|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
OP
|
$238.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$214.20 |
| Rate for Payer: Aetna Commercial |
$202.30
|
| Rate for Payer: Aetna Medicare |
$61.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.38
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$59.50
|
| Rate for Payer: BCBS Trust/PPO |
$185.04
|
| Rate for Payer: BCN Commercial |
$185.04
|
| Rate for Payer: BCN Medicare Advantage |
$59.50
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cash Price |
$190.40
|
| Rate for Payer: Cofinity Commercial |
$204.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.50
|
| Rate for Payer: Healthscope Commercial |
$214.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.50
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$62.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$202.30
|
| Rate for Payer: PACE Senior Care Partners |
$56.52
|
| Rate for Payer: PACE SWMI |
$59.50
|
| Rate for Payer: PHP Commercial |
$202.30
|
| Rate for Payer: PHP Medicare Advantage |
$59.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$166.60
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$207.06
|
| Rate for Payer: Priority Health Medicare |
$59.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.16
|
| Rate for Payer: Railroad Medicare Medicare |
$59.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.44
|
| Rate for Payer: UHC Core |
$198.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.50
|
| Rate for Payer: UHC Medicare Advantage |
$61.28
|
| Rate for Payer: VA VA |
$59.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.50
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
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 CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
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 CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$109.70
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.44 |
| Max. Negotiated Rate |
$98.73 |
| Rate for Payer: Aetna Commercial |
$93.24
|
| Rate for Payer: Aetna Medicare |
$28.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.28
|
| Rate for Payer: BCBS Complete |
$15.16
|
| Rate for Payer: BCBS MAPPO |
$27.42
|
| Rate for Payer: BCBS Trust/PPO |
$85.29
|
| Rate for Payer: BCN Commercial |
$85.29
|
| Rate for Payer: BCN Medicare Advantage |
$27.42
|
| Rate for Payer: Cash Price |
$87.76
|
| Rate for Payer: Cash Price |
$87.76
|
| Rate for Payer: Cofinity Commercial |
$94.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.42
|
| Rate for Payer: Healthscope Commercial |
$98.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.28
|
| Rate for Payer: Mclaren Medicaid |
$14.44
|
| Rate for Payer: Meridian Medicaid |
$15.16
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$28.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.24
|
| Rate for Payer: PACE Senior Care Partners |
$26.05
|
| Rate for Payer: PACE SWMI |
$27.42
|
| Rate for Payer: PHP Commercial |
$93.24
|
| Rate for Payer: PHP Medicare Advantage |
$27.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.44
|
| Rate for Payer: Priority Health Medicare |
$27.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.91
|
| Rate for Payer: Railroad Medicare Medicare |
$27.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.54
|
| Rate for Payer: UHC Core |
$91.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.42
|
| Rate for Payer: UHC Medicare Advantage |
$28.25
|
| Rate for Payer: VA VA |
$27.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.28
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$109.70
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$66.91 |
| Max. Negotiated Rate |
$98.73 |
| Rate for Payer: Aetna Commercial |
$93.24
|
| Rate for Payer: BCBS Trust/PPO |
$84.78
|
| Rate for Payer: BCN Commercial |
$84.78
|
| Rate for Payer: Cash Price |
$87.76
|
| Rate for Payer: Cofinity Commercial |
$94.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.76
|
| Rate for Payer: Healthscope Commercial |
$98.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$93.24
|
| Rate for Payer: PHP Commercial |
$93.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$76.79
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$95.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.54
|
| Rate for Payer: UHC Core |
$91.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.28
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$10.62
|
| Rate for Payer: Meridian Medicaid |
$11.15
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$40.80
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: Aetna Medicare |
$10.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.75
|
| Rate for Payer: BCBS Complete |
$13.06
|
| Rate for Payer: BCBS MAPPO |
$10.20
|
| Rate for Payer: BCBS Trust/PPO |
$31.72
|
| Rate for Payer: BCN Commercial |
$31.72
|
| Rate for Payer: BCN Medicare Advantage |
$10.20
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.20
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Mclaren Medicaid |
$12.44
|
| Rate for Payer: Meridian Medicaid |
$13.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$10.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PACE Senior Care Partners |
$9.69
|
| Rate for Payer: PACE SWMI |
$10.20
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: PHP Medicare Advantage |
$10.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Medicare |
$10.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: Railroad Medicare Medicare |
$10.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.20
|
| Rate for Payer: UHC Medicare Advantage |
$10.51
|
| Rate for Payer: VA VA |
$10.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$40.80
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.88 |
| Max. Negotiated Rate |
$36.72 |
| Rate for Payer: Aetna Commercial |
$34.68
|
| Rate for Payer: BCBS Trust/PPO |
$31.53
|
| Rate for Payer: BCN Commercial |
$31.53
|
| Rate for Payer: Cash Price |
$32.64
|
| Rate for Payer: Cofinity Commercial |
$35.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$36.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$34.68
|
| Rate for Payer: PHP Commercial |
$34.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$35.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.90
|
| Rate for Payer: UHC Core |
$34.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.60
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$131.78
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$80.37 |
| Max. Negotiated Rate |
$118.60 |
| Rate for Payer: Aetna Commercial |
$112.01
|
| Rate for Payer: BCBS Trust/PPO |
$101.84
|
| Rate for Payer: BCN Commercial |
$101.84
|
| Rate for Payer: Cash Price |
$105.42
|
| Rate for Payer: Cofinity Commercial |
$113.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.42
|
| Rate for Payer: Healthscope Commercial |
$118.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.01
|
| Rate for Payer: PHP Commercial |
$112.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.97
|
| Rate for Payer: UHC Core |
$110.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.84
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$131.78
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$31.30 |
| Max. Negotiated Rate |
$118.60 |
| Rate for Payer: Aetna Commercial |
$112.01
|
| Rate for Payer: Aetna Medicare |
$34.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.18
|
| Rate for Payer: BCBS Complete |
$37.33
|
| Rate for Payer: BCBS MAPPO |
$32.94
|
| Rate for Payer: BCBS Trust/PPO |
$102.46
|
| Rate for Payer: BCN Commercial |
$102.46
|
| Rate for Payer: BCN Medicare Advantage |
$32.94
|
| Rate for Payer: Cash Price |
$105.42
|
| Rate for Payer: Cash Price |
$105.42
|
| Rate for Payer: Cofinity Commercial |
$113.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$105.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.94
|
| Rate for Payer: Healthscope Commercial |
$118.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.84
|
| Rate for Payer: Mclaren Medicaid |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$37.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$34.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$112.01
|
| Rate for Payer: PACE Senior Care Partners |
$31.30
|
| Rate for Payer: PACE SWMI |
$32.94
|
| Rate for Payer: PHP Commercial |
$112.01
|
| Rate for Payer: PHP Medicare Advantage |
$32.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$92.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$114.65
|
| Rate for Payer: Priority Health Medicare |
$32.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$80.37
|
| Rate for Payer: Railroad Medicare Medicare |
$32.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.97
|
| Rate for Payer: UHC Core |
$110.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.94
|
| Rate for Payer: UHC Medicare Advantage |
$33.93
|
| Rate for Payer: VA VA |
$32.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.84
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
IP
|
$100.40
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$61.23 |
| Max. Negotiated Rate |
$90.36 |
| Rate for Payer: Aetna Commercial |
$85.34
|
| Rate for Payer: BCBS Trust/PPO |
$77.59
|
| Rate for Payer: BCN Commercial |
$77.59
|
| Rate for Payer: Cash Price |
$80.32
|
| Rate for Payer: Cofinity Commercial |
$86.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.32
|
| Rate for Payer: Healthscope Commercial |
$90.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.34
|
| Rate for Payer: PHP Commercial |
$85.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.35
|
| Rate for Payer: UHC Core |
$83.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.30
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
OP
|
$100.40
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$19.53 |
| Max. Negotiated Rate |
$90.36 |
| Rate for Payer: Aetna Commercial |
$85.34
|
| Rate for Payer: Aetna Medicare |
$26.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.38
|
| Rate for Payer: BCBS Complete |
$20.51
|
| Rate for Payer: BCBS MAPPO |
$25.10
|
| Rate for Payer: BCBS Trust/PPO |
$78.06
|
| Rate for Payer: BCN Commercial |
$78.06
|
| Rate for Payer: BCN Medicare Advantage |
$25.10
|
| Rate for Payer: Cash Price |
$80.32
|
| Rate for Payer: Cash Price |
$80.32
|
| Rate for Payer: Cofinity Commercial |
$86.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.10
|
| Rate for Payer: Healthscope Commercial |
$90.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.30
|
| Rate for Payer: Mclaren Medicaid |
$19.53
|
| Rate for Payer: Meridian Medicaid |
$20.51
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$26.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$85.34
|
| Rate for Payer: PACE Senior Care Partners |
$23.84
|
| Rate for Payer: PACE SWMI |
$25.10
|
| Rate for Payer: PHP Commercial |
$85.34
|
| Rate for Payer: PHP Medicare Advantage |
$25.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$87.35
|
| Rate for Payer: Priority Health Medicare |
$25.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.23
|
| Rate for Payer: Railroad Medicare Medicare |
$25.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.35
|
| Rate for Payer: UHC Core |
$83.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.10
|
| Rate for Payer: UHC Medicare Advantage |
$25.85
|
| Rate for Payer: VA VA |
$25.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.30
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
IP
|
$73.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$44.52 |
| Max. Negotiated Rate |
$65.70 |
| Rate for Payer: Aetna Commercial |
$62.05
|
| Rate for Payer: BCBS Trust/PPO |
$56.41
|
| Rate for Payer: BCN Commercial |
$56.41
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$62.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.40
|
| Rate for Payer: Healthscope Commercial |
$65.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.05
|
| Rate for Payer: PHP Commercial |
$62.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.24
|
| Rate for Payer: UHC Core |
$60.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.75
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
OP
|
$73.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.89 |
| Max. Negotiated Rate |
$65.70 |
| Rate for Payer: Aetna Commercial |
$62.05
|
| Rate for Payer: Aetna Medicare |
$18.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.81
|
| Rate for Payer: BCBS Complete |
$9.34
|
| Rate for Payer: BCBS MAPPO |
$18.25
|
| Rate for Payer: BCBS Trust/PPO |
$56.76
|
| Rate for Payer: BCN Commercial |
$56.76
|
| Rate for Payer: BCN Medicare Advantage |
$18.25
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cash Price |
$58.40
|
| Rate for Payer: Cofinity Commercial |
$62.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$58.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.25
|
| Rate for Payer: Healthscope Commercial |
$65.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$54.75
|
| Rate for Payer: Mclaren Medicaid |
$8.89
|
| Rate for Payer: Meridian Medicaid |
$9.34
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$62.05
|
| Rate for Payer: PACE Senior Care Partners |
$17.34
|
| Rate for Payer: PACE SWMI |
$18.25
|
| Rate for Payer: PHP Commercial |
$62.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$63.51
|
| Rate for Payer: Priority Health Medicare |
$18.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.52
|
| Rate for Payer: Railroad Medicare Medicare |
$18.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$64.24
|
| Rate for Payer: UHC Core |
$60.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.25
|
| Rate for Payer: UHC Medicare Advantage |
$18.80
|
| Rate for Payer: VA VA |
$18.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$54.75
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
OP
|
$783.00
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$185.96 |
| Max. Negotiated Rate |
$704.70 |
| Rate for Payer: Aetna Commercial |
$665.55
|
| Rate for Payer: Aetna Medicare |
$203.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$244.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$244.69
|
| Rate for Payer: BCBS Complete |
$481.33
|
| Rate for Payer: BCBS MAPPO |
$195.75
|
| Rate for Payer: BCBS Trust/PPO |
$608.78
|
| Rate for Payer: BCN Commercial |
$608.78
|
| Rate for Payer: BCN Medicare Advantage |
$195.75
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$673.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.75
|
| Rate for Payer: Healthscope Commercial |
$704.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.25
|
| Rate for Payer: Mclaren Medicaid |
$458.41
|
| Rate for Payer: Meridian Medicaid |
$481.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$205.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$665.55
|
| Rate for Payer: PACE Senior Care Partners |
$185.96
|
| Rate for Payer: PACE SWMI |
$195.75
|
| Rate for Payer: PHP Commercial |
$665.55
|
| Rate for Payer: PHP Medicare Advantage |
$195.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$681.21
|
| Rate for Payer: Priority Health Medicare |
$195.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.55
|
| Rate for Payer: Railroad Medicare Medicare |
$195.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.04
|
| Rate for Payer: UHC Core |
$653.80
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.75
|
| Rate for Payer: UHC Medicare Advantage |
$201.62
|
| Rate for Payer: VA VA |
$195.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.25
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
IP
|
$783.00
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$477.55 |
| Max. Negotiated Rate |
$704.70 |
| Rate for Payer: Aetna Commercial |
$665.55
|
| Rate for Payer: BCBS Trust/PPO |
$605.10
|
| Rate for Payer: BCN Commercial |
$605.10
|
| Rate for Payer: Cash Price |
$626.40
|
| Rate for Payer: Cofinity Commercial |
$673.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.40
|
| Rate for Payer: Healthscope Commercial |
$704.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$665.55
|
| Rate for Payer: PHP Commercial |
$665.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$548.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$681.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$477.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.04
|
| Rate for Payer: UHC Core |
$653.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.25
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
OP
|
$855.04
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$203.07 |
| Max. Negotiated Rate |
$769.54 |
| Rate for Payer: Aetna Commercial |
$726.78
|
| Rate for Payer: Aetna Medicare |
$222.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$267.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$267.20
|
| Rate for Payer: BCBS Complete |
$481.33
|
| Rate for Payer: BCBS MAPPO |
$213.76
|
| Rate for Payer: BCBS Trust/PPO |
$664.79
|
| Rate for Payer: BCN Commercial |
$664.79
|
| Rate for Payer: BCN Medicare Advantage |
$213.76
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cofinity Commercial |
$735.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.76
|
| Rate for Payer: Healthscope Commercial |
$769.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.28
|
| Rate for Payer: Mclaren Medicaid |
$458.41
|
| Rate for Payer: Meridian Medicaid |
$481.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$224.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$245.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$726.78
|
| Rate for Payer: PACE Senior Care Partners |
$203.07
|
| Rate for Payer: PACE SWMI |
$213.76
|
| Rate for Payer: PHP Commercial |
$726.78
|
| Rate for Payer: PHP Medicare Advantage |
$213.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$458.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$743.88
|
| Rate for Payer: Priority Health Medicare |
$213.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.49
|
| Rate for Payer: Railroad Medicare Medicare |
$213.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$752.44
|
| Rate for Payer: UHC Core |
$713.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.76
|
| Rate for Payer: UHC Medicare Advantage |
$220.17
|
| Rate for Payer: VA VA |
$213.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.28
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
IP
|
$855.04
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$521.49 |
| Max. Negotiated Rate |
$769.54 |
| Rate for Payer: Aetna Commercial |
$726.78
|
| Rate for Payer: BCBS Trust/PPO |
$660.77
|
| Rate for Payer: BCN Commercial |
$660.77
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cofinity Commercial |
$735.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.03
|
| Rate for Payer: Healthscope Commercial |
$769.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$726.78
|
| Rate for Payer: PHP Commercial |
$726.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$598.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$743.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$752.44
|
| Rate for Payer: UHC Core |
$713.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.28
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
OP
|
$768.06
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$182.41 |
| Max. Negotiated Rate |
$691.25 |
| Rate for Payer: Aetna Commercial |
$652.85
|
| Rate for Payer: Aetna Medicare |
$199.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$240.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$240.02
|
| Rate for Payer: BCBS Complete |
$307.22
|
| Rate for Payer: BCBS MAPPO |
$192.02
|
| Rate for Payer: BCBS Trust/PPO |
$597.17
|
| Rate for Payer: BCN Commercial |
$597.17
|
| Rate for Payer: BCN Medicare Advantage |
$192.02
|
| Rate for Payer: Cash Price |
$614.45
|
| Rate for Payer: Cofinity Commercial |
$660.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$192.02
|
| Rate for Payer: Healthscope Commercial |
$691.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$201.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$220.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$652.85
|
| Rate for Payer: PACE Senior Care Partners |
$182.41
|
| Rate for Payer: PACE SWMI |
$192.02
|
| Rate for Payer: PHP Commercial |
$652.85
|
| Rate for Payer: PHP Medicare Advantage |
$192.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.21
|
| Rate for Payer: Priority Health Medicare |
$192.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.44
|
| Rate for Payer: Railroad Medicare Medicare |
$192.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$675.89
|
| Rate for Payer: UHC Core |
$641.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$192.02
|
| Rate for Payer: UHC Medicare Advantage |
$197.78
|
| Rate for Payer: VA VA |
$192.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.04
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
IP
|
$768.06
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$468.44 |
| Max. Negotiated Rate |
$691.25 |
| Rate for Payer: Aetna Commercial |
$652.85
|
| Rate for Payer: BCBS Trust/PPO |
$593.56
|
| Rate for Payer: BCN Commercial |
$593.56
|
| Rate for Payer: Cash Price |
$614.45
|
| Rate for Payer: Cofinity Commercial |
$660.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$614.45
|
| Rate for Payer: Healthscope Commercial |
$691.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$576.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$652.85
|
| Rate for Payer: PHP Commercial |
$652.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$537.64
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$668.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$468.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$675.89
|
| Rate for Payer: UHC Core |
$641.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$576.04
|
|
|
HC D & C
|
Facility
|
OP
|
$2,001.38
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$475.33 |
| Max. Negotiated Rate |
$1,801.24 |
| Rate for Payer: Aetna Commercial |
$1,701.17
|
| Rate for Payer: Aetna Medicare |
$520.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$625.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$625.43
|
| Rate for Payer: BCBS Complete |
$800.55
|
| Rate for Payer: BCBS MAPPO |
$500.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,556.07
|
| Rate for Payer: BCN Commercial |
$1,556.07
|
| Rate for Payer: BCN Medicare Advantage |
$500.34
|
| Rate for Payer: Cash Price |
$1,601.10
|
| Rate for Payer: Cofinity Commercial |
$1,721.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$500.34
|
| Rate for Payer: Healthscope Commercial |
$1,801.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,501.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$525.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$575.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,701.17
|
| Rate for Payer: PACE Senior Care Partners |
$475.33
|
| Rate for Payer: PACE SWMI |
$500.34
|
| Rate for Payer: PHP Commercial |
$1,701.17
|
| Rate for Payer: PHP Medicare Advantage |
$500.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,741.20
|
| Rate for Payer: Priority Health Medicare |
$500.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,220.64
|
| Rate for Payer: Railroad Medicare Medicare |
$500.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,761.21
|
| Rate for Payer: UHC Core |
$1,671.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$500.34
|
| Rate for Payer: UHC Medicare Advantage |
$515.36
|
| Rate for Payer: VA VA |
$500.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,501.04
|
|
|
HC D & C
|
Facility
|
IP
|
$2,001.38
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,220.64 |
| Max. Negotiated Rate |
$1,801.24 |
| Rate for Payer: Aetna Commercial |
$1,701.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,546.67
|
| Rate for Payer: BCN Commercial |
$1,546.67
|
| Rate for Payer: Cash Price |
$1,601.10
|
| Rate for Payer: Cofinity Commercial |
$1,721.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,601.10
|
| Rate for Payer: Healthscope Commercial |
$1,801.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,501.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$1,701.17
|
| Rate for Payer: PHP Commercial |
$1,701.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,400.97
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$1,741.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,220.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,761.21
|
| Rate for Payer: UHC Core |
$1,671.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,501.04
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
IP
|
$1,030.78
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$628.67 |
| Max. Negotiated Rate |
$927.70 |
| Rate for Payer: Aetna Commercial |
$876.16
|
| Rate for Payer: BCBS Trust/PPO |
$796.59
|
| Rate for Payer: BCN Commercial |
$796.59
|
| Rate for Payer: Cash Price |
$824.62
|
| Rate for Payer: Cofinity Commercial |
$886.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$824.62
|
| Rate for Payer: Healthscope Commercial |
$927.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$876.16
|
| Rate for Payer: PHP Commercial |
$876.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$628.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.09
|
| Rate for Payer: UHC Core |
$860.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.08
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
OP
|
$1,030.78
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$244.81 |
| Max. Negotiated Rate |
$927.70 |
| Rate for Payer: Aetna Commercial |
$876.16
|
| Rate for Payer: Aetna Medicare |
$268.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$322.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$322.12
|
| Rate for Payer: BCBS Complete |
$412.31
|
| Rate for Payer: BCBS MAPPO |
$257.70
|
| Rate for Payer: BCBS Trust/PPO |
$801.43
|
| Rate for Payer: BCN Commercial |
$801.43
|
| Rate for Payer: BCN Medicare Advantage |
$257.70
|
| Rate for Payer: Cash Price |
$824.62
|
| Rate for Payer: Cofinity Commercial |
$886.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$824.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$257.70
|
| Rate for Payer: Healthscope Commercial |
$927.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$773.08
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$270.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$296.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$876.16
|
| Rate for Payer: PACE Senior Care Partners |
$244.81
|
| Rate for Payer: PACE SWMI |
$257.70
|
| Rate for Payer: PHP Commercial |
$876.16
|
| Rate for Payer: PHP Medicare Advantage |
$257.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$721.55
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$896.78
|
| Rate for Payer: Priority Health Medicare |
$257.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$628.67
|
| Rate for Payer: Railroad Medicare Medicare |
$257.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$907.09
|
| Rate for Payer: UHC Core |
$860.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$257.70
|
| Rate for Payer: UHC Medicare Advantage |
$265.43
|
| Rate for Payer: VA VA |
$257.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$773.08
|
|
