|
HC BARRX ULTRA LONG RFA FOCAL CATHETER
|
Facility
|
OP
|
$4,508.53
|
|
| Hospital Charge Code |
27200288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$794.85 |
| Max. Negotiated Rate |
$4,057.68 |
| Rate for Payer: Aetna Commercial |
$3,832.25
|
| Rate for Payer: Aetna Medicare |
$1,172.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,408.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,408.92
|
| Rate for Payer: BCBS Complete |
$834.53
|
| Rate for Payer: BCBS MAPPO |
$1,127.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,706.46
|
| Rate for Payer: BCN Commercial |
$3,706.46
|
| Rate for Payer: BCN Medicare Advantage |
$1,127.13
|
| Rate for Payer: Cash Price |
$3,606.82
|
| Rate for Payer: Cofinity Commercial |
$3,877.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,606.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,127.13
|
| Rate for Payer: Healthscope Commercial |
$4,057.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,381.40
|
| Rate for Payer: Mclaren Medicaid |
$794.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,183.49
|
| Rate for Payer: Meridian Medicaid |
$834.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,296.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,239.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,832.25
|
| Rate for Payer: Nomi Health Commercial |
$3,696.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,381.40
|
| Rate for Payer: PACE Senior Care Partners |
$1,070.78
|
| Rate for Payer: PACE SWMI |
$1,127.13
|
| Rate for Payer: PHP Commercial |
$3,832.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,127.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$794.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,922.42
|
| Rate for Payer: Priority Health Medicare |
$1,138.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,137.94
|
| Rate for Payer: Railroad Medicare Medicare |
$1,127.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,967.51
|
| Rate for Payer: UHC Core |
$3,764.62
|
| Rate for Payer: UHC Exchange |
$1,127.13
|
| Rate for Payer: UHC Medicaid |
$794.85
|
| Rate for Payer: UHC Medicare Advantage |
$1,127.13
|
| Rate for Payer: UHCCP Medicaid |
$794.85
|
| Rate for Payer: VA VA |
$1,127.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,381.40
|
|
|
HC BARTONELLA HENSELAE CMPT
|
Facility
|
OP
|
$18.24
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200227
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.22 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: Aetna Medicare |
$4.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.70
|
| Rate for Payer: BCBS Complete |
$3.38
|
| Rate for Payer: BCBS MAPPO |
$4.56
|
| Rate for Payer: BCBS Trust/PPO |
$15.00
|
| Rate for Payer: BCN Commercial |
$15.00
|
| Rate for Payer: BCN Medicare Advantage |
$4.56
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cofinity Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.56
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.68
|
| Rate for Payer: Mclaren Medicaid |
$3.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.79
|
| Rate for Payer: Meridian Medicaid |
$3.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Nomi Health Commercial |
$14.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.68
|
| Rate for Payer: PACE Senior Care Partners |
$4.33
|
| Rate for Payer: PACE SWMI |
$4.56
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: PHP Medicare Advantage |
$4.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.87
|
| Rate for Payer: Priority Health Medicare |
$4.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.70
|
| Rate for Payer: Railroad Medicare Medicare |
$4.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.05
|
| Rate for Payer: UHC Core |
$15.23
|
| Rate for Payer: UHC Exchange |
$4.56
|
| Rate for Payer: UHC Medicaid |
$3.22
|
| Rate for Payer: UHC Medicare Advantage |
$4.56
|
| Rate for Payer: UHCCP Medicaid |
$3.22
|
| Rate for Payer: VA VA |
$4.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.68
|
|
|
HC BARTONELLA HENSELAE CMPT
|
Facility
|
IP
|
$18.24
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200227
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.70 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$15.06
|
| Rate for Payer: BCN Commercial |
$15.06
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cofinity Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Nomi Health Commercial |
$14.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.68
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.05
|
| Rate for Payer: UHC Core |
$15.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.68
|
|
|
HC BARTONELLA HENSELAE IGG IGM
|
Facility
|
OP
|
$18.24
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200228
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.22 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: Aetna Medicare |
$4.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.70
|
| Rate for Payer: BCBS Complete |
$3.38
|
| Rate for Payer: BCBS MAPPO |
$4.56
|
| Rate for Payer: BCBS Trust/PPO |
$15.00
|
| Rate for Payer: BCN Commercial |
$15.00
|
| Rate for Payer: BCN Medicare Advantage |
$4.56
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cofinity Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.56
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.68
|
| Rate for Payer: Mclaren Medicaid |
$3.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.79
|
| Rate for Payer: Meridian Medicaid |
$3.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Nomi Health Commercial |
$14.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.68
|
| Rate for Payer: PACE Senior Care Partners |
$4.33
|
| Rate for Payer: PACE SWMI |
$4.56
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: PHP Medicare Advantage |
$4.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.87
|
| Rate for Payer: Priority Health Medicare |
$4.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.70
|
| Rate for Payer: Railroad Medicare Medicare |
$4.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.05
|
| Rate for Payer: UHC Core |
$15.23
|
| Rate for Payer: UHC Exchange |
$4.56
|
| Rate for Payer: UHC Medicaid |
$3.22
|
| Rate for Payer: UHC Medicare Advantage |
$4.56
|
| Rate for Payer: UHCCP Medicaid |
$3.22
|
| Rate for Payer: VA VA |
$4.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.68
|
|
|
HC BARTONELLA HENSELAE IGG IGM
|
Facility
|
IP
|
$18.24
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200228
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.70 |
| Max. Negotiated Rate |
$16.42 |
| Rate for Payer: Aetna Commercial |
$15.50
|
| Rate for Payer: BCBS Trust/PPO |
$15.06
|
| Rate for Payer: BCN Commercial |
$15.06
|
| Rate for Payer: Cash Price |
$14.59
|
| Rate for Payer: Cofinity Commercial |
$15.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.59
|
| Rate for Payer: Healthscope Commercial |
$16.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.50
|
| Rate for Payer: Nomi Health Commercial |
$14.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$13.68
|
| Rate for Payer: PHP Commercial |
$15.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$15.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$12.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$16.05
|
| Rate for Payer: UHC Core |
$15.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.68
|
|
|
HC BASIC METABOLIC PANEL
|
Facility
|
IP
|
$32.48
|
|
|
Service Code
|
CPT 80048
|
| Hospital Charge Code |
30100010
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.61 |
| Max. Negotiated Rate |
$29.23 |
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: BCBS Trust/PPO |
$26.83
|
| Rate for Payer: BCN Commercial |
$26.83
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Healthscope Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.61
|
| Rate for Payer: Nomi Health Commercial |
$26.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.36
|
| Rate for Payer: PHP Commercial |
$27.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.58
|
| Rate for Payer: UHC Core |
$27.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.36
|
|
|
HC BASIC METABOLIC PANEL
|
Facility
|
OP
|
$32.48
|
|
|
Service Code
|
CPT 80048
|
| Hospital Charge Code |
30100010
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.73 |
| Max. Negotiated Rate |
$29.23 |
| Rate for Payer: Aetna Commercial |
$27.61
|
| Rate for Payer: Aetna Medicare |
$8.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.15
|
| Rate for Payer: BCBS Complete |
$6.01
|
| Rate for Payer: BCBS MAPPO |
$8.12
|
| Rate for Payer: BCBS Trust/PPO |
$26.70
|
| Rate for Payer: BCN Commercial |
$26.70
|
| Rate for Payer: BCN Medicare Advantage |
$8.12
|
| Rate for Payer: Cash Price |
$25.98
|
| Rate for Payer: Cofinity Commercial |
$27.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.12
|
| Rate for Payer: Healthscope Commercial |
$29.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.36
|
| Rate for Payer: Mclaren Medicaid |
$5.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.53
|
| Rate for Payer: Meridian Medicaid |
$6.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.61
|
| Rate for Payer: Nomi Health Commercial |
$26.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.36
|
| Rate for Payer: PACE Senior Care Partners |
$7.71
|
| Rate for Payer: PACE SWMI |
$8.12
|
| Rate for Payer: PHP Commercial |
$27.61
|
| Rate for Payer: PHP Medicare Advantage |
$8.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.26
|
| Rate for Payer: Priority Health Medicare |
$8.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.61
|
| Rate for Payer: Railroad Medicare Medicare |
$8.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.58
|
| Rate for Payer: UHC Core |
$27.12
|
| Rate for Payer: UHC Exchange |
$8.12
|
| Rate for Payer: UHC Medicaid |
$5.73
|
| Rate for Payer: UHC Medicare Advantage |
$8.12
|
| Rate for Payer: UHCCP Medicaid |
$5.73
|
| Rate for Payer: VA VA |
$8.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.36
|
|
|
HC BASIC METABOLIC W ION CALCIUM
|
Facility
|
IP
|
$96.68
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100009
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$67.29 |
| Max. Negotiated Rate |
$87.01 |
| Rate for Payer: Aetna Commercial |
$82.18
|
| Rate for Payer: BCBS Trust/PPO |
$79.85
|
| Rate for Payer: BCN Commercial |
$79.85
|
| Rate for Payer: Cash Price |
$77.34
|
| Rate for Payer: Cofinity Commercial |
$83.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.34
|
| Rate for Payer: Healthscope Commercial |
$87.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.18
|
| Rate for Payer: Nomi Health Commercial |
$79.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.51
|
| Rate for Payer: PHP Commercial |
$82.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.08
|
| Rate for Payer: UHC Core |
$80.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.51
|
|
|
HC BASIC METABOLIC W ION CALCIUM
|
Facility
|
OP
|
$96.68
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100009
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.04 |
| Max. Negotiated Rate |
$87.01 |
| Rate for Payer: Aetna Commercial |
$82.18
|
| Rate for Payer: Aetna Medicare |
$25.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.21
|
| Rate for Payer: BCBS Complete |
$17.90
|
| Rate for Payer: BCBS MAPPO |
$24.17
|
| Rate for Payer: BCBS Trust/PPO |
$79.48
|
| Rate for Payer: BCN Commercial |
$79.48
|
| Rate for Payer: BCN Medicare Advantage |
$24.17
|
| Rate for Payer: Cash Price |
$77.34
|
| Rate for Payer: Cofinity Commercial |
$83.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.17
|
| Rate for Payer: Healthscope Commercial |
$87.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.51
|
| Rate for Payer: Mclaren Medicaid |
$17.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.38
|
| Rate for Payer: Meridian Medicaid |
$17.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.18
|
| Rate for Payer: Nomi Health Commercial |
$79.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.51
|
| Rate for Payer: PACE Senior Care Partners |
$22.96
|
| Rate for Payer: PACE SWMI |
$24.17
|
| Rate for Payer: PHP Commercial |
$82.18
|
| Rate for Payer: PHP Medicare Advantage |
$24.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.11
|
| Rate for Payer: Priority Health Medicare |
$24.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.29
|
| Rate for Payer: Railroad Medicare Medicare |
$24.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.08
|
| Rate for Payer: UHC Core |
$80.73
|
| Rate for Payer: UHC Exchange |
$24.17
|
| Rate for Payer: UHC Medicaid |
$17.04
|
| Rate for Payer: UHC Medicare Advantage |
$24.17
|
| Rate for Payer: UHCCP Medicaid |
$17.04
|
| Rate for Payer: VA VA |
$24.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.51
|
|
|
HC BASIC RAD DOSIMETRY
|
Facility
|
OP
|
$440.41
|
|
|
Service Code
|
CPT 77300
|
| Hospital Charge Code |
33300005
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$77.64 |
| Max. Negotiated Rate |
$396.37 |
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: Aetna Medicare |
$114.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$137.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$137.63
|
| Rate for Payer: BCBS Complete |
$81.52
|
| Rate for Payer: BCBS MAPPO |
$110.10
|
| Rate for Payer: BCBS Trust/PPO |
$362.06
|
| Rate for Payer: BCN Commercial |
$362.06
|
| Rate for Payer: BCN Medicare Advantage |
$110.10
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.10
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.31
|
| Rate for Payer: Mclaren Medicaid |
$77.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.61
|
| Rate for Payer: Meridian Medicaid |
$81.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$121.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Nomi Health Commercial |
$361.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PACE Senior Care Partners |
$104.60
|
| Rate for Payer: PACE SWMI |
$110.10
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: PHP Medicare Advantage |
$110.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$383.16
|
| Rate for Payer: Priority Health Medicare |
$111.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.53
|
| Rate for Payer: Railroad Medicare Medicare |
$110.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.56
|
| Rate for Payer: UHC Core |
$367.74
|
| Rate for Payer: UHC Exchange |
$110.10
|
| Rate for Payer: UHC Medicaid |
$77.64
|
| Rate for Payer: UHC Medicare Advantage |
$110.10
|
| Rate for Payer: UHCCP Medicaid |
$77.64
|
| Rate for Payer: VA VA |
$110.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.31
|
|
|
HC BASIC RAD DOSIMETRY
|
Facility
|
IP
|
$440.41
|
|
|
Service Code
|
CPT 77300
|
| Hospital Charge Code |
33300005
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$306.53 |
| Max. Negotiated Rate |
$396.37 |
| Rate for Payer: Aetna Commercial |
$374.35
|
| Rate for Payer: BCBS Trust/PPO |
$363.73
|
| Rate for Payer: BCN Commercial |
$363.73
|
| Rate for Payer: Cash Price |
$352.33
|
| Rate for Payer: Cofinity Commercial |
$378.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$352.33
|
| Rate for Payer: Healthscope Commercial |
$396.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$330.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$374.35
|
| Rate for Payer: Nomi Health Commercial |
$361.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$330.31
|
| Rate for Payer: PHP Commercial |
$374.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$383.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$387.56
|
| Rate for Payer: UHC Core |
$367.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$330.31
|
|
|
HC BB-COMP-FRESH-FROZEN PLASMA EA
|
Facility
|
OP
|
$228.69
|
|
|
Service Code
|
HCPCS P9059
|
| Hospital Charge Code |
39000041
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$40.32 |
| Max. Negotiated Rate |
$205.82 |
| Rate for Payer: Aetna Commercial |
$194.39
|
| Rate for Payer: Aetna Medicare |
$59.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$71.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$71.47
|
| Rate for Payer: BCBS Complete |
$42.33
|
| Rate for Payer: BCBS MAPPO |
$57.17
|
| Rate for Payer: BCBS Trust/PPO |
$188.01
|
| Rate for Payer: BCN Commercial |
$188.01
|
| Rate for Payer: BCN Medicare Advantage |
$57.17
|
| Rate for Payer: Cash Price |
$182.95
|
| Rate for Payer: Cofinity Commercial |
$196.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$57.17
|
| Rate for Payer: Healthscope Commercial |
$205.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.52
|
| Rate for Payer: Mclaren Medicaid |
$40.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$60.03
|
| Rate for Payer: Meridian Medicaid |
$42.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$65.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$62.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.39
|
| Rate for Payer: Nomi Health Commercial |
$187.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.52
|
| Rate for Payer: PACE Senior Care Partners |
$54.31
|
| Rate for Payer: PACE SWMI |
$57.17
|
| Rate for Payer: PHP Commercial |
$194.39
|
| Rate for Payer: PHP Medicare Advantage |
$57.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$40.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$198.96
|
| Rate for Payer: Priority Health Medicare |
$57.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.17
|
| Rate for Payer: Railroad Medicare Medicare |
$57.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.25
|
| Rate for Payer: UHC Core |
$190.96
|
| Rate for Payer: UHC Exchange |
$57.17
|
| Rate for Payer: UHC Medicaid |
$40.32
|
| Rate for Payer: UHC Medicare Advantage |
$57.17
|
| Rate for Payer: UHCCP Medicaid |
$40.32
|
| Rate for Payer: VA VA |
$57.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.52
|
|
|
HC BB-COMP-FRESH-FROZEN PLASMA EA
|
Facility
|
IP
|
$228.69
|
|
|
Service Code
|
HCPCS P9059
|
| Hospital Charge Code |
39000041
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$159.17 |
| Max. Negotiated Rate |
$205.82 |
| Rate for Payer: Aetna Commercial |
$194.39
|
| Rate for Payer: BCBS Trust/PPO |
$188.88
|
| Rate for Payer: BCN Commercial |
$188.88
|
| Rate for Payer: Cash Price |
$182.95
|
| Rate for Payer: Cofinity Commercial |
$196.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$182.95
|
| Rate for Payer: Healthscope Commercial |
$205.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$171.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$194.39
|
| Rate for Payer: Nomi Health Commercial |
$187.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$171.52
|
| Rate for Payer: PHP Commercial |
$194.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$198.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$159.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$201.25
|
| Rate for Payer: UHC Core |
$190.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$171.52
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.21 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: BCBS Trust/PPO |
$79.76
|
| Rate for Payer: BCN Commercial |
$79.76
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$79.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.98
|
| Rate for Payer: UHC Core |
$80.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.43
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
OP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna Medicare |
$25.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.18
|
| Rate for Payer: BCBS Complete |
$17.88
|
| Rate for Payer: BCBS MAPPO |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$79.39
|
| Rate for Payer: BCN Commercial |
$79.39
|
| Rate for Payer: BCN Medicare Advantage |
$24.14
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.43
|
| Rate for Payer: Mclaren Medicaid |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.35
|
| Rate for Payer: Meridian Medicaid |
$17.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$79.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PACE Senior Care Partners |
$22.94
|
| Rate for Payer: PACE SWMI |
$24.14
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: PHP Medicare Advantage |
$24.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.02
|
| Rate for Payer: Priority Health Medicare |
$24.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.21
|
| Rate for Payer: Railroad Medicare Medicare |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.98
|
| Rate for Payer: UHC Core |
$80.64
|
| Rate for Payer: UHC Exchange |
$24.14
|
| Rate for Payer: UHC Medicaid |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$24.14
|
| Rate for Payer: UHCCP Medicaid |
$17.03
|
| Rate for Payer: VA VA |
$24.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.43
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna Medicare |
$27.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.49
|
| Rate for Payer: BCBS Complete |
$19.84
|
| Rate for Payer: BCBS MAPPO |
$26.80
|
| Rate for Payer: BCBS Trust/PPO |
$88.11
|
| Rate for Payer: BCN Commercial |
$88.11
|
| Rate for Payer: BCN Medicare Advantage |
$26.80
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.39
|
| Rate for Payer: Mclaren Medicaid |
$18.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.13
|
| Rate for Payer: Meridian Medicaid |
$19.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PACE Senior Care Partners |
$25.46
|
| Rate for Payer: PACE SWMI |
$26.80
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: PHP Medicare Advantage |
$26.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.25
|
| Rate for Payer: Priority Health Medicare |
$27.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.60
|
| Rate for Payer: Railroad Medicare Medicare |
$26.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.32
|
| Rate for Payer: UHC Core |
$89.50
|
| Rate for Payer: UHC Exchange |
$26.80
|
| Rate for Payer: UHC Medicaid |
$18.90
|
| Rate for Payer: UHC Medicare Advantage |
$26.80
|
| Rate for Payer: UHCCP Medicaid |
$18.90
|
| Rate for Payer: VA VA |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.39
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: BCBS Trust/PPO |
$88.52
|
| Rate for Payer: BCN Commercial |
$88.52
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.32
|
| Rate for Payer: UHC Core |
$89.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.39
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
OP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$17.03 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: Aetna Medicare |
$25.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.18
|
| Rate for Payer: BCBS Complete |
$17.88
|
| Rate for Payer: BCBS MAPPO |
$24.14
|
| Rate for Payer: BCBS Trust/PPO |
$79.39
|
| Rate for Payer: BCN Commercial |
$79.39
|
| Rate for Payer: BCN Medicare Advantage |
$24.14
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.43
|
| Rate for Payer: Mclaren Medicaid |
$17.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.35
|
| Rate for Payer: Meridian Medicaid |
$17.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$26.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$79.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PACE Senior Care Partners |
$22.94
|
| Rate for Payer: PACE SWMI |
$24.14
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: PHP Medicare Advantage |
$24.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.02
|
| Rate for Payer: Priority Health Medicare |
$24.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.21
|
| Rate for Payer: Railroad Medicare Medicare |
$24.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.98
|
| Rate for Payer: UHC Core |
$80.64
|
| Rate for Payer: UHC Exchange |
$24.14
|
| Rate for Payer: UHC Medicaid |
$17.03
|
| Rate for Payer: UHC Medicare Advantage |
$24.14
|
| Rate for Payer: UHCCP Medicaid |
$17.03
|
| Rate for Payer: VA VA |
$24.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.43
|
|
|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$96.57
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.21 |
| Max. Negotiated Rate |
$86.91 |
| Rate for Payer: Aetna Commercial |
$82.08
|
| Rate for Payer: BCBS Trust/PPO |
$79.76
|
| Rate for Payer: BCN Commercial |
$79.76
|
| Rate for Payer: Cash Price |
$77.26
|
| Rate for Payer: Cofinity Commercial |
$83.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.26
|
| Rate for Payer: Healthscope Commercial |
$86.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.08
|
| Rate for Payer: Nomi Health Commercial |
$79.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$72.43
|
| Rate for Payer: PHP Commercial |
$82.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$84.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$84.98
|
| Rate for Payer: UHC Core |
$80.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.43
|
|
|
HC BCR / ABL FISH
|
Facility
|
IP
|
$133.71
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$93.06 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna Commercial |
$113.65
|
| Rate for Payer: BCBS Trust/PPO |
$110.43
|
| Rate for Payer: BCN Commercial |
$110.43
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Commercial |
$114.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Healthscope Commercial |
$120.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Nomi Health Commercial |
$109.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| Rate for Payer: PHP Commercial |
$113.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.66
|
| Rate for Payer: UHC Core |
$111.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.28
|
|
|
HC BCR / ABL FISH
|
Facility
|
OP
|
$133.71
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.57 |
| Max. Negotiated Rate |
$120.34 |
| Rate for Payer: Aetna Commercial |
$113.65
|
| Rate for Payer: Aetna Medicare |
$34.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.78
|
| Rate for Payer: BCBS Complete |
$24.75
|
| Rate for Payer: BCBS MAPPO |
$33.43
|
| Rate for Payer: BCBS Trust/PPO |
$109.92
|
| Rate for Payer: BCN Commercial |
$109.92
|
| Rate for Payer: BCN Medicare Advantage |
$33.43
|
| Rate for Payer: Cash Price |
$106.97
|
| Rate for Payer: Cofinity Commercial |
$114.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.43
|
| Rate for Payer: Healthscope Commercial |
$120.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.28
|
| Rate for Payer: Mclaren Medicaid |
$23.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.10
|
| Rate for Payer: Meridian Medicaid |
$24.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.65
|
| Rate for Payer: Nomi Health Commercial |
$109.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$100.28
|
| Rate for Payer: PACE Senior Care Partners |
$31.76
|
| Rate for Payer: PACE SWMI |
$33.43
|
| Rate for Payer: PHP Commercial |
$113.65
|
| Rate for Payer: PHP Medicare Advantage |
$33.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$116.33
|
| Rate for Payer: Priority Health Medicare |
$33.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$93.06
|
| Rate for Payer: Railroad Medicare Medicare |
$33.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.66
|
| Rate for Payer: UHC Core |
$111.65
|
| Rate for Payer: UHC Exchange |
$33.43
|
| Rate for Payer: UHC Medicaid |
$23.57
|
| Rate for Payer: UHC Medicare Advantage |
$33.43
|
| Rate for Payer: UHCCP Medicaid |
$23.57
|
| Rate for Payer: VA VA |
$33.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.28
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
IP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$74.60 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: BCBS Trust/PPO |
$88.52
|
| Rate for Payer: BCN Commercial |
$88.52
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.32
|
| Rate for Payer: UHC Core |
$89.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.39
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
OP
|
$107.18
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.90 |
| Max. Negotiated Rate |
$96.46 |
| Rate for Payer: Aetna Commercial |
$91.10
|
| Rate for Payer: Aetna Medicare |
$27.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.49
|
| Rate for Payer: BCBS Complete |
$19.84
|
| Rate for Payer: BCBS MAPPO |
$26.80
|
| Rate for Payer: BCBS Trust/PPO |
$88.11
|
| Rate for Payer: BCN Commercial |
$88.11
|
| Rate for Payer: BCN Medicare Advantage |
$26.80
|
| Rate for Payer: Cash Price |
$85.74
|
| Rate for Payer: Cofinity Commercial |
$92.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$85.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.80
|
| Rate for Payer: Healthscope Commercial |
$96.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$80.39
|
| Rate for Payer: Mclaren Medicaid |
$18.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.13
|
| Rate for Payer: Meridian Medicaid |
$19.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.10
|
| Rate for Payer: Nomi Health Commercial |
$87.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$80.39
|
| Rate for Payer: PACE Senior Care Partners |
$25.46
|
| Rate for Payer: PACE SWMI |
$26.80
|
| Rate for Payer: PHP Commercial |
$91.10
|
| Rate for Payer: PHP Medicare Advantage |
$26.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$93.25
|
| Rate for Payer: Priority Health Medicare |
$27.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.60
|
| Rate for Payer: Railroad Medicare Medicare |
$26.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$94.32
|
| Rate for Payer: UHC Core |
$89.50
|
| Rate for Payer: UHC Exchange |
$26.80
|
| Rate for Payer: UHC Medicaid |
$18.90
|
| Rate for Payer: UHC Medicare Advantage |
$26.80
|
| Rate for Payer: UHCCP Medicaid |
$18.90
|
| Rate for Payer: VA VA |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$80.39
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
OP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$71.49 |
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: Aetna Medicare |
$20.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.82
|
| Rate for Payer: BCBS Complete |
$14.70
|
| Rate for Payer: BCBS MAPPO |
$19.86
|
| Rate for Payer: BCBS Trust/PPO |
$65.30
|
| Rate for Payer: BCN Commercial |
$65.30
|
| Rate for Payer: BCN Medicare Advantage |
$19.86
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.86
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.57
|
| Rate for Payer: Mclaren Medicaid |
$14.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.85
|
| Rate for Payer: Meridian Medicaid |
$14.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$65.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PACE Senior Care Partners |
$18.86
|
| Rate for Payer: PACE SWMI |
$19.86
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.10
|
| Rate for Payer: Priority Health Medicare |
$20.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.90
|
| Rate for Payer: UHC Core |
$66.32
|
| Rate for Payer: UHC Exchange |
$19.86
|
| Rate for Payer: UHC Medicaid |
$14.00
|
| Rate for Payer: UHC Medicare Advantage |
$19.86
|
| Rate for Payer: UHCCP Medicaid |
$14.00
|
| Rate for Payer: VA VA |
$19.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.57
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
IP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$55.28 |
| Max. Negotiated Rate |
$71.49 |
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: BCBS Trust/PPO |
$65.60
|
| Rate for Payer: BCN Commercial |
$65.60
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$65.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.90
|
| Rate for Payer: UHC Core |
$66.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.57
|
|
