|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
IP
|
$174.79
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$121.65 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: BCBS Trust/PPO |
$144.36
|
| Rate for Payer: BCN Commercial |
$144.36
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.09
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$152.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.82
|
| Rate for Payer: UHC Core |
$145.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.09
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$174.79
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.82 |
| Max. Negotiated Rate |
$157.31 |
| Rate for Payer: Aetna Commercial |
$148.57
|
| Rate for Payer: Aetna Medicare |
$45.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$54.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$54.62
|
| Rate for Payer: BCBS Complete |
$32.35
|
| Rate for Payer: BCBS MAPPO |
$43.70
|
| Rate for Payer: BCBS Trust/PPO |
$143.69
|
| Rate for Payer: BCN Commercial |
$143.69
|
| Rate for Payer: BCN Medicare Advantage |
$43.70
|
| Rate for Payer: Cash Price |
$139.83
|
| Rate for Payer: Cofinity Commercial |
$150.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.70
|
| Rate for Payer: Healthscope Commercial |
$157.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$131.09
|
| Rate for Payer: Mclaren Medicaid |
$30.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.88
|
| Rate for Payer: Meridian Medicaid |
$32.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$50.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$48.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$148.57
|
| Rate for Payer: Nomi Health Commercial |
$143.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$131.09
|
| Rate for Payer: PACE Senior Care Partners |
$41.51
|
| Rate for Payer: PACE SWMI |
$43.70
|
| Rate for Payer: PHP Commercial |
$148.57
|
| Rate for Payer: PHP Medicare Advantage |
$43.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$152.07
|
| Rate for Payer: Priority Health Medicare |
$44.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.65
|
| Rate for Payer: Railroad Medicare Medicare |
$43.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.82
|
| Rate for Payer: UHC Core |
$145.95
|
| Rate for Payer: UHC Exchange |
$43.70
|
| Rate for Payer: UHC Medicaid |
$30.82
|
| Rate for Payer: UHC Medicare Advantage |
$43.70
|
| Rate for Payer: UHCCP Medicaid |
$30.82
|
| Rate for Payer: VA VA |
$43.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$131.09
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
OP
|
$94.05
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.58 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: Aetna Medicare |
$24.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.39
|
| Rate for Payer: BCBS Complete |
$17.41
|
| Rate for Payer: BCBS MAPPO |
$23.51
|
| Rate for Payer: BCBS Trust/PPO |
$77.32
|
| Rate for Payer: BCN Commercial |
$77.32
|
| Rate for Payer: BCN Medicare Advantage |
$23.51
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.51
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Mclaren Medicaid |
$16.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.69
|
| Rate for Payer: Meridian Medicaid |
$17.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PACE Senior Care Partners |
$22.34
|
| Rate for Payer: PACE SWMI |
$23.51
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: PHP Medicare Advantage |
$23.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.82
|
| Rate for Payer: Priority Health Medicare |
$23.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.46
|
| Rate for Payer: Railroad Medicare Medicare |
$23.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.76
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: UHC Exchange |
$23.51
|
| Rate for Payer: UHC Medicaid |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$23.51
|
| Rate for Payer: UHCCP Medicaid |
$16.58
|
| Rate for Payer: VA VA |
$23.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
IP
|
$94.05
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$65.46 |
| Max. Negotiated Rate |
$84.64 |
| Rate for Payer: Aetna Commercial |
$79.94
|
| Rate for Payer: BCBS Trust/PPO |
$77.68
|
| Rate for Payer: BCN Commercial |
$77.68
|
| Rate for Payer: Cash Price |
$75.24
|
| Rate for Payer: Cofinity Commercial |
$80.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.24
|
| Rate for Payer: Healthscope Commercial |
$84.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$79.94
|
| Rate for Payer: Nomi Health Commercial |
$77.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.54
|
| Rate for Payer: PHP Commercial |
$79.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$81.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$82.76
|
| Rate for Payer: UHC Core |
$78.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.54
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
IP
|
$268.22
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$186.68 |
| Max. Negotiated Rate |
$241.40 |
| Rate for Payer: Aetna Commercial |
$227.99
|
| Rate for Payer: BCBS Trust/PPO |
$221.52
|
| Rate for Payer: BCN Commercial |
$221.52
|
| Rate for Payer: Cash Price |
$214.58
|
| Rate for Payer: Cofinity Commercial |
$230.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.58
|
| Rate for Payer: Healthscope Commercial |
$241.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.99
|
| Rate for Payer: Nomi Health Commercial |
$219.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.16
|
| Rate for Payer: PHP Commercial |
$227.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.03
|
| Rate for Payer: UHC Core |
$223.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.16
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
OP
|
$268.22
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$47.29 |
| Max. Negotiated Rate |
$241.40 |
| Rate for Payer: Aetna Commercial |
$227.99
|
| Rate for Payer: Aetna Medicare |
$69.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.82
|
| Rate for Payer: BCBS Complete |
$49.65
|
| Rate for Payer: BCBS MAPPO |
$67.06
|
| Rate for Payer: BCBS Trust/PPO |
$220.50
|
| Rate for Payer: BCN Commercial |
$220.50
|
| Rate for Payer: BCN Medicare Advantage |
$67.06
|
| Rate for Payer: Cash Price |
$214.58
|
| Rate for Payer: Cofinity Commercial |
$230.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.06
|
| Rate for Payer: Healthscope Commercial |
$241.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.16
|
| Rate for Payer: Mclaren Medicaid |
$47.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.41
|
| Rate for Payer: Meridian Medicaid |
$49.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$73.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.99
|
| Rate for Payer: Nomi Health Commercial |
$219.94
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$201.16
|
| Rate for Payer: PACE Senior Care Partners |
$63.70
|
| Rate for Payer: PACE SWMI |
$67.06
|
| Rate for Payer: PHP Commercial |
$227.99
|
| Rate for Payer: PHP Medicare Advantage |
$67.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$233.35
|
| Rate for Payer: Priority Health Medicare |
$67.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$186.68
|
| Rate for Payer: Railroad Medicare Medicare |
$67.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.03
|
| Rate for Payer: UHC Core |
$223.96
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicaid |
$47.29
|
| Rate for Payer: UHC Medicare Advantage |
$67.06
|
| Rate for Payer: UHCCP Medicaid |
$47.29
|
| Rate for Payer: VA VA |
$67.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.16
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna Medicare |
$38.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.31
|
| Rate for Payer: BCBS Complete |
$27.43
|
| Rate for Payer: BCBS MAPPO |
$37.05
|
| Rate for Payer: BCBS Trust/PPO |
$121.83
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$121.83
|
| Rate for Payer: BCN Medicare Advantage |
$37.05
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Mclaren Medicaid |
$26.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.90
|
| Rate for Payer: Meridian Medicaid |
$27.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.14
|
| Rate for Payer: PACE Senior Care Partners |
$35.20
|
| Rate for Payer: PACE SWMI |
$37.05
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$128.93
|
| Rate for Payer: Priority Health Medicare |
$37.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.14
|
| Rate for Payer: Railroad Medicare Medicare |
$37.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: UHC Exchange |
$37.05
|
| Rate for Payer: UHC Medicaid |
$26.13
|
| Rate for Payer: UHC Medicare Advantage |
$37.05
|
| Rate for Payer: UHCCP Medicaid |
$26.13
|
| Rate for Payer: VA VA |
$37.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$103.14 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: BCBS Trust/PPO |
$122.39
|
| Rate for Payer: BCN Commercial |
$122.39
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.14
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$128.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRIFUGAL HEAD
|
Facility
|
IP
|
$414.48
|
|
| Hospital Charge Code |
27006714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$288.48 |
| Max. Negotiated Rate |
$373.03 |
| Rate for Payer: Aetna Commercial |
$352.31
|
| Rate for Payer: BCBS Trust/PPO |
$342.32
|
| Rate for Payer: BCN Commercial |
$342.32
|
| Rate for Payer: Cash Price |
$331.58
|
| Rate for Payer: Cofinity Commercial |
$356.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.58
|
| Rate for Payer: Healthscope Commercial |
$373.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.31
|
| Rate for Payer: Nomi Health Commercial |
$339.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.86
|
| Rate for Payer: PHP Commercial |
$352.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$360.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.74
|
| Rate for Payer: UHC Core |
$346.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.86
|
|
|
HC CENTRIFUGAL HEAD
|
Facility
|
OP
|
$414.48
|
|
| Hospital Charge Code |
27006714
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.07 |
| Max. Negotiated Rate |
$373.03 |
| Rate for Payer: Aetna Commercial |
$352.31
|
| Rate for Payer: Aetna Medicare |
$107.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$129.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$129.53
|
| Rate for Payer: BCBS Complete |
$76.72
|
| Rate for Payer: BCBS MAPPO |
$103.62
|
| Rate for Payer: BCBS Trust/PPO |
$340.74
|
| Rate for Payer: BCN Commercial |
$340.74
|
| Rate for Payer: BCN Medicare Advantage |
$103.62
|
| Rate for Payer: Cash Price |
$331.58
|
| Rate for Payer: Cofinity Commercial |
$356.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$331.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.62
|
| Rate for Payer: Healthscope Commercial |
$373.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$310.86
|
| Rate for Payer: Mclaren Medicaid |
$73.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.80
|
| Rate for Payer: Meridian Medicaid |
$76.72
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$113.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$352.31
|
| Rate for Payer: Nomi Health Commercial |
$339.87
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$310.86
|
| Rate for Payer: PACE Senior Care Partners |
$98.44
|
| Rate for Payer: PACE SWMI |
$103.62
|
| Rate for Payer: PHP Commercial |
$352.31
|
| Rate for Payer: PHP Medicare Advantage |
$103.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$360.60
|
| Rate for Payer: Priority Health Medicare |
$104.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$288.48
|
| Rate for Payer: Railroad Medicare Medicare |
$103.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$364.74
|
| Rate for Payer: UHC Core |
$346.09
|
| Rate for Payer: UHC Exchange |
$103.62
|
| Rate for Payer: UHC Medicaid |
$73.07
|
| Rate for Payer: UHC Medicare Advantage |
$103.62
|
| Rate for Payer: UHCCP Medicaid |
$73.07
|
| Rate for Payer: VA VA |
$103.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$310.86
|
|
|
HC CENTROMERE AB
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC CENTROMERE AB
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$9.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.21
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$8.97
|
| Rate for Payer: BCBS Trust/PPO |
$29.49
|
| Rate for Payer: BCN Commercial |
$29.49
|
| Rate for Payer: BCN Medicare Advantage |
$8.97
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.97
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.42
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Senior Care Partners |
$8.52
|
| Rate for Payer: PACE SWMI |
$8.97
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$8.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Medicare |
$9.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: UHC Exchange |
$8.97
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.97
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$8.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
IP
|
$254.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$177.41 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: BCBS Trust/PPO |
$210.52
|
| Rate for Payer: BCN Commercial |
$210.52
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
OP
|
$254.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$44.94 |
| Max. Negotiated Rate |
$229.41 |
| Rate for Payer: Aetna Commercial |
$216.66
|
| Rate for Payer: Aetna Medicare |
$66.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.66
|
| Rate for Payer: BCBS Complete |
$47.18
|
| Rate for Payer: BCBS MAPPO |
$63.73
|
| Rate for Payer: BCBS Trust/PPO |
$209.55
|
| Rate for Payer: BCN Commercial |
$209.55
|
| Rate for Payer: BCN Medicare Advantage |
$63.73
|
| Rate for Payer: Cash Price |
$203.92
|
| Rate for Payer: Cofinity Commercial |
$219.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.73
|
| Rate for Payer: Healthscope Commercial |
$229.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.18
|
| Rate for Payer: Mclaren Medicaid |
$44.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.91
|
| Rate for Payer: Meridian Medicaid |
$47.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$70.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.66
|
| Rate for Payer: Nomi Health Commercial |
$209.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$191.18
|
| Rate for Payer: PACE Senior Care Partners |
$60.54
|
| Rate for Payer: PACE SWMI |
$63.73
|
| Rate for Payer: PHP Commercial |
$216.66
|
| Rate for Payer: PHP Medicare Advantage |
$63.73
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$221.76
|
| Rate for Payer: Priority Health Medicare |
$64.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$177.41
|
| Rate for Payer: Railroad Medicare Medicare |
$63.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.31
|
| Rate for Payer: UHC Core |
$212.84
|
| Rate for Payer: UHC Exchange |
$63.73
|
| Rate for Payer: UHC Medicaid |
$44.94
|
| Rate for Payer: UHC Medicare Advantage |
$63.73
|
| Rate for Payer: UHCCP Medicaid |
$44.94
|
| Rate for Payer: VA VA |
$63.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.18
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
OP
|
$4,218.68
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$743.75 |
| Max. Negotiated Rate |
$3,796.81 |
| Rate for Payer: Aetna Commercial |
$3,585.88
|
| Rate for Payer: Aetna Medicare |
$1,096.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,318.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,318.34
|
| Rate for Payer: BCBS Complete |
$780.88
|
| Rate for Payer: BCBS MAPPO |
$1,054.67
|
| Rate for Payer: BCBS Trust/PPO |
$3,468.18
|
| Rate for Payer: BCN Commercial |
$3,468.18
|
| Rate for Payer: BCN Medicare Advantage |
$1,054.67
|
| Rate for Payer: Cash Price |
$3,374.94
|
| Rate for Payer: Cofinity Commercial |
$3,628.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,374.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,054.67
|
| Rate for Payer: Healthscope Commercial |
$3,796.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,164.01
|
| Rate for Payer: Mclaren Medicaid |
$743.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,107.40
|
| Rate for Payer: Meridian Medicaid |
$780.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,212.87
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,160.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,585.88
|
| Rate for Payer: Nomi Health Commercial |
$3,459.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,164.01
|
| Rate for Payer: PACE Senior Care Partners |
$1,001.94
|
| Rate for Payer: PACE SWMI |
$1,054.67
|
| Rate for Payer: PHP Commercial |
$3,585.88
|
| Rate for Payer: PHP Medicare Advantage |
$1,054.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$743.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,670.25
|
| Rate for Payer: Priority Health Medicare |
$1,065.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,936.20
|
| Rate for Payer: Railroad Medicare Medicare |
$1,054.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,712.44
|
| Rate for Payer: UHC Core |
$3,522.60
|
| Rate for Payer: UHC Exchange |
$1,054.67
|
| Rate for Payer: UHC Medicaid |
$743.75
|
| Rate for Payer: UHC Medicare Advantage |
$1,054.67
|
| Rate for Payer: UHCCP Medicaid |
$743.75
|
| Rate for Payer: VA VA |
$1,054.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,164.01
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
IP
|
$4,218.68
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,936.20 |
| Max. Negotiated Rate |
$3,796.81 |
| Rate for Payer: Aetna Commercial |
$3,585.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,484.21
|
| Rate for Payer: BCN Commercial |
$3,484.21
|
| Rate for Payer: Cash Price |
$3,374.94
|
| Rate for Payer: Cofinity Commercial |
$3,628.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,374.94
|
| Rate for Payer: Healthscope Commercial |
$3,796.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,164.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,585.88
|
| Rate for Payer: Nomi Health Commercial |
$3,459.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3,164.01
|
| Rate for Payer: PHP Commercial |
$3,585.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,670.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,936.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,712.44
|
| Rate for Payer: UHC Core |
$3,522.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,164.01
|
|
|
HC CERETEC PER DOSE
|
Facility
|
OP
|
$2,102.21
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$370.62 |
| Max. Negotiated Rate |
$1,891.99 |
| Rate for Payer: Aetna Commercial |
$1,786.88
|
| Rate for Payer: Aetna Medicare |
$546.57
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$656.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$656.94
|
| Rate for Payer: BCBS Complete |
$389.12
|
| Rate for Payer: BCBS MAPPO |
$525.55
|
| Rate for Payer: BCBS Trust/PPO |
$1,728.23
|
| Rate for Payer: BCN Commercial |
$1,728.23
|
| Rate for Payer: BCN Medicare Advantage |
$525.55
|
| Rate for Payer: Cash Price |
$1,681.77
|
| Rate for Payer: Cofinity Commercial |
$1,807.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,681.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$525.55
|
| Rate for Payer: Healthscope Commercial |
$1,891.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,576.66
|
| Rate for Payer: Mclaren Medicaid |
$370.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$551.83
|
| Rate for Payer: Meridian Medicaid |
$389.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$604.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$578.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,786.88
|
| Rate for Payer: Nomi Health Commercial |
$1,723.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,576.66
|
| Rate for Payer: PACE Senior Care Partners |
$499.27
|
| Rate for Payer: PACE SWMI |
$525.55
|
| Rate for Payer: PHP Commercial |
$1,786.88
|
| Rate for Payer: PHP Medicare Advantage |
$525.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$370.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,828.92
|
| Rate for Payer: Priority Health Medicare |
$530.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,463.14
|
| Rate for Payer: Railroad Medicare Medicare |
$525.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,849.94
|
| Rate for Payer: UHC Core |
$1,755.35
|
| Rate for Payer: UHC Exchange |
$525.55
|
| Rate for Payer: UHC Medicaid |
$370.62
|
| Rate for Payer: UHC Medicare Advantage |
$525.55
|
| Rate for Payer: UHCCP Medicaid |
$370.62
|
| Rate for Payer: VA VA |
$525.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,576.66
|
|
|
HC CERETEC PER DOSE
|
Facility
|
IP
|
$2,102.21
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,463.14 |
| Max. Negotiated Rate |
$1,891.99 |
| Rate for Payer: Aetna Commercial |
$1,786.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,736.22
|
| Rate for Payer: BCN Commercial |
$1,736.22
|
| Rate for Payer: Cash Price |
$1,681.77
|
| Rate for Payer: Cofinity Commercial |
$1,807.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,681.77
|
| Rate for Payer: Healthscope Commercial |
$1,891.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,576.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,786.88
|
| Rate for Payer: Nomi Health Commercial |
$1,723.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,576.66
|
| Rate for Payer: PHP Commercial |
$1,786.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,828.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,463.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,849.94
|
| Rate for Payer: UHC Core |
$1,755.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,576.66
|
|
|
HC CERTOLIZUMAB
|
Facility
|
OP
|
$169.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.90 |
| Max. Negotiated Rate |
$152.63 |
| Rate for Payer: Aetna Commercial |
$144.15
|
| Rate for Payer: Aetna Medicare |
$44.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.00
|
| Rate for Payer: BCBS Complete |
$31.39
|
| Rate for Payer: BCBS MAPPO |
$42.40
|
| Rate for Payer: BCBS Trust/PPO |
$139.42
|
| Rate for Payer: BCN Commercial |
$139.42
|
| Rate for Payer: BCN Medicare Advantage |
$42.40
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.40
|
| Rate for Payer: Healthscope Commercial |
$152.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.19
|
| Rate for Payer: Mclaren Medicaid |
$29.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.52
|
| Rate for Payer: Meridian Medicaid |
$31.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.15
|
| Rate for Payer: Nomi Health Commercial |
$139.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.19
|
| Rate for Payer: PACE Senior Care Partners |
$40.28
|
| Rate for Payer: PACE SWMI |
$42.40
|
| Rate for Payer: PHP Commercial |
$144.15
|
| Rate for Payer: PHP Medicare Advantage |
$42.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$147.54
|
| Rate for Payer: Priority Health Medicare |
$42.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.03
|
| Rate for Payer: Railroad Medicare Medicare |
$42.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.24
|
| Rate for Payer: UHC Core |
$141.61
|
| Rate for Payer: UHC Exchange |
$42.40
|
| Rate for Payer: UHC Medicaid |
$29.90
|
| Rate for Payer: UHC Medicare Advantage |
$42.40
|
| Rate for Payer: UHCCP Medicaid |
$29.90
|
| Rate for Payer: VA VA |
$42.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.19
|
|
|
HC CERTOLIZUMAB
|
Facility
|
IP
|
$169.59
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$118.03 |
| Max. Negotiated Rate |
$152.63 |
| Rate for Payer: Aetna Commercial |
$144.15
|
| Rate for Payer: BCBS Trust/PPO |
$140.06
|
| Rate for Payer: BCN Commercial |
$140.06
|
| Rate for Payer: Cash Price |
$135.67
|
| Rate for Payer: Cofinity Commercial |
$145.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$135.67
|
| Rate for Payer: Healthscope Commercial |
$152.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$127.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$144.15
|
| Rate for Payer: Nomi Health Commercial |
$139.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$127.19
|
| Rate for Payer: PHP Commercial |
$144.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$147.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$118.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$149.24
|
| Rate for Payer: UHC Core |
$141.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$127.19
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
OP
|
$133.17
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$23.48 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: Aetna Medicare |
$34.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$41.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$41.62
|
| Rate for Payer: BCBS Complete |
$24.65
|
| Rate for Payer: BCBS MAPPO |
$33.29
|
| Rate for Payer: BCBS Trust/PPO |
$109.48
|
| Rate for Payer: BCN Commercial |
$109.48
|
| Rate for Payer: BCN Medicare Advantage |
$33.29
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.29
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Mclaren Medicaid |
$23.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.96
|
| Rate for Payer: Meridian Medicaid |
$24.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$36.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$109.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.88
|
| Rate for Payer: PACE Senior Care Partners |
$31.63
|
| Rate for Payer: PACE SWMI |
$33.29
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: PHP Medicare Advantage |
$33.29
|
| Rate for Payer: Priority Health Choice Medicaid |
$23.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$115.86
|
| Rate for Payer: Priority Health Medicare |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.69
|
| Rate for Payer: Railroad Medicare Medicare |
$33.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.19
|
| Rate for Payer: UHC Core |
$111.20
|
| Rate for Payer: UHC Exchange |
$33.29
|
| Rate for Payer: UHC Medicaid |
$23.48
|
| Rate for Payer: UHC Medicare Advantage |
$33.29
|
| Rate for Payer: UHCCP Medicaid |
$23.48
|
| Rate for Payer: VA VA |
$33.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
IP
|
$133.17
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$92.69 |
| Max. Negotiated Rate |
$119.85 |
| Rate for Payer: Aetna Commercial |
$113.19
|
| Rate for Payer: BCBS Trust/PPO |
$109.99
|
| Rate for Payer: BCN Commercial |
$109.99
|
| Rate for Payer: Cash Price |
$106.54
|
| Rate for Payer: Cofinity Commercial |
$114.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$106.54
|
| Rate for Payer: Healthscope Commercial |
$119.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$99.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$113.19
|
| Rate for Payer: Nomi Health Commercial |
$109.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$99.88
|
| Rate for Payer: PHP Commercial |
$113.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$115.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$92.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$117.19
|
| Rate for Payer: UHC Core |
$111.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$99.88
|
|
|
HC CERULOPLASMIN
|
Facility
|
OP
|
$43.51
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.67 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: Aetna Medicare |
$11.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.60
|
| Rate for Payer: BCBS Complete |
$8.05
|
| Rate for Payer: BCBS MAPPO |
$10.88
|
| Rate for Payer: BCBS Trust/PPO |
$35.77
|
| Rate for Payer: BCN Commercial |
$35.77
|
| Rate for Payer: BCN Medicare Advantage |
$10.88
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.88
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Mclaren Medicaid |
$7.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.42
|
| Rate for Payer: Meridian Medicaid |
$8.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$35.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PACE Senior Care Partners |
$10.33
|
| Rate for Payer: PACE SWMI |
$10.88
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: PHP Medicare Advantage |
$10.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.85
|
| Rate for Payer: Priority Health Medicare |
$10.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.28
|
| Rate for Payer: Railroad Medicare Medicare |
$10.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.29
|
| Rate for Payer: UHC Core |
$36.33
|
| Rate for Payer: UHC Exchange |
$10.88
|
| Rate for Payer: UHC Medicaid |
$7.67
|
| Rate for Payer: UHC Medicare Advantage |
$10.88
|
| Rate for Payer: UHCCP Medicaid |
$7.67
|
| Rate for Payer: VA VA |
$10.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC CERULOPLASMIN
|
Facility
|
IP
|
$43.51
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$30.28 |
| Max. Negotiated Rate |
$39.16 |
| Rate for Payer: Aetna Commercial |
$36.98
|
| Rate for Payer: BCBS Trust/PPO |
$35.93
|
| Rate for Payer: BCN Commercial |
$35.93
|
| Rate for Payer: Cash Price |
$34.81
|
| Rate for Payer: Cofinity Commercial |
$37.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.81
|
| Rate for Payer: Healthscope Commercial |
$39.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.98
|
| Rate for Payer: Nomi Health Commercial |
$35.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$32.63
|
| Rate for Payer: PHP Commercial |
$36.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$37.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.29
|
| Rate for Payer: UHC Core |
$36.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.63
|
|
|
HC CERVILENZ
|
Facility
|
IP
|
$174.10
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$121.17 |
| Max. Negotiated Rate |
$156.69 |
| Rate for Payer: Aetna Commercial |
$147.99
|
| Rate for Payer: BCBS Trust/PPO |
$143.79
|
| Rate for Payer: BCN Commercial |
$143.79
|
| Rate for Payer: Cash Price |
$139.28
|
| Rate for Payer: Cofinity Commercial |
$149.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$139.28
|
| Rate for Payer: Healthscope Commercial |
$156.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$130.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$147.99
|
| Rate for Payer: Nomi Health Commercial |
$142.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$130.57
|
| Rate for Payer: PHP Commercial |
$147.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$151.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$121.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$153.21
|
| Rate for Payer: UHC Core |
$145.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$130.57
|
|
