|
HC CRYOPRECIPITATE
|
Facility
|
OP
|
$146.02
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$25.74 |
| Max. Negotiated Rate |
$131.42 |
| Rate for Payer: Aetna Commercial |
$124.12
|
| Rate for Payer: Aetna Medicare |
$37.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.63
|
| Rate for Payer: BCBS Complete |
$27.03
|
| Rate for Payer: BCBS MAPPO |
$36.51
|
| Rate for Payer: BCBS Trust/PPO |
$120.04
|
| Rate for Payer: BCN Commercial |
$120.04
|
| Rate for Payer: BCN Medicare Advantage |
$36.51
|
| 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: Health Alliance Plan Medicare Advantage |
$36.51
|
| Rate for Payer: Healthscope Commercial |
$131.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.52
|
| Rate for Payer: Mclaren Medicaid |
$25.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.33
|
| Rate for Payer: Meridian Medicaid |
$27.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.16
|
| 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: PACE Senior Care Partners |
$34.68
|
| Rate for Payer: PACE SWMI |
$36.51
|
| Rate for Payer: PHP Commercial |
$124.12
|
| Rate for Payer: PHP Medicare Advantage |
$36.51
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$127.04
|
| Rate for Payer: Priority Health Medicare |
$36.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$101.63
|
| Rate for Payer: Railroad Medicare Medicare |
$36.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.50
|
| Rate for Payer: UHC Core |
$121.93
|
| Rate for Payer: UHC Exchange |
$36.51
|
| Rate for Payer: UHC Medicaid |
$25.74
|
| Rate for Payer: UHC Medicare Advantage |
$36.51
|
| Rate for Payer: UHCCP Medicaid |
$25.74
|
| Rate for Payer: VA VA |
$36.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.52
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
OP
|
$347.60
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$61.28 |
| Max. Negotiated Rate |
$312.84 |
| Rate for Payer: Aetna Commercial |
$295.46
|
| Rate for Payer: Aetna Medicare |
$90.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.62
|
| Rate for Payer: BCBS Complete |
$64.34
|
| Rate for Payer: BCBS MAPPO |
$86.90
|
| Rate for Payer: BCBS Trust/PPO |
$285.76
|
| Rate for Payer: BCN Commercial |
$285.76
|
| Rate for Payer: BCN Medicare Advantage |
$86.90
|
| Rate for Payer: Cash Price |
$278.08
|
| Rate for Payer: Cofinity Commercial |
$298.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.90
|
| Rate for Payer: Healthscope Commercial |
$312.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.70
|
| Rate for Payer: Mclaren Medicaid |
$61.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.25
|
| Rate for Payer: Meridian Medicaid |
$64.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.46
|
| Rate for Payer: Nomi Health Commercial |
$285.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.70
|
| Rate for Payer: PACE Senior Care Partners |
$82.56
|
| Rate for Payer: PACE SWMI |
$86.90
|
| Rate for Payer: PHP Commercial |
$295.46
|
| Rate for Payer: PHP Medicare Advantage |
$86.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.41
|
| Rate for Payer: Priority Health Medicare |
$87.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.93
|
| Rate for Payer: Railroad Medicare Medicare |
$86.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.89
|
| Rate for Payer: UHC Core |
$290.25
|
| Rate for Payer: UHC Exchange |
$86.90
|
| Rate for Payer: UHC Medicaid |
$61.28
|
| Rate for Payer: UHC Medicare Advantage |
$86.90
|
| Rate for Payer: UHCCP Medicaid |
$61.28
|
| Rate for Payer: VA VA |
$86.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.70
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
IP
|
$347.60
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$241.93 |
| Max. Negotiated Rate |
$312.84 |
| Rate for Payer: Aetna Commercial |
$295.46
|
| Rate for Payer: BCBS Trust/PPO |
$287.08
|
| Rate for Payer: BCN Commercial |
$287.08
|
| Rate for Payer: Cash Price |
$278.08
|
| Rate for Payer: Cofinity Commercial |
$298.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.08
|
| Rate for Payer: Healthscope Commercial |
$312.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$260.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.46
|
| Rate for Payer: Nomi Health Commercial |
$285.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$260.70
|
| Rate for Payer: PHP Commercial |
$295.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$241.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$305.89
|
| Rate for Payer: UHC Core |
$290.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$260.70
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.74 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: Aetna Medicare |
$65.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.31
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$63.45
|
| Rate for Payer: BCBS Trust/PPO |
$208.63
|
| Rate for Payer: BCN Commercial |
$208.63
|
| Rate for Payer: BCN Medicare Advantage |
$63.45
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.45
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Mclaren Medicaid |
$44.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.62
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Senior Care Partners |
$60.27
|
| Rate for Payer: PACE SWMI |
$63.45
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: PHP Medicare Advantage |
$63.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Medicare |
$64.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: Railroad Medicare Medicare |
$63.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: UHC Exchange |
$63.45
|
| Rate for Payer: UHC Medicaid |
$44.74
|
| Rate for Payer: UHC Medicare Advantage |
$63.45
|
| Rate for Payer: UHCCP Medicaid |
$44.74
|
| Rate for Payer: VA VA |
$63.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$176.63 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: BCBS Trust/PPO |
$209.60
|
| Rate for Payer: BCN Commercial |
$209.60
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$176.63 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: BCBS Trust/PPO |
$209.60
|
| Rate for Payer: BCN Commercial |
$209.60
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.74 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: Aetna Medicare |
$65.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.31
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$63.45
|
| Rate for Payer: BCBS Trust/PPO |
$208.63
|
| Rate for Payer: BCN Commercial |
$208.63
|
| Rate for Payer: BCN Medicare Advantage |
$63.45
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.45
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Mclaren Medicaid |
$44.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.62
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Senior Care Partners |
$60.27
|
| Rate for Payer: PACE SWMI |
$63.45
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: PHP Medicare Advantage |
$63.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Medicare |
$64.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: Railroad Medicare Medicare |
$63.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: UHC Exchange |
$63.45
|
| Rate for Payer: UHC Medicaid |
$44.74
|
| Rate for Payer: UHC Medicare Advantage |
$63.45
|
| Rate for Payer: UHCCP Medicaid |
$44.74
|
| Rate for Payer: VA VA |
$63.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.74 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: Aetna Medicare |
$65.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.31
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$63.45
|
| Rate for Payer: BCBS Trust/PPO |
$208.63
|
| Rate for Payer: BCN Commercial |
$208.63
|
| Rate for Payer: BCN Medicare Advantage |
$63.45
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.45
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Mclaren Medicaid |
$44.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.62
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Senior Care Partners |
$60.27
|
| Rate for Payer: PACE SWMI |
$63.45
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: PHP Medicare Advantage |
$63.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Medicare |
$64.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: Railroad Medicare Medicare |
$63.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: UHC Exchange |
$63.45
|
| Rate for Payer: UHC Medicaid |
$44.74
|
| Rate for Payer: UHC Medicare Advantage |
$63.45
|
| Rate for Payer: UHCCP Medicaid |
$44.74
|
| Rate for Payer: VA VA |
$63.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$176.63 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: BCBS Trust/PPO |
$209.60
|
| Rate for Payer: BCN Commercial |
$209.60
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$176.63 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: BCBS Trust/PPO |
$209.60
|
| Rate for Payer: BCN Commercial |
$209.60
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.74 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: Aetna Medicare |
$65.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.31
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$63.45
|
| Rate for Payer: BCBS Trust/PPO |
$208.63
|
| Rate for Payer: BCN Commercial |
$208.63
|
| Rate for Payer: BCN Medicare Advantage |
$63.45
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.45
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Mclaren Medicaid |
$44.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.62
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Senior Care Partners |
$60.27
|
| Rate for Payer: PACE SWMI |
$63.45
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: PHP Medicare Advantage |
$63.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Medicare |
$64.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: Railroad Medicare Medicare |
$63.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: UHC Exchange |
$63.45
|
| Rate for Payer: UHC Medicaid |
$44.74
|
| Rate for Payer: UHC Medicare Advantage |
$63.45
|
| Rate for Payer: UHCCP Medicaid |
$44.74
|
| Rate for Payer: VA VA |
$63.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
IP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$176.63 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: BCBS Trust/PPO |
$209.60
|
| Rate for Payer: BCN Commercial |
$209.60
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
OP
|
$253.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$44.74 |
| Max. Negotiated Rate |
$228.40 |
| Rate for Payer: Aetna Commercial |
$215.71
|
| Rate for Payer: Aetna Medicare |
$65.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.31
|
| Rate for Payer: BCBS Complete |
$46.97
|
| Rate for Payer: BCBS MAPPO |
$63.45
|
| Rate for Payer: BCBS Trust/PPO |
$208.63
|
| Rate for Payer: BCN Commercial |
$208.63
|
| Rate for Payer: BCN Medicare Advantage |
$63.45
|
| Rate for Payer: Cash Price |
$203.02
|
| Rate for Payer: Cofinity Commercial |
$218.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.45
|
| Rate for Payer: Healthscope Commercial |
$228.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$190.34
|
| Rate for Payer: Mclaren Medicaid |
$44.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.62
|
| Rate for Payer: Meridian Medicaid |
$46.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$72.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$69.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$215.71
|
| Rate for Payer: Nomi Health Commercial |
$208.10
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$190.34
|
| Rate for Payer: PACE Senior Care Partners |
$60.27
|
| Rate for Payer: PACE SWMI |
$63.45
|
| Rate for Payer: PHP Commercial |
$215.71
|
| Rate for Payer: PHP Medicare Advantage |
$63.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$44.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$220.79
|
| Rate for Payer: Priority Health Medicare |
$64.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.63
|
| Rate for Payer: Railroad Medicare Medicare |
$63.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$223.33
|
| Rate for Payer: UHC Core |
$211.91
|
| Rate for Payer: UHC Exchange |
$63.45
|
| Rate for Payer: UHC Medicaid |
$44.74
|
| Rate for Payer: UHC Medicare Advantage |
$63.45
|
| Rate for Payer: UHCCP Medicaid |
$44.74
|
| Rate for Payer: VA VA |
$63.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$190.34
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
IP
|
$564.42
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$392.84 |
| Max. Negotiated Rate |
$507.98 |
| Rate for Payer: Aetna Commercial |
$479.76
|
| Rate for Payer: BCBS Trust/PPO |
$466.15
|
| Rate for Payer: BCN Commercial |
$466.15
|
| Rate for Payer: Cash Price |
$451.54
|
| Rate for Payer: Cofinity Commercial |
$485.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.54
|
| Rate for Payer: Healthscope Commercial |
$507.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$479.76
|
| Rate for Payer: Nomi Health Commercial |
$462.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$423.31
|
| Rate for Payer: PHP Commercial |
$479.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$491.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.69
|
| Rate for Payer: UHC Core |
$471.29
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.31
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
OP
|
$564.42
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$99.51 |
| Max. Negotiated Rate |
$507.98 |
| Rate for Payer: Aetna Commercial |
$479.76
|
| Rate for Payer: Aetna Medicare |
$146.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$176.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$176.38
|
| Rate for Payer: BCBS Complete |
$104.47
|
| Rate for Payer: BCBS MAPPO |
$141.10
|
| Rate for Payer: BCBS Trust/PPO |
$464.01
|
| Rate for Payer: BCN Commercial |
$464.01
|
| Rate for Payer: BCN Medicare Advantage |
$141.10
|
| Rate for Payer: Cash Price |
$451.54
|
| Rate for Payer: Cofinity Commercial |
$485.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$451.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$141.10
|
| Rate for Payer: Healthscope Commercial |
$507.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$423.31
|
| Rate for Payer: Mclaren Medicaid |
$99.51
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$148.16
|
| Rate for Payer: Meridian Medicaid |
$104.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$162.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$155.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$479.76
|
| Rate for Payer: Nomi Health Commercial |
$462.82
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$423.31
|
| Rate for Payer: PACE Senior Care Partners |
$134.05
|
| Rate for Payer: PACE SWMI |
$141.10
|
| Rate for Payer: PHP Commercial |
$479.76
|
| Rate for Payer: PHP Medicare Advantage |
$141.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$99.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$491.05
|
| Rate for Payer: Priority Health Medicare |
$142.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$392.84
|
| Rate for Payer: Railroad Medicare Medicare |
$141.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$496.69
|
| Rate for Payer: UHC Core |
$471.29
|
| Rate for Payer: UHC Exchange |
$141.10
|
| Rate for Payer: UHC Medicaid |
$99.51
|
| Rate for Payer: UHC Medicare Advantage |
$141.10
|
| Rate for Payer: UHCCP Medicaid |
$99.51
|
| Rate for Payer: VA VA |
$141.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$423.31
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
OP
|
$47.76
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.42 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: Aetna Medicare |
$12.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.93
|
| Rate for Payer: BCBS Complete |
$8.84
|
| Rate for Payer: BCBS MAPPO |
$11.94
|
| Rate for Payer: BCBS Trust/PPO |
$39.26
|
| Rate for Payer: BCN Commercial |
$39.26
|
| Rate for Payer: BCN Medicare Advantage |
$11.94
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.94
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Mclaren Medicaid |
$8.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.54
|
| Rate for Payer: Meridian Medicaid |
$8.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PACE Senior Care Partners |
$11.34
|
| Rate for Payer: PACE SWMI |
$11.94
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: PHP Medicare Advantage |
$11.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Medicare |
$12.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: Railroad Medicare Medicare |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: UHC Exchange |
$11.94
|
| Rate for Payer: UHC Medicaid |
$8.42
|
| Rate for Payer: UHC Medicare Advantage |
$11.94
|
| Rate for Payer: UHCCP Medicaid |
$8.42
|
| Rate for Payer: VA VA |
$11.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
IP
|
$47.76
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$33.24 |
| Max. Negotiated Rate |
$42.98 |
| Rate for Payer: Aetna Commercial |
$40.60
|
| Rate for Payer: BCBS Trust/PPO |
$39.44
|
| Rate for Payer: BCN Commercial |
$39.44
|
| Rate for Payer: Cash Price |
$38.21
|
| Rate for Payer: Cofinity Commercial |
$41.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.21
|
| Rate for Payer: Healthscope Commercial |
$42.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.60
|
| Rate for Payer: Nomi Health Commercial |
$39.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.82
|
| Rate for Payer: PHP Commercial |
$40.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.03
|
| Rate for Payer: UHC Core |
$39.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.82
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
OP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.35 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: Aetna Medicare |
$13.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.58
|
| Rate for Payer: BCBS Complete |
$9.82
|
| Rate for Payer: BCBS MAPPO |
$13.27
|
| Rate for Payer: BCBS Trust/PPO |
$43.62
|
| Rate for Payer: BCN Commercial |
$43.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.27
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.27
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Mclaren Medicaid |
$9.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.93
|
| Rate for Payer: Meridian Medicaid |
$9.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PACE Senior Care Partners |
$12.60
|
| Rate for Payer: PACE SWMI |
$13.27
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: PHP Medicare Advantage |
$13.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Medicare |
$13.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: UHC Exchange |
$13.27
|
| Rate for Payer: UHC Medicaid |
$9.35
|
| Rate for Payer: UHC Medicare Advantage |
$13.27
|
| Rate for Payer: UHCCP Medicaid |
$9.35
|
| Rate for Payer: VA VA |
$13.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
IP
|
$53.06
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.93 |
| Max. Negotiated Rate |
$47.75 |
| Rate for Payer: Aetna Commercial |
$45.10
|
| Rate for Payer: BCBS Trust/PPO |
$43.82
|
| Rate for Payer: BCN Commercial |
$43.82
|
| Rate for Payer: Cash Price |
$42.45
|
| Rate for Payer: Cofinity Commercial |
$45.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.45
|
| Rate for Payer: Healthscope Commercial |
$47.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.10
|
| Rate for Payer: Nomi Health Commercial |
$43.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.80
|
| Rate for Payer: PHP Commercial |
$45.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.69
|
| Rate for Payer: UHC Core |
$44.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.80
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
OP
|
$46.70
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.23 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: Aetna Medicare |
$12.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.59
|
| Rate for Payer: BCBS Complete |
$8.64
|
| Rate for Payer: BCBS MAPPO |
$11.68
|
| Rate for Payer: BCBS Trust/PPO |
$38.39
|
| Rate for Payer: BCN Commercial |
$38.39
|
| Rate for Payer: BCN Medicare Advantage |
$11.68
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.68
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Mclaren Medicaid |
$8.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.26
|
| Rate for Payer: Meridian Medicaid |
$8.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.43
|
| Rate for Payer: Molina Medicare/Medicaid |
$12.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PACE Senior Care Partners |
$11.09
|
| Rate for Payer: PACE SWMI |
$11.68
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: PHP Medicare Advantage |
$11.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Medicare |
$11.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: Railroad Medicare Medicare |
$11.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: UHC Exchange |
$11.68
|
| Rate for Payer: UHC Medicaid |
$8.23
|
| Rate for Payer: UHC Medicare Advantage |
$11.68
|
| Rate for Payer: UHCCP Medicaid |
$8.23
|
| Rate for Payer: VA VA |
$11.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
IP
|
$46.70
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$32.50 |
| Max. Negotiated Rate |
$42.03 |
| Rate for Payer: Aetna Commercial |
$39.70
|
| Rate for Payer: BCBS Trust/PPO |
$38.57
|
| Rate for Payer: BCN Commercial |
$38.57
|
| Rate for Payer: Cash Price |
$37.36
|
| Rate for Payer: Cofinity Commercial |
$40.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.36
|
| Rate for Payer: Healthscope Commercial |
$42.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.70
|
| Rate for Payer: Nomi Health Commercial |
$38.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35.02
|
| Rate for Payer: PHP Commercial |
$39.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$40.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.10
|
| Rate for Payer: UHC Core |
$38.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.02
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$48.18
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$33.53 |
| Max. Negotiated Rate |
$43.36 |
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: BCBS Trust/PPO |
$39.79
|
| Rate for Payer: BCN Commercial |
$39.79
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Healthscope Commercial |
$43.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Nomi Health Commercial |
$39.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.13
|
| Rate for Payer: PHP Commercial |
$40.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.40
|
| Rate for Payer: UHC Core |
$40.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.13
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$48.18
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$8.49 |
| Max. Negotiated Rate |
$43.36 |
| Rate for Payer: Aetna Commercial |
$40.95
|
| Rate for Payer: Aetna Medicare |
$12.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.06
|
| Rate for Payer: BCBS Complete |
$8.92
|
| Rate for Payer: BCBS MAPPO |
$12.04
|
| Rate for Payer: BCBS Trust/PPO |
$39.61
|
| Rate for Payer: BCN Commercial |
$39.61
|
| Rate for Payer: BCN Medicare Advantage |
$12.04
|
| Rate for Payer: Cash Price |
$38.54
|
| Rate for Payer: Cofinity Commercial |
$41.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$38.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.04
|
| Rate for Payer: Healthscope Commercial |
$43.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.13
|
| Rate for Payer: Mclaren Medicaid |
$8.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.65
|
| Rate for Payer: Meridian Medicaid |
$8.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.95
|
| Rate for Payer: Nomi Health Commercial |
$39.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$36.13
|
| Rate for Payer: PACE Senior Care Partners |
$11.44
|
| Rate for Payer: PACE SWMI |
$12.04
|
| Rate for Payer: PHP Commercial |
$40.95
|
| Rate for Payer: PHP Medicare Advantage |
$12.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41.92
|
| Rate for Payer: Priority Health Medicare |
$12.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$33.53
|
| Rate for Payer: Railroad Medicare Medicare |
$12.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$42.40
|
| Rate for Payer: UHC Core |
$40.23
|
| Rate for Payer: UHC Exchange |
$12.04
|
| Rate for Payer: UHC Medicaid |
$8.49
|
| Rate for Payer: UHC Medicare Advantage |
$12.04
|
| Rate for Payer: UHCCP Medicaid |
$8.49
|
| Rate for Payer: VA VA |
$12.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.13
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
IP
|
$3,056.08
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,127.03 |
| Max. Negotiated Rate |
$2,750.47 |
| Rate for Payer: Aetna Commercial |
$2,597.67
|
| Rate for Payer: BCBS Trust/PPO |
$2,524.02
|
| Rate for Payer: BCN Commercial |
$2,524.02
|
| Rate for Payer: Cash Price |
$2,444.86
|
| Rate for Payer: Cofinity Commercial |
$2,628.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,444.86
|
| Rate for Payer: Healthscope Commercial |
$2,750.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,292.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,597.67
|
| Rate for Payer: Nomi Health Commercial |
$2,505.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.06
|
| Rate for Payer: PHP Commercial |
$2,597.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,658.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,127.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,689.35
|
| Rate for Payer: UHC Core |
$2,551.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,292.06
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
OP
|
$3,056.08
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$538.79 |
| Max. Negotiated Rate |
$2,750.47 |
| Rate for Payer: Aetna Commercial |
$2,597.67
|
| Rate for Payer: Aetna Medicare |
$794.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$955.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$955.02
|
| Rate for Payer: BCBS Complete |
$565.68
|
| Rate for Payer: BCBS MAPPO |
$764.02
|
| Rate for Payer: BCBS Trust/PPO |
$2,512.40
|
| Rate for Payer: BCN Commercial |
$2,512.40
|
| Rate for Payer: BCN Medicare Advantage |
$764.02
|
| Rate for Payer: Cash Price |
$2,444.86
|
| Rate for Payer: Cofinity Commercial |
$2,628.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,444.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$764.02
|
| Rate for Payer: Healthscope Commercial |
$2,750.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,292.06
|
| Rate for Payer: Mclaren Medicaid |
$538.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$802.22
|
| Rate for Payer: Meridian Medicaid |
$565.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$878.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$840.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,597.67
|
| Rate for Payer: Nomi Health Commercial |
$2,505.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,292.06
|
| Rate for Payer: PACE Senior Care Partners |
$725.82
|
| Rate for Payer: PACE SWMI |
$764.02
|
| Rate for Payer: PHP Commercial |
$2,597.67
|
| Rate for Payer: PHP Medicare Advantage |
$764.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$538.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,658.79
|
| Rate for Payer: Priority Health Medicare |
$771.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,127.03
|
| Rate for Payer: Railroad Medicare Medicare |
$764.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,689.35
|
| Rate for Payer: UHC Core |
$2,551.83
|
| Rate for Payer: UHC Exchange |
$764.02
|
| Rate for Payer: UHC Medicaid |
$538.79
|
| Rate for Payer: UHC Medicare Advantage |
$764.02
|
| Rate for Payer: UHCCP Medicaid |
$538.79
|
| Rate for Payer: VA VA |
$764.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,292.06
|
|
