|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$137.11
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$24.17 |
| Max. Negotiated Rate |
$123.40 |
| Rate for Payer: Aetna Commercial |
$116.54
|
| Rate for Payer: Aetna Medicare |
$35.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.85
|
| Rate for Payer: BCBS Complete |
$25.38
|
| Rate for Payer: BCBS MAPPO |
$34.28
|
| Rate for Payer: BCBS Trust/PPO |
$112.72
|
| Rate for Payer: BCN Commercial |
$112.72
|
| Rate for Payer: BCN Medicare Advantage |
$34.28
|
| Rate for Payer: Cash Price |
$109.69
|
| Rate for Payer: Cofinity Commercial |
$117.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$34.28
|
| Rate for Payer: Healthscope Commercial |
$123.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.83
|
| Rate for Payer: Mclaren Medicaid |
$24.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.99
|
| Rate for Payer: Meridian Medicaid |
$25.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$37.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.54
|
| Rate for Payer: Nomi Health Commercial |
$112.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.83
|
| Rate for Payer: PACE Senior Care Partners |
$32.56
|
| Rate for Payer: PACE SWMI |
$34.28
|
| Rate for Payer: PHP Commercial |
$116.54
|
| Rate for Payer: PHP Medicare Advantage |
$34.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$24.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$119.29
|
| Rate for Payer: Priority Health Medicare |
$34.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.43
|
| Rate for Payer: Railroad Medicare Medicare |
$34.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.66
|
| Rate for Payer: UHC Core |
$114.49
|
| Rate for Payer: UHC Exchange |
$34.28
|
| Rate for Payer: UHC Medicaid |
$24.17
|
| Rate for Payer: UHC Medicare Advantage |
$34.28
|
| Rate for Payer: UHCCP Medicaid |
$24.17
|
| Rate for Payer: VA VA |
$34.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.83
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$137.11
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$95.43 |
| Max. Negotiated Rate |
$123.40 |
| Rate for Payer: Aetna Commercial |
$116.54
|
| Rate for Payer: BCBS Trust/PPO |
$113.24
|
| Rate for Payer: BCN Commercial |
$113.24
|
| Rate for Payer: Cash Price |
$109.69
|
| Rate for Payer: Cofinity Commercial |
$117.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$109.69
|
| Rate for Payer: Healthscope Commercial |
$123.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$102.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$116.54
|
| Rate for Payer: Nomi Health Commercial |
$112.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$102.83
|
| Rate for Payer: PHP Commercial |
$116.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$119.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$120.66
|
| Rate for Payer: UHC Core |
$114.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$102.83
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
OP
|
$104.46
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$18.42 |
| Max. Negotiated Rate |
$94.01 |
| Rate for Payer: Aetna Commercial |
$88.79
|
| Rate for Payer: Aetna Medicare |
$27.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.64
|
| Rate for Payer: BCBS Complete |
$19.34
|
| Rate for Payer: BCBS MAPPO |
$26.11
|
| Rate for Payer: BCBS Trust/PPO |
$85.88
|
| Rate for Payer: BCN Commercial |
$85.88
|
| Rate for Payer: BCN Medicare Advantage |
$26.11
|
| Rate for Payer: Cash Price |
$83.57
|
| Rate for Payer: Cofinity Commercial |
$89.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.11
|
| Rate for Payer: Healthscope Commercial |
$94.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.34
|
| Rate for Payer: Mclaren Medicaid |
$18.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.42
|
| Rate for Payer: Meridian Medicaid |
$19.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.79
|
| Rate for Payer: Nomi Health Commercial |
$85.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.34
|
| Rate for Payer: PACE Senior Care Partners |
$24.81
|
| Rate for Payer: PACE SWMI |
$26.11
|
| Rate for Payer: PHP Commercial |
$88.79
|
| Rate for Payer: PHP Medicare Advantage |
$26.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.88
|
| Rate for Payer: Priority Health Medicare |
$26.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.70
|
| Rate for Payer: Railroad Medicare Medicare |
$26.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.92
|
| Rate for Payer: UHC Core |
$87.22
|
| Rate for Payer: UHC Exchange |
$26.11
|
| Rate for Payer: UHC Medicaid |
$18.42
|
| Rate for Payer: UHC Medicare Advantage |
$26.11
|
| Rate for Payer: UHCCP Medicaid |
$18.42
|
| Rate for Payer: VA VA |
$26.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.34
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
IP
|
$104.46
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$72.70 |
| Max. Negotiated Rate |
$94.01 |
| Rate for Payer: Aetna Commercial |
$88.79
|
| Rate for Payer: BCBS Trust/PPO |
$86.27
|
| Rate for Payer: BCN Commercial |
$86.27
|
| Rate for Payer: Cash Price |
$83.57
|
| Rate for Payer: Cofinity Commercial |
$89.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.57
|
| Rate for Payer: Healthscope Commercial |
$94.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.79
|
| Rate for Payer: Nomi Health Commercial |
$85.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.34
|
| Rate for Payer: PHP Commercial |
$88.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.92
|
| Rate for Payer: UHC Core |
$87.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.34
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
OP
|
$81.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$14.28 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: Aetna Medicare |
$21.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$25.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$25.31
|
| Rate for Payer: BCBS Complete |
$14.99
|
| Rate for Payer: BCBS MAPPO |
$20.25
|
| Rate for Payer: BCBS Trust/PPO |
$66.59
|
| Rate for Payer: BCN Commercial |
$66.59
|
| Rate for Payer: BCN Medicare Advantage |
$20.25
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$20.25
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Mclaren Medicaid |
$14.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$21.26
|
| Rate for Payer: Meridian Medicaid |
$14.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$23.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$22.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PACE Senior Care Partners |
$19.24
|
| Rate for Payer: PACE SWMI |
$20.25
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: PHP Medicare Advantage |
$20.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.47
|
| Rate for Payer: Priority Health Medicare |
$20.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.38
|
| Rate for Payer: Railroad Medicare Medicare |
$20.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: UHC Exchange |
$20.25
|
| Rate for Payer: UHC Medicaid |
$14.28
|
| Rate for Payer: UHC Medicare Advantage |
$20.25
|
| Rate for Payer: UHCCP Medicaid |
$14.28
|
| Rate for Payer: VA VA |
$20.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
IP
|
$81.00
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$56.38 |
| Max. Negotiated Rate |
$72.90 |
| Rate for Payer: Aetna Commercial |
$68.85
|
| Rate for Payer: BCBS Trust/PPO |
$66.90
|
| Rate for Payer: BCN Commercial |
$66.90
|
| Rate for Payer: Cash Price |
$64.80
|
| Rate for Payer: Cofinity Commercial |
$69.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$64.80
|
| Rate for Payer: Healthscope Commercial |
$72.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$60.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$68.85
|
| Rate for Payer: Nomi Health Commercial |
$66.42
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$60.75
|
| Rate for Payer: PHP Commercial |
$68.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$70.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$56.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$71.28
|
| Rate for Payer: UHC Core |
$67.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$60.75
|
|
|
HC DAMAGED TYPE III HOME STUDY DEVICE
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.63 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: Aetna Medicare |
$26.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.25
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.25
|
| Rate for Payer: BCBS Complete |
$18.51
|
| Rate for Payer: BCBS MAPPO |
$25.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.21
|
| Rate for Payer: BCN Commercial |
$82.21
|
| Rate for Payer: BCN Medicare Advantage |
$25.00
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Mclaren Medicaid |
$17.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.25
|
| Rate for Payer: Meridian Medicaid |
$18.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PACE Senior Care Partners |
$23.75
|
| Rate for Payer: PACE SWMI |
$25.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: PHP Medicare Advantage |
$25.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.00
|
| Rate for Payer: Priority Health Medicare |
$25.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.60
|
| Rate for Payer: Railroad Medicare Medicare |
$25.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.00
|
| Rate for Payer: UHC Core |
$83.50
|
| Rate for Payer: UHC Exchange |
$25.00
|
| Rate for Payer: UHC Medicaid |
$17.63
|
| Rate for Payer: UHC Medicare Advantage |
$25.00
|
| Rate for Payer: UHCCP Medicaid |
$17.63
|
| Rate for Payer: VA VA |
$25.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC DAMAGED TYPE III HOME STUDY DEVICE
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.60 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.59
|
| Rate for Payer: BCN Commercial |
$82.59
|
| Rate for Payer: Cash Price |
$80.00
|
| Rate for Payer: Cofinity Commercial |
$86.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$80.00
|
| Rate for Payer: Healthscope Commercial |
$90.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$75.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$75.00
|
| Rate for Payer: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$87.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$88.00
|
| Rate for Payer: UHC Core |
$83.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
OP
|
$814.63
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$143.62 |
| Max. Negotiated Rate |
$733.17 |
| Rate for Payer: Aetna Commercial |
$692.44
|
| Rate for Payer: Aetna Medicare |
$211.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$254.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$254.57
|
| Rate for Payer: BCBS Complete |
$150.79
|
| Rate for Payer: BCBS MAPPO |
$203.66
|
| Rate for Payer: BCBS Trust/PPO |
$669.71
|
| Rate for Payer: BCN Commercial |
$669.71
|
| Rate for Payer: BCN Medicare Advantage |
$203.66
|
| Rate for Payer: Cash Price |
$651.70
|
| Rate for Payer: Cofinity Commercial |
$700.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$203.66
|
| Rate for Payer: Healthscope Commercial |
$733.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.97
|
| Rate for Payer: Mclaren Medicaid |
$143.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$213.84
|
| Rate for Payer: Meridian Medicaid |
$150.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$234.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$224.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$692.44
|
| Rate for Payer: Nomi Health Commercial |
$668.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.97
|
| Rate for Payer: PACE Senior Care Partners |
$193.47
|
| Rate for Payer: PACE SWMI |
$203.66
|
| Rate for Payer: PHP Commercial |
$692.44
|
| Rate for Payer: PHP Medicare Advantage |
$203.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$708.73
|
| Rate for Payer: Priority Health Medicare |
$205.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$566.98
|
| Rate for Payer: Railroad Medicare Medicare |
$203.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$716.87
|
| Rate for Payer: UHC Core |
$680.22
|
| Rate for Payer: UHC Exchange |
$203.66
|
| Rate for Payer: UHC Medicaid |
$143.62
|
| Rate for Payer: UHC Medicare Advantage |
$203.66
|
| Rate for Payer: UHCCP Medicaid |
$143.62
|
| Rate for Payer: VA VA |
$203.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.97
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
IP
|
$814.63
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$566.98 |
| Max. Negotiated Rate |
$733.17 |
| Rate for Payer: Aetna Commercial |
$692.44
|
| Rate for Payer: BCBS Trust/PPO |
$672.80
|
| Rate for Payer: BCN Commercial |
$672.80
|
| Rate for Payer: Cash Price |
$651.70
|
| Rate for Payer: Cofinity Commercial |
$700.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$651.70
|
| Rate for Payer: Healthscope Commercial |
$733.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$610.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$692.44
|
| Rate for Payer: Nomi Health Commercial |
$668.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$610.97
|
| Rate for Payer: PHP Commercial |
$692.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$708.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$566.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$716.87
|
| Rate for Payer: UHC Core |
$680.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$610.97
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
OP
|
$872.14
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$153.76 |
| Max. Negotiated Rate |
$784.93 |
| Rate for Payer: Aetna Commercial |
$741.32
|
| Rate for Payer: Aetna Medicare |
$226.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$272.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$272.54
|
| Rate for Payer: BCBS Complete |
$161.43
|
| Rate for Payer: BCBS MAPPO |
$218.03
|
| Rate for Payer: BCBS Trust/PPO |
$716.99
|
| Rate for Payer: BCN Commercial |
$716.99
|
| Rate for Payer: BCN Medicare Advantage |
$218.03
|
| Rate for Payer: Cash Price |
$697.71
|
| Rate for Payer: Cofinity Commercial |
$750.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$218.03
|
| Rate for Payer: Healthscope Commercial |
$784.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$654.11
|
| Rate for Payer: Mclaren Medicaid |
$153.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$228.94
|
| Rate for Payer: Meridian Medicaid |
$161.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$250.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$239.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.32
|
| Rate for Payer: Nomi Health Commercial |
$715.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.11
|
| Rate for Payer: PACE Senior Care Partners |
$207.13
|
| Rate for Payer: PACE SWMI |
$218.03
|
| Rate for Payer: PHP Commercial |
$741.32
|
| Rate for Payer: PHP Medicare Advantage |
$218.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$153.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$758.76
|
| Rate for Payer: Priority Health Medicare |
$220.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$607.01
|
| Rate for Payer: Railroad Medicare Medicare |
$218.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$767.48
|
| Rate for Payer: UHC Core |
$728.24
|
| Rate for Payer: UHC Exchange |
$218.03
|
| Rate for Payer: UHC Medicaid |
$153.76
|
| Rate for Payer: UHC Medicare Advantage |
$218.03
|
| Rate for Payer: UHCCP Medicaid |
$153.76
|
| Rate for Payer: VA VA |
$218.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$654.11
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
IP
|
$872.14
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$607.01 |
| Max. Negotiated Rate |
$784.93 |
| Rate for Payer: Aetna Commercial |
$741.32
|
| Rate for Payer: BCBS Trust/PPO |
$720.30
|
| Rate for Payer: BCN Commercial |
$720.30
|
| Rate for Payer: Cash Price |
$697.71
|
| Rate for Payer: Cofinity Commercial |
$750.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$697.71
|
| Rate for Payer: Healthscope Commercial |
$784.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$654.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$741.32
|
| Rate for Payer: Nomi Health Commercial |
$715.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$654.11
|
| Rate for Payer: PHP Commercial |
$741.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$758.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$607.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$767.48
|
| Rate for Payer: UHC Core |
$728.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$654.11
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
IP
|
$799.09
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$556.17 |
| Max. Negotiated Rate |
$719.18 |
| Rate for Payer: Aetna Commercial |
$679.23
|
| Rate for Payer: BCBS Trust/PPO |
$659.97
|
| Rate for Payer: BCN Commercial |
$659.97
|
| Rate for Payer: Cash Price |
$639.27
|
| Rate for Payer: Cofinity Commercial |
$687.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$639.27
|
| Rate for Payer: Healthscope Commercial |
$719.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$599.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$679.23
|
| Rate for Payer: Nomi Health Commercial |
$655.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$599.32
|
| Rate for Payer: PHP Commercial |
$679.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$695.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$556.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$703.20
|
| Rate for Payer: UHC Core |
$667.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$599.32
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
OP
|
$799.09
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$140.88 |
| Max. Negotiated Rate |
$719.18 |
| Rate for Payer: Aetna Commercial |
$679.23
|
| Rate for Payer: Aetna Medicare |
$207.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.72
|
| Rate for Payer: BCBS Complete |
$147.91
|
| Rate for Payer: BCBS MAPPO |
$199.77
|
| Rate for Payer: BCBS Trust/PPO |
$656.93
|
| Rate for Payer: BCN Commercial |
$656.93
|
| Rate for Payer: BCN Medicare Advantage |
$199.77
|
| Rate for Payer: Cash Price |
$639.27
|
| Rate for Payer: Cofinity Commercial |
$687.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$639.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.77
|
| Rate for Payer: Healthscope Commercial |
$719.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$599.32
|
| Rate for Payer: Mclaren Medicaid |
$140.88
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.76
|
| Rate for Payer: Meridian Medicaid |
$147.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$219.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$679.23
|
| Rate for Payer: Nomi Health Commercial |
$655.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$599.32
|
| Rate for Payer: PACE Senior Care Partners |
$189.78
|
| Rate for Payer: PACE SWMI |
$199.77
|
| Rate for Payer: PHP Commercial |
$679.23
|
| Rate for Payer: PHP Medicare Advantage |
$199.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$140.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$695.21
|
| Rate for Payer: Priority Health Medicare |
$201.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$556.17
|
| Rate for Payer: Railroad Medicare Medicare |
$199.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$703.20
|
| Rate for Payer: UHC Core |
$667.24
|
| Rate for Payer: UHC Exchange |
$199.77
|
| Rate for Payer: UHC Medicaid |
$140.88
|
| Rate for Payer: UHC Medicare Advantage |
$199.77
|
| Rate for Payer: UHCCP Medicaid |
$140.88
|
| Rate for Payer: VA VA |
$199.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$599.32
|
|
|
HC D & C
|
Facility
|
OP
|
$2,082.24
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$125.00 |
| Max. Negotiated Rate |
$1,874.02 |
| Rate for Payer: Aetna Commercial |
$1,769.90
|
| Rate for Payer: Aetna Medicare |
$541.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$650.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$650.70
|
| Rate for Payer: BCBS Complete |
$385.42
|
| Rate for Payer: BCBS MAPPO |
$520.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,711.81
|
| Rate for Payer: BCN Commercial |
$1,711.81
|
| Rate for Payer: BCN Medicare Advantage |
$520.56
|
| Rate for Payer: Cash Price |
$1,665.79
|
| Rate for Payer: Cash Price |
$1,665.79
|
| Rate for Payer: Cofinity Commercial |
$1,790.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$520.56
|
| Rate for Payer: Healthscope Commercial |
$1,874.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,561.68
|
| Rate for Payer: Mclaren Medicaid |
$367.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$546.59
|
| Rate for Payer: Meridian Medicaid |
$385.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$598.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$572.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,769.90
|
| Rate for Payer: Nomi Health Commercial |
$1,707.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.68
|
| Rate for Payer: PACE Senior Care Partners |
$494.53
|
| Rate for Payer: PACE SWMI |
$520.56
|
| Rate for Payer: PHP Commercial |
$1,769.90
|
| Rate for Payer: PHP Medicare Advantage |
$520.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$367.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,811.55
|
| Rate for Payer: Priority Health Medicare |
$525.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,449.24
|
| Rate for Payer: Railroad Medicare Medicare |
$520.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.37
|
| Rate for Payer: UHC Core |
$1,738.67
|
| Rate for Payer: UHC Exchange |
$520.56
|
| Rate for Payer: UHC Medicaid |
$367.10
|
| Rate for Payer: UHC Medicare Advantage |
$520.56
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$520.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,561.68
|
|
|
HC D & C
|
Facility
|
IP
|
$2,082.24
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,449.24 |
| Max. Negotiated Rate |
$1,874.02 |
| Rate for Payer: Aetna Commercial |
$1,769.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,719.72
|
| Rate for Payer: BCN Commercial |
$1,719.72
|
| Rate for Payer: Cash Price |
$1,665.79
|
| Rate for Payer: Cofinity Commercial |
$1,790.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,665.79
|
| Rate for Payer: Healthscope Commercial |
$1,874.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,561.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,769.90
|
| Rate for Payer: Nomi Health Commercial |
$1,707.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,561.68
|
| Rate for Payer: PHP Commercial |
$1,769.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,811.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,449.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,832.37
|
| Rate for Payer: UHC Core |
$1,738.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,561.68
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
OP
|
$1,072.43
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$189.07 |
| Max. Negotiated Rate |
$965.19 |
| Rate for Payer: Aetna Commercial |
$911.57
|
| Rate for Payer: Aetna Medicare |
$278.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$335.13
|
| Rate for Payer: Amish Plain Church Group Commercial |
$335.13
|
| Rate for Payer: BCBS Complete |
$198.51
|
| Rate for Payer: BCBS MAPPO |
$268.11
|
| Rate for Payer: BCBS Trust/PPO |
$881.64
|
| Rate for Payer: BCN Commercial |
$881.64
|
| Rate for Payer: BCN Medicare Advantage |
$268.11
|
| Rate for Payer: Cash Price |
$857.94
|
| Rate for Payer: Cofinity Commercial |
$922.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$268.11
|
| Rate for Payer: Healthscope Commercial |
$965.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.32
|
| Rate for Payer: Mclaren Medicaid |
$189.07
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$281.51
|
| Rate for Payer: Meridian Medicaid |
$198.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$308.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$294.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.57
|
| Rate for Payer: Nomi Health Commercial |
$879.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.32
|
| Rate for Payer: PACE Senior Care Partners |
$254.70
|
| Rate for Payer: PACE SWMI |
$268.11
|
| Rate for Payer: PHP Commercial |
$911.57
|
| Rate for Payer: PHP Medicare Advantage |
$268.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$189.07
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$933.01
|
| Rate for Payer: Priority Health Medicare |
$270.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.41
|
| Rate for Payer: Railroad Medicare Medicare |
$268.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$943.74
|
| Rate for Payer: UHC Core |
$895.48
|
| Rate for Payer: UHC Exchange |
$268.11
|
| Rate for Payer: UHC Medicaid |
$189.07
|
| Rate for Payer: UHC Medicare Advantage |
$268.11
|
| Rate for Payer: UHCCP Medicaid |
$189.07
|
| Rate for Payer: VA VA |
$268.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.32
|
|
|
HC D&C (OB SURGERY)
|
Facility
|
IP
|
$1,072.43
|
|
| Hospital Charge Code |
36000026
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$746.41 |
| Max. Negotiated Rate |
$965.19 |
| Rate for Payer: Aetna Commercial |
$911.57
|
| Rate for Payer: BCBS Trust/PPO |
$885.72
|
| Rate for Payer: BCN Commercial |
$885.72
|
| Rate for Payer: Cash Price |
$857.94
|
| Rate for Payer: Cofinity Commercial |
$922.29
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$857.94
|
| Rate for Payer: Healthscope Commercial |
$965.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$804.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$911.57
|
| Rate for Payer: Nomi Health Commercial |
$879.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$804.32
|
| Rate for Payer: PHP Commercial |
$911.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$933.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$746.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$943.74
|
| Rate for Payer: UHC Core |
$895.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$804.32
|
|
|
HC D & C POSTPARTUM
|
Facility
|
IP
|
$8,104.44
|
|
|
Service Code
|
CPT 59160
|
| Hospital Charge Code |
76100341
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,640.69 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: BCBS Trust/PPO |
$6,693.46
|
| Rate for Payer: BCN Commercial |
$6,693.46
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC D & C POSTPARTUM
|
Facility
|
OP
|
$8,104.44
|
|
|
Service Code
|
CPT 59160
|
| Hospital Charge Code |
76100341
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,428.81 |
| Max. Negotiated Rate |
$7,294.00 |
| Rate for Payer: Aetna Commercial |
$6,888.77
|
| Rate for Payer: Aetna Medicare |
$2,107.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,532.64
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,532.64
|
| Rate for Payer: BCBS Complete |
$1,500.13
|
| Rate for Payer: BCBS MAPPO |
$2,026.11
|
| Rate for Payer: BCBS Trust/PPO |
$6,662.66
|
| Rate for Payer: BCN Commercial |
$6,662.66
|
| Rate for Payer: BCN Medicare Advantage |
$2,026.11
|
| Rate for Payer: Cash Price |
$6,483.55
|
| Rate for Payer: Cofinity Commercial |
$6,969.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,483.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,026.11
|
| Rate for Payer: Healthscope Commercial |
$7,294.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,078.33
|
| Rate for Payer: Mclaren Medicaid |
$1,428.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,127.42
|
| Rate for Payer: Meridian Medicaid |
$1,500.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,330.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,228.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,888.77
|
| Rate for Payer: Nomi Health Commercial |
$6,645.64
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,078.33
|
| Rate for Payer: PACE Senior Care Partners |
$1,924.80
|
| Rate for Payer: PACE SWMI |
$2,026.11
|
| Rate for Payer: PHP Commercial |
$6,888.77
|
| Rate for Payer: PHP Medicare Advantage |
$2,026.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,428.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$7,050.86
|
| Rate for Payer: Priority Health Medicare |
$2,046.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,640.69
|
| Rate for Payer: Railroad Medicare Medicare |
$2,026.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,131.91
|
| Rate for Payer: UHC Core |
$6,767.21
|
| Rate for Payer: UHC Exchange |
$2,026.11
|
| Rate for Payer: UHC Medicaid |
$1,428.81
|
| Rate for Payer: UHC Medicare Advantage |
$2,026.11
|
| Rate for Payer: UHCCP Medicaid |
$1,428.81
|
| Rate for Payer: VA VA |
$2,026.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,078.33
|
|
|
HC DDAVP CMPT1
|
Facility
|
OP
|
$39.26
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna Medicare |
$10.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.27
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$9.81
|
| Rate for Payer: BCBS Trust/PPO |
$32.28
|
| Rate for Payer: BCN Commercial |
$32.28
|
| Rate for Payer: BCN Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Mclaren Medicaid |
$6.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.31
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PACE Senior Care Partners |
$9.32
|
| Rate for Payer: PACE SWMI |
$9.81
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: PHP Medicare Advantage |
$9.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Medicare |
$9.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: Railroad Medicare Medicare |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: UHC Exchange |
$9.81
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: VA VA |
$9.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC DDAVP CMPT1
|
Facility
|
IP
|
$39.26
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500024
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.32 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC DDAVP CMPT2
|
Facility
|
IP
|
$39.26
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.32 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC DDAVP CMPT2
|
Facility
|
OP
|
$39.26
|
|
|
Service Code
|
CPT 85246
|
| Hospital Charge Code |
30500027
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna Medicare |
$10.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.27
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$9.81
|
| Rate for Payer: BCBS Trust/PPO |
$32.28
|
| Rate for Payer: BCN Commercial |
$32.28
|
| Rate for Payer: BCN Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Mclaren Medicaid |
$6.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.31
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PACE Senior Care Partners |
$9.32
|
| Rate for Payer: PACE SWMI |
$9.81
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: PHP Medicare Advantage |
$9.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Medicare |
$9.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: Railroad Medicare Medicare |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: UHC Exchange |
$9.81
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: VA VA |
$9.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC DDAVP FACTOR VIII RISTOCETIN V
|
Facility
|
IP
|
$39.26
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500021
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.32 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
