|
HC JAK2 V617F MUTATION
|
Facility
|
OP
|
$380.46
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
31000101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.65 |
| Max. Negotiated Rate |
$342.41 |
| Rate for Payer: Aetna Commercial |
$323.39
|
| Rate for Payer: Aetna Medicare |
$98.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.89
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.89
|
| Rate for Payer: BCBS Complete |
$71.03
|
| Rate for Payer: BCBS MAPPO |
$95.12
|
| Rate for Payer: BCBS Trust/PPO |
$295.81
|
| Rate for Payer: BCN Commercial |
$295.81
|
| Rate for Payer: BCN Medicare Advantage |
$95.12
|
| Rate for Payer: Cash Price |
$304.37
|
| Rate for Payer: Cash Price |
$304.37
|
| Rate for Payer: Cofinity Commercial |
$327.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.12
|
| Rate for Payer: Healthscope Commercial |
$342.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.34
|
| Rate for Payer: Mclaren Medicaid |
$67.65
|
| Rate for Payer: Meridian Medicaid |
$71.03
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$99.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$323.39
|
| Rate for Payer: PACE Senior Care Partners |
$90.36
|
| Rate for Payer: PACE SWMI |
$95.12
|
| Rate for Payer: PHP Commercial |
$323.39
|
| Rate for Payer: PHP Medicare Advantage |
$95.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.65
|
| Rate for Payer: Priority Health Cigna Priority Health |
$266.32
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$331.00
|
| Rate for Payer: Priority Health Medicare |
$95.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$232.04
|
| Rate for Payer: Railroad Medicare Medicare |
$95.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.80
|
| Rate for Payer: UHC Core |
$317.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$95.12
|
| Rate for Payer: UHC Medicare Advantage |
$97.97
|
| Rate for Payer: VA VA |
$95.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.34
|
|
|
HC JC VIRUS, PCR, CSF
|
Facility
|
OP
|
$106.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600335
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.18 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Aetna Commercial |
$90.10
|
| Rate for Payer: Aetna Medicare |
$27.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.12
|
| Rate for Payer: BCBS Complete |
$27.19
|
| Rate for Payer: BCBS MAPPO |
$26.50
|
| Rate for Payer: BCBS Trust/PPO |
$82.42
|
| Rate for Payer: BCN Commercial |
$82.42
|
| Rate for Payer: BCN Medicare Advantage |
$26.50
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$91.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$26.50
|
| Rate for Payer: Healthscope Commercial |
$95.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.50
|
| Rate for Payer: Mclaren Medicaid |
$25.90
|
| Rate for Payer: Meridian Medicaid |
$27.19
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$27.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$30.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.10
|
| Rate for Payer: PACE Senior Care Partners |
$25.18
|
| Rate for Payer: PACE SWMI |
$26.50
|
| Rate for Payer: PHP Commercial |
$90.10
|
| Rate for Payer: PHP Medicare Advantage |
$26.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.22
|
| Rate for Payer: Priority Health Medicare |
$26.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.65
|
| Rate for Payer: Railroad Medicare Medicare |
$26.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.28
|
| Rate for Payer: UHC Core |
$88.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$26.50
|
| Rate for Payer: UHC Medicare Advantage |
$27.30
|
| Rate for Payer: VA VA |
$26.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.50
|
|
|
HC JC VIRUS, PCR, CSF
|
Facility
|
IP
|
$106.00
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600335
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$64.65 |
| Max. Negotiated Rate |
$95.40 |
| Rate for Payer: Aetna Commercial |
$90.10
|
| Rate for Payer: BCBS Trust/PPO |
$81.92
|
| Rate for Payer: BCN Commercial |
$81.92
|
| Rate for Payer: Cash Price |
$84.80
|
| Rate for Payer: Cofinity Commercial |
$91.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$84.80
|
| Rate for Payer: Healthscope Commercial |
$95.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$79.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$90.10
|
| Rate for Payer: PHP Commercial |
$90.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$74.20
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$92.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$64.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$93.28
|
| Rate for Payer: UHC Core |
$88.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$79.50
|
|
|
HC JO 1 ANTIBODY
|
Facility
|
OP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.19 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: Aetna Medicare |
$8.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.78
|
| Rate for Payer: BCBS Complete |
$13.89
|
| Rate for Payer: BCBS MAPPO |
$8.62
|
| Rate for Payer: BCBS Trust/PPO |
$26.81
|
| Rate for Payer: BCN Commercial |
$26.81
|
| Rate for Payer: BCN Medicare Advantage |
$8.62
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.62
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Mclaren Medicaid |
$13.23
|
| Rate for Payer: Meridian Medicaid |
$13.89
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PACE Senior Care Partners |
$8.19
|
| Rate for Payer: PACE SWMI |
$8.62
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: PHP Medicare Advantage |
$8.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Medicare |
$8.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: Railroad Medicare Medicare |
$8.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.62
|
| Rate for Payer: UHC Medicare Advantage |
$8.88
|
| Rate for Payer: VA VA |
$8.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC JO 1 ANTIBODY
|
Facility
|
IP
|
$34.48
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.03 |
| Max. Negotiated Rate |
$31.03 |
| Rate for Payer: Aetna Commercial |
$29.31
|
| Rate for Payer: BCBS Trust/PPO |
$26.65
|
| Rate for Payer: BCN Commercial |
$26.65
|
| Rate for Payer: Cash Price |
$27.58
|
| Rate for Payer: Cofinity Commercial |
$29.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.58
|
| Rate for Payer: Healthscope Commercial |
$31.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$25.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$29.31
|
| Rate for Payer: PHP Commercial |
$29.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$24.14
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$30.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.34
|
| Rate for Payer: UHC Core |
$28.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$25.86
|
|
|
HC JOBST FOAM PADDING
|
Facility
|
IP
|
$10.89
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000364
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$6.64 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: BCBS Trust/PPO |
$8.42
|
| Rate for Payer: BCN Commercial |
$8.42
|
| Rate for Payer: Cash Price |
$8.71
|
| Rate for Payer: Cofinity Commercial |
$9.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.71
|
| Rate for Payer: Healthscope Commercial |
$9.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.26
|
| Rate for Payer: PHP Commercial |
$9.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.58
|
| Rate for Payer: UHC Core |
$9.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.17
|
|
|
HC JOBST FOAM PADDING
|
Facility
|
OP
|
$10.89
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000364
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.59 |
| Max. Negotiated Rate |
$9.80 |
| Rate for Payer: Aetna Commercial |
$9.26
|
| Rate for Payer: Aetna Medicare |
$2.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.40
|
| Rate for Payer: BCBS Complete |
$4.36
|
| Rate for Payer: BCBS MAPPO |
$2.72
|
| Rate for Payer: BCBS Trust/PPO |
$8.47
|
| Rate for Payer: BCN Commercial |
$8.47
|
| Rate for Payer: BCN Medicare Advantage |
$2.72
|
| Rate for Payer: Cash Price |
$8.71
|
| Rate for Payer: Cofinity Commercial |
$9.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.72
|
| Rate for Payer: Healthscope Commercial |
$9.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.17
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$2.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$9.26
|
| Rate for Payer: PACE Senior Care Partners |
$2.59
|
| Rate for Payer: PACE SWMI |
$2.72
|
| Rate for Payer: PHP Commercial |
$9.26
|
| Rate for Payer: PHP Medicare Advantage |
$2.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.62
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$9.47
|
| Rate for Payer: Priority Health Medicare |
$2.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6.64
|
| Rate for Payer: Railroad Medicare Medicare |
$2.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.58
|
| Rate for Payer: UHC Core |
$9.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.72
|
| Rate for Payer: UHC Medicare Advantage |
$2.80
|
| Rate for Payer: VA VA |
$2.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.17
|
|
|
HC JOINT W MANUAL STRESS
|
Facility
|
OP
|
$208.70
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
32000287
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$49.57 |
| Max. Negotiated Rate |
$187.83 |
| Rate for Payer: Aetna Commercial |
$177.40
|
| Rate for Payer: Aetna Medicare |
$54.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.22
|
| Rate for Payer: BCBS Complete |
$62.59
|
| Rate for Payer: BCBS MAPPO |
$52.18
|
| Rate for Payer: BCBS Trust/PPO |
$162.26
|
| Rate for Payer: BCN Commercial |
$162.26
|
| Rate for Payer: BCN Medicare Advantage |
$52.18
|
| Rate for Payer: Cash Price |
$166.96
|
| Rate for Payer: Cash Price |
$166.96
|
| Rate for Payer: Cofinity Commercial |
$179.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.18
|
| Rate for Payer: Healthscope Commercial |
$187.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.52
|
| Rate for Payer: Mclaren Medicaid |
$59.61
|
| Rate for Payer: Meridian Medicaid |
$62.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$54.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.40
|
| Rate for Payer: PACE Senior Care Partners |
$49.57
|
| Rate for Payer: PACE SWMI |
$52.18
|
| Rate for Payer: PHP Commercial |
$177.40
|
| Rate for Payer: PHP Medicare Advantage |
$52.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.57
|
| Rate for Payer: Priority Health Medicare |
$52.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.29
|
| Rate for Payer: Railroad Medicare Medicare |
$52.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.66
|
| Rate for Payer: UHC Core |
$174.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$52.18
|
| Rate for Payer: UHC Medicare Advantage |
$53.74
|
| Rate for Payer: VA VA |
$52.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.52
|
|
|
HC JOINT W MANUAL STRESS
|
Facility
|
IP
|
$208.70
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
32000287
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$127.29 |
| Max. Negotiated Rate |
$187.83 |
| Rate for Payer: Aetna Commercial |
$177.40
|
| Rate for Payer: BCBS Trust/PPO |
$161.28
|
| Rate for Payer: BCN Commercial |
$161.28
|
| Rate for Payer: Cash Price |
$166.96
|
| Rate for Payer: Cofinity Commercial |
$179.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.96
|
| Rate for Payer: Healthscope Commercial |
$187.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.52
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$177.40
|
| Rate for Payer: PHP Commercial |
$177.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$146.09
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$181.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.66
|
| Rate for Payer: UHC Core |
$174.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.52
|
|
|
HC KAPPA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100307
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.75 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$64.52
|
| Rate for Payer: Aetna Medicare |
$19.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.72
|
| Rate for Payer: BCBS Complete |
$13.38
|
| Rate for Payer: BCBS MAPPO |
$18.98
|
| Rate for Payer: BCBS Trust/PPO |
$59.01
|
| Rate for Payer: BCN Commercial |
$59.01
|
| Rate for Payer: BCN Medicare Advantage |
$18.98
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$65.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.98
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.92
|
| Rate for Payer: Mclaren Medicaid |
$12.75
|
| Rate for Payer: Meridian Medicaid |
$13.38
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$19.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PACE Senior Care Partners |
$18.03
|
| Rate for Payer: PACE SWMI |
$18.98
|
| Rate for Payer: PHP Commercial |
$64.52
|
| Rate for Payer: PHP Medicare Advantage |
$18.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.03
|
| Rate for Payer: Priority Health Medicare |
$18.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.29
|
| Rate for Payer: Railroad Medicare Medicare |
$18.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.79
|
| Rate for Payer: UHC Core |
$63.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$18.98
|
| Rate for Payer: UHC Medicare Advantage |
$19.54
|
| Rate for Payer: VA VA |
$18.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.92
|
|
|
HC KAPPA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$75.90
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100307
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.29 |
| Max. Negotiated Rate |
$68.31 |
| Rate for Payer: Aetna Commercial |
$64.52
|
| Rate for Payer: BCBS Trust/PPO |
$58.66
|
| Rate for Payer: BCN Commercial |
$58.66
|
| Rate for Payer: Cash Price |
$60.72
|
| Rate for Payer: Cofinity Commercial |
$65.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.72
|
| Rate for Payer: Healthscope Commercial |
$68.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$64.52
|
| Rate for Payer: PHP Commercial |
$64.52
|
| Rate for Payer: Priority Health Cigna Priority Health |
$53.13
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$66.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.79
|
| Rate for Payer: UHC Core |
$63.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.92
|
|
|
HC KENTUCKY BLUE IGE
|
Facility
|
OP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200090
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: Aetna Medicare |
$6.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.78
|
| Rate for Payer: BCBS Complete |
$4.04
|
| Rate for Payer: BCBS MAPPO |
$6.22
|
| Rate for Payer: BCBS Trust/PPO |
$19.35
|
| Rate for Payer: BCN Commercial |
$19.35
|
| Rate for Payer: BCN Medicare Advantage |
$6.22
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.22
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Mclaren Medicaid |
$3.85
|
| Rate for Payer: Meridian Medicaid |
$4.04
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$6.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PACE Senior Care Partners |
$5.91
|
| Rate for Payer: PACE SWMI |
$6.22
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: PHP Medicare Advantage |
$6.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Medicare |
$6.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: Railroad Medicare Medicare |
$6.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.22
|
| Rate for Payer: UHC Medicare Advantage |
$6.41
|
| Rate for Payer: VA VA |
$6.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC KENTUCKY BLUE IGE
|
Facility
|
IP
|
$24.89
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200090
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$15.18 |
| Max. Negotiated Rate |
$22.40 |
| Rate for Payer: Aetna Commercial |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$19.23
|
| Rate for Payer: BCN Commercial |
$19.23
|
| Rate for Payer: Cash Price |
$19.91
|
| Rate for Payer: Cofinity Commercial |
$21.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$19.91
|
| Rate for Payer: Healthscope Commercial |
$22.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$18.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$21.16
|
| Rate for Payer: PHP Commercial |
$21.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.42
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$21.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$21.90
|
| Rate for Payer: UHC Core |
$20.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$18.67
|
|
|
HC KETONES (ACETONE)
|
Facility
|
IP
|
$36.10
|
|
|
Service Code
|
CPT 82009
|
| Hospital Charge Code |
30100067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$22.02 |
| Max. Negotiated Rate |
$32.49 |
| Rate for Payer: Aetna Commercial |
$30.68
|
| Rate for Payer: BCBS Trust/PPO |
$27.90
|
| Rate for Payer: BCN Commercial |
$27.90
|
| Rate for Payer: Cash Price |
$28.88
|
| Rate for Payer: Cofinity Commercial |
$31.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.88
|
| Rate for Payer: Healthscope Commercial |
$32.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.68
|
| Rate for Payer: PHP Commercial |
$30.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.77
|
| Rate for Payer: UHC Core |
$30.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.08
|
|
|
HC KETONES (ACETONE)
|
Facility
|
OP
|
$36.10
|
|
|
Service Code
|
CPT 82009
|
| Hospital Charge Code |
30100067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.34 |
| Max. Negotiated Rate |
$32.49 |
| Rate for Payer: Aetna Commercial |
$30.68
|
| Rate for Payer: Aetna Medicare |
$9.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.28
|
| Rate for Payer: BCBS Complete |
$3.50
|
| Rate for Payer: BCBS MAPPO |
$9.02
|
| Rate for Payer: BCBS Trust/PPO |
$28.07
|
| Rate for Payer: BCN Commercial |
$28.07
|
| Rate for Payer: BCN Medicare Advantage |
$9.02
|
| Rate for Payer: Cash Price |
$28.88
|
| Rate for Payer: Cash Price |
$28.88
|
| Rate for Payer: Cofinity Commercial |
$31.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.02
|
| Rate for Payer: Healthscope Commercial |
$32.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$27.08
|
| Rate for Payer: Mclaren Medicaid |
$3.34
|
| Rate for Payer: Meridian Medicaid |
$3.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$30.68
|
| Rate for Payer: PACE Senior Care Partners |
$8.57
|
| Rate for Payer: PACE SWMI |
$9.02
|
| Rate for Payer: PHP Commercial |
$30.68
|
| Rate for Payer: PHP Medicare Advantage |
$9.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.27
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$31.41
|
| Rate for Payer: Priority Health Medicare |
$9.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.02
|
| Rate for Payer: Railroad Medicare Medicare |
$9.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.77
|
| Rate for Payer: UHC Core |
$30.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.02
|
| Rate for Payer: UHC Medicare Advantage |
$9.30
|
| Rate for Payer: VA VA |
$9.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$27.08
|
|
|
HC KIDNEY ENDOSCOPY
|
Facility
|
IP
|
$5,852.76
|
|
|
Service Code
|
CPT 50551
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$3,569.60 |
| Max. Negotiated Rate |
$5,267.48 |
| Rate for Payer: Aetna Commercial |
$4,974.85
|
| Rate for Payer: BCBS Trust/PPO |
$4,523.01
|
| Rate for Payer: BCN Commercial |
$4,523.01
|
| Rate for Payer: Cash Price |
$4,682.21
|
| Rate for Payer: Cofinity Commercial |
$5,033.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,682.21
|
| Rate for Payer: Healthscope Commercial |
$5,267.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,389.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,974.85
|
| Rate for Payer: PHP Commercial |
$4,974.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,096.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,091.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,569.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,150.43
|
| Rate for Payer: UHC Core |
$4,887.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,389.57
|
|
|
HC KIDNEY ENDOSCOPY
|
Facility
|
OP
|
$5,852.76
|
|
|
Service Code
|
CPT 50551
|
| Hospital Charge Code |
76100307
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,390.03 |
| Max. Negotiated Rate |
$5,267.48 |
| Rate for Payer: Aetna Commercial |
$4,974.85
|
| Rate for Payer: Aetna Medicare |
$1,521.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,828.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,828.99
|
| Rate for Payer: BCBS Complete |
$3,564.05
|
| Rate for Payer: BCBS MAPPO |
$1,463.19
|
| Rate for Payer: BCBS Trust/PPO |
$4,550.52
|
| Rate for Payer: BCN Commercial |
$4,550.52
|
| Rate for Payer: BCN Medicare Advantage |
$1,463.19
|
| Rate for Payer: Cash Price |
$4,682.21
|
| Rate for Payer: Cash Price |
$4,682.21
|
| Rate for Payer: Cofinity Commercial |
$5,033.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,682.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,463.19
|
| Rate for Payer: Healthscope Commercial |
$5,267.48
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,389.57
|
| Rate for Payer: Mclaren Medicaid |
$3,394.34
|
| Rate for Payer: Meridian Medicaid |
$3,564.05
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$1,536.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,682.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$4,974.85
|
| Rate for Payer: PACE Senior Care Partners |
$1,390.03
|
| Rate for Payer: PACE SWMI |
$1,463.19
|
| Rate for Payer: PHP Commercial |
$4,974.85
|
| Rate for Payer: PHP Medicare Advantage |
$1,463.19
|
| Rate for Payer: Priority Health Choice Medicaid |
$3,394.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,096.93
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$5,091.90
|
| Rate for Payer: Priority Health Medicare |
$1,463.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3,569.60
|
| Rate for Payer: Railroad Medicare Medicare |
$1,463.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,150.43
|
| Rate for Payer: UHC Core |
$4,887.05
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,463.19
|
| Rate for Payer: UHC Medicare Advantage |
$1,507.09
|
| Rate for Payer: VA VA |
$1,463.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,389.57
|
|
|
HC KINEVAC 5 MCG IV
|
Facility
|
OP
|
$135.72
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
63600014
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.23 |
| Max. Negotiated Rate |
$122.15 |
| Rate for Payer: Aetna Commercial |
$115.36
|
| Rate for Payer: Aetna Medicare |
$35.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$42.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$42.41
|
| Rate for Payer: BCBS Complete |
$54.29
|
| Rate for Payer: BCBS MAPPO |
$33.93
|
| Rate for Payer: BCBS Trust/PPO |
$105.52
|
| Rate for Payer: BCN Commercial |
$105.52
|
| Rate for Payer: BCN Medicare Advantage |
$33.93
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$116.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$33.93
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.79
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$35.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.36
|
| Rate for Payer: PACE Senior Care Partners |
$32.23
|
| Rate for Payer: PACE SWMI |
$33.93
|
| Rate for Payer: PHP Commercial |
$115.36
|
| Rate for Payer: PHP Medicare Advantage |
$33.93
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.08
|
| Rate for Payer: Priority Health Medicare |
$33.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.78
|
| Rate for Payer: Railroad Medicare Medicare |
$33.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.43
|
| Rate for Payer: UHC Core |
$113.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$33.93
|
| Rate for Payer: UHC Medicare Advantage |
$34.95
|
| Rate for Payer: VA VA |
$33.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.79
|
|
|
HC KINEVAC 5 MCG IV
|
Facility
|
IP
|
$135.72
|
|
|
Service Code
|
HCPCS J2805
|
| Hospital Charge Code |
63600014
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$82.78 |
| Max. Negotiated Rate |
$122.15 |
| Rate for Payer: Aetna Commercial |
$115.36
|
| Rate for Payer: BCBS Trust/PPO |
$104.88
|
| Rate for Payer: BCN Commercial |
$104.88
|
| Rate for Payer: Cash Price |
$108.58
|
| Rate for Payer: Cofinity Commercial |
$116.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$108.58
|
| Rate for Payer: Healthscope Commercial |
$122.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$101.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$115.36
|
| Rate for Payer: PHP Commercial |
$115.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$95.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$118.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$119.43
|
| Rate for Payer: UHC Core |
$113.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$101.79
|
|
|
HC KIT ATS
|
Facility
|
IP
|
$150.00
|
|
| Hospital Charge Code |
27000666
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$91.48 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: BCBS Trust/PPO |
$115.92
|
| Rate for Payer: BCN Commercial |
$115.92
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC KIT ATS
|
Facility
|
OP
|
$150.00
|
|
| Hospital Charge Code |
27000666
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$35.62 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Aetna Commercial |
$127.50
|
| Rate for Payer: Aetna Medicare |
$39.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.88
|
| Rate for Payer: BCBS Complete |
$60.00
|
| Rate for Payer: BCBS MAPPO |
$37.50
|
| Rate for Payer: BCBS Trust/PPO |
$116.62
|
| Rate for Payer: BCN Commercial |
$116.62
|
| Rate for Payer: BCN Medicare Advantage |
$37.50
|
| Rate for Payer: Cash Price |
$120.00
|
| Rate for Payer: Cofinity Commercial |
$129.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$120.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.50
|
| Rate for Payer: Healthscope Commercial |
$135.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$112.50
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$39.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$127.50
|
| Rate for Payer: PACE Senior Care Partners |
$35.62
|
| Rate for Payer: PACE SWMI |
$37.50
|
| Rate for Payer: PHP Commercial |
$127.50
|
| Rate for Payer: PHP Medicare Advantage |
$37.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$105.00
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$130.50
|
| Rate for Payer: Priority Health Medicare |
$37.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$91.48
|
| Rate for Payer: Railroad Medicare Medicare |
$37.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$132.00
|
| Rate for Payer: UHC Core |
$125.25
|
| Rate for Payer: UHC Dual Complete DSNP |
$37.50
|
| Rate for Payer: UHC Medicare Advantage |
$38.62
|
| Rate for Payer: VA VA |
$37.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$112.50
|
|
|
HC KIT DILATOR VASC
|
Facility
|
OP
|
$525.00
|
|
| Hospital Charge Code |
27000101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$124.69 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: Aetna Commercial |
$446.25
|
| Rate for Payer: Aetna Medicare |
$136.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$164.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$164.06
|
| Rate for Payer: BCBS Complete |
$210.00
|
| Rate for Payer: BCBS MAPPO |
$131.25
|
| Rate for Payer: BCBS Trust/PPO |
$408.19
|
| Rate for Payer: BCN Commercial |
$408.19
|
| Rate for Payer: BCN Medicare Advantage |
$131.25
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$451.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.25
|
| Rate for Payer: Healthscope Commercial |
$472.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.75
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$137.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.25
|
| Rate for Payer: PACE Senior Care Partners |
$124.69
|
| Rate for Payer: PACE SWMI |
$131.25
|
| Rate for Payer: PHP Commercial |
$446.25
|
| Rate for Payer: PHP Medicare Advantage |
$131.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.75
|
| Rate for Payer: Priority Health Medicare |
$131.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.20
|
| Rate for Payer: Railroad Medicare Medicare |
$131.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.00
|
| Rate for Payer: UHC Core |
$438.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.25
|
| Rate for Payer: UHC Medicare Advantage |
$135.19
|
| Rate for Payer: VA VA |
$131.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.75
|
|
|
HC KIT DILATOR VASC
|
Facility
|
IP
|
$525.00
|
|
| Hospital Charge Code |
27000101
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$320.20 |
| Max. Negotiated Rate |
$472.50 |
| Rate for Payer: Aetna Commercial |
$446.25
|
| Rate for Payer: BCBS Trust/PPO |
$405.72
|
| Rate for Payer: BCN Commercial |
$405.72
|
| Rate for Payer: Cash Price |
$420.00
|
| Rate for Payer: Cofinity Commercial |
$451.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$420.00
|
| Rate for Payer: Healthscope Commercial |
$472.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$446.25
|
| Rate for Payer: PHP Commercial |
$446.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$367.50
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$456.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$320.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$462.00
|
| Rate for Payer: UHC Core |
$438.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.75
|
|
|
HC KLEIHAUER-BETKE STAIN
|
Facility
|
OP
|
$120.80
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
30500046
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.70 |
| Max. Negotiated Rate |
$108.72 |
| Rate for Payer: Aetna Commercial |
$102.68
|
| Rate for Payer: Aetna Medicare |
$31.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.75
|
| Rate for Payer: BCBS Complete |
$5.99
|
| Rate for Payer: BCBS MAPPO |
$30.20
|
| Rate for Payer: BCBS Trust/PPO |
$93.92
|
| Rate for Payer: BCN Commercial |
$93.92
|
| Rate for Payer: BCN Medicare Advantage |
$30.20
|
| Rate for Payer: Cash Price |
$96.64
|
| Rate for Payer: Cash Price |
$96.64
|
| Rate for Payer: Cofinity Commercial |
$103.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.20
|
| Rate for Payer: Healthscope Commercial |
$108.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.60
|
| Rate for Payer: Mclaren Medicaid |
$5.70
|
| Rate for Payer: Meridian Medicaid |
$5.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.68
|
| Rate for Payer: PACE Senior Care Partners |
$28.69
|
| Rate for Payer: PACE SWMI |
$30.20
|
| Rate for Payer: PHP Commercial |
$102.68
|
| Rate for Payer: PHP Medicare Advantage |
$30.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.10
|
| Rate for Payer: Priority Health Medicare |
$30.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.68
|
| Rate for Payer: Railroad Medicare Medicare |
$30.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.30
|
| Rate for Payer: UHC Core |
$100.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.20
|
| Rate for Payer: UHC Medicare Advantage |
$31.11
|
| Rate for Payer: VA VA |
$30.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.60
|
|
|
HC KLEIHAUER-BETKE STAIN
|
Facility
|
IP
|
$120.80
|
|
|
Service Code
|
CPT 85460
|
| Hospital Charge Code |
30500046
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$73.68 |
| Max. Negotiated Rate |
$108.72 |
| Rate for Payer: Aetna Commercial |
$102.68
|
| Rate for Payer: BCBS Trust/PPO |
$93.35
|
| Rate for Payer: BCN Commercial |
$93.35
|
| Rate for Payer: Cash Price |
$96.64
|
| Rate for Payer: Cofinity Commercial |
$103.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$96.64
|
| Rate for Payer: Healthscope Commercial |
$108.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$90.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$102.68
|
| Rate for Payer: PHP Commercial |
$102.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$84.56
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$73.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.30
|
| Rate for Payer: UHC Core |
$100.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$90.60
|
|
