|
HC BETA 2 GP1 AB IGG
|
Facility
|
OP
|
$43.20
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200142
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.26 |
| Max. Negotiated Rate |
$38.88 |
| Rate for Payer: Aetna Commercial |
$36.72
|
| Rate for Payer: Aetna Medicare |
$11.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.50
|
| Rate for Payer: BCBS Complete |
$19.32
|
| Rate for Payer: BCBS MAPPO |
$10.80
|
| Rate for Payer: BCBS Trust/PPO |
$35.51
|
| Rate for Payer: BCN Commercial |
$33.59
|
| Rate for Payer: BCN Medicare Advantage |
$10.80
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cash Price |
$34.56
|
| Rate for Payer: Cofinity Commercial |
$37.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.80
|
| Rate for Payer: Healthscope Commercial |
$38.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.40
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.34
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.72
|
| Rate for Payer: Nomi Health Commercial |
$35.42
|
| Rate for Payer: PACE Senior Care Partners |
$10.26
|
| Rate for Payer: PACE SWMI |
$10.80
|
| Rate for Payer: PHP Commercial |
$36.72
|
| Rate for Payer: PHP Medicare Advantage |
$10.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.08
|
| Rate for Payer: Priority Health HMO/PPO |
$37.58
|
| Rate for Payer: Priority Health Medicare |
$10.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.94
|
| Rate for Payer: Railroad Medicare Medicare |
$10.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.02
|
| Rate for Payer: UHC Core |
$36.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.80
|
| Rate for Payer: UHC Exchange |
$10.80
|
| Rate for Payer: UHC Medicare Advantage |
$10.80
|
| Rate for Payer: UHCCP Medicaid |
$18.40
|
| Rate for Payer: VA VA |
$10.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.40
|
|
|
HC BETA 2 GP1 AB IGM
|
Facility
|
IP
|
$51.40
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.41 |
| Max. Negotiated Rate |
$46.26 |
| Rate for Payer: Aetna Commercial |
$43.69
|
| Rate for Payer: BCBS Trust/PPO |
$41.96
|
| Rate for Payer: BCN Commercial |
$39.72
|
| Rate for Payer: Cash Price |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$44.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.12
|
| Rate for Payer: Healthscope Commercial |
$46.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.69
|
| Rate for Payer: Nomi Health Commercial |
$42.15
|
| Rate for Payer: PHP Commercial |
$43.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.41
|
| Rate for Payer: Priority Health HMO/PPO |
$44.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.23
|
| Rate for Payer: UHC Core |
$42.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.55
|
|
|
HC BETA 2 GP1 AB IGM
|
Facility
|
OP
|
$51.40
|
|
|
Service Code
|
CPT 86146
|
| Hospital Charge Code |
30200141
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.21 |
| Max. Negotiated Rate |
$46.26 |
| Rate for Payer: Aetna Commercial |
$43.69
|
| Rate for Payer: Aetna Medicare |
$13.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.06
|
| Rate for Payer: BCBS Complete |
$19.32
|
| Rate for Payer: BCBS MAPPO |
$12.85
|
| Rate for Payer: BCBS Trust/PPO |
$42.26
|
| Rate for Payer: BCN Commercial |
$39.96
|
| Rate for Payer: BCN Medicare Advantage |
$12.85
|
| Rate for Payer: Cash Price |
$41.12
|
| Rate for Payer: Cash Price |
$41.12
|
| Rate for Payer: Cofinity Commercial |
$44.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.85
|
| Rate for Payer: Healthscope Commercial |
$46.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.55
|
| Rate for Payer: Mclaren Medicaid |
$18.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.49
|
| Rate for Payer: Meridian Medicaid |
$19.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.69
|
| Rate for Payer: Nomi Health Commercial |
$42.15
|
| Rate for Payer: PACE Senior Care Partners |
$12.21
|
| Rate for Payer: PACE SWMI |
$12.85
|
| Rate for Payer: PHP Commercial |
$43.69
|
| Rate for Payer: PHP Medicare Advantage |
$12.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.41
|
| Rate for Payer: Priority Health HMO/PPO |
$44.72
|
| Rate for Payer: Priority Health Medicare |
$12.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.44
|
| Rate for Payer: Railroad Medicare Medicare |
$12.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.23
|
| Rate for Payer: UHC Core |
$42.92
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.85
|
| Rate for Payer: UHC Exchange |
$12.85
|
| Rate for Payer: UHC Medicare Advantage |
$12.85
|
| Rate for Payer: UHCCP Medicaid |
$18.40
|
| Rate for Payer: VA VA |
$12.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.55
|
|
|
HC BETA-2 MICROGLOBULIN
|
Facility
|
OP
|
$42.66
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
30100115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.13 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna Medicare |
$11.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.33
|
| Rate for Payer: BCBS Complete |
$12.28
|
| Rate for Payer: BCBS MAPPO |
$10.66
|
| Rate for Payer: BCBS Trust/PPO |
$35.07
|
| Rate for Payer: BCN Commercial |
$33.17
|
| Rate for Payer: BCN Medicare Advantage |
$10.66
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Mclaren Medicaid |
$11.70
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.20
|
| Rate for Payer: Meridian Medicaid |
$12.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: PACE Senior Care Partners |
$10.13
|
| Rate for Payer: PACE SWMI |
$10.66
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: PHP Medicare Advantage |
$10.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health HMO/PPO |
$37.11
|
| Rate for Payer: Priority Health Medicare |
$10.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.58
|
| Rate for Payer: Railroad Medicare Medicare |
$10.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.54
|
| Rate for Payer: UHC Core |
$35.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.66
|
| Rate for Payer: UHC Exchange |
$10.66
|
| Rate for Payer: UHC Medicare Advantage |
$10.66
|
| Rate for Payer: UHCCP Medicaid |
$11.70
|
| Rate for Payer: VA VA |
$10.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC BETA-2 MICROGLOBULIN
|
Facility
|
IP
|
$42.66
|
|
|
Service Code
|
CPT 82232
|
| Hospital Charge Code |
30100115
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.73 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: BCBS Trust/PPO |
$34.82
|
| Rate for Payer: BCN Commercial |
$32.97
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health HMO/PPO |
$37.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.54
|
| Rate for Payer: UHC Core |
$35.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC BETA HYDROXY BUTYRATE KETONE
|
Facility
|
OP
|
$28.41
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
30100068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.91 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: Aetna Medicare |
$7.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.88
|
| Rate for Payer: BCBS Complete |
$6.20
|
| Rate for Payer: BCBS MAPPO |
$7.10
|
| Rate for Payer: BCBS Trust/PPO |
$23.36
|
| Rate for Payer: BCN Commercial |
$22.09
|
| Rate for Payer: BCN Medicare Advantage |
$7.10
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.10
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Mclaren Medicaid |
$5.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.46
|
| Rate for Payer: Meridian Medicaid |
$6.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PACE Senior Care Partners |
$6.75
|
| Rate for Payer: PACE SWMI |
$7.10
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health Medicare |
$7.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: Railroad Medicare Medicare |
$7.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.10
|
| Rate for Payer: UHC Exchange |
$7.10
|
| Rate for Payer: UHC Medicare Advantage |
$7.10
|
| Rate for Payer: UHCCP Medicaid |
$5.91
|
| Rate for Payer: VA VA |
$7.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
HC BETA HYDROXY BUTYRATE KETONE
|
Facility
|
IP
|
$28.41
|
|
|
Service Code
|
CPT 82010
|
| Hospital Charge Code |
30100068
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.47 |
| Max. Negotiated Rate |
$25.57 |
| Rate for Payer: Aetna Commercial |
$24.15
|
| Rate for Payer: BCBS Trust/PPO |
$23.19
|
| Rate for Payer: BCN Commercial |
$21.96
|
| Rate for Payer: Cash Price |
$22.73
|
| Rate for Payer: Cofinity Commercial |
$24.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.73
|
| Rate for Payer: Healthscope Commercial |
$25.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$24.15
|
| Rate for Payer: Nomi Health Commercial |
$23.30
|
| Rate for Payer: PHP Commercial |
$24.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$18.47
|
| Rate for Payer: Priority Health HMO/PPO |
$24.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$25.00
|
| Rate for Payer: UHC Core |
$23.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.31
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
OP
|
$612.78
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$145.54 |
| Max. Negotiated Rate |
$551.50 |
| Rate for Payer: Aetna Commercial |
$520.86
|
| Rate for Payer: Aetna Medicare |
$159.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$191.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$191.49
|
| Rate for Payer: BCBS Complete |
$219.58
|
| Rate for Payer: BCBS MAPPO |
$153.20
|
| Rate for Payer: BCBS Trust/PPO |
$503.77
|
| Rate for Payer: BCN Commercial |
$476.44
|
| Rate for Payer: BCN Medicare Advantage |
$153.20
|
| Rate for Payer: Cash Price |
$490.22
|
| Rate for Payer: Cash Price |
$490.22
|
| Rate for Payer: Cofinity Commercial |
$526.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$153.20
|
| Rate for Payer: Healthscope Commercial |
$551.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.58
|
| Rate for Payer: Mclaren Medicaid |
$209.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$160.85
|
| Rate for Payer: Meridian Medicaid |
$219.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$176.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.86
|
| Rate for Payer: Nomi Health Commercial |
$502.48
|
| Rate for Payer: PACE Senior Care Partners |
$145.54
|
| Rate for Payer: PACE SWMI |
$153.20
|
| Rate for Payer: PHP Commercial |
$520.86
|
| Rate for Payer: PHP Medicare Advantage |
$153.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$209.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.31
|
| Rate for Payer: Priority Health HMO/PPO |
$533.12
|
| Rate for Payer: Priority Health Medicare |
$154.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.56
|
| Rate for Payer: Railroad Medicare Medicare |
$153.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.25
|
| Rate for Payer: UHC Core |
$511.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$153.20
|
| Rate for Payer: UHC Exchange |
$153.20
|
| Rate for Payer: UHC Medicare Advantage |
$153.20
|
| Rate for Payer: UHCCP Medicaid |
$209.11
|
| Rate for Payer: VA VA |
$153.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.58
|
|
|
HC BILATERAL INJECT CARPAL TUNNEL
|
Facility
|
IP
|
$612.78
|
|
|
Service Code
|
CPT 20526
|
| Hospital Charge Code |
76100242
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$398.31 |
| Max. Negotiated Rate |
$551.50 |
| Rate for Payer: Aetna Commercial |
$520.86
|
| Rate for Payer: BCBS Trust/PPO |
$500.21
|
| Rate for Payer: BCN Commercial |
$473.56
|
| Rate for Payer: Cash Price |
$490.22
|
| Rate for Payer: Cofinity Commercial |
$526.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$490.22
|
| Rate for Payer: Healthscope Commercial |
$551.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$459.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$520.86
|
| Rate for Payer: Nomi Health Commercial |
$502.48
|
| Rate for Payer: PHP Commercial |
$520.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$398.31
|
| Rate for Payer: Priority Health HMO/PPO |
$533.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$410.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$539.25
|
| Rate for Payer: UHC Core |
$511.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$459.58
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
OP
|
$738.48
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.78 |
| Max. Negotiated Rate |
$664.63 |
| Rate for Payer: Aetna Commercial |
$627.71
|
| Rate for Payer: Aetna Medicare |
$192.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$230.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$230.78
|
| Rate for Payer: BCBS Complete |
$117.37
|
| Rate for Payer: BCBS MAPPO |
$184.62
|
| Rate for Payer: BCBS Trust/PPO |
$607.10
|
| Rate for Payer: BCN Commercial |
$574.17
|
| Rate for Payer: BCN Medicare Advantage |
$184.62
|
| Rate for Payer: Cash Price |
$590.78
|
| Rate for Payer: Cash Price |
$590.78
|
| Rate for Payer: Cofinity Commercial |
$635.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$184.62
|
| Rate for Payer: Healthscope Commercial |
$664.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.86
|
| Rate for Payer: Mclaren Medicaid |
$111.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$193.85
|
| Rate for Payer: Meridian Medicaid |
$117.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$212.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$627.71
|
| Rate for Payer: Nomi Health Commercial |
$605.55
|
| Rate for Payer: PACE Senior Care Partners |
$175.39
|
| Rate for Payer: PACE SWMI |
$184.62
|
| Rate for Payer: PHP Commercial |
$627.71
|
| Rate for Payer: PHP Medicare Advantage |
$184.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$480.01
|
| Rate for Payer: Priority Health HMO/PPO |
$642.48
|
| Rate for Payer: Priority Health Medicare |
$186.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.78
|
| Rate for Payer: Railroad Medicare Medicare |
$184.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.86
|
| Rate for Payer: UHC Core |
$616.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$184.62
|
| Rate for Payer: UHC Exchange |
$184.62
|
| Rate for Payer: UHC Medicare Advantage |
$184.62
|
| Rate for Payer: UHCCP Medicaid |
$111.78
|
| Rate for Payer: VA VA |
$184.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.86
|
|
|
HC BILATERAL MULTILAYER COMP DSG BK
|
Facility
|
IP
|
$738.48
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100048
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$480.01 |
| Max. Negotiated Rate |
$664.63 |
| Rate for Payer: Aetna Commercial |
$627.71
|
| Rate for Payer: BCBS Trust/PPO |
$602.82
|
| Rate for Payer: BCN Commercial |
$570.70
|
| Rate for Payer: Cash Price |
$590.78
|
| Rate for Payer: Cofinity Commercial |
$635.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$590.78
|
| Rate for Payer: Healthscope Commercial |
$664.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$553.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$627.71
|
| Rate for Payer: Nomi Health Commercial |
$605.55
|
| Rate for Payer: PHP Commercial |
$627.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$480.01
|
| Rate for Payer: Priority Health HMO/PPO |
$642.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$494.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$649.86
|
| Rate for Payer: UHC Core |
$616.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$553.86
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
OP
|
$116.88
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$27.76 |
| Max. Negotiated Rate |
$105.19 |
| Rate for Payer: Aetna Commercial |
$99.35
|
| Rate for Payer: Aetna Medicare |
$30.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.52
|
| Rate for Payer: BCBS Complete |
$46.75
|
| Rate for Payer: BCBS MAPPO |
$29.22
|
| Rate for Payer: BCBS Trust/PPO |
$96.09
|
| Rate for Payer: BCN Commercial |
$90.87
|
| Rate for Payer: BCN Medicare Advantage |
$29.22
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Cofinity Commercial |
$100.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.22
|
| Rate for Payer: Healthscope Commercial |
$105.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.35
|
| Rate for Payer: Nomi Health Commercial |
$95.84
|
| Rate for Payer: PACE Senior Care Partners |
$27.76
|
| Rate for Payer: PACE SWMI |
$29.22
|
| Rate for Payer: PHP Commercial |
$99.35
|
| Rate for Payer: PHP Medicare Advantage |
$29.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.97
|
| Rate for Payer: Priority Health HMO/PPO |
$101.69
|
| Rate for Payer: Priority Health Medicare |
$29.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.31
|
| Rate for Payer: Railroad Medicare Medicare |
$29.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.85
|
| Rate for Payer: UHC Core |
$97.59
|
| Rate for Payer: UHC Dual Complete DSNP |
$29.22
|
| Rate for Payer: UHC Exchange |
$29.22
|
| Rate for Payer: UHC Medicare Advantage |
$29.22
|
| Rate for Payer: VA VA |
$29.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.66
|
|
|
HC BILATERAL TOMOSYNTHESIS
|
Facility
|
IP
|
$116.88
|
|
|
Service Code
|
CPT 77062
|
| Hospital Charge Code |
32000300
|
|
Hospital Revenue Code
|
401
|
| Min. Negotiated Rate |
$75.97 |
| Max. Negotiated Rate |
$105.19 |
| Rate for Payer: Aetna Commercial |
$99.35
|
| Rate for Payer: BCBS Trust/PPO |
$95.41
|
| Rate for Payer: BCN Commercial |
$90.32
|
| Rate for Payer: Cash Price |
$93.50
|
| Rate for Payer: Cofinity Commercial |
$100.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$93.50
|
| Rate for Payer: Healthscope Commercial |
$105.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$87.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$99.35
|
| Rate for Payer: Nomi Health Commercial |
$95.84
|
| Rate for Payer: PHP Commercial |
$99.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.97
|
| Rate for Payer: Priority Health HMO/PPO |
$101.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$102.85
|
| Rate for Payer: UHC Core |
$97.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$87.66
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
OP
|
$456.96
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$108.53 |
| Max. Negotiated Rate |
$411.26 |
| Rate for Payer: Aetna Commercial |
$388.42
|
| Rate for Payer: Aetna Medicare |
$118.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$142.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$142.80
|
| Rate for Payer: BCBS Complete |
$117.37
|
| Rate for Payer: BCBS MAPPO |
$114.24
|
| Rate for Payer: BCBS Trust/PPO |
$375.67
|
| Rate for Payer: BCN Commercial |
$355.29
|
| Rate for Payer: BCN Medicare Advantage |
$114.24
|
| Rate for Payer: Cash Price |
$365.57
|
| Rate for Payer: Cash Price |
$365.57
|
| Rate for Payer: Cofinity Commercial |
$392.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$114.24
|
| Rate for Payer: Healthscope Commercial |
$411.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.72
|
| Rate for Payer: Mclaren Medicaid |
$111.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$119.95
|
| Rate for Payer: Meridian Medicaid |
$117.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$131.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.42
|
| Rate for Payer: Nomi Health Commercial |
$374.71
|
| Rate for Payer: PACE Senior Care Partners |
$108.53
|
| Rate for Payer: PACE SWMI |
$114.24
|
| Rate for Payer: PHP Commercial |
$388.42
|
| Rate for Payer: PHP Medicare Advantage |
$114.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.02
|
| Rate for Payer: Priority Health HMO/PPO |
$397.56
|
| Rate for Payer: Priority Health Medicare |
$115.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.16
|
| Rate for Payer: Railroad Medicare Medicare |
$114.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.12
|
| Rate for Payer: UHC Core |
$381.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$114.24
|
| Rate for Payer: UHC Exchange |
$114.24
|
| Rate for Payer: UHC Medicare Advantage |
$114.24
|
| Rate for Payer: UHCCP Medicaid |
$111.78
|
| Rate for Payer: VA VA |
$114.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.72
|
|
|
HC BILATERAL UNNA BOOT
|
Facility
|
IP
|
$456.96
|
|
|
Service Code
|
CPT 29580
|
| Hospital Charge Code |
76100047
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$297.02 |
| Max. Negotiated Rate |
$411.26 |
| Rate for Payer: Aetna Commercial |
$388.42
|
| Rate for Payer: BCBS Trust/PPO |
$373.02
|
| Rate for Payer: BCN Commercial |
$353.14
|
| Rate for Payer: Cash Price |
$365.57
|
| Rate for Payer: Cofinity Commercial |
$392.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$365.57
|
| Rate for Payer: Healthscope Commercial |
$411.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$342.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$388.42
|
| Rate for Payer: Nomi Health Commercial |
$374.71
|
| Rate for Payer: PHP Commercial |
$388.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$297.02
|
| Rate for Payer: Priority Health HMO/PPO |
$397.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$306.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$402.12
|
| Rate for Payer: UHC Core |
$381.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$342.72
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
OP
|
$14,483.45
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,439.82 |
| Max. Negotiated Rate |
$13,035.10 |
| Rate for Payer: Aetna Commercial |
$12,310.93
|
| Rate for Payer: Aetna Medicare |
$3,765.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,526.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,526.08
|
| Rate for Payer: BCBS Complete |
$4,881.81
|
| Rate for Payer: BCBS MAPPO |
$3,620.86
|
| Rate for Payer: BCBS Trust/PPO |
$11,906.84
|
| Rate for Payer: BCN Commercial |
$11,260.88
|
| Rate for Payer: BCN Medicare Advantage |
$3,620.86
|
| Rate for Payer: Cash Price |
$11,586.76
|
| Rate for Payer: Cash Price |
$11,586.76
|
| Rate for Payer: Cofinity Commercial |
$12,455.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,586.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,620.86
|
| Rate for Payer: Healthscope Commercial |
$13,035.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,862.59
|
| Rate for Payer: Mclaren Medicaid |
$4,649.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,801.91
|
| Rate for Payer: Meridian Medicaid |
$4,881.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4,163.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,310.93
|
| Rate for Payer: Nomi Health Commercial |
$11,876.43
|
| Rate for Payer: PACE Senior Care Partners |
$3,439.82
|
| Rate for Payer: PACE SWMI |
$3,620.86
|
| Rate for Payer: PHP Commercial |
$12,310.93
|
| Rate for Payer: PHP Medicare Advantage |
$3,620.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,649.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,414.24
|
| Rate for Payer: Priority Health HMO/PPO |
$12,600.60
|
| Rate for Payer: Priority Health Medicare |
$3,657.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,703.91
|
| Rate for Payer: Railroad Medicare Medicare |
$3,620.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,745.44
|
| Rate for Payer: UHC Core |
$12,093.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,620.86
|
| Rate for Payer: UHC Exchange |
$3,620.86
|
| Rate for Payer: UHC Medicare Advantage |
$3,620.86
|
| Rate for Payer: UHCCP Medicaid |
$4,649.03
|
| Rate for Payer: VA VA |
$3,620.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,862.59
|
|
|
HC BILAT PERC IMPLANT NEUROSTIM ELTRD,SACRAL NERVE W/IMAG
|
Facility
|
IP
|
$14,483.45
|
|
|
Service Code
|
CPT 64561
|
| Hospital Charge Code |
76100261
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9,414.24 |
| Max. Negotiated Rate |
$13,035.10 |
| Rate for Payer: Aetna Commercial |
$12,310.93
|
| Rate for Payer: BCBS Trust/PPO |
$11,822.84
|
| Rate for Payer: BCN Commercial |
$11,192.81
|
| Rate for Payer: Cash Price |
$11,586.76
|
| Rate for Payer: Cofinity Commercial |
$12,455.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,586.76
|
| Rate for Payer: Healthscope Commercial |
$13,035.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,862.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12,310.93
|
| Rate for Payer: Nomi Health Commercial |
$11,876.43
|
| Rate for Payer: PHP Commercial |
$12,310.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$9,414.24
|
| Rate for Payer: Priority Health HMO/PPO |
$12,600.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,703.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,745.44
|
| Rate for Payer: UHC Core |
$12,093.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,862.59
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
OP
|
$907.80
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$111.78 |
| Max. Negotiated Rate |
$817.02 |
| Rate for Payer: Aetna Commercial |
$771.63
|
| Rate for Payer: Aetna Medicare |
$236.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$283.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$283.69
|
| Rate for Payer: BCBS Complete |
$117.37
|
| Rate for Payer: BCBS MAPPO |
$226.95
|
| Rate for Payer: BCBS Trust/PPO |
$746.30
|
| Rate for Payer: BCN Commercial |
$705.81
|
| Rate for Payer: BCN Medicare Advantage |
$226.95
|
| Rate for Payer: Cash Price |
$726.24
|
| Rate for Payer: Cash Price |
$726.24
|
| Rate for Payer: Cofinity Commercial |
$780.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$226.95
|
| Rate for Payer: Healthscope Commercial |
$817.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$680.85
|
| Rate for Payer: Mclaren Medicaid |
$111.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$238.30
|
| Rate for Payer: Meridian Medicaid |
$117.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$260.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.63
|
| Rate for Payer: Nomi Health Commercial |
$744.40
|
| Rate for Payer: PACE Senior Care Partners |
$215.60
|
| Rate for Payer: PACE SWMI |
$226.95
|
| Rate for Payer: PHP Commercial |
$771.63
|
| Rate for Payer: PHP Medicare Advantage |
$226.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$111.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.07
|
| Rate for Payer: Priority Health HMO/PPO |
$789.79
|
| Rate for Payer: Priority Health Medicare |
$229.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.23
|
| Rate for Payer: Railroad Medicare Medicare |
$226.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.86
|
| Rate for Payer: UHC Core |
$758.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$226.95
|
| Rate for Payer: UHC Exchange |
$226.95
|
| Rate for Payer: UHC Medicare Advantage |
$226.95
|
| Rate for Payer: UHCCP Medicaid |
$111.78
|
| Rate for Payer: VA VA |
$226.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$680.85
|
|
|
HC BIL COMPLEX MULTILAYER COMP DSG
|
Facility
|
IP
|
$907.80
|
|
|
Service Code
|
CPT 29581
|
| Hospital Charge Code |
76100072
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$590.07 |
| Max. Negotiated Rate |
$817.02 |
| Rate for Payer: Aetna Commercial |
$771.63
|
| Rate for Payer: BCBS Trust/PPO |
$741.04
|
| Rate for Payer: BCN Commercial |
$701.55
|
| Rate for Payer: Cash Price |
$726.24
|
| Rate for Payer: Cofinity Commercial |
$780.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$726.24
|
| Rate for Payer: Healthscope Commercial |
$817.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$680.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$771.63
|
| Rate for Payer: Nomi Health Commercial |
$744.40
|
| Rate for Payer: PHP Commercial |
$771.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$590.07
|
| Rate for Payer: Priority Health HMO/PPO |
$789.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$608.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$798.86
|
| Rate for Payer: UHC Core |
$758.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$680.85
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
OP
|
$3,251.25
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$772.17 |
| Max. Negotiated Rate |
$2,926.12 |
| Rate for Payer: Aetna Commercial |
$2,763.56
|
| Rate for Payer: Aetna Medicare |
$845.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,016.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,016.02
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$812.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,672.85
|
| Rate for Payer: BCN Commercial |
$2,527.85
|
| Rate for Payer: BCN Medicare Advantage |
$812.81
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cofinity Commercial |
$2,796.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,601.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$812.81
|
| Rate for Payer: Healthscope Commercial |
$2,926.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,438.44
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$853.45
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$934.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,763.56
|
| Rate for Payer: Nomi Health Commercial |
$2,666.02
|
| Rate for Payer: PACE Senior Care Partners |
$772.17
|
| Rate for Payer: PACE SWMI |
$812.81
|
| Rate for Payer: PHP Commercial |
$2,763.56
|
| Rate for Payer: PHP Medicare Advantage |
$812.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,113.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,828.59
|
| Rate for Payer: Priority Health Medicare |
$820.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,178.34
|
| Rate for Payer: Railroad Medicare Medicare |
$812.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,861.10
|
| Rate for Payer: UHC Core |
$2,714.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$812.81
|
| Rate for Payer: UHC Exchange |
$812.81
|
| Rate for Payer: UHC Medicare Advantage |
$812.81
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$812.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,438.44
|
|
|
HC BIL DIAG BONE MARROW ASP
|
Facility
|
IP
|
$3,251.25
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
76100292
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,113.31 |
| Max. Negotiated Rate |
$2,926.12 |
| Rate for Payer: Aetna Commercial |
$2,763.56
|
| Rate for Payer: BCBS Trust/PPO |
$2,654.00
|
| Rate for Payer: BCN Commercial |
$2,512.57
|
| Rate for Payer: Cash Price |
$2,601.00
|
| Rate for Payer: Cofinity Commercial |
$2,796.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,601.00
|
| Rate for Payer: Healthscope Commercial |
$2,926.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,438.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,763.56
|
| Rate for Payer: Nomi Health Commercial |
$2,666.02
|
| Rate for Payer: PHP Commercial |
$2,763.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,113.31
|
| Rate for Payer: Priority Health HMO/PPO |
$2,828.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,178.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,861.10
|
| Rate for Payer: UHC Core |
$2,714.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,438.44
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
OP
|
$3,096.23
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$735.35 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: Aetna Medicare |
$805.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.57
|
| Rate for Payer: BCBS Complete |
$2,128.93
|
| Rate for Payer: BCBS MAPPO |
$774.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,545.41
|
| Rate for Payer: BCN Commercial |
$2,407.32
|
| Rate for Payer: BCN Medicare Advantage |
$774.06
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.06
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.17
|
| Rate for Payer: Mclaren Medicaid |
$2,027.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.76
|
| Rate for Payer: Meridian Medicaid |
$2,128.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PACE Senior Care Partners |
$735.35
|
| Rate for Payer: PACE SWMI |
$774.06
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: PHP Medicare Advantage |
$774.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,027.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,693.72
|
| Rate for Payer: Priority Health Medicare |
$781.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,074.47
|
| Rate for Payer: Railroad Medicare Medicare |
$774.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,724.68
|
| Rate for Payer: UHC Core |
$2,585.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.06
|
| Rate for Payer: UHC Exchange |
$774.06
|
| Rate for Payer: UHC Medicare Advantage |
$774.06
|
| Rate for Payer: UHCCP Medicaid |
$2,027.42
|
| Rate for Payer: VA VA |
$774.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.17
|
|
|
HC BIL DIAG BONE MARROW ASP AND BX
|
Facility
|
IP
|
$3,096.23
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
76100294
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,012.55 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,527.45
|
| Rate for Payer: BCN Commercial |
$2,392.77
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,693.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,074.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,724.68
|
| Rate for Payer: UHC Core |
$2,585.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.17
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
OP
|
$3,096.23
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$735.35 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: Aetna Medicare |
$805.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$967.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$967.57
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$774.06
|
| Rate for Payer: BCBS Trust/PPO |
$2,545.41
|
| Rate for Payer: BCN Commercial |
$2,407.32
|
| Rate for Payer: BCN Medicare Advantage |
$774.06
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$774.06
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.17
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$812.76
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$890.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PACE Senior Care Partners |
$735.35
|
| Rate for Payer: PACE SWMI |
$774.06
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: PHP Medicare Advantage |
$774.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,693.72
|
| Rate for Payer: Priority Health Medicare |
$781.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,074.47
|
| Rate for Payer: Railroad Medicare Medicare |
$774.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,724.68
|
| Rate for Payer: UHC Core |
$2,585.35
|
| Rate for Payer: UHC Dual Complete DSNP |
$774.06
|
| Rate for Payer: UHC Exchange |
$774.06
|
| Rate for Payer: UHC Medicare Advantage |
$774.06
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$774.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.17
|
|
|
HC BIL DIAG BONE MARROW BX
|
Facility
|
IP
|
$3,096.23
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
76100293
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,012.55 |
| Max. Negotiated Rate |
$2,786.61 |
| Rate for Payer: Aetna Commercial |
$2,631.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,527.45
|
| Rate for Payer: BCN Commercial |
$2,392.77
|
| Rate for Payer: Cash Price |
$2,476.98
|
| Rate for Payer: Cofinity Commercial |
$2,662.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,476.98
|
| Rate for Payer: Healthscope Commercial |
$2,786.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,322.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,631.80
|
| Rate for Payer: Nomi Health Commercial |
$2,538.91
|
| Rate for Payer: PHP Commercial |
$2,631.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,012.55
|
| Rate for Payer: Priority Health HMO/PPO |
$2,693.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,074.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,724.68
|
| Rate for Payer: UHC Core |
$2,585.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,322.17
|
|
