|
HC APTT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500063
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC APTT MIXING STUDY
|
Facility
|
OP
|
$101.96
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.98 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: Aetna Medicare |
$26.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.86
|
| Rate for Payer: BCBS Complete |
$18.87
|
| Rate for Payer: BCBS MAPPO |
$25.49
|
| Rate for Payer: BCBS Trust/PPO |
$83.82
|
| Rate for Payer: BCN Commercial |
$83.82
|
| Rate for Payer: BCN Medicare Advantage |
$25.49
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.49
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Mclaren Medicaid |
$17.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.76
|
| Rate for Payer: Meridian Medicaid |
$18.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$83.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PACE Senior Care Partners |
$24.22
|
| Rate for Payer: PACE SWMI |
$25.49
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: PHP Medicare Advantage |
$25.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.71
|
| Rate for Payer: Priority Health Medicare |
$25.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.96
|
| Rate for Payer: Railroad Medicare Medicare |
$25.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.14
|
| Rate for Payer: UHC Exchange |
$25.49
|
| Rate for Payer: UHC Medicaid |
$17.98
|
| Rate for Payer: UHC Medicare Advantage |
$25.49
|
| Rate for Payer: UHCCP Medicaid |
$17.98
|
| Rate for Payer: VA VA |
$25.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC APTT MIXING STUDY
|
Facility
|
IP
|
$101.96
|
|
|
Service Code
|
CPT 85732
|
| Hospital Charge Code |
30500064
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$70.96 |
| Max. Negotiated Rate |
$91.76 |
| Rate for Payer: Aetna Commercial |
$86.67
|
| Rate for Payer: BCBS Trust/PPO |
$84.21
|
| Rate for Payer: BCN Commercial |
$84.21
|
| Rate for Payer: Cash Price |
$81.57
|
| Rate for Payer: Cofinity Commercial |
$87.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.57
|
| Rate for Payer: Healthscope Commercial |
$91.76
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.67
|
| Rate for Payer: Nomi Health Commercial |
$83.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.47
|
| Rate for Payer: PHP Commercial |
$86.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.72
|
| Rate for Payer: UHC Core |
$85.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.47
|
|
|
HC AQUATIC THERAPY EA 15 MIN
|
Facility
|
OP
|
$95.51
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
42000022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$16.84 |
| Max. Negotiated Rate |
$85.96 |
| Rate for Payer: Aetna Commercial |
$81.18
|
| Rate for Payer: Aetna Medicare |
$24.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.85
|
| Rate for Payer: BCBS Complete |
$17.68
|
| Rate for Payer: BCBS MAPPO |
$23.88
|
| Rate for Payer: BCBS Trust/PPO |
$78.52
|
| Rate for Payer: BCN Commercial |
$78.52
|
| Rate for Payer: BCN Medicare Advantage |
$23.88
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cofinity Commercial |
$82.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.88
|
| Rate for Payer: Healthscope Commercial |
$85.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.63
|
| Rate for Payer: Mclaren Medicaid |
$16.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.07
|
| Rate for Payer: Meridian Medicaid |
$17.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.18
|
| Rate for Payer: Nomi Health Commercial |
$78.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.63
|
| Rate for Payer: PACE Senior Care Partners |
$22.68
|
| Rate for Payer: PACE SWMI |
$23.88
|
| Rate for Payer: PHP Commercial |
$81.18
|
| Rate for Payer: PHP Medicare Advantage |
$23.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.09
|
| Rate for Payer: Priority Health Medicare |
$24.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.47
|
| Rate for Payer: Railroad Medicare Medicare |
$23.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.05
|
| Rate for Payer: UHC Core |
$79.75
|
| Rate for Payer: UHC Exchange |
$23.88
|
| Rate for Payer: UHC Medicaid |
$16.84
|
| Rate for Payer: UHC Medicare Advantage |
$23.88
|
| Rate for Payer: UHCCP Medicaid |
$16.84
|
| Rate for Payer: VA VA |
$23.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.63
|
|
|
HC AQUATIC THERAPY EA 15 MIN
|
Facility
|
IP
|
$95.51
|
|
|
Service Code
|
CPT 97113
|
| Hospital Charge Code |
42000022
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$66.47 |
| Max. Negotiated Rate |
$85.96 |
| Rate for Payer: Aetna Commercial |
$81.18
|
| Rate for Payer: BCBS Trust/PPO |
$78.88
|
| Rate for Payer: BCN Commercial |
$78.88
|
| Rate for Payer: Cash Price |
$76.41
|
| Rate for Payer: Cofinity Commercial |
$82.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.41
|
| Rate for Payer: Healthscope Commercial |
$85.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$81.18
|
| Rate for Payer: Nomi Health Commercial |
$78.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$71.63
|
| Rate for Payer: PHP Commercial |
$81.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$83.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.05
|
| Rate for Payer: UHC Core |
$79.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.63
|
|
|
HC ARBOVIRUS CALIF CMPT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200388
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS CALIF CMPT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200388
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS E EQUINE CMPT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200389
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS E EQUINE CMPT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
30200389
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS IGG/IGM PNL, CSF
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200387
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS IGG/IGM PNL, CSF
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86651
|
| Hospital Charge Code |
30200387
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS T LOUIS CMPT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86653
|
| Hospital Charge Code |
30200390
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARBOVIRUS W EQUINE CMPT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 86654
|
| Hospital Charge Code |
30200391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
IP
|
$2,632.46
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$1,832.19 |
| Max. Negotiated Rate |
$2,369.21 |
| Rate for Payer: Aetna Commercial |
$2,237.59
|
| Rate for Payer: BCBS Trust/PPO |
$2,174.15
|
| Rate for Payer: BCN Commercial |
$2,174.15
|
| Rate for Payer: Cash Price |
$2,105.97
|
| Rate for Payer: Cofinity Commercial |
$2,263.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.97
|
| Rate for Payer: Healthscope Commercial |
$2,369.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,974.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.59
|
| Rate for Payer: Nomi Health Commercial |
$2,158.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,974.35
|
| Rate for Payer: PHP Commercial |
$2,237.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,290.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,832.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,316.56
|
| Rate for Payer: UHC Core |
$2,198.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,974.35
|
|
|
HC ARCTIC SUN TORSO/LEG PADS
|
Facility
|
OP
|
$2,632.46
|
|
| Hospital Charge Code |
27000610
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$464.10 |
| Max. Negotiated Rate |
$2,369.21 |
| Rate for Payer: Aetna Commercial |
$2,237.59
|
| Rate for Payer: Aetna Medicare |
$684.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$822.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$822.64
|
| Rate for Payer: BCBS Complete |
$487.27
|
| Rate for Payer: BCBS MAPPO |
$658.12
|
| Rate for Payer: BCBS Trust/PPO |
$2,164.15
|
| Rate for Payer: BCN Commercial |
$2,164.15
|
| Rate for Payer: BCN Medicare Advantage |
$658.12
|
| Rate for Payer: Cash Price |
$2,105.97
|
| Rate for Payer: Cofinity Commercial |
$2,263.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,105.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$658.12
|
| Rate for Payer: Healthscope Commercial |
$2,369.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,974.35
|
| Rate for Payer: Mclaren Medicaid |
$464.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$691.02
|
| Rate for Payer: Meridian Medicaid |
$487.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$756.83
|
| Rate for Payer: Molina Medicare/Medicaid |
$723.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,237.59
|
| Rate for Payer: Nomi Health Commercial |
$2,158.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,974.35
|
| Rate for Payer: PACE Senior Care Partners |
$625.21
|
| Rate for Payer: PACE SWMI |
$658.12
|
| Rate for Payer: PHP Commercial |
$2,237.59
|
| Rate for Payer: PHP Medicare Advantage |
$658.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$464.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,290.24
|
| Rate for Payer: Priority Health Medicare |
$664.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,832.19
|
| Rate for Payer: Railroad Medicare Medicare |
$658.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,316.56
|
| Rate for Payer: UHC Core |
$2,198.10
|
| Rate for Payer: UHC Exchange |
$658.12
|
| Rate for Payer: UHC Medicaid |
$464.10
|
| Rate for Payer: UHC Medicare Advantage |
$658.12
|
| Rate for Payer: UHCCP Medicaid |
$464.10
|
| Rate for Payer: VA VA |
$658.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,974.35
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
OP
|
$1,140.74
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$201.11 |
| Max. Negotiated Rate |
$1,026.67 |
| Rate for Payer: Aetna Commercial |
$969.63
|
| Rate for Payer: Aetna Medicare |
$296.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$356.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$356.48
|
| Rate for Payer: BCBS Complete |
$211.15
|
| Rate for Payer: BCBS MAPPO |
$285.19
|
| Rate for Payer: BCBS Trust/PPO |
$937.80
|
| Rate for Payer: BCN Commercial |
$937.80
|
| Rate for Payer: BCN Medicare Advantage |
$285.19
|
| Rate for Payer: Cash Price |
$912.59
|
| Rate for Payer: Cofinity Commercial |
$981.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$912.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$285.19
|
| Rate for Payer: Healthscope Commercial |
$1,026.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$855.55
|
| Rate for Payer: Mclaren Medicaid |
$201.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$299.44
|
| Rate for Payer: Meridian Medicaid |
$211.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$327.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$313.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$969.63
|
| Rate for Payer: Nomi Health Commercial |
$935.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$855.55
|
| Rate for Payer: PACE Senior Care Partners |
$270.93
|
| Rate for Payer: PACE SWMI |
$285.19
|
| Rate for Payer: PHP Commercial |
$969.63
|
| Rate for Payer: PHP Medicare Advantage |
$285.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$201.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$992.44
|
| Rate for Payer: Priority Health Medicare |
$288.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$793.96
|
| Rate for Payer: Railroad Medicare Medicare |
$285.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,003.85
|
| Rate for Payer: UHC Core |
$952.52
|
| Rate for Payer: UHC Exchange |
$285.19
|
| Rate for Payer: UHC Medicaid |
$201.11
|
| Rate for Payer: UHC Medicare Advantage |
$285.19
|
| Rate for Payer: UHCCP Medicaid |
$201.11
|
| Rate for Payer: VA VA |
$285.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$855.55
|
|
|
HC ARCTIC SUN UNIVERSAL PAD
|
Facility
|
IP
|
$1,140.74
|
|
| Hospital Charge Code |
27000617
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$793.96 |
| Max. Negotiated Rate |
$1,026.67 |
| Rate for Payer: Aetna Commercial |
$969.63
|
| Rate for Payer: BCBS Trust/PPO |
$942.14
|
| Rate for Payer: BCN Commercial |
$942.14
|
| Rate for Payer: Cash Price |
$912.59
|
| Rate for Payer: Cofinity Commercial |
$981.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$912.59
|
| Rate for Payer: Healthscope Commercial |
$1,026.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$855.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$969.63
|
| Rate for Payer: Nomi Health Commercial |
$935.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$855.55
|
| Rate for Payer: PHP Commercial |
$969.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$992.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$793.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,003.85
|
| Rate for Payer: UHC Core |
$952.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$855.55
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
OP
|
$1,897.29
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$334.49 |
| Max. Negotiated Rate |
$1,707.56 |
| Rate for Payer: Aetna Commercial |
$1,612.70
|
| Rate for Payer: Aetna Medicare |
$493.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$592.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$592.90
|
| Rate for Payer: BCBS Complete |
$351.19
|
| Rate for Payer: BCBS MAPPO |
$474.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,559.76
|
| Rate for Payer: BCN Commercial |
$1,559.76
|
| Rate for Payer: BCN Medicare Advantage |
$474.32
|
| Rate for Payer: Cash Price |
$1,517.83
|
| Rate for Payer: Cofinity Commercial |
$1,631.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,517.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.32
|
| Rate for Payer: Healthscope Commercial |
$1,707.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,422.97
|
| Rate for Payer: Mclaren Medicaid |
$334.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.04
|
| Rate for Payer: Meridian Medicaid |
$351.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$545.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$521.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,612.70
|
| Rate for Payer: Nomi Health Commercial |
$1,555.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,422.97
|
| Rate for Payer: PACE Senior Care Partners |
$450.61
|
| Rate for Payer: PACE SWMI |
$474.32
|
| Rate for Payer: PHP Commercial |
$1,612.70
|
| Rate for Payer: PHP Medicare Advantage |
$474.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$334.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,650.64
|
| Rate for Payer: Priority Health Medicare |
$479.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,320.51
|
| Rate for Payer: Railroad Medicare Medicare |
$474.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,669.62
|
| Rate for Payer: UHC Core |
$1,584.24
|
| Rate for Payer: UHC Exchange |
$474.32
|
| Rate for Payer: UHC Medicaid |
$334.49
|
| Rate for Payer: UHC Medicare Advantage |
$474.32
|
| Rate for Payer: UHCCP Medicaid |
$334.49
|
| Rate for Payer: VA VA |
$474.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,422.97
|
|
|
HC ARGON PLASMA COAGULATION
|
Facility
|
IP
|
$1,897.29
|
|
| Hospital Charge Code |
36000007
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,320.51 |
| Max. Negotiated Rate |
$1,707.56 |
| Rate for Payer: Aetna Commercial |
$1,612.70
|
| Rate for Payer: BCBS Trust/PPO |
$1,566.97
|
| Rate for Payer: BCN Commercial |
$1,566.97
|
| Rate for Payer: Cash Price |
$1,517.83
|
| Rate for Payer: Cofinity Commercial |
$1,631.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,517.83
|
| Rate for Payer: Healthscope Commercial |
$1,707.56
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,422.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,612.70
|
| Rate for Payer: Nomi Health Commercial |
$1,555.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,422.97
|
| Rate for Payer: PHP Commercial |
$1,612.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,650.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,320.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,669.62
|
| Rate for Payer: UHC Core |
$1,584.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,422.97
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
IP
|
$1,164.50
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$810.49 |
| Max. Negotiated Rate |
$1,048.05 |
| Rate for Payer: Aetna Commercial |
$989.83
|
| Rate for Payer: BCBS Trust/PPO |
$961.76
|
| Rate for Payer: BCN Commercial |
$961.76
|
| Rate for Payer: Cash Price |
$931.60
|
| Rate for Payer: Cofinity Commercial |
$1,001.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$931.60
|
| Rate for Payer: Healthscope Commercial |
$1,048.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$873.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$989.83
|
| Rate for Payer: Nomi Health Commercial |
$954.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$873.38
|
| Rate for Payer: PHP Commercial |
$989.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,013.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$810.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,024.76
|
| Rate for Payer: UHC Core |
$972.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$873.38
|
|
|
HC ARISTA HEMOSTAT
|
Facility
|
OP
|
$1,164.50
|
|
| Hospital Charge Code |
27200111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$205.30 |
| Max. Negotiated Rate |
$1,048.05 |
| Rate for Payer: Aetna Commercial |
$989.83
|
| Rate for Payer: Aetna Medicare |
$302.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$363.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$363.91
|
| Rate for Payer: BCBS Complete |
$215.55
|
| Rate for Payer: BCBS MAPPO |
$291.12
|
| Rate for Payer: BCBS Trust/PPO |
$957.34
|
| Rate for Payer: BCN Commercial |
$957.34
|
| Rate for Payer: BCN Medicare Advantage |
$291.12
|
| Rate for Payer: Cash Price |
$931.60
|
| Rate for Payer: Cofinity Commercial |
$1,001.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$931.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$291.12
|
| Rate for Payer: Healthscope Commercial |
$1,048.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$873.38
|
| Rate for Payer: Mclaren Medicaid |
$205.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$305.68
|
| Rate for Payer: Meridian Medicaid |
$215.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$334.79
|
| Rate for Payer: Molina Medicare/Medicaid |
$320.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$989.83
|
| Rate for Payer: Nomi Health Commercial |
$954.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$873.38
|
| Rate for Payer: PACE Senior Care Partners |
$276.57
|
| Rate for Payer: PACE SWMI |
$291.12
|
| Rate for Payer: PHP Commercial |
$989.83
|
| Rate for Payer: PHP Medicare Advantage |
$291.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$205.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,013.12
|
| Rate for Payer: Priority Health Medicare |
$294.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$810.49
|
| Rate for Payer: Railroad Medicare Medicare |
$291.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,024.76
|
| Rate for Payer: UHC Core |
$972.36
|
| Rate for Payer: UHC Exchange |
$291.12
|
| Rate for Payer: UHC Medicaid |
$205.30
|
| Rate for Payer: UHC Medicare Advantage |
$291.12
|
| Rate for Payer: UHCCP Medicaid |
$205.30
|
| Rate for Payer: VA VA |
$291.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$873.38
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
IP
|
$1,628.95
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$1,133.75 |
| Max. Negotiated Rate |
$1,466.06 |
| Rate for Payer: Aetna Commercial |
$1,384.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,345.35
|
| Rate for Payer: BCN Commercial |
$1,345.35
|
| Rate for Payer: Cash Price |
$1,303.16
|
| Rate for Payer: Cofinity Commercial |
$1,400.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,303.16
|
| Rate for Payer: Healthscope Commercial |
$1,466.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,221.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,384.61
|
| Rate for Payer: Nomi Health Commercial |
$1,335.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,221.71
|
| Rate for Payer: PHP Commercial |
$1,384.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,417.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,133.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,433.48
|
| Rate for Payer: UHC Core |
$1,360.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,221.71
|
|
|
HC ARRAY COMPARATIVE GENOMIC ACGH
|
Facility
|
OP
|
$1,628.95
|
|
|
Service Code
|
CPT 81228
|
| Hospital Charge Code |
31000094
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$287.18 |
| Max. Negotiated Rate |
$1,466.06 |
| Rate for Payer: Aetna Commercial |
$1,384.61
|
| Rate for Payer: Aetna Medicare |
$423.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$509.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$509.05
|
| Rate for Payer: BCBS Complete |
$301.52
|
| Rate for Payer: BCBS MAPPO |
$407.24
|
| Rate for Payer: BCBS Trust/PPO |
$1,339.16
|
| Rate for Payer: BCN Commercial |
$1,339.16
|
| Rate for Payer: BCN Medicare Advantage |
$407.24
|
| Rate for Payer: Cash Price |
$1,303.16
|
| Rate for Payer: Cofinity Commercial |
$1,400.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,303.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$407.24
|
| Rate for Payer: Healthscope Commercial |
$1,466.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,221.71
|
| Rate for Payer: Mclaren Medicaid |
$287.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$427.60
|
| Rate for Payer: Meridian Medicaid |
$301.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$468.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$447.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,384.61
|
| Rate for Payer: Nomi Health Commercial |
$1,335.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,221.71
|
| Rate for Payer: PACE Senior Care Partners |
$386.88
|
| Rate for Payer: PACE SWMI |
$407.24
|
| Rate for Payer: PHP Commercial |
$1,384.61
|
| Rate for Payer: PHP Medicare Advantage |
$407.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$287.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,417.19
|
| Rate for Payer: Priority Health Medicare |
$411.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,133.75
|
| Rate for Payer: Railroad Medicare Medicare |
$407.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,433.48
|
| Rate for Payer: UHC Core |
$1,360.17
|
| Rate for Payer: UHC Exchange |
$407.24
|
| Rate for Payer: UHC Medicaid |
$287.18
|
| Rate for Payer: UHC Medicare Advantage |
$407.24
|
| Rate for Payer: UHCCP Medicaid |
$287.18
|
| Rate for Payer: VA VA |
$407.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,221.71
|
|
