|
HC B CELL ACUTE LYMPH LEUK FISH
|
Facility
|
IP
|
$94.68
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
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 FISH
|
Facility
|
OP
|
$94.68
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000041
|
|
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 BCR / ABL FISH
|
Facility
|
IP
|
$131.09
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$85.21 |
| Max. Negotiated Rate |
$117.98 |
| Rate for Payer: Aetna Commercial |
$111.43
|
| Rate for Payer: BCBS Trust/PPO |
$107.01
|
| Rate for Payer: BCN Commercial |
$101.31
|
| Rate for Payer: Cash Price |
$104.87
|
| Rate for Payer: Cofinity Commercial |
$112.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.87
|
| Rate for Payer: Healthscope Commercial |
$117.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.43
|
| Rate for Payer: Nomi Health Commercial |
$107.49
|
| Rate for Payer: PHP Commercial |
$111.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.21
|
| Rate for Payer: Priority Health HMO/PPO |
$114.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.36
|
| Rate for Payer: UHC Core |
$109.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.32
|
|
|
HC BCR / ABL FISH
|
Facility
|
OP
|
$131.09
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000024
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$117.98 |
| Rate for Payer: Aetna Commercial |
$111.43
|
| Rate for Payer: Aetna Medicare |
$34.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.97
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$32.77
|
| Rate for Payer: BCBS Trust/PPO |
$107.77
|
| Rate for Payer: BCN Commercial |
$101.92
|
| Rate for Payer: BCN Medicare Advantage |
$32.77
|
| Rate for Payer: Cash Price |
$104.87
|
| Rate for Payer: Cash Price |
$104.87
|
| Rate for Payer: Cofinity Commercial |
$112.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.77
|
| Rate for Payer: Healthscope Commercial |
$117.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$98.32
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.41
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$111.43
|
| Rate for Payer: Nomi Health Commercial |
$107.49
|
| Rate for Payer: PACE Senior Care Partners |
$31.13
|
| Rate for Payer: PACE SWMI |
$32.77
|
| Rate for Payer: PHP Commercial |
$111.43
|
| Rate for Payer: PHP Medicare Advantage |
$32.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.21
|
| Rate for Payer: Priority Health HMO/PPO |
$114.05
|
| Rate for Payer: Priority Health Medicare |
$33.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.83
|
| Rate for Payer: Railroad Medicare Medicare |
$32.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$115.36
|
| Rate for Payer: UHC Core |
$109.46
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.77
|
| Rate for Payer: UHC Exchange |
$32.77
|
| Rate for Payer: UHC Medicare Advantage |
$32.77
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$32.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$98.32
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
IP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
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
|
|
|
HC BCR / ABL FISH CMPT1
|
Facility
|
OP
|
$105.08
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000112
|
|
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 BCR/ABL FISH CMPT 2
|
Facility
|
OP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$70.08 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: Aetna Medicare |
$20.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.33
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$64.02
|
| Rate for Payer: BCN Commercial |
$60.54
|
| Rate for Payer: BCN Medicare Advantage |
$19.47
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.47
|
| Rate for Payer: Healthscope Commercial |
$70.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.40
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.44
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: PACE Senior Care Partners |
$18.49
|
| Rate for Payer: PACE SWMI |
$19.47
|
| Rate for Payer: PHP Commercial |
$66.19
|
| Rate for Payer: PHP Medicare Advantage |
$19.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health HMO/PPO |
$67.75
|
| Rate for Payer: Priority Health Medicare |
$19.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.17
|
| Rate for Payer: Railroad Medicare Medicare |
$19.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.53
|
| Rate for Payer: UHC Core |
$65.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.47
|
| Rate for Payer: UHC Exchange |
$19.47
|
| Rate for Payer: UHC Medicare Advantage |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$19.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.40
|
|
|
HC BCR/ABL FISH CMPT 2
|
Facility
|
IP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000035
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$70.08 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: BCBS Trust/PPO |
$63.57
|
| Rate for Payer: BCN Commercial |
$60.18
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Healthscope Commercial |
$70.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: PHP Commercial |
$66.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health HMO/PPO |
$67.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.53
|
| Rate for Payer: UHC Core |
$65.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.40
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
OP
|
$390.15
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$92.66 |
| Max. Negotiated Rate |
$351.14 |
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: Aetna Medicare |
$101.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.92
|
| Rate for Payer: BCBS Complete |
$124.48
|
| Rate for Payer: BCBS MAPPO |
$97.54
|
| Rate for Payer: BCBS Trust/PPO |
$320.74
|
| Rate for Payer: BCN Commercial |
$303.34
|
| Rate for Payer: BCN Medicare Advantage |
$97.54
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.54
|
| Rate for Payer: Healthscope Commercial |
$351.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.61
|
| Rate for Payer: Mclaren Medicaid |
$118.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$102.41
|
| Rate for Payer: Meridian Medicaid |
$124.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$112.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: PACE Senior Care Partners |
$92.66
|
| Rate for Payer: PACE SWMI |
$97.54
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: PHP Medicare Advantage |
$97.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.60
|
| Rate for Payer: Priority Health HMO/PPO |
$339.43
|
| Rate for Payer: Priority Health Medicare |
$98.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.40
|
| Rate for Payer: Railroad Medicare Medicare |
$97.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.33
|
| Rate for Payer: UHC Core |
$325.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.54
|
| Rate for Payer: UHC Exchange |
$97.54
|
| Rate for Payer: UHC Medicare Advantage |
$97.54
|
| Rate for Payer: UHCCP Medicaid |
$118.54
|
| Rate for Payer: VA VA |
$97.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.61
|
|
|
HC BCR/ABL P210 QUANT
|
Facility
|
IP
|
$390.15
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000096
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$253.60 |
| Max. Negotiated Rate |
$351.14 |
| Rate for Payer: Aetna Commercial |
$331.63
|
| Rate for Payer: BCBS Trust/PPO |
$318.48
|
| Rate for Payer: BCN Commercial |
$301.51
|
| Rate for Payer: Cash Price |
$312.12
|
| Rate for Payer: Cofinity Commercial |
$335.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$312.12
|
| Rate for Payer: Healthscope Commercial |
$351.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$292.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$331.63
|
| Rate for Payer: Nomi Health Commercial |
$319.92
|
| Rate for Payer: PHP Commercial |
$331.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$253.60
|
| Rate for Payer: Priority Health HMO/PPO |
$339.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$261.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$343.33
|
| Rate for Payer: UHC Core |
$325.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$292.61
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
IP
|
$236.92
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$154.00 |
| Max. Negotiated Rate |
$213.23 |
| Rate for Payer: Aetna Commercial |
$201.38
|
| Rate for Payer: BCBS Trust/PPO |
$193.40
|
| Rate for Payer: BCN Commercial |
$183.09
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cofinity Commercial |
$203.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.54
|
| Rate for Payer: Healthscope Commercial |
$213.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.38
|
| Rate for Payer: Nomi Health Commercial |
$194.27
|
| Rate for Payer: PHP Commercial |
$201.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO |
$206.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.49
|
| Rate for Payer: UHC Core |
$197.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.69
|
|
|
HC BCRABL RNA, CMPT 1
|
Facility
|
OP
|
$236.92
|
|
|
Service Code
|
CPT 81207
|
| Hospital Charge Code |
31000144
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$56.27 |
| Max. Negotiated Rate |
$213.23 |
| Rate for Payer: Aetna Commercial |
$201.38
|
| Rate for Payer: Aetna Medicare |
$61.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.04
|
| Rate for Payer: BCBS Complete |
$109.96
|
| Rate for Payer: BCBS MAPPO |
$59.23
|
| Rate for Payer: BCBS Trust/PPO |
$194.77
|
| Rate for Payer: BCN Commercial |
$184.21
|
| Rate for Payer: BCN Medicare Advantage |
$59.23
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cash Price |
$189.54
|
| Rate for Payer: Cofinity Commercial |
$203.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$189.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.23
|
| Rate for Payer: Healthscope Commercial |
$213.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$177.69
|
| Rate for Payer: Mclaren Medicaid |
$104.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.19
|
| Rate for Payer: Meridian Medicaid |
$109.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$201.38
|
| Rate for Payer: Nomi Health Commercial |
$194.27
|
| Rate for Payer: PACE Senior Care Partners |
$56.27
|
| Rate for Payer: PACE SWMI |
$59.23
|
| Rate for Payer: PHP Commercial |
$201.38
|
| Rate for Payer: PHP Medicare Advantage |
$59.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$154.00
|
| Rate for Payer: Priority Health HMO/PPO |
$206.12
|
| Rate for Payer: Priority Health Medicare |
$59.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$158.74
|
| Rate for Payer: Railroad Medicare Medicare |
$59.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$208.49
|
| Rate for Payer: UHC Core |
$197.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$59.23
|
| Rate for Payer: UHC Exchange |
$59.23
|
| Rate for Payer: UHC Medicare Advantage |
$59.23
|
| Rate for Payer: UHCCP Medicaid |
$104.72
|
| Rate for Payer: VA VA |
$59.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$177.69
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
OP
|
$351.08
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$83.38 |
| Max. Negotiated Rate |
$315.97 |
| Rate for Payer: Aetna Commercial |
$298.42
|
| Rate for Payer: Aetna Medicare |
$91.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$109.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$109.71
|
| Rate for Payer: BCBS Complete |
$162.94
|
| Rate for Payer: BCBS MAPPO |
$87.77
|
| Rate for Payer: BCBS Trust/PPO |
$288.62
|
| Rate for Payer: BCN Commercial |
$272.96
|
| Rate for Payer: BCN Medicare Advantage |
$87.77
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cofinity Commercial |
$301.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.77
|
| Rate for Payer: Healthscope Commercial |
$315.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.31
|
| Rate for Payer: Mclaren Medicaid |
$155.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$92.16
|
| Rate for Payer: Meridian Medicaid |
$162.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.42
|
| Rate for Payer: Nomi Health Commercial |
$287.89
|
| Rate for Payer: PACE Senior Care Partners |
$83.38
|
| Rate for Payer: PACE SWMI |
$87.77
|
| Rate for Payer: PHP Commercial |
$298.42
|
| Rate for Payer: PHP Medicare Advantage |
$87.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$155.17
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.20
|
| Rate for Payer: Priority Health HMO/PPO |
$305.44
|
| Rate for Payer: Priority Health Medicare |
$88.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.22
|
| Rate for Payer: Railroad Medicare Medicare |
$87.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.95
|
| Rate for Payer: UHC Core |
$293.15
|
| Rate for Payer: UHC Dual Complete DSNP |
$87.77
|
| Rate for Payer: UHC Exchange |
$87.77
|
| Rate for Payer: UHC Medicare Advantage |
$87.77
|
| Rate for Payer: UHCCP Medicaid |
$155.17
|
| Rate for Payer: VA VA |
$87.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.31
|
|
|
HC BCRABL RNA, CMPT 2
|
Facility
|
IP
|
$351.08
|
|
|
Service Code
|
CPT 81208
|
| Hospital Charge Code |
31000145
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$228.20 |
| Max. Negotiated Rate |
$315.97 |
| Rate for Payer: Aetna Commercial |
$298.42
|
| Rate for Payer: BCBS Trust/PPO |
$286.59
|
| Rate for Payer: BCN Commercial |
$271.31
|
| Rate for Payer: Cash Price |
$280.86
|
| Rate for Payer: Cofinity Commercial |
$301.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$280.86
|
| Rate for Payer: Healthscope Commercial |
$315.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$263.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$298.42
|
| Rate for Payer: Nomi Health Commercial |
$287.89
|
| Rate for Payer: PHP Commercial |
$298.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$228.20
|
| Rate for Payer: Priority Health HMO/PPO |
$305.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$308.95
|
| Rate for Payer: UHC Core |
$293.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$263.31
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
OP
|
$268.20
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.70 |
| Max. Negotiated Rate |
$241.38 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: Aetna Medicare |
$69.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.81
|
| Rate for Payer: BCBS Complete |
$124.48
|
| Rate for Payer: BCBS MAPPO |
$67.05
|
| Rate for Payer: BCBS Trust/PPO |
$220.49
|
| Rate for Payer: BCN Commercial |
$208.53
|
| Rate for Payer: BCN Medicare Advantage |
$67.05
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cofinity Commercial |
$230.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.05
|
| Rate for Payer: Healthscope Commercial |
$241.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.15
|
| Rate for Payer: Mclaren Medicaid |
$118.54
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.40
|
| Rate for Payer: Meridian Medicaid |
$124.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.97
|
| Rate for Payer: Nomi Health Commercial |
$219.92
|
| Rate for Payer: PACE Senior Care Partners |
$63.70
|
| Rate for Payer: PACE SWMI |
$67.05
|
| Rate for Payer: PHP Commercial |
$227.97
|
| Rate for Payer: PHP Medicare Advantage |
$67.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$118.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.33
|
| Rate for Payer: Priority Health HMO/PPO |
$233.33
|
| Rate for Payer: Priority Health Medicare |
$67.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.69
|
| Rate for Payer: Railroad Medicare Medicare |
$67.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.02
|
| Rate for Payer: UHC Core |
$223.95
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.05
|
| Rate for Payer: UHC Exchange |
$67.05
|
| Rate for Payer: UHC Medicare Advantage |
$67.05
|
| Rate for Payer: UHCCP Medicaid |
$118.54
|
| Rate for Payer: VA VA |
$67.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.15
|
|
|
HC BCRABL RNA, QUAL
|
Facility
|
IP
|
$268.20
|
|
|
Service Code
|
CPT 81206
|
| Hospital Charge Code |
31000143
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$174.33 |
| Max. Negotiated Rate |
$241.38 |
| Rate for Payer: Aetna Commercial |
$227.97
|
| Rate for Payer: BCBS Trust/PPO |
$218.93
|
| Rate for Payer: BCN Commercial |
$207.26
|
| Rate for Payer: Cash Price |
$214.56
|
| Rate for Payer: Cofinity Commercial |
$230.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.56
|
| Rate for Payer: Healthscope Commercial |
$241.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$227.97
|
| Rate for Payer: Nomi Health Commercial |
$219.92
|
| Rate for Payer: PHP Commercial |
$227.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.33
|
| Rate for Payer: Priority Health HMO/PPO |
$233.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.02
|
| Rate for Payer: UHC Core |
$223.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.15
|
|
|
HC BDIAL APTT
|
Facility
|
IP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.91 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: BCBS Trust/PPO |
$21.23
|
| Rate for Payer: BCN Commercial |
$20.10
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC BDIAL APTT
|
Facility
|
OP
|
$26.01
|
|
|
Service Code
|
CPT 85730
|
| Hospital Charge Code |
30500096
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.35 |
| Max. Negotiated Rate |
$23.41 |
| Rate for Payer: Aetna Commercial |
$22.11
|
| Rate for Payer: Aetna Medicare |
$6.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.13
|
| Rate for Payer: BCBS Complete |
$4.56
|
| Rate for Payer: BCBS MAPPO |
$6.50
|
| Rate for Payer: BCBS Trust/PPO |
$21.38
|
| Rate for Payer: BCN Commercial |
$20.22
|
| Rate for Payer: BCN Medicare Advantage |
$6.50
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cash Price |
$20.81
|
| Rate for Payer: Cofinity Commercial |
$22.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.81
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.50
|
| Rate for Payer: Healthscope Commercial |
$23.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.51
|
| Rate for Payer: Mclaren Medicaid |
$4.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.83
|
| Rate for Payer: Meridian Medicaid |
$4.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.11
|
| Rate for Payer: Nomi Health Commercial |
$21.33
|
| Rate for Payer: PACE Senior Care Partners |
$6.18
|
| Rate for Payer: PACE SWMI |
$6.50
|
| Rate for Payer: PHP Commercial |
$22.11
|
| Rate for Payer: PHP Medicare Advantage |
$6.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.91
|
| Rate for Payer: Priority Health HMO/PPO |
$22.63
|
| Rate for Payer: Priority Health Medicare |
$6.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.43
|
| Rate for Payer: Railroad Medicare Medicare |
$6.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.89
|
| Rate for Payer: UHC Core |
$21.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.50
|
| Rate for Payer: UHC Exchange |
$6.50
|
| Rate for Payer: UHC Medicare Advantage |
$6.50
|
| Rate for Payer: UHCCP Medicaid |
$4.35
|
| Rate for Payer: VA VA |
$6.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.51
|
|
|
HC BDIAL DIRM
|
Facility
|
IP
|
$40.32
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$26.21 |
| Max. Negotiated Rate |
$36.29 |
| Rate for Payer: Aetna Commercial |
$34.27
|
| Rate for Payer: BCBS Trust/PPO |
$32.91
|
| Rate for Payer: BCN Commercial |
$31.16
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cofinity Commercial |
$34.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.26
|
| Rate for Payer: Healthscope Commercial |
$36.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.27
|
| Rate for Payer: Nomi Health Commercial |
$33.06
|
| Rate for Payer: PHP Commercial |
$34.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.21
|
| Rate for Payer: Priority Health HMO/PPO |
$35.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.48
|
| Rate for Payer: UHC Core |
$33.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.24
|
|
|
HC BDIAL DIRM
|
Facility
|
OP
|
$40.32
|
|
|
Service Code
|
CPT 85379
|
| Hospital Charge Code |
30500088
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.36 |
| Max. Negotiated Rate |
$36.29 |
| Rate for Payer: Aetna Commercial |
$34.27
|
| Rate for Payer: Aetna Medicare |
$10.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.60
|
| Rate for Payer: BCBS Complete |
$7.73
|
| Rate for Payer: BCBS MAPPO |
$10.08
|
| Rate for Payer: BCBS Trust/PPO |
$33.15
|
| Rate for Payer: BCN Commercial |
$31.35
|
| Rate for Payer: BCN Medicare Advantage |
$10.08
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cash Price |
$32.26
|
| Rate for Payer: Cofinity Commercial |
$34.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.08
|
| Rate for Payer: Healthscope Commercial |
$36.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.24
|
| Rate for Payer: Mclaren Medicaid |
$7.36
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.58
|
| Rate for Payer: Meridian Medicaid |
$7.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.27
|
| Rate for Payer: Nomi Health Commercial |
$33.06
|
| Rate for Payer: PACE Senior Care Partners |
$9.58
|
| Rate for Payer: PACE SWMI |
$10.08
|
| Rate for Payer: PHP Commercial |
$34.27
|
| Rate for Payer: PHP Medicare Advantage |
$10.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.21
|
| Rate for Payer: Priority Health HMO/PPO |
$35.08
|
| Rate for Payer: Priority Health Medicare |
$10.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.01
|
| Rate for Payer: Railroad Medicare Medicare |
$10.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.48
|
| Rate for Payer: UHC Core |
$33.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.08
|
| Rate for Payer: UHC Exchange |
$10.08
|
| Rate for Payer: UHC Medicare Advantage |
$10.08
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$10.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.24
|
|
|
HC BDIAL F8A
|
Facility
|
IP
|
$66.95
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$43.52 |
| Max. Negotiated Rate |
$60.26 |
| Rate for Payer: Aetna Commercial |
$56.91
|
| Rate for Payer: BCBS Trust/PPO |
$54.65
|
| Rate for Payer: BCN Commercial |
$51.74
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cofinity Commercial |
$57.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.56
|
| Rate for Payer: Healthscope Commercial |
$60.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.91
|
| Rate for Payer: Nomi Health Commercial |
$54.90
|
| Rate for Payer: PHP Commercial |
$56.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.52
|
| Rate for Payer: Priority Health HMO/PPO |
$58.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.92
|
| Rate for Payer: UHC Core |
$55.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.21
|
|
|
HC BDIAL F8A
|
Facility
|
OP
|
$66.95
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500091
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$60.26 |
| Rate for Payer: Aetna Commercial |
$56.91
|
| Rate for Payer: Aetna Medicare |
$17.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.92
|
| Rate for Payer: BCBS Complete |
$13.59
|
| Rate for Payer: BCBS MAPPO |
$16.74
|
| Rate for Payer: BCBS Trust/PPO |
$55.04
|
| Rate for Payer: BCN Commercial |
$52.05
|
| Rate for Payer: BCN Medicare Advantage |
$16.74
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cash Price |
$53.56
|
| Rate for Payer: Cofinity Commercial |
$57.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.74
|
| Rate for Payer: Healthscope Commercial |
$60.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$50.21
|
| Rate for Payer: Mclaren Medicaid |
$12.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.57
|
| Rate for Payer: Meridian Medicaid |
$13.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.91
|
| Rate for Payer: Nomi Health Commercial |
$54.90
|
| Rate for Payer: PACE Senior Care Partners |
$15.90
|
| Rate for Payer: PACE SWMI |
$16.74
|
| Rate for Payer: PHP Commercial |
$56.91
|
| Rate for Payer: PHP Medicare Advantage |
$16.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.52
|
| Rate for Payer: Priority Health HMO/PPO |
$58.25
|
| Rate for Payer: Priority Health Medicare |
$16.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.86
|
| Rate for Payer: Railroad Medicare Medicare |
$16.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.92
|
| Rate for Payer: UHC Core |
$55.90
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.74
|
| Rate for Payer: UHC Exchange |
$16.74
|
| Rate for Payer: UHC Medicare Advantage |
$16.74
|
| Rate for Payer: UHCCP Medicaid |
$12.94
|
| Rate for Payer: VA VA |
$16.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$50.21
|
|
|
HC BDIAL FIBC
|
Facility
|
IP
|
$35.37
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.99 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: BCBS Trust/PPO |
$28.87
|
| Rate for Payer: BCN Commercial |
$27.33
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC BDIAL FIBC
|
Facility
|
OP
|
$35.37
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500090
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$7.03 |
| Max. Negotiated Rate |
$31.83 |
| Rate for Payer: Aetna Commercial |
$30.06
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.05
|
| Rate for Payer: BCBS Complete |
$7.38
|
| Rate for Payer: BCBS MAPPO |
$8.84
|
| Rate for Payer: BCBS Trust/PPO |
$29.08
|
| Rate for Payer: BCN Commercial |
$27.50
|
| Rate for Payer: BCN Medicare Advantage |
$8.84
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cash Price |
$28.30
|
| Rate for Payer: Cofinity Commercial |
$30.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.84
|
| Rate for Payer: Healthscope Commercial |
$31.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.53
|
| Rate for Payer: Mclaren Medicaid |
$7.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.28
|
| Rate for Payer: Meridian Medicaid |
$7.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.06
|
| Rate for Payer: Nomi Health Commercial |
$29.00
|
| Rate for Payer: PACE Senior Care Partners |
$8.40
|
| Rate for Payer: PACE SWMI |
$8.84
|
| Rate for Payer: PHP Commercial |
$30.06
|
| Rate for Payer: PHP Medicare Advantage |
$8.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.99
|
| Rate for Payer: Priority Health HMO/PPO |
$30.77
|
| Rate for Payer: Priority Health Medicare |
$8.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.70
|
| Rate for Payer: Railroad Medicare Medicare |
$8.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.13
|
| Rate for Payer: UHC Core |
$29.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.84
|
| Rate for Payer: UHC Exchange |
$8.84
|
| Rate for Payer: UHC Medicare Advantage |
$8.84
|
| Rate for Payer: UHCCP Medicaid |
$7.03
|
| Rate for Payer: VA VA |
$8.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.53
|
|
|
HC BDIAL FXIII
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 85291
|
| Hospital Charge Code |
30500094
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
