|
HC CELIAC PLEXUS BLOCK
|
Facility
|
OP
|
$1,211.27
|
|
|
Service Code
|
CPT 64530
|
| Hospital Charge Code |
36100546
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$287.68 |
| Max. Negotiated Rate |
$1,090.14 |
| Rate for Payer: Aetna Commercial |
$1,029.58
|
| Rate for Payer: Aetna Medicare |
$314.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$378.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$378.52
|
| Rate for Payer: BCBS Complete |
$662.24
|
| Rate for Payer: BCBS MAPPO |
$302.82
|
| Rate for Payer: BCBS Trust/PPO |
$995.79
|
| Rate for Payer: BCN Commercial |
$941.76
|
| Rate for Payer: BCN Medicare Advantage |
$302.82
|
| Rate for Payer: Cash Price |
$969.02
|
| Rate for Payer: Cash Price |
$969.02
|
| Rate for Payer: Cofinity Commercial |
$1,041.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$969.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$302.82
|
| Rate for Payer: Healthscope Commercial |
$1,090.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$908.45
|
| Rate for Payer: Mclaren Medicaid |
$630.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$317.96
|
| Rate for Payer: Meridian Medicaid |
$662.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$348.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,029.58
|
| Rate for Payer: Nomi Health Commercial |
$993.24
|
| Rate for Payer: PACE Senior Care Partners |
$287.68
|
| Rate for Payer: PACE SWMI |
$302.82
|
| Rate for Payer: PHP Commercial |
$1,029.58
|
| Rate for Payer: PHP Medicare Advantage |
$302.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$630.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$787.33
|
| Rate for Payer: Priority Health HMO/PPO |
$1,053.80
|
| Rate for Payer: Priority Health Medicare |
$305.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$811.55
|
| Rate for Payer: Railroad Medicare Medicare |
$302.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,065.92
|
| Rate for Payer: UHC Core |
$1,011.41
|
| Rate for Payer: UHC Dual Complete DSNP |
$302.82
|
| Rate for Payer: UHC Exchange |
$302.82
|
| Rate for Payer: UHC Medicare Advantage |
$302.82
|
| Rate for Payer: UHCCP Medicaid |
$630.67
|
| Rate for Payer: VA VA |
$302.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$908.45
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
OP
|
$171.36
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.01 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$145.66
|
| Rate for Payer: Aetna Medicare |
$44.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.55
|
| Rate for Payer: BCBS Complete |
$9.46
|
| Rate for Payer: BCBS MAPPO |
$42.84
|
| Rate for Payer: BCBS Trust/PPO |
$140.88
|
| Rate for Payer: BCN Commercial |
$133.23
|
| Rate for Payer: BCN Medicare Advantage |
$42.84
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$147.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.84
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.52
|
| Rate for Payer: Mclaren Medicaid |
$9.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.98
|
| Rate for Payer: Meridian Medicaid |
$9.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.66
|
| Rate for Payer: Nomi Health Commercial |
$140.52
|
| Rate for Payer: PACE Senior Care Partners |
$40.70
|
| Rate for Payer: PACE SWMI |
$42.84
|
| Rate for Payer: PHP Commercial |
$145.66
|
| Rate for Payer: PHP Medicare Advantage |
$42.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.38
|
| Rate for Payer: Priority Health HMO/PPO |
$149.08
|
| Rate for Payer: Priority Health Medicare |
$43.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.81
|
| Rate for Payer: Railroad Medicare Medicare |
$42.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.80
|
| Rate for Payer: UHC Core |
$143.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.84
|
| Rate for Payer: UHC Exchange |
$42.84
|
| Rate for Payer: UHC Medicare Advantage |
$42.84
|
| Rate for Payer: UHCCP Medicaid |
$9.01
|
| Rate for Payer: VA VA |
$42.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.52
|
|
|
HC CELL BOUND PLATELET AB SCREEN, B
|
Facility
|
IP
|
$171.36
|
|
|
Service Code
|
CPT 86023
|
| Hospital Charge Code |
30200428
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$111.38 |
| Max. Negotiated Rate |
$154.22 |
| Rate for Payer: Aetna Commercial |
$145.66
|
| Rate for Payer: BCBS Trust/PPO |
$139.88
|
| Rate for Payer: BCN Commercial |
$132.43
|
| Rate for Payer: Cash Price |
$137.09
|
| Rate for Payer: Cofinity Commercial |
$147.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.09
|
| Rate for Payer: Healthscope Commercial |
$154.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.66
|
| Rate for Payer: Nomi Health Commercial |
$140.52
|
| Rate for Payer: PHP Commercial |
$145.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.38
|
| Rate for Payer: Priority Health HMO/PPO |
$149.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.80
|
| Rate for Payer: UHC Core |
$143.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.52
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
OP
|
$92.21
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$78.38
|
| Rate for Payer: Aetna Medicare |
$23.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.82
|
| Rate for Payer: BCBS Complete |
$4.25
|
| Rate for Payer: BCBS MAPPO |
$23.05
|
| Rate for Payer: BCBS Trust/PPO |
$75.81
|
| Rate for Payer: BCN Commercial |
$71.69
|
| Rate for Payer: BCN Medicare Advantage |
$23.05
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$79.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.05
|
| Rate for Payer: Healthscope Commercial |
$82.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
| Rate for Payer: Mclaren Medicaid |
$4.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.21
|
| Rate for Payer: Meridian Medicaid |
$4.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: PACE Senior Care Partners |
$21.90
|
| Rate for Payer: PACE SWMI |
$23.05
|
| Rate for Payer: PHP Commercial |
$78.38
|
| Rate for Payer: PHP Medicare Advantage |
$23.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health HMO/PPO |
$80.22
|
| Rate for Payer: Priority Health Medicare |
$23.28
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.78
|
| Rate for Payer: Railroad Medicare Medicare |
$23.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.14
|
| Rate for Payer: UHC Core |
$77.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.05
|
| Rate for Payer: UHC Exchange |
$23.05
|
| Rate for Payer: UHC Medicare Advantage |
$23.05
|
| Rate for Payer: UHCCP Medicaid |
$4.05
|
| Rate for Payer: VA VA |
$23.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
|
HC CELL COUNT/DIFF MISC FLUID
|
Facility
|
IP
|
$92.21
|
|
|
Service Code
|
CPT 89051
|
| Hospital Charge Code |
30500067
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$59.94 |
| Max. Negotiated Rate |
$82.99 |
| Rate for Payer: Aetna Commercial |
$78.38
|
| Rate for Payer: BCBS Trust/PPO |
$75.27
|
| Rate for Payer: BCN Commercial |
$71.26
|
| Rate for Payer: Cash Price |
$73.77
|
| Rate for Payer: Cofinity Commercial |
$79.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.77
|
| Rate for Payer: Healthscope Commercial |
$82.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.38
|
| Rate for Payer: Nomi Health Commercial |
$75.61
|
| Rate for Payer: PHP Commercial |
$78.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.94
|
| Rate for Payer: Priority Health HMO/PPO |
$80.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.14
|
| Rate for Payer: UHC Core |
$77.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.16
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
IP
|
$262.96
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$170.92 |
| Max. Negotiated Rate |
$236.66 |
| Rate for Payer: Aetna Commercial |
$223.52
|
| Rate for Payer: BCBS Trust/PPO |
$214.65
|
| Rate for Payer: BCN Commercial |
$203.22
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cofinity Commercial |
$226.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.37
|
| Rate for Payer: Healthscope Commercial |
$236.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.52
|
| Rate for Payer: Nomi Health Commercial |
$215.63
|
| Rate for Payer: PHP Commercial |
$223.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.92
|
| Rate for Payer: Priority Health HMO/PPO |
$228.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.40
|
| Rate for Payer: UHC Core |
$219.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.22
|
|
|
HC CELL FUNCTION ASSAY W/STIM
|
Facility
|
OP
|
$262.96
|
|
|
Service Code
|
CPT 86352
|
| Hospital Charge Code |
30200502
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$62.45 |
| Max. Negotiated Rate |
$236.66 |
| Rate for Payer: Aetna Commercial |
$223.52
|
| Rate for Payer: Aetna Medicare |
$68.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.18
|
| Rate for Payer: BCBS Complete |
$103.14
|
| Rate for Payer: BCBS MAPPO |
$65.74
|
| Rate for Payer: BCBS Trust/PPO |
$216.18
|
| Rate for Payer: BCN Commercial |
$204.45
|
| Rate for Payer: BCN Medicare Advantage |
$65.74
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cash Price |
$210.37
|
| Rate for Payer: Cofinity Commercial |
$226.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.74
|
| Rate for Payer: Healthscope Commercial |
$236.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.22
|
| Rate for Payer: Mclaren Medicaid |
$98.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.03
|
| Rate for Payer: Meridian Medicaid |
$103.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$223.52
|
| Rate for Payer: Nomi Health Commercial |
$215.63
|
| Rate for Payer: PACE Senior Care Partners |
$62.45
|
| Rate for Payer: PACE SWMI |
$65.74
|
| Rate for Payer: PHP Commercial |
$223.52
|
| Rate for Payer: PHP Medicare Advantage |
$65.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$98.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$170.92
|
| Rate for Payer: Priority Health HMO/PPO |
$228.78
|
| Rate for Payer: Priority Health Medicare |
$66.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$176.18
|
| Rate for Payer: Railroad Medicare Medicare |
$65.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.40
|
| Rate for Payer: UHC Core |
$219.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.74
|
| Rate for Payer: UHC Exchange |
$65.74
|
| Rate for Payer: UHC Medicare Advantage |
$65.74
|
| Rate for Payer: UHCCP Medicaid |
$98.23
|
| Rate for Payer: VA VA |
$65.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.22
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
OP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: Aetna Medicare |
$38.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.31
|
| Rate for Payer: BCBS Complete |
$59.28
|
| Rate for Payer: BCBS MAPPO |
$37.05
|
| Rate for Payer: BCBS Trust/PPO |
$121.83
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$115.22
|
| Rate for Payer: BCN Medicare Advantage |
$37.05
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.05
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: PACE Senior Care Partners |
$35.20
|
| Rate for Payer: PACE SWMI |
$37.05
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: PHP Medicare Advantage |
$37.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.32
|
| Rate for Payer: Priority Health HMO/PPO |
$128.93
|
| Rate for Payer: Priority Health Medicare |
$37.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.29
|
| Rate for Payer: Railroad Medicare Medicare |
$37.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.05
|
| Rate for Payer: UHC Exchange |
$37.05
|
| Rate for Payer: UHC Medicare Advantage |
$37.05
|
| Rate for Payer: VA VA |
$37.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTRAL LINE DRSG CHANGE
|
Facility
|
IP
|
$148.19
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51000059
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$96.32 |
| Max. Negotiated Rate |
$133.37 |
| Rate for Payer: Aetna Commercial |
$125.96
|
| Rate for Payer: BCBS Trust/PPO |
$120.97
|
| Rate for Payer: BCN Commercial |
$114.52
|
| Rate for Payer: Cash Price |
$118.55
|
| Rate for Payer: Cofinity Commercial |
$127.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$118.55
|
| Rate for Payer: Healthscope Commercial |
$133.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$125.96
|
| Rate for Payer: Nomi Health Commercial |
$121.52
|
| Rate for Payer: PHP Commercial |
$125.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$96.32
|
| Rate for Payer: Priority Health HMO/PPO |
$128.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$99.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$130.41
|
| Rate for Payer: UHC Core |
$123.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.14
|
|
|
HC CENTROMERE AB
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC CENTROMERE AB
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200167
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
IP
|
$249.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$162.44 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: BCBS Trust/PPO |
$203.99
|
| Rate for Payer: BCN Commercial |
$193.12
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO |
$217.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC CEPHEID SARS-COV2/FLU A&B
|
Facility
|
OP
|
$249.90
|
|
|
Service Code
|
CPT 0240U
|
| Hospital Charge Code |
30600317
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$59.35 |
| Max. Negotiated Rate |
$224.91 |
| Rate for Payer: Aetna Commercial |
$212.42
|
| Rate for Payer: Aetna Medicare |
$64.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$78.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$78.09
|
| Rate for Payer: BCBS Complete |
$108.28
|
| Rate for Payer: BCBS MAPPO |
$62.48
|
| Rate for Payer: BCBS Trust/PPO |
$205.44
|
| Rate for Payer: BCN Commercial |
$194.30
|
| Rate for Payer: BCN Medicare Advantage |
$62.48
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cash Price |
$199.92
|
| Rate for Payer: Cofinity Commercial |
$214.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.92
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.48
|
| Rate for Payer: Healthscope Commercial |
$224.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$187.42
|
| Rate for Payer: Mclaren Medicaid |
$103.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: Meridian Medicaid |
$108.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.42
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PACE Senior Care Partners |
$59.35
|
| Rate for Payer: PACE SWMI |
$62.48
|
| Rate for Payer: PHP Commercial |
$212.42
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$103.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$162.44
|
| Rate for Payer: Priority Health HMO/PPO |
$217.41
|
| Rate for Payer: Priority Health Medicare |
$63.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$167.43
|
| Rate for Payer: Railroad Medicare Medicare |
$62.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$219.91
|
| Rate for Payer: UHC Core |
$208.67
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.48
|
| Rate for Payer: UHC Exchange |
$62.48
|
| Rate for Payer: UHC Medicare Advantage |
$62.48
|
| Rate for Payer: UHCCP Medicaid |
$103.12
|
| Rate for Payer: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.42
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
OP
|
$4,135.96
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$982.29 |
| Max. Negotiated Rate |
$3,722.36 |
| Rate for Payer: Aetna Commercial |
$3,515.57
|
| Rate for Payer: Aetna Medicare |
$1,075.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,292.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,292.49
|
| Rate for Payer: BCBS Complete |
$1,654.38
|
| Rate for Payer: BCBS MAPPO |
$1,033.99
|
| Rate for Payer: BCBS Trust/PPO |
$3,400.17
|
| Rate for Payer: BCN Commercial |
$3,215.71
|
| Rate for Payer: BCN Medicare Advantage |
$1,033.99
|
| Rate for Payer: Cash Price |
$3,308.77
|
| Rate for Payer: Cofinity Commercial |
$3,556.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,308.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,033.99
|
| Rate for Payer: Healthscope Commercial |
$3,722.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,101.97
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,085.69
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,189.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,515.57
|
| Rate for Payer: Nomi Health Commercial |
$3,391.49
|
| Rate for Payer: PACE Senior Care Partners |
$982.29
|
| Rate for Payer: PACE SWMI |
$1,033.99
|
| Rate for Payer: PHP Commercial |
$3,515.57
|
| Rate for Payer: PHP Medicare Advantage |
$1,033.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,688.37
|
| Rate for Payer: Priority Health HMO/PPO |
$3,598.29
|
| Rate for Payer: Priority Health Medicare |
$1,044.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,771.09
|
| Rate for Payer: Railroad Medicare Medicare |
$1,033.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,639.64
|
| Rate for Payer: UHC Core |
$3,453.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,033.99
|
| Rate for Payer: UHC Exchange |
$1,033.99
|
| Rate for Payer: UHC Medicare Advantage |
$1,033.99
|
| Rate for Payer: VA VA |
$1,033.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,101.97
|
|
|
HC CERCLAGE (OB SURGERY)
|
Facility
|
IP
|
$4,135.96
|
|
| Hospital Charge Code |
36000017
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,688.37 |
| Max. Negotiated Rate |
$3,722.36 |
| Rate for Payer: Aetna Commercial |
$3,515.57
|
| Rate for Payer: BCBS Trust/PPO |
$3,376.18
|
| Rate for Payer: BCN Commercial |
$3,196.27
|
| Rate for Payer: Cash Price |
$3,308.77
|
| Rate for Payer: Cofinity Commercial |
$3,556.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,308.77
|
| Rate for Payer: Healthscope Commercial |
$3,722.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3,101.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,515.57
|
| Rate for Payer: Nomi Health Commercial |
$3,391.49
|
| Rate for Payer: PHP Commercial |
$3,515.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,688.37
|
| Rate for Payer: Priority Health HMO/PPO |
$3,598.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,771.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,639.64
|
| Rate for Payer: UHC Core |
$3,453.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3,101.97
|
|
|
HC CERETEC PER DOSE
|
Facility
|
IP
|
$2,060.99
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$1,339.64 |
| Max. Negotiated Rate |
$1,854.89 |
| Rate for Payer: Aetna Commercial |
$1,751.84
|
| Rate for Payer: BCBS Trust/PPO |
$1,682.39
|
| Rate for Payer: BCN Commercial |
$1,592.73
|
| Rate for Payer: Cash Price |
$1,648.79
|
| Rate for Payer: Cofinity Commercial |
$1,772.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,648.79
|
| Rate for Payer: Healthscope Commercial |
$1,854.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,545.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,751.84
|
| Rate for Payer: Nomi Health Commercial |
$1,690.01
|
| Rate for Payer: PHP Commercial |
$1,751.84
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.64
|
| Rate for Payer: Priority Health HMO/PPO |
$1,793.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,380.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,813.67
|
| Rate for Payer: UHC Core |
$1,720.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,545.74
|
|
|
HC CERETEC PER DOSE
|
Facility
|
OP
|
$2,060.99
|
|
|
Service Code
|
HCPCS A9521
|
| Hospital Charge Code |
34300002
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$489.49 |
| Max. Negotiated Rate |
$1,854.89 |
| Rate for Payer: Aetna Commercial |
$1,751.84
|
| Rate for Payer: Aetna Medicare |
$535.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$644.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$644.06
|
| Rate for Payer: BCBS Complete |
$609.14
|
| Rate for Payer: BCBS MAPPO |
$515.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,694.34
|
| Rate for Payer: BCN Commercial |
$1,602.42
|
| Rate for Payer: BCN Medicare Advantage |
$515.25
|
| Rate for Payer: Cash Price |
$1,648.79
|
| Rate for Payer: Cash Price |
$1,648.79
|
| Rate for Payer: Cofinity Commercial |
$1,772.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,648.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$515.25
|
| Rate for Payer: Healthscope Commercial |
$1,854.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,545.74
|
| Rate for Payer: Mclaren Medicaid |
$580.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$541.01
|
| Rate for Payer: Meridian Medicaid |
$609.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$592.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,751.84
|
| Rate for Payer: Nomi Health Commercial |
$1,690.01
|
| Rate for Payer: PACE Senior Care Partners |
$489.49
|
| Rate for Payer: PACE SWMI |
$515.25
|
| Rate for Payer: PHP Commercial |
$1,751.84
|
| Rate for Payer: PHP Medicare Advantage |
$515.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$580.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,339.64
|
| Rate for Payer: Priority Health HMO/PPO |
$1,793.06
|
| Rate for Payer: Priority Health Medicare |
$520.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,380.86
|
| Rate for Payer: Railroad Medicare Medicare |
$515.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,813.67
|
| Rate for Payer: UHC Core |
$1,720.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$515.25
|
| Rate for Payer: UHC Exchange |
$515.25
|
| Rate for Payer: UHC Medicare Advantage |
$515.25
|
| Rate for Payer: UHCCP Medicaid |
$580.09
|
| Rate for Payer: VA VA |
$515.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,545.74
|
|
|
HC CERTOLIZUMAB
|
Facility
|
IP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$108.07 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: BCBS Trust/PPO |
$135.72
|
| Rate for Payer: BCN Commercial |
$128.49
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: Nomi Health Commercial |
$136.33
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health HMO/PPO |
$144.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.31
|
| Rate for Payer: UHC Core |
$138.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.70
|
|
|
HC CERTOLIZUMAB
|
Facility
|
OP
|
$166.26
|
|
|
Service Code
|
CPT 83520
|
| Hospital Charge Code |
30100675
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$149.63 |
| Rate for Payer: Aetna Commercial |
$141.32
|
| Rate for Payer: Aetna Medicare |
$43.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.96
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$136.68
|
| Rate for Payer: BCN Commercial |
$129.27
|
| Rate for Payer: BCN Medicare Advantage |
$41.56
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cash Price |
$133.01
|
| Rate for Payer: Cofinity Commercial |
$142.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.56
|
| Rate for Payer: Healthscope Commercial |
$149.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.70
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.64
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.32
|
| Rate for Payer: Nomi Health Commercial |
$136.33
|
| Rate for Payer: PACE Senior Care Partners |
$39.49
|
| Rate for Payer: PACE SWMI |
$41.56
|
| Rate for Payer: PHP Commercial |
$141.32
|
| Rate for Payer: PHP Medicare Advantage |
$41.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.07
|
| Rate for Payer: Priority Health HMO/PPO |
$144.65
|
| Rate for Payer: Priority Health Medicare |
$41.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.39
|
| Rate for Payer: Railroad Medicare Medicare |
$41.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.31
|
| Rate for Payer: UHC Core |
$138.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$41.56
|
| Rate for Payer: UHC Exchange |
$41.56
|
| Rate for Payer: UHC Medicare Advantage |
$41.56
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$41.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.70
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
IP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$84.86 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: BCBS Trust/PPO |
$106.58
|
| Rate for Payer: BCN Commercial |
$100.90
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health HMO/PPO |
$113.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC CERTOLIZUMAB CMPT
|
Facility
|
OP
|
$130.56
|
|
|
Service Code
|
CPT 80299
|
| Hospital Charge Code |
30100676
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.48 |
| Max. Negotiated Rate |
$117.50 |
| Rate for Payer: Aetna Commercial |
$110.98
|
| Rate for Payer: Aetna Medicare |
$33.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$40.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$40.80
|
| Rate for Payer: BCBS Complete |
$14.15
|
| Rate for Payer: BCBS MAPPO |
$32.64
|
| Rate for Payer: BCBS Trust/PPO |
$107.33
|
| Rate for Payer: BCN Commercial |
$101.51
|
| Rate for Payer: BCN Medicare Advantage |
$32.64
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cash Price |
$104.45
|
| Rate for Payer: Cofinity Commercial |
$112.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$104.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$32.64
|
| Rate for Payer: Healthscope Commercial |
$117.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$97.92
|
| Rate for Payer: Mclaren Medicaid |
$13.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$34.27
|
| Rate for Payer: Meridian Medicaid |
$14.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$37.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$110.98
|
| Rate for Payer: Nomi Health Commercial |
$107.06
|
| Rate for Payer: PACE Senior Care Partners |
$31.01
|
| Rate for Payer: PACE SWMI |
$32.64
|
| Rate for Payer: PHP Commercial |
$110.98
|
| Rate for Payer: PHP Medicare Advantage |
$32.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.86
|
| Rate for Payer: Priority Health HMO/PPO |
$113.59
|
| Rate for Payer: Priority Health Medicare |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$87.48
|
| Rate for Payer: Railroad Medicare Medicare |
$32.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$114.89
|
| Rate for Payer: UHC Core |
$109.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$32.64
|
| Rate for Payer: UHC Exchange |
$32.64
|
| Rate for Payer: UHC Medicare Advantage |
$32.64
|
| Rate for Payer: UHCCP Medicaid |
$13.48
|
| Rate for Payer: VA VA |
$32.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$97.92
|
|
|
HC CERULOPLASMIN
|
Facility
|
OP
|
$42.66
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.77 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: Aetna Medicare |
$11.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.33
|
| Rate for Payer: BCBS Complete |
$8.15
|
| Rate for Payer: BCBS MAPPO |
$10.66
|
| Rate for Payer: BCBS Trust/PPO |
$35.07
|
| Rate for Payer: BCN Commercial |
$33.17
|
| Rate for Payer: BCN Medicare Advantage |
$10.66
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.66
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Mclaren Medicaid |
$7.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.20
|
| Rate for Payer: Meridian Medicaid |
$8.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: PACE Senior Care Partners |
$10.13
|
| Rate for Payer: PACE SWMI |
$10.66
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: PHP Medicare Advantage |
$10.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health HMO/PPO |
$37.11
|
| Rate for Payer: Priority Health Medicare |
$10.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.58
|
| Rate for Payer: Railroad Medicare Medicare |
$10.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.54
|
| Rate for Payer: UHC Core |
$35.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.66
|
| Rate for Payer: UHC Exchange |
$10.66
|
| Rate for Payer: UHC Medicare Advantage |
$10.66
|
| Rate for Payer: UHCCP Medicaid |
$7.77
|
| Rate for Payer: VA VA |
$10.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC CERULOPLASMIN
|
Facility
|
IP
|
$42.66
|
|
|
Service Code
|
CPT 82390
|
| Hospital Charge Code |
30100140
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.73 |
| Max. Negotiated Rate |
$38.39 |
| Rate for Payer: Aetna Commercial |
$36.26
|
| Rate for Payer: BCBS Trust/PPO |
$34.82
|
| Rate for Payer: BCN Commercial |
$32.97
|
| Rate for Payer: Cash Price |
$34.13
|
| Rate for Payer: Cofinity Commercial |
$36.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$34.13
|
| Rate for Payer: Healthscope Commercial |
$38.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$36.26
|
| Rate for Payer: Nomi Health Commercial |
$34.98
|
| Rate for Payer: PHP Commercial |
$36.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.73
|
| Rate for Payer: Priority Health HMO/PPO |
$37.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$37.54
|
| Rate for Payer: UHC Core |
$35.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.00
|
|
|
HC CERVILENZ
|
Facility
|
OP
|
$170.69
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$40.54 |
| Max. Negotiated Rate |
$153.62 |
| Rate for Payer: Aetna Commercial |
$145.09
|
| Rate for Payer: Aetna Medicare |
$44.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.34
|
| Rate for Payer: BCBS Complete |
$68.28
|
| Rate for Payer: BCBS MAPPO |
$42.67
|
| Rate for Payer: BCBS Trust/PPO |
$140.32
|
| Rate for Payer: BCN Commercial |
$132.71
|
| Rate for Payer: BCN Medicare Advantage |
$42.67
|
| Rate for Payer: Cash Price |
$136.55
|
| Rate for Payer: Cofinity Commercial |
$146.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.67
|
| Rate for Payer: Healthscope Commercial |
$153.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.09
|
| Rate for Payer: Nomi Health Commercial |
$139.97
|
| Rate for Payer: PACE Senior Care Partners |
$40.54
|
| Rate for Payer: PACE SWMI |
$42.67
|
| Rate for Payer: PHP Commercial |
$145.09
|
| Rate for Payer: PHP Medicare Advantage |
$42.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.95
|
| Rate for Payer: Priority Health HMO/PPO |
$148.50
|
| Rate for Payer: Priority Health Medicare |
$43.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.36
|
| Rate for Payer: Railroad Medicare Medicare |
$42.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.21
|
| Rate for Payer: UHC Core |
$142.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.67
|
| Rate for Payer: UHC Exchange |
$42.67
|
| Rate for Payer: UHC Medicare Advantage |
$42.67
|
| Rate for Payer: VA VA |
$42.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.02
|
|
|
HC CERVILENZ
|
Facility
|
IP
|
$170.69
|
|
| Hospital Charge Code |
27200171
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$110.95 |
| Max. Negotiated Rate |
$153.62 |
| Rate for Payer: Aetna Commercial |
$145.09
|
| Rate for Payer: BCBS Trust/PPO |
$139.33
|
| Rate for Payer: BCN Commercial |
$131.91
|
| Rate for Payer: Cash Price |
$136.55
|
| Rate for Payer: Cofinity Commercial |
$146.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.55
|
| Rate for Payer: Healthscope Commercial |
$153.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.09
|
| Rate for Payer: Nomi Health Commercial |
$139.97
|
| Rate for Payer: PHP Commercial |
$145.09
|
| Rate for Payer: Priority Health Cigna Priority Health |
$110.95
|
| Rate for Payer: Priority Health HMO/PPO |
$148.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.21
|
| Rate for Payer: UHC Core |
$142.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.02
|
|
