|
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 |
$4.17
|
| Rate for Payer: BCBS Trust/PPO |
$13.70
|
| Rate for Payer: BCN Commercial |
$12.95
|
| Rate for Payer: BCN Medicare Advantage |
$4.17
|
| 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 |
$4.17
|
| Rate for Payer: Healthscope Commercial |
$14.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.49
|
| 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 |
$4.17
|
| Rate for Payer: PHP Commercial |
$14.16
|
| Rate for Payer: PHP Medicare Advantage |
$4.17
|
| 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 |
$4.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.66
|
| Rate for Payer: UHC Core |
$13.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.17
|
| Rate for Payer: UHC Exchange |
$4.17
|
| Rate for Payer: UHC Medicare Advantage |
$4.17
|
| Rate for Payer: UHCCP Medicaid |
$7.36
|
| Rate for Payer: VA VA |
$4.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.49
|
|
|
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 |
$12.49
|
| 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 |
$12.49
|
|
|
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 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 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 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 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 |
$95.99 |
| 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 |
$100.80
|
| 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 |
$95.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$113.34
|
| Rate for Payer: Meridian Medicaid |
$100.80
|
| 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 |
$95.99
|
| 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 |
$95.99
|
| 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 |
$51.40 |
| 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 |
$53.97
|
| 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 |
$51.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.86
|
| Rate for Payer: Meridian Medicaid |
$53.97
|
| 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 |
$51.40
|
| 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 |
$51.40
|
| 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
|
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
|
|
|
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 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 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 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
|
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 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 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 |
$351.13 |
| 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 |
$351.13
|
| 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
|
|
