|
HC BLOOD SMEAR EXAM
|
Facility
|
IP
|
$23.05
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$14.98 |
| Max. Negotiated Rate |
$20.74 |
| Rate for Payer: Aetna Commercial |
$19.59
|
| Rate for Payer: BCBS Trust/PPO |
$18.82
|
| Rate for Payer: BCN Commercial |
$17.81
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$19.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.44
|
| Rate for Payer: Healthscope Commercial |
$20.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.59
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: PHP Commercial |
$19.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.98
|
| Rate for Payer: Priority Health HMO/PPO |
$20.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.28
|
| Rate for Payer: UHC Core |
$19.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.29
|
|
|
HC BLOOD SMEAR EXAM
|
Facility
|
OP
|
$23.05
|
|
|
Service Code
|
CPT 85008
|
| Hospital Charge Code |
30500003
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$20.74 |
| Rate for Payer: Aetna Commercial |
$19.59
|
| Rate for Payer: Aetna Medicare |
$5.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.20
|
| Rate for Payer: BCBS Complete |
$2.60
|
| Rate for Payer: BCBS MAPPO |
$5.76
|
| Rate for Payer: BCBS Trust/PPO |
$18.95
|
| Rate for Payer: BCN Commercial |
$17.92
|
| Rate for Payer: BCN Medicare Advantage |
$5.76
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cash Price |
$18.44
|
| Rate for Payer: Cofinity Commercial |
$19.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.76
|
| Rate for Payer: Healthscope Commercial |
$20.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.29
|
| Rate for Payer: Mclaren Medicaid |
$2.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.05
|
| Rate for Payer: Meridian Medicaid |
$2.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.59
|
| Rate for Payer: Nomi Health Commercial |
$18.90
|
| Rate for Payer: PACE Senior Care Partners |
$5.47
|
| Rate for Payer: PACE SWMI |
$5.76
|
| Rate for Payer: PHP Commercial |
$19.59
|
| Rate for Payer: PHP Medicare Advantage |
$5.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.98
|
| Rate for Payer: Priority Health HMO/PPO |
$20.05
|
| Rate for Payer: Priority Health Medicare |
$5.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.44
|
| Rate for Payer: Railroad Medicare Medicare |
$5.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.28
|
| Rate for Payer: UHC Core |
$19.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.76
|
| Rate for Payer: UHC Exchange |
$5.76
|
| Rate for Payer: UHC Medicare Advantage |
$5.76
|
| Rate for Payer: UHCCP Medicaid |
$2.48
|
| Rate for Payer: VA VA |
$5.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.29
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$59.09 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.75
|
| Rate for Payer: BCBS Complete |
$105.48
|
| Rate for Payer: BCBS MAPPO |
$62.20
|
| Rate for Payer: BCBS Trust/PPO |
$204.54
|
| Rate for Payer: BCN Commercial |
$193.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.20
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.20
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Mclaren Medicaid |
$100.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.31
|
| Rate for Payer: Meridian Medicaid |
$105.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Senior Care Partners |
$59.09
|
| Rate for Payer: PACE SWMI |
$62.20
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Medicare |
$62.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: Railroad Medicare Medicare |
$62.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.20
|
| Rate for Payer: UHC Exchange |
$62.20
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$100.45
|
| Rate for Payer: VA VA |
$62.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC BLOOD SPLIT CRYOPRECIPITATE UNIT
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000094
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: BCBS Trust/PPO |
$203.10
|
| Rate for Payer: BCN Commercial |
$192.27
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
IP
|
$46.43
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$30.18 |
| Max. Negotiated Rate |
$41.79 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: BCBS Trust/PPO |
$37.90
|
| Rate for Payer: BCN Commercial |
$35.88
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$39.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.14
|
| Rate for Payer: Healthscope Commercial |
$41.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.47
|
| Rate for Payer: Nomi Health Commercial |
$38.07
|
| Rate for Payer: PHP Commercial |
$39.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.18
|
| Rate for Payer: Priority Health HMO/PPO |
$40.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.86
|
| Rate for Payer: UHC Core |
$38.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.82
|
|
|
HC BLOOD SPLIT FFP UNIT
|
Facility
|
OP
|
$46.43
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000091
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$11.03 |
| Max. Negotiated Rate |
$105.48 |
| Rate for Payer: Aetna Commercial |
$39.47
|
| Rate for Payer: Aetna Medicare |
$12.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.51
|
| Rate for Payer: BCBS Complete |
$105.48
|
| Rate for Payer: BCBS MAPPO |
$11.61
|
| Rate for Payer: BCBS Trust/PPO |
$38.17
|
| Rate for Payer: BCN Commercial |
$36.10
|
| Rate for Payer: BCN Medicare Advantage |
$11.61
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cash Price |
$37.14
|
| Rate for Payer: Cofinity Commercial |
$39.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.61
|
| Rate for Payer: Healthscope Commercial |
$41.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.82
|
| Rate for Payer: Mclaren Medicaid |
$100.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.19
|
| Rate for Payer: Meridian Medicaid |
$105.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.47
|
| Rate for Payer: Nomi Health Commercial |
$38.07
|
| Rate for Payer: PACE Senior Care Partners |
$11.03
|
| Rate for Payer: PACE SWMI |
$11.61
|
| Rate for Payer: PHP Commercial |
$39.47
|
| Rate for Payer: PHP Medicare Advantage |
$11.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.18
|
| Rate for Payer: Priority Health HMO/PPO |
$40.39
|
| Rate for Payer: Priority Health Medicare |
$11.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.11
|
| Rate for Payer: Railroad Medicare Medicare |
$11.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.86
|
| Rate for Payer: UHC Core |
$38.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.61
|
| Rate for Payer: UHC Exchange |
$11.61
|
| Rate for Payer: UHC Medicare Advantage |
$11.61
|
| Rate for Payer: UHCCP Medicaid |
$100.45
|
| Rate for Payer: VA VA |
$11.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.82
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
OP
|
$358.58
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$85.16 |
| Max. Negotiated Rate |
$322.72 |
| Rate for Payer: Aetna Commercial |
$304.79
|
| Rate for Payer: Aetna Medicare |
$93.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.06
|
| Rate for Payer: BCBS Complete |
$105.48
|
| Rate for Payer: BCBS MAPPO |
$89.64
|
| Rate for Payer: BCBS Trust/PPO |
$294.79
|
| Rate for Payer: BCN Commercial |
$278.80
|
| Rate for Payer: BCN Medicare Advantage |
$89.64
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cofinity Commercial |
$308.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.64
|
| Rate for Payer: Healthscope Commercial |
$322.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.94
|
| Rate for Payer: Mclaren Medicaid |
$100.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.13
|
| Rate for Payer: Meridian Medicaid |
$105.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.79
|
| Rate for Payer: Nomi Health Commercial |
$294.04
|
| Rate for Payer: PACE Senior Care Partners |
$85.16
|
| Rate for Payer: PACE SWMI |
$89.64
|
| Rate for Payer: PHP Commercial |
$304.79
|
| Rate for Payer: PHP Medicare Advantage |
$89.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.08
|
| Rate for Payer: Priority Health HMO/PPO |
$311.96
|
| Rate for Payer: Priority Health Medicare |
$90.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.25
|
| Rate for Payer: Railroad Medicare Medicare |
$89.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.55
|
| Rate for Payer: UHC Core |
$299.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.64
|
| Rate for Payer: UHC Exchange |
$89.64
|
| Rate for Payer: UHC Medicare Advantage |
$89.64
|
| Rate for Payer: UHCCP Medicaid |
$100.45
|
| Rate for Payer: VA VA |
$89.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.94
|
|
|
HC BLOOD SPLIT LVDS PLT UNIT
|
Facility
|
IP
|
$358.58
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000092
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$233.08 |
| Max. Negotiated Rate |
$322.72 |
| Rate for Payer: Aetna Commercial |
$304.79
|
| Rate for Payer: BCBS Trust/PPO |
$292.71
|
| Rate for Payer: BCN Commercial |
$277.11
|
| Rate for Payer: Cash Price |
$286.86
|
| Rate for Payer: Cofinity Commercial |
$308.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$286.86
|
| Rate for Payer: Healthscope Commercial |
$322.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$268.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$304.79
|
| Rate for Payer: Nomi Health Commercial |
$294.04
|
| Rate for Payer: PHP Commercial |
$304.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.08
|
| Rate for Payer: Priority Health HMO/PPO |
$311.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.55
|
| Rate for Payer: UHC Core |
$299.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$268.94
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
OP
|
$300.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$71.41 |
| Max. Negotiated Rate |
$270.61 |
| Rate for Payer: Aetna Commercial |
$255.58
|
| Rate for Payer: Aetna Medicare |
$78.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.96
|
| Rate for Payer: BCBS Complete |
$105.48
|
| Rate for Payer: BCBS MAPPO |
$75.17
|
| Rate for Payer: BCBS Trust/PPO |
$247.19
|
| Rate for Payer: BCN Commercial |
$233.78
|
| Rate for Payer: BCN Medicare Advantage |
$75.17
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cofinity Commercial |
$258.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.17
|
| Rate for Payer: Healthscope Commercial |
$270.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.51
|
| Rate for Payer: Mclaren Medicaid |
$100.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.93
|
| Rate for Payer: Meridian Medicaid |
$105.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.58
|
| Rate for Payer: Nomi Health Commercial |
$246.56
|
| Rate for Payer: PACE Senior Care Partners |
$71.41
|
| Rate for Payer: PACE SWMI |
$75.17
|
| Rate for Payer: PHP Commercial |
$255.58
|
| Rate for Payer: PHP Medicare Advantage |
$75.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.44
|
| Rate for Payer: Priority Health HMO/PPO |
$261.59
|
| Rate for Payer: Priority Health Medicare |
$75.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.46
|
| Rate for Payer: Railroad Medicare Medicare |
$75.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.60
|
| Rate for Payer: UHC Core |
$251.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$75.17
|
| Rate for Payer: UHC Exchange |
$75.17
|
| Rate for Payer: UHC Medicare Advantage |
$75.17
|
| Rate for Payer: UHCCP Medicaid |
$100.45
|
| Rate for Payer: VA VA |
$75.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.51
|
|
|
HC BLOOD SPLIT PSORALEN PLT UNIT
|
Facility
|
IP
|
$300.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000093
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$195.44 |
| Max. Negotiated Rate |
$270.61 |
| Rate for Payer: Aetna Commercial |
$255.58
|
| Rate for Payer: BCBS Trust/PPO |
$245.45
|
| Rate for Payer: BCN Commercial |
$232.37
|
| Rate for Payer: Cash Price |
$240.54
|
| Rate for Payer: Cofinity Commercial |
$258.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.54
|
| Rate for Payer: Healthscope Commercial |
$270.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.58
|
| Rate for Payer: Nomi Health Commercial |
$246.56
|
| Rate for Payer: PHP Commercial |
$255.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$195.44
|
| Rate for Payer: Priority Health HMO/PPO |
$261.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$201.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.60
|
| Rate for Payer: UHC Core |
$251.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.51
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
OP
|
$81.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$19.40 |
| Max. Negotiated Rate |
$105.48 |
| Rate for Payer: Aetna Commercial |
$69.43
|
| Rate for Payer: Aetna Medicare |
$21.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.52
|
| Rate for Payer: BCBS Complete |
$105.48
|
| Rate for Payer: BCBS MAPPO |
$20.42
|
| Rate for Payer: BCBS Trust/PPO |
$67.15
|
| Rate for Payer: BCN Commercial |
$63.51
|
| Rate for Payer: BCN Medicare Advantage |
$20.42
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$70.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.42
|
| Rate for Payer: Healthscope Commercial |
$73.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.26
|
| Rate for Payer: Mclaren Medicaid |
$100.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.44
|
| Rate for Payer: Meridian Medicaid |
$105.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.43
|
| Rate for Payer: Nomi Health Commercial |
$66.98
|
| Rate for Payer: PACE Senior Care Partners |
$19.40
|
| Rate for Payer: PACE SWMI |
$20.42
|
| Rate for Payer: PHP Commercial |
$69.43
|
| Rate for Payer: PHP Medicare Advantage |
$20.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.09
|
| Rate for Payer: Priority Health HMO/PPO |
$71.06
|
| Rate for Payer: Priority Health Medicare |
$20.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.73
|
| Rate for Payer: Railroad Medicare Medicare |
$20.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.88
|
| Rate for Payer: UHC Core |
$68.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$20.42
|
| Rate for Payer: UHC Exchange |
$20.42
|
| Rate for Payer: UHC Medicare Advantage |
$20.42
|
| Rate for Payer: UHCCP Medicaid |
$100.45
|
| Rate for Payer: VA VA |
$20.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.26
|
|
|
HC BLOOD SPLIT RBC UNIT
|
Facility
|
IP
|
$81.68
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000090
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$53.09 |
| Max. Negotiated Rate |
$73.51 |
| Rate for Payer: Aetna Commercial |
$69.43
|
| Rate for Payer: BCBS Trust/PPO |
$66.68
|
| Rate for Payer: BCN Commercial |
$63.12
|
| Rate for Payer: Cash Price |
$65.34
|
| Rate for Payer: Cofinity Commercial |
$70.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$65.34
|
| Rate for Payer: Healthscope Commercial |
$73.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$61.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$69.43
|
| Rate for Payer: Nomi Health Commercial |
$66.98
|
| Rate for Payer: PHP Commercial |
$69.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.09
|
| Rate for Payer: Priority Health HMO/PPO |
$71.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.88
|
| Rate for Payer: UHC Core |
$68.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$61.26
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
IP
|
$103.65
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$67.37 |
| Max. Negotiated Rate |
$93.28 |
| Rate for Payer: Aetna Commercial |
$88.10
|
| Rate for Payer: BCBS Trust/PPO |
$84.61
|
| Rate for Payer: BCN Commercial |
$80.10
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cofinity Commercial |
$89.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.92
|
| Rate for Payer: Healthscope Commercial |
$93.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.10
|
| Rate for Payer: Nomi Health Commercial |
$84.99
|
| Rate for Payer: PHP Commercial |
$88.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.37
|
| Rate for Payer: Priority Health HMO/PPO |
$90.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.21
|
| Rate for Payer: UHC Core |
$86.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.74
|
|
|
HC BLOOD SPLIT WASHED RBC UNIT
|
Facility
|
OP
|
$103.65
|
|
|
Service Code
|
HCPCS P9011
|
| Hospital Charge Code |
39000095
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$24.62 |
| Max. Negotiated Rate |
$105.48 |
| Rate for Payer: Aetna Commercial |
$88.10
|
| Rate for Payer: Aetna Medicare |
$26.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.39
|
| Rate for Payer: BCBS Complete |
$105.48
|
| Rate for Payer: BCBS MAPPO |
$25.91
|
| Rate for Payer: BCBS Trust/PPO |
$85.21
|
| Rate for Payer: BCN Commercial |
$80.59
|
| Rate for Payer: BCN Medicare Advantage |
$25.91
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cash Price |
$82.92
|
| Rate for Payer: Cofinity Commercial |
$89.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$82.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.91
|
| Rate for Payer: Healthscope Commercial |
$93.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$77.74
|
| Rate for Payer: Mclaren Medicaid |
$100.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.21
|
| Rate for Payer: Meridian Medicaid |
$105.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.10
|
| Rate for Payer: Nomi Health Commercial |
$84.99
|
| Rate for Payer: PACE Senior Care Partners |
$24.62
|
| Rate for Payer: PACE SWMI |
$25.91
|
| Rate for Payer: PHP Commercial |
$88.10
|
| Rate for Payer: PHP Medicare Advantage |
$25.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$100.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$67.37
|
| Rate for Payer: Priority Health HMO/PPO |
$90.18
|
| Rate for Payer: Priority Health Medicare |
$26.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.45
|
| Rate for Payer: Railroad Medicare Medicare |
$25.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.21
|
| Rate for Payer: UHC Core |
$86.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.91
|
| Rate for Payer: UHC Exchange |
$25.91
|
| Rate for Payer: UHC Medicare Advantage |
$25.91
|
| Rate for Payer: UHCCP Medicaid |
$100.45
|
| Rate for Payer: VA VA |
$25.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$77.74
|
|
|
HC BLOOD TYPING RH
|
Facility
|
OP
|
$22.27
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.29 |
| Max. Negotiated Rate |
$29.20 |
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: Aetna Medicare |
$5.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.96
|
| Rate for Payer: BCBS Complete |
$29.20
|
| Rate for Payer: BCBS MAPPO |
$5.57
|
| Rate for Payer: BCBS Trust/PPO |
$18.31
|
| Rate for Payer: BCN Commercial |
$17.31
|
| Rate for Payer: BCN Medicare Advantage |
$5.57
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.57
|
| Rate for Payer: Healthscope Commercial |
$20.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.70
|
| Rate for Payer: Mclaren Medicaid |
$27.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: Meridian Medicaid |
$29.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$18.26
|
| Rate for Payer: PACE Senior Care Partners |
$5.29
|
| Rate for Payer: PACE SWMI |
$5.57
|
| Rate for Payer: PHP Commercial |
$18.93
|
| Rate for Payer: PHP Medicare Advantage |
$5.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$27.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: Priority Health HMO/PPO |
$19.37
|
| Rate for Payer: Priority Health Medicare |
$5.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.92
|
| Rate for Payer: Railroad Medicare Medicare |
$5.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.60
|
| Rate for Payer: UHC Core |
$18.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.57
|
| Rate for Payer: UHC Exchange |
$5.57
|
| Rate for Payer: UHC Medicare Advantage |
$5.57
|
| Rate for Payer: UHCCP Medicaid |
$27.81
|
| Rate for Payer: VA VA |
$5.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.70
|
|
|
HC BLOOD TYPING RH
|
Facility
|
IP
|
$22.27
|
|
|
Service Code
|
CPT 86901
|
| Hospital Charge Code |
30200348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.48 |
| Max. Negotiated Rate |
$20.04 |
| Rate for Payer: Aetna Commercial |
$18.93
|
| Rate for Payer: BCBS Trust/PPO |
$18.18
|
| Rate for Payer: BCN Commercial |
$17.21
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Cofinity Commercial |
$19.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.82
|
| Rate for Payer: Healthscope Commercial |
$20.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.93
|
| Rate for Payer: Nomi Health Commercial |
$18.26
|
| Rate for Payer: PHP Commercial |
$18.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.48
|
| Rate for Payer: Priority Health HMO/PPO |
$19.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.60
|
| Rate for Payer: UHC Core |
$18.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.70
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
OP
|
$1,530.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$159.47 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: Aetna Medicare |
$397.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.12
|
| Rate for Payer: BCBS Complete |
$167.46
|
| Rate for Payer: BCBS MAPPO |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,257.81
|
| Rate for Payer: BCN Commercial |
$1,189.58
|
| Rate for Payer: BCN Medicare Advantage |
$382.50
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$382.50
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Mclaren Medicaid |
$159.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.62
|
| Rate for Payer: Meridian Medicaid |
$167.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$439.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$1,254.60
|
| Rate for Payer: PACE Senior Care Partners |
$363.38
|
| Rate for Payer: PACE SWMI |
$382.50
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: PHP Medicare Advantage |
$382.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$159.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,331.10
|
| Rate for Payer: Priority Health Medicare |
$386.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.10
|
| Rate for Payer: Railroad Medicare Medicare |
$382.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$382.50
|
| Rate for Payer: UHC Exchange |
$382.50
|
| Rate for Payer: UHC Medicare Advantage |
$382.50
|
| Rate for Payer: UHCCP Medicaid |
$159.47
|
| Rate for Payer: VA VA |
$382.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC BLOOD (WHOLE) FOR TRANSFUSION PER UNIT
|
Facility
|
IP
|
$1,530.00
|
|
|
Service Code
|
HCPCS P9010
|
| Hospital Charge Code |
39000089
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$994.50 |
| Max. Negotiated Rate |
$1,377.00 |
| Rate for Payer: Aetna Commercial |
$1,300.50
|
| Rate for Payer: BCBS Trust/PPO |
$1,248.94
|
| Rate for Payer: BCN Commercial |
$1,182.38
|
| Rate for Payer: Cash Price |
$1,224.00
|
| Rate for Payer: Cofinity Commercial |
$1,315.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,224.00
|
| Rate for Payer: Healthscope Commercial |
$1,377.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,147.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,300.50
|
| Rate for Payer: Nomi Health Commercial |
$1,254.60
|
| Rate for Payer: PHP Commercial |
$1,300.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$994.50
|
| Rate for Payer: Priority Health HMO/PPO |
$1,331.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,025.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,346.40
|
| Rate for Payer: UHC Core |
$1,277.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
IP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$100.24 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Aetna Commercial |
$131.09
|
| Rate for Payer: BCBS Trust/PPO |
$125.89
|
| Rate for Payer: BCN Commercial |
$119.18
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$132.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health HMO/PPO |
$134.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.71
|
| Rate for Payer: UHC Core |
$128.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.66
|
|
|
HC B.NATRIURETIC PEPTIDE
|
Facility
|
OP
|
$154.22
|
|
|
Service Code
|
HCPCS 83880
|
| Hospital Charge Code |
30100562
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.38 |
| Max. Negotiated Rate |
$138.80 |
| Rate for Payer: Aetna Commercial |
$131.09
|
| Rate for Payer: Aetna Medicare |
$40.10
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.19
|
| Rate for Payer: BCBS Complete |
$29.81
|
| Rate for Payer: BCBS MAPPO |
$38.56
|
| Rate for Payer: BCBS Trust/PPO |
$126.78
|
| Rate for Payer: BCN Commercial |
$119.91
|
| Rate for Payer: BCN Medicare Advantage |
$38.56
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cash Price |
$123.38
|
| Rate for Payer: Cofinity Commercial |
$132.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$123.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.56
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.66
|
| Rate for Payer: Mclaren Medicaid |
$28.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$40.48
|
| Rate for Payer: Meridian Medicaid |
$29.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$131.09
|
| Rate for Payer: Nomi Health Commercial |
$126.46
|
| Rate for Payer: PACE Senior Care Partners |
$36.63
|
| Rate for Payer: PACE SWMI |
$38.56
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: PHP Medicare Advantage |
$38.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$100.24
|
| Rate for Payer: Priority Health HMO/PPO |
$134.17
|
| Rate for Payer: Priority Health Medicare |
$38.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.33
|
| Rate for Payer: Railroad Medicare Medicare |
$38.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.71
|
| Rate for Payer: UHC Core |
$128.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.56
|
| Rate for Payer: UHC Exchange |
$38.56
|
| Rate for Payer: UHC Medicare Advantage |
$38.56
|
| Rate for Payer: UHCCP Medicaid |
$28.38
|
| Rate for Payer: VA VA |
$38.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.66
|
|
|
HC BONE CEMENT
|
Facility
|
IP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,323.03 |
| Max. Negotiated Rate |
$1,831.89 |
| Rate for Payer: Aetna Commercial |
$1,730.12
|
| Rate for Payer: BCBS Trust/PPO |
$1,661.52
|
| Rate for Payer: BCN Commercial |
$1,572.98
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,750.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Healthscope Commercial |
$1,831.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,526.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: Nomi Health Commercial |
$1,669.05
|
| Rate for Payer: PHP Commercial |
$1,730.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,770.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,363.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,791.18
|
| Rate for Payer: UHC Core |
$1,699.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,526.57
|
|
|
HC BONE CEMENT
|
Facility
|
OP
|
$2,035.43
|
|
|
Service Code
|
HCPCS C1713
|
| Hospital Charge Code |
27800095
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$483.41 |
| Max. Negotiated Rate |
$1,831.89 |
| Rate for Payer: Aetna Commercial |
$1,730.12
|
| Rate for Payer: Aetna Medicare |
$529.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$636.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$636.07
|
| Rate for Payer: BCBS Complete |
$814.17
|
| Rate for Payer: BCBS MAPPO |
$508.86
|
| Rate for Payer: BCBS Trust/PPO |
$1,673.33
|
| Rate for Payer: BCN Commercial |
$1,582.55
|
| Rate for Payer: BCN Medicare Advantage |
$508.86
|
| Rate for Payer: Cash Price |
$1,628.34
|
| Rate for Payer: Cofinity Commercial |
$1,750.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,628.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$508.86
|
| Rate for Payer: Healthscope Commercial |
$1,831.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,526.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$585.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,730.12
|
| Rate for Payer: Nomi Health Commercial |
$1,669.05
|
| Rate for Payer: PACE Senior Care Partners |
$483.41
|
| Rate for Payer: PACE SWMI |
$508.86
|
| Rate for Payer: PHP Commercial |
$1,730.12
|
| Rate for Payer: PHP Medicare Advantage |
$508.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,323.03
|
| Rate for Payer: Priority Health HMO/PPO |
$1,770.82
|
| Rate for Payer: Priority Health Medicare |
$513.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,363.74
|
| Rate for Payer: Railroad Medicare Medicare |
$508.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,791.18
|
| Rate for Payer: UHC Core |
$1,699.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$508.86
|
| Rate for Payer: UHC Exchange |
$508.86
|
| Rate for Payer: UHC Medicare Advantage |
$508.86
|
| Rate for Payer: VA VA |
$508.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,526.57
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
IP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,409.14 |
| Max. Negotiated Rate |
$1,951.12 |
| Rate for Payer: Aetna Commercial |
$1,842.72
|
| Rate for Payer: BCBS Trust/PPO |
$1,769.66
|
| Rate for Payer: BCN Commercial |
$1,675.36
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$1,864.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Healthscope Commercial |
$1,951.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,625.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: Nomi Health Commercial |
$1,777.69
|
| Rate for Payer: PHP Commercial |
$1,842.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: Priority Health HMO/PPO |
$1,886.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,452.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,907.76
|
| Rate for Payer: UHC Core |
$1,810.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,625.93
|
|
|
HC BONE MARROW ASPIRATION
|
Facility
|
OP
|
$2,167.91
|
|
|
Service Code
|
CPT 38220
|
| Hospital Charge Code |
36100184
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$514.88 |
| Max. Negotiated Rate |
$1,951.12 |
| Rate for Payer: Aetna Commercial |
$1,842.72
|
| Rate for Payer: Aetna Medicare |
$563.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$677.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$677.47
|
| Rate for Payer: BCBS Complete |
$1,205.21
|
| Rate for Payer: BCBS MAPPO |
$541.98
|
| Rate for Payer: BCBS Trust/PPO |
$1,782.24
|
| Rate for Payer: BCN Commercial |
$1,685.55
|
| Rate for Payer: BCN Medicare Advantage |
$541.98
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cash Price |
$1,734.33
|
| Rate for Payer: Cofinity Commercial |
$1,864.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,734.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$541.98
|
| Rate for Payer: Healthscope Commercial |
$1,951.12
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,625.93
|
| Rate for Payer: Mclaren Medicaid |
$1,147.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.08
|
| Rate for Payer: Meridian Medicaid |
$1,205.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$623.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,842.72
|
| Rate for Payer: Nomi Health Commercial |
$1,777.69
|
| Rate for Payer: PACE Senior Care Partners |
$514.88
|
| Rate for Payer: PACE SWMI |
$541.98
|
| Rate for Payer: PHP Commercial |
$1,842.72
|
| Rate for Payer: PHP Medicare Advantage |
$541.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,147.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,409.14
|
| Rate for Payer: Priority Health HMO/PPO |
$1,886.08
|
| Rate for Payer: Priority Health Medicare |
$547.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,452.50
|
| Rate for Payer: Railroad Medicare Medicare |
$541.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,907.76
|
| Rate for Payer: UHC Core |
$1,810.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$541.98
|
| Rate for Payer: UHC Exchange |
$541.98
|
| Rate for Payer: UHC Medicare Advantage |
$541.98
|
| Rate for Payer: UHCCP Medicaid |
$1,147.75
|
| Rate for Payer: VA VA |
$541.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,625.93
|
|
|
HC BONE MARROW BIOPSY
|
Facility
|
IP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,342.04 |
| Max. Negotiated Rate |
$1,858.20 |
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: BCBS Trust/PPO |
$1,685.39
|
| Rate for Payer: BCN Commercial |
$1,595.58
|
| Rate for Payer: Cash Price |
$1,651.74
|
| Rate for Payer: Cofinity Commercial |
$1,775.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,651.74
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: Nomi Health Commercial |
$1,693.03
|
| Rate for Payer: PHP Commercial |
$1,754.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,342.04
|
| Rate for Payer: Priority Health HMO/PPO |
$1,796.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,383.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,816.91
|
| Rate for Payer: UHC Core |
$1,724.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.50
|
|
