|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
OP
|
$180.51
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$162.46 |
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: Aetna Medicare |
$46.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.41
|
| Rate for Payer: BCBS Complete |
$33.41
|
| Rate for Payer: BCBS MAPPO |
$45.13
|
| Rate for Payer: BCBS Trust/PPO |
$148.40
|
| Rate for Payer: BCN Commercial |
$148.40
|
| Rate for Payer: BCN Medicare Advantage |
$45.13
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cofinity Commercial |
$155.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.13
|
| Rate for Payer: Healthscope Commercial |
$162.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.38
|
| Rate for Payer: Mclaren Medicaid |
$31.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.38
|
| Rate for Payer: Meridian Medicaid |
$33.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.43
|
| Rate for Payer: Nomi Health Commercial |
$148.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.38
|
| Rate for Payer: PACE Senior Care Partners |
$42.87
|
| Rate for Payer: PACE SWMI |
$45.13
|
| Rate for Payer: PHP Commercial |
$153.43
|
| Rate for Payer: PHP Medicare Advantage |
$45.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.04
|
| Rate for Payer: Priority Health Medicare |
$45.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.63
|
| Rate for Payer: Railroad Medicare Medicare |
$45.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.85
|
| Rate for Payer: UHC Core |
$150.73
|
| Rate for Payer: UHC Exchange |
$45.13
|
| Rate for Payer: UHC Medicaid |
$31.82
|
| Rate for Payer: UHC Medicare Advantage |
$45.13
|
| Rate for Payer: UHCCP Medicaid |
$31.82
|
| Rate for Payer: VA VA |
$45.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.38
|
|
|
HC BLOOD GAS PKG, CALC O2 SAT
|
Facility
|
IP
|
$180.51
|
|
|
Service Code
|
CPT 82803
|
| Hospital Charge Code |
30100216
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$125.63 |
| Max. Negotiated Rate |
$162.46 |
| Rate for Payer: Aetna Commercial |
$153.43
|
| Rate for Payer: BCBS Trust/PPO |
$149.08
|
| Rate for Payer: BCN Commercial |
$149.08
|
| Rate for Payer: Cash Price |
$144.41
|
| Rate for Payer: Cofinity Commercial |
$155.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.41
|
| Rate for Payer: Healthscope Commercial |
$162.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.43
|
| Rate for Payer: Nomi Health Commercial |
$148.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$135.38
|
| Rate for Payer: PHP Commercial |
$153.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$157.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$125.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.85
|
| Rate for Payer: UHC Core |
$150.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.38
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
OP
|
$191.76
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$172.58 |
| Rate for Payer: Aetna Commercial |
$163.00
|
| Rate for Payer: Aetna Medicare |
$49.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.92
|
| Rate for Payer: BCBS Complete |
$35.49
|
| Rate for Payer: BCBS MAPPO |
$47.94
|
| Rate for Payer: BCBS Trust/PPO |
$157.65
|
| Rate for Payer: BCN Commercial |
$157.65
|
| Rate for Payer: BCN Medicare Advantage |
$47.94
|
| Rate for Payer: Cash Price |
$153.41
|
| Rate for Payer: Cofinity Commercial |
$164.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.94
|
| Rate for Payer: Healthscope Commercial |
$172.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.82
|
| Rate for Payer: Mclaren Medicaid |
$33.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.34
|
| Rate for Payer: Meridian Medicaid |
$35.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.00
|
| Rate for Payer: Nomi Health Commercial |
$157.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.82
|
| Rate for Payer: PACE Senior Care Partners |
$45.54
|
| Rate for Payer: PACE SWMI |
$47.94
|
| Rate for Payer: PHP Commercial |
$163.00
|
| Rate for Payer: PHP Medicare Advantage |
$47.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.83
|
| Rate for Payer: Priority Health Medicare |
$48.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.46
|
| Rate for Payer: Railroad Medicare Medicare |
$47.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.75
|
| Rate for Payer: UHC Core |
$160.12
|
| Rate for Payer: UHC Exchange |
$47.94
|
| Rate for Payer: UHC Medicaid |
$33.81
|
| Rate for Payer: UHC Medicare Advantage |
$47.94
|
| Rate for Payer: UHCCP Medicaid |
$33.81
|
| Rate for Payer: VA VA |
$47.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.82
|
|
|
HC BLOOD GAS PKG & DIRECT O2 SAT
|
Facility
|
IP
|
$191.76
|
|
|
Service Code
|
CPT 82805
|
| Hospital Charge Code |
30100218
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$133.46 |
| Max. Negotiated Rate |
$172.58 |
| Rate for Payer: Aetna Commercial |
$163.00
|
| Rate for Payer: BCBS Trust/PPO |
$158.37
|
| Rate for Payer: BCN Commercial |
$158.37
|
| Rate for Payer: Cash Price |
$153.41
|
| Rate for Payer: Cofinity Commercial |
$164.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.41
|
| Rate for Payer: Healthscope Commercial |
$172.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$143.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.00
|
| Rate for Payer: Nomi Health Commercial |
$157.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$143.82
|
| Rate for Payer: PHP Commercial |
$163.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$166.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$168.75
|
| Rate for Payer: UHC Core |
$160.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$143.82
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
OP
|
$31.92
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.63 |
| Max. Negotiated Rate |
$28.73 |
| Rate for Payer: Aetna Commercial |
$27.13
|
| Rate for Payer: Aetna Medicare |
$8.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.97
|
| Rate for Payer: BCBS Complete |
$5.91
|
| Rate for Payer: BCBS MAPPO |
$7.98
|
| Rate for Payer: BCBS Trust/PPO |
$26.24
|
| Rate for Payer: BCN Commercial |
$26.24
|
| Rate for Payer: BCN Medicare Advantage |
$7.98
|
| Rate for Payer: Cash Price |
$25.54
|
| Rate for Payer: Cofinity Commercial |
$27.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.98
|
| Rate for Payer: Healthscope Commercial |
$28.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.94
|
| Rate for Payer: Mclaren Medicaid |
$5.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.38
|
| Rate for Payer: Meridian Medicaid |
$5.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.18
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.13
|
| Rate for Payer: Nomi Health Commercial |
$26.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.94
|
| Rate for Payer: PACE Senior Care Partners |
$7.58
|
| Rate for Payer: PACE SWMI |
$7.98
|
| Rate for Payer: PHP Commercial |
$27.13
|
| Rate for Payer: PHP Medicare Advantage |
$7.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.77
|
| Rate for Payer: Priority Health Medicare |
$8.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.22
|
| Rate for Payer: Railroad Medicare Medicare |
$7.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.09
|
| Rate for Payer: UHC Core |
$26.65
|
| Rate for Payer: UHC Exchange |
$7.98
|
| Rate for Payer: UHC Medicaid |
$5.63
|
| Rate for Payer: UHC Medicare Advantage |
$7.98
|
| Rate for Payer: UHCCP Medicaid |
$5.63
|
| Rate for Payer: VA VA |
$7.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.94
|
|
|
HC BLOOD,OCLT,FECES IMMUNO SCREEN
|
Facility
|
IP
|
$31.92
|
|
|
Service Code
|
HCPCS G0328
|
| Hospital Charge Code |
30100000
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.22 |
| Max. Negotiated Rate |
$28.73 |
| Rate for Payer: Aetna Commercial |
$27.13
|
| Rate for Payer: BCBS Trust/PPO |
$26.36
|
| Rate for Payer: BCN Commercial |
$26.36
|
| Rate for Payer: Cash Price |
$25.54
|
| Rate for Payer: Cofinity Commercial |
$27.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.54
|
| Rate for Payer: Healthscope Commercial |
$28.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.13
|
| Rate for Payer: Nomi Health Commercial |
$26.17
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.94
|
| Rate for Payer: PHP Commercial |
$27.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.09
|
| Rate for Payer: UHC Core |
$26.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.94
|
|
|
HC BLOOD PATCH
|
Facility
|
IP
|
$1,273.14
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$886.11 |
| Max. Negotiated Rate |
$1,145.83 |
| Rate for Payer: Aetna Commercial |
$1,082.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,051.49
|
| Rate for Payer: BCN Commercial |
$1,051.49
|
| Rate for Payer: Cash Price |
$1,018.51
|
| Rate for Payer: Cofinity Commercial |
$1,094.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,018.51
|
| Rate for Payer: Healthscope Commercial |
$1,145.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$954.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,082.17
|
| Rate for Payer: Nomi Health Commercial |
$1,043.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$954.86
|
| Rate for Payer: PHP Commercial |
$1,082.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,107.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$886.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,120.36
|
| Rate for Payer: UHC Core |
$1,063.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$954.86
|
|
|
HC BLOOD PATCH
|
Facility
|
OP
|
$1,273.14
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
45000033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$224.45 |
| Max. Negotiated Rate |
$1,145.83 |
| Rate for Payer: Aetna Commercial |
$1,082.17
|
| Rate for Payer: Aetna Medicare |
$331.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$397.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$397.86
|
| Rate for Payer: BCBS Complete |
$235.66
|
| Rate for Payer: BCBS MAPPO |
$318.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,046.65
|
| Rate for Payer: BCN Commercial |
$1,046.65
|
| Rate for Payer: BCN Medicare Advantage |
$318.29
|
| Rate for Payer: Cash Price |
$1,018.51
|
| Rate for Payer: Cofinity Commercial |
$1,094.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,018.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.29
|
| Rate for Payer: Healthscope Commercial |
$1,145.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$954.86
|
| Rate for Payer: Mclaren Medicaid |
$224.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.20
|
| Rate for Payer: Meridian Medicaid |
$235.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$350.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,082.17
|
| Rate for Payer: Nomi Health Commercial |
$1,043.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$954.86
|
| Rate for Payer: PACE Senior Care Partners |
$302.37
|
| Rate for Payer: PACE SWMI |
$318.29
|
| Rate for Payer: PHP Commercial |
$1,082.17
|
| Rate for Payer: PHP Medicare Advantage |
$318.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,107.63
|
| Rate for Payer: Priority Health Medicare |
$321.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$886.11
|
| Rate for Payer: Railroad Medicare Medicare |
$318.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,120.36
|
| Rate for Payer: UHC Core |
$1,063.07
|
| Rate for Payer: UHC Exchange |
$318.29
|
| Rate for Payer: UHC Medicaid |
$224.45
|
| Rate for Payer: UHC Medicare Advantage |
$318.29
|
| Rate for Payer: UHCCP Medicaid |
$224.45
|
| Rate for Payer: VA VA |
$318.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$954.86
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
OP
|
$1,273.14
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$224.45 |
| Max. Negotiated Rate |
$1,145.83 |
| Rate for Payer: Aetna Commercial |
$1,082.17
|
| Rate for Payer: Aetna Medicare |
$331.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$397.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$397.86
|
| Rate for Payer: BCBS Complete |
$235.66
|
| Rate for Payer: BCBS MAPPO |
$318.29
|
| Rate for Payer: BCBS Trust/PPO |
$1,046.65
|
| Rate for Payer: BCN Commercial |
$1,046.65
|
| Rate for Payer: BCN Medicare Advantage |
$318.29
|
| Rate for Payer: Cash Price |
$1,018.51
|
| Rate for Payer: Cofinity Commercial |
$1,094.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,018.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$318.29
|
| Rate for Payer: Healthscope Commercial |
$1,145.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$954.86
|
| Rate for Payer: Mclaren Medicaid |
$224.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$334.20
|
| Rate for Payer: Meridian Medicaid |
$235.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$366.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$350.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,082.17
|
| Rate for Payer: Nomi Health Commercial |
$1,043.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$954.86
|
| Rate for Payer: PACE Senior Care Partners |
$302.37
|
| Rate for Payer: PACE SWMI |
$318.29
|
| Rate for Payer: PHP Commercial |
$1,082.17
|
| Rate for Payer: PHP Medicare Advantage |
$318.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$224.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,107.63
|
| Rate for Payer: Priority Health Medicare |
$321.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$886.11
|
| Rate for Payer: Railroad Medicare Medicare |
$318.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,120.36
|
| Rate for Payer: UHC Core |
$1,063.07
|
| Rate for Payer: UHC Exchange |
$318.29
|
| Rate for Payer: UHC Medicaid |
$224.45
|
| Rate for Payer: UHC Medicare Advantage |
$318.29
|
| Rate for Payer: UHCCP Medicaid |
$224.45
|
| Rate for Payer: VA VA |
$318.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$954.86
|
|
|
HC BLOOD PATCH PROCEDURE
|
Facility
|
IP
|
$1,273.14
|
|
|
Service Code
|
CPT 62273
|
| Hospital Charge Code |
36100280
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$886.11 |
| Max. Negotiated Rate |
$1,145.83 |
| Rate for Payer: Aetna Commercial |
$1,082.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,051.49
|
| Rate for Payer: BCN Commercial |
$1,051.49
|
| Rate for Payer: Cash Price |
$1,018.51
|
| Rate for Payer: Cofinity Commercial |
$1,094.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,018.51
|
| Rate for Payer: Healthscope Commercial |
$1,145.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$954.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,082.17
|
| Rate for Payer: Nomi Health Commercial |
$1,043.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$954.86
|
| Rate for Payer: PHP Commercial |
$1,082.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,107.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$886.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,120.36
|
| Rate for Payer: UHC Core |
$1,063.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$954.86
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
IP
|
$23.51
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.36 |
| Max. Negotiated Rate |
$21.16 |
| Rate for Payer: Aetna Commercial |
$19.98
|
| Rate for Payer: BCBS Trust/PPO |
$19.42
|
| Rate for Payer: BCN Commercial |
$19.42
|
| Rate for Payer: Cash Price |
$18.81
|
| Rate for Payer: Cofinity Commercial |
$20.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.81
|
| Rate for Payer: Healthscope Commercial |
$21.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.98
|
| Rate for Payer: Nomi Health Commercial |
$19.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.63
|
| Rate for Payer: PHP Commercial |
$19.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.69
|
| Rate for Payer: UHC Core |
$19.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.63
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
OP
|
$23.51
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.14 |
| Max. Negotiated Rate |
$21.16 |
| Rate for Payer: Aetna Commercial |
$19.98
|
| Rate for Payer: Aetna Medicare |
$6.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.35
|
| Rate for Payer: BCBS Complete |
$4.35
|
| Rate for Payer: BCBS MAPPO |
$5.88
|
| Rate for Payer: BCBS Trust/PPO |
$19.33
|
| Rate for Payer: BCN Commercial |
$19.33
|
| Rate for Payer: BCN Medicare Advantage |
$5.88
|
| Rate for Payer: Cash Price |
$18.81
|
| Rate for Payer: Cofinity Commercial |
$20.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.88
|
| Rate for Payer: Healthscope Commercial |
$21.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.63
|
| Rate for Payer: Mclaren Medicaid |
$4.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.17
|
| Rate for Payer: Meridian Medicaid |
$4.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.98
|
| Rate for Payer: Nomi Health Commercial |
$19.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.63
|
| Rate for Payer: PACE Senior Care Partners |
$5.58
|
| Rate for Payer: PACE SWMI |
$5.88
|
| Rate for Payer: PHP Commercial |
$19.98
|
| Rate for Payer: PHP Medicare Advantage |
$5.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.45
|
| Rate for Payer: Priority Health Medicare |
$5.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.36
|
| Rate for Payer: Railroad Medicare Medicare |
$5.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.69
|
| Rate for Payer: UHC Core |
$19.63
|
| Rate for Payer: UHC Exchange |
$5.88
|
| Rate for Payer: UHC Medicaid |
$4.14
|
| Rate for Payer: UHC Medicare Advantage |
$5.88
|
| Rate for Payer: UHCCP Medicaid |
$4.14
|
| Rate for Payer: VA VA |
$5.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.63
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$176.63 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: BCBS Trust/PPO |
$209.60
|
| Rate for Payer: BCN Commercial |
$209.60
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.74 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: Aetna Medicare |
$65.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.31
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$63.45
|
| Rate for Payer: BCBS Trust/PPO |
$208.63
|
| Rate for Payer: BCN Commercial |
$208.63
|
| Rate for Payer: BCN Medicare Advantage |
$63.45
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.45
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Mclaren Medicaid |
$44.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.62
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Senior Care Partners |
$60.27
|
| Rate for Payer: PACE SWMI |
$63.45
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: PHP Medicare Advantage |
$63.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Medicare |
$64.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: Railroad Medicare Medicare |
$63.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: UHC Exchange |
$63.45
|
| Rate for Payer: UHC Medicaid |
$44.74
|
| Rate for Payer: UHC Medicare Advantage |
$63.45
|
| Rate for Payer: UHCCP Medicaid |
$44.74
|
| Rate for Payer: VA VA |
$63.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
IP
|
$47.36
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$32.96 |
| Max. Negotiated Rate |
$42.62 |
| Rate for Payer: Aetna Commercial |
$40.26
|
| Rate for Payer: BCBS Trust/PPO |
$39.11
|
| Rate for Payer: BCN Commercial |
$39.11
|
| Rate for Payer: Cash Price |
$37.89
|
| Rate for Payer: Cofinity Commercial |
$40.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.89
|
| Rate for Payer: Healthscope Commercial |
$42.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.26
|
| Rate for Payer: Nomi Health Commercial |
$38.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.52
|
| Rate for Payer: PHP Commercial |
$40.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.68
|
| Rate for Payer: UHC Core |
$39.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.52
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
OP
|
$47.36
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$42.62 |
| Rate for Payer: Aetna Commercial |
$40.26
|
| Rate for Payer: Aetna Medicare |
$12.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.80
|
| Rate for Payer: BCBS Complete |
$8.77
|
| Rate for Payer: BCBS MAPPO |
$11.84
|
| Rate for Payer: BCBS Trust/PPO |
$38.93
|
| Rate for Payer: BCN Commercial |
$38.93
|
| Rate for Payer: BCN Medicare Advantage |
$11.84
|
| Rate for Payer: Cash Price |
$37.89
|
| Rate for Payer: Cofinity Commercial |
$40.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.84
|
| Rate for Payer: Healthscope Commercial |
$42.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.52
|
| Rate for Payer: Mclaren Medicaid |
$8.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.43
|
| Rate for Payer: Meridian Medicaid |
$8.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.26
|
| Rate for Payer: Nomi Health Commercial |
$38.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.52
|
| Rate for Payer: PACE Senior Care Partners |
$11.25
|
| Rate for Payer: PACE SWMI |
$11.84
|
| Rate for Payer: PHP Commercial |
$40.26
|
| Rate for Payer: PHP Medicare Advantage |
$11.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.20
|
| Rate for Payer: Priority Health Medicare |
$11.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.96
|
| Rate for Payer: Railroad Medicare Medicare |
$11.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.68
|
| Rate for Payer: UHC Core |
$39.55
|
| Rate for Payer: UHC Exchange |
$11.84
|
| Rate for Payer: UHC Medicaid |
$8.35
|
| Rate for Payer: UHC Medicare Advantage |
$11.84
|
| Rate for Payer: UHCCP Medicaid |
$8.35
|
| Rate for Payer: VA VA |
$11.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.52
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
IP
|
$365.75
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$254.56 |
| Max. Negotiated Rate |
$329.18 |
| Rate for Payer: Aetna Commercial |
$310.89
|
| Rate for Payer: BCBS Trust/PPO |
$302.07
|
| Rate for Payer: BCN Commercial |
$302.07
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cofinity Commercial |
$314.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.60
|
| Rate for Payer: Healthscope Commercial |
$329.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.89
|
| Rate for Payer: Nomi Health Commercial |
$299.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.31
|
| Rate for Payer: PHP Commercial |
$310.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.86
|
| Rate for Payer: UHC Core |
$305.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.31
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
OP
|
$365.75
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$64.48 |
| Max. Negotiated Rate |
$329.18 |
| Rate for Payer: Aetna Commercial |
$310.89
|
| Rate for Payer: Aetna Medicare |
$95.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.30
|
| Rate for Payer: BCBS Complete |
$67.70
|
| Rate for Payer: BCBS MAPPO |
$91.44
|
| Rate for Payer: BCBS Trust/PPO |
$300.68
|
| Rate for Payer: BCN Commercial |
$300.68
|
| Rate for Payer: BCN Medicare Advantage |
$91.44
|
| Rate for Payer: Cash Price |
$292.60
|
| Rate for Payer: Cofinity Commercial |
$314.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.44
|
| Rate for Payer: Healthscope Commercial |
$329.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$274.31
|
| Rate for Payer: Mclaren Medicaid |
$64.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$96.01
|
| Rate for Payer: Meridian Medicaid |
$67.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$105.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$100.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.89
|
| Rate for Payer: Nomi Health Commercial |
$299.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$274.31
|
| Rate for Payer: PACE Senior Care Partners |
$86.87
|
| Rate for Payer: PACE SWMI |
$91.44
|
| Rate for Payer: PHP Commercial |
$310.89
|
| Rate for Payer: PHP Medicare Advantage |
$91.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$64.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$318.20
|
| Rate for Payer: Priority Health Medicare |
$92.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.56
|
| Rate for Payer: Railroad Medicare Medicare |
$91.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.86
|
| Rate for Payer: UHC Core |
$305.40
|
| Rate for Payer: UHC Exchange |
$91.44
|
| Rate for Payer: UHC Medicaid |
$64.48
|
| Rate for Payer: UHC Medicare Advantage |
$91.44
|
| Rate for Payer: UHCCP Medicaid |
$64.48
|
| Rate for Payer: VA VA |
$91.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$274.31
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$306.69
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$54.07 |
| Max. Negotiated Rate |
$276.02 |
| Rate for Payer: Aetna Commercial |
$260.69
|
| Rate for Payer: Aetna Medicare |
$79.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$95.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$95.84
|
| Rate for Payer: BCBS Complete |
$56.77
|
| Rate for Payer: BCBS MAPPO |
$76.67
|
| Rate for Payer: BCBS Trust/PPO |
$252.13
|
| Rate for Payer: BCN Commercial |
$252.13
|
| Rate for Payer: BCN Medicare Advantage |
$76.67
|
| Rate for Payer: Cash Price |
$245.35
|
| Rate for Payer: Cofinity Commercial |
$263.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$76.67
|
| Rate for Payer: Healthscope Commercial |
$276.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.02
|
| Rate for Payer: Mclaren Medicaid |
$54.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$80.51
|
| Rate for Payer: Meridian Medicaid |
$56.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$88.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$84.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.69
|
| Rate for Payer: Nomi Health Commercial |
$251.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.02
|
| Rate for Payer: PACE Senior Care Partners |
$72.84
|
| Rate for Payer: PACE SWMI |
$76.67
|
| Rate for Payer: PHP Commercial |
$260.69
|
| Rate for Payer: PHP Medicare Advantage |
$76.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$266.82
|
| Rate for Payer: Priority Health Medicare |
$77.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.46
|
| Rate for Payer: Railroad Medicare Medicare |
$76.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.89
|
| Rate for Payer: UHC Core |
$256.09
|
| Rate for Payer: UHC Exchange |
$76.67
|
| Rate for Payer: UHC Medicaid |
$54.07
|
| Rate for Payer: UHC Medicare Advantage |
$76.67
|
| Rate for Payer: UHCCP Medicaid |
$54.07
|
| Rate for Payer: VA VA |
$76.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.02
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
IP
|
$306.69
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$213.46 |
| Max. Negotiated Rate |
$276.02 |
| Rate for Payer: Aetna Commercial |
$260.69
|
| Rate for Payer: BCBS Trust/PPO |
$253.30
|
| Rate for Payer: BCN Commercial |
$253.30
|
| Rate for Payer: Cash Price |
$245.35
|
| Rate for Payer: Cofinity Commercial |
$263.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$245.35
|
| Rate for Payer: Healthscope Commercial |
$276.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$230.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$260.69
|
| Rate for Payer: Nomi Health Commercial |
$251.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$230.02
|
| Rate for Payer: PHP Commercial |
$260.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$266.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$213.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$269.89
|
| Rate for Payer: UHC Core |
$256.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$230.02
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
OP
|
$83.31
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$74.98 |
| Rate for Payer: Aetna Commercial |
$70.81
|
| Rate for Payer: Aetna Medicare |
$21.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.03
|
| Rate for Payer: BCBS Complete |
$15.42
|
| Rate for Payer: BCBS MAPPO |
$20.83
|
| Rate for Payer: BCBS Trust/PPO |
$68.49
|
| Rate for Payer: BCN Commercial |
$68.49
|
| Rate for Payer: BCN Medicare Advantage |
$20.83
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cofinity Commercial |
$71.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.83
|
| Rate for Payer: Healthscope Commercial |
$74.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.48
|
| Rate for Payer: Mclaren Medicaid |
$14.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.87
|
| Rate for Payer: Meridian Medicaid |
$15.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.81
|
| Rate for Payer: Nomi Health Commercial |
$68.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.48
|
| Rate for Payer: PACE Senior Care Partners |
$19.79
|
| Rate for Payer: PACE SWMI |
$20.83
|
| Rate for Payer: PHP Commercial |
$70.81
|
| Rate for Payer: PHP Medicare Advantage |
$20.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.48
|
| Rate for Payer: Priority Health Medicare |
$21.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.98
|
| Rate for Payer: Railroad Medicare Medicare |
$20.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.31
|
| Rate for Payer: UHC Core |
$69.56
|
| Rate for Payer: UHC Exchange |
$20.83
|
| Rate for Payer: UHC Medicaid |
$14.69
|
| Rate for Payer: UHC Medicare Advantage |
$20.83
|
| Rate for Payer: UHCCP Medicaid |
$14.69
|
| Rate for Payer: VA VA |
$20.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.48
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
IP
|
$83.31
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$57.98 |
| Max. Negotiated Rate |
$74.98 |
| Rate for Payer: Aetna Commercial |
$70.81
|
| Rate for Payer: BCBS Trust/PPO |
$68.81
|
| Rate for Payer: BCN Commercial |
$68.81
|
| Rate for Payer: Cash Price |
$66.65
|
| Rate for Payer: Cofinity Commercial |
$71.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$66.65
|
| Rate for Payer: Healthscope Commercial |
$74.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$62.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$70.81
|
| Rate for Payer: Nomi Health Commercial |
$68.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$62.48
|
| Rate for Payer: PHP Commercial |
$70.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$72.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$73.31
|
| Rate for Payer: UHC Core |
$69.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$62.48
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$105.72
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$73.58 |
| Max. Negotiated Rate |
$95.15 |
| Rate for Payer: Aetna Commercial |
$89.86
|
| Rate for Payer: BCBS Trust/PPO |
$87.31
|
| Rate for Payer: BCN Commercial |
$87.31
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cofinity Commercial |
$90.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.58
|
| Rate for Payer: Healthscope Commercial |
$95.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.86
|
| Rate for Payer: Nomi Health Commercial |
$86.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.29
|
| Rate for Payer: PHP Commercial |
$89.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.03
|
| Rate for Payer: UHC Core |
$88.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.29
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$105.72
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$18.64 |
| Max. Negotiated Rate |
$95.15 |
| Rate for Payer: Aetna Commercial |
$89.86
|
| Rate for Payer: Aetna Medicare |
$27.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.04
|
| Rate for Payer: BCBS Complete |
$19.57
|
| Rate for Payer: BCBS MAPPO |
$26.43
|
| Rate for Payer: BCBS Trust/PPO |
$86.91
|
| Rate for Payer: BCN Commercial |
$86.91
|
| Rate for Payer: BCN Medicare Advantage |
$26.43
|
| Rate for Payer: Cash Price |
$84.58
|
| Rate for Payer: Cofinity Commercial |
$90.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.43
|
| Rate for Payer: Healthscope Commercial |
$95.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.29
|
| Rate for Payer: Mclaren Medicaid |
$18.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.75
|
| Rate for Payer: Meridian Medicaid |
$19.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$29.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.86
|
| Rate for Payer: Nomi Health Commercial |
$86.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$79.29
|
| Rate for Payer: PACE Senior Care Partners |
$25.11
|
| Rate for Payer: PACE SWMI |
$26.43
|
| Rate for Payer: PHP Commercial |
$89.86
|
| Rate for Payer: PHP Medicare Advantage |
$26.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$91.98
|
| Rate for Payer: Priority Health Medicare |
$26.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.58
|
| Rate for Payer: Railroad Medicare Medicare |
$26.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.03
|
| Rate for Payer: UHC Core |
$88.28
|
| Rate for Payer: UHC Exchange |
$26.43
|
| Rate for Payer: UHC Medicaid |
$18.64
|
| Rate for Payer: UHC Medicare Advantage |
$26.43
|
| Rate for Payer: UHCCP Medicaid |
$18.64
|
| Rate for Payer: VA VA |
$26.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.29
|
|
|
HC BLOOD TYPING RH
|
Facility
|
OP
|
$22.72
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.01 |
| Max. Negotiated Rate |
$20.45 |
| Rate for Payer: Aetna Commercial |
$19.31
|
| Rate for Payer: Aetna Medicare |
$5.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.10
|
| Rate for Payer: BCBS Complete |
$4.21
|
| Rate for Payer: BCBS MAPPO |
$5.68
|
| Rate for Payer: BCBS Trust/PPO |
$18.68
|
| Rate for Payer: BCN Commercial |
$18.68
|
| Rate for Payer: BCN Medicare Advantage |
$5.68
|
| Rate for Payer: Cash Price |
$18.18
|
| Rate for Payer: Cofinity Commercial |
$19.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.68
|
| Rate for Payer: Healthscope Commercial |
$20.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.04
|
| Rate for Payer: Mclaren Medicaid |
$4.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.96
|
| Rate for Payer: Meridian Medicaid |
$4.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.31
|
| Rate for Payer: Nomi Health Commercial |
$18.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.04
|
| Rate for Payer: PACE Senior Care Partners |
$5.40
|
| Rate for Payer: PACE SWMI |
$5.68
|
| Rate for Payer: PHP Commercial |
$19.31
|
| Rate for Payer: PHP Medicare Advantage |
$5.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$19.77
|
| Rate for Payer: Priority Health Medicare |
$5.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.81
|
| Rate for Payer: Railroad Medicare Medicare |
$5.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.99
|
| Rate for Payer: UHC Core |
$18.97
|
| Rate for Payer: UHC Exchange |
$5.68
|
| Rate for Payer: UHC Medicaid |
$4.01
|
| Rate for Payer: UHC Medicare Advantage |
$5.68
|
| Rate for Payer: UHCCP Medicaid |
$4.01
|
| Rate for Payer: VA VA |
$5.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.04
|
|
