|
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 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 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 |
$212.41
|
| 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 |
$187.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| Rate for Payer: Nomi Health Commercial |
$204.92
|
| Rate for Payer: PHP Commercial |
$212.41
|
| 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 |
$187.43
|
|
|
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 |
$212.41
|
| 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 |
$99.96
|
| 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: 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 |
$187.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$212.41
|
| 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 |
$212.41
|
| Rate for Payer: PHP Medicare Advantage |
$62.48
|
| 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: VA VA |
$62.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$187.43
|
|
|
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
|
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 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 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 |
$124.69
|
| 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 |
$124.69
|
|
|
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 |
$124.69
|
| 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 |
$124.69
|
|
|
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
|
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 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 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
|
|
|
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 CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
IP
|
$140.78
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$91.51 |
| Max. Negotiated Rate |
$126.70 |
| Rate for Payer: Aetna Commercial |
$119.66
|
| Rate for Payer: BCBS Trust/PPO |
$114.92
|
| Rate for Payer: BCN Commercial |
$108.79
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cofinity Commercial |
$121.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.62
|
| Rate for Payer: Healthscope Commercial |
$126.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.66
|
| Rate for Payer: Nomi Health Commercial |
$115.44
|
| Rate for Payer: PHP Commercial |
$119.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.51
|
| Rate for Payer: Priority Health HMO/PPO |
$122.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.89
|
| Rate for Payer: UHC Core |
$117.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.58
|
|
|
HC CERV OR VAG CA SCREEN PELVIC/BREAST EXAM
|
Facility
|
OP
|
$140.78
|
|
|
Service Code
|
CPT G0101
|
| Hospital Charge Code |
77000001
|
|
Hospital Revenue Code
|
770
|
| Min. Negotiated Rate |
$33.44 |
| Max. Negotiated Rate |
$126.70 |
| Rate for Payer: Aetna Commercial |
$119.66
|
| Rate for Payer: Aetna Medicare |
$36.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$43.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$43.99
|
| Rate for Payer: BCBS Complete |
$70.23
|
| Rate for Payer: BCBS MAPPO |
$35.20
|
| Rate for Payer: BCBS Trust/PPO |
$115.74
|
| Rate for Payer: BCN Commercial |
$109.46
|
| Rate for Payer: BCN Medicare Advantage |
$35.20
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cash Price |
$112.62
|
| Rate for Payer: Cofinity Commercial |
$121.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$112.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.20
|
| Rate for Payer: Healthscope Commercial |
$126.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$105.58
|
| Rate for Payer: Mclaren Medicaid |
$66.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$36.95
|
| Rate for Payer: Meridian Medicaid |
$70.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$40.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$119.66
|
| Rate for Payer: Nomi Health Commercial |
$115.44
|
| Rate for Payer: PACE Senior Care Partners |
$33.44
|
| Rate for Payer: PACE SWMI |
$35.20
|
| Rate for Payer: PHP Commercial |
$119.66
|
| Rate for Payer: PHP Medicare Advantage |
$35.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$91.51
|
| Rate for Payer: Priority Health HMO/PPO |
$122.48
|
| Rate for Payer: Priority Health Medicare |
$35.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.32
|
| Rate for Payer: Railroad Medicare Medicare |
$35.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$123.89
|
| Rate for Payer: UHC Core |
$117.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.20
|
| Rate for Payer: UHC Exchange |
$35.20
|
| Rate for Payer: UHC Medicare Advantage |
$35.20
|
| Rate for Payer: UHCCP Medicaid |
$66.88
|
| Rate for Payer: VA VA |
$35.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$105.58
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
IP
|
$777.71
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$505.51 |
| Max. Negotiated Rate |
$699.94 |
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: BCBS Trust/PPO |
$634.84
|
| Rate for Payer: BCN Commercial |
$601.01
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health HMO/PPO |
$676.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.07
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.38
|
| Rate for Payer: UHC Core |
$649.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC CESIUM 137 PER SOURCE
|
Facility
|
OP
|
$777.71
|
|
| Hospital Charge Code |
34000001
|
|
Hospital Revenue Code
|
340
|
| Min. Negotiated Rate |
$184.71 |
| Max. Negotiated Rate |
$699.94 |
| Rate for Payer: Aetna Commercial |
$661.05
|
| Rate for Payer: Aetna Medicare |
$202.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$243.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$243.03
|
| Rate for Payer: BCBS Complete |
$311.08
|
| Rate for Payer: BCBS MAPPO |
$194.43
|
| Rate for Payer: BCBS Trust/PPO |
$639.36
|
| Rate for Payer: BCN Commercial |
$604.67
|
| Rate for Payer: BCN Medicare Advantage |
$194.43
|
| Rate for Payer: Cash Price |
$622.17
|
| Rate for Payer: Cofinity Commercial |
$668.83
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$622.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$194.43
|
| Rate for Payer: Healthscope Commercial |
$699.94
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$583.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$204.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$223.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$661.05
|
| Rate for Payer: Nomi Health Commercial |
$637.72
|
| Rate for Payer: PACE Senior Care Partners |
$184.71
|
| Rate for Payer: PACE SWMI |
$194.43
|
| Rate for Payer: PHP Commercial |
$661.05
|
| Rate for Payer: PHP Medicare Advantage |
$194.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$505.51
|
| Rate for Payer: Priority Health HMO/PPO |
$676.61
|
| Rate for Payer: Priority Health Medicare |
$196.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$521.07
|
| Rate for Payer: Railroad Medicare Medicare |
$194.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$684.38
|
| Rate for Payer: UHC Core |
$649.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$194.43
|
| Rate for Payer: UHC Exchange |
$194.43
|
| Rate for Payer: UHC Medicare Advantage |
$194.43
|
| Rate for Payer: VA VA |
$194.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$583.28
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
OP
|
$22.32
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$20.09 |
| Rate for Payer: Aetna Commercial |
$18.97
|
| Rate for Payer: Aetna Medicare |
$5.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.97
|
| Rate for Payer: BCBS Complete |
$8.93
|
| Rate for Payer: BCBS MAPPO |
$5.58
|
| Rate for Payer: BCBS Trust/PPO |
$18.35
|
| Rate for Payer: BCN Commercial |
$17.35
|
| Rate for Payer: BCN Medicare Advantage |
$5.58
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.58
|
| Rate for Payer: Healthscope Commercial |
$20.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.97
|
| Rate for Payer: Nomi Health Commercial |
$18.30
|
| Rate for Payer: PACE Senior Care Partners |
$5.30
|
| Rate for Payer: PACE SWMI |
$5.58
|
| Rate for Payer: PHP Commercial |
$18.97
|
| Rate for Payer: PHP Medicare Advantage |
$5.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.51
|
| Rate for Payer: Priority Health HMO/PPO |
$19.42
|
| Rate for Payer: Priority Health Medicare |
$5.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: Railroad Medicare Medicare |
$5.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.64
|
| Rate for Payer: UHC Core |
$18.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.58
|
| Rate for Payer: UHC Exchange |
$5.58
|
| Rate for Payer: UHC Medicare Advantage |
$5.58
|
| Rate for Payer: VA VA |
$5.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.74
|
|
|
HC CHAMBER HOLDING OPTI CHAMBER
|
Facility
|
IP
|
$22.32
|
|
| Hospital Charge Code |
27000044
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.51 |
| Max. Negotiated Rate |
$20.09 |
| Rate for Payer: Aetna Commercial |
$18.97
|
| Rate for Payer: BCBS Trust/PPO |
$18.22
|
| Rate for Payer: BCN Commercial |
$17.25
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Cofinity Commercial |
$19.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$17.86
|
| Rate for Payer: Healthscope Commercial |
$20.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$16.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.97
|
| Rate for Payer: Nomi Health Commercial |
$18.30
|
| Rate for Payer: PHP Commercial |
$18.97
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.51
|
| Rate for Payer: Priority Health HMO/PPO |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$19.64
|
| Rate for Payer: UHC Core |
$18.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$16.74
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
OP
|
$1,016.47
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$241.41 |
| Max. Negotiated Rate |
$914.82 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: Aetna Medicare |
$264.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$317.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$317.65
|
| Rate for Payer: BCBS Complete |
$506.74
|
| Rate for Payer: BCBS MAPPO |
$254.12
|
| Rate for Payer: BCBS Trust/PPO |
$835.64
|
| Rate for Payer: BCN Commercial |
$790.31
|
| Rate for Payer: BCN Medicare Advantage |
$254.12
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cofinity Commercial |
$874.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$813.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$254.12
|
| Rate for Payer: Healthscope Commercial |
$914.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$762.35
|
| Rate for Payer: Mclaren Medicaid |
$482.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$266.82
|
| Rate for Payer: Meridian Medicaid |
$506.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$292.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$864.00
|
| Rate for Payer: Nomi Health Commercial |
$833.51
|
| Rate for Payer: PACE Senior Care Partners |
$241.41
|
| Rate for Payer: PACE SWMI |
$254.12
|
| Rate for Payer: PHP Commercial |
$864.00
|
| Rate for Payer: PHP Medicare Advantage |
$254.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$482.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$660.71
|
| Rate for Payer: Priority Health HMO/PPO |
$884.33
|
| Rate for Payer: Priority Health Medicare |
$256.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$681.03
|
| Rate for Payer: Railroad Medicare Medicare |
$254.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.49
|
| Rate for Payer: UHC Core |
$848.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$254.12
|
| Rate for Payer: UHC Exchange |
$254.12
|
| Rate for Payer: UHC Medicare Advantage |
$254.12
|
| Rate for Payer: UHCCP Medicaid |
$482.58
|
| Rate for Payer: VA VA |
$254.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$762.35
|
|
|
HC CHANGE CYSTOSTOMY TUBE COMPLICATED
|
Facility
|
IP
|
$1,016.47
|
|
|
Service Code
|
CPT 51710
|
| Hospital Charge Code |
76100297
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$660.71 |
| Max. Negotiated Rate |
$914.82 |
| Rate for Payer: Aetna Commercial |
$864.00
|
| Rate for Payer: BCBS Trust/PPO |
$829.74
|
| Rate for Payer: BCN Commercial |
$785.53
|
| Rate for Payer: Cash Price |
$813.18
|
| Rate for Payer: Cofinity Commercial |
$874.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$813.18
|
| Rate for Payer: Healthscope Commercial |
$914.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$762.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$864.00
|
| Rate for Payer: Nomi Health Commercial |
$833.51
|
| Rate for Payer: PHP Commercial |
$864.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$660.71
|
| Rate for Payer: Priority Health HMO/PPO |
$884.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$681.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$894.49
|
| Rate for Payer: UHC Core |
$848.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$762.35
|
|
|
HC CHANNEL RFA ENDO CATHETER
|
Facility
|
IP
|
$3,721.58
|
|
| Hospital Charge Code |
27200289
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,419.03 |
| Max. Negotiated Rate |
$3,349.42 |
| Rate for Payer: Aetna Commercial |
$3,163.34
|
| Rate for Payer: BCBS Trust/PPO |
$3,037.93
|
| Rate for Payer: BCN Commercial |
$2,876.04
|
| Rate for Payer: Cash Price |
$2,977.26
|
| Rate for Payer: Cofinity Commercial |
$3,200.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,977.26
|
| Rate for Payer: Healthscope Commercial |
$3,349.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,791.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,163.34
|
| Rate for Payer: Nomi Health Commercial |
$3,051.70
|
| Rate for Payer: PHP Commercial |
$3,163.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,419.03
|
| Rate for Payer: Priority Health HMO/PPO |
$3,237.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,493.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,274.99
|
| Rate for Payer: UHC Core |
$3,107.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,791.18
|
|
