|
HC CRRT MONITORING PER HOUR
|
Facility
|
OP
|
$425.18
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$74.96 |
| Max. Negotiated Rate |
$382.66 |
| Rate for Payer: Aetna Commercial |
$361.40
|
| Rate for Payer: Aetna Medicare |
$110.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$132.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$132.87
|
| Rate for Payer: BCBS Complete |
$78.70
|
| Rate for Payer: BCBS MAPPO |
$106.30
|
| Rate for Payer: BCBS Trust/PPO |
$349.54
|
| Rate for Payer: BCN Commercial |
$349.54
|
| Rate for Payer: BCN Medicare Advantage |
$106.30
|
| Rate for Payer: Cash Price |
$340.14
|
| Rate for Payer: Cofinity Commercial |
$365.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$106.30
|
| Rate for Payer: Healthscope Commercial |
$382.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.88
|
| Rate for Payer: Mclaren Medicaid |
$74.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$111.61
|
| Rate for Payer: Meridian Medicaid |
$78.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$122.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$116.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.40
|
| Rate for Payer: Nomi Health Commercial |
$348.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.88
|
| Rate for Payer: PACE Senior Care Partners |
$100.98
|
| Rate for Payer: PACE SWMI |
$106.30
|
| Rate for Payer: PHP Commercial |
$361.40
|
| Rate for Payer: PHP Medicare Advantage |
$106.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$74.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$369.91
|
| Rate for Payer: Priority Health Medicare |
$107.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.93
|
| Rate for Payer: Railroad Medicare Medicare |
$106.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.16
|
| Rate for Payer: UHC Core |
$355.03
|
| Rate for Payer: UHC Exchange |
$106.30
|
| Rate for Payer: UHC Medicaid |
$74.96
|
| Rate for Payer: UHC Medicare Advantage |
$106.30
|
| Rate for Payer: UHCCP Medicaid |
$74.96
|
| Rate for Payer: VA VA |
$106.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.88
|
|
|
HC CRRT MONITORING PER HOUR
|
Facility
|
IP
|
$425.18
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$295.93 |
| Max. Negotiated Rate |
$382.66 |
| Rate for Payer: Aetna Commercial |
$361.40
|
| Rate for Payer: BCBS Trust/PPO |
$351.16
|
| Rate for Payer: BCN Commercial |
$351.16
|
| Rate for Payer: Cash Price |
$340.14
|
| Rate for Payer: Cofinity Commercial |
$365.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$340.14
|
| Rate for Payer: Healthscope Commercial |
$382.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$318.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$361.40
|
| Rate for Payer: Nomi Health Commercial |
$348.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$318.88
|
| Rate for Payer: PHP Commercial |
$361.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$369.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$295.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$374.16
|
| Rate for Payer: UHC Core |
$355.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$318.88
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$286.11
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$50.44 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: Aetna Medicare |
$74.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$89.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$89.41
|
| Rate for Payer: BCBS Complete |
$52.96
|
| Rate for Payer: BCBS MAPPO |
$71.53
|
| Rate for Payer: BCBS Trust/PPO |
$235.21
|
| Rate for Payer: BCN Commercial |
$235.21
|
| Rate for Payer: BCN Medicare Advantage |
$71.53
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.53
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: Mclaren Medicaid |
$50.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$75.10
|
| Rate for Payer: Meridian Medicaid |
$52.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$82.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Nomi Health Commercial |
$234.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PACE Senior Care Partners |
$67.95
|
| Rate for Payer: PACE SWMI |
$71.53
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: PHP Medicare Advantage |
$71.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$248.92
|
| Rate for Payer: Priority Health Medicare |
$72.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.13
|
| Rate for Payer: Railroad Medicare Medicare |
$71.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.78
|
| Rate for Payer: UHC Core |
$238.90
|
| Rate for Payer: UHC Exchange |
$71.53
|
| Rate for Payer: UHC Medicaid |
$50.44
|
| Rate for Payer: UHC Medicare Advantage |
$71.53
|
| Rate for Payer: UHCCP Medicaid |
$50.44
|
| Rate for Payer: VA VA |
$71.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$286.11
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$199.13 |
| Max. Negotiated Rate |
$257.50 |
| Rate for Payer: Aetna Commercial |
$243.19
|
| Rate for Payer: BCBS Trust/PPO |
$236.30
|
| Rate for Payer: BCN Commercial |
$236.30
|
| Rate for Payer: Cash Price |
$228.89
|
| Rate for Payer: Cofinity Commercial |
$246.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.89
|
| Rate for Payer: Healthscope Commercial |
$257.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$214.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$243.19
|
| Rate for Payer: Nomi Health Commercial |
$234.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.58
|
| Rate for Payer: PHP Commercial |
$243.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$248.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$199.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$251.78
|
| Rate for Payer: UHC Core |
$238.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$214.58
|
|
|
HC CRUTCHES
|
Facility
|
IP
|
$129.23
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$89.94 |
| Max. Negotiated Rate |
$116.31 |
| Rate for Payer: Aetna Commercial |
$109.85
|
| Rate for Payer: BCBS Trust/PPO |
$106.73
|
| Rate for Payer: BCN Commercial |
$106.73
|
| Rate for Payer: Cash Price |
$103.38
|
| Rate for Payer: Cofinity Commercial |
$111.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.38
|
| Rate for Payer: Healthscope Commercial |
$116.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.85
|
| Rate for Payer: Nomi Health Commercial |
$105.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.92
|
| Rate for Payer: PHP Commercial |
$109.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.72
|
| Rate for Payer: UHC Core |
$107.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.92
|
|
|
HC CRUTCHES
|
Facility
|
OP
|
$129.23
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$22.78 |
| Max. Negotiated Rate |
$116.31 |
| Rate for Payer: Aetna Commercial |
$109.85
|
| Rate for Payer: Aetna Medicare |
$33.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.38
|
| Rate for Payer: BCBS Complete |
$23.92
|
| Rate for Payer: BCBS MAPPO |
$32.31
|
| Rate for Payer: BCBS Trust/PPO |
$106.24
|
| Rate for Payer: BCN Commercial |
$106.24
|
| Rate for Payer: BCN Medicare Advantage |
$32.31
|
| Rate for Payer: Cash Price |
$103.38
|
| Rate for Payer: Cofinity Commercial |
$111.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$103.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.31
|
| Rate for Payer: Healthscope Commercial |
$116.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$96.92
|
| Rate for Payer: Mclaren Medicaid |
$22.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.92
|
| Rate for Payer: Meridian Medicaid |
$23.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$35.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$109.85
|
| Rate for Payer: Nomi Health Commercial |
$105.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$96.92
|
| Rate for Payer: PACE Senior Care Partners |
$30.69
|
| Rate for Payer: PACE SWMI |
$32.31
|
| Rate for Payer: PHP Commercial |
$109.85
|
| Rate for Payer: PHP Medicare Advantage |
$32.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$112.43
|
| Rate for Payer: Priority Health Medicare |
$32.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$89.94
|
| Rate for Payer: Railroad Medicare Medicare |
$32.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$113.72
|
| Rate for Payer: UHC Core |
$107.91
|
| Rate for Payer: UHC Exchange |
$32.31
|
| Rate for Payer: UHC Medicaid |
$22.78
|
| Rate for Payer: UHC Medicare Advantage |
$32.31
|
| Rate for Payer: UHCCP Medicaid |
$22.78
|
| Rate for Payer: VA VA |
$32.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$96.92
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
IP
|
$12,685.18
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$8,828.89 |
| Max. Negotiated Rate |
$11,416.66 |
| Rate for Payer: Aetna Commercial |
$10,782.40
|
| Rate for Payer: BCBS Trust/PPO |
$10,476.69
|
| Rate for Payer: BCN Commercial |
$10,476.69
|
| Rate for Payer: Cash Price |
$10,148.14
|
| Rate for Payer: Cofinity Commercial |
$10,909.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,148.14
|
| Rate for Payer: Healthscope Commercial |
$11,416.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,513.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,782.40
|
| Rate for Payer: Nomi Health Commercial |
$10,401.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,513.89
|
| Rate for Payer: PHP Commercial |
$10,782.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,036.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,828.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,162.96
|
| Rate for Payer: UHC Core |
$10,592.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,513.89
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
OP
|
$12,685.18
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,236.40 |
| Max. Negotiated Rate |
$11,416.66 |
| Rate for Payer: Aetna Commercial |
$10,782.40
|
| Rate for Payer: Aetna Medicare |
$3,298.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,964.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,964.12
|
| Rate for Payer: BCBS Complete |
$2,348.03
|
| Rate for Payer: BCBS MAPPO |
$3,171.30
|
| Rate for Payer: BCBS Trust/PPO |
$10,428.49
|
| Rate for Payer: BCN Commercial |
$10,428.49
|
| Rate for Payer: BCN Medicare Advantage |
$3,171.30
|
| Rate for Payer: Cash Price |
$10,148.14
|
| Rate for Payer: Cofinity Commercial |
$10,909.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,148.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,171.30
|
| Rate for Payer: Healthscope Commercial |
$11,416.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,513.89
|
| Rate for Payer: Mclaren Medicaid |
$2,236.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,329.86
|
| Rate for Payer: Meridian Medicaid |
$2,348.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,646.99
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,488.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,782.40
|
| Rate for Payer: Nomi Health Commercial |
$10,401.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,513.89
|
| Rate for Payer: PACE Senior Care Partners |
$3,012.73
|
| Rate for Payer: PACE SWMI |
$3,171.30
|
| Rate for Payer: PHP Commercial |
$10,782.40
|
| Rate for Payer: PHP Medicare Advantage |
$3,171.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,236.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$11,036.11
|
| Rate for Payer: Priority Health Medicare |
$3,203.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,828.89
|
| Rate for Payer: Railroad Medicare Medicare |
$3,171.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,162.96
|
| Rate for Payer: UHC Core |
$10,592.13
|
| Rate for Payer: UHC Exchange |
$3,171.30
|
| Rate for Payer: UHC Medicaid |
$2,236.40
|
| Rate for Payer: UHC Medicare Advantage |
$3,171.30
|
| Rate for Payer: UHCCP Medicaid |
$2,236.40
|
| Rate for Payer: VA VA |
$3,171.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,513.89
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
IP
|
$10,740.37
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,475.30 |
| Max. Negotiated Rate |
$9,666.33 |
| Rate for Payer: Aetna Commercial |
$9,129.31
|
| Rate for Payer: BCBS Trust/PPO |
$8,870.47
|
| Rate for Payer: BCN Commercial |
$8,870.47
|
| Rate for Payer: Cash Price |
$8,592.30
|
| Rate for Payer: Cofinity Commercial |
$9,236.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,592.30
|
| Rate for Payer: Healthscope Commercial |
$9,666.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,055.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,129.31
|
| Rate for Payer: Nomi Health Commercial |
$8,807.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,055.28
|
| Rate for Payer: PHP Commercial |
$9,129.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,344.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,475.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,451.53
|
| Rate for Payer: UHC Core |
$8,968.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,055.28
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
OP
|
$10,740.37
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,893.53 |
| Max. Negotiated Rate |
$9,666.33 |
| Rate for Payer: Aetna Commercial |
$9,129.31
|
| Rate for Payer: Aetna Medicare |
$2,792.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,356.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,356.37
|
| Rate for Payer: BCBS Complete |
$1,988.04
|
| Rate for Payer: BCBS MAPPO |
$2,685.09
|
| Rate for Payer: BCBS Trust/PPO |
$8,829.66
|
| Rate for Payer: BCN Commercial |
$8,829.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,685.09
|
| Rate for Payer: Cash Price |
$8,592.30
|
| Rate for Payer: Cofinity Commercial |
$9,236.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,592.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,685.09
|
| Rate for Payer: Healthscope Commercial |
$9,666.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,055.28
|
| Rate for Payer: Mclaren Medicaid |
$1,893.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,819.35
|
| Rate for Payer: Meridian Medicaid |
$1,988.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,087.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,953.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,129.31
|
| Rate for Payer: Nomi Health Commercial |
$8,807.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,055.28
|
| Rate for Payer: PACE Senior Care Partners |
$2,550.84
|
| Rate for Payer: PACE SWMI |
$2,685.09
|
| Rate for Payer: PHP Commercial |
$9,129.31
|
| Rate for Payer: PHP Medicare Advantage |
$2,685.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,893.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,344.12
|
| Rate for Payer: Priority Health Medicare |
$2,711.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,475.30
|
| Rate for Payer: Railroad Medicare Medicare |
$2,685.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,451.53
|
| Rate for Payer: UHC Core |
$8,968.21
|
| Rate for Payer: UHC Exchange |
$2,685.09
|
| Rate for Payer: UHC Medicaid |
$1,893.53
|
| Rate for Payer: UHC Medicare Advantage |
$2,685.09
|
| Rate for Payer: UHCCP Medicaid |
$1,893.53
|
| Rate for Payer: VA VA |
$2,685.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,055.28
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
OP
|
$11,109.39
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,958.59 |
| Max. Negotiated Rate |
$9,998.45 |
| Rate for Payer: Aetna Commercial |
$9,442.98
|
| Rate for Payer: Aetna Medicare |
$2,888.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,471.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,471.68
|
| Rate for Payer: BCBS Complete |
$2,056.35
|
| Rate for Payer: BCBS MAPPO |
$2,777.35
|
| Rate for Payer: BCBS Trust/PPO |
$9,133.03
|
| Rate for Payer: BCN Commercial |
$9,133.03
|
| Rate for Payer: BCN Medicare Advantage |
$2,777.35
|
| Rate for Payer: Cash Price |
$8,887.51
|
| Rate for Payer: Cofinity Commercial |
$9,554.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,887.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,777.35
|
| Rate for Payer: Healthscope Commercial |
$9,998.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,332.04
|
| Rate for Payer: Mclaren Medicaid |
$1,958.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,916.21
|
| Rate for Payer: Meridian Medicaid |
$2,056.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,193.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,055.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,442.98
|
| Rate for Payer: Nomi Health Commercial |
$9,109.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,332.04
|
| Rate for Payer: PACE Senior Care Partners |
$2,638.48
|
| Rate for Payer: PACE SWMI |
$2,777.35
|
| Rate for Payer: PHP Commercial |
$9,442.98
|
| Rate for Payer: PHP Medicare Advantage |
$2,777.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,958.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,665.17
|
| Rate for Payer: Priority Health Medicare |
$2,805.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,732.14
|
| Rate for Payer: Railroad Medicare Medicare |
$2,777.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,776.26
|
| Rate for Payer: UHC Core |
$9,276.34
|
| Rate for Payer: UHC Exchange |
$2,777.35
|
| Rate for Payer: UHC Medicaid |
$1,958.59
|
| Rate for Payer: UHC Medicare Advantage |
$2,777.35
|
| Rate for Payer: UHCCP Medicaid |
$1,958.59
|
| Rate for Payer: VA VA |
$2,777.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,332.04
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
IP
|
$11,109.39
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,732.14 |
| Max. Negotiated Rate |
$9,998.45 |
| Rate for Payer: Aetna Commercial |
$9,442.98
|
| Rate for Payer: BCBS Trust/PPO |
$9,175.25
|
| Rate for Payer: BCN Commercial |
$9,175.25
|
| Rate for Payer: Cash Price |
$8,887.51
|
| Rate for Payer: Cofinity Commercial |
$9,554.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,887.51
|
| Rate for Payer: Healthscope Commercial |
$9,998.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,332.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,442.98
|
| Rate for Payer: Nomi Health Commercial |
$9,109.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8,332.04
|
| Rate for Payer: PHP Commercial |
$9,442.98
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9,665.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,732.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,776.26
|
| Rate for Payer: UHC Core |
$9,276.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,332.04
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
OP
|
$3,597.50
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$634.24 |
| Max. Negotiated Rate |
$3,237.75 |
| Rate for Payer: Aetna Commercial |
$3,057.88
|
| Rate for Payer: Aetna Medicare |
$935.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,124.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,124.22
|
| Rate for Payer: BCBS Complete |
$665.90
|
| Rate for Payer: BCBS MAPPO |
$899.38
|
| Rate for Payer: BCBS Trust/PPO |
$2,957.50
|
| Rate for Payer: BCN Commercial |
$2,957.50
|
| Rate for Payer: BCN Medicare Advantage |
$899.38
|
| Rate for Payer: Cash Price |
$2,878.00
|
| Rate for Payer: Cofinity Commercial |
$3,093.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,878.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$899.38
|
| Rate for Payer: Healthscope Commercial |
$3,237.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,698.12
|
| Rate for Payer: Mclaren Medicaid |
$634.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$944.34
|
| Rate for Payer: Meridian Medicaid |
$665.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,034.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$989.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,057.88
|
| Rate for Payer: Nomi Health Commercial |
$2,949.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,698.12
|
| Rate for Payer: PACE Senior Care Partners |
$854.41
|
| Rate for Payer: PACE SWMI |
$899.38
|
| Rate for Payer: PHP Commercial |
$3,057.88
|
| Rate for Payer: PHP Medicare Advantage |
$899.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$634.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,129.82
|
| Rate for Payer: Priority Health Medicare |
$908.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,503.86
|
| Rate for Payer: Railroad Medicare Medicare |
$899.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,165.80
|
| Rate for Payer: UHC Core |
$3,003.91
|
| Rate for Payer: UHC Exchange |
$899.38
|
| Rate for Payer: UHC Medicaid |
$634.24
|
| Rate for Payer: UHC Medicare Advantage |
$899.38
|
| Rate for Payer: UHCCP Medicaid |
$634.24
|
| Rate for Payer: VA VA |
$899.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,698.12
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
IP
|
$3,597.50
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,503.86 |
| Max. Negotiated Rate |
$3,237.75 |
| Rate for Payer: Aetna Commercial |
$3,057.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,971.18
|
| Rate for Payer: BCN Commercial |
$2,971.18
|
| Rate for Payer: Cash Price |
$2,878.00
|
| Rate for Payer: Cofinity Commercial |
$3,093.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,878.00
|
| Rate for Payer: Healthscope Commercial |
$3,237.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,698.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,057.88
|
| Rate for Payer: Nomi Health Commercial |
$2,949.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,698.12
|
| Rate for Payer: PHP Commercial |
$3,057.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,129.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,503.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,165.80
|
| Rate for Payer: UHC Core |
$3,003.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,698.12
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
IP
|
$8,343.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,807.31 |
| Max. Negotiated Rate |
$7,509.46 |
| Rate for Payer: Aetna Commercial |
$7,092.26
|
| Rate for Payer: BCBS Trust/PPO |
$6,891.18
|
| Rate for Payer: BCN Commercial |
$6,891.18
|
| Rate for Payer: Cash Price |
$6,675.07
|
| Rate for Payer: Cofinity Commercial |
$7,175.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,675.07
|
| Rate for Payer: Healthscope Commercial |
$7,509.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,257.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,092.26
|
| Rate for Payer: Nomi Health Commercial |
$6,841.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,257.88
|
| Rate for Payer: PHP Commercial |
$7,092.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,259.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,807.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,342.58
|
| Rate for Payer: UHC Core |
$6,967.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,257.88
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
OP
|
$8,343.84
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,471.02 |
| Max. Negotiated Rate |
$7,509.46 |
| Rate for Payer: Aetna Commercial |
$7,092.26
|
| Rate for Payer: Aetna Medicare |
$2,169.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,607.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,607.45
|
| Rate for Payer: BCBS Complete |
$1,544.44
|
| Rate for Payer: BCBS MAPPO |
$2,085.96
|
| Rate for Payer: BCBS Trust/PPO |
$6,859.47
|
| Rate for Payer: BCN Commercial |
$6,859.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,085.96
|
| Rate for Payer: Cash Price |
$6,675.07
|
| Rate for Payer: Cofinity Commercial |
$7,175.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,675.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,085.96
|
| Rate for Payer: Healthscope Commercial |
$7,509.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,257.88
|
| Rate for Payer: Mclaren Medicaid |
$1,471.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,190.26
|
| Rate for Payer: Meridian Medicaid |
$1,544.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,398.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,294.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,092.26
|
| Rate for Payer: Nomi Health Commercial |
$6,841.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,257.88
|
| Rate for Payer: PACE Senior Care Partners |
$1,981.66
|
| Rate for Payer: PACE SWMI |
$2,085.96
|
| Rate for Payer: PHP Commercial |
$7,092.26
|
| Rate for Payer: PHP Medicare Advantage |
$2,085.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,471.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,259.14
|
| Rate for Payer: Priority Health Medicare |
$2,106.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,807.31
|
| Rate for Payer: Railroad Medicare Medicare |
$2,085.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,342.58
|
| Rate for Payer: UHC Core |
$6,967.11
|
| Rate for Payer: UHC Exchange |
$2,085.96
|
| Rate for Payer: UHC Medicaid |
$1,471.02
|
| Rate for Payer: UHC Medicare Advantage |
$2,085.96
|
| Rate for Payer: UHCCP Medicaid |
$1,471.02
|
| Rate for Payer: VA VA |
$2,085.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,257.88
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
IP
|
$12,517.61
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8,712.26 |
| Max. Negotiated Rate |
$11,265.85 |
| Rate for Payer: Aetna Commercial |
$10,639.97
|
| Rate for Payer: BCBS Trust/PPO |
$10,338.29
|
| Rate for Payer: BCN Commercial |
$10,338.29
|
| Rate for Payer: Cash Price |
$10,014.09
|
| Rate for Payer: Cofinity Commercial |
$10,765.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,014.09
|
| Rate for Payer: Healthscope Commercial |
$11,265.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,388.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,639.97
|
| Rate for Payer: Nomi Health Commercial |
$10,264.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,388.21
|
| Rate for Payer: PHP Commercial |
$10,639.97
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,890.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,712.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,015.50
|
| Rate for Payer: UHC Core |
$10,452.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,388.21
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
OP
|
$12,517.61
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,206.85 |
| Max. Negotiated Rate |
$11,265.85 |
| Rate for Payer: Aetna Commercial |
$10,639.97
|
| Rate for Payer: Aetna Medicare |
$3,254.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,911.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,911.75
|
| Rate for Payer: BCBS Complete |
$2,317.01
|
| Rate for Payer: BCBS MAPPO |
$3,129.40
|
| Rate for Payer: BCBS Trust/PPO |
$10,290.73
|
| Rate for Payer: BCN Commercial |
$10,290.73
|
| Rate for Payer: BCN Medicare Advantage |
$3,129.40
|
| Rate for Payer: Cash Price |
$10,014.09
|
| Rate for Payer: Cofinity Commercial |
$10,765.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$10,014.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,129.40
|
| Rate for Payer: Healthscope Commercial |
$11,265.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,388.21
|
| Rate for Payer: Mclaren Medicaid |
$2,206.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,285.87
|
| Rate for Payer: Meridian Medicaid |
$2,317.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,598.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,442.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,639.97
|
| Rate for Payer: Nomi Health Commercial |
$10,264.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$9,388.21
|
| Rate for Payer: PACE Senior Care Partners |
$2,972.93
|
| Rate for Payer: PACE SWMI |
$3,129.40
|
| Rate for Payer: PHP Commercial |
$10,639.97
|
| Rate for Payer: PHP Medicare Advantage |
$3,129.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,206.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$10,890.32
|
| Rate for Payer: Priority Health Medicare |
$3,160.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,712.26
|
| Rate for Payer: Railroad Medicare Medicare |
$3,129.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$11,015.50
|
| Rate for Payer: UHC Core |
$10,452.20
|
| Rate for Payer: UHC Exchange |
$3,129.40
|
| Rate for Payer: UHC Medicaid |
$2,206.85
|
| Rate for Payer: UHC Medicare Advantage |
$3,129.40
|
| Rate for Payer: UHCCP Medicaid |
$2,206.85
|
| Rate for Payer: VA VA |
$3,129.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,388.21
|
|
|
HC CRYOGLOBULINS
|
Facility
|
OP
|
$20.17
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.56 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: Aetna Medicare |
$5.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.30
|
| Rate for Payer: BCBS Complete |
$3.73
|
| Rate for Payer: BCBS MAPPO |
$5.04
|
| Rate for Payer: BCBS Trust/PPO |
$16.58
|
| Rate for Payer: BCN Commercial |
$16.58
|
| Rate for Payer: BCN Medicare Advantage |
$5.04
|
| Rate for Payer: Cash Price |
$16.14
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.04
|
| Rate for Payer: Healthscope Commercial |
$18.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.13
|
| Rate for Payer: Mclaren Medicaid |
$3.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.29
|
| Rate for Payer: Meridian Medicaid |
$3.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Nomi Health Commercial |
$16.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.13
|
| Rate for Payer: PACE Senior Care Partners |
$4.79
|
| Rate for Payer: PACE SWMI |
$5.04
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: PHP Medicare Advantage |
$5.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.55
|
| Rate for Payer: Priority Health Medicare |
$5.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.04
|
| Rate for Payer: Railroad Medicare Medicare |
$5.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.75
|
| Rate for Payer: UHC Core |
$16.84
|
| Rate for Payer: UHC Exchange |
$5.04
|
| Rate for Payer: UHC Medicaid |
$3.56
|
| Rate for Payer: UHC Medicare Advantage |
$5.04
|
| Rate for Payer: UHCCP Medicaid |
$3.56
|
| Rate for Payer: VA VA |
$5.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.13
|
|
|
HC CRYOGLOBULINS
|
Facility
|
IP
|
$20.17
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.04 |
| Max. Negotiated Rate |
$18.15 |
| Rate for Payer: Aetna Commercial |
$17.14
|
| Rate for Payer: BCBS Trust/PPO |
$16.66
|
| Rate for Payer: BCN Commercial |
$16.66
|
| Rate for Payer: Cash Price |
$16.14
|
| Rate for Payer: Cofinity Commercial |
$17.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.14
|
| Rate for Payer: Healthscope Commercial |
$18.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.14
|
| Rate for Payer: Nomi Health Commercial |
$16.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.13
|
| Rate for Payer: PHP Commercial |
$17.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.75
|
| Rate for Payer: UHC Core |
$16.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.13
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
IP
|
$25.32
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.62 |
| Max. Negotiated Rate |
$22.79 |
| Rate for Payer: Aetna Commercial |
$21.52
|
| Rate for Payer: BCBS Trust/PPO |
$20.91
|
| Rate for Payer: BCN Commercial |
$20.91
|
| Rate for Payer: Cash Price |
$20.26
|
| Rate for Payer: Cofinity Commercial |
$21.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.26
|
| Rate for Payer: Healthscope Commercial |
$22.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.52
|
| Rate for Payer: Nomi Health Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.99
|
| Rate for Payer: PHP Commercial |
$21.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.28
|
| Rate for Payer: UHC Core |
$21.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.99
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
OP
|
$25.32
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$22.79 |
| Rate for Payer: Aetna Commercial |
$21.52
|
| Rate for Payer: Aetna Medicare |
$6.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.91
|
| Rate for Payer: BCBS Complete |
$4.69
|
| Rate for Payer: BCBS MAPPO |
$6.33
|
| Rate for Payer: BCBS Trust/PPO |
$20.82
|
| Rate for Payer: BCN Commercial |
$20.82
|
| Rate for Payer: BCN Medicare Advantage |
$6.33
|
| Rate for Payer: Cash Price |
$20.26
|
| Rate for Payer: Cofinity Commercial |
$21.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.33
|
| Rate for Payer: Healthscope Commercial |
$22.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.99
|
| Rate for Payer: Mclaren Medicaid |
$4.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.65
|
| Rate for Payer: Meridian Medicaid |
$4.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.52
|
| Rate for Payer: Nomi Health Commercial |
$20.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$18.99
|
| Rate for Payer: PACE Senior Care Partners |
$6.01
|
| Rate for Payer: PACE SWMI |
$6.33
|
| Rate for Payer: PHP Commercial |
$21.52
|
| Rate for Payer: PHP Medicare Advantage |
$6.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.03
|
| Rate for Payer: Priority Health Medicare |
$6.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.62
|
| Rate for Payer: Railroad Medicare Medicare |
$6.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.28
|
| Rate for Payer: UHC Core |
$21.14
|
| Rate for Payer: UHC Exchange |
$6.33
|
| Rate for Payer: UHC Medicaid |
$4.46
|
| Rate for Payer: UHC Medicare Advantage |
$6.33
|
| Rate for Payer: UHCCP Medicaid |
$4.46
|
| Rate for Payer: VA VA |
$6.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.99
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
IP
|
$44.74
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.14 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: BCBS Trust/PPO |
$36.95
|
| Rate for Payer: BCN Commercial |
$36.95
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.55
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
OP
|
$44.74
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.89 |
| Max. Negotiated Rate |
$40.27 |
| Rate for Payer: Aetna Commercial |
$38.03
|
| Rate for Payer: Aetna Medicare |
$11.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.98
|
| Rate for Payer: BCBS Complete |
$8.28
|
| Rate for Payer: BCBS MAPPO |
$11.19
|
| Rate for Payer: BCBS Trust/PPO |
$36.78
|
| Rate for Payer: BCN Commercial |
$36.78
|
| Rate for Payer: BCN Medicare Advantage |
$11.19
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Cofinity Commercial |
$38.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.19
|
| Rate for Payer: Healthscope Commercial |
$40.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$33.55
|
| Rate for Payer: Mclaren Medicaid |
$7.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.74
|
| Rate for Payer: Meridian Medicaid |
$8.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.03
|
| Rate for Payer: Nomi Health Commercial |
$36.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.55
|
| Rate for Payer: PACE Senior Care Partners |
$10.63
|
| Rate for Payer: PACE SWMI |
$11.19
|
| Rate for Payer: PHP Commercial |
$38.03
|
| Rate for Payer: PHP Medicare Advantage |
$11.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$38.92
|
| Rate for Payer: Priority Health Medicare |
$11.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.14
|
| Rate for Payer: Railroad Medicare Medicare |
$11.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$39.37
|
| Rate for Payer: UHC Core |
$37.36
|
| Rate for Payer: UHC Exchange |
$11.19
|
| Rate for Payer: UHC Medicaid |
$7.89
|
| Rate for Payer: UHC Medicare Advantage |
$11.19
|
| Rate for Payer: UHCCP Medicaid |
$7.89
|
| Rate for Payer: VA VA |
$11.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$33.55
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
IP
|
$146.02
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$101.63 |
| Max. Negotiated Rate |
$131.42 |
| Rate for Payer: Aetna Commercial |
$124.12
|
| Rate for Payer: BCBS Trust/PPO |
$120.60
|
| Rate for Payer: BCN Commercial |
$120.60
|
| Rate for Payer: Cash Price |
$116.82
|
| Rate for Payer: Cofinity Commercial |
$125.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.82
|
| Rate for Payer: Healthscope Commercial |
$131.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.12
|
| Rate for Payer: Nomi Health Commercial |
$119.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$109.52
|
| Rate for Payer: PHP Commercial |
$124.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$127.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.50
|
| Rate for Payer: UHC Core |
$121.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.52
|
|
