|
HC CRRT MONITORING PER HOUR
|
Facility
|
IP
|
$416.84
|
|
| Hospital Charge Code |
88000002
|
|
Hospital Revenue Code
|
809
|
| Min. Negotiated Rate |
$270.95 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: BCBS Trust/PPO |
$340.27
|
| Rate for Payer: BCN Commercial |
$322.13
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: Nomi Health Commercial |
$341.81
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$270.95
|
| Rate for Payer: Priority Health HMO/PPO |
$362.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$279.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.82
|
| Rate for Payer: UHC Core |
$348.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
OP
|
$280.50
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$66.62 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Aetna Commercial |
$238.43
|
| Rate for Payer: Aetna Medicare |
$72.93
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.66
|
| Rate for Payer: BCBS Complete |
$112.20
|
| Rate for Payer: BCBS MAPPO |
$70.12
|
| Rate for Payer: BCBS Trust/PPO |
$230.60
|
| Rate for Payer: BCN Commercial |
$218.09
|
| Rate for Payer: BCN Medicare Advantage |
$70.12
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cofinity Commercial |
$241.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$70.12
|
| Rate for Payer: Healthscope Commercial |
$252.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.43
|
| Rate for Payer: Nomi Health Commercial |
$230.01
|
| Rate for Payer: PACE Senior Care Partners |
$66.62
|
| Rate for Payer: PACE SWMI |
$70.12
|
| Rate for Payer: PHP Commercial |
$238.43
|
| Rate for Payer: PHP Medicare Advantage |
$70.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.32
|
| Rate for Payer: Priority Health HMO/PPO |
$244.03
|
| Rate for Payer: Priority Health Medicare |
$70.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.94
|
| Rate for Payer: Railroad Medicare Medicare |
$70.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.84
|
| Rate for Payer: UHC Core |
$234.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$70.12
|
| Rate for Payer: UHC Exchange |
$70.12
|
| Rate for Payer: UHC Medicare Advantage |
$70.12
|
| Rate for Payer: VA VA |
$70.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.38
|
|
|
HC CRRT SUBSEQUENT CARTRIDGE
|
Facility
|
IP
|
$280.50
|
|
| Hospital Charge Code |
27000608
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$182.32 |
| Max. Negotiated Rate |
$252.45 |
| Rate for Payer: Aetna Commercial |
$238.43
|
| Rate for Payer: BCBS Trust/PPO |
$228.97
|
| Rate for Payer: BCN Commercial |
$216.77
|
| Rate for Payer: Cash Price |
$224.40
|
| Rate for Payer: Cofinity Commercial |
$241.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$224.40
|
| Rate for Payer: Healthscope Commercial |
$252.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$210.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$238.43
|
| Rate for Payer: Nomi Health Commercial |
$230.01
|
| Rate for Payer: PHP Commercial |
$238.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$182.32
|
| Rate for Payer: Priority Health HMO/PPO |
$244.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$246.84
|
| Rate for Payer: UHC Core |
$234.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$210.38
|
|
|
HC CRUTCHES
|
Facility
|
IP
|
$126.70
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$82.36 |
| Max. Negotiated Rate |
$114.03 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: BCBS Trust/PPO |
$103.43
|
| Rate for Payer: BCN Commercial |
$97.91
|
| Rate for Payer: Cash Price |
$101.36
|
| Rate for Payer: Cofinity Commercial |
$108.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.36
|
| Rate for Payer: Healthscope Commercial |
$114.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.69
|
| Rate for Payer: Nomi Health Commercial |
$103.89
|
| Rate for Payer: PHP Commercial |
$107.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.36
|
| Rate for Payer: Priority Health HMO/PPO |
$110.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.50
|
| Rate for Payer: UHC Core |
$105.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.03
|
|
|
HC CRUTCHES
|
Facility
|
OP
|
$126.70
|
|
| Hospital Charge Code |
96000002
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$30.09 |
| Max. Negotiated Rate |
$114.03 |
| Rate for Payer: Aetna Commercial |
$107.69
|
| Rate for Payer: Aetna Medicare |
$32.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.59
|
| Rate for Payer: BCBS Complete |
$50.68
|
| Rate for Payer: BCBS MAPPO |
$31.68
|
| Rate for Payer: BCBS Trust/PPO |
$104.16
|
| Rate for Payer: BCN Commercial |
$98.51
|
| Rate for Payer: BCN Medicare Advantage |
$31.68
|
| Rate for Payer: Cash Price |
$101.36
|
| Rate for Payer: Cofinity Commercial |
$108.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.68
|
| Rate for Payer: Healthscope Commercial |
$114.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$95.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.69
|
| Rate for Payer: Nomi Health Commercial |
$103.89
|
| Rate for Payer: PACE Senior Care Partners |
$30.09
|
| Rate for Payer: PACE SWMI |
$31.68
|
| Rate for Payer: PHP Commercial |
$107.69
|
| Rate for Payer: PHP Medicare Advantage |
$31.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.36
|
| Rate for Payer: Priority Health HMO/PPO |
$110.23
|
| Rate for Payer: Priority Health Medicare |
$31.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.89
|
| Rate for Payer: Railroad Medicare Medicare |
$31.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.50
|
| Rate for Payer: UHC Core |
$105.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.68
|
| Rate for Payer: UHC Exchange |
$31.68
|
| Rate for Payer: UHC Medicare Advantage |
$31.68
|
| Rate for Payer: VA VA |
$31.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$95.03
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
OP
|
$12,081.12
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,869.27 |
| Max. Negotiated Rate |
$10,873.01 |
| Rate for Payer: Aetna Commercial |
$10,268.95
|
| Rate for Payer: Aetna Medicare |
$3,141.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,775.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,775.35
|
| Rate for Payer: BCBS Complete |
$7,904.20
|
| Rate for Payer: BCBS MAPPO |
$3,020.28
|
| Rate for Payer: BCBS Trust/PPO |
$9,931.89
|
| Rate for Payer: BCN Commercial |
$9,393.07
|
| Rate for Payer: BCN Medicare Advantage |
$3,020.28
|
| Rate for Payer: Cash Price |
$9,664.90
|
| Rate for Payer: Cash Price |
$9,664.90
|
| Rate for Payer: Cofinity Commercial |
$10,389.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,664.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,020.28
|
| Rate for Payer: Healthscope Commercial |
$10,873.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,060.84
|
| Rate for Payer: Mclaren Medicaid |
$7,527.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,171.29
|
| Rate for Payer: Meridian Medicaid |
$7,904.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,473.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,268.95
|
| Rate for Payer: Nomi Health Commercial |
$9,906.52
|
| Rate for Payer: PACE Senior Care Partners |
$2,869.27
|
| Rate for Payer: PACE SWMI |
$3,020.28
|
| Rate for Payer: PHP Commercial |
$10,268.95
|
| Rate for Payer: PHP Medicare Advantage |
$3,020.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,527.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,852.73
|
| Rate for Payer: Priority Health HMO/PPO |
$10,510.57
|
| Rate for Payer: Priority Health Medicare |
$3,050.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,094.35
|
| Rate for Payer: Railroad Medicare Medicare |
$3,020.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,631.39
|
| Rate for Payer: UHC Core |
$10,087.74
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,020.28
|
| Rate for Payer: UHC Exchange |
$3,020.28
|
| Rate for Payer: UHC Medicare Advantage |
$3,020.28
|
| Rate for Payer: UHCCP Medicaid |
$7,527.31
|
| Rate for Payer: VA VA |
$3,020.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,060.84
|
|
|
HC CRYOABLATION KIDNEY UNILATERAL
|
Facility
|
IP
|
$12,081.12
|
|
|
Service Code
|
CPT 50593
|
| Hospital Charge Code |
36100572
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$7,852.73 |
| Max. Negotiated Rate |
$10,873.01 |
| Rate for Payer: Aetna Commercial |
$10,268.95
|
| Rate for Payer: BCBS Trust/PPO |
$9,861.82
|
| Rate for Payer: BCN Commercial |
$9,336.29
|
| Rate for Payer: Cash Price |
$9,664.90
|
| Rate for Payer: Cofinity Commercial |
$10,389.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,664.90
|
| Rate for Payer: Healthscope Commercial |
$10,873.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,060.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,268.95
|
| Rate for Payer: Nomi Health Commercial |
$9,906.52
|
| Rate for Payer: PHP Commercial |
$10,268.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,852.73
|
| Rate for Payer: Priority Health HMO/PPO |
$10,510.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,094.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,631.39
|
| Rate for Payer: UHC Core |
$10,087.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,060.84
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
IP
|
$10,529.77
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,844.35 |
| Max. Negotiated Rate |
$9,476.79 |
| Rate for Payer: Aetna Commercial |
$8,950.30
|
| Rate for Payer: BCBS Trust/PPO |
$8,595.45
|
| Rate for Payer: BCN Commercial |
$8,137.41
|
| Rate for Payer: Cash Price |
$8,423.82
|
| Rate for Payer: Cofinity Commercial |
$9,055.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,423.82
|
| Rate for Payer: Healthscope Commercial |
$9,476.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,897.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,950.30
|
| Rate for Payer: Nomi Health Commercial |
$8,634.41
|
| Rate for Payer: PHP Commercial |
$8,950.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,844.35
|
| Rate for Payer: Priority Health HMO/PPO |
$9,160.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,054.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,266.20
|
| Rate for Payer: UHC Core |
$8,792.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,897.33
|
|
|
HC CRYOABLATION LIVER TUMOR
|
Facility
|
OP
|
$10,529.77
|
|
|
Service Code
|
CPT 47383
|
| Hospital Charge Code |
36100613
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,500.82 |
| Max. Negotiated Rate |
$9,476.79 |
| Rate for Payer: Aetna Commercial |
$8,950.30
|
| Rate for Payer: Aetna Medicare |
$2,737.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,290.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,290.55
|
| Rate for Payer: BCBS Complete |
$7,904.20
|
| Rate for Payer: BCBS MAPPO |
$2,632.44
|
| Rate for Payer: BCBS Trust/PPO |
$8,656.52
|
| Rate for Payer: BCN Commercial |
$8,186.90
|
| Rate for Payer: BCN Medicare Advantage |
$2,632.44
|
| Rate for Payer: Cash Price |
$8,423.82
|
| Rate for Payer: Cash Price |
$8,423.82
|
| Rate for Payer: Cofinity Commercial |
$9,055.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,423.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,632.44
|
| Rate for Payer: Healthscope Commercial |
$9,476.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,897.33
|
| Rate for Payer: Mclaren Medicaid |
$7,527.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,764.06
|
| Rate for Payer: Meridian Medicaid |
$7,904.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,027.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,950.30
|
| Rate for Payer: Nomi Health Commercial |
$8,634.41
|
| Rate for Payer: PACE Senior Care Partners |
$2,500.82
|
| Rate for Payer: PACE SWMI |
$2,632.44
|
| Rate for Payer: PHP Commercial |
$8,950.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,632.44
|
| Rate for Payer: Priority Health Choice Medicaid |
$7,527.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$6,844.35
|
| Rate for Payer: Priority Health HMO/PPO |
$9,160.90
|
| Rate for Payer: Priority Health Medicare |
$2,658.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,054.95
|
| Rate for Payer: Railroad Medicare Medicare |
$2,632.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,266.20
|
| Rate for Payer: UHC Core |
$8,792.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,632.44
|
| Rate for Payer: UHC Exchange |
$2,632.44
|
| Rate for Payer: UHC Medicare Advantage |
$2,632.44
|
| Rate for Payer: UHCCP Medicaid |
$7,527.31
|
| Rate for Payer: VA VA |
$2,632.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,897.33
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
OP
|
$10,891.56
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,586.75 |
| Max. Negotiated Rate |
$9,802.40 |
| Rate for Payer: Aetna Commercial |
$9,257.83
|
| Rate for Payer: Aetna Medicare |
$2,831.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,403.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,403.61
|
| Rate for Payer: BCBS Complete |
$4,491.17
|
| Rate for Payer: BCBS MAPPO |
$2,722.89
|
| Rate for Payer: BCBS Trust/PPO |
$8,953.95
|
| Rate for Payer: BCN Commercial |
$8,468.19
|
| Rate for Payer: BCN Medicare Advantage |
$2,722.89
|
| Rate for Payer: Cash Price |
$8,713.25
|
| Rate for Payer: Cash Price |
$8,713.25
|
| Rate for Payer: Cofinity Commercial |
$9,366.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,713.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,722.89
|
| Rate for Payer: Healthscope Commercial |
$9,802.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,168.67
|
| Rate for Payer: Mclaren Medicaid |
$4,277.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,859.03
|
| Rate for Payer: Meridian Medicaid |
$4,491.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,131.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,257.83
|
| Rate for Payer: Nomi Health Commercial |
$8,931.08
|
| Rate for Payer: PACE Senior Care Partners |
$2,586.75
|
| Rate for Payer: PACE SWMI |
$2,722.89
|
| Rate for Payer: PHP Commercial |
$9,257.83
|
| Rate for Payer: PHP Medicare Advantage |
$2,722.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$4,277.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,079.51
|
| Rate for Payer: Priority Health HMO/PPO |
$9,475.66
|
| Rate for Payer: Priority Health Medicare |
$2,750.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,297.35
|
| Rate for Payer: Railroad Medicare Medicare |
$2,722.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,584.57
|
| Rate for Payer: UHC Core |
$9,094.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,722.89
|
| Rate for Payer: UHC Exchange |
$2,722.89
|
| Rate for Payer: UHC Medicare Advantage |
$2,722.89
|
| Rate for Payer: UHCCP Medicaid |
$4,277.02
|
| Rate for Payer: VA VA |
$2,722.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,168.67
|
|
|
HC CRYOABLATION NASAL TISSUE OR NERVES UNI OR BIL
|
Facility
|
IP
|
$10,891.56
|
|
|
Service Code
|
CPT 31243
|
| Hospital Charge Code |
76100399
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$7,079.51 |
| Max. Negotiated Rate |
$9,802.40 |
| Rate for Payer: Aetna Commercial |
$9,257.83
|
| Rate for Payer: BCBS Trust/PPO |
$8,890.78
|
| Rate for Payer: BCN Commercial |
$8,417.00
|
| Rate for Payer: Cash Price |
$8,713.25
|
| Rate for Payer: Cofinity Commercial |
$9,366.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,713.25
|
| Rate for Payer: Healthscope Commercial |
$9,802.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,168.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,257.83
|
| Rate for Payer: Nomi Health Commercial |
$8,931.08
|
| Rate for Payer: PHP Commercial |
$9,257.83
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,079.51
|
| Rate for Payer: Priority Health HMO/PPO |
$9,475.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,297.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,584.57
|
| Rate for Payer: UHC Core |
$9,094.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,168.67
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
OP
|
$3,526.96
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$837.65 |
| Max. Negotiated Rate |
$3,174.26 |
| Rate for Payer: Aetna Commercial |
$2,997.92
|
| Rate for Payer: Aetna Medicare |
$917.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,102.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,102.17
|
| Rate for Payer: BCBS Complete |
$1,410.78
|
| Rate for Payer: BCBS MAPPO |
$881.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,899.51
|
| Rate for Payer: BCN Commercial |
$2,742.21
|
| Rate for Payer: BCN Medicare Advantage |
$881.74
|
| Rate for Payer: Cash Price |
$2,821.57
|
| Rate for Payer: Cofinity Commercial |
$3,033.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$881.74
|
| Rate for Payer: Healthscope Commercial |
$3,174.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$925.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,014.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.92
|
| Rate for Payer: Nomi Health Commercial |
$2,892.11
|
| Rate for Payer: PACE Senior Care Partners |
$837.65
|
| Rate for Payer: PACE SWMI |
$881.74
|
| Rate for Payer: PHP Commercial |
$2,997.92
|
| Rate for Payer: PHP Medicare Advantage |
$881.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,292.52
|
| Rate for Payer: Priority Health HMO/PPO |
$3,068.46
|
| Rate for Payer: Priority Health Medicare |
$890.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,363.06
|
| Rate for Payer: Railroad Medicare Medicare |
$881.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,103.72
|
| Rate for Payer: UHC Core |
$2,945.01
|
| Rate for Payer: UHC Dual Complete DSNP |
$881.74
|
| Rate for Payer: UHC Exchange |
$881.74
|
| Rate for Payer: UHC Medicare Advantage |
$881.74
|
| Rate for Payer: VA VA |
$881.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.22
|
|
|
HC CRYOABLATION NEEDLE/PROBE
|
Facility
|
IP
|
$3,526.96
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200244
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,292.52 |
| Max. Negotiated Rate |
$3,174.26 |
| Rate for Payer: Aetna Commercial |
$2,997.92
|
| Rate for Payer: BCBS Trust/PPO |
$2,879.06
|
| Rate for Payer: BCN Commercial |
$2,725.63
|
| Rate for Payer: Cash Price |
$2,821.57
|
| Rate for Payer: Cofinity Commercial |
$3,033.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,821.57
|
| Rate for Payer: Healthscope Commercial |
$3,174.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,645.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,997.92
|
| Rate for Payer: Nomi Health Commercial |
$2,892.11
|
| Rate for Payer: PHP Commercial |
$2,997.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,292.52
|
| Rate for Payer: Priority Health HMO/PPO |
$3,068.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,363.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,103.72
|
| Rate for Payer: UHC Core |
$2,945.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,645.22
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
IP
|
$8,180.24
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5,317.16 |
| Max. Negotiated Rate |
$7,362.22 |
| Rate for Payer: Aetna Commercial |
$6,953.20
|
| Rate for Payer: BCBS Trust/PPO |
$6,677.53
|
| Rate for Payer: BCN Commercial |
$6,321.69
|
| Rate for Payer: Cash Price |
$6,544.19
|
| Rate for Payer: Cofinity Commercial |
$7,035.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,544.19
|
| Rate for Payer: Healthscope Commercial |
$7,362.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,135.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,953.20
|
| Rate for Payer: Nomi Health Commercial |
$6,707.80
|
| Rate for Payer: PHP Commercial |
$6,953.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,317.16
|
| Rate for Payer: Priority Health HMO/PPO |
$7,116.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,480.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,198.61
|
| Rate for Payer: UHC Core |
$6,830.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,135.18
|
|
|
HC CRYOABLATION STANDBY
|
Facility
|
OP
|
$8,180.24
|
|
| Hospital Charge Code |
27200283
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,942.81 |
| Max. Negotiated Rate |
$7,362.22 |
| Rate for Payer: Aetna Commercial |
$6,953.20
|
| Rate for Payer: Aetna Medicare |
$2,126.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,556.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,556.32
|
| Rate for Payer: BCBS Complete |
$3,272.10
|
| Rate for Payer: BCBS MAPPO |
$2,045.06
|
| Rate for Payer: BCBS Trust/PPO |
$6,724.98
|
| Rate for Payer: BCN Commercial |
$6,360.14
|
| Rate for Payer: BCN Medicare Advantage |
$2,045.06
|
| Rate for Payer: Cash Price |
$6,544.19
|
| Rate for Payer: Cofinity Commercial |
$7,035.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,544.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,045.06
|
| Rate for Payer: Healthscope Commercial |
$7,362.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,135.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,147.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,351.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,953.20
|
| Rate for Payer: Nomi Health Commercial |
$6,707.80
|
| Rate for Payer: PACE Senior Care Partners |
$1,942.81
|
| Rate for Payer: PACE SWMI |
$2,045.06
|
| Rate for Payer: PHP Commercial |
$6,953.20
|
| Rate for Payer: PHP Medicare Advantage |
$2,045.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,317.16
|
| Rate for Payer: Priority Health HMO/PPO |
$7,116.81
|
| Rate for Payer: Priority Health Medicare |
$2,065.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,480.76
|
| Rate for Payer: Railroad Medicare Medicare |
$2,045.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,198.61
|
| Rate for Payer: UHC Core |
$6,830.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,045.06
|
| Rate for Payer: UHC Exchange |
$2,045.06
|
| Rate for Payer: UHC Medicare Advantage |
$2,045.06
|
| Rate for Payer: VA VA |
$2,045.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,135.18
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
OP
|
$12,272.17
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,914.64 |
| Max. Negotiated Rate |
$11,044.95 |
| Rate for Payer: Aetna Commercial |
$10,431.34
|
| Rate for Payer: Aetna Medicare |
$3,190.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,835.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,835.05
|
| Rate for Payer: BCBS Complete |
$4,908.87
|
| Rate for Payer: BCBS MAPPO |
$3,068.04
|
| Rate for Payer: BCBS Trust/PPO |
$10,088.95
|
| Rate for Payer: BCN Commercial |
$9,541.61
|
| Rate for Payer: BCN Medicare Advantage |
$3,068.04
|
| Rate for Payer: Cash Price |
$9,817.74
|
| Rate for Payer: Cofinity Commercial |
$10,554.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,817.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,068.04
|
| Rate for Payer: Healthscope Commercial |
$11,044.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,204.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,221.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,528.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,431.34
|
| Rate for Payer: Nomi Health Commercial |
$10,063.18
|
| Rate for Payer: PACE Senior Care Partners |
$2,914.64
|
| Rate for Payer: PACE SWMI |
$3,068.04
|
| Rate for Payer: PHP Commercial |
$10,431.34
|
| Rate for Payer: PHP Medicare Advantage |
$3,068.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,976.91
|
| Rate for Payer: Priority Health HMO/PPO |
$10,676.79
|
| Rate for Payer: Priority Health Medicare |
$3,098.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,222.35
|
| Rate for Payer: Railroad Medicare Medicare |
$3,068.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,799.51
|
| Rate for Payer: UHC Core |
$10,247.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$3,068.04
|
| Rate for Payer: UHC Exchange |
$3,068.04
|
| Rate for Payer: UHC Medicare Advantage |
$3,068.04
|
| Rate for Payer: VA VA |
$3,068.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,204.13
|
|
|
HC CRYOABLATION SUPPLIES
|
Facility
|
IP
|
$12,272.17
|
|
|
Service Code
|
HCPCS C2618
|
| Hospital Charge Code |
27200284
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7,976.91 |
| Max. Negotiated Rate |
$11,044.95 |
| Rate for Payer: Aetna Commercial |
$10,431.34
|
| Rate for Payer: BCBS Trust/PPO |
$10,017.77
|
| Rate for Payer: BCN Commercial |
$9,483.93
|
| Rate for Payer: Cash Price |
$9,817.74
|
| Rate for Payer: Cofinity Commercial |
$10,554.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9,817.74
|
| Rate for Payer: Healthscope Commercial |
$11,044.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$9,204.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$10,431.34
|
| Rate for Payer: Nomi Health Commercial |
$10,063.18
|
| Rate for Payer: PHP Commercial |
$10,431.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,976.91
|
| Rate for Payer: Priority Health HMO/PPO |
$10,676.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$8,222.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$10,799.51
|
| Rate for Payer: UHC Core |
$10,247.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$9,204.13
|
|
|
HC CRYOGLOBULINS
|
Facility
|
OP
|
$19.77
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$17.79 |
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: Aetna Medicare |
$5.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.18
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$4.94
|
| Rate for Payer: BCBS Trust/PPO |
$16.25
|
| Rate for Payer: BCN Commercial |
$15.37
|
| Rate for Payer: BCN Medicare Advantage |
$4.94
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$17.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.94
|
| Rate for Payer: Healthscope Commercial |
$17.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.83
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.19
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Nomi Health Commercial |
$16.21
|
| Rate for Payer: PACE Senior Care Partners |
$4.70
|
| Rate for Payer: PACE SWMI |
$4.94
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: PHP Medicare Advantage |
$4.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO |
$17.20
|
| Rate for Payer: Priority Health Medicare |
$4.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.25
|
| Rate for Payer: Railroad Medicare Medicare |
$4.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.40
|
| Rate for Payer: UHC Core |
$16.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.94
|
| Rate for Payer: UHC Exchange |
$4.94
|
| Rate for Payer: UHC Medicare Advantage |
$4.94
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$4.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.83
|
|
|
HC CRYOGLOBULINS
|
Facility
|
IP
|
$19.77
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100184
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.85 |
| Max. Negotiated Rate |
$17.79 |
| Rate for Payer: Aetna Commercial |
$16.80
|
| Rate for Payer: BCBS Trust/PPO |
$16.14
|
| Rate for Payer: BCN Commercial |
$15.28
|
| Rate for Payer: Cash Price |
$15.82
|
| Rate for Payer: Cofinity Commercial |
$17.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.82
|
| Rate for Payer: Healthscope Commercial |
$17.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.80
|
| Rate for Payer: Nomi Health Commercial |
$16.21
|
| Rate for Payer: PHP Commercial |
$16.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.85
|
| Rate for Payer: Priority Health HMO/PPO |
$17.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.40
|
| Rate for Payer: UHC Core |
$16.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.83
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
IP
|
$23.14
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$15.04 |
| Max. Negotiated Rate |
$20.83 |
| Rate for Payer: Aetna Commercial |
$19.67
|
| Rate for Payer: BCBS Trust/PPO |
$18.89
|
| Rate for Payer: BCN Commercial |
$17.88
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cofinity Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.51
|
| Rate for Payer: Healthscope Commercial |
$20.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.67
|
| Rate for Payer: Nomi Health Commercial |
$18.97
|
| Rate for Payer: PHP Commercial |
$19.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.04
|
| Rate for Payer: Priority Health HMO/PPO |
$20.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.36
|
| Rate for Payer: UHC Core |
$19.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.36
|
|
|
HC CRYOGLOBULINS CMPT
|
Facility
|
OP
|
$23.14
|
|
|
Service Code
|
CPT 82585
|
| Hospital Charge Code |
30100183
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.50 |
| Max. Negotiated Rate |
$20.83 |
| Rate for Payer: Aetna Commercial |
$19.67
|
| Rate for Payer: Aetna Medicare |
$6.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.23
|
| Rate for Payer: BCBS Complete |
$10.74
|
| Rate for Payer: BCBS MAPPO |
$5.79
|
| Rate for Payer: BCBS Trust/PPO |
$19.02
|
| Rate for Payer: BCN Commercial |
$17.99
|
| Rate for Payer: BCN Medicare Advantage |
$5.79
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cash Price |
$18.51
|
| Rate for Payer: Cofinity Commercial |
$19.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.79
|
| Rate for Payer: Healthscope Commercial |
$20.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.36
|
| Rate for Payer: Mclaren Medicaid |
$10.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.07
|
| Rate for Payer: Meridian Medicaid |
$10.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.67
|
| Rate for Payer: Nomi Health Commercial |
$18.97
|
| Rate for Payer: PACE Senior Care Partners |
$5.50
|
| Rate for Payer: PACE SWMI |
$5.79
|
| Rate for Payer: PHP Commercial |
$19.67
|
| Rate for Payer: PHP Medicare Advantage |
$5.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$15.04
|
| Rate for Payer: Priority Health HMO/PPO |
$20.13
|
| Rate for Payer: Priority Health Medicare |
$5.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.50
|
| Rate for Payer: Railroad Medicare Medicare |
$5.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.36
|
| Rate for Payer: UHC Core |
$19.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.79
|
| Rate for Payer: UHC Exchange |
$5.79
|
| Rate for Payer: UHC Medicare Advantage |
$5.79
|
| Rate for Payer: UHCCP Medicaid |
$10.22
|
| Rate for Payer: VA VA |
$5.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.36
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
OP
|
$43.86
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.68 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: Aetna Medicare |
$11.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.71
|
| Rate for Payer: BCBS Complete |
$4.91
|
| Rate for Payer: BCBS MAPPO |
$10.96
|
| Rate for Payer: BCBS Trust/PPO |
$36.06
|
| Rate for Payer: BCN Commercial |
$34.10
|
| Rate for Payer: BCN Medicare Advantage |
$10.96
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.96
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Mclaren Medicaid |
$4.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$11.51
|
| Rate for Payer: Meridian Medicaid |
$4.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: PACE Senior Care Partners |
$10.42
|
| Rate for Payer: PACE SWMI |
$10.96
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: PHP Medicare Advantage |
$10.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: Priority Health HMO/PPO |
$38.16
|
| Rate for Payer: Priority Health Medicare |
$11.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.39
|
| Rate for Payer: Railroad Medicare Medicare |
$10.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.96
|
| Rate for Payer: UHC Exchange |
$10.96
|
| Rate for Payer: UHC Medicare Advantage |
$10.96
|
| Rate for Payer: UHCCP Medicaid |
$4.68
|
| Rate for Payer: VA VA |
$10.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC CRYOGLOBULIN, SERUM
|
Facility
|
IP
|
$43.86
|
|
|
Service Code
|
CPT 82595
|
| Hospital Charge Code |
30100600
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.51 |
| Max. Negotiated Rate |
$39.47 |
| Rate for Payer: Aetna Commercial |
$37.28
|
| Rate for Payer: BCBS Trust/PPO |
$35.80
|
| Rate for Payer: BCN Commercial |
$33.90
|
| Rate for Payer: Cash Price |
$35.09
|
| Rate for Payer: Cofinity Commercial |
$37.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.09
|
| Rate for Payer: Healthscope Commercial |
$39.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$37.28
|
| Rate for Payer: Nomi Health Commercial |
$35.97
|
| Rate for Payer: PHP Commercial |
$37.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$28.51
|
| Rate for Payer: Priority Health HMO/PPO |
$38.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$29.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$38.60
|
| Rate for Payer: UHC Core |
$36.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$32.90
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
IP
|
$143.16
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$93.05 |
| Max. Negotiated Rate |
$128.84 |
| Rate for Payer: Aetna Commercial |
$121.69
|
| Rate for Payer: BCBS Trust/PPO |
$116.86
|
| Rate for Payer: BCN Commercial |
$110.63
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cofinity Commercial |
$123.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.53
|
| Rate for Payer: Healthscope Commercial |
$128.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.69
|
| Rate for Payer: Nomi Health Commercial |
$117.39
|
| Rate for Payer: PHP Commercial |
$121.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.05
|
| Rate for Payer: Priority Health HMO/PPO |
$124.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.98
|
| Rate for Payer: UHC Core |
$119.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.37
|
|
|
HC CRYOPRECIPITATE
|
Facility
|
OP
|
$143.16
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000042
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$128.84 |
| Rate for Payer: Aetna Commercial |
$121.69
|
| Rate for Payer: Aetna Medicare |
$37.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$44.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$44.74
|
| Rate for Payer: BCBS Complete |
$48.26
|
| Rate for Payer: BCBS MAPPO |
$35.79
|
| Rate for Payer: BCBS Trust/PPO |
$117.69
|
| Rate for Payer: BCN Commercial |
$111.31
|
| Rate for Payer: BCN Medicare Advantage |
$35.79
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cash Price |
$114.53
|
| Rate for Payer: Cofinity Commercial |
$123.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$114.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$35.79
|
| Rate for Payer: Healthscope Commercial |
$128.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$107.37
|
| Rate for Payer: Mclaren Medicaid |
$45.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$37.58
|
| Rate for Payer: Meridian Medicaid |
$48.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$121.69
|
| Rate for Payer: Nomi Health Commercial |
$117.39
|
| Rate for Payer: PACE Senior Care Partners |
$34.00
|
| Rate for Payer: PACE SWMI |
$35.79
|
| Rate for Payer: PHP Commercial |
$121.69
|
| Rate for Payer: PHP Medicare Advantage |
$35.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$93.05
|
| Rate for Payer: Priority Health HMO/PPO |
$124.55
|
| Rate for Payer: Priority Health Medicare |
$36.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.92
|
| Rate for Payer: Railroad Medicare Medicare |
$35.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$125.98
|
| Rate for Payer: UHC Core |
$119.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$35.79
|
| Rate for Payer: UHC Exchange |
$35.79
|
| Rate for Payer: UHC Medicare Advantage |
$35.79
|
| Rate for Payer: UHCCP Medicaid |
$45.96
|
| Rate for Payer: VA VA |
$35.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$107.37
|
|
