|
HC ADALIMUMAB AB, S
|
Facility
|
OP
|
$210.16
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.05 |
| Max. Negotiated Rate |
$189.14 |
| Rate for Payer: Aetna Commercial |
$178.64
|
| Rate for Payer: Aetna Medicare |
$54.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.67
|
| Rate for Payer: BCBS Complete |
$38.90
|
| Rate for Payer: BCBS MAPPO |
$52.54
|
| Rate for Payer: BCBS Trust/PPO |
$172.77
|
| Rate for Payer: BCN Commercial |
$172.77
|
| Rate for Payer: BCN Medicare Advantage |
$52.54
|
| Rate for Payer: Cash Price |
$168.13
|
| Rate for Payer: Cofinity Commercial |
$180.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.54
|
| Rate for Payer: Healthscope Commercial |
$189.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.62
|
| Rate for Payer: Mclaren Medicaid |
$37.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.17
|
| Rate for Payer: Meridian Medicaid |
$38.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.64
|
| Rate for Payer: Nomi Health Commercial |
$172.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.62
|
| Rate for Payer: PACE Senior Care Partners |
$49.91
|
| Rate for Payer: PACE SWMI |
$52.54
|
| Rate for Payer: PHP Commercial |
$178.64
|
| Rate for Payer: PHP Medicare Advantage |
$52.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$182.84
|
| Rate for Payer: Priority Health Medicare |
$53.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.27
|
| Rate for Payer: Railroad Medicare Medicare |
$52.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.94
|
| Rate for Payer: UHC Core |
$175.48
|
| Rate for Payer: UHC Exchange |
$52.54
|
| Rate for Payer: UHC Medicaid |
$37.05
|
| Rate for Payer: UHC Medicare Advantage |
$52.54
|
| Rate for Payer: UHCCP Medicaid |
$37.05
|
| Rate for Payer: VA VA |
$52.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.62
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
IP
|
$210.16
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$146.27 |
| Max. Negotiated Rate |
$189.14 |
| Rate for Payer: Aetna Commercial |
$178.64
|
| Rate for Payer: BCBS Trust/PPO |
$173.57
|
| Rate for Payer: BCN Commercial |
$173.57
|
| Rate for Payer: Cash Price |
$168.13
|
| Rate for Payer: Cofinity Commercial |
$180.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.13
|
| Rate for Payer: Healthscope Commercial |
$189.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$157.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$178.64
|
| Rate for Payer: Nomi Health Commercial |
$172.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$157.62
|
| Rate for Payer: PHP Commercial |
$178.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$182.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.94
|
| Rate for Payer: UHC Core |
$175.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$157.62
|
|
|
HC ADALIMUMAB, S
|
Facility
|
IP
|
$306.92
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$213.62 |
| Max. Negotiated Rate |
$276.23 |
| Rate for Payer: Aetna Commercial |
$260.88
|
| Rate for Payer: BCBS Trust/PPO |
$253.49
|
| Rate for Payer: BCN Commercial |
$253.49
|
| Rate for Payer: Cash Price |
$245.54
|
| Rate for Payer: Cofinity Commercial |
$263.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.54
|
| Rate for Payer: Healthscope Commercial |
$276.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.88
|
| Rate for Payer: Nomi Health Commercial |
$251.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.19
|
| Rate for Payer: PHP Commercial |
$260.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$267.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.09
|
| Rate for Payer: UHC Core |
$256.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.19
|
|
|
HC ADALIMUMAB, S
|
Facility
|
OP
|
$306.92
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.11 |
| Max. Negotiated Rate |
$276.23 |
| Rate for Payer: Aetna Commercial |
$260.88
|
| Rate for Payer: Aetna Medicare |
$79.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.91
|
| Rate for Payer: BCBS Complete |
$56.81
|
| Rate for Payer: BCBS MAPPO |
$76.73
|
| Rate for Payer: BCBS Trust/PPO |
$252.32
|
| Rate for Payer: BCN Commercial |
$252.32
|
| Rate for Payer: BCN Medicare Advantage |
$76.73
|
| Rate for Payer: Cash Price |
$245.54
|
| Rate for Payer: Cofinity Commercial |
$263.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.73
|
| Rate for Payer: Healthscope Commercial |
$276.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.19
|
| Rate for Payer: Mclaren Medicaid |
$54.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.57
|
| Rate for Payer: Meridian Medicaid |
$56.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.88
|
| Rate for Payer: Nomi Health Commercial |
$251.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.19
|
| Rate for Payer: PACE Senior Care Partners |
$72.89
|
| Rate for Payer: PACE SWMI |
$76.73
|
| Rate for Payer: PHP Commercial |
$260.88
|
| Rate for Payer: PHP Medicare Advantage |
$76.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$267.02
|
| Rate for Payer: Priority Health Medicare |
$77.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.62
|
| Rate for Payer: Railroad Medicare Medicare |
$76.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$270.09
|
| Rate for Payer: UHC Core |
$256.28
|
| Rate for Payer: UHC Exchange |
$76.73
|
| Rate for Payer: UHC Medicaid |
$54.11
|
| Rate for Payer: UHC Medicare Advantage |
$76.73
|
| Rate for Payer: UHCCP Medicaid |
$54.11
|
| Rate for Payer: VA VA |
$76.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.19
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
IP
|
$163.97
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$114.12 |
| Max. Negotiated Rate |
$147.57 |
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: BCBS Trust/PPO |
$135.42
|
| Rate for Payer: BCN Commercial |
$135.42
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cofinity Commercial |
$141.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.18
|
| Rate for Payer: Healthscope Commercial |
$147.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.37
|
| Rate for Payer: Nomi Health Commercial |
$134.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.98
|
| Rate for Payer: PHP Commercial |
$139.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.29
|
| Rate for Payer: UHC Core |
$136.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.98
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
OP
|
$163.97
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$28.91 |
| Max. Negotiated Rate |
$147.57 |
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna Medicare |
$42.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.24
|
| Rate for Payer: BCBS Complete |
$30.35
|
| Rate for Payer: BCBS MAPPO |
$40.99
|
| Rate for Payer: BCBS Trust/PPO |
$134.80
|
| Rate for Payer: BCN Commercial |
$134.80
|
| Rate for Payer: BCN Medicare Advantage |
$40.99
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cofinity Commercial |
$141.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.99
|
| Rate for Payer: Healthscope Commercial |
$147.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.98
|
| Rate for Payer: Mclaren Medicaid |
$28.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.04
|
| Rate for Payer: Meridian Medicaid |
$30.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.37
|
| Rate for Payer: Nomi Health Commercial |
$134.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.98
|
| Rate for Payer: PACE Senior Care Partners |
$38.94
|
| Rate for Payer: PACE SWMI |
$40.99
|
| Rate for Payer: PHP Commercial |
$139.37
|
| Rate for Payer: PHP Medicare Advantage |
$40.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.65
|
| Rate for Payer: Priority Health Medicare |
$41.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.12
|
| Rate for Payer: Railroad Medicare Medicare |
$40.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.29
|
| Rate for Payer: UHC Core |
$136.91
|
| Rate for Payer: UHC Exchange |
$40.99
|
| Rate for Payer: UHC Medicaid |
$28.91
|
| Rate for Payer: UHC Medicare Advantage |
$40.99
|
| Rate for Payer: UHCCP Medicaid |
$28.91
|
| Rate for Payer: VA VA |
$40.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.98
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
OP
|
$184.15
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$32.47 |
| Max. Negotiated Rate |
$165.74 |
| Rate for Payer: Aetna Commercial |
$156.53
|
| Rate for Payer: Aetna Medicare |
$47.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.55
|
| Rate for Payer: BCBS Complete |
$34.09
|
| Rate for Payer: BCBS MAPPO |
$46.04
|
| Rate for Payer: BCBS Trust/PPO |
$151.39
|
| Rate for Payer: BCN Commercial |
$151.39
|
| Rate for Payer: BCN Medicare Advantage |
$46.04
|
| Rate for Payer: Cash Price |
$147.32
|
| Rate for Payer: Cofinity Commercial |
$158.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$46.04
|
| Rate for Payer: Healthscope Commercial |
$165.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.11
|
| Rate for Payer: Mclaren Medicaid |
$32.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.34
|
| Rate for Payer: Meridian Medicaid |
$34.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$50.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.53
|
| Rate for Payer: Nomi Health Commercial |
$151.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.11
|
| Rate for Payer: PACE Senior Care Partners |
$43.74
|
| Rate for Payer: PACE SWMI |
$46.04
|
| Rate for Payer: PHP Commercial |
$156.53
|
| Rate for Payer: PHP Medicare Advantage |
$46.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$32.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$160.21
|
| Rate for Payer: Priority Health Medicare |
$46.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.17
|
| Rate for Payer: Railroad Medicare Medicare |
$46.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.05
|
| Rate for Payer: UHC Core |
$153.77
|
| Rate for Payer: UHC Exchange |
$46.04
|
| Rate for Payer: UHC Medicaid |
$32.47
|
| Rate for Payer: UHC Medicare Advantage |
$46.04
|
| Rate for Payer: UHCCP Medicaid |
$32.47
|
| Rate for Payer: VA VA |
$46.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.11
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
IP
|
$184.15
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$128.17 |
| Max. Negotiated Rate |
$165.74 |
| Rate for Payer: Aetna Commercial |
$156.53
|
| Rate for Payer: BCBS Trust/PPO |
$152.09
|
| Rate for Payer: BCN Commercial |
$152.09
|
| Rate for Payer: Cash Price |
$147.32
|
| Rate for Payer: Cofinity Commercial |
$158.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$147.32
|
| Rate for Payer: Healthscope Commercial |
$165.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$138.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.53
|
| Rate for Payer: Nomi Health Commercial |
$151.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$138.11
|
| Rate for Payer: PHP Commercial |
$156.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$160.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$128.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$162.05
|
| Rate for Payer: UHC Core |
$153.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$138.11
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
IP
|
$154.94
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$107.84 |
| Max. Negotiated Rate |
$139.45 |
| Rate for Payer: Aetna Commercial |
$131.70
|
| Rate for Payer: BCBS Trust/PPO |
$127.96
|
| Rate for Payer: BCN Commercial |
$127.96
|
| Rate for Payer: Cash Price |
$123.95
|
| Rate for Payer: Cofinity Commercial |
$133.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.95
|
| Rate for Payer: Healthscope Commercial |
$139.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.70
|
| Rate for Payer: Nomi Health Commercial |
$127.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.20
|
| Rate for Payer: PHP Commercial |
$131.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$134.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.35
|
| Rate for Payer: UHC Core |
$129.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.20
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
OP
|
$154.94
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$27.32 |
| Max. Negotiated Rate |
$139.45 |
| Rate for Payer: Aetna Commercial |
$131.70
|
| Rate for Payer: Aetna Medicare |
$40.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.42
|
| Rate for Payer: BCBS Complete |
$28.68
|
| Rate for Payer: BCBS MAPPO |
$38.73
|
| Rate for Payer: BCBS Trust/PPO |
$127.38
|
| Rate for Payer: BCN Commercial |
$127.38
|
| Rate for Payer: BCN Medicare Advantage |
$38.73
|
| Rate for Payer: Cash Price |
$123.95
|
| Rate for Payer: Cofinity Commercial |
$133.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.73
|
| Rate for Payer: Healthscope Commercial |
$139.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.20
|
| Rate for Payer: Mclaren Medicaid |
$27.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.67
|
| Rate for Payer: Meridian Medicaid |
$28.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.70
|
| Rate for Payer: Nomi Health Commercial |
$127.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$116.20
|
| Rate for Payer: PACE Senior Care Partners |
$36.80
|
| Rate for Payer: PACE SWMI |
$38.73
|
| Rate for Payer: PHP Commercial |
$131.70
|
| Rate for Payer: PHP Medicare Advantage |
$38.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$134.80
|
| Rate for Payer: Priority Health Medicare |
$39.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.84
|
| Rate for Payer: Railroad Medicare Medicare |
$38.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.35
|
| Rate for Payer: UHC Core |
$129.37
|
| Rate for Payer: UHC Exchange |
$38.73
|
| Rate for Payer: UHC Medicaid |
$27.32
|
| Rate for Payer: UHC Medicare Advantage |
$38.73
|
| Rate for Payer: UHCCP Medicaid |
$27.32
|
| Rate for Payer: VA VA |
$38.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.20
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
OP
|
$163.97
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$28.91 |
| Max. Negotiated Rate |
$147.57 |
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: Aetna Medicare |
$42.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.24
|
| Rate for Payer: BCBS Complete |
$30.35
|
| Rate for Payer: BCBS MAPPO |
$40.99
|
| Rate for Payer: BCBS Trust/PPO |
$134.80
|
| Rate for Payer: BCN Commercial |
$134.80
|
| Rate for Payer: BCN Medicare Advantage |
$40.99
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cofinity Commercial |
$141.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.99
|
| Rate for Payer: Healthscope Commercial |
$147.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.98
|
| Rate for Payer: Mclaren Medicaid |
$28.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.04
|
| Rate for Payer: Meridian Medicaid |
$30.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.14
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.37
|
| Rate for Payer: Nomi Health Commercial |
$134.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.98
|
| Rate for Payer: PACE Senior Care Partners |
$38.94
|
| Rate for Payer: PACE SWMI |
$40.99
|
| Rate for Payer: PHP Commercial |
$139.37
|
| Rate for Payer: PHP Medicare Advantage |
$40.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.65
|
| Rate for Payer: Priority Health Medicare |
$41.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.12
|
| Rate for Payer: Railroad Medicare Medicare |
$40.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.29
|
| Rate for Payer: UHC Core |
$136.91
|
| Rate for Payer: UHC Exchange |
$40.99
|
| Rate for Payer: UHC Medicaid |
$28.91
|
| Rate for Payer: UHC Medicare Advantage |
$40.99
|
| Rate for Payer: UHCCP Medicaid |
$28.91
|
| Rate for Payer: VA VA |
$40.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.98
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
IP
|
$163.97
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$114.12 |
| Max. Negotiated Rate |
$147.57 |
| Rate for Payer: Aetna Commercial |
$139.37
|
| Rate for Payer: BCBS Trust/PPO |
$135.42
|
| Rate for Payer: BCN Commercial |
$135.42
|
| Rate for Payer: Cash Price |
$131.18
|
| Rate for Payer: Cofinity Commercial |
$141.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.18
|
| Rate for Payer: Healthscope Commercial |
$147.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.37
|
| Rate for Payer: Nomi Health Commercial |
$134.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.98
|
| Rate for Payer: PHP Commercial |
$139.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.29
|
| Rate for Payer: UHC Core |
$136.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.98
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
IP
|
$9.04
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.29 |
| Max. Negotiated Rate |
$8.14 |
| Rate for Payer: Aetna Commercial |
$7.68
|
| Rate for Payer: BCBS Trust/PPO |
$7.47
|
| Rate for Payer: BCN Commercial |
$7.47
|
| Rate for Payer: Cash Price |
$7.23
|
| Rate for Payer: Cofinity Commercial |
$7.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.23
|
| Rate for Payer: Healthscope Commercial |
$8.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.68
|
| Rate for Payer: Nomi Health Commercial |
$7.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.78
|
| Rate for Payer: PHP Commercial |
$7.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$7.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.78
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
OP
|
$9.04
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$8.14 |
| Rate for Payer: Aetna Commercial |
$7.68
|
| Rate for Payer: Aetna Medicare |
$2.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.83
|
| Rate for Payer: BCBS Complete |
$1.67
|
| Rate for Payer: BCBS MAPPO |
$2.26
|
| Rate for Payer: BCBS Trust/PPO |
$7.43
|
| Rate for Payer: BCN Commercial |
$7.43
|
| Rate for Payer: BCN Medicare Advantage |
$2.26
|
| Rate for Payer: Cash Price |
$7.23
|
| Rate for Payer: Cofinity Commercial |
$7.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.26
|
| Rate for Payer: Healthscope Commercial |
$8.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.78
|
| Rate for Payer: Mclaren Medicaid |
$1.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.37
|
| Rate for Payer: Meridian Medicaid |
$1.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.68
|
| Rate for Payer: Nomi Health Commercial |
$7.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6.78
|
| Rate for Payer: PACE Senior Care Partners |
$2.15
|
| Rate for Payer: PACE SWMI |
$2.26
|
| Rate for Payer: PHP Commercial |
$7.68
|
| Rate for Payer: PHP Medicare Advantage |
$2.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7.86
|
| Rate for Payer: Priority Health Medicare |
$2.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.96
|
| Rate for Payer: UHC Core |
$7.55
|
| Rate for Payer: UHC Exchange |
$2.26
|
| Rate for Payer: UHC Medicaid |
$1.59
|
| Rate for Payer: UHC Medicare Advantage |
$2.26
|
| Rate for Payer: UHCCP Medicaid |
$1.59
|
| Rate for Payer: VA VA |
$2.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.78
|
|
|
HC ADAPTER PERFUSION STERILE
|
Facility
|
IP
|
$93.64
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| 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 ADAPTER PERFUSION STERILE
|
Facility
|
OP
|
$93.64
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| 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 ADAPTOR PERFUSION
|
Facility
|
OP
|
$12.48
|
|
| Hospital Charge Code |
27000264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: Aetna Medicare |
$3.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.90
|
| Rate for Payer: BCBS Complete |
$2.31
|
| Rate for Payer: BCBS MAPPO |
$3.12
|
| Rate for Payer: BCBS Trust/PPO |
$10.26
|
| Rate for Payer: BCN Commercial |
$10.26
|
| Rate for Payer: BCN Medicare Advantage |
$3.12
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.12
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Mclaren Medicaid |
$2.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.28
|
| Rate for Payer: Meridian Medicaid |
$2.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: PACE Senior Care Partners |
$2.96
|
| Rate for Payer: PACE SWMI |
$3.12
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: PHP Medicare Advantage |
$3.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.86
|
| Rate for Payer: Priority Health Medicare |
$3.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.69
|
| Rate for Payer: Railroad Medicare Medicare |
$3.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.98
|
| Rate for Payer: UHC Core |
$10.42
|
| Rate for Payer: UHC Exchange |
$3.12
|
| Rate for Payer: UHC Medicaid |
$2.20
|
| Rate for Payer: UHC Medicare Advantage |
$3.12
|
| Rate for Payer: UHCCP Medicaid |
$2.20
|
| Rate for Payer: VA VA |
$3.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC ADAPTOR PERFUSION
|
Facility
|
IP
|
$12.48
|
|
| Hospital Charge Code |
27000264
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.69 |
| Max. Negotiated Rate |
$11.23 |
| Rate for Payer: Aetna Commercial |
$10.61
|
| Rate for Payer: BCBS Trust/PPO |
$10.31
|
| Rate for Payer: BCN Commercial |
$10.31
|
| Rate for Payer: Cash Price |
$9.98
|
| Rate for Payer: Cofinity Commercial |
$10.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.98
|
| Rate for Payer: Healthscope Commercial |
$11.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10.61
|
| Rate for Payer: Nomi Health Commercial |
$10.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9.36
|
| Rate for Payer: PHP Commercial |
$10.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10.98
|
| Rate for Payer: UHC Core |
$10.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9.36
|
|
|
HC ADD. ABLATION
|
Facility
|
OP
|
$9,080.04
|
|
|
Service Code
|
CPT 93655
|
| Hospital Charge Code |
48100093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,600.81 |
| Max. Negotiated Rate |
$8,172.04 |
| Rate for Payer: Aetna Commercial |
$7,718.03
|
| Rate for Payer: Aetna Medicare |
$2,360.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,837.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,837.51
|
| Rate for Payer: BCBS Complete |
$1,680.72
|
| Rate for Payer: BCBS MAPPO |
$2,270.01
|
| Rate for Payer: BCBS Trust/PPO |
$7,464.70
|
| Rate for Payer: BCN Commercial |
$7,464.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,270.01
|
| Rate for Payer: Cash Price |
$7,264.03
|
| Rate for Payer: Cofinity Commercial |
$7,808.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,264.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,270.01
|
| Rate for Payer: Healthscope Commercial |
$8,172.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,810.03
|
| Rate for Payer: Mclaren Medicaid |
$1,600.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,383.51
|
| Rate for Payer: Meridian Medicaid |
$1,680.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,610.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,497.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,718.03
|
| Rate for Payer: Nomi Health Commercial |
$7,445.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,810.03
|
| Rate for Payer: PACE Senior Care Partners |
$2,156.51
|
| Rate for Payer: PACE SWMI |
$2,270.01
|
| Rate for Payer: PHP Commercial |
$7,718.03
|
| Rate for Payer: PHP Medicare Advantage |
$2,270.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,600.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,899.63
|
| Rate for Payer: Priority Health Medicare |
$2,292.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,319.71
|
| Rate for Payer: Railroad Medicare Medicare |
$2,270.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,990.44
|
| Rate for Payer: UHC Core |
$7,581.83
|
| Rate for Payer: UHC Exchange |
$2,270.01
|
| Rate for Payer: UHC Medicaid |
$1,600.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,270.01
|
| Rate for Payer: UHCCP Medicaid |
$1,600.81
|
| Rate for Payer: VA VA |
$2,270.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,810.03
|
|
|
HC ADD. ABLATION
|
Facility
|
IP
|
$9,080.04
|
|
|
Service Code
|
CPT 93655
|
| Hospital Charge Code |
48100093
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,319.71 |
| Max. Negotiated Rate |
$8,172.04 |
| Rate for Payer: Aetna Commercial |
$7,718.03
|
| Rate for Payer: BCBS Trust/PPO |
$7,499.21
|
| Rate for Payer: BCN Commercial |
$7,499.21
|
| Rate for Payer: Cash Price |
$7,264.03
|
| Rate for Payer: Cofinity Commercial |
$7,808.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,264.03
|
| Rate for Payer: Healthscope Commercial |
$8,172.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,810.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,718.03
|
| Rate for Payer: Nomi Health Commercial |
$7,445.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,810.03
|
| Rate for Payer: PHP Commercial |
$7,718.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,899.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,319.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,990.44
|
| Rate for Payer: UHC Core |
$7,581.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,810.03
|
|
|
HC ADD.AFIB ABL AFTER PVI
|
Facility
|
OP
|
$9,080.04
|
|
|
Service Code
|
CPT 93657
|
| Hospital Charge Code |
48100095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,600.81 |
| Max. Negotiated Rate |
$8,172.04 |
| Rate for Payer: Aetna Commercial |
$7,718.03
|
| Rate for Payer: Aetna Medicare |
$2,360.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,837.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,837.51
|
| Rate for Payer: BCBS Complete |
$1,680.72
|
| Rate for Payer: BCBS MAPPO |
$2,270.01
|
| Rate for Payer: BCBS Trust/PPO |
$7,464.70
|
| Rate for Payer: BCN Commercial |
$7,464.70
|
| Rate for Payer: BCN Medicare Advantage |
$2,270.01
|
| Rate for Payer: Cash Price |
$7,264.03
|
| Rate for Payer: Cofinity Commercial |
$7,808.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,264.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,270.01
|
| Rate for Payer: Healthscope Commercial |
$8,172.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,810.03
|
| Rate for Payer: Mclaren Medicaid |
$1,600.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,383.51
|
| Rate for Payer: Meridian Medicaid |
$1,680.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,610.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,497.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,718.03
|
| Rate for Payer: Nomi Health Commercial |
$7,445.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,810.03
|
| Rate for Payer: PACE Senior Care Partners |
$2,156.51
|
| Rate for Payer: PACE SWMI |
$2,270.01
|
| Rate for Payer: PHP Commercial |
$7,718.03
|
| Rate for Payer: PHP Medicare Advantage |
$2,270.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,600.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,899.63
|
| Rate for Payer: Priority Health Medicare |
$2,292.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,319.71
|
| Rate for Payer: Railroad Medicare Medicare |
$2,270.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,990.44
|
| Rate for Payer: UHC Core |
$7,581.83
|
| Rate for Payer: UHC Exchange |
$2,270.01
|
| Rate for Payer: UHC Medicaid |
$1,600.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,270.01
|
| Rate for Payer: UHCCP Medicaid |
$1,600.81
|
| Rate for Payer: VA VA |
$2,270.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,810.03
|
|
|
HC ADD.AFIB ABL AFTER PVI
|
Facility
|
IP
|
$9,080.04
|
|
|
Service Code
|
CPT 93657
|
| Hospital Charge Code |
48100095
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$6,319.71 |
| Max. Negotiated Rate |
$8,172.04 |
| Rate for Payer: Aetna Commercial |
$7,718.03
|
| Rate for Payer: BCBS Trust/PPO |
$7,499.21
|
| Rate for Payer: BCN Commercial |
$7,499.21
|
| Rate for Payer: Cash Price |
$7,264.03
|
| Rate for Payer: Cofinity Commercial |
$7,808.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,264.03
|
| Rate for Payer: Healthscope Commercial |
$8,172.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,810.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,718.03
|
| Rate for Payer: Nomi Health Commercial |
$7,445.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,810.03
|
| Rate for Payer: PHP Commercial |
$7,718.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,899.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,319.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,990.44
|
| Rate for Payer: UHC Core |
$7,581.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,810.03
|
|
|
HC ADDL DOSE TC99M DOM PROD NON HEU
|
Facility
|
OP
|
$55.71
|
|
|
Service Code
|
HCPCS C9176
|
| Hospital Charge Code |
34300041
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$50.14 |
| Rate for Payer: Aetna Commercial |
$47.35
|
| Rate for Payer: Aetna Medicare |
$14.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.41
|
| Rate for Payer: BCBS Complete |
$10.31
|
| Rate for Payer: BCBS MAPPO |
$13.93
|
| Rate for Payer: BCBS Trust/PPO |
$45.80
|
| Rate for Payer: BCN Commercial |
$45.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.93
|
| Rate for Payer: Cash Price |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$47.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.93
|
| Rate for Payer: Healthscope Commercial |
$50.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.78
|
| Rate for Payer: Mclaren Medicaid |
$9.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.62
|
| Rate for Payer: Meridian Medicaid |
$10.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.35
|
| Rate for Payer: Nomi Health Commercial |
$45.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.78
|
| Rate for Payer: PACE Senior Care Partners |
$13.23
|
| Rate for Payer: PACE SWMI |
$13.93
|
| Rate for Payer: PHP Commercial |
$47.35
|
| Rate for Payer: PHP Medicare Advantage |
$13.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.47
|
| Rate for Payer: Priority Health Medicare |
$14.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.77
|
| Rate for Payer: Railroad Medicare Medicare |
$13.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.02
|
| Rate for Payer: UHC Core |
$46.52
|
| Rate for Payer: UHC Exchange |
$13.93
|
| Rate for Payer: UHC Medicaid |
$9.82
|
| Rate for Payer: UHC Medicare Advantage |
$13.93
|
| Rate for Payer: UHCCP Medicaid |
$9.82
|
| Rate for Payer: VA VA |
$13.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.78
|
|
|
HC ADDL DOSE TC99M DOM PROD NON HEU
|
Facility
|
IP
|
$55.71
|
|
|
Service Code
|
HCPCS C9176
|
| Hospital Charge Code |
34300041
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$50.14 |
| Rate for Payer: Aetna Commercial |
$47.35
|
| Rate for Payer: BCBS Trust/PPO |
$46.01
|
| Rate for Payer: BCN Commercial |
$46.01
|
| Rate for Payer: Cash Price |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$47.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.57
|
| Rate for Payer: Healthscope Commercial |
$50.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.35
|
| Rate for Payer: Nomi Health Commercial |
$45.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.78
|
| Rate for Payer: PHP Commercial |
$47.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.02
|
| Rate for Payer: UHC Core |
$46.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.78
|
|
|
HC ADDL DOSE TC99M NON HEU
|
Facility
|
IP
|
$55.71
|
|
|
Service Code
|
HCPCS Q9969
|
| Hospital Charge Code |
34300036
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$38.77 |
| Max. Negotiated Rate |
$50.14 |
| Rate for Payer: Aetna Commercial |
$47.35
|
| Rate for Payer: BCBS Trust/PPO |
$46.01
|
| Rate for Payer: BCN Commercial |
$46.01
|
| Rate for Payer: Cash Price |
$44.57
|
| Rate for Payer: Cofinity Commercial |
$47.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.57
|
| Rate for Payer: Healthscope Commercial |
$50.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.35
|
| Rate for Payer: Nomi Health Commercial |
$45.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.78
|
| Rate for Payer: PHP Commercial |
$47.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.02
|
| Rate for Payer: UHC Core |
$46.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.78
|
|
