|
HC ACUTE MYELOID LEUKEMIA FISH
|
Facility
|
IP
|
$37.74
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100023
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$24.53 |
| Max. Negotiated Rate |
$33.97 |
| Rate for Payer: Aetna Commercial |
$32.08
|
| Rate for Payer: BCBS Trust/PPO |
$30.81
|
| Rate for Payer: BCN Commercial |
$29.17
|
| Rate for Payer: Cash Price |
$30.19
|
| Rate for Payer: Cofinity Commercial |
$32.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.19
|
| Rate for Payer: Healthscope Commercial |
$33.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.08
|
| Rate for Payer: Nomi Health Commercial |
$30.95
|
| Rate for Payer: PHP Commercial |
$32.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.53
|
| Rate for Payer: Priority Health HMO/PPO |
$32.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.21
|
| Rate for Payer: UHC Core |
$31.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.30
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$76.85
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.71
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100024
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$64.25 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$80.68
|
| Rate for Payer: BCN Commercial |
$76.38
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.25
|
| Rate for Payer: Priority Health HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
OP
|
$91.80
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC ACUTE MYELOID LEUKEMIA FISH CMPT2
|
Facility
|
IP
|
$91.80
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31100026
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
IP
|
$785.70
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$510.70 |
| Max. Negotiated Rate |
$707.13 |
| Rate for Payer: Aetna Commercial |
$667.84
|
| Rate for Payer: BCBS Trust/PPO |
$641.37
|
| Rate for Payer: BCN Commercial |
$607.19
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cofinity Commercial |
$675.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.56
|
| Rate for Payer: Healthscope Commercial |
$707.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.84
|
| Rate for Payer: Nomi Health Commercial |
$644.27
|
| Rate for Payer: PHP Commercial |
$667.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.70
|
| Rate for Payer: Priority Health HMO/PPO |
$683.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$691.42
|
| Rate for Payer: UHC Core |
$656.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.28
|
|
|
HC ACUTE RENAL DIALYSIS
|
Facility
|
OP
|
$785.70
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
82000001
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$186.60 |
| Max. Negotiated Rate |
$707.13 |
| Rate for Payer: Aetna Commercial |
$667.84
|
| Rate for Payer: Aetna Medicare |
$204.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$245.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$245.53
|
| Rate for Payer: BCBS Complete |
$520.48
|
| Rate for Payer: BCBS MAPPO |
$196.42
|
| Rate for Payer: BCBS Trust/PPO |
$645.92
|
| Rate for Payer: BCN Commercial |
$610.88
|
| Rate for Payer: BCN Medicare Advantage |
$196.42
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cash Price |
$628.56
|
| Rate for Payer: Cofinity Commercial |
$675.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$628.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.42
|
| Rate for Payer: Healthscope Commercial |
$707.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.28
|
| Rate for Payer: Mclaren Medicaid |
$495.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.25
|
| Rate for Payer: Meridian Medicaid |
$520.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$667.84
|
| Rate for Payer: Nomi Health Commercial |
$644.27
|
| Rate for Payer: PACE Senior Care Partners |
$186.60
|
| Rate for Payer: PACE SWMI |
$196.42
|
| Rate for Payer: PHP Commercial |
$667.84
|
| Rate for Payer: PHP Medicare Advantage |
$196.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$495.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$510.70
|
| Rate for Payer: Priority Health HMO/PPO |
$683.56
|
| Rate for Payer: Priority Health Medicare |
$198.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$526.42
|
| Rate for Payer: Railroad Medicare Medicare |
$196.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$691.42
|
| Rate for Payer: UHC Core |
$656.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$196.42
|
| Rate for Payer: UHC Exchange |
$196.42
|
| Rate for Payer: UHC Medicare Advantage |
$196.42
|
| Rate for Payer: UHCCP Medicaid |
$495.67
|
| Rate for Payer: VA VA |
$196.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.28
|
|
|
HC ACYLCARNITINES
|
Facility
|
IP
|
$76.50
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.72 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: BCBS Trust/PPO |
$62.45
|
| Rate for Payer: BCN Commercial |
$59.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ACYLCARNITINES
|
Facility
|
OP
|
$76.50
|
|
|
Service Code
|
CPT 82017
|
| Hospital Charge Code |
30100070
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.20 |
| Max. Negotiated Rate |
$68.85 |
| Rate for Payer: Aetna Commercial |
$65.02
|
| Rate for Payer: Aetna Medicare |
$19.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.91
|
| Rate for Payer: BCBS Complete |
$12.81
|
| Rate for Payer: BCBS MAPPO |
$19.12
|
| Rate for Payer: BCBS Trust/PPO |
$62.89
|
| Rate for Payer: BCN Commercial |
$59.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.12
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Cofinity Commercial |
$65.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.12
|
| Rate for Payer: Healthscope Commercial |
$68.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.38
|
| Rate for Payer: Mclaren Medicaid |
$12.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.08
|
| Rate for Payer: Meridian Medicaid |
$12.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.02
|
| Rate for Payer: Nomi Health Commercial |
$62.73
|
| Rate for Payer: PACE Senior Care Partners |
$18.17
|
| Rate for Payer: PACE SWMI |
$19.12
|
| Rate for Payer: PHP Commercial |
$65.02
|
| Rate for Payer: PHP Medicare Advantage |
$19.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.72
|
| Rate for Payer: Priority Health HMO/PPO |
$66.56
|
| Rate for Payer: Priority Health Medicare |
$19.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.26
|
| Rate for Payer: Railroad Medicare Medicare |
$19.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.32
|
| Rate for Payer: UHC Core |
$63.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.12
|
| Rate for Payer: UHC Exchange |
$19.12
|
| Rate for Payer: UHC Medicare Advantage |
$19.12
|
| Rate for Payer: UHCCP Medicaid |
$12.20
|
| Rate for Payer: VA VA |
$19.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.38
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
IP
|
$206.04
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$133.93 |
| Max. Negotiated Rate |
$185.44 |
| Rate for Payer: Aetna Commercial |
$175.13
|
| Rate for Payer: BCBS Trust/PPO |
$168.19
|
| Rate for Payer: BCN Commercial |
$159.23
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cofinity Commercial |
$177.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.83
|
| Rate for Payer: Healthscope Commercial |
$185.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.13
|
| Rate for Payer: Nomi Health Commercial |
$168.95
|
| Rate for Payer: PHP Commercial |
$175.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.93
|
| Rate for Payer: Priority Health HMO/PPO |
$179.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.32
|
| Rate for Payer: UHC Core |
$172.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.53
|
|
|
HC ADALIMUMAB AB, S
|
Facility
|
OP
|
$206.04
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100666
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$185.44 |
| Rate for Payer: Aetna Commercial |
$175.13
|
| Rate for Payer: Aetna Medicare |
$53.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$64.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$64.39
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$51.51
|
| Rate for Payer: BCBS Trust/PPO |
$169.39
|
| Rate for Payer: BCN Commercial |
$160.20
|
| Rate for Payer: BCN Medicare Advantage |
$51.51
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cash Price |
$164.83
|
| Rate for Payer: Cofinity Commercial |
$177.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$164.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.51
|
| Rate for Payer: Healthscope Commercial |
$185.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$154.53
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.09
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$175.13
|
| Rate for Payer: Nomi Health Commercial |
$168.95
|
| Rate for Payer: PACE Senior Care Partners |
$48.93
|
| Rate for Payer: PACE SWMI |
$51.51
|
| Rate for Payer: PHP Commercial |
$175.13
|
| Rate for Payer: PHP Medicare Advantage |
$51.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$133.93
|
| Rate for Payer: Priority Health HMO/PPO |
$179.25
|
| Rate for Payer: Priority Health Medicare |
$52.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$138.05
|
| Rate for Payer: Railroad Medicare Medicare |
$51.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$181.32
|
| Rate for Payer: UHC Core |
$172.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.51
|
| Rate for Payer: UHC Exchange |
$51.51
|
| Rate for Payer: UHC Medicare Advantage |
$51.51
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$51.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$154.53
|
|
|
HC ADALIMUMAB, S
|
Facility
|
OP
|
$300.90
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.89 |
| Max. Negotiated Rate |
$270.81 |
| Rate for Payer: Aetna Commercial |
$255.76
|
| Rate for Payer: Aetna Medicare |
$78.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.03
|
| Rate for Payer: BCBS Complete |
$29.28
|
| Rate for Payer: BCBS MAPPO |
$75.22
|
| Rate for Payer: BCBS Trust/PPO |
$247.37
|
| Rate for Payer: BCN Commercial |
$233.95
|
| Rate for Payer: BCN Medicare Advantage |
$75.22
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cofinity Commercial |
$258.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.22
|
| Rate for Payer: Healthscope Commercial |
$270.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.68
|
| Rate for Payer: Mclaren Medicaid |
$27.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.99
|
| Rate for Payer: Meridian Medicaid |
$29.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.76
|
| Rate for Payer: Nomi Health Commercial |
$246.74
|
| Rate for Payer: PACE Senior Care Partners |
$71.46
|
| Rate for Payer: PACE SWMI |
$75.22
|
| Rate for Payer: PHP Commercial |
$255.76
|
| Rate for Payer: PHP Medicare Advantage |
$75.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.58
|
| Rate for Payer: Priority Health HMO/PPO |
$261.78
|
| Rate for Payer: Priority Health Medicare |
$75.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.60
|
| Rate for Payer: Railroad Medicare Medicare |
$75.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.79
|
| Rate for Payer: UHC Core |
$251.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.22
|
| Rate for Payer: UHC Exchange |
$75.22
|
| Rate for Payer: UHC Medicare Advantage |
$75.22
|
| Rate for Payer: UHCCP Medicaid |
$27.89
|
| Rate for Payer: VA VA |
$75.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.68
|
|
|
HC ADALIMUMAB, S
|
Facility
|
IP
|
$300.90
|
|
|
Service Code
|
CPT 80145
|
| Hospital Charge Code |
30100704
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$195.58 |
| Max. Negotiated Rate |
$270.81 |
| Rate for Payer: Aetna Commercial |
$255.76
|
| Rate for Payer: BCBS Trust/PPO |
$245.62
|
| Rate for Payer: BCN Commercial |
$232.54
|
| Rate for Payer: Cash Price |
$240.72
|
| Rate for Payer: Cofinity Commercial |
$258.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.72
|
| Rate for Payer: Healthscope Commercial |
$270.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.76
|
| Rate for Payer: Nomi Health Commercial |
$246.74
|
| Rate for Payer: PHP Commercial |
$255.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.58
|
| Rate for Payer: Priority Health HMO/PPO |
$261.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.79
|
| Rate for Payer: UHC Core |
$251.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.68
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
OP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.31 |
| Max. Negotiated Rate |
$144.68 |
| Rate for Payer: Aetna Commercial |
$136.64
|
| Rate for Payer: Aetna Medicare |
$41.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.23
|
| Rate for Payer: BCBS Complete |
$23.43
|
| Rate for Payer: BCBS MAPPO |
$40.19
|
| Rate for Payer: BCBS Trust/PPO |
$132.15
|
| Rate for Payer: BCN Commercial |
$124.98
|
| Rate for Payer: BCN Medicare Advantage |
$40.19
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$138.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.19
|
| Rate for Payer: Healthscope Commercial |
$144.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.56
|
| Rate for Payer: Mclaren Medicaid |
$22.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.20
|
| Rate for Payer: Meridian Medicaid |
$23.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.82
|
| Rate for Payer: PACE Senior Care Partners |
$38.18
|
| Rate for Payer: PACE SWMI |
$40.19
|
| Rate for Payer: PHP Commercial |
$136.64
|
| Rate for Payer: PHP Medicare Advantage |
$40.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: Priority Health HMO/PPO |
$139.85
|
| Rate for Payer: Priority Health Medicare |
$40.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.70
|
| Rate for Payer: Railroad Medicare Medicare |
$40.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.46
|
| Rate for Payer: UHC Core |
$134.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.19
|
| Rate for Payer: UHC Exchange |
$40.19
|
| Rate for Payer: UHC Medicare Advantage |
$40.19
|
| Rate for Payer: UHCCP Medicaid |
$22.31
|
| Rate for Payer: VA VA |
$40.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.56
|
|
|
HC ADAMTS13 ACTIVITY AND INHIBITOR PROFILE, PLASMA
|
Facility
|
IP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500106
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$104.49 |
| Max. Negotiated Rate |
$144.68 |
| Rate for Payer: Aetna Commercial |
$136.64
|
| Rate for Payer: BCBS Trust/PPO |
$131.22
|
| Rate for Payer: BCN Commercial |
$124.23
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$138.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Healthscope Commercial |
$144.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.82
|
| Rate for Payer: PHP Commercial |
$136.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: Priority Health HMO/PPO |
$139.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.46
|
| Rate for Payer: UHC Core |
$134.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.56
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
IP
|
$180.54
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$117.35 |
| Max. Negotiated Rate |
$162.49 |
| Rate for Payer: Aetna Commercial |
$153.46
|
| Rate for Payer: BCBS Trust/PPO |
$147.37
|
| Rate for Payer: BCN Commercial |
$139.52
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cofinity Commercial |
$155.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.43
|
| Rate for Payer: Healthscope Commercial |
$162.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.46
|
| Rate for Payer: Nomi Health Commercial |
$148.04
|
| Rate for Payer: PHP Commercial |
$153.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.35
|
| Rate for Payer: Priority Health HMO/PPO |
$157.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.88
|
| Rate for Payer: UHC Core |
$150.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.40
|
|
|
HC ADAMTS 13 ANTIBODY
|
Facility
|
OP
|
$180.54
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30000056
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$162.49 |
| Rate for Payer: Aetna Commercial |
$153.46
|
| Rate for Payer: Aetna Medicare |
$46.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$56.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$56.42
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$45.14
|
| Rate for Payer: BCBS Trust/PPO |
$148.42
|
| Rate for Payer: BCN Commercial |
$140.37
|
| Rate for Payer: BCN Medicare Advantage |
$45.14
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cash Price |
$144.43
|
| Rate for Payer: Cofinity Commercial |
$155.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$144.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.14
|
| Rate for Payer: Healthscope Commercial |
$162.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$135.40
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$47.39
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$153.46
|
| Rate for Payer: Nomi Health Commercial |
$148.04
|
| Rate for Payer: PACE Senior Care Partners |
$42.88
|
| Rate for Payer: PACE SWMI |
$45.14
|
| Rate for Payer: PHP Commercial |
$153.46
|
| Rate for Payer: PHP Medicare Advantage |
$45.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$117.35
|
| Rate for Payer: Priority Health HMO/PPO |
$157.07
|
| Rate for Payer: Priority Health Medicare |
$45.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.96
|
| Rate for Payer: Railroad Medicare Medicare |
$45.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$158.88
|
| Rate for Payer: UHC Core |
$150.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.14
|
| Rate for Payer: UHC Exchange |
$45.14
|
| Rate for Payer: UHC Medicare Advantage |
$45.14
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$45.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$135.40
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
IP
|
$151.90
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$98.74 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: BCBS Trust/PPO |
$124.00
|
| Rate for Payer: BCN Commercial |
$117.39
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.74
|
| Rate for Payer: Priority Health HMO/PPO |
$132.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.67
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC ADAMTS 13 INHIBITOR
|
Facility
|
OP
|
$151.90
|
|
|
Service Code
|
CPT 85335
|
| Hospital Charge Code |
30000055
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$9.31 |
| Max. Negotiated Rate |
$136.71 |
| Rate for Payer: Aetna Commercial |
$129.12
|
| Rate for Payer: Aetna Medicare |
$39.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.47
|
| Rate for Payer: BCBS Complete |
$9.77
|
| Rate for Payer: BCBS MAPPO |
$37.98
|
| Rate for Payer: BCBS Trust/PPO |
$124.88
|
| Rate for Payer: BCN Commercial |
$118.10
|
| Rate for Payer: BCN Medicare Advantage |
$37.98
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cash Price |
$121.52
|
| Rate for Payer: Cofinity Commercial |
$130.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.98
|
| Rate for Payer: Healthscope Commercial |
$136.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.92
|
| Rate for Payer: Mclaren Medicaid |
$9.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.87
|
| Rate for Payer: Meridian Medicaid |
$9.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.12
|
| Rate for Payer: Nomi Health Commercial |
$124.56
|
| Rate for Payer: PACE Senior Care Partners |
$36.08
|
| Rate for Payer: PACE SWMI |
$37.98
|
| Rate for Payer: PHP Commercial |
$129.12
|
| Rate for Payer: PHP Medicare Advantage |
$37.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$98.74
|
| Rate for Payer: Priority Health HMO/PPO |
$132.15
|
| Rate for Payer: Priority Health Medicare |
$38.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.77
|
| Rate for Payer: Railroad Medicare Medicare |
$37.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.67
|
| Rate for Payer: UHC Core |
$126.84
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.98
|
| Rate for Payer: UHC Exchange |
$37.98
|
| Rate for Payer: UHC Medicare Advantage |
$37.98
|
| Rate for Payer: UHCCP Medicaid |
$9.31
|
| Rate for Payer: VA VA |
$37.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.92
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
IP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$104.49 |
| Max. Negotiated Rate |
$144.68 |
| Rate for Payer: Aetna Commercial |
$136.64
|
| Rate for Payer: BCBS Trust/PPO |
$131.22
|
| Rate for Payer: BCN Commercial |
$124.23
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$138.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Healthscope Commercial |
$144.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.82
|
| Rate for Payer: PHP Commercial |
$136.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: Priority Health HMO/PPO |
$139.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.46
|
| Rate for Payer: UHC Core |
$134.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.56
|
|
|
HC ADAMTS ACTIVITY AND INHIB PROFILE
|
Facility
|
OP
|
$160.75
|
|
|
Service Code
|
CPT 85397
|
| Hospital Charge Code |
30500103
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.31 |
| Max. Negotiated Rate |
$144.68 |
| Rate for Payer: Aetna Commercial |
$136.64
|
| Rate for Payer: Aetna Medicare |
$41.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.23
|
| Rate for Payer: BCBS Complete |
$23.43
|
| Rate for Payer: BCBS MAPPO |
$40.19
|
| Rate for Payer: BCBS Trust/PPO |
$132.15
|
| Rate for Payer: BCN Commercial |
$124.98
|
| Rate for Payer: BCN Medicare Advantage |
$40.19
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cash Price |
$128.60
|
| Rate for Payer: Cofinity Commercial |
$138.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.19
|
| Rate for Payer: Healthscope Commercial |
$144.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.56
|
| Rate for Payer: Mclaren Medicaid |
$22.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.20
|
| Rate for Payer: Meridian Medicaid |
$23.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.64
|
| Rate for Payer: Nomi Health Commercial |
$131.82
|
| Rate for Payer: PACE Senior Care Partners |
$38.18
|
| Rate for Payer: PACE SWMI |
$40.19
|
| Rate for Payer: PHP Commercial |
$136.64
|
| Rate for Payer: PHP Medicare Advantage |
$40.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.49
|
| Rate for Payer: Priority Health HMO/PPO |
$139.85
|
| Rate for Payer: Priority Health Medicare |
$40.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.70
|
| Rate for Payer: Railroad Medicare Medicare |
$40.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$141.46
|
| Rate for Payer: UHC Core |
$134.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.19
|
| Rate for Payer: UHC Exchange |
$40.19
|
| Rate for Payer: UHC Medicare Advantage |
$40.19
|
| Rate for Payer: UHCCP Medicaid |
$22.31
|
| Rate for Payer: VA VA |
$40.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.56
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
OP
|
$8.86
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.10 |
| Max. Negotiated Rate |
$7.97 |
| Rate for Payer: Aetna Commercial |
$7.53
|
| Rate for Payer: Aetna Medicare |
$2.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2.77
|
| Rate for Payer: BCBS Complete |
$3.54
|
| Rate for Payer: BCBS MAPPO |
$2.22
|
| Rate for Payer: BCBS Trust/PPO |
$7.28
|
| Rate for Payer: BCN Commercial |
$6.89
|
| Rate for Payer: BCN Medicare Advantage |
$2.22
|
| Rate for Payer: Cash Price |
$7.09
|
| Rate for Payer: Cofinity Commercial |
$7.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.22
|
| Rate for Payer: Healthscope Commercial |
$7.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.53
|
| Rate for Payer: Nomi Health Commercial |
$7.27
|
| Rate for Payer: PACE Senior Care Partners |
$2.10
|
| Rate for Payer: PACE SWMI |
$2.22
|
| Rate for Payer: PHP Commercial |
$7.53
|
| Rate for Payer: PHP Medicare Advantage |
$2.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.76
|
| Rate for Payer: Priority Health HMO/PPO |
$7.71
|
| Rate for Payer: Priority Health Medicare |
$2.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.94
|
| Rate for Payer: Railroad Medicare Medicare |
$2.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.80
|
| Rate for Payer: UHC Core |
$7.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.22
|
| Rate for Payer: UHC Exchange |
$2.22
|
| Rate for Payer: UHC Medicare Advantage |
$2.22
|
| Rate for Payer: VA VA |
$2.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.64
|
|
|
HC ADAPT BARRIER RING
|
Facility
|
IP
|
$8.86
|
|
| Hospital Charge Code |
27100020
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$7.97 |
| Rate for Payer: Aetna Commercial |
$7.53
|
| Rate for Payer: BCBS Trust/PPO |
$7.23
|
| Rate for Payer: BCN Commercial |
$6.85
|
| Rate for Payer: Cash Price |
$7.09
|
| Rate for Payer: Cofinity Commercial |
$7.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7.09
|
| Rate for Payer: Healthscope Commercial |
$7.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7.53
|
| Rate for Payer: Nomi Health Commercial |
$7.27
|
| Rate for Payer: PHP Commercial |
$7.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5.76
|
| Rate for Payer: Priority Health HMO/PPO |
$7.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7.80
|
| Rate for Payer: UHC Core |
$7.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6.64
|
|
|
HC ADAPTER PERFUSION STERILE
|
Facility
|
IP
|
$91.80
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC ADAPTER PERFUSION STERILE
|
Facility
|
OP
|
$91.80
|
|
| Hospital Charge Code |
27000677
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
