|
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
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
OP
|
$334.10
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$41.22 |
| Max. Negotiated Rate |
$300.69 |
| Rate for Payer: Aetna Commercial |
$283.98
|
| Rate for Payer: Aetna Medicare |
$86.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$104.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$104.41
|
| Rate for Payer: BCBS Complete |
$43.28
|
| Rate for Payer: BCBS MAPPO |
$83.52
|
| Rate for Payer: BCBS Trust/PPO |
$259.76
|
| Rate for Payer: BCN Commercial |
$259.76
|
| Rate for Payer: BCN Medicare Advantage |
$83.52
|
| Rate for Payer: Cash Price |
$267.28
|
| Rate for Payer: Cash Price |
$267.28
|
| Rate for Payer: Cofinity Commercial |
$287.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$83.52
|
| Rate for Payer: Healthscope Commercial |
$300.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.58
|
| Rate for Payer: Mclaren Medicaid |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$43.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$87.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$96.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.98
|
| Rate for Payer: PACE Senior Care Partners |
$79.35
|
| Rate for Payer: PACE SWMI |
$83.52
|
| Rate for Payer: PHP Commercial |
$283.98
|
| Rate for Payer: PHP Medicare Advantage |
$83.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.67
|
| Rate for Payer: Priority Health Medicare |
$83.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.77
|
| Rate for Payer: Railroad Medicare Medicare |
$83.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.01
|
| Rate for Payer: UHC Core |
$278.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$83.52
|
| Rate for Payer: UHC Medicare Advantage |
$86.03
|
| Rate for Payer: VA VA |
$83.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.58
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
IP
|
$334.10
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$203.77 |
| Max. Negotiated Rate |
$300.69 |
| Rate for Payer: Aetna Commercial |
$283.98
|
| Rate for Payer: BCBS Trust/PPO |
$258.19
|
| Rate for Payer: BCN Commercial |
$258.19
|
| Rate for Payer: Cash Price |
$267.28
|
| Rate for Payer: Cofinity Commercial |
$287.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$267.28
|
| Rate for Payer: Healthscope Commercial |
$300.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$250.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$283.98
|
| Rate for Payer: PHP Commercial |
$283.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.87
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$290.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$294.01
|
| Rate for Payer: UHC Core |
$278.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$250.58
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$148.77 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: BCBS Trust/PPO |
$188.50
|
| Rate for Payer: BCN Commercial |
$188.50
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$41.22 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna Medicare |
$63.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.22
|
| Rate for Payer: BCBS Complete |
$43.28
|
| Rate for Payer: BCBS MAPPO |
$60.98
|
| Rate for Payer: BCBS Trust/PPO |
$189.65
|
| Rate for Payer: BCN Commercial |
$189.65
|
| Rate for Payer: BCN Medicare Advantage |
$60.98
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.98
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Mclaren Medicaid |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$43.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Senior Care Partners |
$57.93
|
| Rate for Payer: PACE SWMI |
$60.98
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: PHP Medicare Advantage |
$60.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Medicare |
$60.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: Railroad Medicare Medicare |
$60.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.98
|
| Rate for Payer: UHC Medicare Advantage |
$62.81
|
| Rate for Payer: VA VA |
$60.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$148.77 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: BCBS Trust/PPO |
$188.50
|
| Rate for Payer: BCN Commercial |
$188.50
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$41.22 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna Medicare |
$63.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.22
|
| Rate for Payer: BCBS Complete |
$43.28
|
| Rate for Payer: BCBS MAPPO |
$60.98
|
| Rate for Payer: BCBS Trust/PPO |
$189.65
|
| Rate for Payer: BCN Commercial |
$189.65
|
| Rate for Payer: BCN Medicare Advantage |
$60.98
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.98
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Mclaren Medicaid |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$43.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Senior Care Partners |
$57.93
|
| Rate for Payer: PACE SWMI |
$60.98
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: PHP Medicare Advantage |
$60.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Medicare |
$60.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: Railroad Medicare Medicare |
$60.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.98
|
| Rate for Payer: UHC Medicare Advantage |
$62.81
|
| Rate for Payer: VA VA |
$60.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$148.77 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: BCBS Trust/PPO |
$188.50
|
| Rate for Payer: BCN Commercial |
$188.50
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$41.22 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna Medicare |
$63.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.22
|
| Rate for Payer: BCBS Complete |
$43.28
|
| Rate for Payer: BCBS MAPPO |
$60.98
|
| Rate for Payer: BCBS Trust/PPO |
$189.65
|
| Rate for Payer: BCN Commercial |
$189.65
|
| Rate for Payer: BCN Medicare Advantage |
$60.98
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.98
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Mclaren Medicaid |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$43.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Senior Care Partners |
$57.93
|
| Rate for Payer: PACE SWMI |
$60.98
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: PHP Medicare Advantage |
$60.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Medicare |
$60.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: Railroad Medicare Medicare |
$60.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.98
|
| Rate for Payer: UHC Medicare Advantage |
$62.81
|
| Rate for Payer: VA VA |
$60.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$41.22 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna Medicare |
$63.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.22
|
| Rate for Payer: BCBS Complete |
$43.28
|
| Rate for Payer: BCBS MAPPO |
$60.98
|
| Rate for Payer: BCBS Trust/PPO |
$189.65
|
| Rate for Payer: BCN Commercial |
$189.65
|
| Rate for Payer: BCN Medicare Advantage |
$60.98
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.98
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Mclaren Medicaid |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$43.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Senior Care Partners |
$57.93
|
| Rate for Payer: PACE SWMI |
$60.98
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: PHP Medicare Advantage |
$60.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Medicare |
$60.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: Railroad Medicare Medicare |
$60.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.98
|
| Rate for Payer: UHC Medicare Advantage |
$62.81
|
| Rate for Payer: VA VA |
$60.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$148.77 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: BCBS Trust/PPO |
$188.50
|
| Rate for Payer: BCN Commercial |
$188.50
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
OP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$41.22 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: Aetna Medicare |
$63.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$76.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$76.22
|
| Rate for Payer: BCBS Complete |
$43.28
|
| Rate for Payer: BCBS MAPPO |
$60.98
|
| Rate for Payer: BCBS Trust/PPO |
$189.65
|
| Rate for Payer: BCN Commercial |
$189.65
|
| Rate for Payer: BCN Medicare Advantage |
$60.98
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.98
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Mclaren Medicaid |
$41.22
|
| Rate for Payer: Meridian Medicaid |
$43.28
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$64.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$70.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PACE Senior Care Partners |
$57.93
|
| Rate for Payer: PACE SWMI |
$60.98
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: PHP Medicare Advantage |
$60.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Medicare |
$60.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: Railroad Medicare Medicare |
$60.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.98
|
| Rate for Payer: UHC Medicare Advantage |
$62.81
|
| Rate for Payer: VA VA |
$60.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
IP
|
$243.92
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$148.77 |
| Max. Negotiated Rate |
$219.53 |
| Rate for Payer: Aetna Commercial |
$207.33
|
| Rate for Payer: BCBS Trust/PPO |
$188.50
|
| Rate for Payer: BCN Commercial |
$188.50
|
| Rate for Payer: Cash Price |
$195.14
|
| Rate for Payer: Cofinity Commercial |
$209.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$195.14
|
| Rate for Payer: Healthscope Commercial |
$219.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$207.33
|
| Rate for Payer: PHP Commercial |
$207.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.74
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$212.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$148.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$214.65
|
| Rate for Payer: UHC Core |
$203.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.94
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
OP
|
$542.50
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$128.84 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna Commercial |
$461.12
|
| Rate for Payer: Aetna Medicare |
$141.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$169.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$169.53
|
| Rate for Payer: BCBS Complete |
$137.89
|
| Rate for Payer: BCBS MAPPO |
$135.62
|
| Rate for Payer: BCBS Trust/PPO |
$421.79
|
| Rate for Payer: BCN Commercial |
$421.79
|
| Rate for Payer: BCN Medicare Advantage |
$135.62
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cofinity Commercial |
$466.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$135.62
|
| Rate for Payer: Healthscope Commercial |
$488.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.88
|
| Rate for Payer: Mclaren Medicaid |
$131.33
|
| Rate for Payer: Meridian Medicaid |
$137.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$142.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$155.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$461.12
|
| Rate for Payer: PACE Senior Care Partners |
$128.84
|
| Rate for Payer: PACE SWMI |
$135.62
|
| Rate for Payer: PHP Commercial |
$461.12
|
| Rate for Payer: PHP Medicare Advantage |
$135.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$131.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.98
|
| Rate for Payer: Priority Health Medicare |
$135.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.87
|
| Rate for Payer: Railroad Medicare Medicare |
$135.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.40
|
| Rate for Payer: UHC Core |
$452.99
|
| Rate for Payer: UHC Dual Complete DSNP |
$135.62
|
| Rate for Payer: UHC Medicare Advantage |
$139.69
|
| Rate for Payer: VA VA |
$135.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.88
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
IP
|
$542.50
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$330.87 |
| Max. Negotiated Rate |
$488.25 |
| Rate for Payer: Aetna Commercial |
$461.12
|
| Rate for Payer: BCBS Trust/PPO |
$419.24
|
| Rate for Payer: BCN Commercial |
$419.24
|
| Rate for Payer: Cash Price |
$434.00
|
| Rate for Payer: Cofinity Commercial |
$466.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$434.00
|
| Rate for Payer: Healthscope Commercial |
$488.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$406.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$461.12
|
| Rate for Payer: PHP Commercial |
$461.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$379.75
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$471.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$330.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$477.40
|
| Rate for Payer: UHC Core |
$452.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$406.88
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
OP
|
$45.90
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.90 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: Aetna Medicare |
$11.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.34
|
| Rate for Payer: BCBS Complete |
$12.45
|
| Rate for Payer: BCBS MAPPO |
$11.48
|
| Rate for Payer: BCBS Trust/PPO |
$35.69
|
| Rate for Payer: BCN Commercial |
$35.69
|
| Rate for Payer: BCN Medicare Advantage |
$11.48
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.48
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Mclaren Medicaid |
$11.86
|
| Rate for Payer: Meridian Medicaid |
$12.45
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PACE Senior Care Partners |
$10.90
|
| Rate for Payer: PACE SWMI |
$11.48
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: PHP Medicare Advantage |
$11.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Medicare |
$11.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: Railroad Medicare Medicare |
$11.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.48
|
| Rate for Payer: UHC Medicare Advantage |
$11.82
|
| Rate for Payer: VA VA |
$11.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
IP
|
$45.90
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.99 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Aetna Commercial |
$39.02
|
| Rate for Payer: BCBS Trust/PPO |
$35.47
|
| Rate for Payer: BCN Commercial |
$35.47
|
| Rate for Payer: Cash Price |
$36.72
|
| Rate for Payer: Cofinity Commercial |
$39.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.72
|
| Rate for Payer: Healthscope Commercial |
$41.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.02
|
| Rate for Payer: PHP Commercial |
$39.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.39
|
| Rate for Payer: UHC Core |
$38.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.42
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$31.10 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$39.41
|
| Rate for Payer: BCN Commercial |
$39.41
|
| 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 Multiplan/Beech St/PHCS |
$43.35
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.11 |
| 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 |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$39.65
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| 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 |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.35
|
| 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 |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.70
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.10
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$13.13
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
OP
|
$44.88
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$10.20 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: Aetna Medicare |
$11.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.02
|
| Rate for Payer: BCBS Complete |
$10.71
|
| Rate for Payer: BCBS MAPPO |
$11.22
|
| Rate for Payer: BCBS Trust/PPO |
$34.89
|
| Rate for Payer: BCN Commercial |
$34.89
|
| Rate for Payer: BCN Medicare Advantage |
$11.22
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.22
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Mclaren Medicaid |
$10.20
|
| Rate for Payer: Meridian Medicaid |
$10.71
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$11.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PACE Senior Care Partners |
$10.66
|
| Rate for Payer: PACE SWMI |
$11.22
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Medicare |
$11.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.22
|
| Rate for Payer: UHC Medicare Advantage |
$11.56
|
| Rate for Payer: VA VA |
$11.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
IP
|
$44.88
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$27.37 |
| Max. Negotiated Rate |
$40.39 |
| Rate for Payer: Aetna Commercial |
$38.15
|
| Rate for Payer: BCBS Trust/PPO |
$34.68
|
| Rate for Payer: BCN Commercial |
$34.68
|
| Rate for Payer: Cash Price |
$35.90
|
| Rate for Payer: Cofinity Commercial |
$38.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.90
|
| Rate for Payer: Healthscope Commercial |
$40.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$38.15
|
| Rate for Payer: PHP Commercial |
$38.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$39.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.49
|
| Rate for Payer: UHC Core |
$37.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.66
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$46.31
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: Aetna Medicare |
$12.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.47
|
| Rate for Payer: BCBS Complete |
$5.68
|
| Rate for Payer: BCBS MAPPO |
$11.58
|
| Rate for Payer: BCBS Trust/PPO |
$36.01
|
| Rate for Payer: BCN Commercial |
$36.01
|
| Rate for Payer: BCN Medicare Advantage |
$11.58
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.58
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Mclaren Medicaid |
$5.41
|
| Rate for Payer: Meridian Medicaid |
$5.68
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$12.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.36
|
| Rate for Payer: PACE Senior Care Partners |
$11.00
|
| Rate for Payer: PACE SWMI |
$11.58
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: PHP Medicare Advantage |
$11.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.29
|
| Rate for Payer: Priority Health Medicare |
$11.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.75
|
| Rate for Payer: UHC Core |
$38.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.58
|
| Rate for Payer: UHC Medicare Advantage |
$11.92
|
| Rate for Payer: VA VA |
$11.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$46.31
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$28.24 |
| Max. Negotiated Rate |
$41.68 |
| Rate for Payer: Aetna Commercial |
$39.36
|
| Rate for Payer: BCBS Trust/PPO |
$35.79
|
| Rate for Payer: BCN Commercial |
$35.79
|
| Rate for Payer: Cash Price |
$37.05
|
| Rate for Payer: Cofinity Commercial |
$39.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$41.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$39.36
|
| Rate for Payer: PHP Commercial |
$39.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$32.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$40.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.75
|
| Rate for Payer: UHC Core |
$38.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.73
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
IP
|
$2,937.41
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,791.53 |
| Max. Negotiated Rate |
$2,643.67 |
| Rate for Payer: Aetna Commercial |
$2,496.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,270.03
|
| Rate for Payer: BCN Commercial |
$2,270.03
|
| Rate for Payer: Cash Price |
$2,349.93
|
| Rate for Payer: Cofinity Commercial |
$2,526.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.93
|
| Rate for Payer: Healthscope Commercial |
$2,643.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,203.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,496.80
|
| Rate for Payer: PHP Commercial |
$2,496.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,555.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,791.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,584.92
|
| Rate for Payer: UHC Core |
$2,452.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,203.06
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
OP
|
$2,937.41
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$697.63 |
| Max. Negotiated Rate |
$2,643.67 |
| Rate for Payer: Aetna Commercial |
$2,496.80
|
| Rate for Payer: Aetna Medicare |
$763.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$917.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$917.94
|
| Rate for Payer: BCBS Complete |
$1,174.96
|
| Rate for Payer: BCBS MAPPO |
$734.35
|
| Rate for Payer: BCBS Trust/PPO |
$2,283.84
|
| Rate for Payer: BCN Commercial |
$2,283.84
|
| Rate for Payer: BCN Medicare Advantage |
$734.35
|
| Rate for Payer: Cash Price |
$2,349.93
|
| Rate for Payer: Cofinity Commercial |
$2,526.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,349.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$734.35
|
| Rate for Payer: Healthscope Commercial |
$2,643.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,203.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$771.07
|
| Rate for Payer: MI Amish Medical Board Commercial |
$844.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$2,496.80
|
| Rate for Payer: PACE Senior Care Partners |
$697.63
|
| Rate for Payer: PACE SWMI |
$734.35
|
| Rate for Payer: PHP Commercial |
$2,496.80
|
| Rate for Payer: PHP Medicare Advantage |
$734.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,056.19
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$2,555.55
|
| Rate for Payer: Priority Health Medicare |
$734.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,791.53
|
| Rate for Payer: Railroad Medicare Medicare |
$734.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,584.92
|
| Rate for Payer: UHC Core |
$2,452.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$734.35
|
| Rate for Payer: UHC Medicare Advantage |
$756.38
|
| Rate for Payer: VA VA |
$734.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,203.06
|
|
