|
HC BCR/ABL P210 QUANT
|
Facility
|
OP
|
$397.95
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$70.16 |
| Max. Negotiated Rate |
$358.15 |
| Rate for Payer: Aetna Commercial |
$338.26
|
| Rate for Payer: Aetna Medicare |
$103.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$124.36
|
| Rate for Payer: Amish Plain Church Group Commercial |
$124.36
|
| Rate for Payer: BCBS Complete |
$73.66
|
| Rate for Payer: BCBS MAPPO |
$99.49
|
| Rate for Payer: BCBS Trust/PPO |
$327.15
|
| Rate for Payer: BCN Commercial |
$327.15
|
| Rate for Payer: BCN Medicare Advantage |
$99.49
|
| Rate for Payer: Cash Price |
$318.36
|
| Rate for Payer: Cofinity Commercial |
$342.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$99.49
|
| Rate for Payer: Healthscope Commercial |
$358.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.46
|
| Rate for Payer: Mclaren Medicaid |
$70.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$104.46
|
| Rate for Payer: Meridian Medicaid |
$73.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$114.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$109.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.26
|
| Rate for Payer: Nomi Health Commercial |
$326.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.46
|
| Rate for Payer: PACE Senior Care Partners |
$94.51
|
| Rate for Payer: PACE SWMI |
$99.49
|
| Rate for Payer: PHP Commercial |
$338.26
|
| Rate for Payer: PHP Medicare Advantage |
$99.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$70.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$346.22
|
| Rate for Payer: Priority Health Medicare |
$100.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.97
|
| Rate for Payer: Railroad Medicare Medicare |
$99.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.20
|
| Rate for Payer: UHC Core |
$332.29
|
| Rate for Payer: UHC Exchange |
$99.49
|
| Rate for Payer: UHC Medicaid |
$70.16
|
| Rate for Payer: UHC Medicare Advantage |
$99.49
|
| Rate for Payer: UHCCP Medicaid |
$70.16
|
| Rate for Payer: VA VA |
$99.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.46
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
IP
|
$397.95
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$276.97 |
| Max. Negotiated Rate |
$358.15 |
| Rate for Payer: Aetna Commercial |
$338.26
|
| Rate for Payer: BCBS Trust/PPO |
$328.67
|
| Rate for Payer: BCN Commercial |
$328.67
|
| Rate for Payer: Cash Price |
$318.36
|
| Rate for Payer: Cofinity Commercial |
$342.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$318.36
|
| Rate for Payer: Healthscope Commercial |
$358.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$298.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$338.26
|
| Rate for Payer: Nomi Health Commercial |
$326.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$298.46
|
| Rate for Payer: PHP Commercial |
$338.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$346.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$350.20
|
| Rate for Payer: UHC Core |
$332.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$298.46
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
IP
|
$259.28
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$180.46 |
| Max. Negotiated Rate |
$233.35 |
| Rate for Payer: Aetna Commercial |
$220.39
|
| Rate for Payer: BCBS Trust/PPO |
$214.14
|
| Rate for Payer: BCN Commercial |
$214.14
|
| Rate for Payer: Cash Price |
$207.42
|
| Rate for Payer: Cofinity Commercial |
$222.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.42
|
| Rate for Payer: Healthscope Commercial |
$233.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.39
|
| Rate for Payer: Nomi Health Commercial |
$212.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.46
|
| Rate for Payer: PHP Commercial |
$220.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$225.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.17
|
| Rate for Payer: UHC Core |
$216.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.46
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
OP
|
$259.28
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.71 |
| Max. Negotiated Rate |
$233.35 |
| Rate for Payer: Aetna Commercial |
$220.39
|
| Rate for Payer: Aetna Medicare |
$67.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.03
|
| Rate for Payer: BCBS Complete |
$47.99
|
| Rate for Payer: BCBS MAPPO |
$64.82
|
| Rate for Payer: BCBS Trust/PPO |
$213.15
|
| Rate for Payer: BCN Commercial |
$213.15
|
| Rate for Payer: BCN Medicare Advantage |
$64.82
|
| Rate for Payer: Cash Price |
$207.42
|
| Rate for Payer: Cofinity Commercial |
$222.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.82
|
| Rate for Payer: Healthscope Commercial |
$233.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.46
|
| Rate for Payer: Mclaren Medicaid |
$45.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.06
|
| Rate for Payer: Meridian Medicaid |
$47.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.39
|
| Rate for Payer: Nomi Health Commercial |
$212.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$194.46
|
| Rate for Payer: PACE Senior Care Partners |
$61.58
|
| Rate for Payer: PACE SWMI |
$64.82
|
| Rate for Payer: PHP Commercial |
$220.39
|
| Rate for Payer: PHP Medicare Advantage |
$64.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$225.57
|
| Rate for Payer: Priority Health Medicare |
$65.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.46
|
| Rate for Payer: Railroad Medicare Medicare |
$64.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.17
|
| Rate for Payer: UHC Core |
$216.50
|
| Rate for Payer: UHC Exchange |
$64.82
|
| Rate for Payer: UHC Medicaid |
$45.71
|
| Rate for Payer: UHC Medicare Advantage |
$64.82
|
| Rate for Payer: UHCCP Medicaid |
$45.71
|
| Rate for Payer: VA VA |
$64.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.46
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
IP
|
$384.20
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$267.40 |
| Max. Negotiated Rate |
$345.78 |
| Rate for Payer: Aetna Commercial |
$326.57
|
| Rate for Payer: BCBS Trust/PPO |
$317.31
|
| Rate for Payer: BCN Commercial |
$317.31
|
| Rate for Payer: Cash Price |
$307.36
|
| Rate for Payer: Cofinity Commercial |
$330.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.36
|
| Rate for Payer: Healthscope Commercial |
$345.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.57
|
| Rate for Payer: Nomi Health Commercial |
$315.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.15
|
| Rate for Payer: PHP Commercial |
$326.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$334.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.10
|
| Rate for Payer: UHC Core |
$320.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.15
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
OP
|
$384.20
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.73 |
| Max. Negotiated Rate |
$345.78 |
| Rate for Payer: Aetna Commercial |
$326.57
|
| Rate for Payer: Aetna Medicare |
$99.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.06
|
| Rate for Payer: BCBS Complete |
$71.12
|
| Rate for Payer: BCBS MAPPO |
$96.05
|
| Rate for Payer: BCBS Trust/PPO |
$315.85
|
| Rate for Payer: BCN Commercial |
$315.85
|
| Rate for Payer: BCN Medicare Advantage |
$96.05
|
| Rate for Payer: Cash Price |
$307.36
|
| Rate for Payer: Cofinity Commercial |
$330.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$307.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.05
|
| Rate for Payer: Healthscope Commercial |
$345.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$288.15
|
| Rate for Payer: Mclaren Medicaid |
$67.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$100.85
|
| Rate for Payer: Meridian Medicaid |
$71.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$110.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$105.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$326.57
|
| Rate for Payer: Nomi Health Commercial |
$315.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$288.15
|
| Rate for Payer: PACE Senior Care Partners |
$91.25
|
| Rate for Payer: PACE SWMI |
$96.05
|
| Rate for Payer: PHP Commercial |
$326.57
|
| Rate for Payer: PHP Medicare Advantage |
$96.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$334.25
|
| Rate for Payer: Priority Health Medicare |
$97.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$267.40
|
| Rate for Payer: Railroad Medicare Medicare |
$96.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$338.10
|
| Rate for Payer: UHC Core |
$320.81
|
| Rate for Payer: UHC Exchange |
$96.05
|
| Rate for Payer: UHC Medicaid |
$67.73
|
| Rate for Payer: UHC Medicare Advantage |
$96.05
|
| Rate for Payer: UHCCP Medicaid |
$67.73
|
| Rate for Payer: VA VA |
$96.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$288.15
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
OP
|
$293.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$51.74 |
| Max. Negotiated Rate |
$264.15 |
| Rate for Payer: Aetna Commercial |
$249.47
|
| Rate for Payer: Aetna Medicare |
$76.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.72
|
| Rate for Payer: BCBS Complete |
$54.33
|
| Rate for Payer: BCBS MAPPO |
$73.38
|
| Rate for Payer: BCBS Trust/PPO |
$241.29
|
| Rate for Payer: BCN Commercial |
$241.29
|
| Rate for Payer: BCN Medicare Advantage |
$73.38
|
| Rate for Payer: Cash Price |
$234.80
|
| Rate for Payer: Cofinity Commercial |
$252.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$73.38
|
| Rate for Payer: Healthscope Commercial |
$264.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.12
|
| Rate for Payer: Mclaren Medicaid |
$51.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.04
|
| Rate for Payer: Meridian Medicaid |
$54.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$84.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.47
|
| Rate for Payer: Nomi Health Commercial |
$240.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.12
|
| Rate for Payer: PACE Senior Care Partners |
$69.71
|
| Rate for Payer: PACE SWMI |
$73.38
|
| Rate for Payer: PHP Commercial |
$249.47
|
| Rate for Payer: PHP Medicare Advantage |
$73.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$255.34
|
| Rate for Payer: Priority Health Medicare |
$74.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.28
|
| Rate for Payer: Railroad Medicare Medicare |
$73.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.28
|
| Rate for Payer: UHC Core |
$245.07
|
| Rate for Payer: UHC Exchange |
$73.38
|
| Rate for Payer: UHC Medicaid |
$51.74
|
| Rate for Payer: UHC Medicare Advantage |
$73.38
|
| Rate for Payer: UHCCP Medicaid |
$51.74
|
| Rate for Payer: VA VA |
$73.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.12
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
IP
|
$293.50
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$204.28 |
| Max. Negotiated Rate |
$264.15 |
| Rate for Payer: Aetna Commercial |
$249.47
|
| Rate for Payer: BCBS Trust/PPO |
$242.40
|
| Rate for Payer: BCN Commercial |
$242.40
|
| Rate for Payer: Cash Price |
$234.80
|
| Rate for Payer: Cofinity Commercial |
$252.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$234.80
|
| Rate for Payer: Healthscope Commercial |
$264.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$220.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$249.47
|
| Rate for Payer: Nomi Health Commercial |
$240.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$220.12
|
| Rate for Payer: PHP Commercial |
$249.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$255.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$204.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$258.28
|
| Rate for Payer: UHC Core |
$245.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$220.12
|
|
|
HC BDIAL APTT
|
Facility
|
OP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: Aetna Medicare |
$6.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.29
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$6.63
|
| Rate for Payer: BCBS Trust/PPO |
$21.81
|
| Rate for Payer: BCN Commercial |
$21.81
|
| Rate for Payer: BCN Medicare Advantage |
$6.63
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.63
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.96
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PACE Senior Care Partners |
$6.30
|
| Rate for Payer: PACE SWMI |
$6.63
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: PHP Medicare Advantage |
$6.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Medicare |
$6.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: Railroad Medicare Medicare |
$6.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: UHC Exchange |
$6.63
|
| Rate for Payer: UHC Medicaid |
$4.68
|
| Rate for Payer: UHC Medicare Advantage |
$6.63
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$6.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC BDIAL APTT
|
Facility
|
IP
|
$26.53
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.46 |
| Max. Negotiated Rate |
$23.88 |
| Rate for Payer: Aetna Commercial |
$22.55
|
| Rate for Payer: BCBS Trust/PPO |
$21.91
|
| Rate for Payer: BCN Commercial |
$21.91
|
| Rate for Payer: Cash Price |
$21.22
|
| Rate for Payer: Cofinity Commercial |
$22.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.22
|
| Rate for Payer: Healthscope Commercial |
$23.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.55
|
| Rate for Payer: Nomi Health Commercial |
$21.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.90
|
| Rate for Payer: PHP Commercial |
$22.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.35
|
| Rate for Payer: UHC Core |
$22.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.90
|
|
|
HC BDIAL DIRM
|
Facility
|
IP
|
$41.13
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$28.63 |
| Max. Negotiated Rate |
$37.02 |
| Rate for Payer: Aetna Commercial |
$34.96
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$33.97
|
| Rate for Payer: Cash Price |
$32.90
|
| Rate for Payer: Cofinity Commercial |
$35.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.90
|
| Rate for Payer: Healthscope Commercial |
$37.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.96
|
| Rate for Payer: Nomi Health Commercial |
$33.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.85
|
| Rate for Payer: PHP Commercial |
$34.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.19
|
| Rate for Payer: UHC Core |
$34.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.85
|
|
|
HC BDIAL DIRM
|
Facility
|
OP
|
$41.13
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.25 |
| Max. Negotiated Rate |
$37.02 |
| Rate for Payer: Aetna Commercial |
$34.96
|
| Rate for Payer: Aetna Medicare |
$10.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.85
|
| Rate for Payer: BCBS Complete |
$7.61
|
| Rate for Payer: BCBS MAPPO |
$10.28
|
| Rate for Payer: BCBS Trust/PPO |
$33.81
|
| Rate for Payer: BCN Commercial |
$33.81
|
| Rate for Payer: BCN Medicare Advantage |
$10.28
|
| Rate for Payer: Cash Price |
$32.90
|
| Rate for Payer: Cofinity Commercial |
$35.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.28
|
| Rate for Payer: Healthscope Commercial |
$37.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.85
|
| Rate for Payer: Mclaren Medicaid |
$7.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.80
|
| Rate for Payer: Meridian Medicaid |
$7.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.96
|
| Rate for Payer: Nomi Health Commercial |
$33.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.85
|
| Rate for Payer: PACE Senior Care Partners |
$9.77
|
| Rate for Payer: PACE SWMI |
$10.28
|
| Rate for Payer: PHP Commercial |
$34.96
|
| Rate for Payer: PHP Medicare Advantage |
$10.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.78
|
| Rate for Payer: Priority Health Medicare |
$10.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.63
|
| Rate for Payer: Railroad Medicare Medicare |
$10.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.19
|
| Rate for Payer: UHC Core |
$34.34
|
| Rate for Payer: UHC Exchange |
$10.28
|
| Rate for Payer: UHC Medicaid |
$7.25
|
| Rate for Payer: UHC Medicare Advantage |
$10.28
|
| Rate for Payer: UHCCP Medicaid |
$7.25
|
| Rate for Payer: VA VA |
$10.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.85
|
|
|
HC BDIAL F8A
|
Facility
|
IP
|
$68.29
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$47.53 |
| Max. Negotiated Rate |
$61.46 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: BCBS Trust/PPO |
$56.40
|
| Rate for Payer: BCN Commercial |
$56.40
|
| Rate for Payer: Cash Price |
$54.63
|
| Rate for Payer: Cofinity Commercial |
$58.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.63
|
| Rate for Payer: Healthscope Commercial |
$61.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.05
|
| Rate for Payer: Nomi Health Commercial |
$56.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.22
|
| Rate for Payer: PHP Commercial |
$58.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.10
|
| Rate for Payer: UHC Core |
$57.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.22
|
|
|
HC BDIAL F8A
|
Facility
|
OP
|
$68.29
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.04 |
| Max. Negotiated Rate |
$61.46 |
| Rate for Payer: Aetna Commercial |
$58.05
|
| Rate for Payer: Aetna Medicare |
$17.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.34
|
| Rate for Payer: BCBS Complete |
$12.64
|
| Rate for Payer: BCBS MAPPO |
$17.07
|
| Rate for Payer: BCBS Trust/PPO |
$56.14
|
| Rate for Payer: BCN Commercial |
$56.14
|
| Rate for Payer: BCN Medicare Advantage |
$17.07
|
| Rate for Payer: Cash Price |
$54.63
|
| Rate for Payer: Cofinity Commercial |
$58.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.07
|
| Rate for Payer: Healthscope Commercial |
$61.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.22
|
| Rate for Payer: Mclaren Medicaid |
$12.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.93
|
| Rate for Payer: Meridian Medicaid |
$12.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.05
|
| Rate for Payer: Nomi Health Commercial |
$56.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.22
|
| Rate for Payer: PACE Senior Care Partners |
$16.22
|
| Rate for Payer: PACE SWMI |
$17.07
|
| Rate for Payer: PHP Commercial |
$58.05
|
| Rate for Payer: PHP Medicare Advantage |
$17.07
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.41
|
| Rate for Payer: Priority Health Medicare |
$17.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.53
|
| Rate for Payer: Railroad Medicare Medicare |
$17.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.10
|
| Rate for Payer: UHC Core |
$57.02
|
| Rate for Payer: UHC Exchange |
$17.07
|
| Rate for Payer: UHC Medicaid |
$12.04
|
| Rate for Payer: UHC Medicare Advantage |
$17.07
|
| Rate for Payer: UHCCP Medicaid |
$12.04
|
| Rate for Payer: VA VA |
$17.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.22
|
|
|
HC BDIAL FACTOR IX ASSAY
|
Facility
|
IP
|
$100.82
|
|
|
Service Code
|
CPT 85250
|
| Hospital Charge Code |
30500030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$70.17 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: BCBS Trust/PPO |
$83.27
|
| Rate for Payer: BCN Commercial |
$83.27
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.72
|
| Rate for Payer: UHC Core |
$84.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC BDIAL FACTOR IX ASSAY
|
Facility
|
OP
|
$100.82
|
|
|
Service Code
|
CPT 85250
|
| Hospital Charge Code |
30500030
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.77 |
| Max. Negotiated Rate |
$90.74 |
| Rate for Payer: Aetna Commercial |
$85.70
|
| Rate for Payer: Aetna Medicare |
$26.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.51
|
| Rate for Payer: BCBS Complete |
$18.66
|
| Rate for Payer: BCBS MAPPO |
$25.20
|
| Rate for Payer: BCBS Trust/PPO |
$82.88
|
| Rate for Payer: BCN Commercial |
$82.88
|
| Rate for Payer: BCN Medicare Advantage |
$25.20
|
| Rate for Payer: Cash Price |
$80.66
|
| Rate for Payer: Cofinity Commercial |
$86.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.20
|
| Rate for Payer: Healthscope Commercial |
$90.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.61
|
| Rate for Payer: Mclaren Medicaid |
$17.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.47
|
| Rate for Payer: Meridian Medicaid |
$18.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.70
|
| Rate for Payer: Nomi Health Commercial |
$82.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.61
|
| Rate for Payer: PACE Senior Care Partners |
$23.94
|
| Rate for Payer: PACE SWMI |
$25.20
|
| Rate for Payer: PHP Commercial |
$85.70
|
| Rate for Payer: PHP Medicare Advantage |
$25.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.71
|
| Rate for Payer: Priority Health Medicare |
$25.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.17
|
| Rate for Payer: Railroad Medicare Medicare |
$25.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.72
|
| Rate for Payer: UHC Core |
$84.18
|
| Rate for Payer: UHC Exchange |
$25.20
|
| Rate for Payer: UHC Medicaid |
$17.77
|
| Rate for Payer: UHC Medicare Advantage |
$25.20
|
| Rate for Payer: UHCCP Medicaid |
$17.77
|
| Rate for Payer: VA VA |
$25.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.61
|
|
|
HC BDIAL FIBC
|
Facility
|
IP
|
$36.08
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$25.11 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: BCBS Trust/PPO |
$29.80
|
| Rate for Payer: BCN Commercial |
$29.80
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC BDIAL FIBC
|
Facility
|
OP
|
$36.08
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.36 |
| Max. Negotiated Rate |
$32.47 |
| Rate for Payer: Aetna Commercial |
$30.67
|
| Rate for Payer: Aetna Medicare |
$9.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.28
|
| Rate for Payer: BCBS Complete |
$6.68
|
| Rate for Payer: BCBS MAPPO |
$9.02
|
| Rate for Payer: BCBS Trust/PPO |
$29.66
|
| Rate for Payer: BCN Commercial |
$29.66
|
| Rate for Payer: BCN Medicare Advantage |
$9.02
|
| Rate for Payer: Cash Price |
$28.86
|
| Rate for Payer: Cofinity Commercial |
$31.03
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.02
|
| Rate for Payer: Healthscope Commercial |
$32.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.06
|
| Rate for Payer: Mclaren Medicaid |
$6.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.47
|
| Rate for Payer: Meridian Medicaid |
$6.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.67
|
| Rate for Payer: Nomi Health Commercial |
$29.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$27.06
|
| Rate for Payer: PACE Senior Care Partners |
$8.57
|
| Rate for Payer: PACE SWMI |
$9.02
|
| Rate for Payer: PHP Commercial |
$30.67
|
| Rate for Payer: PHP Medicare Advantage |
$9.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.39
|
| Rate for Payer: Priority Health Medicare |
$9.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.11
|
| Rate for Payer: Railroad Medicare Medicare |
$9.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.75
|
| Rate for Payer: UHC Core |
$30.13
|
| Rate for Payer: UHC Exchange |
$9.02
|
| Rate for Payer: UHC Medicaid |
$6.36
|
| Rate for Payer: UHC Medicare Advantage |
$9.02
|
| Rate for Payer: UHCCP Medicaid |
$6.36
|
| Rate for Payer: VA VA |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.06
|
|
|
HC BDIAL FXIII
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$9.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.21
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$8.97
|
| Rate for Payer: BCBS Trust/PPO |
$29.49
|
| Rate for Payer: BCN Commercial |
$29.49
|
| Rate for Payer: BCN Medicare Advantage |
$8.97
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.97
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.42
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Senior Care Partners |
$8.52
|
| Rate for Payer: PACE SWMI |
$8.97
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$8.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Medicare |
$9.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: UHC Exchange |
$8.97
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.97
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$8.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC BDIAL FXIII
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC BDIAL PTIN
|
Facility
|
IP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$20.68 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: BCBS Trust/PPO |
$24.54
|
| Rate for Payer: BCN Commercial |
$24.54
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.14
|
| Rate for Payer: UHC Core |
$24.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC BDIAL PTIN
|
Facility
|
OP
|
$29.71
|
|
|
Service Code
|
CPT 85610
|
| Hospital Charge Code |
30500095
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.24 |
| Max. Negotiated Rate |
$26.74 |
| Rate for Payer: Aetna Commercial |
$25.25
|
| Rate for Payer: Aetna Medicare |
$7.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.28
|
| Rate for Payer: BCBS Complete |
$5.50
|
| Rate for Payer: BCBS MAPPO |
$7.43
|
| Rate for Payer: BCBS Trust/PPO |
$24.42
|
| Rate for Payer: BCN Commercial |
$24.42
|
| Rate for Payer: BCN Medicare Advantage |
$7.43
|
| Rate for Payer: Cash Price |
$23.77
|
| Rate for Payer: Cofinity Commercial |
$25.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$23.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.43
|
| Rate for Payer: Healthscope Commercial |
$26.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.28
|
| Rate for Payer: Mclaren Medicaid |
$5.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.80
|
| Rate for Payer: Meridian Medicaid |
$5.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.25
|
| Rate for Payer: Nomi Health Commercial |
$24.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.28
|
| Rate for Payer: PACE Senior Care Partners |
$7.06
|
| Rate for Payer: PACE SWMI |
$7.43
|
| Rate for Payer: PHP Commercial |
$25.25
|
| Rate for Payer: PHP Medicare Advantage |
$7.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$25.85
|
| Rate for Payer: Priority Health Medicare |
$7.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.68
|
| Rate for Payer: Railroad Medicare Medicare |
$7.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.14
|
| Rate for Payer: UHC Core |
$24.81
|
| Rate for Payer: UHC Exchange |
$7.43
|
| Rate for Payer: UHC Medicaid |
$5.24
|
| Rate for Payer: UHC Medicare Advantage |
$7.43
|
| Rate for Payer: UHCCP Medicaid |
$5.24
|
| Rate for Payer: VA VA |
$7.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.28
|
|
|
HC BDIAL SFM
|
Facility
|
OP
|
$254.98
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$44.95 |
| Max. Negotiated Rate |
$229.48 |
| Rate for Payer: Aetna Commercial |
$216.73
|
| Rate for Payer: Aetna Medicare |
$66.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.68
|
| Rate for Payer: BCBS Complete |
$47.20
|
| Rate for Payer: BCBS MAPPO |
$63.74
|
| Rate for Payer: BCBS Trust/PPO |
$209.62
|
| Rate for Payer: BCN Commercial |
$209.62
|
| Rate for Payer: BCN Medicare Advantage |
$63.74
|
| Rate for Payer: Cash Price |
$203.98
|
| Rate for Payer: Cofinity Commercial |
$219.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.74
|
| Rate for Payer: Healthscope Commercial |
$229.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.24
|
| Rate for Payer: Mclaren Medicaid |
$44.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.93
|
| Rate for Payer: Meridian Medicaid |
$47.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.73
|
| Rate for Payer: Nomi Health Commercial |
$209.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.24
|
| Rate for Payer: PACE Senior Care Partners |
$60.56
|
| Rate for Payer: PACE SWMI |
$63.74
|
| Rate for Payer: PHP Commercial |
$216.73
|
| Rate for Payer: PHP Medicare Advantage |
$63.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$221.83
|
| Rate for Payer: Priority Health Medicare |
$64.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.47
|
| Rate for Payer: Railroad Medicare Medicare |
$63.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.38
|
| Rate for Payer: UHC Core |
$212.91
|
| Rate for Payer: UHC Exchange |
$63.74
|
| Rate for Payer: UHC Medicaid |
$44.95
|
| Rate for Payer: UHC Medicare Advantage |
$63.74
|
| Rate for Payer: UHCCP Medicaid |
$44.95
|
| Rate for Payer: VA VA |
$63.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.24
|
|
|
HC BDIAL SFM
|
Facility
|
IP
|
$254.98
|
|
|
Service Code
|
CPT 85366
|
| Hospital Charge Code |
30500089
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$177.47 |
| Max. Negotiated Rate |
$229.48 |
| Rate for Payer: Aetna Commercial |
$216.73
|
| Rate for Payer: BCBS Trust/PPO |
$210.59
|
| Rate for Payer: BCN Commercial |
$210.59
|
| Rate for Payer: Cash Price |
$203.98
|
| Rate for Payer: Cofinity Commercial |
$219.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.98
|
| Rate for Payer: Healthscope Commercial |
$229.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.73
|
| Rate for Payer: Nomi Health Commercial |
$209.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.24
|
| Rate for Payer: PHP Commercial |
$216.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$221.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.38
|
| Rate for Payer: UHC Core |
$212.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.24
|
|
|
HC BDIAL TT
|
Facility
|
OP
|
$25.60
|
|
|
Service Code
|
CPT 85670
|
| Hospital Charge Code |
30500087
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$23.04 |
| Rate for Payer: Aetna Commercial |
$21.76
|
| Rate for Payer: Aetna Medicare |
$6.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.00
|
| Rate for Payer: BCBS Complete |
$4.74
|
| Rate for Payer: BCBS MAPPO |
$6.40
|
| Rate for Payer: BCBS Trust/PPO |
$21.05
|
| Rate for Payer: BCN Commercial |
$21.05
|
| Rate for Payer: BCN Medicare Advantage |
$6.40
|
| Rate for Payer: Cash Price |
$20.48
|
| Rate for Payer: Cofinity Commercial |
$22.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.40
|
| Rate for Payer: Healthscope Commercial |
$23.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.20
|
| Rate for Payer: Mclaren Medicaid |
$4.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.72
|
| Rate for Payer: Meridian Medicaid |
$4.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.36
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.76
|
| Rate for Payer: Nomi Health Commercial |
$20.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.20
|
| Rate for Payer: PACE Senior Care Partners |
$6.08
|
| Rate for Payer: PACE SWMI |
$6.40
|
| Rate for Payer: PHP Commercial |
$21.76
|
| Rate for Payer: PHP Medicare Advantage |
$6.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.27
|
| Rate for Payer: Priority Health Medicare |
$6.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.82
|
| Rate for Payer: Railroad Medicare Medicare |
$6.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.53
|
| Rate for Payer: UHC Core |
$21.38
|
| Rate for Payer: UHC Exchange |
$6.40
|
| Rate for Payer: UHC Medicaid |
$4.51
|
| Rate for Payer: UHC Medicare Advantage |
$6.40
|
| Rate for Payer: UHCCP Medicaid |
$4.51
|
| Rate for Payer: VA VA |
$6.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.20
|
|
