|
HC BARRIER ADHESION
|
Facility
|
IP
|
$589.96
|
|
|
Service Code
|
HCPCS C1765
|
| Hospital Charge Code |
27000463
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$383.47 |
| Max. Negotiated Rate |
$530.96 |
| Rate for Payer: Aetna Commercial |
$501.47
|
| Rate for Payer: BCBS Trust/PPO |
$481.58
|
| Rate for Payer: BCN Commercial |
$455.92
|
| Rate for Payer: Cash Price |
$471.97
|
| Rate for Payer: Cofinity Commercial |
$507.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$471.97
|
| Rate for Payer: Healthscope Commercial |
$530.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$442.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$501.47
|
| Rate for Payer: Nomi Health Commercial |
$483.77
|
| Rate for Payer: PHP Commercial |
$501.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$383.47
|
| Rate for Payer: Priority Health HMO/PPO |
$513.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$395.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$519.16
|
| Rate for Payer: UHC Core |
$492.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$442.47
|
|
|
HC BARRX 360 EXPRESS CATH BALLOON
|
Facility
|
IP
|
$5,720.86
|
|
| Hospital Charge Code |
27200286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3,718.56 |
| Max. Negotiated Rate |
$5,148.77 |
| Rate for Payer: Aetna Commercial |
$4,862.73
|
| Rate for Payer: BCBS Trust/PPO |
$4,669.94
|
| Rate for Payer: BCN Commercial |
$4,421.08
|
| Rate for Payer: Cash Price |
$4,576.69
|
| Rate for Payer: Cofinity Commercial |
$4,919.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,576.69
|
| Rate for Payer: Healthscope Commercial |
$5,148.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,290.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,862.73
|
| Rate for Payer: Nomi Health Commercial |
$4,691.11
|
| Rate for Payer: PHP Commercial |
$4,862.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,718.56
|
| Rate for Payer: Priority Health HMO/PPO |
$4,977.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,832.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,034.36
|
| Rate for Payer: UHC Core |
$4,776.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,290.64
|
|
|
HC BARRX 360 EXPRESS CATH BALLOON
|
Facility
|
OP
|
$5,720.86
|
|
| Hospital Charge Code |
27200286
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,358.70 |
| Max. Negotiated Rate |
$5,148.77 |
| Rate for Payer: Aetna Commercial |
$4,862.73
|
| Rate for Payer: Aetna Medicare |
$1,487.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,787.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,787.77
|
| Rate for Payer: BCBS Complete |
$2,288.34
|
| Rate for Payer: BCBS MAPPO |
$1,430.22
|
| Rate for Payer: BCBS Trust/PPO |
$4,703.12
|
| Rate for Payer: BCN Commercial |
$4,447.97
|
| Rate for Payer: BCN Medicare Advantage |
$1,430.22
|
| Rate for Payer: Cash Price |
$4,576.69
|
| Rate for Payer: Cofinity Commercial |
$4,919.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,576.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,430.22
|
| Rate for Payer: Healthscope Commercial |
$5,148.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,290.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,501.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,644.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$4,862.73
|
| Rate for Payer: Nomi Health Commercial |
$4,691.11
|
| Rate for Payer: PACE Senior Care Partners |
$1,358.70
|
| Rate for Payer: PACE SWMI |
$1,430.22
|
| Rate for Payer: PHP Commercial |
$4,862.73
|
| Rate for Payer: PHP Medicare Advantage |
$1,430.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$3,718.56
|
| Rate for Payer: Priority Health HMO/PPO |
$4,977.15
|
| Rate for Payer: Priority Health Medicare |
$1,444.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,832.98
|
| Rate for Payer: Railroad Medicare Medicare |
$1,430.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,034.36
|
| Rate for Payer: UHC Core |
$4,776.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,430.22
|
| Rate for Payer: UHC Exchange |
$1,430.22
|
| Rate for Payer: UHC Medicare Advantage |
$1,430.22
|
| Rate for Payer: VA VA |
$1,430.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,290.64
|
|
|
HC BARRX 90 RFA FOCAL CATHETER
|
Facility
|
IP
|
$4,350.88
|
|
| Hospital Charge Code |
27200287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,828.07 |
| Max. Negotiated Rate |
$3,915.79 |
| Rate for Payer: Aetna Commercial |
$3,698.25
|
| Rate for Payer: BCBS Trust/PPO |
$3,551.62
|
| Rate for Payer: BCN Commercial |
$3,362.36
|
| Rate for Payer: Cash Price |
$3,480.70
|
| Rate for Payer: Cofinity Commercial |
$3,741.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,480.70
|
| Rate for Payer: Healthscope Commercial |
$3,915.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,263.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,698.25
|
| Rate for Payer: Nomi Health Commercial |
$3,567.72
|
| Rate for Payer: PHP Commercial |
$3,698.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,828.07
|
| Rate for Payer: Priority Health HMO/PPO |
$3,785.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,915.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,828.77
|
| Rate for Payer: UHC Core |
$3,632.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,263.16
|
|
|
HC BARRX 90 RFA FOCAL CATHETER
|
Facility
|
OP
|
$4,350.88
|
|
| Hospital Charge Code |
27200287
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,033.33 |
| Max. Negotiated Rate |
$3,915.79 |
| Rate for Payer: Aetna Commercial |
$3,698.25
|
| Rate for Payer: Aetna Medicare |
$1,131.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,359.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,359.65
|
| Rate for Payer: BCBS Complete |
$1,740.35
|
| Rate for Payer: BCBS MAPPO |
$1,087.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,576.86
|
| Rate for Payer: BCN Commercial |
$3,382.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,087.72
|
| Rate for Payer: Cash Price |
$3,480.70
|
| Rate for Payer: Cofinity Commercial |
$3,741.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,480.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,087.72
|
| Rate for Payer: Healthscope Commercial |
$3,915.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,263.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,142.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,250.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,698.25
|
| Rate for Payer: Nomi Health Commercial |
$3,567.72
|
| Rate for Payer: PACE Senior Care Partners |
$1,033.33
|
| Rate for Payer: PACE SWMI |
$1,087.72
|
| Rate for Payer: PHP Commercial |
$3,698.25
|
| Rate for Payer: PHP Medicare Advantage |
$1,087.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,828.07
|
| Rate for Payer: Priority Health HMO/PPO |
$3,785.27
|
| Rate for Payer: Priority Health Medicare |
$1,098.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,915.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,087.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,828.77
|
| Rate for Payer: UHC Core |
$3,632.98
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,087.72
|
| Rate for Payer: UHC Exchange |
$1,087.72
|
| Rate for Payer: UHC Medicare Advantage |
$1,087.72
|
| Rate for Payer: VA VA |
$1,087.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,263.16
|
|
|
HC BARRX RFA
|
Facility
|
OP
|
$2,044.39
|
|
| Hospital Charge Code |
36000101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$485.54 |
| Max. Negotiated Rate |
$1,839.95 |
| Rate for Payer: Aetna Commercial |
$1,737.73
|
| Rate for Payer: Aetna Medicare |
$531.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$638.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$638.87
|
| Rate for Payer: BCBS Complete |
$817.76
|
| Rate for Payer: BCBS MAPPO |
$511.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,680.69
|
| Rate for Payer: BCN Commercial |
$1,589.51
|
| Rate for Payer: BCN Medicare Advantage |
$511.10
|
| Rate for Payer: Cash Price |
$1,635.51
|
| Rate for Payer: Cofinity Commercial |
$1,758.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$511.10
|
| Rate for Payer: Healthscope Commercial |
$1,839.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,533.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$536.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$587.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.73
|
| Rate for Payer: Nomi Health Commercial |
$1,676.40
|
| Rate for Payer: PACE Senior Care Partners |
$485.54
|
| Rate for Payer: PACE SWMI |
$511.10
|
| Rate for Payer: PHP Commercial |
$1,737.73
|
| Rate for Payer: PHP Medicare Advantage |
$511.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,778.62
|
| Rate for Payer: Priority Health Medicare |
$516.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,369.74
|
| Rate for Payer: Railroad Medicare Medicare |
$511.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,799.06
|
| Rate for Payer: UHC Core |
$1,707.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$511.10
|
| Rate for Payer: UHC Exchange |
$511.10
|
| Rate for Payer: UHC Medicare Advantage |
$511.10
|
| Rate for Payer: VA VA |
$511.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,533.29
|
|
|
HC BARRX RFA
|
Facility
|
IP
|
$2,044.39
|
|
| Hospital Charge Code |
36000101
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,328.85 |
| Max. Negotiated Rate |
$1,839.95 |
| Rate for Payer: Aetna Commercial |
$1,737.73
|
| Rate for Payer: BCBS Trust/PPO |
$1,668.84
|
| Rate for Payer: BCN Commercial |
$1,579.90
|
| Rate for Payer: Cash Price |
$1,635.51
|
| Rate for Payer: Cofinity Commercial |
$1,758.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,635.51
|
| Rate for Payer: Healthscope Commercial |
$1,839.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,533.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,737.73
|
| Rate for Payer: Nomi Health Commercial |
$1,676.40
|
| Rate for Payer: PHP Commercial |
$1,737.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,328.85
|
| Rate for Payer: Priority Health HMO/PPO |
$1,778.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,369.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,799.06
|
| Rate for Payer: UHC Core |
$1,707.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,533.29
|
|
|
HC BARRX ULTRA LONG RFA FOCAL CATHETER
|
Facility
|
OP
|
$4,420.13
|
|
| Hospital Charge Code |
27200288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,049.78 |
| Max. Negotiated Rate |
$3,978.12 |
| Rate for Payer: Aetna Commercial |
$3,757.11
|
| Rate for Payer: Aetna Medicare |
$1,149.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,381.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,381.29
|
| Rate for Payer: BCBS Complete |
$1,768.05
|
| Rate for Payer: BCBS MAPPO |
$1,105.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,633.79
|
| Rate for Payer: BCN Commercial |
$3,436.65
|
| Rate for Payer: BCN Medicare Advantage |
$1,105.03
|
| Rate for Payer: Cash Price |
$3,536.10
|
| Rate for Payer: Cofinity Commercial |
$3,801.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,536.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,105.03
|
| Rate for Payer: Healthscope Commercial |
$3,978.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,315.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,160.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,270.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,757.11
|
| Rate for Payer: Nomi Health Commercial |
$3,624.51
|
| Rate for Payer: PACE Senior Care Partners |
$1,049.78
|
| Rate for Payer: PACE SWMI |
$1,105.03
|
| Rate for Payer: PHP Commercial |
$3,757.11
|
| Rate for Payer: PHP Medicare Advantage |
$1,105.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,873.08
|
| Rate for Payer: Priority Health HMO/PPO |
$3,845.51
|
| Rate for Payer: Priority Health Medicare |
$1,116.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,961.49
|
| Rate for Payer: Railroad Medicare Medicare |
$1,105.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,889.71
|
| Rate for Payer: UHC Core |
$3,690.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,105.03
|
| Rate for Payer: UHC Exchange |
$1,105.03
|
| Rate for Payer: UHC Medicare Advantage |
$1,105.03
|
| Rate for Payer: VA VA |
$1,105.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,315.10
|
|
|
HC BARRX ULTRA LONG RFA FOCAL CATHETER
|
Facility
|
IP
|
$4,420.13
|
|
| Hospital Charge Code |
27200288
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,873.08 |
| Max. Negotiated Rate |
$3,978.12 |
| Rate for Payer: Aetna Commercial |
$3,757.11
|
| Rate for Payer: BCBS Trust/PPO |
$3,608.15
|
| Rate for Payer: BCN Commercial |
$3,415.88
|
| Rate for Payer: Cash Price |
$3,536.10
|
| Rate for Payer: Cofinity Commercial |
$3,801.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,536.10
|
| Rate for Payer: Healthscope Commercial |
$3,978.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,315.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,757.11
|
| Rate for Payer: Nomi Health Commercial |
$3,624.51
|
| Rate for Payer: PHP Commercial |
$3,757.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,873.08
|
| Rate for Payer: Priority Health HMO/PPO |
$3,845.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,961.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,889.71
|
| Rate for Payer: UHC Core |
$3,690.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,315.10
|
|
|
HC BARTONELLA HENSELAE CMPT
|
Facility
|
OP
|
$16.66
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200227
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.96 |
| Max. Negotiated Rate |
$14.99 |
| Rate for Payer: Aetna Commercial |
$14.16
|
| Rate for Payer: Aetna Medicare |
$4.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.21
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$4.16
|
| Rate for Payer: BCBS Trust/PPO |
$13.70
|
| Rate for Payer: BCN Commercial |
$12.95
|
| Rate for Payer: BCN Medicare Advantage |
$4.16
|
| Rate for Payer: Cash Price |
$13.33
|
| Rate for Payer: Cash Price |
$13.33
|
| Rate for Payer: Cofinity Commercial |
$14.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.16
|
| Rate for Payer: Healthscope Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.50
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.37
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.16
|
| Rate for Payer: Nomi Health Commercial |
$13.66
|
| Rate for Payer: PACE Senior Care Partners |
$3.96
|
| Rate for Payer: PACE SWMI |
$4.16
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicare Advantage |
$4.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.83
|
| Rate for Payer: Priority Health HMO/PPO |
$14.49
|
| Rate for Payer: Priority Health Medicare |
$4.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.16
|
| Rate for Payer: Railroad Medicare Medicare |
$4.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.66
|
| Rate for Payer: UHC Core |
$13.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.16
|
| Rate for Payer: UHC Exchange |
$4.16
|
| Rate for Payer: UHC Medicare Advantage |
$4.16
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$4.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.50
|
|
|
HC BARTONELLA HENSELAE CMPT
|
Facility
|
IP
|
$16.66
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200227
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.83 |
| Max. Negotiated Rate |
$14.99 |
| Rate for Payer: Aetna Commercial |
$14.16
|
| Rate for Payer: BCBS Trust/PPO |
$13.60
|
| Rate for Payer: BCN Commercial |
$12.87
|
| Rate for Payer: Cash Price |
$13.33
|
| Rate for Payer: Cofinity Commercial |
$14.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.33
|
| Rate for Payer: Healthscope Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.16
|
| Rate for Payer: Nomi Health Commercial |
$13.66
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$10.83
|
| Rate for Payer: Priority Health HMO/PPO |
$14.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.66
|
| Rate for Payer: UHC Core |
$13.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.50
|
|
|
HC BARTONELLA HENSELAE IGG IGM
|
Facility
|
OP
|
$17.69
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200228
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.20 |
| Max. Negotiated Rate |
$15.92 |
| Rate for Payer: Aetna Commercial |
$15.04
|
| Rate for Payer: Aetna Medicare |
$4.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.53
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$4.42
|
| Rate for Payer: BCBS Trust/PPO |
$14.54
|
| Rate for Payer: BCN Commercial |
$13.75
|
| Rate for Payer: BCN Medicare Advantage |
$4.42
|
| Rate for Payer: Cash Price |
$14.15
|
| Rate for Payer: Cash Price |
$14.15
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.15
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.42
|
| Rate for Payer: Healthscope Commercial |
$15.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.27
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.64
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.04
|
| Rate for Payer: Nomi Health Commercial |
$14.51
|
| Rate for Payer: PACE Senior Care Partners |
$4.20
|
| Rate for Payer: PACE SWMI |
$4.42
|
| Rate for Payer: PHP Commercial |
$15.04
|
| Rate for Payer: PHP Medicare Advantage |
$4.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.50
|
| Rate for Payer: Priority Health HMO/PPO |
$15.39
|
| Rate for Payer: Priority Health Medicare |
$4.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.85
|
| Rate for Payer: Railroad Medicare Medicare |
$4.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.57
|
| Rate for Payer: UHC Core |
$14.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.42
|
| Rate for Payer: UHC Exchange |
$4.42
|
| Rate for Payer: UHC Medicare Advantage |
$4.42
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$4.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.27
|
|
|
HC BARTONELLA HENSELAE IGG IGM
|
Facility
|
IP
|
$17.69
|
|
|
Service Code
|
CPT 86611
|
| Hospital Charge Code |
30200228
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$15.92 |
| Rate for Payer: Aetna Commercial |
$15.04
|
| Rate for Payer: BCBS Trust/PPO |
$14.44
|
| Rate for Payer: BCN Commercial |
$13.67
|
| Rate for Payer: Cash Price |
$14.15
|
| Rate for Payer: Cofinity Commercial |
$15.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$14.15
|
| Rate for Payer: Healthscope Commercial |
$15.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$13.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$15.04
|
| Rate for Payer: Nomi Health Commercial |
$14.51
|
| Rate for Payer: PHP Commercial |
$15.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$11.50
|
| Rate for Payer: Priority Health HMO/PPO |
$15.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$15.57
|
| Rate for Payer: UHC Core |
$14.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$13.27
|
|
|
HC BASIC METABOLIC PANEL
|
Facility
|
OP
|
$31.84
|
|
|
Service Code
|
CPT 80048
|
| Hospital Charge Code |
30100010
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.12 |
| Max. Negotiated Rate |
$28.66 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: Aetna Medicare |
$8.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.95
|
| Rate for Payer: BCBS Complete |
$6.42
|
| Rate for Payer: BCBS MAPPO |
$7.96
|
| Rate for Payer: BCBS Trust/PPO |
$26.18
|
| Rate for Payer: BCN Commercial |
$24.76
|
| Rate for Payer: BCN Medicare Advantage |
$7.96
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.96
|
| Rate for Payer: Healthscope Commercial |
$28.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.88
|
| Rate for Payer: Mclaren Medicaid |
$6.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.36
|
| Rate for Payer: Meridian Medicaid |
$6.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.11
|
| Rate for Payer: PACE Senior Care Partners |
$7.56
|
| Rate for Payer: PACE SWMI |
$7.96
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: PHP Medicare Advantage |
$7.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.70
|
| Rate for Payer: Priority Health HMO/PPO |
$27.70
|
| Rate for Payer: Priority Health Medicare |
$8.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.33
|
| Rate for Payer: Railroad Medicare Medicare |
$7.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.02
|
| Rate for Payer: UHC Core |
$26.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.96
|
| Rate for Payer: UHC Exchange |
$7.96
|
| Rate for Payer: UHC Medicare Advantage |
$7.96
|
| Rate for Payer: UHCCP Medicaid |
$6.12
|
| Rate for Payer: VA VA |
$7.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.88
|
|
|
HC BASIC METABOLIC PANEL
|
Facility
|
IP
|
$31.84
|
|
|
Service Code
|
CPT 80048
|
| Hospital Charge Code |
30100010
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.70 |
| Max. Negotiated Rate |
$28.66 |
| Rate for Payer: Aetna Commercial |
$27.06
|
| Rate for Payer: BCBS Trust/PPO |
$25.99
|
| Rate for Payer: BCN Commercial |
$24.61
|
| Rate for Payer: Cash Price |
$25.47
|
| Rate for Payer: Cofinity Commercial |
$27.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$28.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.06
|
| Rate for Payer: Nomi Health Commercial |
$26.11
|
| Rate for Payer: PHP Commercial |
$27.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.70
|
| Rate for Payer: Priority Health HMO/PPO |
$27.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.02
|
| Rate for Payer: UHC Core |
$26.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.88
|
|
|
HC BASIC METABOLIC W ION CALCIUM
|
Facility
|
OP
|
$94.78
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100009
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.93 |
| Max. Negotiated Rate |
$85.30 |
| Rate for Payer: Aetna Commercial |
$80.56
|
| Rate for Payer: Aetna Medicare |
$24.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.62
|
| Rate for Payer: BCBS Complete |
$10.42
|
| Rate for Payer: BCBS MAPPO |
$23.70
|
| Rate for Payer: BCBS Trust/PPO |
$77.92
|
| Rate for Payer: BCN Commercial |
$73.69
|
| Rate for Payer: BCN Medicare Advantage |
$23.70
|
| Rate for Payer: Cash Price |
$75.82
|
| Rate for Payer: Cash Price |
$75.82
|
| Rate for Payer: Cofinity Commercial |
$81.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.70
|
| Rate for Payer: Healthscope Commercial |
$85.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.08
|
| Rate for Payer: Mclaren Medicaid |
$9.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.88
|
| Rate for Payer: Meridian Medicaid |
$10.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.56
|
| Rate for Payer: Nomi Health Commercial |
$77.72
|
| Rate for Payer: PACE Senior Care Partners |
$22.51
|
| Rate for Payer: PACE SWMI |
$23.70
|
| Rate for Payer: PHP Commercial |
$80.56
|
| Rate for Payer: PHP Medicare Advantage |
$23.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.61
|
| Rate for Payer: Priority Health HMO/PPO |
$82.46
|
| Rate for Payer: Priority Health Medicare |
$23.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.50
|
| Rate for Payer: Railroad Medicare Medicare |
$23.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.41
|
| Rate for Payer: UHC Core |
$79.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.70
|
| Rate for Payer: UHC Exchange |
$23.70
|
| Rate for Payer: UHC Medicare Advantage |
$23.70
|
| Rate for Payer: UHCCP Medicaid |
$9.93
|
| Rate for Payer: VA VA |
$23.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.08
|
|
|
HC BASIC METABOLIC W ION CALCIUM
|
Facility
|
IP
|
$94.78
|
|
|
Service Code
|
CPT 80047
|
| Hospital Charge Code |
30100009
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$61.61 |
| Max. Negotiated Rate |
$85.30 |
| Rate for Payer: Aetna Commercial |
$80.56
|
| Rate for Payer: BCBS Trust/PPO |
$77.37
|
| Rate for Payer: BCN Commercial |
$73.25
|
| Rate for Payer: Cash Price |
$75.82
|
| Rate for Payer: Cofinity Commercial |
$81.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.82
|
| Rate for Payer: Healthscope Commercial |
$85.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.56
|
| Rate for Payer: Nomi Health Commercial |
$77.72
|
| Rate for Payer: PHP Commercial |
$80.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.61
|
| Rate for Payer: Priority Health HMO/PPO |
$82.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.41
|
| Rate for Payer: UHC Core |
$79.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.08
|
|
|
HC BASIC RAD DOSIMETRY
|
Facility
|
IP
|
$431.77
|
|
|
Service Code
|
CPT 77300
|
| Hospital Charge Code |
33300005
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$280.65 |
| Max. Negotiated Rate |
$388.59 |
| Rate for Payer: Aetna Commercial |
$367.00
|
| Rate for Payer: BCBS Trust/PPO |
$352.45
|
| Rate for Payer: BCN Commercial |
$333.67
|
| Rate for Payer: Cash Price |
$345.42
|
| Rate for Payer: Cofinity Commercial |
$371.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.42
|
| Rate for Payer: Healthscope Commercial |
$388.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.00
|
| Rate for Payer: Nomi Health Commercial |
$354.05
|
| Rate for Payer: PHP Commercial |
$367.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.65
|
| Rate for Payer: Priority Health HMO/PPO |
$375.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.96
|
| Rate for Payer: UHC Core |
$360.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.83
|
|
|
HC BASIC RAD DOSIMETRY
|
Facility
|
OP
|
$431.77
|
|
|
Service Code
|
CPT 77300
|
| Hospital Charge Code |
33300005
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$94.06 |
| Max. Negotiated Rate |
$388.59 |
| Rate for Payer: Aetna Commercial |
$367.00
|
| Rate for Payer: Aetna Medicare |
$112.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$134.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$134.93
|
| Rate for Payer: BCBS Complete |
$98.76
|
| Rate for Payer: BCBS MAPPO |
$107.94
|
| Rate for Payer: BCBS Trust/PPO |
$354.96
|
| Rate for Payer: BCN Commercial |
$335.70
|
| Rate for Payer: BCN Medicare Advantage |
$107.94
|
| Rate for Payer: Cash Price |
$345.42
|
| Rate for Payer: Cash Price |
$345.42
|
| Rate for Payer: Cofinity Commercial |
$371.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$345.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$107.94
|
| Rate for Payer: Healthscope Commercial |
$388.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$323.83
|
| Rate for Payer: Mclaren Medicaid |
$94.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.34
|
| Rate for Payer: Meridian Medicaid |
$98.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$124.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$367.00
|
| Rate for Payer: Nomi Health Commercial |
$354.05
|
| Rate for Payer: PACE Senior Care Partners |
$102.55
|
| Rate for Payer: PACE SWMI |
$107.94
|
| Rate for Payer: PHP Commercial |
$367.00
|
| Rate for Payer: PHP Medicare Advantage |
$107.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$280.65
|
| Rate for Payer: Priority Health HMO/PPO |
$375.64
|
| Rate for Payer: Priority Health Medicare |
$109.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$289.29
|
| Rate for Payer: Railroad Medicare Medicare |
$107.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$379.96
|
| Rate for Payer: UHC Core |
$360.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$107.94
|
| Rate for Payer: UHC Exchange |
$107.94
|
| Rate for Payer: UHC Medicare Advantage |
$107.94
|
| Rate for Payer: UHCCP Medicaid |
$94.06
|
| Rate for Payer: VA VA |
$107.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$323.83
|
|
|
HC BB-COMP-FRESH-FROZEN PLASMA EA
|
Facility
|
OP
|
$224.21
|
|
|
Service Code
|
HCPCS P9059
|
| Hospital Charge Code |
39000041
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$50.36 |
| Max. Negotiated Rate |
$201.79 |
| Rate for Payer: Aetna Commercial |
$190.58
|
| Rate for Payer: Aetna Medicare |
$58.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.07
|
| Rate for Payer: BCBS Complete |
$52.88
|
| Rate for Payer: BCBS MAPPO |
$56.05
|
| Rate for Payer: BCBS Trust/PPO |
$184.32
|
| Rate for Payer: BCN Commercial |
$174.32
|
| Rate for Payer: BCN Medicare Advantage |
$56.05
|
| Rate for Payer: Cash Price |
$179.37
|
| Rate for Payer: Cash Price |
$179.37
|
| Rate for Payer: Cofinity Commercial |
$192.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.05
|
| Rate for Payer: Healthscope Commercial |
$201.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.16
|
| Rate for Payer: Mclaren Medicaid |
$50.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.86
|
| Rate for Payer: Meridian Medicaid |
$52.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.58
|
| Rate for Payer: Nomi Health Commercial |
$183.85
|
| Rate for Payer: PACE Senior Care Partners |
$53.25
|
| Rate for Payer: PACE SWMI |
$56.05
|
| Rate for Payer: PHP Commercial |
$190.58
|
| Rate for Payer: PHP Medicare Advantage |
$56.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.74
|
| Rate for Payer: Priority Health HMO/PPO |
$195.06
|
| Rate for Payer: Priority Health Medicare |
$56.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.22
|
| Rate for Payer: Railroad Medicare Medicare |
$56.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.30
|
| Rate for Payer: UHC Core |
$187.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$56.05
|
| Rate for Payer: UHC Exchange |
$56.05
|
| Rate for Payer: UHC Medicare Advantage |
$56.05
|
| Rate for Payer: UHCCP Medicaid |
$50.36
|
| Rate for Payer: VA VA |
$56.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.16
|
|
|
HC BB-COMP-FRESH-FROZEN PLASMA EA
|
Facility
|
IP
|
$224.21
|
|
|
Service Code
|
HCPCS P9059
|
| Hospital Charge Code |
39000041
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$145.74 |
| Max. Negotiated Rate |
$201.79 |
| Rate for Payer: Aetna Commercial |
$190.58
|
| Rate for Payer: BCBS Trust/PPO |
$183.02
|
| Rate for Payer: BCN Commercial |
$173.27
|
| Rate for Payer: Cash Price |
$179.37
|
| Rate for Payer: Cofinity Commercial |
$192.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.37
|
| Rate for Payer: Healthscope Commercial |
$201.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.58
|
| Rate for Payer: Nomi Health Commercial |
$183.85
|
| Rate for Payer: PHP Commercial |
$190.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.74
|
| Rate for Payer: Priority Health HMO/PPO |
$195.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$150.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$197.30
|
| Rate for Payer: UHC Core |
$187.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.16
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
OP
|
$94.68
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$22.49 |
| Max. Negotiated Rate |
$85.21 |
| Rate for Payer: Aetna Commercial |
$80.48
|
| Rate for Payer: Aetna Medicare |
$24.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.59
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$23.67
|
| Rate for Payer: BCBS Trust/PPO |
$77.84
|
| Rate for Payer: BCN Commercial |
$73.61
|
| Rate for Payer: BCN Medicare Advantage |
$23.67
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Cofinity Commercial |
$81.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.67
|
| Rate for Payer: Healthscope Commercial |
$85.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.01
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.85
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.48
|
| Rate for Payer: Nomi Health Commercial |
$77.64
|
| Rate for Payer: PACE Senior Care Partners |
$22.49
|
| Rate for Payer: PACE SWMI |
$23.67
|
| Rate for Payer: PHP Commercial |
$80.48
|
| Rate for Payer: PHP Medicare Advantage |
$23.67
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.54
|
| Rate for Payer: Priority Health HMO/PPO |
$82.37
|
| Rate for Payer: Priority Health Medicare |
$23.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.44
|
| Rate for Payer: Railroad Medicare Medicare |
$23.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.32
|
| Rate for Payer: UHC Core |
$79.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.67
|
| Rate for Payer: UHC Exchange |
$23.67
|
| Rate for Payer: UHC Medicare Advantage |
$23.67
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$23.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.01
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT1
|
Facility
|
IP
|
$94.68
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000042
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$61.54 |
| Max. Negotiated Rate |
$85.21 |
| Rate for Payer: Aetna Commercial |
$80.48
|
| Rate for Payer: BCBS Trust/PPO |
$77.29
|
| Rate for Payer: BCN Commercial |
$73.17
|
| Rate for Payer: Cash Price |
$75.74
|
| Rate for Payer: Cofinity Commercial |
$81.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.74
|
| Rate for Payer: Healthscope Commercial |
$85.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.48
|
| Rate for Payer: Nomi Health Commercial |
$77.64
|
| Rate for Payer: PHP Commercial |
$80.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.54
|
| Rate for Payer: Priority Health HMO/PPO |
$82.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.32
|
| Rate for Payer: UHC Core |
$79.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.01
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: Aetna Medicare |
$27.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.84
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$26.27
|
| Rate for Payer: BCBS Trust/PPO |
$86.39
|
| Rate for Payer: BCN Commercial |
$81.70
|
| Rate for Payer: BCN Medicare Advantage |
$26.27
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.27
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.58
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: PACE Senior Care Partners |
$24.96
|
| Rate for Payer: PACE SWMI |
$26.27
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: PHP Medicare Advantage |
$26.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health HMO/PPO |
$91.42
|
| Rate for Payer: Priority Health Medicare |
$26.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.40
|
| Rate for Payer: Railroad Medicare Medicare |
$26.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.47
|
| Rate for Payer: UHC Core |
$87.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.27
|
| Rate for Payer: UHC Exchange |
$26.27
|
| Rate for Payer: UHC Medicare Advantage |
$26.27
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$26.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
|
HC B CELL ACUTE LYMPH LEUK CMPT2
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000030
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.30 |
| Max. Negotiated Rate |
$94.57 |
| Rate for Payer: Aetna Commercial |
$89.32
|
| Rate for Payer: BCBS Trust/PPO |
$85.78
|
| Rate for Payer: BCN Commercial |
$81.21
|
| Rate for Payer: Cash Price |
$84.06
|
| Rate for Payer: Cofinity Commercial |
$90.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.06
|
| Rate for Payer: Healthscope Commercial |
$94.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$89.32
|
| Rate for Payer: Nomi Health Commercial |
$86.17
|
| Rate for Payer: PHP Commercial |
$89.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.30
|
| Rate for Payer: Priority Health HMO/PPO |
$91.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$92.47
|
| Rate for Payer: UHC Core |
$87.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.81
|
|
