|
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
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,560.60
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,086.18 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: BCBS Trust/PPO |
$1,288.90
|
| Rate for Payer: BCN Commercial |
$1,288.90
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.45
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,357.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,086.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.33
|
| Rate for Payer: UHC Core |
$1,303.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,560.60
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$275.13 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,326.51
|
| Rate for Payer: Aetna Medicare |
$405.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$487.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$487.69
|
| Rate for Payer: BCBS Complete |
$288.87
|
| Rate for Payer: BCBS MAPPO |
$390.15
|
| Rate for Payer: BCBS Trust/PPO |
$1,282.97
|
| Rate for Payer: BCN Commercial |
$1,282.97
|
| Rate for Payer: BCN Medicare Advantage |
$390.15
|
| Rate for Payer: Cash Price |
$1,248.48
|
| Rate for Payer: Cofinity Commercial |
$1,342.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,248.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$390.15
|
| Rate for Payer: Healthscope Commercial |
$1,404.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,170.45
|
| Rate for Payer: Mclaren Medicaid |
$275.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$409.66
|
| Rate for Payer: Meridian Medicaid |
$288.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$448.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$429.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,326.51
|
| Rate for Payer: Nomi Health Commercial |
$1,279.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,170.45
|
| Rate for Payer: PACE Senior Care Partners |
$370.64
|
| Rate for Payer: PACE SWMI |
$390.15
|
| Rate for Payer: PHP Commercial |
$1,326.51
|
| Rate for Payer: PHP Medicare Advantage |
$390.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$275.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,357.72
|
| Rate for Payer: Priority Health Medicare |
$394.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,086.18
|
| Rate for Payer: Railroad Medicare Medicare |
$390.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,373.33
|
| Rate for Payer: UHC Core |
$1,303.10
|
| Rate for Payer: UHC Exchange |
$390.15
|
| Rate for Payer: UHC Medicaid |
$275.13
|
| Rate for Payer: UHC Medicare Advantage |
$390.15
|
| Rate for Payer: UHCCP Medicaid |
$275.13
|
| Rate for Payer: VA VA |
$390.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,170.45
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$157.30
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$109.48 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: BCBS Trust/PPO |
$129.91
|
| Rate for Payer: BCN Commercial |
$129.91
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$128.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.42
|
| Rate for Payer: UHC Core |
$131.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.97
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$157.30
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.73 |
| Max. Negotiated Rate |
$141.57 |
| Rate for Payer: Aetna Commercial |
$133.71
|
| Rate for Payer: Aetna Medicare |
$40.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.16
|
| Rate for Payer: BCBS Complete |
$29.12
|
| Rate for Payer: BCBS MAPPO |
$39.33
|
| Rate for Payer: BCBS Trust/PPO |
$129.32
|
| Rate for Payer: BCN Commercial |
$129.32
|
| Rate for Payer: BCN Medicare Advantage |
$39.33
|
| Rate for Payer: Cash Price |
$125.84
|
| Rate for Payer: Cofinity Commercial |
$135.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.33
|
| Rate for Payer: Healthscope Commercial |
$141.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.97
|
| Rate for Payer: Mclaren Medicaid |
$27.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.29
|
| Rate for Payer: Meridian Medicaid |
$29.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.22
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$133.71
|
| Rate for Payer: Nomi Health Commercial |
$128.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$117.97
|
| Rate for Payer: PACE Senior Care Partners |
$37.36
|
| Rate for Payer: PACE SWMI |
$39.33
|
| Rate for Payer: PHP Commercial |
$133.71
|
| Rate for Payer: PHP Medicare Advantage |
$39.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$136.85
|
| Rate for Payer: Priority Health Medicare |
$39.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$109.48
|
| Rate for Payer: Railroad Medicare Medicare |
$39.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.42
|
| Rate for Payer: UHC Core |
$131.35
|
| Rate for Payer: UHC Exchange |
$39.33
|
| Rate for Payer: UHC Medicaid |
$27.73
|
| Rate for Payer: UHC Medicare Advantage |
$39.33
|
| Rate for Payer: UHCCP Medicaid |
$27.73
|
| Rate for Payer: VA VA |
$39.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.97
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,076.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$366.02 |
| Max. Negotiated Rate |
$1,868.53 |
| Rate for Payer: Aetna Commercial |
$1,764.72
|
| Rate for Payer: Aetna Medicare |
$539.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$648.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$648.79
|
| Rate for Payer: BCBS Complete |
$384.29
|
| Rate for Payer: BCBS MAPPO |
$519.03
|
| Rate for Payer: BCBS Trust/PPO |
$1,706.79
|
| Rate for Payer: BCN Commercial |
$1,706.79
|
| Rate for Payer: BCN Medicare Advantage |
$519.03
|
| Rate for Payer: Cash Price |
$1,660.91
|
| Rate for Payer: Cofinity Commercial |
$1,785.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$519.03
|
| Rate for Payer: Healthscope Commercial |
$1,868.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,557.11
|
| Rate for Payer: Mclaren Medicaid |
$366.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$544.99
|
| Rate for Payer: Meridian Medicaid |
$384.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$596.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$570.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.72
|
| Rate for Payer: Nomi Health Commercial |
$1,702.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.11
|
| Rate for Payer: PACE Senior Care Partners |
$493.08
|
| Rate for Payer: PACE SWMI |
$519.03
|
| Rate for Payer: PHP Commercial |
$1,764.72
|
| Rate for Payer: PHP Medicare Advantage |
$519.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$366.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,806.24
|
| Rate for Payer: Priority Health Medicare |
$524.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.99
|
| Rate for Payer: Railroad Medicare Medicare |
$519.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,827.00
|
| Rate for Payer: UHC Core |
$1,733.58
|
| Rate for Payer: UHC Exchange |
$519.03
|
| Rate for Payer: UHC Medicaid |
$366.02
|
| Rate for Payer: UHC Medicare Advantage |
$519.03
|
| Rate for Payer: UHCCP Medicaid |
$366.02
|
| Rate for Payer: VA VA |
$519.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,557.11
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,076.14
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,444.99 |
| Max. Negotiated Rate |
$1,868.53 |
| Rate for Payer: Aetna Commercial |
$1,764.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,714.68
|
| Rate for Payer: BCN Commercial |
$1,714.68
|
| Rate for Payer: Cash Price |
$1,660.91
|
| Rate for Payer: Cofinity Commercial |
$1,785.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,660.91
|
| Rate for Payer: Healthscope Commercial |
$1,868.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,557.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,764.72
|
| Rate for Payer: Nomi Health Commercial |
$1,702.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,557.11
|
| Rate for Payer: PHP Commercial |
$1,764.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,806.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,444.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,827.00
|
| Rate for Payer: UHC Core |
$1,733.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,557.11
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,211.27
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$389.85 |
| Max. Negotiated Rate |
$1,990.14 |
| Rate for Payer: Aetna Commercial |
$1,879.58
|
| Rate for Payer: Aetna Medicare |
$574.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$691.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$691.02
|
| Rate for Payer: BCBS Complete |
$409.31
|
| Rate for Payer: BCBS MAPPO |
$552.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,817.89
|
| Rate for Payer: BCN Commercial |
$1,817.89
|
| Rate for Payer: BCN Medicare Advantage |
$552.82
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cofinity Commercial |
$1,901.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,769.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$552.82
|
| Rate for Payer: Healthscope Commercial |
$1,990.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,658.45
|
| Rate for Payer: Mclaren Medicaid |
$389.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$580.46
|
| Rate for Payer: Meridian Medicaid |
$409.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$635.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$608.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,879.58
|
| Rate for Payer: Nomi Health Commercial |
$1,813.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.45
|
| Rate for Payer: PACE Senior Care Partners |
$525.18
|
| Rate for Payer: PACE SWMI |
$552.82
|
| Rate for Payer: PHP Commercial |
$1,879.58
|
| Rate for Payer: PHP Medicare Advantage |
$552.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$389.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,923.80
|
| Rate for Payer: Priority Health Medicare |
$558.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,539.04
|
| Rate for Payer: Railroad Medicare Medicare |
$552.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,945.92
|
| Rate for Payer: UHC Core |
$1,846.41
|
| Rate for Payer: UHC Exchange |
$552.82
|
| Rate for Payer: UHC Medicaid |
$389.85
|
| Rate for Payer: UHC Medicare Advantage |
$552.82
|
| Rate for Payer: UHCCP Medicaid |
$389.85
|
| Rate for Payer: VA VA |
$552.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,658.45
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,211.27
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,539.04 |
| Max. Negotiated Rate |
$1,990.14 |
| Rate for Payer: Aetna Commercial |
$1,879.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,826.29
|
| Rate for Payer: BCN Commercial |
$1,826.29
|
| Rate for Payer: Cash Price |
$1,769.02
|
| Rate for Payer: Cofinity Commercial |
$1,901.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,769.02
|
| Rate for Payer: Healthscope Commercial |
$1,990.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,658.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,879.58
|
| Rate for Payer: Nomi Health Commercial |
$1,813.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,658.45
|
| Rate for Payer: PHP Commercial |
$1,879.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,923.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,539.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,945.92
|
| Rate for Payer: UHC Core |
$1,846.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,658.45
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
OP
|
$2,105.96
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$371.28 |
| Max. Negotiated Rate |
$1,895.36 |
| Rate for Payer: Aetna Commercial |
$1,790.07
|
| Rate for Payer: Aetna Medicare |
$547.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$658.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$658.11
|
| Rate for Payer: BCBS Complete |
$389.81
|
| Rate for Payer: BCBS MAPPO |
$526.49
|
| Rate for Payer: BCBS Trust/PPO |
$1,731.31
|
| Rate for Payer: BCN Commercial |
$1,731.31
|
| Rate for Payer: BCN Medicare Advantage |
$526.49
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cofinity Commercial |
$1,811.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$526.49
|
| Rate for Payer: Healthscope Commercial |
$1,895.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,579.47
|
| Rate for Payer: Mclaren Medicaid |
$371.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$552.81
|
| Rate for Payer: Meridian Medicaid |
$389.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$605.46
|
| Rate for Payer: Molina Medicare/Medicaid |
$579.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.07
|
| Rate for Payer: Nomi Health Commercial |
$1,726.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,579.47
|
| Rate for Payer: PACE Senior Care Partners |
$500.17
|
| Rate for Payer: PACE SWMI |
$526.49
|
| Rate for Payer: PHP Commercial |
$1,790.07
|
| Rate for Payer: PHP Medicare Advantage |
$526.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$371.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,832.19
|
| Rate for Payer: Priority Health Medicare |
$531.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,465.75
|
| Rate for Payer: Railroad Medicare Medicare |
$526.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,853.24
|
| Rate for Payer: UHC Core |
$1,758.48
|
| Rate for Payer: UHC Exchange |
$526.49
|
| Rate for Payer: UHC Medicaid |
$371.28
|
| Rate for Payer: UHC Medicare Advantage |
$526.49
|
| Rate for Payer: UHCCP Medicaid |
$371.28
|
| Rate for Payer: VA VA |
$526.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,579.47
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,105.96
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,465.75 |
| Max. Negotiated Rate |
$1,895.36 |
| Rate for Payer: Aetna Commercial |
$1,790.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,739.31
|
| Rate for Payer: BCN Commercial |
$1,739.31
|
| Rate for Payer: Cash Price |
$1,684.77
|
| Rate for Payer: Cofinity Commercial |
$1,811.13
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,684.77
|
| Rate for Payer: Healthscope Commercial |
$1,895.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,579.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,790.07
|
| Rate for Payer: Nomi Health Commercial |
$1,726.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,579.47
|
| Rate for Payer: PHP Commercial |
$1,790.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,832.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,465.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,853.24
|
| Rate for Payer: UHC Core |
$1,758.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,579.47
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,550.48
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$449.65 |
| Max. Negotiated Rate |
$2,295.43 |
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: Aetna Medicare |
$663.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$797.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$797.02
|
| Rate for Payer: BCBS Complete |
$472.09
|
| Rate for Payer: BCBS MAPPO |
$637.62
|
| Rate for Payer: BCBS Trust/PPO |
$2,096.75
|
| Rate for Payer: BCN Commercial |
$2,096.75
|
| Rate for Payer: BCN Medicare Advantage |
$637.62
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$637.62
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.86
|
| Rate for Payer: Mclaren Medicaid |
$449.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$669.50
|
| Rate for Payer: Meridian Medicaid |
$472.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$733.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$701.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$2,091.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.86
|
| Rate for Payer: PACE Senior Care Partners |
$605.74
|
| Rate for Payer: PACE SWMI |
$637.62
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: PHP Medicare Advantage |
$637.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$449.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,218.92
|
| Rate for Payer: Priority Health Medicare |
$644.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,775.13
|
| Rate for Payer: Railroad Medicare Medicare |
$637.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,244.42
|
| Rate for Payer: UHC Core |
$2,129.65
|
| Rate for Payer: UHC Exchange |
$637.62
|
| Rate for Payer: UHC Medicaid |
$449.65
|
| Rate for Payer: UHC Medicare Advantage |
$637.62
|
| Rate for Payer: UHCCP Medicaid |
$449.65
|
| Rate for Payer: VA VA |
$637.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.86
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,550.48
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,775.13 |
| Max. Negotiated Rate |
$2,295.43 |
| Rate for Payer: Aetna Commercial |
$2,167.91
|
| Rate for Payer: BCBS Trust/PPO |
$2,106.44
|
| Rate for Payer: BCN Commercial |
$2,106.44
|
| Rate for Payer: Cash Price |
$2,040.38
|
| Rate for Payer: Cofinity Commercial |
$2,193.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,040.38
|
| Rate for Payer: Healthscope Commercial |
$2,295.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,912.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,167.91
|
| Rate for Payer: Nomi Health Commercial |
$2,091.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,912.86
|
| Rate for Payer: PHP Commercial |
$2,167.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,218.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,775.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,244.42
|
| Rate for Payer: UHC Core |
$2,129.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,912.86
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$198.32
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$34.96 |
| Max. Negotiated Rate |
$178.49 |
| Rate for Payer: Aetna Commercial |
$168.57
|
| Rate for Payer: Aetna Medicare |
$51.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.98
|
| Rate for Payer: BCBS Complete |
$36.71
|
| Rate for Payer: BCBS MAPPO |
$49.58
|
| Rate for Payer: BCBS Trust/PPO |
$163.04
|
| Rate for Payer: BCN Commercial |
$163.04
|
| Rate for Payer: BCN Medicare Advantage |
$49.58
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cofinity Commercial |
$170.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.58
|
| Rate for Payer: Healthscope Commercial |
$178.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.74
|
| Rate for Payer: Mclaren Medicaid |
$34.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$52.06
|
| Rate for Payer: Meridian Medicaid |
$36.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$57.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Nomi Health Commercial |
$162.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.74
|
| Rate for Payer: PACE Senior Care Partners |
$47.10
|
| Rate for Payer: PACE SWMI |
$49.58
|
| Rate for Payer: PHP Commercial |
$168.57
|
| Rate for Payer: PHP Medicare Advantage |
$49.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.54
|
| Rate for Payer: Priority Health Medicare |
$50.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.03
|
| Rate for Payer: Railroad Medicare Medicare |
$49.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.52
|
| Rate for Payer: UHC Core |
$165.60
|
| Rate for Payer: UHC Exchange |
$49.58
|
| Rate for Payer: UHC Medicaid |
$34.96
|
| Rate for Payer: UHC Medicare Advantage |
$49.58
|
| Rate for Payer: UHCCP Medicaid |
$34.96
|
| Rate for Payer: VA VA |
$49.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.74
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$198.32
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$138.03 |
| Max. Negotiated Rate |
$178.49 |
| Rate for Payer: Aetna Commercial |
$168.57
|
| Rate for Payer: BCBS Trust/PPO |
$163.79
|
| Rate for Payer: BCN Commercial |
$163.79
|
| Rate for Payer: Cash Price |
$158.66
|
| Rate for Payer: Cofinity Commercial |
$170.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$158.66
|
| Rate for Payer: Healthscope Commercial |
$178.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$168.57
|
| Rate for Payer: Nomi Health Commercial |
$162.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.74
|
| Rate for Payer: PHP Commercial |
$168.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$172.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$174.52
|
| Rate for Payer: UHC Core |
$165.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.74
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$151.13
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$26.64 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: Aetna Medicare |
$39.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.23
|
| Rate for Payer: BCBS Complete |
$27.97
|
| Rate for Payer: BCBS MAPPO |
$37.78
|
| Rate for Payer: BCBS Trust/PPO |
$124.24
|
| Rate for Payer: BCN Commercial |
$124.24
|
| Rate for Payer: BCN Medicare Advantage |
$37.78
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.78
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.35
|
| Rate for Payer: Mclaren Medicaid |
$26.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.67
|
| Rate for Payer: Meridian Medicaid |
$27.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Nomi Health Commercial |
$123.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PACE Senior Care Partners |
$35.89
|
| Rate for Payer: PACE SWMI |
$37.78
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: PHP Medicare Advantage |
$37.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$131.48
|
| Rate for Payer: Priority Health Medicare |
$38.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.19
|
| Rate for Payer: Railroad Medicare Medicare |
$37.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.99
|
| Rate for Payer: UHC Core |
$126.19
|
| Rate for Payer: UHC Exchange |
$37.78
|
| Rate for Payer: UHC Medicaid |
$26.64
|
| Rate for Payer: UHC Medicare Advantage |
$37.78
|
| Rate for Payer: UHCCP Medicaid |
$26.64
|
| Rate for Payer: VA VA |
$37.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.35
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$151.13
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$105.19 |
| Max. Negotiated Rate |
$136.02 |
| Rate for Payer: Aetna Commercial |
$128.46
|
| Rate for Payer: BCBS Trust/PPO |
$124.82
|
| Rate for Payer: BCN Commercial |
$124.82
|
| Rate for Payer: Cash Price |
$120.90
|
| Rate for Payer: Cofinity Commercial |
$129.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.90
|
| Rate for Payer: Healthscope Commercial |
$136.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$128.46
|
| Rate for Payer: Nomi Health Commercial |
$123.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.35
|
| Rate for Payer: PHP Commercial |
$128.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$131.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.99
|
| Rate for Payer: UHC Core |
$126.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.35
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
OP
|
$49.78
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.78 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna Commercial |
$42.31
|
| Rate for Payer: Aetna Medicare |
$12.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.56
|
| Rate for Payer: BCBS Complete |
$9.21
|
| Rate for Payer: BCBS MAPPO |
$12.45
|
| Rate for Payer: BCBS Trust/PPO |
$40.92
|
| Rate for Payer: BCN Commercial |
$40.92
|
| Rate for Payer: BCN Medicare Advantage |
$12.45
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.45
|
| Rate for Payer: Healthscope Commercial |
$44.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.34
|
| Rate for Payer: Mclaren Medicaid |
$8.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.07
|
| Rate for Payer: Meridian Medicaid |
$9.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.31
|
| Rate for Payer: Nomi Health Commercial |
$40.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.34
|
| Rate for Payer: PACE Senior Care Partners |
$11.82
|
| Rate for Payer: PACE SWMI |
$12.45
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: PHP Medicare Advantage |
$12.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.31
|
| Rate for Payer: Priority Health Medicare |
$12.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.65
|
| Rate for Payer: Railroad Medicare Medicare |
$12.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.81
|
| Rate for Payer: UHC Core |
$41.57
|
| Rate for Payer: UHC Exchange |
$12.45
|
| Rate for Payer: UHC Medicaid |
$8.78
|
| Rate for Payer: UHC Medicare Advantage |
$12.45
|
| Rate for Payer: UHCCP Medicaid |
$8.78
|
| Rate for Payer: VA VA |
$12.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.34
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
IP
|
$49.78
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$34.65 |
| Max. Negotiated Rate |
$44.80 |
| Rate for Payer: Aetna Commercial |
$42.31
|
| Rate for Payer: BCBS Trust/PPO |
$41.11
|
| Rate for Payer: BCN Commercial |
$41.11
|
| Rate for Payer: Cash Price |
$39.82
|
| Rate for Payer: Cofinity Commercial |
$42.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.82
|
| Rate for Payer: Healthscope Commercial |
$44.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.31
|
| Rate for Payer: Nomi Health Commercial |
$40.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.34
|
| Rate for Payer: PHP Commercial |
$42.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.81
|
| Rate for Payer: UHC Core |
$41.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.34
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
IP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$18,686.60 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: BCBS Trust/PPO |
$22,174.23
|
| Rate for Payer: BCN Commercial |
$22,174.23
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,136.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Nomi Health Commercial |
$22,015.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23,358.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,686.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,626.73
|
| Rate for Payer: UHC Core |
$22,418.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,136.42
|
|
|
HC BOSTON SCI CRT ICD
|
Facility
|
OP
|
$26,848.56
|
|
|
Service Code
|
HCPCS C1882
|
| Hospital Charge Code |
27500003
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$4,733.40 |
| Max. Negotiated Rate |
$24,163.70 |
| Rate for Payer: Aetna Commercial |
$22,821.28
|
| Rate for Payer: Aetna Medicare |
$6,980.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8,390.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8,390.17
|
| Rate for Payer: BCBS Complete |
$4,969.67
|
| Rate for Payer: BCBS MAPPO |
$6,712.14
|
| Rate for Payer: BCBS Trust/PPO |
$22,072.20
|
| Rate for Payer: BCN Commercial |
$22,072.20
|
| Rate for Payer: BCN Medicare Advantage |
$6,712.14
|
| Rate for Payer: Cash Price |
$21,478.85
|
| Rate for Payer: Cofinity Commercial |
$23,089.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21,478.85
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6,712.14
|
| Rate for Payer: Healthscope Commercial |
$24,163.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20,136.42
|
| Rate for Payer: Mclaren Medicaid |
$4,733.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7,047.75
|
| Rate for Payer: Meridian Medicaid |
$4,969.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7,718.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$7,383.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22,821.28
|
| Rate for Payer: Nomi Health Commercial |
$22,015.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20,136.42
|
| Rate for Payer: PACE Senior Care Partners |
$6,376.53
|
| Rate for Payer: PACE SWMI |
$6,712.14
|
| Rate for Payer: PHP Commercial |
$22,821.28
|
| Rate for Payer: PHP Medicare Advantage |
$6,712.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,733.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23,358.25
|
| Rate for Payer: Priority Health Medicare |
$6,779.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18,686.60
|
| Rate for Payer: Railroad Medicare Medicare |
$6,712.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23,626.73
|
| Rate for Payer: UHC Core |
$22,418.55
|
| Rate for Payer: UHC Exchange |
$6,712.14
|
| Rate for Payer: UHC Medicaid |
$4,733.40
|
| Rate for Payer: UHC Medicare Advantage |
$6,712.14
|
| Rate for Payer: UHCCP Medicaid |
$4,733.40
|
| Rate for Payer: VA VA |
$6,712.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20,136.42
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
OP
|
$7,024.55
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,238.43 |
| Max. Negotiated Rate |
$6,322.10 |
| Rate for Payer: Aetna Commercial |
$5,970.87
|
| Rate for Payer: Aetna Medicare |
$1,826.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,195.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,195.17
|
| Rate for Payer: BCBS Complete |
$1,300.24
|
| Rate for Payer: BCBS MAPPO |
$1,756.14
|
| Rate for Payer: BCBS Trust/PPO |
$5,774.88
|
| Rate for Payer: BCN Commercial |
$5,774.88
|
| Rate for Payer: BCN Medicare Advantage |
$1,756.14
|
| Rate for Payer: Cash Price |
$5,619.64
|
| Rate for Payer: Cofinity Commercial |
$6,041.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,619.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,756.14
|
| Rate for Payer: Healthscope Commercial |
$6,322.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,268.41
|
| Rate for Payer: Mclaren Medicaid |
$1,238.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,843.94
|
| Rate for Payer: Meridian Medicaid |
$1,300.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,019.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,931.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,970.87
|
| Rate for Payer: Nomi Health Commercial |
$5,760.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,268.41
|
| Rate for Payer: PACE Senior Care Partners |
$1,668.33
|
| Rate for Payer: PACE SWMI |
$1,756.14
|
| Rate for Payer: PHP Commercial |
$5,970.87
|
| Rate for Payer: PHP Medicare Advantage |
$1,756.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,238.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,111.36
|
| Rate for Payer: Priority Health Medicare |
$1,773.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,889.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,756.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,181.60
|
| Rate for Payer: UHC Core |
$5,865.50
|
| Rate for Payer: UHC Exchange |
$1,756.14
|
| Rate for Payer: UHC Medicaid |
$1,238.43
|
| Rate for Payer: UHC Medicare Advantage |
$1,756.14
|
| Rate for Payer: UHCCP Medicaid |
$1,238.43
|
| Rate for Payer: VA VA |
$1,756.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,268.41
|
|
|
HC BOSTON SCI CRT LEAD
|
Facility
|
IP
|
$7,024.55
|
|
|
Service Code
|
HCPCS C1900
|
| Hospital Charge Code |
27800076
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$4,889.09 |
| Max. Negotiated Rate |
$6,322.10 |
| Rate for Payer: Aetna Commercial |
$5,970.87
|
| Rate for Payer: BCBS Trust/PPO |
$5,801.58
|
| Rate for Payer: BCN Commercial |
$5,801.58
|
| Rate for Payer: Cash Price |
$5,619.64
|
| Rate for Payer: Cofinity Commercial |
$6,041.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,619.64
|
| Rate for Payer: Healthscope Commercial |
$6,322.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,268.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,970.87
|
| Rate for Payer: Nomi Health Commercial |
$5,760.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,268.41
|
| Rate for Payer: PHP Commercial |
$5,970.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$6,111.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,889.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,181.60
|
| Rate for Payer: UHC Core |
$5,865.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,268.41
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
IP
|
$8,744.36
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$6,086.07 |
| Max. Negotiated Rate |
$7,869.92 |
| Rate for Payer: Aetna Commercial |
$7,432.71
|
| Rate for Payer: BCBS Trust/PPO |
$7,221.97
|
| Rate for Payer: BCN Commercial |
$7,221.97
|
| Rate for Payer: Cash Price |
$6,995.49
|
| Rate for Payer: Cofinity Commercial |
$7,520.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,995.49
|
| Rate for Payer: Healthscope Commercial |
$7,869.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,558.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,432.71
|
| Rate for Payer: Nomi Health Commercial |
$7,170.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,558.27
|
| Rate for Payer: PHP Commercial |
$7,432.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,607.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,086.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,695.04
|
| Rate for Payer: UHC Core |
$7,301.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,558.27
|
|
|
HC BOSTON SCI DUAL PACEMAKER
|
Facility
|
OP
|
$8,744.36
|
|
|
Service Code
|
HCPCS C1785
|
| Hospital Charge Code |
27500004
|
|
Hospital Revenue Code
|
275
|
| Min. Negotiated Rate |
$1,541.63 |
| Max. Negotiated Rate |
$7,869.92 |
| Rate for Payer: Aetna Commercial |
$7,432.71
|
| Rate for Payer: Aetna Medicare |
$2,273.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,732.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,732.61
|
| Rate for Payer: BCBS Complete |
$1,618.58
|
| Rate for Payer: BCBS MAPPO |
$2,186.09
|
| Rate for Payer: BCBS Trust/PPO |
$7,188.74
|
| Rate for Payer: BCN Commercial |
$7,188.74
|
| Rate for Payer: BCN Medicare Advantage |
$2,186.09
|
| Rate for Payer: Cash Price |
$6,995.49
|
| Rate for Payer: Cofinity Commercial |
$7,520.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,995.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,186.09
|
| Rate for Payer: Healthscope Commercial |
$7,869.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,558.27
|
| Rate for Payer: Mclaren Medicaid |
$1,541.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,295.39
|
| Rate for Payer: Meridian Medicaid |
$1,618.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,514.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,404.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,432.71
|
| Rate for Payer: Nomi Health Commercial |
$7,170.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,558.27
|
| Rate for Payer: PACE Senior Care Partners |
$2,076.79
|
| Rate for Payer: PACE SWMI |
$2,186.09
|
| Rate for Payer: PHP Commercial |
$7,432.71
|
| Rate for Payer: PHP Medicare Advantage |
$2,186.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,541.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,607.59
|
| Rate for Payer: Priority Health Medicare |
$2,207.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,086.07
|
| Rate for Payer: Railroad Medicare Medicare |
$2,186.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,695.04
|
| Rate for Payer: UHC Core |
$7,301.54
|
| Rate for Payer: UHC Exchange |
$2,186.09
|
| Rate for Payer: UHC Medicaid |
$1,541.63
|
| Rate for Payer: UHC Medicare Advantage |
$2,186.09
|
| Rate for Payer: UHCCP Medicaid |
$1,541.63
|
| Rate for Payer: VA VA |
$2,186.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,558.27
|
|
