|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
OP
|
$70.75
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.47 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: Aetna Medicare |
$18.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.11
|
| Rate for Payer: BCBS Complete |
$13.10
|
| Rate for Payer: BCBS MAPPO |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.16
|
| Rate for Payer: BCN Commercial |
$58.16
|
| Rate for Payer: BCN Medicare Advantage |
$17.69
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.69
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Mclaren Medicaid |
$12.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.57
|
| Rate for Payer: Meridian Medicaid |
$13.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PACE Senior Care Partners |
$16.80
|
| Rate for Payer: PACE SWMI |
$17.69
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: PHP Medicare Advantage |
$17.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Medicare |
$17.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: Railroad Medicare Medicare |
$17.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: UHC Exchange |
$17.69
|
| Rate for Payer: UHC Medicaid |
$12.47
|
| Rate for Payer: UHC Medicare Advantage |
$17.69
|
| Rate for Payer: UHCCP Medicaid |
$12.47
|
| Rate for Payer: VA VA |
$17.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC ANTISTREPTOLYSIN TITER/ASO
|
Facility
|
IP
|
$70.75
|
|
|
Service Code
|
CPT 86060
|
| Hospital Charge Code |
30200136
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$49.24 |
| Max. Negotiated Rate |
$63.67 |
| Rate for Payer: Aetna Commercial |
$60.14
|
| Rate for Payer: BCBS Trust/PPO |
$58.43
|
| Rate for Payer: BCN Commercial |
$58.43
|
| Rate for Payer: Cash Price |
$56.60
|
| Rate for Payer: Cofinity Commercial |
$60.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$56.60
|
| Rate for Payer: Healthscope Commercial |
$63.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.14
|
| Rate for Payer: Nomi Health Commercial |
$58.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$53.06
|
| Rate for Payer: PHP Commercial |
$60.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$61.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.26
|
| Rate for Payer: UHC Core |
$59.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.06
|
|
|
HC ANTI THROMBIN III
|
Facility
|
OP
|
$50.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.98 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: Aetna Medicare |
$13.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.92
|
| Rate for Payer: BCBS Complete |
$9.43
|
| Rate for Payer: BCBS MAPPO |
$12.73
|
| Rate for Payer: BCBS Trust/PPO |
$41.88
|
| Rate for Payer: BCN Commercial |
$41.88
|
| Rate for Payer: BCN Medicare Advantage |
$12.73
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.73
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Mclaren Medicaid |
$8.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.37
|
| Rate for Payer: Meridian Medicaid |
$9.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PACE Senior Care Partners |
$12.10
|
| Rate for Payer: PACE SWMI |
$12.73
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: PHP Medicare Advantage |
$12.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Medicare |
$12.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: Railroad Medicare Medicare |
$12.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: UHC Exchange |
$12.73
|
| Rate for Payer: UHC Medicaid |
$8.98
|
| Rate for Payer: UHC Medicare Advantage |
$12.73
|
| Rate for Payer: UHCCP Medicaid |
$8.98
|
| Rate for Payer: VA VA |
$12.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC ANTI THROMBIN III
|
Facility
|
IP
|
$50.94
|
|
|
Service Code
|
CPT 85300
|
| Hospital Charge Code |
30500035
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$35.45 |
| Max. Negotiated Rate |
$45.85 |
| Rate for Payer: Aetna Commercial |
$43.30
|
| Rate for Payer: BCBS Trust/PPO |
$42.07
|
| Rate for Payer: BCN Commercial |
$42.07
|
| Rate for Payer: Cash Price |
$40.75
|
| Rate for Payer: Cofinity Commercial |
$43.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.75
|
| Rate for Payer: Healthscope Commercial |
$45.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.30
|
| Rate for Payer: Nomi Health Commercial |
$41.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.20
|
| Rate for Payer: PHP Commercial |
$43.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.83
|
| Rate for Payer: UHC Core |
$42.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.20
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
OP
|
$62.42
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.00 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: Aetna Medicare |
$16.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.51
|
| Rate for Payer: BCBS Complete |
$11.55
|
| Rate for Payer: BCBS MAPPO |
$15.61
|
| Rate for Payer: BCBS Trust/PPO |
$51.32
|
| Rate for Payer: BCN Commercial |
$51.32
|
| Rate for Payer: BCN Medicare Advantage |
$15.61
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.61
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Mclaren Medicaid |
$11.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.39
|
| Rate for Payer: Meridian Medicaid |
$11.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PACE Senior Care Partners |
$14.82
|
| Rate for Payer: PACE SWMI |
$15.61
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: PHP Medicare Advantage |
$15.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Medicare |
$15.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.44
|
| Rate for Payer: Railroad Medicare Medicare |
$15.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: UHC Exchange |
$15.61
|
| Rate for Payer: UHC Medicaid |
$11.00
|
| Rate for Payer: UHC Medicare Advantage |
$15.61
|
| Rate for Payer: UHCCP Medicaid |
$11.00
|
| Rate for Payer: VA VA |
$15.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC ANTITHROMBIN III ANTIGEN
|
Facility
|
IP
|
$62.42
|
|
|
Service Code
|
CPT 85301
|
| Hospital Charge Code |
30500036
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.44 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Aetna Commercial |
$53.06
|
| Rate for Payer: BCBS Trust/PPO |
$51.55
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: Cash Price |
$49.94
|
| Rate for Payer: Cofinity Commercial |
$53.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.94
|
| Rate for Payer: Healthscope Commercial |
$56.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.06
|
| Rate for Payer: Nomi Health Commercial |
$51.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.81
|
| Rate for Payer: PHP Commercial |
$53.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$54.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$43.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.93
|
| Rate for Payer: UHC Core |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.81
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
IP
|
$63.67
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$44.31 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: BCBS Trust/PPO |
$52.59
|
| Rate for Payer: BCN Commercial |
$52.59
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC ANTITRYPSIN GENOTYPE CMPT 1
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 81332
|
| Hospital Charge Code |
31000095
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: BCBS Complete |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$11.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$11.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicaid |
$11.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UHCCP Medicaid |
$11.23
|
| Rate for Payer: VA VA |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
IP
|
$853.42
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$593.98 |
| Max. Negotiated Rate |
$768.08 |
| Rate for Payer: Aetna Commercial |
$725.41
|
| Rate for Payer: BCBS Trust/PPO |
$704.84
|
| Rate for Payer: BCN Commercial |
$704.84
|
| Rate for Payer: Cash Price |
$682.74
|
| Rate for Payer: Cofinity Commercial |
$733.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.74
|
| Rate for Payer: Healthscope Commercial |
$768.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$640.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.41
|
| Rate for Payer: Nomi Health Commercial |
$699.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$640.07
|
| Rate for Payer: PHP Commercial |
$725.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$742.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$593.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.01
|
| Rate for Payer: UHC Core |
$712.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$640.07
|
|
|
HC AO GRAM W HEART CATH
|
Facility
|
OP
|
$853.42
|
|
|
Service Code
|
CPT 93567
|
| Hospital Charge Code |
48100026
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$150.46 |
| Max. Negotiated Rate |
$768.08 |
| Rate for Payer: Aetna Commercial |
$725.41
|
| Rate for Payer: Aetna Medicare |
$221.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$266.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$266.69
|
| Rate for Payer: BCBS Complete |
$157.97
|
| Rate for Payer: BCBS MAPPO |
$213.35
|
| Rate for Payer: BCBS Trust/PPO |
$701.60
|
| Rate for Payer: BCN Commercial |
$701.60
|
| Rate for Payer: BCN Medicare Advantage |
$213.35
|
| Rate for Payer: Cash Price |
$682.74
|
| Rate for Payer: Cofinity Commercial |
$733.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$682.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.35
|
| Rate for Payer: Healthscope Commercial |
$768.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$640.07
|
| Rate for Payer: Mclaren Medicaid |
$150.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.02
|
| Rate for Payer: Meridian Medicaid |
$157.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$245.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$234.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$725.41
|
| Rate for Payer: Nomi Health Commercial |
$699.80
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$640.07
|
| Rate for Payer: PACE Senior Care Partners |
$202.69
|
| Rate for Payer: PACE SWMI |
$213.35
|
| Rate for Payer: PHP Commercial |
$725.41
|
| Rate for Payer: PHP Medicare Advantage |
$213.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$150.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$742.48
|
| Rate for Payer: Priority Health Medicare |
$215.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$593.98
|
| Rate for Payer: Railroad Medicare Medicare |
$213.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$751.01
|
| Rate for Payer: UHC Core |
$712.61
|
| Rate for Payer: UHC Exchange |
$213.35
|
| Rate for Payer: UHC Medicaid |
$150.46
|
| Rate for Payer: UHC Medicare Advantage |
$213.35
|
| Rate for Payer: UHCCP Medicaid |
$150.46
|
| Rate for Payer: VA VA |
$213.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$640.07
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
IP
|
$1,347.24
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$937.68 |
| Max. Negotiated Rate |
$1,212.52 |
| Rate for Payer: Aetna Commercial |
$1,145.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,112.69
|
| Rate for Payer: BCN Commercial |
$1,112.69
|
| Rate for Payer: Cash Price |
$1,077.79
|
| Rate for Payer: Cofinity Commercial |
$1,158.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,077.79
|
| Rate for Payer: Healthscope Commercial |
$1,212.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,010.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,145.15
|
| Rate for Payer: Nomi Health Commercial |
$1,104.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,010.43
|
| Rate for Payer: PHP Commercial |
$1,145.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,172.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,185.57
|
| Rate for Payer: UHC Core |
$1,124.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,010.43
|
|
|
HC AORTA ILIAC ULTRA COMPL
|
Facility
|
OP
|
$1,347.24
|
|
|
Service Code
|
CPT 93978
|
| Hospital Charge Code |
92100015
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$237.52 |
| Max. Negotiated Rate |
$1,212.52 |
| Rate for Payer: Aetna Commercial |
$1,145.15
|
| Rate for Payer: Aetna Medicare |
$350.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$421.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$421.01
|
| Rate for Payer: BCBS Complete |
$249.37
|
| Rate for Payer: BCBS MAPPO |
$336.81
|
| Rate for Payer: BCBS Trust/PPO |
$1,107.57
|
| Rate for Payer: BCN Commercial |
$1,107.57
|
| Rate for Payer: BCN Medicare Advantage |
$336.81
|
| Rate for Payer: Cash Price |
$1,077.79
|
| Rate for Payer: Cofinity Commercial |
$1,158.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,077.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$336.81
|
| Rate for Payer: Healthscope Commercial |
$1,212.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,010.43
|
| Rate for Payer: Mclaren Medicaid |
$237.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$353.65
|
| Rate for Payer: Meridian Medicaid |
$249.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$387.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$370.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,145.15
|
| Rate for Payer: Nomi Health Commercial |
$1,104.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,010.43
|
| Rate for Payer: PACE Senior Care Partners |
$319.97
|
| Rate for Payer: PACE SWMI |
$336.81
|
| Rate for Payer: PHP Commercial |
$1,145.15
|
| Rate for Payer: PHP Medicare Advantage |
$336.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$237.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,172.10
|
| Rate for Payer: Priority Health Medicare |
$340.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$937.68
|
| Rate for Payer: Railroad Medicare Medicare |
$336.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,185.57
|
| Rate for Payer: UHC Core |
$1,124.95
|
| Rate for Payer: UHC Exchange |
$336.81
|
| Rate for Payer: UHC Medicaid |
$237.52
|
| Rate for Payer: UHC Medicare Advantage |
$336.81
|
| Rate for Payer: UHCCP Medicaid |
$237.52
|
| Rate for Payer: VA VA |
$336.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,010.43
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
OP
|
$832.87
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$146.83 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: Aetna Medicare |
$216.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$260.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$260.27
|
| Rate for Payer: BCBS Complete |
$154.16
|
| Rate for Payer: BCBS MAPPO |
$208.22
|
| Rate for Payer: BCBS Trust/PPO |
$684.70
|
| Rate for Payer: BCN Commercial |
$684.70
|
| Rate for Payer: BCN Medicare Advantage |
$208.22
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$208.22
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.65
|
| Rate for Payer: Mclaren Medicaid |
$146.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$218.63
|
| Rate for Payer: Meridian Medicaid |
$154.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$239.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$229.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PACE Senior Care Partners |
$197.81
|
| Rate for Payer: PACE SWMI |
$208.22
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: PHP Medicare Advantage |
$208.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$146.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.60
|
| Rate for Payer: Priority Health Medicare |
$210.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.68
|
| Rate for Payer: Railroad Medicare Medicare |
$208.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.93
|
| Rate for Payer: UHC Core |
$695.45
|
| Rate for Payer: UHC Exchange |
$208.22
|
| Rate for Payer: UHC Medicaid |
$146.83
|
| Rate for Payer: UHC Medicare Advantage |
$208.22
|
| Rate for Payer: UHCCP Medicaid |
$146.83
|
| Rate for Payer: VA VA |
$208.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.65
|
|
|
HC AORTA ILIAC ULTRA LIMITD
|
Facility
|
IP
|
$832.87
|
|
|
Service Code
|
CPT 93979
|
| Hospital Charge Code |
92100016
|
|
Hospital Revenue Code
|
921
|
| Min. Negotiated Rate |
$579.68 |
| Max. Negotiated Rate |
$749.58 |
| Rate for Payer: Aetna Commercial |
$707.94
|
| Rate for Payer: BCBS Trust/PPO |
$687.87
|
| Rate for Payer: BCN Commercial |
$687.87
|
| Rate for Payer: Cash Price |
$666.30
|
| Rate for Payer: Cofinity Commercial |
$716.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$666.30
|
| Rate for Payer: Healthscope Commercial |
$749.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$624.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$707.94
|
| Rate for Payer: Nomi Health Commercial |
$682.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$624.65
|
| Rate for Payer: PHP Commercial |
$707.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$724.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$579.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$732.93
|
| Rate for Payer: UHC Core |
$695.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$624.65
|
|
|
HC APHERESIS
|
Facility
|
IP
|
$2,606.60
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,814.19 |
| Max. Negotiated Rate |
$2,345.94 |
| Rate for Payer: Aetna Commercial |
$2,215.61
|
| Rate for Payer: BCBS Trust/PPO |
$2,152.79
|
| Rate for Payer: BCN Commercial |
$2,152.79
|
| Rate for Payer: Cash Price |
$2,085.28
|
| Rate for Payer: Cofinity Commercial |
$2,241.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,085.28
|
| Rate for Payer: Healthscope Commercial |
$2,345.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,954.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,215.61
|
| Rate for Payer: Nomi Health Commercial |
$2,137.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,954.95
|
| Rate for Payer: PHP Commercial |
$2,215.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,267.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,814.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,293.81
|
| Rate for Payer: UHC Core |
$2,176.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,954.95
|
|
|
HC APHERESIS
|
Facility
|
OP
|
$2,606.60
|
|
| Hospital Charge Code |
36000006
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$459.54 |
| Max. Negotiated Rate |
$2,345.94 |
| Rate for Payer: Aetna Commercial |
$2,215.61
|
| Rate for Payer: Aetna Medicare |
$677.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$814.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$814.56
|
| Rate for Payer: BCBS Complete |
$482.48
|
| Rate for Payer: BCBS MAPPO |
$651.65
|
| Rate for Payer: BCBS Trust/PPO |
$2,142.89
|
| Rate for Payer: BCN Commercial |
$2,142.89
|
| Rate for Payer: BCN Medicare Advantage |
$651.65
|
| Rate for Payer: Cash Price |
$2,085.28
|
| Rate for Payer: Cofinity Commercial |
$2,241.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,085.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$651.65
|
| Rate for Payer: Healthscope Commercial |
$2,345.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,954.95
|
| Rate for Payer: Mclaren Medicaid |
$459.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$684.23
|
| Rate for Payer: Meridian Medicaid |
$482.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$749.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$716.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,215.61
|
| Rate for Payer: Nomi Health Commercial |
$2,137.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,954.95
|
| Rate for Payer: PACE Senior Care Partners |
$619.07
|
| Rate for Payer: PACE SWMI |
$651.65
|
| Rate for Payer: PHP Commercial |
$2,215.61
|
| Rate for Payer: PHP Medicare Advantage |
$651.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$459.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,267.74
|
| Rate for Payer: Priority Health Medicare |
$658.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,814.19
|
| Rate for Payer: Railroad Medicare Medicare |
$651.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,293.81
|
| Rate for Payer: UHC Core |
$2,176.51
|
| Rate for Payer: UHC Exchange |
$651.65
|
| Rate for Payer: UHC Medicaid |
$459.54
|
| Rate for Payer: UHC Medicare Advantage |
$651.65
|
| Rate for Payer: UHCCP Medicaid |
$459.54
|
| Rate for Payer: VA VA |
$651.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,954.95
|
|
|
HC APIXABAN
|
Facility
|
OP
|
$156.06
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100758
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.51 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: Aetna Medicare |
$40.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.77
|
| Rate for Payer: BCBS Complete |
$28.89
|
| Rate for Payer: BCBS MAPPO |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$128.30
|
| Rate for Payer: BCN Commercial |
$128.30
|
| Rate for Payer: BCN Medicare Advantage |
$39.02
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.02
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Mclaren Medicaid |
$27.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.97
|
| Rate for Payer: Meridian Medicaid |
$28.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$42.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PACE Senior Care Partners |
$37.06
|
| Rate for Payer: PACE SWMI |
$39.02
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: PHP Medicare Advantage |
$39.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Medicare |
$39.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: Railroad Medicare Medicare |
$39.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: UHC Exchange |
$39.02
|
| Rate for Payer: UHC Medicaid |
$27.51
|
| Rate for Payer: UHC Medicare Advantage |
$39.02
|
| Rate for Payer: UHCCP Medicaid |
$27.51
|
| Rate for Payer: VA VA |
$39.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC APIXABAN
|
Facility
|
IP
|
$156.06
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100758
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.62 |
| Max. Negotiated Rate |
$140.45 |
| Rate for Payer: Aetna Commercial |
$132.65
|
| Rate for Payer: BCBS Trust/PPO |
$128.89
|
| Rate for Payer: BCN Commercial |
$128.89
|
| Rate for Payer: Cash Price |
$124.85
|
| Rate for Payer: Cofinity Commercial |
$134.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.85
|
| Rate for Payer: Healthscope Commercial |
$140.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$132.65
|
| Rate for Payer: Nomi Health Commercial |
$127.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.05
|
| Rate for Payer: PHP Commercial |
$132.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$135.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$108.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$137.33
|
| Rate for Payer: UHC Core |
$130.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.05
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
IP
|
$134.35
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$93.51 |
| Max. Negotiated Rate |
$120.92 |
| Rate for Payer: Aetna Commercial |
$114.20
|
| Rate for Payer: BCBS Trust/PPO |
$110.96
|
| Rate for Payer: BCN Commercial |
$110.96
|
| Rate for Payer: Cash Price |
$107.48
|
| Rate for Payer: Cofinity Commercial |
$115.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.48
|
| Rate for Payer: Healthscope Commercial |
$120.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.20
|
| Rate for Payer: Nomi Health Commercial |
$110.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.76
|
| Rate for Payer: PHP Commercial |
$114.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.23
|
| Rate for Payer: UHC Core |
$112.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.76
|
|
|
HC APLIGRAF PER SQ CM
|
Facility
|
OP
|
$134.35
|
|
|
Service Code
|
HCPCS Q4101
|
| Hospital Charge Code |
63600001
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.69 |
| Max. Negotiated Rate |
$120.92 |
| Rate for Payer: Aetna Commercial |
$114.20
|
| Rate for Payer: Aetna Medicare |
$34.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.98
|
| Rate for Payer: BCBS Complete |
$24.87
|
| Rate for Payer: BCBS MAPPO |
$33.59
|
| Rate for Payer: BCBS Trust/PPO |
$110.45
|
| Rate for Payer: BCN Commercial |
$110.45
|
| Rate for Payer: BCN Medicare Advantage |
$33.59
|
| Rate for Payer: Cash Price |
$107.48
|
| Rate for Payer: Cofinity Commercial |
$115.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.59
|
| Rate for Payer: Healthscope Commercial |
$120.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.76
|
| Rate for Payer: Mclaren Medicaid |
$23.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.27
|
| Rate for Payer: Meridian Medicaid |
$24.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.20
|
| Rate for Payer: Nomi Health Commercial |
$110.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.76
|
| Rate for Payer: PACE Senior Care Partners |
$31.91
|
| Rate for Payer: PACE SWMI |
$33.59
|
| Rate for Payer: PHP Commercial |
$114.20
|
| Rate for Payer: PHP Medicare Advantage |
$33.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.88
|
| Rate for Payer: Priority Health Medicare |
$33.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.51
|
| Rate for Payer: Railroad Medicare Medicare |
$33.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.23
|
| Rate for Payer: UHC Core |
$112.18
|
| Rate for Payer: UHC Exchange |
$33.59
|
| Rate for Payer: UHC Medicaid |
$23.69
|
| Rate for Payer: UHC Medicare Advantage |
$33.59
|
| Rate for Payer: UHCCP Medicaid |
$23.69
|
| Rate for Payer: VA VA |
$33.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.76
|
|
|
HC APOLIPO E GENE, WB
|
Facility
|
IP
|
$344.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
31000089
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$239.42 |
| Max. Negotiated Rate |
$309.60 |
| Rate for Payer: Aetna Commercial |
$292.40
|
| Rate for Payer: BCBS Trust/PPO |
$284.11
|
| Rate for Payer: BCN Commercial |
$284.11
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$295.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.20
|
| Rate for Payer: Healthscope Commercial |
$309.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.40
|
| Rate for Payer: Nomi Health Commercial |
$282.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.00
|
| Rate for Payer: PHP Commercial |
$292.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$299.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.72
|
| Rate for Payer: UHC Core |
$287.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.00
|
|
|
HC APOLIPO E GENE, WB
|
Facility
|
OP
|
$344.00
|
|
|
Service Code
|
CPT 81401
|
| Hospital Charge Code |
31000089
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$60.65 |
| Max. Negotiated Rate |
$309.60 |
| Rate for Payer: Aetna Commercial |
$292.40
|
| Rate for Payer: Aetna Medicare |
$89.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.50
|
| Rate for Payer: BCBS Complete |
$63.67
|
| Rate for Payer: BCBS MAPPO |
$86.00
|
| Rate for Payer: BCBS Trust/PPO |
$282.80
|
| Rate for Payer: BCN Commercial |
$282.80
|
| Rate for Payer: BCN Medicare Advantage |
$86.00
|
| Rate for Payer: Cash Price |
$275.20
|
| Rate for Payer: Cofinity Commercial |
$295.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$275.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.00
|
| Rate for Payer: Healthscope Commercial |
$309.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$258.00
|
| Rate for Payer: Mclaren Medicaid |
$60.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.30
|
| Rate for Payer: Meridian Medicaid |
$63.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$292.40
|
| Rate for Payer: Nomi Health Commercial |
$282.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$258.00
|
| Rate for Payer: PACE Senior Care Partners |
$81.70
|
| Rate for Payer: PACE SWMI |
$86.00
|
| Rate for Payer: PHP Commercial |
$292.40
|
| Rate for Payer: PHP Medicare Advantage |
$86.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$299.28
|
| Rate for Payer: Priority Health Medicare |
$86.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$239.42
|
| Rate for Payer: Railroad Medicare Medicare |
$86.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$302.72
|
| Rate for Payer: UHC Core |
$287.24
|
| Rate for Payer: UHC Exchange |
$86.00
|
| Rate for Payer: UHC Medicaid |
$60.65
|
| Rate for Payer: UHC Medicare Advantage |
$86.00
|
| Rate for Payer: UHCCP Medicaid |
$60.65
|
| Rate for Payer: VA VA |
$86.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$258.00
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.50 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$42.12
|
| Rate for Payer: BCN Commercial |
$42.12
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC APOLIPOPROTEIN A1
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100106
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.99 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$9.44
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$41.93
|
| Rate for Payer: BCN Commercial |
$41.93
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$8.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: Meridian Medicaid |
$9.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$38.25
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.50
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.59
|
| Rate for Payer: UHC Exchange |
$12.75
|
| Rate for Payer: UHC Medicaid |
$8.99
|
| Rate for Payer: UHC Medicare Advantage |
$12.75
|
| Rate for Payer: UHCCP Medicaid |
$8.99
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC APOLIPOPROTEIN B
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 82172
|
| Hospital Charge Code |
30100107
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$46.80 |
| Rate for Payer: Aetna Commercial |
$44.20
|
| Rate for Payer: Aetna Medicare |
$13.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.25
|
| Rate for Payer: BCBS Complete |
$9.63
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.75
|
| Rate for Payer: BCN Commercial |
$42.75
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.60
|
| Rate for Payer: Cofinity Commercial |
$44.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.00
|
| Rate for Payer: Mclaren Medicaid |
$9.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.65
|
| Rate for Payer: Meridian Medicaid |
$9.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.20
|
| Rate for Payer: Nomi Health Commercial |
$42.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.00
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.20
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$45.24
|
| Rate for Payer: Priority Health Medicare |
$13.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.19
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.76
|
| Rate for Payer: UHC Core |
$43.42
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicaid |
$9.17
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$9.17
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.00
|
|
