|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
IP
|
$340.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$221.51 |
| Max. Negotiated Rate |
$306.70 |
| Rate for Payer: Aetna Commercial |
$289.66
|
| Rate for Payer: BCBS Trust/PPO |
$278.18
|
| Rate for Payer: BCN Commercial |
$263.35
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$293.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.62
|
| Rate for Payer: Healthscope Commercial |
$306.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.66
|
| Rate for Payer: Nomi Health Commercial |
$279.44
|
| Rate for Payer: PHP Commercial |
$289.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.51
|
| Rate for Payer: Priority Health HMO/PPO |
$296.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.89
|
| Rate for Payer: UHC Core |
$284.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.59
|
|
|
HC CRYOPRECIPITATE DIRECT
|
Facility
|
OP
|
$340.78
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000043
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$306.70 |
| Rate for Payer: Aetna Commercial |
$289.66
|
| Rate for Payer: Aetna Medicare |
$88.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.49
|
| Rate for Payer: BCBS Complete |
$48.26
|
| Rate for Payer: BCBS MAPPO |
$85.19
|
| Rate for Payer: BCBS Trust/PPO |
$280.16
|
| Rate for Payer: BCN Commercial |
$264.96
|
| Rate for Payer: BCN Medicare Advantage |
$85.19
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cash Price |
$272.62
|
| Rate for Payer: Cofinity Commercial |
$293.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$272.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.19
|
| Rate for Payer: Healthscope Commercial |
$306.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$255.59
|
| Rate for Payer: Mclaren Medicaid |
$45.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.45
|
| Rate for Payer: Meridian Medicaid |
$48.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$289.66
|
| Rate for Payer: Nomi Health Commercial |
$279.44
|
| Rate for Payer: PACE Senior Care Partners |
$80.94
|
| Rate for Payer: PACE SWMI |
$85.19
|
| Rate for Payer: PHP Commercial |
$289.66
|
| Rate for Payer: PHP Medicare Advantage |
$85.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$221.51
|
| Rate for Payer: Priority Health HMO/PPO |
$296.48
|
| Rate for Payer: Priority Health Medicare |
$86.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.32
|
| Rate for Payer: Railroad Medicare Medicare |
$85.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$299.89
|
| Rate for Payer: UHC Core |
$284.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$85.19
|
| Rate for Payer: UHC Exchange |
$85.19
|
| Rate for Payer: UHC Medicare Advantage |
$85.19
|
| Rate for Payer: UHCCP Medicaid |
$45.96
|
| Rate for Payer: VA VA |
$85.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$255.59
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.75
|
| Rate for Payer: BCBS Complete |
$48.26
|
| Rate for Payer: BCBS MAPPO |
$62.20
|
| Rate for Payer: BCBS Trust/PPO |
$204.54
|
| Rate for Payer: BCN Commercial |
$193.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.20
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.20
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Mclaren Medicaid |
$45.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.31
|
| Rate for Payer: Meridian Medicaid |
$48.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Senior Care Partners |
$59.09
|
| Rate for Payer: PACE SWMI |
$62.20
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Medicare |
$62.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: Railroad Medicare Medicare |
$62.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.20
|
| Rate for Payer: UHC Exchange |
$62.20
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$45.96
|
| Rate for Payer: VA VA |
$62.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000044
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: BCBS Trust/PPO |
$203.10
|
| Rate for Payer: BCN Commercial |
$192.27
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.75
|
| Rate for Payer: BCBS Complete |
$48.26
|
| Rate for Payer: BCBS MAPPO |
$62.20
|
| Rate for Payer: BCBS Trust/PPO |
$204.54
|
| Rate for Payer: BCN Commercial |
$193.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.20
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.20
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Mclaren Medicaid |
$45.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.31
|
| Rate for Payer: Meridian Medicaid |
$48.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Senior Care Partners |
$59.09
|
| Rate for Payer: PACE SWMI |
$62.20
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Medicare |
$62.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: Railroad Medicare Medicare |
$62.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.20
|
| Rate for Payer: UHC Exchange |
$62.20
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$45.96
|
| Rate for Payer: VA VA |
$62.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL CMPT1
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000045
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: BCBS Trust/PPO |
$203.10
|
| Rate for Payer: BCN Commercial |
$192.27
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.75
|
| Rate for Payer: BCBS Complete |
$48.26
|
| Rate for Payer: BCBS MAPPO |
$62.20
|
| Rate for Payer: BCBS Trust/PPO |
$204.54
|
| Rate for Payer: BCN Commercial |
$193.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.20
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.20
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Mclaren Medicaid |
$45.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.31
|
| Rate for Payer: Meridian Medicaid |
$48.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Senior Care Partners |
$59.09
|
| Rate for Payer: PACE SWMI |
$62.20
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Medicare |
$62.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: Railroad Medicare Medicare |
$62.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.20
|
| Rate for Payer: UHC Exchange |
$62.20
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$45.96
|
| Rate for Payer: VA VA |
$62.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL CMPT2
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000046
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: BCBS Trust/PPO |
$203.10
|
| Rate for Payer: BCN Commercial |
$192.27
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: BCBS Trust/PPO |
$203.10
|
| Rate for Payer: BCN Commercial |
$192.27
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL CMPT3
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000047
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.75
|
| Rate for Payer: BCBS Complete |
$48.26
|
| Rate for Payer: BCBS MAPPO |
$62.20
|
| Rate for Payer: BCBS Trust/PPO |
$204.54
|
| Rate for Payer: BCN Commercial |
$193.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.20
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.20
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Mclaren Medicaid |
$45.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.31
|
| Rate for Payer: Meridian Medicaid |
$48.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Senior Care Partners |
$59.09
|
| Rate for Payer: PACE SWMI |
$62.20
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Medicare |
$62.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: Railroad Medicare Medicare |
$62.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.20
|
| Rate for Payer: UHC Exchange |
$62.20
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$45.96
|
| Rate for Payer: VA VA |
$62.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
OP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$45.96 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: Aetna Medicare |
$64.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$77.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$77.75
|
| Rate for Payer: BCBS Complete |
$48.26
|
| Rate for Payer: BCBS MAPPO |
$62.20
|
| Rate for Payer: BCBS Trust/PPO |
$204.54
|
| Rate for Payer: BCN Commercial |
$193.44
|
| Rate for Payer: BCN Medicare Advantage |
$62.20
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$62.20
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Mclaren Medicaid |
$45.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$65.31
|
| Rate for Payer: Meridian Medicaid |
$48.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PACE Senior Care Partners |
$59.09
|
| Rate for Payer: PACE SWMI |
$62.20
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: PHP Medicare Advantage |
$62.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Medicare |
$62.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: Railroad Medicare Medicare |
$62.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$62.20
|
| Rate for Payer: UHC Exchange |
$62.20
|
| Rate for Payer: UHC Medicare Advantage |
$62.20
|
| Rate for Payer: UHCCP Medicaid |
$45.96
|
| Rate for Payer: VA VA |
$62.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOPRECIPITATE POOL CMPT4
|
Facility
|
IP
|
$248.80
|
|
|
Service Code
|
HCPCS P9012
|
| Hospital Charge Code |
39000048
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$161.72 |
| Max. Negotiated Rate |
$223.92 |
| Rate for Payer: Aetna Commercial |
$211.48
|
| Rate for Payer: BCBS Trust/PPO |
$203.10
|
| Rate for Payer: BCN Commercial |
$192.27
|
| Rate for Payer: Cash Price |
$199.04
|
| Rate for Payer: Cofinity Commercial |
$213.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$199.04
|
| Rate for Payer: Healthscope Commercial |
$223.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$186.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$211.48
|
| Rate for Payer: Nomi Health Commercial |
$204.02
|
| Rate for Payer: PHP Commercial |
$211.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$161.72
|
| Rate for Payer: Priority Health HMO/PPO |
$216.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$218.94
|
| Rate for Payer: UHC Core |
$207.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$186.60
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
OP
|
$553.35
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$131.42 |
| Max. Negotiated Rate |
$498.01 |
| Rate for Payer: Aetna Commercial |
$470.35
|
| Rate for Payer: Aetna Medicare |
$143.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$172.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$172.92
|
| Rate for Payer: BCBS Complete |
$150.85
|
| Rate for Payer: BCBS MAPPO |
$138.34
|
| Rate for Payer: BCBS Trust/PPO |
$454.91
|
| Rate for Payer: BCN Commercial |
$430.23
|
| Rate for Payer: BCN Medicare Advantage |
$138.34
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cofinity Commercial |
$475.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$138.34
|
| Rate for Payer: Healthscope Commercial |
$498.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.01
|
| Rate for Payer: Mclaren Medicaid |
$143.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$145.25
|
| Rate for Payer: Meridian Medicaid |
$150.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$159.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.35
|
| Rate for Payer: Nomi Health Commercial |
$453.75
|
| Rate for Payer: PACE Senior Care Partners |
$131.42
|
| Rate for Payer: PACE SWMI |
$138.34
|
| Rate for Payer: PHP Commercial |
$470.35
|
| Rate for Payer: PHP Medicare Advantage |
$138.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$143.66
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.68
|
| Rate for Payer: Priority Health HMO/PPO |
$481.41
|
| Rate for Payer: Priority Health Medicare |
$139.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$370.74
|
| Rate for Payer: Railroad Medicare Medicare |
$138.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.95
|
| Rate for Payer: UHC Core |
$462.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$138.34
|
| Rate for Payer: UHC Exchange |
$138.34
|
| Rate for Payer: UHC Medicare Advantage |
$138.34
|
| Rate for Payer: UHCCP Medicaid |
$143.66
|
| Rate for Payer: VA VA |
$138.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.01
|
|
|
HC CRYOSURGERY ANAL LESION(S)
|
Facility
|
IP
|
$553.35
|
|
|
Service Code
|
CPT 46916
|
| Hospital Charge Code |
76100353
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$359.68 |
| Max. Negotiated Rate |
$498.01 |
| Rate for Payer: Aetna Commercial |
$470.35
|
| Rate for Payer: BCBS Trust/PPO |
$451.70
|
| Rate for Payer: BCN Commercial |
$427.63
|
| Rate for Payer: Cash Price |
$442.68
|
| Rate for Payer: Cofinity Commercial |
$475.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$442.68
|
| Rate for Payer: Healthscope Commercial |
$498.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$415.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$470.35
|
| Rate for Payer: Nomi Health Commercial |
$453.75
|
| Rate for Payer: PHP Commercial |
$470.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$359.68
|
| Rate for Payer: Priority Health HMO/PPO |
$481.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$370.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$486.95
|
| Rate for Payer: UHC Core |
$462.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$415.01
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
IP
|
$46.82
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.43 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: BCBS Trust/PPO |
$38.22
|
| Rate for Payer: BCN Commercial |
$36.18
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC CRYPTOCOCCAL ANTIGEN FLUID
|
Facility
|
OP
|
$46.82
|
|
|
Service Code
|
CPT 87899
|
| Hospital Charge Code |
30200210
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.12 |
| Max. Negotiated Rate |
$42.14 |
| Rate for Payer: Aetna Commercial |
$39.80
|
| Rate for Payer: Aetna Medicare |
$12.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.63
|
| Rate for Payer: BCBS Complete |
$12.20
|
| Rate for Payer: BCBS MAPPO |
$11.71
|
| Rate for Payer: BCBS Trust/PPO |
$38.49
|
| Rate for Payer: BCN Commercial |
$36.40
|
| Rate for Payer: BCN Medicare Advantage |
$11.71
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cash Price |
$37.46
|
| Rate for Payer: Cofinity Commercial |
$40.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.71
|
| Rate for Payer: Healthscope Commercial |
$42.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.12
|
| Rate for Payer: Mclaren Medicaid |
$11.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.29
|
| Rate for Payer: Meridian Medicaid |
$12.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39.80
|
| Rate for Payer: Nomi Health Commercial |
$38.39
|
| Rate for Payer: PACE Senior Care Partners |
$11.12
|
| Rate for Payer: PACE SWMI |
$11.71
|
| Rate for Payer: PHP Commercial |
$39.80
|
| Rate for Payer: PHP Medicare Advantage |
$11.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.43
|
| Rate for Payer: Priority Health HMO/PPO |
$40.73
|
| Rate for Payer: Priority Health Medicare |
$11.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.37
|
| Rate for Payer: Railroad Medicare Medicare |
$11.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.20
|
| Rate for Payer: UHC Core |
$39.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.71
|
| Rate for Payer: UHC Exchange |
$11.71
|
| Rate for Payer: UHC Medicare Advantage |
$11.71
|
| Rate for Payer: UHCCP Medicaid |
$11.62
|
| Rate for Payer: VA VA |
$11.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.12
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CRYPTOCOCCUS NEOFORMANS GATTII
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600265
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$12.35 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$13.01
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.01
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.01
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.01
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.01
|
| Rate for Payer: UHC Exchange |
$13.01
|
| Rate for Payer: UHC Medicare Advantage |
$13.01
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$13.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
OP
|
$45.78
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.99 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: Aetna Medicare |
$11.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.31
|
| Rate for Payer: BCBS Complete |
$10.49
|
| Rate for Payer: BCBS MAPPO |
$11.45
|
| Rate for Payer: BCBS Trust/PPO |
$37.64
|
| Rate for Payer: BCN Commercial |
$35.59
|
| Rate for Payer: BCN Medicare Advantage |
$11.45
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.45
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Mclaren Medicaid |
$9.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.02
|
| Rate for Payer: Meridian Medicaid |
$10.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PACE Senior Care Partners |
$10.87
|
| Rate for Payer: PACE SWMI |
$11.45
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: PHP Medicare Advantage |
$11.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Medicare |
$11.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: Railroad Medicare Medicare |
$11.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.45
|
| Rate for Payer: UHC Exchange |
$11.45
|
| Rate for Payer: UHC Medicare Advantage |
$11.45
|
| Rate for Payer: UHCCP Medicaid |
$9.99
|
| Rate for Payer: VA VA |
$11.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC CRYPTOSPORIDIUM SCREEN
|
Facility
|
IP
|
$45.78
|
|
|
Service Code
|
CPT 87328
|
| Hospital Charge Code |
30600120
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.76 |
| Max. Negotiated Rate |
$41.20 |
| Rate for Payer: Aetna Commercial |
$38.91
|
| Rate for Payer: BCBS Trust/PPO |
$37.37
|
| Rate for Payer: BCN Commercial |
$35.38
|
| Rate for Payer: Cash Price |
$36.62
|
| Rate for Payer: Cofinity Commercial |
$39.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.62
|
| Rate for Payer: Healthscope Commercial |
$41.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.91
|
| Rate for Payer: Nomi Health Commercial |
$37.54
|
| Rate for Payer: PHP Commercial |
$38.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$29.76
|
| Rate for Payer: Priority Health HMO/PPO |
$39.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40.29
|
| Rate for Payer: UHC Core |
$38.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34.34
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
OP
|
$47.24
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: Aetna Medicare |
$12.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14.76
|
| Rate for Payer: BCBS Complete |
$5.56
|
| Rate for Payer: BCBS MAPPO |
$11.81
|
| Rate for Payer: BCBS Trust/PPO |
$38.84
|
| Rate for Payer: BCN Commercial |
$36.73
|
| Rate for Payer: BCN Medicare Advantage |
$11.81
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11.81
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Mclaren Medicaid |
$5.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.40
|
| Rate for Payer: Meridian Medicaid |
$5.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: PACE Senior Care Partners |
$11.22
|
| Rate for Payer: PACE SWMI |
$11.81
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: PHP Medicare Advantage |
$11.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.71
|
| Rate for Payer: Priority Health HMO/PPO |
$41.10
|
| Rate for Payer: Priority Health Medicare |
$11.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.65
|
| Rate for Payer: Railroad Medicare Medicare |
$11.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.57
|
| Rate for Payer: UHC Core |
$39.45
|
| Rate for Payer: UHC Dual Complete DSNP |
$11.81
|
| Rate for Payer: UHC Exchange |
$11.81
|
| Rate for Payer: UHC Medicare Advantage |
$11.81
|
| Rate for Payer: UHCCP Medicaid |
$5.30
|
| Rate for Payer: VA VA |
$11.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC CRYSTALS BODY FLUID
|
Facility
|
IP
|
$47.24
|
|
|
Service Code
|
CPT 89060
|
| Hospital Charge Code |
30000002
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$30.71 |
| Max. Negotiated Rate |
$42.52 |
| Rate for Payer: Aetna Commercial |
$40.15
|
| Rate for Payer: BCBS Trust/PPO |
$38.56
|
| Rate for Payer: BCN Commercial |
$36.51
|
| Rate for Payer: Cash Price |
$37.79
|
| Rate for Payer: Cofinity Commercial |
$40.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37.79
|
| Rate for Payer: Healthscope Commercial |
$42.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40.15
|
| Rate for Payer: Nomi Health Commercial |
$38.74
|
| Rate for Payer: PHP Commercial |
$40.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30.71
|
| Rate for Payer: Priority Health HMO/PPO |
$41.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41.57
|
| Rate for Payer: UHC Core |
$39.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35.43
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
IP
|
$2,996.16
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,947.50 |
| Max. Negotiated Rate |
$2,696.54 |
| Rate for Payer: Aetna Commercial |
$2,546.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,445.77
|
| Rate for Payer: BCN Commercial |
$2,315.43
|
| Rate for Payer: Cash Price |
$2,396.93
|
| Rate for Payer: Cofinity Commercial |
$2,576.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,396.93
|
| Rate for Payer: Healthscope Commercial |
$2,696.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,247.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,546.74
|
| Rate for Payer: Nomi Health Commercial |
$2,456.85
|
| Rate for Payer: PHP Commercial |
$2,546.74
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,606.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,007.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,636.62
|
| Rate for Payer: UHC Core |
$2,501.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,247.12
|
|
|
HC C-SECTION (OB SURGERY)
|
Facility
|
OP
|
$2,996.16
|
|
| Hospital Charge Code |
36000024
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$711.59 |
| Max. Negotiated Rate |
$2,696.54 |
| Rate for Payer: Aetna Commercial |
$2,546.74
|
| Rate for Payer: Aetna Medicare |
$779.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$936.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$936.30
|
| Rate for Payer: BCBS Complete |
$1,198.46
|
| Rate for Payer: BCBS MAPPO |
$749.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,463.14
|
| Rate for Payer: BCN Commercial |
$2,329.51
|
| Rate for Payer: BCN Medicare Advantage |
$749.04
|
| Rate for Payer: Cash Price |
$2,396.93
|
| Rate for Payer: Cofinity Commercial |
$2,576.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,396.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$749.04
|
| Rate for Payer: Healthscope Commercial |
$2,696.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,247.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$786.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$861.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,546.74
|
| Rate for Payer: Nomi Health Commercial |
$2,456.85
|
| Rate for Payer: PACE Senior Care Partners |
$711.59
|
| Rate for Payer: PACE SWMI |
$749.04
|
| Rate for Payer: PHP Commercial |
$2,546.74
|
| Rate for Payer: PHP Medicare Advantage |
$749.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,947.50
|
| Rate for Payer: Priority Health HMO/PPO |
$2,606.66
|
| Rate for Payer: Priority Health Medicare |
$756.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,007.43
|
| Rate for Payer: Railroad Medicare Medicare |
$749.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,636.62
|
| Rate for Payer: UHC Core |
$2,501.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$749.04
|
| Rate for Payer: UHC Exchange |
$749.04
|
| Rate for Payer: UHC Medicare Advantage |
$749.04
|
| Rate for Payer: VA VA |
$749.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,247.12
|
|
|
HC C-SECTION W/STERIL (OB SURGERY
|
Facility
|
IP
|
$3,679.58
|
|
| Hospital Charge Code |
36000025
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,391.73 |
| Max. Negotiated Rate |
$3,311.62 |
| Rate for Payer: Aetna Commercial |
$3,127.64
|
| Rate for Payer: BCBS Trust/PPO |
$3,003.64
|
| Rate for Payer: BCN Commercial |
$2,843.58
|
| Rate for Payer: Cash Price |
$2,943.66
|
| Rate for Payer: Cofinity Commercial |
$3,164.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,943.66
|
| Rate for Payer: Healthscope Commercial |
$3,311.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,759.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,127.64
|
| Rate for Payer: Nomi Health Commercial |
$3,017.26
|
| Rate for Payer: PHP Commercial |
$3,127.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,391.73
|
| Rate for Payer: Priority Health HMO/PPO |
$3,201.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,465.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,238.03
|
| Rate for Payer: UHC Core |
$3,072.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,759.68
|
|
