|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
IP
|
$242.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$157.79 |
| Max. Negotiated Rate |
$218.48 |
| Rate for Payer: Aetna Commercial |
$206.35
|
| Rate for Payer: BCBS Trust/PPO |
$198.16
|
| Rate for Payer: BCN Commercial |
$187.60
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cofinity Commercial |
$208.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.21
|
| Rate for Payer: Healthscope Commercial |
$218.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.35
|
| Rate for Payer: Nomi Health Commercial |
$199.06
|
| Rate for Payer: PHP Commercial |
$206.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.79
|
| Rate for Payer: Priority Health HMO/PPO |
$211.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.63
|
| Rate for Payer: UHC Core |
$202.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.07
|
|
|
HC CYTOGENETICS DNA PROBE CMPT
|
Facility
|
OP
|
$242.76
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31000129
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$218.48 |
| Rate for Payer: Aetna Commercial |
$206.35
|
| Rate for Payer: Aetna Medicare |
$63.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$75.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$75.86
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$60.69
|
| Rate for Payer: BCBS Trust/PPO |
$199.57
|
| Rate for Payer: BCN Commercial |
$188.75
|
| Rate for Payer: BCN Medicare Advantage |
$60.69
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cash Price |
$194.21
|
| Rate for Payer: Cofinity Commercial |
$208.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$194.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$60.69
|
| Rate for Payer: Healthscope Commercial |
$218.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$182.07
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$63.72
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$69.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$206.35
|
| Rate for Payer: Nomi Health Commercial |
$199.06
|
| Rate for Payer: PACE Senior Care Partners |
$57.66
|
| Rate for Payer: PACE SWMI |
$60.69
|
| Rate for Payer: PHP Commercial |
$206.35
|
| Rate for Payer: PHP Medicare Advantage |
$60.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$157.79
|
| Rate for Payer: Priority Health HMO/PPO |
$211.20
|
| Rate for Payer: Priority Health Medicare |
$61.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$162.65
|
| Rate for Payer: Railroad Medicare Medicare |
$60.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$213.63
|
| Rate for Payer: UHC Core |
$202.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$60.69
|
| Rate for Payer: UHC Exchange |
$60.69
|
| Rate for Payer: UHC Medicare Advantage |
$60.69
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$60.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$182.07
|
|
|
HC CYTOMEGALOVIRUS (CMV)
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
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 CYTOMEGALOVIRUS (CMV)
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 87496
|
| Hospital Charge Code |
30600266
|
|
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 CYTOMEGALOVIRUS CULTURE
|
Facility
|
OP
|
$111.89
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.14 |
| Max. Negotiated Rate |
$100.70 |
| Rate for Payer: Aetna Commercial |
$95.11
|
| Rate for Payer: Aetna Medicare |
$29.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.97
|
| Rate for Payer: BCBS Complete |
$14.85
|
| Rate for Payer: BCBS MAPPO |
$27.97
|
| Rate for Payer: BCBS Trust/PPO |
$91.98
|
| Rate for Payer: BCN Commercial |
$86.99
|
| Rate for Payer: BCN Medicare Advantage |
$27.97
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cofinity Commercial |
$96.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.97
|
| Rate for Payer: Healthscope Commercial |
$100.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.92
|
| Rate for Payer: Mclaren Medicaid |
$14.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.37
|
| Rate for Payer: Meridian Medicaid |
$14.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.11
|
| Rate for Payer: Nomi Health Commercial |
$91.75
|
| Rate for Payer: PACE Senior Care Partners |
$26.57
|
| Rate for Payer: PACE SWMI |
$27.97
|
| Rate for Payer: PHP Commercial |
$95.11
|
| Rate for Payer: PHP Medicare Advantage |
$27.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.73
|
| Rate for Payer: Priority Health HMO/PPO |
$97.34
|
| Rate for Payer: Priority Health Medicare |
$28.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.97
|
| Rate for Payer: Railroad Medicare Medicare |
$27.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.46
|
| Rate for Payer: UHC Core |
$93.43
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.97
|
| Rate for Payer: UHC Exchange |
$27.97
|
| Rate for Payer: UHC Medicare Advantage |
$27.97
|
| Rate for Payer: UHCCP Medicaid |
$14.14
|
| Rate for Payer: VA VA |
$27.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.92
|
|
|
HC CYTOMEGALOVIRUS CULTURE
|
Facility
|
IP
|
$111.89
|
|
|
Service Code
|
CPT 87254
|
| Hospital Charge Code |
30600115
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.73 |
| Max. Negotiated Rate |
$100.70 |
| Rate for Payer: Aetna Commercial |
$95.11
|
| Rate for Payer: BCBS Trust/PPO |
$91.34
|
| Rate for Payer: BCN Commercial |
$86.47
|
| Rate for Payer: Cash Price |
$89.51
|
| Rate for Payer: Cofinity Commercial |
$96.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.51
|
| Rate for Payer: Healthscope Commercial |
$100.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.11
|
| Rate for Payer: Nomi Health Commercial |
$91.75
|
| Rate for Payer: PHP Commercial |
$95.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$72.73
|
| Rate for Payer: Priority Health HMO/PPO |
$97.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.46
|
| Rate for Payer: UHC Core |
$93.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.92
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$10.92
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$10.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$10.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$10.40
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYTOMEGALOVIRUS IGG
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86644
|
| Hospital Charge Code |
30200249
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYTOMEGALOVIRUS IGM
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 86645
|
| Hospital Charge Code |
30200252
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$12.79
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.21
|
| Rate for Payer: Mclaren Medicaid |
$12.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$12.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.18
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$12.18
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.21
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
IP
|
$134.42
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$87.37 |
| Max. Negotiated Rate |
$120.98 |
| Rate for Payer: Aetna Commercial |
$114.26
|
| Rate for Payer: BCBS Trust/PPO |
$109.73
|
| Rate for Payer: BCN Commercial |
$103.88
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cofinity Commercial |
$115.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.54
|
| Rate for Payer: Healthscope Commercial |
$120.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.26
|
| Rate for Payer: Nomi Health Commercial |
$110.22
|
| Rate for Payer: PHP Commercial |
$114.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.37
|
| Rate for Payer: Priority Health HMO/PPO |
$116.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.29
|
| Rate for Payer: UHC Core |
$112.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.81
|
|
|
HC CYTOPATH CELL ENHANCE TECHNIQU
|
Facility
|
OP
|
$134.42
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
31100003
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$31.92 |
| Max. Negotiated Rate |
$120.98 |
| Rate for Payer: Aetna Commercial |
$114.26
|
| Rate for Payer: Aetna Medicare |
$34.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.01
|
| Rate for Payer: BCBS Complete |
$40.56
|
| Rate for Payer: BCBS MAPPO |
$33.60
|
| Rate for Payer: BCBS Trust/PPO |
$110.51
|
| Rate for Payer: BCN Commercial |
$104.51
|
| Rate for Payer: BCN Medicare Advantage |
$33.60
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cash Price |
$107.54
|
| Rate for Payer: Cofinity Commercial |
$115.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$107.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.60
|
| Rate for Payer: Healthscope Commercial |
$120.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$100.81
|
| Rate for Payer: Mclaren Medicaid |
$38.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$35.29
|
| Rate for Payer: Meridian Medicaid |
$40.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$38.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$114.26
|
| Rate for Payer: Nomi Health Commercial |
$110.22
|
| Rate for Payer: PACE Senior Care Partners |
$31.92
|
| Rate for Payer: PACE SWMI |
$33.60
|
| Rate for Payer: PHP Commercial |
$114.26
|
| Rate for Payer: PHP Medicare Advantage |
$33.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.63
|
| Rate for Payer: Priority Health Cigna Priority Health |
$87.37
|
| Rate for Payer: Priority Health HMO/PPO |
$116.95
|
| Rate for Payer: Priority Health Medicare |
$33.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$90.06
|
| Rate for Payer: Railroad Medicare Medicare |
$33.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$118.29
|
| Rate for Payer: UHC Core |
$112.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.60
|
| Rate for Payer: UHC Exchange |
$33.60
|
| Rate for Payer: UHC Medicare Advantage |
$33.60
|
| Rate for Payer: UHCCP Medicaid |
$38.63
|
| Rate for Payer: VA VA |
$33.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$100.81
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
OP
|
$102.41
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$17.71 |
| Max. Negotiated Rate |
$92.17 |
| Rate for Payer: Aetna Commercial |
$87.05
|
| Rate for Payer: Aetna Medicare |
$26.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.00
|
| Rate for Payer: BCBS Complete |
$18.59
|
| Rate for Payer: BCBS MAPPO |
$25.60
|
| Rate for Payer: BCBS Trust/PPO |
$84.19
|
| Rate for Payer: BCN Commercial |
$79.62
|
| Rate for Payer: BCN Medicare Advantage |
$25.60
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cofinity Commercial |
$88.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$25.60
|
| Rate for Payer: Healthscope Commercial |
$92.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.81
|
| Rate for Payer: Mclaren Medicaid |
$17.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.88
|
| Rate for Payer: Meridian Medicaid |
$18.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.05
|
| Rate for Payer: Nomi Health Commercial |
$83.98
|
| Rate for Payer: PACE Senior Care Partners |
$24.32
|
| Rate for Payer: PACE SWMI |
$25.60
|
| Rate for Payer: PHP Commercial |
$87.05
|
| Rate for Payer: PHP Medicare Advantage |
$25.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.57
|
| Rate for Payer: Priority Health HMO/PPO |
$89.10
|
| Rate for Payer: Priority Health Medicare |
$25.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.61
|
| Rate for Payer: Railroad Medicare Medicare |
$25.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.12
|
| Rate for Payer: UHC Core |
$85.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$25.60
|
| Rate for Payer: UHC Exchange |
$25.60
|
| Rate for Payer: UHC Medicare Advantage |
$25.60
|
| Rate for Payer: UHCCP Medicaid |
$17.71
|
| Rate for Payer: VA VA |
$25.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.81
|
|
|
HC CYTOPATH SCREEN & INTERPRETATION
|
Facility
|
IP
|
$102.41
|
|
|
Service Code
|
CPT 88160
|
| Hospital Charge Code |
31100005
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$66.57 |
| Max. Negotiated Rate |
$92.17 |
| Rate for Payer: Aetna Commercial |
$87.05
|
| Rate for Payer: BCBS Trust/PPO |
$83.60
|
| Rate for Payer: BCN Commercial |
$79.14
|
| Rate for Payer: Cash Price |
$81.93
|
| Rate for Payer: Cofinity Commercial |
$88.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.93
|
| Rate for Payer: Healthscope Commercial |
$92.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$87.05
|
| Rate for Payer: Nomi Health Commercial |
$83.98
|
| Rate for Payer: PHP Commercial |
$87.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.57
|
| Rate for Payer: Priority Health HMO/PPO |
$89.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$90.12
|
| Rate for Payer: UHC Core |
$85.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.81
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
OP
|
$74.46
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.71 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: Aetna Medicare |
$19.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.27
|
| Rate for Payer: BCBS Complete |
$9.15
|
| Rate for Payer: BCBS MAPPO |
$18.61
|
| Rate for Payer: BCBS Trust/PPO |
$61.21
|
| Rate for Payer: BCN Commercial |
$57.89
|
| Rate for Payer: BCN Medicare Advantage |
$18.61
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.61
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Mclaren Medicaid |
$8.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.55
|
| Rate for Payer: Meridian Medicaid |
$9.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: Nomi Health Commercial |
$61.06
|
| Rate for Payer: PACE Senior Care Partners |
$17.68
|
| Rate for Payer: PACE SWMI |
$18.61
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: PHP Medicare Advantage |
$18.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health HMO/PPO |
$64.78
|
| Rate for Payer: Priority Health Medicare |
$18.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.89
|
| Rate for Payer: Railroad Medicare Medicare |
$18.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.61
|
| Rate for Payer: UHC Exchange |
$18.61
|
| Rate for Payer: UHC Medicare Advantage |
$18.61
|
| Rate for Payer: UHCCP Medicaid |
$8.71
|
| Rate for Payer: VA VA |
$18.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC CYTOPLASMIC NEUTROPHIL ANCA AB
|
Facility
|
IP
|
$74.46
|
|
|
Service Code
|
CPT 86255
|
| Hospital Charge Code |
30200173
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.40 |
| Max. Negotiated Rate |
$67.01 |
| Rate for Payer: Aetna Commercial |
$63.29
|
| Rate for Payer: BCBS Trust/PPO |
$60.78
|
| Rate for Payer: BCN Commercial |
$57.54
|
| Rate for Payer: Cash Price |
$59.57
|
| Rate for Payer: Cofinity Commercial |
$64.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$59.57
|
| Rate for Payer: Healthscope Commercial |
$67.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$55.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.29
|
| Rate for Payer: Nomi Health Commercial |
$61.06
|
| Rate for Payer: PHP Commercial |
$63.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$48.40
|
| Rate for Payer: Priority Health HMO/PPO |
$64.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$49.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$65.52
|
| Rate for Payer: UHC Core |
$62.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$55.84
|
|
|
HC DAMAGED WATCH PAT DEVICE
|
Facility
|
OP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$23.75 |
| 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 |
$40.00
|
| Rate for Payer: BCBS MAPPO |
$25.00
|
| Rate for Payer: BCBS Trust/PPO |
$82.21
|
| Rate for Payer: BCN Commercial |
$77.75
|
| 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: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$85.00
|
| Rate for Payer: Nomi Health Commercial |
$82.00
|
| 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 Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health HMO/PPO |
$87.00
|
| Rate for Payer: Priority Health Medicare |
$25.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.00
|
| 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 Dual Complete DSNP |
$25.00
|
| Rate for Payer: UHC Exchange |
$25.00
|
| Rate for Payer: UHC Medicare Advantage |
$25.00
|
| Rate for Payer: VA VA |
$25.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$75.00
|
|
|
HC DAMAGED WATCH PAT DEVICE
|
Facility
|
IP
|
$100.00
|
|
| Hospital Charge Code |
27000706
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$90.00 |
| Rate for Payer: Aetna Commercial |
$85.00
|
| Rate for Payer: BCBS Trust/PPO |
$81.63
|
| Rate for Payer: BCN Commercial |
$77.28
|
| 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: PHP Commercial |
$85.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$65.00
|
| Rate for Payer: Priority Health HMO/PPO |
$87.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$67.00
|
| 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
|
$798.66
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$189.68 |
| Max. Negotiated Rate |
$718.79 |
| Rate for Payer: Aetna Commercial |
$678.86
|
| Rate for Payer: Aetna Medicare |
$207.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$249.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$249.58
|
| Rate for Payer: BCBS Complete |
$531.23
|
| Rate for Payer: BCBS MAPPO |
$199.66
|
| Rate for Payer: BCBS Trust/PPO |
$656.58
|
| Rate for Payer: BCN Commercial |
$620.96
|
| Rate for Payer: BCN Medicare Advantage |
$199.66
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cofinity Commercial |
$686.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$199.66
|
| Rate for Payer: Healthscope Commercial |
$718.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$599.00
|
| Rate for Payer: Mclaren Medicaid |
$505.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$209.65
|
| Rate for Payer: Meridian Medicaid |
$531.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$229.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.86
|
| Rate for Payer: Nomi Health Commercial |
$654.90
|
| Rate for Payer: PACE Senior Care Partners |
$189.68
|
| Rate for Payer: PACE SWMI |
$199.66
|
| Rate for Payer: PHP Commercial |
$678.86
|
| Rate for Payer: PHP Medicare Advantage |
$199.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.13
|
| Rate for Payer: Priority Health HMO/PPO |
$694.83
|
| Rate for Payer: Priority Health Medicare |
$201.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$535.10
|
| Rate for Payer: Railroad Medicare Medicare |
$199.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$702.82
|
| Rate for Payer: UHC Core |
$666.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$199.66
|
| Rate for Payer: UHC Exchange |
$199.66
|
| Rate for Payer: UHC Medicare Advantage |
$199.66
|
| Rate for Payer: UHCCP Medicaid |
$505.90
|
| Rate for Payer: VA VA |
$199.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$599.00
|
|
|
HC DAVITA IP HEMODIALYSIS SGL
|
Facility
|
IP
|
$798.66
|
|
|
Service Code
|
CPT 90935
|
| Hospital Charge Code |
80100003
|
|
Hospital Revenue Code
|
801
|
| Min. Negotiated Rate |
$519.13 |
| Max. Negotiated Rate |
$718.79 |
| Rate for Payer: Aetna Commercial |
$678.86
|
| Rate for Payer: BCBS Trust/PPO |
$651.95
|
| Rate for Payer: BCN Commercial |
$617.20
|
| Rate for Payer: Cash Price |
$638.93
|
| Rate for Payer: Cofinity Commercial |
$686.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$638.93
|
| Rate for Payer: Healthscope Commercial |
$718.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$599.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$678.86
|
| Rate for Payer: Nomi Health Commercial |
$654.90
|
| Rate for Payer: PHP Commercial |
$678.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$519.13
|
| Rate for Payer: Priority Health HMO/PPO |
$694.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$535.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$702.82
|
| Rate for Payer: UHC Core |
$666.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$599.00
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
OP
|
$855.04
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$203.07 |
| Max. Negotiated Rate |
$769.54 |
| Rate for Payer: Aetna Commercial |
$726.78
|
| Rate for Payer: Aetna Medicare |
$222.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$267.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$267.20
|
| Rate for Payer: BCBS Complete |
$531.23
|
| Rate for Payer: BCBS MAPPO |
$213.76
|
| Rate for Payer: BCBS Trust/PPO |
$702.93
|
| Rate for Payer: BCN Commercial |
$664.79
|
| Rate for Payer: BCN Medicare Advantage |
$213.76
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cofinity Commercial |
$735.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$213.76
|
| Rate for Payer: Healthscope Commercial |
$769.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.28
|
| Rate for Payer: Mclaren Medicaid |
$505.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$224.45
|
| Rate for Payer: Meridian Medicaid |
$531.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$245.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$726.78
|
| Rate for Payer: Nomi Health Commercial |
$701.13
|
| Rate for Payer: PACE Senior Care Partners |
$203.07
|
| Rate for Payer: PACE SWMI |
$213.76
|
| Rate for Payer: PHP Commercial |
$726.78
|
| Rate for Payer: PHP Medicare Advantage |
$213.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$505.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.78
|
| Rate for Payer: Priority Health HMO/PPO |
$743.88
|
| Rate for Payer: Priority Health Medicare |
$215.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$572.88
|
| Rate for Payer: Railroad Medicare Medicare |
$213.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$752.44
|
| Rate for Payer: UHC Core |
$713.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$213.76
|
| Rate for Payer: UHC Exchange |
$213.76
|
| Rate for Payer: UHC Medicare Advantage |
$213.76
|
| Rate for Payer: UHCCP Medicaid |
$505.90
|
| Rate for Payer: VA VA |
$213.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.28
|
|
|
HC DAVITA OP HEMODIALYSIS
|
Facility
|
IP
|
$855.04
|
|
|
Service Code
|
HCPCS G0257
|
| Hospital Charge Code |
88100002
|
|
Hospital Revenue Code
|
820
|
| Min. Negotiated Rate |
$555.78 |
| Max. Negotiated Rate |
$769.54 |
| Rate for Payer: Aetna Commercial |
$726.78
|
| Rate for Payer: BCBS Trust/PPO |
$697.97
|
| Rate for Payer: BCN Commercial |
$660.77
|
| Rate for Payer: Cash Price |
$684.03
|
| Rate for Payer: Cofinity Commercial |
$735.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$684.03
|
| Rate for Payer: Healthscope Commercial |
$769.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$641.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$726.78
|
| Rate for Payer: Nomi Health Commercial |
$701.13
|
| Rate for Payer: PHP Commercial |
$726.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$555.78
|
| Rate for Payer: Priority Health HMO/PPO |
$743.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$572.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$752.44
|
| Rate for Payer: UHC Core |
$713.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$641.28
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
OP
|
$783.42
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$186.06 |
| Max. Negotiated Rate |
$705.08 |
| Rate for Payer: Aetna Commercial |
$665.91
|
| Rate for Payer: Aetna Medicare |
$203.69
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$244.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$244.82
|
| Rate for Payer: BCBS Complete |
$313.37
|
| Rate for Payer: BCBS MAPPO |
$195.85
|
| Rate for Payer: BCBS Trust/PPO |
$644.05
|
| Rate for Payer: BCN Commercial |
$609.11
|
| Rate for Payer: BCN Medicare Advantage |
$195.85
|
| Rate for Payer: Cash Price |
$626.74
|
| Rate for Payer: Cofinity Commercial |
$673.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$195.85
|
| Rate for Payer: Healthscope Commercial |
$705.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$205.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$225.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.91
|
| Rate for Payer: Nomi Health Commercial |
$642.40
|
| Rate for Payer: PACE Senior Care Partners |
$186.06
|
| Rate for Payer: PACE SWMI |
$195.85
|
| Rate for Payer: PHP Commercial |
$665.91
|
| Rate for Payer: PHP Medicare Advantage |
$195.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.22
|
| Rate for Payer: Priority Health HMO/PPO |
$681.58
|
| Rate for Payer: Priority Health Medicare |
$197.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.89
|
| Rate for Payer: Railroad Medicare Medicare |
$195.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.41
|
| Rate for Payer: UHC Core |
$654.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$195.85
|
| Rate for Payer: UHC Exchange |
$195.85
|
| Rate for Payer: UHC Medicare Advantage |
$195.85
|
| Rate for Payer: VA VA |
$195.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.57
|
|
|
HC DBL PIGTAIL BILIARY STENT
|
Facility
|
IP
|
$783.42
|
|
|
Service Code
|
HCPCS C2617
|
| Hospital Charge Code |
27800064
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$509.22 |
| Max. Negotiated Rate |
$705.08 |
| Rate for Payer: Aetna Commercial |
$665.91
|
| Rate for Payer: BCBS Trust/PPO |
$639.51
|
| Rate for Payer: BCN Commercial |
$605.43
|
| Rate for Payer: Cash Price |
$626.74
|
| Rate for Payer: Cofinity Commercial |
$673.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$626.74
|
| Rate for Payer: Healthscope Commercial |
$705.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$587.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$665.91
|
| Rate for Payer: Nomi Health Commercial |
$642.40
|
| Rate for Payer: PHP Commercial |
$665.91
|
| Rate for Payer: Priority Health Cigna Priority Health |
$509.22
|
| Rate for Payer: Priority Health HMO/PPO |
$681.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$524.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$689.41
|
| Rate for Payer: UHC Core |
$654.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$587.57
|
|
|
HC D & C
|
Facility
|
OP
|
$2,041.41
|
|
| Hospital Charge Code |
45000037
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$484.83 |
| Max. Negotiated Rate |
$1,837.27 |
| Rate for Payer: Aetna Commercial |
$1,735.20
|
| Rate for Payer: Aetna Medicare |
$530.77
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$637.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$637.94
|
| Rate for Payer: BCBS Complete |
$816.56
|
| Rate for Payer: BCBS MAPPO |
$510.35
|
| Rate for Payer: BCBS Trust/PPO |
$1,678.24
|
| Rate for Payer: BCN Commercial |
$1,587.20
|
| Rate for Payer: BCN Medicare Advantage |
$510.35
|
| Rate for Payer: Cash Price |
$1,633.13
|
| Rate for Payer: Cofinity Commercial |
$1,755.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,633.13
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$510.35
|
| Rate for Payer: Healthscope Commercial |
$1,837.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,531.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$535.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$586.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,735.20
|
| Rate for Payer: Nomi Health Commercial |
$1,673.96
|
| Rate for Payer: PACE Senior Care Partners |
$484.83
|
| Rate for Payer: PACE SWMI |
$510.35
|
| Rate for Payer: PHP Commercial |
$1,735.20
|
| Rate for Payer: PHP Medicare Advantage |
$510.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,326.92
|
| Rate for Payer: Priority Health HMO/PPO |
$1,776.03
|
| Rate for Payer: Priority Health Medicare |
$515.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,367.74
|
| Rate for Payer: Railroad Medicare Medicare |
$510.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,796.44
|
| Rate for Payer: UHC Core |
$1,704.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$510.35
|
| Rate for Payer: UHC Exchange |
$510.35
|
| Rate for Payer: UHC Medicare Advantage |
$510.35
|
| Rate for Payer: VA VA |
$510.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,531.06
|
|
