$226.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$226.25
|
| Rate for Payer: BCBS Complete |
$108.53
|
| Rate for Payer: BCBS MAPPO |
$181.00
|
| Rate for Payer: BCBS Trust/PPO |
$562.91
|
| Rate for Payer: BCN Commercial |
$562.91
|
| Rate for Payer: BCN Medicare Advantage |
$181.00
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cash Price |
$579.20
|
| Rate for Payer: Cofinity Commercial |
$622.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$579.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$181.00
|
| Rate for Payer: Healthscope Commercial |
$651.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$543.00
|
| Rate for Payer: Mclaren Medicaid |
$103.36
|
| Rate for Payer: Meridian Medicaid |
$108.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$190.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$208.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$615.40
|
| Rate for Payer: PACE Senior Care Partners |
$171.95
|
| Rate for Payer: PACE SWMI |
$181.00
|
| Rate for Payer: PHP Commercial |
$615.40
|
| Rate for Payer: PHP Medicare Advantage |
$181.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$506.80
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$629.88
|
| Rate for Payer: Priority Health Medicare |
$181.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$441.57
|
| Rate for Payer: Railroad Medicare Medicare |
$181.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$637.12
|
| Rate for Payer: UHC Core |
$604.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$181.00
|
| Rate for Payer: UHC Medicare Advantage |
$186.43
|
| Rate for Payer: VA VA |
$181.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$543.00
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$106.25
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$64.80 |
| Max. Negotiated Rate |
$95.62 |
| Rate for Payer: Aetna Commercial |
$90.31
|
| Rate for Payer: BCBS Trust/PPO |
$82.11
|
| Rate for Payer: BCN Commercial |
$82.11
|
| Rate for Payer: Cash Price |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$91.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.00
|
| Rate for Payer: Healthscope Commercial |
$95.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.31
|
| Rate for Payer: PHP Commercial |
$90.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.50
|
| Rate for Payer: UHC Core |
$88.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.69
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$106.25
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$25.23 |
| Max. Negotiated Rate |
$95.62 |
| Rate for Payer: Aetna Commercial |
$90.31
|
| Rate for Payer: Aetna Medicare |
$27.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.20
|
| Rate for Payer: BCBS Complete |
$42.50
|
| Rate for Payer: BCBS MAPPO |
$26.56
|
| Rate for Payer: BCBS Trust/PPO |
$82.61
|
| Rate for Payer: BCN Commercial |
$82.61
|
| Rate for Payer: BCN Medicare Advantage |
$26.56
|
| Rate for Payer: Cash Price |
$85.00
|
| Rate for Payer: Cofinity Commercial |
$91.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.56
|
| Rate for Payer: Healthscope Commercial |
$95.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.69
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.31
|
| Rate for Payer: PACE Senior Care Partners |
$25.23
|
| Rate for Payer: PACE SWMI |
$26.56
|
| Rate for Payer: PHP Commercial |
$90.31
|
| Rate for Payer: PHP Medicare Advantage |
$26.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.38
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.44
|
| Rate for Payer: Priority Health Medicare |
$26.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.80
|
| Rate for Payer: Railroad Medicare Medicare |
$26.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.50
|
| Rate for Payer: UHC Core |
$88.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.56
|
| Rate for Payer: UHC Medicare Advantage |
$27.36
|
| Rate for Payer: VA VA |
$26.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.69
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
IP
|
$448.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$273.24 |
| Max. Negotiated Rate |
$403.20 |
| Rate for Payer: Aetna Commercial |
$380.80
|
| Rate for Payer: BCBS Trust/PPO |
$346.21
|
| Rate for Payer: BCN Commercial |
$346.21
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$385.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.40
|
| Rate for Payer: Healthscope Commercial |
$403.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.80
|
| Rate for Payer: PHP Commercial |
$380.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.24
|
| Rate for Payer: UHC Core |
$374.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.00
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
OP
|
$448.00
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.36 |
| Max. Negotiated Rate |
$403.20 |
| Rate for Payer: Aetna Commercial |
$380.80
|
| Rate for Payer: Aetna Medicare |
$116.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$140.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$140.00
|
| Rate for Payer: BCBS Complete |
$108.53
|
| Rate for Payer: BCBS MAPPO |
$112.00
|
| Rate for Payer: BCBS Trust/PPO |
$348.32
|
| Rate for Payer: BCN Commercial |
$348.32
|
| Rate for Payer: BCN Medicare Advantage |
$112.00
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cash Price |
$358.40
|
| Rate for Payer: Cofinity Commercial |
$385.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$358.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$112.00
|
| Rate for Payer: Healthscope Commercial |
$403.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$336.00
|
| Rate for Payer: Mclaren Medicaid |
$103.36
|
| Rate for Payer: Meridian Medicaid |
$108.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$117.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$128.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$380.80
|
| Rate for Payer: PACE Senior Care Partners |
$106.40
|
| Rate for Payer: PACE SWMI |
$112.00
|
| Rate for Payer: PHP Commercial |
$380.80
|
| Rate for Payer: PHP Medicare Advantage |
$112.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$313.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$389.76
|
| Rate for Payer: Priority Health Medicare |
$112.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$273.24
|
| Rate for Payer: Railroad Medicare Medicare |
$112.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$394.24
|
| Rate for Payer: UHC Core |
$374.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$112.00
|
| Rate for Payer: UHC Medicare Advantage |
$115.36
|
| Rate for Payer: VA VA |
$112.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$336.00
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$14,199.46
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$8,660.25 |
| Max. Negotiated Rate |
$12,779.51 |
| Rate for Payer: Aetna Commercial |
$12,069.54
|
| Rate for Payer: BCBS Trust/PPO |
$10,973.34
|
| Rate for Payer: BCN Commercial |
$10,973.34
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cofinity Commercial |
$12,211.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,359.57
|
| Rate for Payer: Healthscope Commercial |
$12,779.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,649.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,069.54
|
| Rate for Payer: PHP Commercial |
$12,069.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,939.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,353.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,660.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,495.52
|
| Rate for Payer: UHC Core |
$11,856.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,649.60
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$14,199.46
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,372.37 |
| Max. Negotiated Rate |
$12,779.51 |
| Rate for Payer: Aetna Commercial |
$12,069.54
|
| Rate for Payer: Aetna Medicare |
$3,691.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,437.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,437.33
|
| Rate for Payer: BCBS Complete |
$4,710.75
|
| Rate for Payer: BCBS MAPPO |
$3,549.86
|
| Rate for Payer: BCBS Trust/PPO |
$11,040.08
|
| Rate for Payer: BCN Commercial |
$11,040.08
|
| Rate for Payer: BCN Medicare Advantage |
$3,549.86
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cash Price |
$11,359.57
|
| Rate for Payer: Cofinity Commercial |
$12,211.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,359.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,549.86
|
| Rate for Payer: Healthscope Commercial |
$12,779.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,649.60
|
| Rate for Payer: Mclaren Medicaid |
$4,486.43
|
| Rate for Payer: Meridian Medicaid |
$4,710.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,727.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,082.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$12,069.54
|
| Rate for Payer: PACE Senior Care Partners |
$3,372.37
|
| Rate for Payer: PACE SWMI |
$3,549.86
|
| Rate for Payer: PHP Commercial |
$12,069.54
|
| Rate for Payer: PHP Medicare Advantage |
$3,549.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,486.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,939.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$12,353.53
|
| Rate for Payer: Priority Health Medicare |
$3,549.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,660.25
|
| Rate for Payer: Railroad Medicare Medicare |
$3,549.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,495.52
|
| Rate for Payer: UHC Core |
$11,856.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,549.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,656.36
|
| Rate for Payer: VA VA |
$3,549.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,649.60
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$890.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.36 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Aetna Commercial |
$756.50
|
| Rate for Payer: Aetna Medicare |
$231.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$278.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$278.12
|
| Rate for Payer: BCBS Complete |
$108.53
|
| Rate for Payer: BCBS MAPPO |
$222.50
|
| Rate for Payer: BCBS Trust/PPO |
$691.98
|
| Rate for Payer: BCN Commercial |
$691.98
|
| Rate for Payer: BCN Medicare Advantage |
$222.50
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$765.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$222.50
|
| Rate for Payer: Healthscope Commercial |
$801.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.50
|
| Rate for Payer: Mclaren Medicaid |
$103.36
|
| Rate for Payer: Meridian Medicaid |
$108.53
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$233.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$255.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.50
|
| Rate for Payer: PACE Senior Care Partners |
$211.38
|
| Rate for Payer: PACE SWMI |
$222.50
|
| Rate for Payer: PHP Commercial |
$756.50
|
| Rate for Payer: PHP Medicare Advantage |
$222.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.30
|
| Rate for Payer: Priority Health Medicare |
$222.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$542.81
|
| Rate for Payer: Railroad Medicare Medicare |
$222.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.20
|
| Rate for Payer: UHC Core |
$743.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$222.50
|
| Rate for Payer: UHC Medicare Advantage |
$229.18
|
| Rate for Payer: VA VA |
$222.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.50
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
IP
|
$890.00
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$542.81 |
| Max. Negotiated Rate |
$801.00 |
| Rate for Payer: Aetna Commercial |
$756.50
|
| Rate for Payer: BCBS Trust/PPO |
$687.79
|
| Rate for Payer: BCN Commercial |
$687.79
|
| Rate for Payer: Cash Price |
$712.00
|
| Rate for Payer: Cofinity Commercial |
$765.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$712.00
|
| Rate for Payer: Healthscope Commercial |
$801.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$667.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$756.50
|
| Rate for Payer: PHP Commercial |
$756.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$623.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$774.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$542.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$783.20
|
| Rate for Payer: UHC Core |
$743.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$667.50
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,187.50
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,944.06 |
| Max. Negotiated Rate |
$2,868.75 |
| Rate for Payer: Aetna Commercial |
$2,709.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,463.30
|
| Rate for Payer: BCN Commercial |
$2,463.30
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cofinity Commercial |
$2,741.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,550.00
|
| Rate for Payer: Healthscope Commercial |
$2,868.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,390.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,709.38
|
| Rate for Payer: PHP Commercial |
$2,709.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,231.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,773.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,944.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,805.00
|
| Rate for Payer: UHC Core |
$2,661.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,390.62
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,187.50
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$757.03 |
| Max. Negotiated Rate |
$2,868.75 |
| Rate for Payer: Aetna Commercial |
$2,709.38
|
| Rate for Payer: Aetna Medicare |
$828.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$996.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$996.09
|
| Rate for Payer: BCBS Complete |
$1,116.73
|
| Rate for Payer: BCBS MAPPO |
$796.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,478.28
|
| Rate for Payer: BCN Commercial |
$2,478.28
|
| Rate for Payer: BCN Medicare Advantage |
$796.88
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cash Price |
$2,550.00
|
| Rate for Payer: Cofinity Commercial |
$2,741.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,550.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$796.88
|
| Rate for Payer: Healthscope Commercial |
$2,868.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,390.62
|
| Rate for Payer: Mclaren Medicaid |
$1,063.55
|
| Rate for Payer: Meridian Medicaid |
$1,116.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$836.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$916.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,709.38
|
| Rate for Payer: PACE Senior Care Partners |
$757.03
|
| Rate for Payer: PACE SWMI |
$796.88
|
| Rate for Payer: PHP Commercial |
$2,709.38
|
| Rate for Payer: PHP Medicare Advantage |
$796.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,063.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,231.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,773.12
|
| Rate for Payer: Priority Health Medicare |
$796.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,944.06
|
| Rate for Payer: Railroad Medicare Medicare |
$796.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,805.00
|
| Rate for Payer: UHC Core |
$2,661.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$796.88
|
| Rate for Payer: UHC Medicare Advantage |
$820.78
|
| Rate for Payer: VA VA |
$796.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,390.62
|
|
