|
HC ACHR MODULATING FLOW CYTOMETRY S
|
Facility
|
IP
|
$80.00
|
|
|
Service Code
|
CPT 86043
|
| Hospital Charge Code |
30200519
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$55.68 |
| Max. Negotiated Rate |
$72.00 |
| Rate for Payer: Aetna Commercial |
$68.00
|
| Rate for Payer: BCBS Trust/PPO |
$66.07
|
| Rate for Payer: BCN Commercial |
$66.07
|
| Rate for Payer: Cash Price |
$64.00
|
| Rate for Payer: Cofinity Commercial |
$68.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.00
|
| Rate for Payer: Healthscope Commercial |
$72.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.00
|
| Rate for Payer: Nomi Health Commercial |
$65.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.00
|
| Rate for Payer: PHP Commercial |
$68.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$70.40
|
| Rate for Payer: UHC Core |
$66.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.00
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$105.72 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: BCBS Trust/PPO |
$125.45
|
| Rate for Payer: BCN Commercial |
$125.45
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.67
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC ACOUSTIC IMMITANCE TESTING
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 92570
|
| Hospital Charge Code |
76100509
|
|
Hospital Revenue Code
|
471
|
| Min. Negotiated Rate |
$26.78 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna Medicare |
$39.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.47
|
| Rate for Payer: BCBS Complete |
$28.12
|
| Rate for Payer: BCBS MAPPO |
$37.98
|
| Rate for Payer: BCBS Trust/PPO |
$124.88
|
| Rate for Payer: BCN Commercial |
$124.88
|
| Rate for Payer: BCN Medicare Advantage |
$37.98
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.98
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Mclaren Medicaid |
$26.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.87
|
| Rate for Payer: Meridian Medicaid |
$28.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.92
|
| Rate for Payer: PACE Senior Care Partners |
$36.08
|
| Rate for Payer: PACE SWMI |
$37.98
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: PHP Medicare Advantage |
$37.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.15
|
| Rate for Payer: Priority Health Medicare |
$38.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.72
|
| Rate for Payer: Railroad Medicare Medicare |
$37.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.67
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: UHC Exchange |
$37.98
|
| Rate for Payer: UHC Medicaid |
$26.78
|
| Rate for Payer: UHC Medicare Advantage |
$37.98
|
| Rate for Payer: UHCCP Medicaid |
$26.78
|
| Rate for Payer: VA VA |
$37.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC ACTIGRAPHY
|
Facility
|
OP
|
$281.07
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$49.55 |
| Max. Negotiated Rate |
$252.96 |
| Rate for Payer: Aetna Commercial |
$238.91
|
| Rate for Payer: Aetna Medicare |
$73.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.83
|
| Rate for Payer: BCBS Complete |
$52.03
|
| Rate for Payer: BCBS MAPPO |
$70.27
|
| Rate for Payer: BCBS Trust/PPO |
$231.07
|
| Rate for Payer: BCN Commercial |
$231.07
|
| Rate for Payer: BCN Medicare Advantage |
$70.27
|
| Rate for Payer: Cash Price |
$224.86
|
| Rate for Payer: Cofinity Commercial |
$241.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.27
|
| Rate for Payer: Healthscope Commercial |
$252.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.80
|
| Rate for Payer: Mclaren Medicaid |
$49.55
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.78
|
| Rate for Payer: Meridian Medicaid |
$52.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$77.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.91
|
| Rate for Payer: Nomi Health Commercial |
$230.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.80
|
| Rate for Payer: PACE Senior Care Partners |
$66.75
|
| Rate for Payer: PACE SWMI |
$70.27
|
| Rate for Payer: PHP Commercial |
$238.91
|
| Rate for Payer: PHP Medicare Advantage |
$70.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$49.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$244.53
|
| Rate for Payer: Priority Health Medicare |
$70.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.62
|
| Rate for Payer: Railroad Medicare Medicare |
$70.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.34
|
| Rate for Payer: UHC Core |
$234.69
|
| Rate for Payer: UHC Exchange |
$70.27
|
| Rate for Payer: UHC Medicaid |
$49.55
|
| Rate for Payer: UHC Medicare Advantage |
$70.27
|
| Rate for Payer: UHCCP Medicaid |
$49.55
|
| Rate for Payer: VA VA |
$70.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.80
|
|
|
HC ACTIGRAPHY
|
Facility
|
IP
|
$281.07
|
|
|
Service Code
|
CPT 95803
|
| Hospital Charge Code |
92000016
|
|
Hospital Revenue Code
|
920
|
| Min. Negotiated Rate |
$195.62 |
| Max. Negotiated Rate |
$252.96 |
| Rate for Payer: Aetna Commercial |
$238.91
|
| Rate for Payer: BCBS Trust/PPO |
$232.14
|
| Rate for Payer: BCN Commercial |
$232.14
|
| Rate for Payer: Cash Price |
$224.86
|
| Rate for Payer: Cofinity Commercial |
$241.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.86
|
| Rate for Payer: Healthscope Commercial |
$252.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.91
|
| Rate for Payer: Nomi Health Commercial |
$230.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$210.80
|
| Rate for Payer: PHP Commercial |
$238.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$244.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$195.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$247.34
|
| Rate for Payer: UHC Core |
$234.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.80
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
IP
|
$94.45
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$65.74 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: BCBS Trust/PPO |
$78.01
|
| Rate for Payer: BCN Commercial |
$78.01
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$77.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$82.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.12
|
| Rate for Payer: UHC Core |
$78.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE
|
Facility
|
OP
|
$94.45
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500040
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: Aetna Medicare |
$24.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.52
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: BCBS MAPPO |
$23.61
|
| Rate for Payer: BCBS Trust/PPO |
$77.65
|
| Rate for Payer: BCN Commercial |
$77.65
|
| Rate for Payer: BCN Medicare Advantage |
$23.61
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.61
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Mclaren Medicaid |
$16.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.79
|
| Rate for Payer: Meridian Medicaid |
$17.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$77.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PACE Senior Care Partners |
$22.43
|
| Rate for Payer: PACE SWMI |
$23.61
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: PHP Medicare Advantage |
$23.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$82.17
|
| Rate for Payer: Priority Health Medicare |
$23.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.74
|
| Rate for Payer: Railroad Medicare Medicare |
$23.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.12
|
| Rate for Payer: UHC Core |
$78.87
|
| Rate for Payer: UHC Exchange |
$23.61
|
| Rate for Payer: UHC Medicaid |
$16.65
|
| Rate for Payer: UHC Medicare Advantage |
$23.61
|
| Rate for Payer: UHCCP Medicaid |
$16.65
|
| Rate for Payer: VA VA |
$23.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
OP
|
$67.92
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.97 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: Aetna Medicare |
$17.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.23
|
| Rate for Payer: BCBS Complete |
$12.57
|
| Rate for Payer: BCBS MAPPO |
$16.98
|
| Rate for Payer: BCBS Trust/PPO |
$55.84
|
| Rate for Payer: BCN Commercial |
$55.84
|
| Rate for Payer: BCN Medicare Advantage |
$16.98
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Mclaren Medicaid |
$11.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.83
|
| Rate for Payer: Meridian Medicaid |
$12.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PACE Senior Care Partners |
$16.13
|
| Rate for Payer: PACE SWMI |
$16.98
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: PHP Medicare Advantage |
$16.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.09
|
| Rate for Payer: Priority Health Medicare |
$17.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.27
|
| Rate for Payer: Railroad Medicare Medicare |
$16.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.77
|
| Rate for Payer: UHC Core |
$56.71
|
| Rate for Payer: UHC Exchange |
$16.98
|
| Rate for Payer: UHC Medicaid |
$11.97
|
| Rate for Payer: UHC Medicare Advantage |
$16.98
|
| Rate for Payer: UHCCP Medicaid |
$11.97
|
| Rate for Payer: VA VA |
$16.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC ACTIVATED PROTEIN C RESISTANCE.
|
Facility
|
IP
|
$67.92
|
|
|
Service Code
|
CPT 85307
|
| Hospital Charge Code |
30500084
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.27 |
| Max. Negotiated Rate |
$61.13 |
| Rate for Payer: Aetna Commercial |
$57.73
|
| Rate for Payer: BCBS Trust/PPO |
$56.10
|
| Rate for Payer: BCN Commercial |
$56.10
|
| Rate for Payer: Cash Price |
$54.34
|
| Rate for Payer: Cofinity Commercial |
$58.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.34
|
| Rate for Payer: Healthscope Commercial |
$61.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$57.73
|
| Rate for Payer: Nomi Health Commercial |
$55.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$50.94
|
| Rate for Payer: PHP Commercial |
$57.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$59.77
|
| Rate for Payer: UHC Core |
$56.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.94
|
|
|
HC ACUNAV CATHETER
|
Facility
|
IP
|
$5,836.64
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,062.30 |
| Max. Negotiated Rate |
$5,252.98 |
| Rate for Payer: Aetna Commercial |
$4,961.14
|
| Rate for Payer: BCBS Trust/PPO |
$4,820.48
|
| Rate for Payer: BCN Commercial |
$4,820.48
|
| Rate for Payer: Cash Price |
$4,669.31
|
| Rate for Payer: Cofinity Commercial |
$5,019.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,669.31
|
| Rate for Payer: Healthscope Commercial |
$5,252.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,377.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,961.14
|
| Rate for Payer: Nomi Health Commercial |
$4,786.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,377.48
|
| Rate for Payer: PHP Commercial |
$4,961.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,077.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,062.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,136.24
|
| Rate for Payer: UHC Core |
$4,873.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,377.48
|
|
|
HC ACUNAV CATHETER
|
Facility
|
OP
|
$5,836.64
|
|
|
Service Code
|
HCPCS C1759
|
| Hospital Charge Code |
27200010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,029.00 |
| Max. Negotiated Rate |
$5,252.98 |
| Rate for Payer: Aetna Commercial |
$4,961.14
|
| Rate for Payer: Aetna Medicare |
$1,517.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,823.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,823.95
|
| Rate for Payer: BCBS Complete |
$1,080.36
|
| Rate for Payer: BCBS MAPPO |
$1,459.16
|
| Rate for Payer: BCBS Trust/PPO |
$4,798.30
|
| Rate for Payer: BCN Commercial |
$4,798.30
|
| Rate for Payer: BCN Medicare Advantage |
$1,459.16
|
| Rate for Payer: Cash Price |
$4,669.31
|
| Rate for Payer: Cofinity Commercial |
$5,019.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,669.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,459.16
|
| Rate for Payer: Healthscope Commercial |
$5,252.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,377.48
|
| Rate for Payer: Mclaren Medicaid |
$1,029.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,532.12
|
| Rate for Payer: Meridian Medicaid |
$1,080.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,678.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,605.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,961.14
|
| Rate for Payer: Nomi Health Commercial |
$4,786.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$4,377.48
|
| Rate for Payer: PACE Senior Care Partners |
$1,386.20
|
| Rate for Payer: PACE SWMI |
$1,459.16
|
| Rate for Payer: PHP Commercial |
$4,961.14
|
| Rate for Payer: PHP Medicare Advantage |
$1,459.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,029.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$5,077.88
|
| Rate for Payer: Priority Health Medicare |
$1,473.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,062.30
|
| Rate for Payer: Railroad Medicare Medicare |
$1,459.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,136.24
|
| Rate for Payer: UHC Core |
$4,873.59
|
| Rate for Payer: UHC Exchange |
$1,459.16
|
| Rate for Payer: UHC Medicaid |
$1,029.00
|
| Rate for Payer: UHC Medicare Advantage |
$1,459.16
|
| Rate for Payer: UHCCP Medicaid |
$1,029.00
|
| Rate for Payer: VA VA |
$1,459.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,377.48
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
IP
|
$147.98
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$102.99 |
| Max. Negotiated Rate |
$133.18 |
| Rate for Payer: Aetna Commercial |
$125.78
|
| Rate for Payer: BCBS Trust/PPO |
$122.22
|
| Rate for Payer: BCN Commercial |
$122.22
|
| Rate for Payer: Cash Price |
$118.38
|
| Rate for Payer: Cofinity Commercial |
$127.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.38
|
| Rate for Payer: Healthscope Commercial |
$133.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.78
|
| Rate for Payer: Nomi Health Commercial |
$121.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.98
|
| Rate for Payer: PHP Commercial |
$125.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$128.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.22
|
| Rate for Payer: UHC Core |
$123.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.98
|
|
|
HC ACU OBSERVATION PER HOUR
|
Facility
|
OP
|
$147.98
|
|
|
Service Code
|
HCPCS G0378
|
| Hospital Charge Code |
76200003
|
|
Hospital Revenue Code
|
762
|
| Min. Negotiated Rate |
$26.09 |
| Max. Negotiated Rate |
$850.00 |
| Rate for Payer: Aetna Commercial |
$125.78
|
| Rate for Payer: Aetna Medicare |
$38.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.24
|
| Rate for Payer: BCBS Complete |
$27.39
|
| Rate for Payer: BCBS MAPPO |
$36.99
|
| Rate for Payer: BCBS Trust/PPO |
$121.65
|
| Rate for Payer: BCN Commercial |
$121.65
|
| Rate for Payer: BCN Medicare Advantage |
$36.99
|
| Rate for Payer: Cash Price |
$118.38
|
| Rate for Payer: Cash Price |
$118.38
|
| Rate for Payer: Cofinity Commercial |
$127.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.99
|
| Rate for Payer: Healthscope Commercial |
$133.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$110.98
|
| Rate for Payer: Mclaren Medicaid |
$26.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.84
|
| Rate for Payer: Meridian Medicaid |
$27.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.78
|
| Rate for Payer: Nomi Health Commercial |
$121.34
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$110.98
|
| Rate for Payer: PACE Senior Care Partners |
$35.15
|
| Rate for Payer: PACE SWMI |
$36.99
|
| Rate for Payer: PHP Commercial |
$125.78
|
| Rate for Payer: PHP Medicare Advantage |
$36.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$128.74
|
| Rate for Payer: Priority Health Medicare |
$37.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$102.99
|
| Rate for Payer: Railroad Medicare Medicare |
$36.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.22
|
| Rate for Payer: UHC Core |
$123.56
|
| Rate for Payer: UHC Exchange |
$36.99
|
| Rate for Payer: UHC Medicaid |
$26.09
|
| Rate for Payer: UHC Medicare Advantage |
$36.99
|
| Rate for Payer: UHCCP Medicaid |
$850.00
|
| Rate for Payer: VA VA |
$36.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$110.98
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
IP
|
$139.76
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$97.27 |
| Max. Negotiated Rate |
$125.78 |
| Rate for Payer: Aetna Commercial |
$118.80
|
| Rate for Payer: BCBS Trust/PPO |
$115.43
|
| Rate for Payer: BCN Commercial |
$115.43
|
| Rate for Payer: Cash Price |
$111.81
|
| Rate for Payer: Cofinity Commercial |
$120.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.81
|
| Rate for Payer: Healthscope Commercial |
$125.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.80
|
| Rate for Payer: Nomi Health Commercial |
$114.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.82
|
| Rate for Payer: PHP Commercial |
$118.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$121.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.99
|
| Rate for Payer: UHC Core |
$116.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.82
|
|
|
HC ACU OBS OVERFLOW PER HOUR
|
Facility
|
OP
|
$139.76
|
|
| Hospital Charge Code |
76900001
|
|
Hospital Revenue Code
|
769
|
| Min. Negotiated Rate |
$24.64 |
| Max. Negotiated Rate |
$125.78 |
| Rate for Payer: Aetna Commercial |
$118.80
|
| Rate for Payer: Aetna Medicare |
$36.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.67
|
| Rate for Payer: BCBS Complete |
$25.87
|
| Rate for Payer: BCBS MAPPO |
$34.94
|
| Rate for Payer: BCBS Trust/PPO |
$114.90
|
| Rate for Payer: BCN Commercial |
$114.90
|
| Rate for Payer: BCN Medicare Advantage |
$34.94
|
| Rate for Payer: Cash Price |
$111.81
|
| Rate for Payer: Cofinity Commercial |
$120.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$111.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.94
|
| Rate for Payer: Healthscope Commercial |
$125.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$104.82
|
| Rate for Payer: Mclaren Medicaid |
$24.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.69
|
| Rate for Payer: Meridian Medicaid |
$25.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$38.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$118.80
|
| Rate for Payer: Nomi Health Commercial |
$114.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$104.82
|
| Rate for Payer: PACE Senior Care Partners |
$33.19
|
| Rate for Payer: PACE SWMI |
$34.94
|
| Rate for Payer: PHP Commercial |
$118.80
|
| Rate for Payer: PHP Medicare Advantage |
$34.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$121.59
|
| Rate for Payer: Priority Health Medicare |
$35.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.27
|
| Rate for Payer: Railroad Medicare Medicare |
$34.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$122.99
|
| Rate for Payer: UHC Core |
$116.70
|
| Rate for Payer: UHC Exchange |
$34.94
|
| Rate for Payer: UHC Medicaid |
$24.64
|
| Rate for Payer: UHC Medicare Advantage |
$34.94
|
| Rate for Payer: UHCCP Medicaid |
$24.64
|
| Rate for Payer: VA VA |
$34.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$104.82
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
IP
|
$38.49
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.79 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: BCBS Trust/PPO |
$31.79
|
| Rate for Payer: BCN Commercial |
$31.79
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.87
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.87
|
| Rate for Payer: UHC Core |
$32.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
OP
|
$38.49
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$34.64 |
| Rate for Payer: Aetna Commercial |
$32.72
|
| Rate for Payer: Aetna Medicare |
$10.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.03
|
| Rate for Payer: BCBS Complete |
$7.12
|
| Rate for Payer: BCBS MAPPO |
$9.62
|
| Rate for Payer: BCBS Trust/PPO |
$31.64
|
| Rate for Payer: BCN Commercial |
$31.64
|
| Rate for Payer: BCN Medicare Advantage |
$9.62
|
| Rate for Payer: Cash Price |
$30.79
|
| Rate for Payer: Cofinity Commercial |
$33.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.62
|
| Rate for Payer: Healthscope Commercial |
$34.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.87
|
| Rate for Payer: Mclaren Medicaid |
$6.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.10
|
| Rate for Payer: Meridian Medicaid |
$7.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.72
|
| Rate for Payer: Nomi Health Commercial |
$31.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$28.87
|
| Rate for Payer: PACE Senior Care Partners |
$9.14
|
| Rate for Payer: PACE SWMI |
$9.62
|
| Rate for Payer: PHP Commercial |
$32.72
|
| Rate for Payer: PHP Medicare Advantage |
$9.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$33.49
|
| Rate for Payer: Priority Health Medicare |
$9.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.79
|
| Rate for Payer: Railroad Medicare Medicare |
$9.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.87
|
| Rate for Payer: UHC Core |
$32.14
|
| Rate for Payer: UHC Exchange |
$9.62
|
| Rate for Payer: UHC Medicaid |
$6.79
|
| Rate for Payer: UHC Medicare Advantage |
$9.62
|
| Rate for Payer: UHCCP Medicaid |
$6.79
|
| Rate for Payer: VA VA |
$9.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.87
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$17.77 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna Medicare |
$26.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.51
|
| Rate for Payer: BCBS Complete |
$18.66
|
| Rate for Payer: BCBS MAPPO |
$25.20
|
| Rate for Payer: BCBS Trust/PPO |
$82.88
|
| Rate for Payer: BCN Commercial |
$82.88
|
| Rate for Payer: BCN Medicare Advantage |
$25.20
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.20
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Mclaren Medicaid |
$17.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$18.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PACE Senior Care Partners |
$23.94
|
| Rate for Payer: PACE SWMI |
$25.20
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: PHP Medicare Advantage |
$25.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.71
|
| Rate for Payer: Priority Health Medicare |
$25.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.17
|
| Rate for Payer: Railroad Medicare Medicare |
$25.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.72
|
| Rate for Payer: UHC Core |
$84.18
|
| Rate for Payer: UHC Exchange |
$25.20
|
| Rate for Payer: UHC Medicaid |
$17.77
|
| Rate for Payer: UHC Medicare Advantage |
$25.20
|
| Rate for Payer: UHCCP Medicaid |
$17.77
|
| Rate for Payer: VA VA |
$25.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$70.17 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: BCBS Trust/PPO |
$83.27
|
| Rate for Payer: BCN Commercial |
$83.27
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.72
|
| Rate for Payer: UHC Core |
$84.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
OP
|
$93.64
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$16.51 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: Aetna Medicare |
$24.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.26
|
| Rate for Payer: BCBS Complete |
$17.33
|
| Rate for Payer: BCBS MAPPO |
$23.41
|
| Rate for Payer: BCBS Trust/PPO |
$76.98
|
| Rate for Payer: BCN Commercial |
$76.98
|
| Rate for Payer: BCN Medicare Advantage |
$23.41
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.41
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Mclaren Medicaid |
$16.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.58
|
| Rate for Payer: Meridian Medicaid |
$17.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PACE Senior Care Partners |
$22.24
|
| Rate for Payer: PACE SWMI |
$23.41
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: PHP Medicare Advantage |
$23.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Medicare |
$23.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: UHC Exchange |
$23.41
|
| Rate for Payer: UHC Medicaid |
$16.51
|
| Rate for Payer: UHC Medicare Advantage |
$23.41
|
| Rate for Payer: UHCCP Medicaid |
$16.51
|
| Rate for Payer: VA VA |
$23.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
IP
|
$93.64
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$65.17 |
| Max. Negotiated Rate |
$84.28 |
| Rate for Payer: Aetna Commercial |
$79.59
|
| Rate for Payer: BCBS Trust/PPO |
$77.34
|
| Rate for Payer: BCN Commercial |
$77.34
|
| Rate for Payer: Cash Price |
$74.91
|
| Rate for Payer: Cofinity Commercial |
$80.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.91
|
| Rate for Payer: Healthscope Commercial |
$84.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.59
|
| Rate for Payer: Nomi Health Commercial |
$76.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.23
|
| Rate for Payer: PHP Commercial |
$79.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.40
|
| Rate for Payer: UHC Core |
$78.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.23
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
OP
|
$801.41
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$141.29 |
| Max. Negotiated Rate |
$721.27 |
| Rate for Payer: Aetna Commercial |
$681.20
|
| Rate for Payer: Aetna Medicare |
$208.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$250.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$250.44
|
| Rate for Payer: BCBS Complete |
$148.34
|
| Rate for Payer: BCBS MAPPO |
$200.35
|
| Rate for Payer: BCBS Trust/PPO |
$658.84
|
| Rate for Payer: BCN Commercial |
$658.84
|
| Rate for Payer: BCN Medicare Advantage |
$200.35
|
| Rate for Payer: Cash Price |
$641.13
|
| Rate for Payer: Cofinity Commercial |
$689.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$200.35
|
| Rate for Payer: Healthscope Commercial |
$721.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.06
|
| Rate for Payer: Mclaren Medicaid |
$141.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$210.37
|
| Rate for Payer: Meridian Medicaid |
$148.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$230.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$220.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.20
|
| Rate for Payer: Nomi Health Commercial |
$657.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.06
|
| Rate for Payer: PACE Senior Care Partners |
$190.33
|
| Rate for Payer: PACE SWMI |
$200.35
|
| Rate for Payer: PHP Commercial |
$681.20
|
| Rate for Payer: PHP Medicare Advantage |
$200.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$141.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$697.23
|
| Rate for Payer: Priority Health Medicare |
$202.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.78
|
| Rate for Payer: Railroad Medicare Medicare |
$200.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.24
|
| Rate for Payer: UHC Core |
$669.18
|
| Rate for Payer: UHC Exchange |
$200.35
|
| Rate for Payer: UHC Medicaid |
$141.29
|
| Rate for Payer: UHC Medicare Advantage |
$200.35
|
| Rate for Payer: UHCCP Medicaid |
$141.29
|
| Rate for Payer: VA VA |
$200.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.06
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
IP
|
$801.41
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$557.78 |
| Max. Negotiated Rate |
$721.27 |
| Rate for Payer: Aetna Commercial |
$681.20
|
| Rate for Payer: BCBS Trust/PPO |
$661.88
|
| Rate for Payer: BCN Commercial |
$661.88
|
| Rate for Payer: Cash Price |
$641.13
|
| Rate for Payer: Cofinity Commercial |
$689.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$641.13
|
| Rate for Payer: Healthscope Commercial |
$721.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$601.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$681.20
|
| Rate for Payer: Nomi Health Commercial |
$657.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$601.06
|
| Rate for Payer: PHP Commercial |
$681.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$697.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$557.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$705.24
|
| Rate for Payer: UHC Core |
$669.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$601.06
|
|
|
HC ACYLCARNITINES
|
Facility
|
IP
|
$78.03
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.31 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$64.44
|
| Rate for Payer: BCN Commercial |
$64.44
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
|
HC ACYLCARNITINES
|
Facility
|
OP
|
$78.03
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.76 |
| Max. Negotiated Rate |
$70.23 |
| Rate for Payer: Aetna Commercial |
$66.33
|
| Rate for Payer: Aetna Medicare |
$20.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.38
|
| Rate for Payer: BCBS Complete |
$14.44
|
| Rate for Payer: BCBS MAPPO |
$19.51
|
| Rate for Payer: BCBS Trust/PPO |
$64.15
|
| Rate for Payer: BCN Commercial |
$64.15
|
| Rate for Payer: BCN Medicare Advantage |
$19.51
|
| Rate for Payer: Cash Price |
$62.42
|
| Rate for Payer: Cofinity Commercial |
$67.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.51
|
| Rate for Payer: Healthscope Commercial |
$70.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.52
|
| Rate for Payer: Mclaren Medicaid |
$13.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.48
|
| Rate for Payer: Meridian Medicaid |
$14.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.33
|
| Rate for Payer: Nomi Health Commercial |
$63.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.52
|
| Rate for Payer: PACE Senior Care Partners |
$18.53
|
| Rate for Payer: PACE SWMI |
$19.51
|
| Rate for Payer: PHP Commercial |
$66.33
|
| Rate for Payer: PHP Medicare Advantage |
$19.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$67.89
|
| Rate for Payer: Priority Health Medicare |
$19.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.31
|
| Rate for Payer: Railroad Medicare Medicare |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.67
|
| Rate for Payer: UHC Core |
$65.16
|
| Rate for Payer: UHC Exchange |
$19.51
|
| Rate for Payer: UHC Medicaid |
$13.76
|
| Rate for Payer: UHC Medicare Advantage |
$19.51
|
| Rate for Payer: UHCCP Medicaid |
$13.76
|
| Rate for Payer: VA VA |
$19.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.52
|
|
