|
HC F427 RARA H9 LTP PEANUT
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200451
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F427 RARA H9 LTP PEANUT
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200451
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F447 RARA H6 PEANUT
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200449
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F447 RARA H6 PEANUT
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200449
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F76 ALPHA-LACTALBUMIN
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200442
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F76 ALPHA-LACTALBUMIN
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200442
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F77 BETA-LACTOGLOBULIN
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200445
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F77 BETA-LACTOGLOBULIN
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200445
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F78 CASEIN
|
Facility
|
OP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200441
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.66 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: Aetna Medicare |
$8.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.03
|
| Rate for Payer: BCBS Complete |
$5.94
|
| Rate for Payer: BCBS MAPPO |
$8.03
|
| Rate for Payer: BCBS Trust/PPO |
$26.39
|
| Rate for Payer: BCN Commercial |
$26.39
|
| Rate for Payer: BCN Medicare Advantage |
$8.03
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.03
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Mclaren Medicaid |
$5.66
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.43
|
| Rate for Payer: Meridian Medicaid |
$5.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PACE Senior Care Partners |
$7.62
|
| Rate for Payer: PACE SWMI |
$8.03
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: PHP Medicare Advantage |
$8.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Medicare |
$8.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: Railroad Medicare Medicare |
$8.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: UHC Exchange |
$8.03
|
| Rate for Payer: UHC Medicaid |
$5.66
|
| Rate for Payer: UHC Medicare Advantage |
$8.03
|
| Rate for Payer: UHCCP Medicaid |
$5.66
|
| Rate for Payer: VA VA |
$8.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC F78 CASEIN
|
Facility
|
IP
|
$32.10
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
30200441
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.34 |
| Max. Negotiated Rate |
$28.89 |
| Rate for Payer: Aetna Commercial |
$27.29
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: Cash Price |
$25.68
|
| Rate for Payer: Cofinity Commercial |
$27.61
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.68
|
| Rate for Payer: Healthscope Commercial |
$28.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.29
|
| Rate for Payer: Nomi Health Commercial |
$26.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.07
|
| Rate for Payer: PHP Commercial |
$27.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.25
|
| Rate for Payer: UHC Core |
$26.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.07
|
|
|
HC FACTOR II ASSAY
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 85210
|
| Hospital Charge Code |
30500015
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.43 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$18.30
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$81.26
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$17.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$18.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicaid |
$17.43
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$17.43
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC FACTOR II ASSAY
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 85210
|
| Hospital Charge Code |
30500015
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$68.79 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$81.63
|
| Rate for Payer: BCN Commercial |
$81.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC FACTOR IX
|
Facility
|
IP
|
$159.92
|
|
|
Service Code
|
CPT 85250
|
| Hospital Charge Code |
30500029
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$111.30 |
| Max. Negotiated Rate |
$143.93 |
| Rate for Payer: Aetna Commercial |
$135.93
|
| Rate for Payer: BCBS Trust/PPO |
$132.08
|
| Rate for Payer: BCN Commercial |
$132.08
|
| Rate for Payer: Cash Price |
$127.94
|
| Rate for Payer: Cofinity Commercial |
$137.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.94
|
| Rate for Payer: Healthscope Commercial |
$143.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.93
|
| Rate for Payer: Nomi Health Commercial |
$131.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.94
|
| Rate for Payer: PHP Commercial |
$135.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.73
|
| Rate for Payer: UHC Core |
$133.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.94
|
|
|
HC FACTOR IX
|
Facility
|
OP
|
$159.92
|
|
|
Service Code
|
CPT 85250
|
| Hospital Charge Code |
30500029
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$28.19 |
| Max. Negotiated Rate |
$143.93 |
| Rate for Payer: Aetna Commercial |
$135.93
|
| Rate for Payer: Aetna Medicare |
$41.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.98
|
| Rate for Payer: BCBS Complete |
$29.60
|
| Rate for Payer: BCBS MAPPO |
$39.98
|
| Rate for Payer: BCBS Trust/PPO |
$131.47
|
| Rate for Payer: BCN Commercial |
$131.47
|
| Rate for Payer: BCN Medicare Advantage |
$39.98
|
| Rate for Payer: Cash Price |
$127.94
|
| Rate for Payer: Cofinity Commercial |
$137.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$127.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.98
|
| Rate for Payer: Healthscope Commercial |
$143.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$119.94
|
| Rate for Payer: Mclaren Medicaid |
$28.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.98
|
| Rate for Payer: Meridian Medicaid |
$29.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.98
|
| Rate for Payer: Molina Medicare/Medicaid |
$43.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$135.93
|
| Rate for Payer: Nomi Health Commercial |
$131.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$119.94
|
| Rate for Payer: PACE Senior Care Partners |
$37.98
|
| Rate for Payer: PACE SWMI |
$39.98
|
| Rate for Payer: PHP Commercial |
$135.93
|
| Rate for Payer: PHP Medicare Advantage |
$39.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.19
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$139.13
|
| Rate for Payer: Priority Health Medicare |
$40.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$111.30
|
| Rate for Payer: Railroad Medicare Medicare |
$39.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.73
|
| Rate for Payer: UHC Core |
$133.53
|
| Rate for Payer: UHC Exchange |
$39.98
|
| Rate for Payer: UHC Medicaid |
$28.19
|
| Rate for Payer: UHC Medicare Advantage |
$39.98
|
| Rate for Payer: UHCCP Medicaid |
$28.19
|
| Rate for Payer: VA VA |
$39.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$119.94
|
|
|
HC FACTOR V ASSAY
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 85220
|
| Hospital Charge Code |
30500016
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$68.79 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$81.63
|
| Rate for Payer: BCN Commercial |
$81.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC FACTOR V ASSAY
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 85220
|
| Hospital Charge Code |
30500016
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.43 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$18.30
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$81.26
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$17.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$18.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicaid |
$17.43
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$17.43
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC FACTOR VII ASSAY
|
Facility
|
IP
|
$98.84
|
|
|
Service Code
|
CPT 85230
|
| Hospital Charge Code |
30500017
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$68.79 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: BCBS Trust/PPO |
$81.63
|
| Rate for Payer: BCN Commercial |
$81.63
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC FACTOR VII ASSAY
|
Facility
|
OP
|
$98.84
|
|
|
Service Code
|
CPT 85230
|
| Hospital Charge Code |
30500017
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.43 |
| Max. Negotiated Rate |
$88.96 |
| Rate for Payer: Aetna Commercial |
$84.01
|
| Rate for Payer: Aetna Medicare |
$25.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.89
|
| Rate for Payer: BCBS Complete |
$18.30
|
| Rate for Payer: BCBS MAPPO |
$24.71
|
| Rate for Payer: BCBS Trust/PPO |
$81.26
|
| Rate for Payer: BCN Commercial |
$81.26
|
| Rate for Payer: BCN Medicare Advantage |
$24.71
|
| Rate for Payer: Cash Price |
$79.07
|
| Rate for Payer: Cofinity Commercial |
$85.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.71
|
| Rate for Payer: Healthscope Commercial |
$88.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.13
|
| Rate for Payer: Mclaren Medicaid |
$17.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.95
|
| Rate for Payer: Meridian Medicaid |
$18.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.01
|
| Rate for Payer: Nomi Health Commercial |
$81.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.13
|
| Rate for Payer: PACE Senior Care Partners |
$23.47
|
| Rate for Payer: PACE SWMI |
$24.71
|
| Rate for Payer: PHP Commercial |
$84.01
|
| Rate for Payer: PHP Medicare Advantage |
$24.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$85.99
|
| Rate for Payer: Priority Health Medicare |
$24.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.79
|
| Rate for Payer: Railroad Medicare Medicare |
$24.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.98
|
| Rate for Payer: UHC Core |
$82.53
|
| Rate for Payer: UHC Exchange |
$24.71
|
| Rate for Payer: UHC Medicaid |
$17.43
|
| Rate for Payer: UHC Medicare Advantage |
$24.71
|
| Rate for Payer: UHCCP Medicaid |
$17.43
|
| Rate for Payer: VA VA |
$24.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.13
|
|
|
HC FACTOR VIII ASSAY
|
Facility
|
OP
|
$172.50
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500018
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$30.41 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$44.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.91
|
| Rate for Payer: BCBS Complete |
$31.93
|
| Rate for Payer: BCBS MAPPO |
$43.12
|
| Rate for Payer: BCBS Trust/PPO |
$141.81
|
| Rate for Payer: BCN Commercial |
$141.81
|
| Rate for Payer: BCN Medicare Advantage |
$43.12
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$148.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.12
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.38
|
| Rate for Payer: Mclaren Medicaid |
$30.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.28
|
| Rate for Payer: Meridian Medicaid |
$31.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PACE Senior Care Partners |
$40.97
|
| Rate for Payer: PACE SWMI |
$43.12
|
| Rate for Payer: PHP Commercial |
$146.62
|
| Rate for Payer: PHP Medicare Advantage |
$43.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.07
|
| Rate for Payer: Priority Health Medicare |
$43.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.06
|
| Rate for Payer: Railroad Medicare Medicare |
$43.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.80
|
| Rate for Payer: UHC Core |
$144.04
|
| Rate for Payer: UHC Exchange |
$43.12
|
| Rate for Payer: UHC Medicaid |
$30.41
|
| Rate for Payer: UHC Medicare Advantage |
$43.12
|
| Rate for Payer: UHCCP Medicaid |
$30.41
|
| Rate for Payer: VA VA |
$43.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.38
|
|
|
HC FACTOR VIII ASSAY
|
Facility
|
IP
|
$172.50
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500018
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$120.06 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: BCBS Trust/PPO |
$142.47
|
| Rate for Payer: BCN Commercial |
$142.47
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$148.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PHP Commercial |
$146.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.80
|
| Rate for Payer: UHC Core |
$144.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.38
|
|
|
HC FACTOR VIII INHIBITOR EVALUATION
|
Facility
|
OP
|
$104.00
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500019
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.34 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna Commercial |
$88.40
|
| Rate for Payer: Aetna Medicare |
$27.04
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$32.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$32.50
|
| Rate for Payer: BCBS Complete |
$19.25
|
| Rate for Payer: BCBS MAPPO |
$26.00
|
| Rate for Payer: BCBS Trust/PPO |
$85.50
|
| Rate for Payer: BCN Commercial |
$85.50
|
| Rate for Payer: BCN Medicare Advantage |
$26.00
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$89.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.00
|
| Rate for Payer: Healthscope Commercial |
$93.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.00
|
| Rate for Payer: Mclaren Medicaid |
$18.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$27.30
|
| Rate for Payer: Meridian Medicaid |
$19.25
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.40
|
| Rate for Payer: Nomi Health Commercial |
$85.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.00
|
| Rate for Payer: PACE Senior Care Partners |
$24.70
|
| Rate for Payer: PACE SWMI |
$26.00
|
| Rate for Payer: PHP Commercial |
$88.40
|
| Rate for Payer: PHP Medicare Advantage |
$26.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.48
|
| Rate for Payer: Priority Health Medicare |
$26.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.38
|
| Rate for Payer: Railroad Medicare Medicare |
$26.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.52
|
| Rate for Payer: UHC Core |
$86.84
|
| Rate for Payer: UHC Exchange |
$26.00
|
| Rate for Payer: UHC Medicaid |
$18.34
|
| Rate for Payer: UHC Medicare Advantage |
$26.00
|
| Rate for Payer: UHCCP Medicaid |
$18.34
|
| Rate for Payer: VA VA |
$26.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.00
|
|
|
HC FACTOR VIII INHIBITOR EVALUATION
|
Facility
|
IP
|
$104.00
|
|
|
Service Code
|
CPT 85240
|
| Hospital Charge Code |
30500019
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$72.38 |
| Max. Negotiated Rate |
$93.60 |
| Rate for Payer: Aetna Commercial |
$88.40
|
| Rate for Payer: BCBS Trust/PPO |
$85.89
|
| Rate for Payer: BCN Commercial |
$85.89
|
| Rate for Payer: Cash Price |
$83.20
|
| Rate for Payer: Cofinity Commercial |
$89.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$83.20
|
| Rate for Payer: Healthscope Commercial |
$93.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$78.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$88.40
|
| Rate for Payer: Nomi Health Commercial |
$85.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$78.00
|
| Rate for Payer: PHP Commercial |
$88.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$90.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$91.52
|
| Rate for Payer: UHC Core |
$86.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$78.00
|
|
|
HC FACTOR X ASSAY
|
Facility
|
IP
|
$111.42
|
|
|
Service Code
|
CPT 85260
|
| Hospital Charge Code |
30500031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: BCBS Trust/PPO |
$92.02
|
| Rate for Payer: BCN Commercial |
$92.02
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC FACTOR X ASSAY
|
Facility
|
OP
|
$111.42
|
|
|
Service Code
|
CPT 85260
|
| Hospital Charge Code |
30500031
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.64 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: Aetna Medicare |
$28.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.82
|
| Rate for Payer: BCBS Complete |
$20.62
|
| Rate for Payer: BCBS MAPPO |
$27.86
|
| Rate for Payer: BCBS Trust/PPO |
$91.60
|
| Rate for Payer: BCN Commercial |
$91.60
|
| Rate for Payer: BCN Medicare Advantage |
$27.86
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.86
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Mclaren Medicaid |
$19.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.25
|
| Rate for Payer: Meridian Medicaid |
$20.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PACE Senior Care Partners |
$26.46
|
| Rate for Payer: PACE SWMI |
$27.86
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: PHP Medicare Advantage |
$27.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Medicare |
$28.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: Railroad Medicare Medicare |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: UHC Exchange |
$27.86
|
| Rate for Payer: UHC Medicaid |
$19.64
|
| Rate for Payer: UHC Medicare Advantage |
$27.86
|
| Rate for Payer: UHCCP Medicaid |
$19.64
|
| Rate for Payer: VA VA |
$27.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC FACTOR XI ASSAY
|
Facility
|
OP
|
$109.24
|
|
|
Service Code
|
CPT 85270
|
| Hospital Charge Code |
30500032
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$19.26 |
| Max. Negotiated Rate |
$98.32 |
| Rate for Payer: Aetna Commercial |
$92.85
|
| Rate for Payer: Aetna Medicare |
$28.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.14
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.14
|
| Rate for Payer: BCBS Complete |
$20.22
|
| Rate for Payer: BCBS MAPPO |
$27.31
|
| Rate for Payer: BCBS Trust/PPO |
$89.81
|
| Rate for Payer: BCN Commercial |
$89.81
|
| Rate for Payer: BCN Medicare Advantage |
$27.31
|
| Rate for Payer: Cash Price |
$87.39
|
| Rate for Payer: Cofinity Commercial |
$93.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$87.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.31
|
| Rate for Payer: Healthscope Commercial |
$98.32
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.93
|
| Rate for Payer: Mclaren Medicaid |
$19.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.68
|
| Rate for Payer: Meridian Medicaid |
$20.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$92.85
|
| Rate for Payer: Nomi Health Commercial |
$89.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$81.93
|
| Rate for Payer: PACE Senior Care Partners |
$25.94
|
| Rate for Payer: PACE SWMI |
$27.31
|
| Rate for Payer: PHP Commercial |
$92.85
|
| Rate for Payer: PHP Medicare Advantage |
$27.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.04
|
| Rate for Payer: Priority Health Medicare |
$27.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.03
|
| Rate for Payer: Railroad Medicare Medicare |
$27.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$96.13
|
| Rate for Payer: UHC Core |
$91.22
|
| Rate for Payer: UHC Exchange |
$27.31
|
| Rate for Payer: UHC Medicaid |
$19.26
|
| Rate for Payer: UHC Medicare Advantage |
$27.31
|
| Rate for Payer: UHCCP Medicaid |
$19.26
|
| Rate for Payer: VA VA |
$27.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.93
|
|
