|
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 |
$107.65
|
| 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 |
$102.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.93
|
| Rate for Payer: Meridian Medicaid |
$107.65
|
| 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 |
$102.52
|
| 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 |
$102.52
|
| Rate for Payer: VA VA |
$75.17
|
| 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 |
$107.65 |
| 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 |
$107.65
|
| 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 |
$102.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.44
|
| Rate for Payer: Meridian Medicaid |
$107.65
|
| 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 |
$102.52
|
| 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 |
$102.52
|
| 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 |
$107.65 |
| 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 |
$107.65
|
| 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 |
$102.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.21
|
| Rate for Payer: Meridian Medicaid |
$107.65
|
| 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 |
$102.52
|
| 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 |
$102.52
|
| 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 |
$2.16 |
| Max. Negotiated Rate |
$20.04 |
| 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 |
$2.27
|
| 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 |
$2.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.85
|
| Rate for Payer: Meridian Medicaid |
$2.27
|
| 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 |
$2.16
|
| 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 |
$2.16
|
| 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
|
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 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 |
$162.76 |
| 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 |
$170.91
|
| 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 |
$162.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$401.62
|
| Rate for Payer: Meridian Medicaid |
$170.91
|
| 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 |
$162.76
|
| 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 |
$162.76
|
| Rate for Payer: VA VA |
$382.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,147.50
|
|
|
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 |
$38.55
|
| Rate for Payer: BCBS Trust/PPO |
$126.78
|
| Rate for Payer: BCN Commercial |
$119.91
|
| Rate for Payer: BCN Medicare Advantage |
$38.55
|
| 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 |
$38.55
|
| Rate for Payer: Healthscope Commercial |
$138.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$115.67
|
| 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 |
$38.55
|
| Rate for Payer: PHP Commercial |
$131.09
|
| Rate for Payer: PHP Medicare Advantage |
$38.55
|
| 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 |
$38.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$135.71
|
| Rate for Payer: UHC Core |
$128.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.55
|
| Rate for Payer: UHC Exchange |
$38.55
|
| Rate for Payer: UHC Medicare Advantage |
$38.55
|
| Rate for Payer: UHCCP Medicaid |
$28.38
|
| Rate for Payer: VA VA |
$38.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$115.67
|
|
|
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 |
$115.67
|
| 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 |
$115.67
|
|
|
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
|
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 |
$1,230.09
|
| 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 |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$569.08
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| 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 |
$1,171.43
|
| 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 |
$1,171.43
|
| Rate for Payer: VA VA |
$541.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,625.93
|
|
|
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 BIOPSY
|
Facility
|
OP
|
$2,064.67
|
|
|
Service Code
|
CPT 38221
|
| Hospital Charge Code |
36100185
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$490.36 |
| Max. Negotiated Rate |
$1,858.20 |
| Rate for Payer: Aetna Commercial |
$1,754.97
|
| Rate for Payer: Aetna Medicare |
$536.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$645.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$645.21
|
| Rate for Payer: BCBS Complete |
$1,230.09
|
| Rate for Payer: BCBS MAPPO |
$516.17
|
| Rate for Payer: BCBS Trust/PPO |
$1,697.37
|
| Rate for Payer: BCN Commercial |
$1,605.28
|
| Rate for Payer: BCN Medicare Advantage |
$516.17
|
| Rate for Payer: Cash Price |
$1,651.74
|
| 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: Health Alliance Plan Medicare Advantage |
$516.17
|
| Rate for Payer: Healthscope Commercial |
$1,858.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,548.50
|
| Rate for Payer: Mclaren Medicaid |
$1,171.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$541.98
|
| Rate for Payer: Meridian Medicaid |
$1,230.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$593.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,754.97
|
| Rate for Payer: Nomi Health Commercial |
$1,693.03
|
| Rate for Payer: PACE Senior Care Partners |
$490.36
|
| Rate for Payer: PACE SWMI |
$516.17
|
| Rate for Payer: PHP Commercial |
$1,754.97
|
| Rate for Payer: PHP Medicare Advantage |
$516.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,171.43
|
| 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 Medicare |
$521.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,383.33
|
| Rate for Payer: Railroad Medicare Medicare |
$516.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,816.91
|
| Rate for Payer: UHC Core |
$1,724.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$516.17
|
| Rate for Payer: UHC Exchange |
$516.17
|
| Rate for Payer: UHC Medicare Advantage |
$516.17
|
| Rate for Payer: UHCCP Medicaid |
$1,171.43
|
| Rate for Payer: VA VA |
$516.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,548.50
|
|
|
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
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
IP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,578.87 |
| Max. Negotiated Rate |
$2,186.13 |
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: BCBS Trust/PPO |
$1,982.82
|
| Rate for Payer: BCN Commercial |
$1,877.15
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,821.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$1,991.80
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health HMO/PPO |
$2,113.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,627.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,137.55
|
| Rate for Payer: UHC Core |
$2,028.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,821.77
|
|
|
HC BONE MARROW BX AND ASP DIAGNOSTIC
|
Facility
|
OP
|
$2,429.03
|
|
|
Service Code
|
CPT 38222
|
| Hospital Charge Code |
36100549
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$576.89 |
| Max. Negotiated Rate |
$2,186.13 |
| Rate for Payer: Aetna Commercial |
$2,064.68
|
| Rate for Payer: Aetna Medicare |
$631.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$759.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$759.07
|
| Rate for Payer: BCBS Complete |
$2,172.87
|
| Rate for Payer: BCBS MAPPO |
$607.26
|
| Rate for Payer: BCBS Trust/PPO |
$1,996.91
|
| Rate for Payer: BCN Commercial |
$1,888.57
|
| Rate for Payer: BCN Medicare Advantage |
$607.26
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cash Price |
$1,943.22
|
| Rate for Payer: Cofinity Commercial |
$2,088.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,943.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$607.26
|
| Rate for Payer: Healthscope Commercial |
$2,186.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,821.77
|
| Rate for Payer: Mclaren Medicaid |
$2,069.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$637.62
|
| Rate for Payer: Meridian Medicaid |
$2,172.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$698.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,064.68
|
| Rate for Payer: Nomi Health Commercial |
$1,991.80
|
| Rate for Payer: PACE Senior Care Partners |
$576.89
|
| Rate for Payer: PACE SWMI |
$607.26
|
| Rate for Payer: PHP Commercial |
$2,064.68
|
| Rate for Payer: PHP Medicare Advantage |
$607.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,069.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,578.87
|
| Rate for Payer: Priority Health HMO/PPO |
$2,113.26
|
| Rate for Payer: Priority Health Medicare |
$613.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,627.45
|
| Rate for Payer: Railroad Medicare Medicare |
$607.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,137.55
|
| Rate for Payer: UHC Core |
$2,028.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$607.26
|
| Rate for Payer: UHC Exchange |
$607.26
|
| Rate for Payer: UHC Medicare Advantage |
$607.26
|
| Rate for Payer: UHCCP Medicaid |
$2,069.26
|
| Rate for Payer: VA VA |
$607.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,821.77
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
IP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$109.02 |
| Max. Negotiated Rate |
$150.96 |
| Rate for Payer: Aetna Commercial |
$142.57
|
| Rate for Payer: BCBS Trust/PPO |
$136.92
|
| Rate for Payer: BCN Commercial |
$129.62
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$144.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: PHP Commercial |
$142.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health HMO/PPO |
$145.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.60
|
| Rate for Payer: UHC Core |
$140.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.80
|
|
|
HC BONE MARROW SMEAR INTERPRETATION
|
Facility
|
OP
|
$167.73
|
|
|
Service Code
|
CPT 85097
|
| Hospital Charge Code |
30500069
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$39.84 |
| Max. Negotiated Rate |
$620.19 |
| Rate for Payer: Aetna Commercial |
$142.57
|
| Rate for Payer: Aetna Medicare |
$43.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.42
|
| Rate for Payer: BCBS Complete |
$620.19
|
| Rate for Payer: BCBS MAPPO |
$41.93
|
| Rate for Payer: BCBS Trust/PPO |
$137.89
|
| Rate for Payer: BCN Commercial |
$130.41
|
| Rate for Payer: BCN Medicare Advantage |
$41.93
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cash Price |
$134.18
|
| Rate for Payer: Cofinity Commercial |
$144.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.93
|
| Rate for Payer: Healthscope Commercial |
$150.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.80
|
| Rate for Payer: Mclaren Medicaid |
$590.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.03
|
| Rate for Payer: Meridian Medicaid |
$620.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.57
|
| Rate for Payer: Nomi Health Commercial |
$137.54
|
| Rate for Payer: PACE Senior Care Partners |
$39.84
|
| Rate for Payer: PACE SWMI |
$41.93
|
| Rate for Payer: PHP Commercial |
$142.57
|
| Rate for Payer: PHP Medicare Advantage |
$41.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$590.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.02
|
| Rate for Payer: Priority Health HMO/PPO |
$145.93
|
| Rate for Payer: Priority Health Medicare |
$42.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.38
|
| Rate for Payer: Railroad Medicare Medicare |
$41.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.60
|
| Rate for Payer: UHC Core |
$140.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.93
|
| Rate for Payer: UHC Exchange |
$41.93
|
| Rate for Payer: UHC Medicare Advantage |
$41.93
|
| Rate for Payer: UHCCP Medicaid |
$590.62
|
| Rate for Payer: VA VA |
$41.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.80
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
OP
|
$148.17
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.19 |
| Max. Negotiated Rate |
$133.35 |
| Rate for Payer: Aetna Commercial |
$125.94
|
| Rate for Payer: Aetna Medicare |
$38.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.30
|
| Rate for Payer: BCBS Complete |
$59.27
|
| Rate for Payer: BCBS MAPPO |
$37.04
|
| Rate for Payer: BCBS Trust/PPO |
$121.81
|
| Rate for Payer: BCN Commercial |
$115.20
|
| Rate for Payer: BCN Medicare Advantage |
$37.04
|
| Rate for Payer: Cash Price |
$118.54
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.04
|
| Rate for Payer: Healthscope Commercial |
$133.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.94
|
| Rate for Payer: Nomi Health Commercial |
$121.50
|
| Rate for Payer: PACE Senior Care Partners |
$35.19
|
| Rate for Payer: PACE SWMI |
$37.04
|
| Rate for Payer: PHP Commercial |
$125.94
|
| Rate for Payer: PHP Medicare Advantage |
$37.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.31
|
| Rate for Payer: Priority Health HMO/PPO |
$128.91
|
| Rate for Payer: Priority Health Medicare |
$37.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.27
|
| Rate for Payer: Railroad Medicare Medicare |
$37.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.39
|
| Rate for Payer: UHC Core |
$123.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.04
|
| Rate for Payer: UHC Exchange |
$37.04
|
| Rate for Payer: UHC Medicare Advantage |
$37.04
|
| Rate for Payer: VA VA |
$37.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.13
|
|
|
HC BOOT HEEL PROTECT FLUID Z-FLEX
|
Facility
|
IP
|
$148.17
|
|
| Hospital Charge Code |
27000630
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$96.31 |
| Max. Negotiated Rate |
$133.35 |
| Rate for Payer: Aetna Commercial |
$125.94
|
| Rate for Payer: BCBS Trust/PPO |
$120.95
|
| Rate for Payer: BCN Commercial |
$114.51
|
| Rate for Payer: Cash Price |
$118.54
|
| Rate for Payer: Cofinity Commercial |
$127.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.54
|
| Rate for Payer: Healthscope Commercial |
$133.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.94
|
| Rate for Payer: Nomi Health Commercial |
$121.50
|
| Rate for Payer: PHP Commercial |
$125.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.31
|
| Rate for Payer: Priority Health HMO/PPO |
$128.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.39
|
| Rate for Payer: UHC Core |
$123.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.13
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
IP
|
$48.80
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$31.72 |
| Max. Negotiated Rate |
$43.92 |
| Rate for Payer: Aetna Commercial |
$41.48
|
| Rate for Payer: BCBS Trust/PPO |
$39.84
|
| Rate for Payer: BCN Commercial |
$37.71
|
| Rate for Payer: Cash Price |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$41.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.04
|
| Rate for Payer: Healthscope Commercial |
$43.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.48
|
| Rate for Payer: Nomi Health Commercial |
$40.02
|
| Rate for Payer: PHP Commercial |
$41.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.72
|
| Rate for Payer: Priority Health HMO/PPO |
$42.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.94
|
| Rate for Payer: UHC Core |
$40.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.60
|
|
|
HC BOOT STATIC AIR W/STAB Z-FLEX
|
Facility
|
OP
|
$48.80
|
|
| Hospital Charge Code |
27000631
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$11.59 |
| Max. Negotiated Rate |
$43.92 |
| Rate for Payer: Aetna Commercial |
$41.48
|
| Rate for Payer: Aetna Medicare |
$12.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.25
|
| Rate for Payer: BCBS Complete |
$19.52
|
| Rate for Payer: BCBS MAPPO |
$12.20
|
| Rate for Payer: BCBS Trust/PPO |
$40.12
|
| Rate for Payer: BCN Commercial |
$37.94
|
| Rate for Payer: BCN Medicare Advantage |
$12.20
|
| Rate for Payer: Cash Price |
$39.04
|
| Rate for Payer: Cofinity Commercial |
$41.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.20
|
| Rate for Payer: Healthscope Commercial |
$43.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.48
|
| Rate for Payer: Nomi Health Commercial |
$40.02
|
| Rate for Payer: PACE Senior Care Partners |
$11.59
|
| Rate for Payer: PACE SWMI |
$12.20
|
| Rate for Payer: PHP Commercial |
$41.48
|
| Rate for Payer: PHP Medicare Advantage |
$12.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.72
|
| Rate for Payer: Priority Health HMO/PPO |
$42.46
|
| Rate for Payer: Priority Health Medicare |
$12.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.70
|
| Rate for Payer: Railroad Medicare Medicare |
$12.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.94
|
| Rate for Payer: UHC Core |
$40.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.20
|
| Rate for Payer: UHC Exchange |
$12.20
|
| Rate for Payer: UHC Medicare Advantage |
$12.20
|
| Rate for Payer: VA VA |
$12.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.60
|
|
