|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
IP
|
$90.40
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$55.13 |
| Max. Negotiated Rate |
$81.36 |
| Rate for Payer: Aetna Commercial |
$76.84
|
| Rate for Payer: BCBS Trust/PPO |
$69.86
|
| Rate for Payer: BCN Commercial |
$69.86
|
| Rate for Payer: Cash Price |
$72.32
|
| Rate for Payer: Cofinity Commercial |
$77.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$72.32
|
| Rate for Payer: Healthscope Commercial |
$81.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$67.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$76.84
|
| Rate for Payer: PHP Commercial |
$76.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$78.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$79.55
|
| Rate for Payer: UHC Core |
$75.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$67.80
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
OP
|
$257.80
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$61.23 |
| Max. Negotiated Rate |
$232.02 |
| Rate for Payer: Aetna Commercial |
$219.13
|
| Rate for Payer: Aetna Medicare |
$67.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.56
|
| Rate for Payer: BCBS Complete |
$105.28
|
| Rate for Payer: BCBS MAPPO |
$64.45
|
| Rate for Payer: BCBS Trust/PPO |
$200.44
|
| Rate for Payer: BCN Commercial |
$200.44
|
| Rate for Payer: BCN Medicare Advantage |
$64.45
|
| Rate for Payer: Cash Price |
$206.24
|
| Rate for Payer: Cash Price |
$206.24
|
| Rate for Payer: Cofinity Commercial |
$221.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.45
|
| Rate for Payer: Healthscope Commercial |
$232.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.35
|
| Rate for Payer: Mclaren Medicaid |
$100.26
|
| Rate for Payer: Meridian Medicaid |
$105.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$67.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.13
|
| Rate for Payer: PACE Senior Care Partners |
$61.23
|
| Rate for Payer: PACE SWMI |
$64.45
|
| Rate for Payer: PHP Commercial |
$219.13
|
| Rate for Payer: PHP Medicare Advantage |
$64.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.29
|
| Rate for Payer: Priority Health Medicare |
$64.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.23
|
| Rate for Payer: Railroad Medicare Medicare |
$64.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.86
|
| Rate for Payer: UHC Core |
$215.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.45
|
| Rate for Payer: UHC Medicare Advantage |
$66.38
|
| Rate for Payer: VA VA |
$64.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.35
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
IP
|
$257.80
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$157.23 |
| Max. Negotiated Rate |
$232.02 |
| Rate for Payer: Aetna Commercial |
$219.13
|
| Rate for Payer: BCBS Trust/PPO |
$199.23
|
| Rate for Payer: BCN Commercial |
$199.23
|
| Rate for Payer: Cash Price |
$206.24
|
| Rate for Payer: Cofinity Commercial |
$221.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$206.24
|
| Rate for Payer: Healthscope Commercial |
$232.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$193.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$219.13
|
| Rate for Payer: PHP Commercial |
$219.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$180.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$224.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$157.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$226.86
|
| Rate for Payer: UHC Core |
$215.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$193.35
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna Medicare |
$38.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.31
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: BCBS MAPPO |
$37.05
|
| Rate for Payer: BCBS Trust/PPO |
$115.22
|
| Rate for Payer: BCCCP Commercial |
$22.00
|
| Rate for Payer: BCN Commercial |
$115.22
|
| Rate for Payer: BCN Medicare Advantage |
$37.05
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$38.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.96
|
| Rate for Payer: PACE Senior Care Partners |
$35.20
|
| Rate for Payer: PACE SWMI |
$37.05
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.93
|
| Rate for Payer: Priority Health Medicare |
$37.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.38
|
| Rate for Payer: Railroad Medicare Medicare |
$37.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.05
|
| Rate for Payer: UHC Medicare Advantage |
$38.16
|
| Rate for Payer: VA VA |
$37.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$90.38 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: BCBS Trust/PPO |
$114.52
|
| Rate for Payer: BCN Commercial |
$114.52
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$125.96
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$103.73
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$128.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTROMERE AB
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.81
|
| Rate for Payer: BCN Commercial |
$26.81
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC CENTROMERE AB
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.65
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
OP
|
$245.00
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$58.19 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: Aetna Medicare |
$63.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.56
|
| Rate for Payer: BCBS Complete |
$110.52
|
| Rate for Payer: BCBS MAPPO |
$61.25
|
| Rate for Payer: BCBS Trust/PPO |
$190.49
|
| Rate for Payer: BCN Commercial |
$190.49
|
| Rate for Payer: BCN Medicare Advantage |
$61.25
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$61.25
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Mclaren Medicaid |
$105.26
|
| Rate for Payer: Meridian Medicaid |
$110.52
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PACE Senior Care Partners |
$58.19
|
| Rate for Payer: PACE SWMI |
$61.25
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: PHP Medicare Advantage |
$61.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$105.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.15
|
| Rate for Payer: Priority Health Medicare |
$61.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.43
|
| Rate for Payer: Railroad Medicare Medicare |
$61.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.60
|
| Rate for Payer: UHC Core |
$204.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$61.25
|
| Rate for Payer: UHC Medicare Advantage |
$63.09
|
| Rate for Payer: VA VA |
$61.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
IP
|
$245.00
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$149.43 |
| Max. Negotiated Rate |
$220.50 |
| Rate for Payer: Aetna Commercial |
$208.25
|
| Rate for Payer: BCBS Trust/PPO |
$189.34
|
| Rate for Payer: BCN Commercial |
$189.34
|
| Rate for Payer: Cash Price |
$196.00
|
| Rate for Payer: Cofinity Commercial |
$210.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$196.00
|
| Rate for Payer: Healthscope Commercial |
$220.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$183.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$208.25
|
| Rate for Payer: PHP Commercial |
$208.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$171.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$213.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$215.60
|
| Rate for Payer: UHC Core |
$204.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$183.75
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
OP
|
$4,054.86
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$963.03 |
| Max. Negotiated Rate |
$3,649.37 |
| Rate for Payer: Aetna Commercial |
$3,446.63
|
| Rate for Payer: Aetna Medicare |
$1,054.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,267.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,267.14
|
| Rate for Payer: BCBS Complete |
$1,621.94
|
| Rate for Payer: BCBS MAPPO |
$1,013.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,152.65
|
| Rate for Payer: BCN Commercial |
$3,152.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,013.72
|
| Rate for Payer: Cash Price |
$3,243.89
|
| Rate for Payer: Cofinity Commercial |
$3,487.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,243.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,013.72
|
| Rate for Payer: Healthscope Commercial |
$3,649.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,041.14
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,064.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,165.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,446.63
|
| Rate for Payer: PACE Senior Care Partners |
$963.03
|
| Rate for Payer: PACE SWMI |
$1,013.72
|
| Rate for Payer: PHP Commercial |
$3,446.63
|
| Rate for Payer: PHP Medicare Advantage |
$1,013.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,838.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,527.73
|
| Rate for Payer: Priority Health Medicare |
$1,013.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,473.06
|
| Rate for Payer: Railroad Medicare Medicare |
$1,013.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,568.28
|
| Rate for Payer: UHC Core |
$3,385.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,013.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,044.13
|
| Rate for Payer: VA VA |
$1,013.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,041.14
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
IP
|
$4,054.86
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,473.06 |
| Max. Negotiated Rate |
$3,649.37 |
| Rate for Payer: Aetna Commercial |
$3,446.63
|
| Rate for Payer: BCBS Trust/PPO |
$3,133.60
|
| Rate for Payer: BCN Commercial |
$3,133.60
|
| Rate for Payer: Cash Price |
$3,243.89
|
| Rate for Payer: Cofinity Commercial |
$3,487.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,243.89
|
| Rate for Payer: Healthscope Commercial |
$3,649.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,041.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,446.63
|
| Rate for Payer: PHP Commercial |
$3,446.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,838.40
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,527.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,473.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,568.28
|
| Rate for Payer: UHC Core |
$3,385.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,041.14
|
|
|
HC CERETEC PER DOSE
|
Facility
|
OP
|
$2,020.58
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$479.89 |
| Max. Negotiated Rate |
$1,818.52 |
| Rate for Payer: Aetna Commercial |
$1,717.49
|
| Rate for Payer: Aetna Medicare |
$525.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$631.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$631.43
|
| Rate for Payer: BCBS Complete |
$808.23
|
| Rate for Payer: BCBS MAPPO |
$505.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,571.00
|
| Rate for Payer: BCN Commercial |
$1,571.00
|
| Rate for Payer: BCN Medicare Advantage |
$505.14
|
| Rate for Payer: Cash Price |
$1,616.46
|
| Rate for Payer: Cofinity Commercial |
$1,737.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,616.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$505.14
|
| Rate for Payer: Healthscope Commercial |
$1,818.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,515.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$530.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$580.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,717.49
|
| Rate for Payer: PACE Senior Care Partners |
$479.89
|
| Rate for Payer: PACE SWMI |
$505.14
|
| Rate for Payer: PHP Commercial |
$1,717.49
|
| Rate for Payer: PHP Medicare Advantage |
$505.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,414.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.90
|
| Rate for Payer: Priority Health Medicare |
$505.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,232.35
|
| Rate for Payer: Railroad Medicare Medicare |
$505.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,778.11
|
| Rate for Payer: UHC Core |
$1,687.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$505.14
|
| Rate for Payer: UHC Medicare Advantage |
$520.30
|
| Rate for Payer: VA VA |
$505.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,515.44
|
|
|
HC CERETEC PER DOSE
|
Facility
|
IP
|
$2,020.58
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,232.35 |
| Max. Negotiated Rate |
$1,818.52 |
| Rate for Payer: Aetna Commercial |
$1,717.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,561.50
|
| Rate for Payer: BCN Commercial |
$1,561.50
|
| Rate for Payer: Cash Price |
$1,616.46
|
| Rate for Payer: Cofinity Commercial |
$1,737.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,616.46
|
| Rate for Payer: Healthscope Commercial |
$1,818.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,515.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,717.49
|
| Rate for Payer: PHP Commercial |
$1,717.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,414.41
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,757.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,232.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,778.11
|
| Rate for Payer: UHC Core |
$1,687.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,515.44
|
|
|
HC CERTOLIZUMAB
|
Facility
|
IP
|
$163.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$99.41 |
| Max. Negotiated Rate |
$146.70 |
| Rate for Payer: Aetna Commercial |
$138.55
|
| Rate for Payer: BCBS Trust/PPO |
$125.97
|
| Rate for Payer: BCN Commercial |
$125.97
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$140.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.40
|
| Rate for Payer: Healthscope Commercial |
$146.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.55
|
| Rate for Payer: PHP Commercial |
$138.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.44
|
| Rate for Payer: UHC Core |
$136.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.25
|
|
|
HC CERTOLIZUMAB
|
Facility
|
OP
|
$163.00
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$146.70 |
| Rate for Payer: Aetna Commercial |
$138.55
|
| Rate for Payer: Aetna Medicare |
$42.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.94
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$40.75
|
| Rate for Payer: BCBS Trust/PPO |
$126.73
|
| Rate for Payer: BCN Commercial |
$126.73
|
| Rate for Payer: BCN Medicare Advantage |
$40.75
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cash Price |
$130.40
|
| Rate for Payer: Cofinity Commercial |
$140.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$146.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.25
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$42.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$138.55
|
| Rate for Payer: PACE Senior Care Partners |
$38.71
|
| Rate for Payer: PACE SWMI |
$40.75
|
| Rate for Payer: PHP Commercial |
$138.55
|
| Rate for Payer: PHP Medicare Advantage |
$40.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$114.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$141.81
|
| Rate for Payer: Priority Health Medicare |
$40.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.41
|
| Rate for Payer: Railroad Medicare Medicare |
$40.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.44
|
| Rate for Payer: UHC Core |
$136.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.75
|
| Rate for Payer: UHC Medicare Advantage |
$41.97
|
| Rate for Payer: VA VA |
$40.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.25
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: Aetna Medicare |
$33.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.00
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$32.00
|
| Rate for Payer: BCBS Trust/PPO |
$99.52
|
| Rate for Payer: BCN Commercial |
$99.52
|
| Rate for Payer: BCN Medicare Advantage |
$32.00
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.00
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$33.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.80
|
| Rate for Payer: PACE Senior Care Partners |
$30.40
|
| Rate for Payer: PACE SWMI |
$32.00
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: PHP Medicare Advantage |
$32.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.36
|
| Rate for Payer: Priority Health Medicare |
$32.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.07
|
| Rate for Payer: Railroad Medicare Medicare |
$32.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.64
|
| Rate for Payer: UHC Core |
$106.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.00
|
| Rate for Payer: UHC Medicare Advantage |
$32.96
|
| Rate for Payer: VA VA |
$32.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.07 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Aetna Commercial |
$108.80
|
| Rate for Payer: BCBS Trust/PPO |
$98.92
|
| Rate for Payer: BCN Commercial |
$98.92
|
| Rate for Payer: Cash Price |
$102.40
|
| Rate for Payer: Cofinity Commercial |
$110.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$102.40
|
| Rate for Payer: Healthscope Commercial |
$115.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$108.80
|
| Rate for Payer: PHP Commercial |
$108.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$89.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$111.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$112.64
|
| Rate for Payer: UHC Core |
$106.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.00
|
|
|
HC CERULOPLASMIN
|
Facility
|
OP
|
$41.82
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.93 |
| 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 |
$8.32
|
| 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 |
$7.93
|
| Rate for Payer: Meridian Medicaid |
$8.32
|
| 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 |
$7.93
|
| 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 CERULOPLASMIN
|
Facility
|
IP
|
$41.82
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
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 CERVILENZ
|
Facility
|
IP
|
$167.34
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$102.06 |
| Max. Negotiated Rate |
$150.61 |
| Rate for Payer: Aetna Commercial |
$142.24
|
| Rate for Payer: BCBS Trust/PPO |
$129.32
|
| Rate for Payer: BCN Commercial |
$129.32
|
| Rate for Payer: Cash Price |
$133.87
|
| Rate for Payer: Cofinity Commercial |
$143.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.87
|
| Rate for Payer: Healthscope Commercial |
$150.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.24
|
| Rate for Payer: PHP Commercial |
$142.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.26
|
| Rate for Payer: UHC Core |
$139.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.50
|
|
|
HC CERVILENZ
|
Facility
|
OP
|
$167.34
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$39.74 |
| Max. Negotiated Rate |
$150.61 |
| Rate for Payer: Aetna Commercial |
$142.24
|
| Rate for Payer: Aetna Medicare |
$43.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.29
|
| Rate for Payer: BCBS Complete |
$66.94
|
| Rate for Payer: BCBS MAPPO |
$41.84
|
| Rate for Payer: BCBS Trust/PPO |
$130.11
|
| Rate for Payer: BCN Commercial |
$130.11
|
| Rate for Payer: BCN Medicare Advantage |
$41.84
|
| Rate for Payer: Cash Price |
$133.87
|
| Rate for Payer: Cofinity Commercial |
$143.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.84
|
| Rate for Payer: Healthscope Commercial |
$150.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$43.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$142.24
|
| Rate for Payer: PACE Senior Care Partners |
$39.74
|
| Rate for Payer: PACE SWMI |
$41.84
|
| Rate for Payer: PHP Commercial |
$142.24
|
| Rate for Payer: PHP Medicare Advantage |
$41.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$145.59
|
| Rate for Payer: Priority Health Medicare |
$41.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.06
|
| Rate for Payer: Railroad Medicare Medicare |
$41.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.26
|
| Rate for Payer: UHC Core |
$139.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.84
|
| Rate for Payer: UHC Medicare Advantage |
$43.09
|
| Rate for Payer: VA VA |
$41.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.50
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
IP
|
$138.02
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$84.18 |
| Max. Negotiated Rate |
$124.22 |
| Rate for Payer: Aetna Commercial |
$117.32
|
| Rate for Payer: BCBS Trust/PPO |
$106.66
|
| Rate for Payer: BCN Commercial |
$106.66
|
| Rate for Payer: Cash Price |
$110.42
|
| Rate for Payer: Cofinity Commercial |
$118.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.42
|
| Rate for Payer: Healthscope Commercial |
$124.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.32
|
| Rate for Payer: PHP Commercial |
$117.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.46
|
| Rate for Payer: UHC Core |
$115.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.52
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
OP
|
$138.02
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$32.78 |
| Max. Negotiated Rate |
$124.22 |
| Rate for Payer: Aetna Commercial |
$117.32
|
| Rate for Payer: Aetna Medicare |
$35.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.13
|
| Rate for Payer: BCBS Complete |
$61.40
|
| Rate for Payer: BCBS MAPPO |
$34.50
|
| Rate for Payer: BCBS Trust/PPO |
$107.31
|
| Rate for Payer: BCN Commercial |
$107.31
|
| Rate for Payer: BCN Medicare Advantage |
$34.50
|
| Rate for Payer: Cash Price |
$110.42
|
| Rate for Payer: Cash Price |
$110.42
|
| Rate for Payer: Cofinity Commercial |
$118.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$110.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.50
|
| Rate for Payer: Healthscope Commercial |
$124.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$103.52
|
| Rate for Payer: Mclaren Medicaid |
$58.47
|
| Rate for Payer: Meridian Medicaid |
$61.40
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$36.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$117.32
|
| Rate for Payer: PACE Senior Care Partners |
$32.78
|
| Rate for Payer: PACE SWMI |
$34.50
|
| Rate for Payer: PHP Commercial |
$117.32
|
| Rate for Payer: PHP Medicare Advantage |
$34.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$58.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.61
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$120.08
|
| Rate for Payer: Priority Health Medicare |
$34.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.18
|
| Rate for Payer: Railroad Medicare Medicare |
$34.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$121.46
|
| Rate for Payer: UHC Core |
$115.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$34.50
|
| Rate for Payer: UHC Medicare Advantage |
$35.54
|
| Rate for Payer: VA VA |
$34.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$103.52
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
OP
|
$762.46
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$181.08 |
| Max. Negotiated Rate |
$686.21 |
| Rate for Payer: Aetna Commercial |
$648.09
|
| Rate for Payer: Aetna Medicare |
$198.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$238.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$238.27
|
| Rate for Payer: BCBS Complete |
$304.98
|
| Rate for Payer: BCBS MAPPO |
$190.62
|
| Rate for Payer: BCBS Trust/PPO |
$592.81
|
| Rate for Payer: BCN Commercial |
$592.81
|
| Rate for Payer: BCN Medicare Advantage |
$190.62
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$655.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.62
|
| Rate for Payer: Healthscope Commercial |
$686.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.84
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$200.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$219.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PACE Senior Care Partners |
$181.08
|
| Rate for Payer: PACE SWMI |
$190.62
|
| Rate for Payer: PHP Commercial |
$648.09
|
| Rate for Payer: PHP Medicare Advantage |
$190.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.34
|
| Rate for Payer: Priority Health Medicare |
$190.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$465.02
|
| Rate for Payer: Railroad Medicare Medicare |
$190.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.96
|
| Rate for Payer: UHC Core |
$636.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$190.62
|
| Rate for Payer: UHC Medicare Advantage |
$196.33
|
| Rate for Payer: VA VA |
$190.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.84
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
IP
|
$762.46
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$465.02 |
| Max. Negotiated Rate |
$686.21 |
| Rate for Payer: Aetna Commercial |
$648.09
|
| Rate for Payer: BCBS Trust/PPO |
$589.23
|
| Rate for Payer: BCN Commercial |
$589.23
|
| Rate for Payer: Cash Price |
$609.97
|
| Rate for Payer: Cofinity Commercial |
$655.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$609.97
|
| Rate for Payer: Healthscope Commercial |
$686.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$571.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$648.09
|
| Rate for Payer: PHP Commercial |
$648.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$533.72
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$663.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$465.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$670.96
|
| Rate for Payer: UHC Core |
$636.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$571.84
|
|
