|
HC CRRT MONITORING PER HOUR
|
Facility
|
IP
|
$408.67
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$249.25 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: BCBS Trust/PPO |
$315.82
|
| Rate for Payer: BCN Commercial |
$315.82
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$355.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.63
|
| Rate for Payer: UHC Core |
$341.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
OP
|
$408.67
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$97.06 |
| Max. Negotiated Rate |
$367.80 |
| Rate for Payer: Aetna Commercial |
$347.37
|
| Rate for Payer: Aetna Medicare |
$106.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$127.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$127.71
|
| Rate for Payer: BCBS Complete |
$163.47
|
| Rate for Payer: BCBS MAPPO |
$102.17
|
| Rate for Payer: BCBS Trust/PPO |
$317.74
|
| Rate for Payer: BCN Commercial |
$317.74
|
| Rate for Payer: BCN Medicare Advantage |
$102.17
|
| Rate for Payer: Cash Price |
$326.94
|
| Rate for Payer: Cofinity Commercial |
$351.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$326.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.17
|
| Rate for Payer: Healthscope Commercial |
$367.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$306.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$107.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$117.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$347.37
|
| Rate for Payer: PACE Senior Care Partners |
$97.06
|
| Rate for Payer: PACE SWMI |
$102.17
|
| Rate for Payer: PHP Commercial |
$347.37
|
| Rate for Payer: PHP Medicare Advantage |
$102.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$286.07
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$355.54
|
| Rate for Payer: Priority Health Medicare |
$102.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$249.25
|
| Rate for Payer: Railroad Medicare Medicare |
$102.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$359.63
|
| Rate for Payer: UHC Core |
$341.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$102.17
|
| Rate for Payer: UHC Medicare Advantage |
$105.23
|
| Rate for Payer: VA VA |
$102.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$306.50
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$275.00
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$65.31 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$233.75
|
| Rate for Payer: Aetna Medicare |
$71.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.94
|
| Rate for Payer: BCBS Complete |
$110.00
|
| Rate for Payer: BCBS MAPPO |
$68.75
|
| Rate for Payer: BCBS Trust/PPO |
$213.81
|
| Rate for Payer: BCN Commercial |
$213.81
|
| Rate for Payer: BCN Medicare Advantage |
$68.75
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$236.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.75
|
| Rate for Payer: Healthscope Commercial |
$247.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.25
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$72.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.75
|
| Rate for Payer: PACE Senior Care Partners |
$65.31
|
| Rate for Payer: PACE SWMI |
$68.75
|
| Rate for Payer: PHP Commercial |
$233.75
|
| Rate for Payer: PHP Medicare Advantage |
$68.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.25
|
| Rate for Payer: Priority Health Medicare |
$68.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.72
|
| Rate for Payer: Railroad Medicare Medicare |
$68.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.00
|
| Rate for Payer: UHC Core |
$229.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.75
|
| Rate for Payer: UHC Medicare Advantage |
$70.81
|
| Rate for Payer: VA VA |
$68.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.25
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$275.00
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$167.72 |
| Max. Negotiated Rate |
$247.50 |
| Rate for Payer: Aetna Commercial |
$233.75
|
| Rate for Payer: BCBS Trust/PPO |
$212.52
|
| Rate for Payer: BCN Commercial |
$212.52
|
| Rate for Payer: Cash Price |
$220.00
|
| Rate for Payer: Cofinity Commercial |
$236.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$220.00
|
| Rate for Payer: Healthscope Commercial |
$247.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$233.75
|
| Rate for Payer: PHP Commercial |
$233.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$192.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$239.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$242.00
|
| Rate for Payer: UHC Core |
$229.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.25
|
|
|
HC CRUTCHES
|
Facility
|
OP
|
$124.22
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna Commercial |
$105.59
|
| Rate for Payer: Aetna Medicare |
$32.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.82
|
| Rate for Payer: BCBS Complete |
$49.69
|
| Rate for Payer: BCBS MAPPO |
$31.06
|
| Rate for Payer: BCBS Trust/PPO |
$96.58
|
| Rate for Payer: BCN Commercial |
$96.58
|
| Rate for Payer: BCN Medicare Advantage |
$31.06
|
| Rate for Payer: Cash Price |
$99.38
|
| Rate for Payer: Cofinity Commercial |
$106.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.06
|
| Rate for Payer: Healthscope Commercial |
$111.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$32.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.59
|
| Rate for Payer: PACE Senior Care Partners |
$29.50
|
| Rate for Payer: PACE SWMI |
$31.06
|
| Rate for Payer: PHP Commercial |
$105.59
|
| Rate for Payer: PHP Medicare Advantage |
$31.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.07
|
| Rate for Payer: Priority Health Medicare |
$31.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.76
|
| Rate for Payer: Railroad Medicare Medicare |
$31.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.31
|
| Rate for Payer: UHC Core |
$103.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.06
|
| Rate for Payer: UHC Medicare Advantage |
$31.99
|
| Rate for Payer: VA VA |
$31.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.16
|
|
|
HC CRUTCHES
|
Facility
|
IP
|
$124.22
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$75.76 |
| Max. Negotiated Rate |
$111.80 |
| Rate for Payer: Aetna Commercial |
$105.59
|
| Rate for Payer: BCBS Trust/PPO |
$96.00
|
| Rate for Payer: BCN Commercial |
$96.00
|
| Rate for Payer: Cash Price |
$99.38
|
| Rate for Payer: Cofinity Commercial |
$106.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.38
|
| Rate for Payer: Healthscope Commercial |
$111.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$105.59
|
| Rate for Payer: PHP Commercial |
$105.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$86.95
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$108.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$75.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.31
|
| Rate for Payer: UHC Core |
$103.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.16
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
IP
|
$11,844.24
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,223.80 |
| Max. Negotiated Rate |
$10,659.82 |
| Rate for Payer: Aetna Commercial |
$10,067.60
|
| Rate for Payer: BCBS Trust/PPO |
$9,153.23
|
| Rate for Payer: BCN Commercial |
$9,153.23
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cofinity Commercial |
$10,186.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,475.39
|
| Rate for Payer: Healthscope Commercial |
$10,659.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,883.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,067.60
|
| Rate for Payer: PHP Commercial |
$10,067.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,290.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,304.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,223.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,422.93
|
| Rate for Payer: UHC Core |
$9,889.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,883.18
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
OP
|
$11,844.24
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,813.01 |
| Max. Negotiated Rate |
$10,659.82 |
| Rate for Payer: Aetna Commercial |
$10,067.60
|
| Rate for Payer: Aetna Medicare |
$3,079.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,701.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,701.32
|
| Rate for Payer: BCBS Complete |
$7,090.23
|
| Rate for Payer: BCBS MAPPO |
$2,961.06
|
| Rate for Payer: BCBS Trust/PPO |
$9,208.90
|
| Rate for Payer: BCN Commercial |
$9,208.90
|
| Rate for Payer: BCN Medicare Advantage |
$2,961.06
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cash Price |
$9,475.39
|
| Rate for Payer: Cofinity Commercial |
$10,186.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,475.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,961.06
|
| Rate for Payer: Healthscope Commercial |
$10,659.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,883.18
|
| Rate for Payer: Mclaren Medicaid |
$6,752.60
|
| Rate for Payer: Meridian Medicaid |
$7,090.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,109.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,405.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,067.60
|
| Rate for Payer: PACE Senior Care Partners |
$2,813.01
|
| Rate for Payer: PACE SWMI |
$2,961.06
|
| Rate for Payer: PHP Commercial |
$10,067.60
|
| Rate for Payer: PHP Medicare Advantage |
$2,961.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,752.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,290.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,304.49
|
| Rate for Payer: Priority Health Medicare |
$2,961.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,223.80
|
| Rate for Payer: Railroad Medicare Medicare |
$2,961.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,422.93
|
| Rate for Payer: UHC Core |
$9,889.94
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,961.06
|
| Rate for Payer: UHC Medicare Advantage |
$3,049.89
|
| Rate for Payer: VA VA |
$2,961.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,883.18
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
OP
|
$10,323.30
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,451.78 |
| Max. Negotiated Rate |
$9,290.97 |
| Rate for Payer: Aetna Commercial |
$8,774.80
|
| Rate for Payer: Aetna Medicare |
$2,684.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,226.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,226.03
|
| Rate for Payer: BCBS Complete |
$7,090.23
|
| Rate for Payer: BCBS MAPPO |
$2,580.82
|
| Rate for Payer: BCBS Trust/PPO |
$8,026.37
|
| Rate for Payer: BCN Commercial |
$8,026.37
|
| Rate for Payer: BCN Medicare Advantage |
$2,580.82
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cofinity Commercial |
$8,878.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,258.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,580.82
|
| Rate for Payer: Healthscope Commercial |
$9,290.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,742.48
|
| Rate for Payer: Mclaren Medicaid |
$6,752.60
|
| Rate for Payer: Meridian Medicaid |
$7,090.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,709.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,967.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,774.80
|
| Rate for Payer: PACE Senior Care Partners |
$2,451.78
|
| Rate for Payer: PACE SWMI |
$2,580.82
|
| Rate for Payer: PHP Commercial |
$8,774.80
|
| Rate for Payer: PHP Medicare Advantage |
$2,580.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$6,752.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,981.27
|
| Rate for Payer: Priority Health Medicare |
$2,580.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,296.18
|
| Rate for Payer: Railroad Medicare Medicare |
$2,580.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,084.50
|
| Rate for Payer: UHC Core |
$8,619.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,580.82
|
| Rate for Payer: UHC Medicare Advantage |
$2,658.25
|
| Rate for Payer: VA VA |
$2,580.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,742.48
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
IP
|
$10,323.30
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,296.18 |
| Max. Negotiated Rate |
$9,290.97 |
| Rate for Payer: Aetna Commercial |
$8,774.80
|
| Rate for Payer: BCBS Trust/PPO |
$7,977.85
|
| Rate for Payer: BCN Commercial |
$7,977.85
|
| Rate for Payer: Cash Price |
$8,258.64
|
| Rate for Payer: Cofinity Commercial |
$8,878.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,258.64
|
| Rate for Payer: Healthscope Commercial |
$9,290.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,742.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$8,774.80
|
| Rate for Payer: PHP Commercial |
$8,774.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,226.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$8,981.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,296.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,084.50
|
| Rate for Payer: UHC Core |
$8,619.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,742.48
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
OP
|
$10,678.00
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,536.02 |
| Max. Negotiated Rate |
$9,610.20 |
| Rate for Payer: Aetna Commercial |
$9,076.30
|
| Rate for Payer: Aetna Medicare |
$2,776.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,336.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,336.88
|
| Rate for Payer: BCBS Complete |
$4,033.68
|
| Rate for Payer: BCBS MAPPO |
$2,669.50
|
| Rate for Payer: BCBS Trust/PPO |
$8,302.14
|
| Rate for Payer: BCN Commercial |
$8,302.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,669.50
|
| Rate for Payer: Cash Price |
$8,542.40
|
| Rate for Payer: Cash Price |
$8,542.40
|
| Rate for Payer: Cofinity Commercial |
$9,183.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,542.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,669.50
|
| Rate for Payer: Healthscope Commercial |
$9,610.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,008.50
|
| Rate for Payer: Mclaren Medicaid |
$3,841.60
|
| Rate for Payer: Meridian Medicaid |
$4,033.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,802.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,069.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,076.30
|
| Rate for Payer: PACE Senior Care Partners |
$2,536.02
|
| Rate for Payer: PACE SWMI |
$2,669.50
|
| Rate for Payer: PHP Commercial |
$9,076.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,669.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,841.60
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,474.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,289.86
|
| Rate for Payer: Priority Health Medicare |
$2,669.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,512.51
|
| Rate for Payer: Railroad Medicare Medicare |
$2,669.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,396.64
|
| Rate for Payer: UHC Core |
$8,916.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,669.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,749.58
|
| Rate for Payer: VA VA |
$2,669.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,008.50
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
IP
|
$10,678.00
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$6,512.51 |
| Max. Negotiated Rate |
$9,610.20 |
| Rate for Payer: Aetna Commercial |
$9,076.30
|
| Rate for Payer: BCBS Trust/PPO |
$8,251.96
|
| Rate for Payer: BCN Commercial |
$8,251.96
|
| Rate for Payer: Cash Price |
$8,542.40
|
| Rate for Payer: Cofinity Commercial |
$9,183.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,542.40
|
| Rate for Payer: Healthscope Commercial |
$9,610.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,008.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9,076.30
|
| Rate for Payer: PHP Commercial |
$9,076.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,474.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9,289.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,512.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,396.64
|
| Rate for Payer: UHC Core |
$8,916.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,008.50
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
OP
|
$3,457.80
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$821.23 |
| Max. Negotiated Rate |
$3,112.02 |
| Rate for Payer: Aetna Commercial |
$2,939.13
|
| Rate for Payer: Aetna Medicare |
$899.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,080.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,080.56
|
| Rate for Payer: BCBS Complete |
$1,383.12
|
| Rate for Payer: BCBS MAPPO |
$864.45
|
| Rate for Payer: BCBS Trust/PPO |
$2,688.44
|
| Rate for Payer: BCN Commercial |
$2,688.44
|
| Rate for Payer: BCN Medicare Advantage |
$864.45
|
| Rate for Payer: Cash Price |
$2,766.24
|
| Rate for Payer: Cofinity Commercial |
$2,973.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$864.45
|
| Rate for Payer: Healthscope Commercial |
$3,112.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,593.35
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$907.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$994.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,939.13
|
| Rate for Payer: PACE Senior Care Partners |
$821.23
|
| Rate for Payer: PACE SWMI |
$864.45
|
| Rate for Payer: PHP Commercial |
$2,939.13
|
| Rate for Payer: PHP Medicare Advantage |
$864.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,420.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,008.29
|
| Rate for Payer: Priority Health Medicare |
$864.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,108.91
|
| Rate for Payer: Railroad Medicare Medicare |
$864.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,042.86
|
| Rate for Payer: UHC Core |
$2,887.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$864.45
|
| Rate for Payer: UHC Medicare Advantage |
$890.38
|
| Rate for Payer: VA VA |
$864.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,593.35
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
IP
|
$3,457.80
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,108.91 |
| Max. Negotiated Rate |
$3,112.02 |
| Rate for Payer: Aetna Commercial |
$2,939.13
|
| Rate for Payer: BCBS Trust/PPO |
$2,672.19
|
| Rate for Payer: BCN Commercial |
$2,672.19
|
| Rate for Payer: Cash Price |
$2,766.24
|
| Rate for Payer: Cofinity Commercial |
$2,973.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,766.24
|
| Rate for Payer: Healthscope Commercial |
$3,112.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,593.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,939.13
|
| Rate for Payer: PHP Commercial |
$2,939.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,420.46
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,008.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,108.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,042.86
|
| Rate for Payer: UHC Core |
$2,887.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,593.35
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
OP
|
$8,019.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,904.71 |
| Max. Negotiated Rate |
$7,217.86 |
| Rate for Payer: Aetna Commercial |
$6,816.86
|
| Rate for Payer: Aetna Medicare |
$2,085.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,506.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,506.20
|
| Rate for Payer: BCBS Complete |
$3,207.94
|
| Rate for Payer: BCBS MAPPO |
$2,004.96
|
| Rate for Payer: BCBS Trust/PPO |
$6,235.43
|
| Rate for Payer: BCN Commercial |
$6,235.43
|
| Rate for Payer: BCN Medicare Advantage |
$2,004.96
|
| Rate for Payer: Cash Price |
$6,415.87
|
| Rate for Payer: Cofinity Commercial |
$6,897.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,415.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,004.96
|
| Rate for Payer: Healthscope Commercial |
$7,217.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,014.88
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2,105.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,305.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,816.86
|
| Rate for Payer: PACE Senior Care Partners |
$1,904.71
|
| Rate for Payer: PACE SWMI |
$2,004.96
|
| Rate for Payer: PHP Commercial |
$6,816.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,004.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,613.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,977.26
|
| Rate for Payer: Priority Health Medicare |
$2,004.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,891.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2,004.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,057.46
|
| Rate for Payer: UHC Core |
$6,696.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,004.96
|
| Rate for Payer: UHC Medicare Advantage |
$2,065.11
|
| Rate for Payer: VA VA |
$2,004.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,014.88
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
IP
|
$8,019.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4,891.30 |
| Max. Negotiated Rate |
$7,217.86 |
| Rate for Payer: Aetna Commercial |
$6,816.86
|
| Rate for Payer: BCBS Trust/PPO |
$6,197.73
|
| Rate for Payer: BCN Commercial |
$6,197.73
|
| Rate for Payer: Cash Price |
$6,415.87
|
| Rate for Payer: Cofinity Commercial |
$6,897.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,415.87
|
| Rate for Payer: Healthscope Commercial |
$7,217.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,014.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$6,816.86
|
| Rate for Payer: PHP Commercial |
$6,816.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,613.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$6,977.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,891.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,057.46
|
| Rate for Payer: UHC Core |
$6,696.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,014.88
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
OP
|
$12,031.54
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,857.49 |
| Max. Negotiated Rate |
$10,828.39 |
| Rate for Payer: Aetna Commercial |
$10,226.81
|
| Rate for Payer: Aetna Medicare |
$3,128.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,759.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,759.86
|
| Rate for Payer: BCBS Complete |
$4,812.62
|
| Rate for Payer: BCBS MAPPO |
$3,007.88
|
| Rate for Payer: BCBS Trust/PPO |
$9,354.52
|
| Rate for Payer: BCN Commercial |
$9,354.52
|
| Rate for Payer: BCN Medicare Advantage |
$3,007.88
|
| Rate for Payer: Cash Price |
$9,625.23
|
| Rate for Payer: Cofinity Commercial |
$10,347.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,625.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,007.88
|
| Rate for Payer: Healthscope Commercial |
$10,828.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,023.66
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$3,158.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,459.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,226.81
|
| Rate for Payer: PACE Senior Care Partners |
$2,857.49
|
| Rate for Payer: PACE SWMI |
$3,007.88
|
| Rate for Payer: PHP Commercial |
$10,226.81
|
| Rate for Payer: PHP Medicare Advantage |
$3,007.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,422.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,467.44
|
| Rate for Payer: Priority Health Medicare |
$3,007.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,338.04
|
| Rate for Payer: Railroad Medicare Medicare |
$3,007.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,587.76
|
| Rate for Payer: UHC Core |
$10,046.34
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,007.88
|
| Rate for Payer: UHC Medicare Advantage |
$3,098.12
|
| Rate for Payer: VA VA |
$3,007.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,023.66
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
IP
|
$12,031.54
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,338.04 |
| Max. Negotiated Rate |
$10,828.39 |
| Rate for Payer: Aetna Commercial |
$10,226.81
|
| Rate for Payer: BCBS Trust/PPO |
$9,297.97
|
| Rate for Payer: BCN Commercial |
$9,297.97
|
| Rate for Payer: Cash Price |
$9,625.23
|
| Rate for Payer: Cofinity Commercial |
$10,347.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,625.23
|
| Rate for Payer: Healthscope Commercial |
$10,828.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,023.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$10,226.81
|
| Rate for Payer: PHP Commercial |
$10,226.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8,422.08
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$10,467.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,338.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,587.76
|
| Rate for Payer: UHC Core |
$10,046.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,023.66
|
|
|
HC CRYOGLOBULINS
|
Facility
|
IP
|
$19.38
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: BCBS Trust/PPO |
$14.98
|
| Rate for Payer: BCN Commercial |
$14.98
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.05
|
| Rate for Payer: UHC Core |
$16.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
HC CRYOGLOBULINS
|
Facility
|
OP
|
$19.38
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.60 |
| Max. Negotiated Rate |
$17.44 |
| Rate for Payer: Aetna Commercial |
$16.47
|
| Rate for Payer: Aetna Medicare |
$5.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.06
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$4.84
|
| Rate for Payer: BCBS Trust/PPO |
$15.07
|
| Rate for Payer: BCN Commercial |
$15.07
|
| Rate for Payer: BCN Medicare Advantage |
$4.84
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cash Price |
$15.50
|
| Rate for Payer: Cofinity Commercial |
$16.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.84
|
| Rate for Payer: Healthscope Commercial |
$17.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.54
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$16.47
|
| Rate for Payer: PACE Senior Care Partners |
$4.60
|
| Rate for Payer: PACE SWMI |
$4.84
|
| Rate for Payer: PHP Commercial |
$16.47
|
| Rate for Payer: PHP Medicare Advantage |
$4.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$16.86
|
| Rate for Payer: Priority Health Medicare |
$4.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.05
|
| Rate for Payer: UHC Core |
$16.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.84
|
| Rate for Payer: UHC Medicare Advantage |
$4.99
|
| Rate for Payer: VA VA |
$4.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.54
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
IP
|
$22.44
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.69 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: BCBS Trust/PPO |
$17.34
|
| Rate for Payer: BCN Commercial |
$17.34
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
OP
|
$22.44
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$20.20 |
| Rate for Payer: Aetna Commercial |
$19.07
|
| Rate for Payer: Aetna Medicare |
$5.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.01
|
| Rate for Payer: BCBS Complete |
$10.96
|
| Rate for Payer: BCBS MAPPO |
$5.61
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.61
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cash Price |
$17.95
|
| Rate for Payer: Cofinity Commercial |
$19.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.61
|
| Rate for Payer: Healthscope Commercial |
$20.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.83
|
| Rate for Payer: Mclaren Medicaid |
$10.44
|
| Rate for Payer: Meridian Medicaid |
$10.96
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$5.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$19.07
|
| Rate for Payer: PACE Senior Care Partners |
$5.33
|
| Rate for Payer: PACE SWMI |
$5.61
|
| Rate for Payer: PHP Commercial |
$19.07
|
| Rate for Payer: PHP Medicare Advantage |
$5.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.71
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$19.52
|
| Rate for Payer: Priority Health Medicare |
$5.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.69
|
| Rate for Payer: Railroad Medicare Medicare |
$5.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.75
|
| Rate for Payer: UHC Core |
$18.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.61
|
| Rate for Payer: UHC Medicare Advantage |
$5.78
|
| Rate for Payer: VA VA |
$5.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.83
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
OP
|
$43.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.77 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: Aetna Medicare |
$11.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.44
|
| Rate for Payer: BCBS Complete |
$5.01
|
| Rate for Payer: BCBS MAPPO |
$10.75
|
| Rate for Payer: BCBS Trust/PPO |
$33.43
|
| Rate for Payer: BCN Commercial |
$33.43
|
| Rate for Payer: BCN Medicare Advantage |
$10.75
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.75
|
| Rate for Payer: Healthscope Commercial |
$38.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.25
|
| Rate for Payer: Mclaren Medicaid |
$4.77
|
| Rate for Payer: Meridian Medicaid |
$5.01
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.55
|
| Rate for Payer: PACE Senior Care Partners |
$10.21
|
| Rate for Payer: PACE SWMI |
$10.75
|
| Rate for Payer: PHP Commercial |
$36.55
|
| Rate for Payer: PHP Medicare Advantage |
$10.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.41
|
| Rate for Payer: Priority Health Medicare |
$10.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.23
|
| Rate for Payer: Railroad Medicare Medicare |
$10.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.84
|
| Rate for Payer: UHC Core |
$35.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.75
|
| Rate for Payer: UHC Medicare Advantage |
$11.07
|
| Rate for Payer: VA VA |
$10.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.25
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
IP
|
$43.00
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.23 |
| Max. Negotiated Rate |
$38.70 |
| Rate for Payer: Aetna Commercial |
$36.55
|
| Rate for Payer: BCBS Trust/PPO |
$33.23
|
| Rate for Payer: BCN Commercial |
$33.23
|
| Rate for Payer: Cash Price |
$34.40
|
| Rate for Payer: Cofinity Commercial |
$36.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.40
|
| Rate for Payer: Healthscope Commercial |
$38.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$36.55
|
| Rate for Payer: PHP Commercial |
$36.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$37.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.84
|
| Rate for Payer: UHC Core |
$35.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.25
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
IP
|
$140.35
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$85.60 |
| Max. Negotiated Rate |
$126.32 |
| Rate for Payer: Aetna Commercial |
$119.30
|
| Rate for Payer: BCBS Trust/PPO |
$108.46
|
| Rate for Payer: BCN Commercial |
$108.46
|
| Rate for Payer: Cash Price |
$112.28
|
| Rate for Payer: Cofinity Commercial |
$120.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.28
|
| Rate for Payer: Healthscope Commercial |
$126.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$119.30
|
| Rate for Payer: PHP Commercial |
$119.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.24
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$122.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$85.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.51
|
| Rate for Payer: UHC Core |
$117.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.26
|
|
