|
HC FERRITIN LEVEL
|
Facility
|
OP
|
$63.67
|
|
|
Service Code
|
CPT 82728
|
| Hospital Charge Code |
30100202
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.23 |
| Max. Negotiated Rate |
$57.30 |
| Rate for Payer: Aetna Commercial |
$54.12
|
| Rate for Payer: Aetna Medicare |
$16.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.90
|
| Rate for Payer: BCBS Complete |
$11.79
|
| Rate for Payer: BCBS MAPPO |
$15.92
|
| Rate for Payer: BCBS Trust/PPO |
$52.34
|
| Rate for Payer: BCN Commercial |
$52.34
|
| Rate for Payer: BCN Medicare Advantage |
$15.92
|
| Rate for Payer: Cash Price |
$50.94
|
| Rate for Payer: Cofinity Commercial |
$54.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.92
|
| Rate for Payer: Healthscope Commercial |
$57.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.75
|
| Rate for Payer: Mclaren Medicaid |
$11.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.71
|
| Rate for Payer: Meridian Medicaid |
$11.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.12
|
| Rate for Payer: Nomi Health Commercial |
$52.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$47.75
|
| Rate for Payer: PACE Senior Care Partners |
$15.12
|
| Rate for Payer: PACE SWMI |
$15.92
|
| Rate for Payer: PHP Commercial |
$54.12
|
| Rate for Payer: PHP Medicare Advantage |
$15.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$55.39
|
| Rate for Payer: Priority Health Medicare |
$16.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.31
|
| Rate for Payer: Railroad Medicare Medicare |
$15.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.03
|
| Rate for Payer: UHC Core |
$53.16
|
| Rate for Payer: UHC Exchange |
$15.92
|
| Rate for Payer: UHC Medicaid |
$11.23
|
| Rate for Payer: UHC Medicare Advantage |
$15.92
|
| Rate for Payer: UHCCP Medicaid |
$11.23
|
| Rate for Payer: VA VA |
$15.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.75
|
|
|
HC FETAL BIOPHYSICAL PROFILE
|
Facility
|
IP
|
$348.08
|
|
|
Service Code
|
CPT 76818
|
| Hospital Charge Code |
40200080
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$242.26 |
| Max. Negotiated Rate |
$313.27 |
| Rate for Payer: Aetna Commercial |
$295.87
|
| Rate for Payer: BCBS Trust/PPO |
$287.48
|
| Rate for Payer: BCN Commercial |
$287.48
|
| Rate for Payer: Cash Price |
$278.46
|
| Rate for Payer: Cofinity Commercial |
$299.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.46
|
| Rate for Payer: Healthscope Commercial |
$313.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.87
|
| Rate for Payer: Nomi Health Commercial |
$285.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.06
|
| Rate for Payer: PHP Commercial |
$295.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.31
|
| Rate for Payer: UHC Core |
$290.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.06
|
|
|
HC FETAL BIOPHYSICAL PROFILE
|
Facility
|
OP
|
$348.08
|
|
|
Service Code
|
CPT 76818
|
| Hospital Charge Code |
40200080
|
|
Hospital Revenue Code
|
402
|
| Min. Negotiated Rate |
$61.37 |
| Max. Negotiated Rate |
$313.27 |
| Rate for Payer: Aetna Commercial |
$295.87
|
| Rate for Payer: Aetna Medicare |
$90.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.78
|
| Rate for Payer: BCBS Complete |
$64.43
|
| Rate for Payer: BCBS MAPPO |
$87.02
|
| Rate for Payer: BCBS Trust/PPO |
$286.16
|
| Rate for Payer: BCN Commercial |
$286.16
|
| Rate for Payer: BCN Medicare Advantage |
$87.02
|
| Rate for Payer: Cash Price |
$278.46
|
| Rate for Payer: Cofinity Commercial |
$299.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$278.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$87.02
|
| Rate for Payer: Healthscope Commercial |
$313.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$261.06
|
| Rate for Payer: Mclaren Medicaid |
$61.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$91.37
|
| Rate for Payer: Meridian Medicaid |
$64.43
|
| Rate for Payer: MI Amish Medical Board Commercial |
$100.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$295.87
|
| Rate for Payer: Nomi Health Commercial |
$285.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$261.06
|
| Rate for Payer: PACE Senior Care Partners |
$82.67
|
| Rate for Payer: PACE SWMI |
$87.02
|
| Rate for Payer: PHP Commercial |
$295.87
|
| Rate for Payer: PHP Medicare Advantage |
$87.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$302.83
|
| Rate for Payer: Priority Health Medicare |
$87.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$242.26
|
| Rate for Payer: Railroad Medicare Medicare |
$87.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$306.31
|
| Rate for Payer: UHC Core |
$290.65
|
| Rate for Payer: UHC Exchange |
$87.02
|
| Rate for Payer: UHC Medicaid |
$61.37
|
| Rate for Payer: UHC Medicare Advantage |
$87.02
|
| Rate for Payer: UHCCP Medicaid |
$61.37
|
| Rate for Payer: VA VA |
$87.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$261.06
|
|
|
HC FETAL FIBRONECTIN
|
Facility
|
OP
|
$443.93
|
|
|
Service Code
|
CPT 82731
|
| Hospital Charge Code |
30100203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.26 |
| Max. Negotiated Rate |
$399.54 |
| Rate for Payer: Aetna Commercial |
$377.34
|
| Rate for Payer: Aetna Medicare |
$115.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$138.73
|
| Rate for Payer: Amish Plain Church Group Commercial |
$138.73
|
| Rate for Payer: BCBS Complete |
$82.17
|
| Rate for Payer: BCBS MAPPO |
$110.98
|
| Rate for Payer: BCBS Trust/PPO |
$364.95
|
| Rate for Payer: BCN Commercial |
$364.95
|
| Rate for Payer: BCN Medicare Advantage |
$110.98
|
| Rate for Payer: Cash Price |
$355.14
|
| Rate for Payer: Cofinity Commercial |
$381.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$110.98
|
| Rate for Payer: Healthscope Commercial |
$399.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.95
|
| Rate for Payer: Mclaren Medicaid |
$78.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$116.53
|
| Rate for Payer: Meridian Medicaid |
$82.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$127.63
|
| Rate for Payer: Molina Medicare/Medicaid |
$122.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.34
|
| Rate for Payer: Nomi Health Commercial |
$364.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$332.95
|
| Rate for Payer: PACE Senior Care Partners |
$105.43
|
| Rate for Payer: PACE SWMI |
$110.98
|
| Rate for Payer: PHP Commercial |
$377.34
|
| Rate for Payer: PHP Medicare Advantage |
$110.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$78.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$386.22
|
| Rate for Payer: Priority Health Medicare |
$112.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$308.98
|
| Rate for Payer: Railroad Medicare Medicare |
$110.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.66
|
| Rate for Payer: UHC Core |
$370.68
|
| Rate for Payer: UHC Exchange |
$110.98
|
| Rate for Payer: UHC Medicaid |
$78.26
|
| Rate for Payer: UHC Medicare Advantage |
$110.98
|
| Rate for Payer: UHCCP Medicaid |
$78.26
|
| Rate for Payer: VA VA |
$110.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.95
|
|
|
HC FETAL FIBRONECTIN
|
Facility
|
IP
|
$443.93
|
|
|
Service Code
|
CPT 82731
|
| Hospital Charge Code |
30100203
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$308.98 |
| Max. Negotiated Rate |
$399.54 |
| Rate for Payer: Aetna Commercial |
$377.34
|
| Rate for Payer: BCBS Trust/PPO |
$366.64
|
| Rate for Payer: BCN Commercial |
$366.64
|
| Rate for Payer: Cash Price |
$355.14
|
| Rate for Payer: Cofinity Commercial |
$381.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$355.14
|
| Rate for Payer: Healthscope Commercial |
$399.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$332.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$377.34
|
| Rate for Payer: Nomi Health Commercial |
$364.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$332.95
|
| Rate for Payer: PHP Commercial |
$377.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$386.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$308.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$390.66
|
| Rate for Payer: UHC Core |
$370.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$332.95
|
|
|
HC FETAL PULSE OXIMETRY
|
Facility
|
IP
|
$311.37
|
|
| Hospital Charge Code |
27200122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$216.71 |
| Max. Negotiated Rate |
$280.23 |
| Rate for Payer: Aetna Commercial |
$264.66
|
| Rate for Payer: BCBS Trust/PPO |
$257.16
|
| Rate for Payer: BCN Commercial |
$257.16
|
| Rate for Payer: Cash Price |
$249.10
|
| Rate for Payer: Cofinity Commercial |
$267.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.10
|
| Rate for Payer: Healthscope Commercial |
$280.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.66
|
| Rate for Payer: Nomi Health Commercial |
$255.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.53
|
| Rate for Payer: PHP Commercial |
$264.66
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$270.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.01
|
| Rate for Payer: UHC Core |
$259.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.53
|
|
|
HC FETAL PULSE OXIMETRY
|
Facility
|
OP
|
$311.37
|
|
| Hospital Charge Code |
27200122
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$54.89 |
| Max. Negotiated Rate |
$280.23 |
| Rate for Payer: Aetna Commercial |
$264.66
|
| Rate for Payer: Aetna Medicare |
$80.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$97.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$97.30
|
| Rate for Payer: BCBS Complete |
$57.63
|
| Rate for Payer: BCBS MAPPO |
$77.84
|
| Rate for Payer: BCBS Trust/PPO |
$255.98
|
| Rate for Payer: BCN Commercial |
$255.98
|
| Rate for Payer: BCN Medicare Advantage |
$77.84
|
| Rate for Payer: Cash Price |
$249.10
|
| Rate for Payer: Cofinity Commercial |
$267.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$249.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$77.84
|
| Rate for Payer: Healthscope Commercial |
$280.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$233.53
|
| Rate for Payer: Mclaren Medicaid |
$54.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$81.73
|
| Rate for Payer: Meridian Medicaid |
$57.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$89.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$85.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$264.66
|
| Rate for Payer: Nomi Health Commercial |
$255.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$233.53
|
| Rate for Payer: PACE Senior Care Partners |
$73.95
|
| Rate for Payer: PACE SWMI |
$77.84
|
| Rate for Payer: PHP Commercial |
$264.66
|
| Rate for Payer: PHP Medicare Advantage |
$77.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$54.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$270.89
|
| Rate for Payer: Priority Health Medicare |
$78.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$216.71
|
| Rate for Payer: Railroad Medicare Medicare |
$77.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$274.01
|
| Rate for Payer: UHC Core |
$259.99
|
| Rate for Payer: UHC Exchange |
$77.84
|
| Rate for Payer: UHC Medicaid |
$54.89
|
| Rate for Payer: UHC Medicare Advantage |
$77.84
|
| Rate for Payer: UHCCP Medicaid |
$54.89
|
| Rate for Payer: VA VA |
$77.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$233.53
|
|
|
HC FETAL SCREEN ROSETTE
|
Facility
|
OP
|
$75.53
|
|
|
Service Code
|
CPT 85461
|
| Hospital Charge Code |
30500047
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.32 |
| Max. Negotiated Rate |
$67.98 |
| Rate for Payer: Aetna Commercial |
$64.20
|
| Rate for Payer: Aetna Medicare |
$19.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.60
|
| Rate for Payer: BCBS Complete |
$13.98
|
| Rate for Payer: BCBS MAPPO |
$18.88
|
| Rate for Payer: BCBS Trust/PPO |
$62.09
|
| Rate for Payer: BCN Commercial |
$62.09
|
| Rate for Payer: BCN Medicare Advantage |
$18.88
|
| Rate for Payer: Cash Price |
$60.42
|
| Rate for Payer: Cofinity Commercial |
$64.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.88
|
| Rate for Payer: Healthscope Commercial |
$67.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.65
|
| Rate for Payer: Mclaren Medicaid |
$13.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.83
|
| Rate for Payer: Meridian Medicaid |
$13.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.20
|
| Rate for Payer: Nomi Health Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.65
|
| Rate for Payer: PACE Senior Care Partners |
$17.94
|
| Rate for Payer: PACE SWMI |
$18.88
|
| Rate for Payer: PHP Commercial |
$64.20
|
| Rate for Payer: PHP Medicare Advantage |
$18.88
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.71
|
| Rate for Payer: Priority Health Medicare |
$19.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.57
|
| Rate for Payer: Railroad Medicare Medicare |
$18.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.47
|
| Rate for Payer: UHC Core |
$63.07
|
| Rate for Payer: UHC Exchange |
$18.88
|
| Rate for Payer: UHC Medicaid |
$13.32
|
| Rate for Payer: UHC Medicare Advantage |
$18.88
|
| Rate for Payer: UHCCP Medicaid |
$13.32
|
| Rate for Payer: VA VA |
$18.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.65
|
|
|
HC FETAL SCREEN ROSETTE
|
Facility
|
IP
|
$75.53
|
|
|
Service Code
|
CPT 85461
|
| Hospital Charge Code |
30500047
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$52.57 |
| Max. Negotiated Rate |
$67.98 |
| Rate for Payer: Aetna Commercial |
$64.20
|
| Rate for Payer: BCBS Trust/PPO |
$62.38
|
| Rate for Payer: BCN Commercial |
$62.38
|
| Rate for Payer: Cash Price |
$60.42
|
| Rate for Payer: Cofinity Commercial |
$64.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.42
|
| Rate for Payer: Healthscope Commercial |
$67.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$64.20
|
| Rate for Payer: Nomi Health Commercial |
$61.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.65
|
| Rate for Payer: PHP Commercial |
$64.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.47
|
| Rate for Payer: UHC Core |
$63.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.65
|
|
|
HC FETUS EACH ADDL GESTATION
|
Facility
|
OP
|
$210.77
|
|
|
Service Code
|
CPT 74713
|
| Hospital Charge Code |
61000084
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$37.16 |
| Max. Negotiated Rate |
$189.69 |
| Rate for Payer: Aetna Commercial |
$179.15
|
| Rate for Payer: Aetna Medicare |
$54.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.87
|
| Rate for Payer: BCBS Complete |
$39.01
|
| Rate for Payer: BCBS MAPPO |
$52.69
|
| Rate for Payer: BCBS Trust/PPO |
$173.27
|
| Rate for Payer: BCN Commercial |
$173.27
|
| Rate for Payer: BCN Medicare Advantage |
$52.69
|
| Rate for Payer: Cash Price |
$168.62
|
| Rate for Payer: Cofinity Commercial |
$181.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.69
|
| Rate for Payer: Healthscope Commercial |
$189.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.08
|
| Rate for Payer: Mclaren Medicaid |
$37.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.33
|
| Rate for Payer: Meridian Medicaid |
$39.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.60
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.15
|
| Rate for Payer: Nomi Health Commercial |
$172.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.08
|
| Rate for Payer: PACE Senior Care Partners |
$50.06
|
| Rate for Payer: PACE SWMI |
$52.69
|
| Rate for Payer: PHP Commercial |
$179.15
|
| Rate for Payer: PHP Medicare Advantage |
$52.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$183.37
|
| Rate for Payer: Priority Health Medicare |
$53.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.70
|
| Rate for Payer: Railroad Medicare Medicare |
$52.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.48
|
| Rate for Payer: UHC Core |
$175.99
|
| Rate for Payer: UHC Exchange |
$52.69
|
| Rate for Payer: UHC Medicaid |
$37.16
|
| Rate for Payer: UHC Medicare Advantage |
$52.69
|
| Rate for Payer: UHCCP Medicaid |
$37.16
|
| Rate for Payer: VA VA |
$52.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.08
|
|
|
HC FETUS EACH ADDL GESTATION
|
Facility
|
IP
|
$210.77
|
|
|
Service Code
|
CPT 74713
|
| Hospital Charge Code |
61000084
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$146.70 |
| Max. Negotiated Rate |
$189.69 |
| Rate for Payer: Aetna Commercial |
$179.15
|
| Rate for Payer: BCBS Trust/PPO |
$174.07
|
| Rate for Payer: BCN Commercial |
$174.07
|
| Rate for Payer: Cash Price |
$168.62
|
| Rate for Payer: Cofinity Commercial |
$181.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$168.62
|
| Rate for Payer: Healthscope Commercial |
$189.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$158.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$179.15
|
| Rate for Payer: Nomi Health Commercial |
$172.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$158.08
|
| Rate for Payer: PHP Commercial |
$179.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$183.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$146.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$185.48
|
| Rate for Payer: UHC Core |
$175.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$158.08
|
|
|
HC FETUS SINGLE OR FIRST GESTATION
|
Facility
|
OP
|
$374.54
|
|
|
Service Code
|
CPT 74712
|
| Hospital Charge Code |
61000083
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$66.03 |
| Max. Negotiated Rate |
$337.09 |
| Rate for Payer: Aetna Commercial |
$318.36
|
| Rate for Payer: Aetna Medicare |
$97.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.04
|
| Rate for Payer: BCBS Complete |
$69.33
|
| Rate for Payer: BCBS MAPPO |
$93.64
|
| Rate for Payer: BCBS Trust/PPO |
$307.91
|
| Rate for Payer: BCN Commercial |
$307.91
|
| Rate for Payer: BCN Medicare Advantage |
$93.64
|
| Rate for Payer: Cash Price |
$299.63
|
| Rate for Payer: Cofinity Commercial |
$322.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.64
|
| Rate for Payer: Healthscope Commercial |
$337.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.90
|
| Rate for Payer: Mclaren Medicaid |
$66.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.32
|
| Rate for Payer: Meridian Medicaid |
$69.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.68
|
| Rate for Payer: Molina Medicare/Medicaid |
$103.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.36
|
| Rate for Payer: Nomi Health Commercial |
$307.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.90
|
| Rate for Payer: PACE Senior Care Partners |
$88.95
|
| Rate for Payer: PACE SWMI |
$93.64
|
| Rate for Payer: PHP Commercial |
$318.36
|
| Rate for Payer: PHP Medicare Advantage |
$93.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$325.85
|
| Rate for Payer: Priority Health Medicare |
$94.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.68
|
| Rate for Payer: Railroad Medicare Medicare |
$93.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.60
|
| Rate for Payer: UHC Core |
$312.74
|
| Rate for Payer: UHC Exchange |
$93.64
|
| Rate for Payer: UHC Medicaid |
$66.03
|
| Rate for Payer: UHC Medicare Advantage |
$93.64
|
| Rate for Payer: UHCCP Medicaid |
$66.03
|
| Rate for Payer: VA VA |
$93.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.90
|
|
|
HC FETUS SINGLE OR FIRST GESTATION
|
Facility
|
IP
|
$374.54
|
|
|
Service Code
|
CPT 74712
|
| Hospital Charge Code |
61000083
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$260.68 |
| Max. Negotiated Rate |
$337.09 |
| Rate for Payer: Aetna Commercial |
$318.36
|
| Rate for Payer: BCBS Trust/PPO |
$309.33
|
| Rate for Payer: BCN Commercial |
$309.33
|
| Rate for Payer: Cash Price |
$299.63
|
| Rate for Payer: Cofinity Commercial |
$322.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$299.63
|
| Rate for Payer: Healthscope Commercial |
$337.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$280.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$318.36
|
| Rate for Payer: Nomi Health Commercial |
$307.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$280.90
|
| Rate for Payer: PHP Commercial |
$318.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$325.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$329.60
|
| Rate for Payer: UHC Core |
$312.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$280.90
|
|
|
HC FFR DEVICE
|
Facility
|
IP
|
$2,138.43
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,488.35 |
| Max. Negotiated Rate |
$1,924.59 |
| Rate for Payer: Aetna Commercial |
$1,817.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,766.13
|
| Rate for Payer: BCN Commercial |
$1,766.13
|
| Rate for Payer: Cash Price |
$1,710.74
|
| Rate for Payer: Cofinity Commercial |
$1,839.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,710.74
|
| Rate for Payer: Healthscope Commercial |
$1,924.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,603.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,817.67
|
| Rate for Payer: Nomi Health Commercial |
$1,753.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,603.82
|
| Rate for Payer: PHP Commercial |
$1,817.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,860.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,488.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,881.82
|
| Rate for Payer: UHC Core |
$1,785.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,603.82
|
|
|
HC FFR DEVICE
|
Facility
|
OP
|
$2,138.43
|
|
|
Service Code
|
HCPCS C1769
|
| Hospital Charge Code |
27200242
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$377.01 |
| Max. Negotiated Rate |
$1,924.59 |
| Rate for Payer: Aetna Commercial |
$1,817.67
|
| Rate for Payer: Aetna Medicare |
$555.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$668.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$668.26
|
| Rate for Payer: BCBS Complete |
$395.82
|
| Rate for Payer: BCBS MAPPO |
$534.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,758.00
|
| Rate for Payer: BCN Commercial |
$1,758.00
|
| Rate for Payer: BCN Medicare Advantage |
$534.61
|
| Rate for Payer: Cash Price |
$1,710.74
|
| Rate for Payer: Cofinity Commercial |
$1,839.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,710.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$534.61
|
| Rate for Payer: Healthscope Commercial |
$1,924.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,603.82
|
| Rate for Payer: Mclaren Medicaid |
$377.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$561.34
|
| Rate for Payer: Meridian Medicaid |
$395.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$614.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$588.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,817.67
|
| Rate for Payer: Nomi Health Commercial |
$1,753.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,603.82
|
| Rate for Payer: PACE Senior Care Partners |
$507.88
|
| Rate for Payer: PACE SWMI |
$534.61
|
| Rate for Payer: PHP Commercial |
$1,817.67
|
| Rate for Payer: PHP Medicare Advantage |
$534.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$377.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,860.43
|
| Rate for Payer: Priority Health Medicare |
$539.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,488.35
|
| Rate for Payer: Railroad Medicare Medicare |
$534.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,881.82
|
| Rate for Payer: UHC Core |
$1,785.59
|
| Rate for Payer: UHC Exchange |
$534.61
|
| Rate for Payer: UHC Medicaid |
$377.01
|
| Rate for Payer: UHC Medicare Advantage |
$534.61
|
| Rate for Payer: UHCCP Medicaid |
$377.01
|
| Rate for Payer: VA VA |
$534.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,603.82
|
|
|
HC FFR MEASUREMENT
|
Facility
|
IP
|
$3,956.14
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
48100027
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,753.47 |
| Max. Negotiated Rate |
$3,560.53 |
| Rate for Payer: Aetna Commercial |
$3,362.72
|
| Rate for Payer: BCBS Trust/PPO |
$3,267.38
|
| Rate for Payer: BCN Commercial |
$3,267.38
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cofinity Commercial |
$3,402.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.91
|
| Rate for Payer: Healthscope Commercial |
$3,560.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,967.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,362.72
|
| Rate for Payer: Nomi Health Commercial |
$3,244.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,967.11
|
| Rate for Payer: PHP Commercial |
$3,362.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,441.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,753.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,481.40
|
| Rate for Payer: UHC Core |
$3,303.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,967.11
|
|
|
HC FFR MEASUREMENT
|
Facility
|
OP
|
$3,956.14
|
|
|
Service Code
|
CPT 93571
|
| Hospital Charge Code |
48100027
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$697.47 |
| Max. Negotiated Rate |
$3,560.53 |
| Rate for Payer: Aetna Commercial |
$3,362.72
|
| Rate for Payer: Aetna Medicare |
$1,028.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,236.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,236.29
|
| Rate for Payer: BCBS Complete |
$732.28
|
| Rate for Payer: BCBS MAPPO |
$989.03
|
| Rate for Payer: BCBS Trust/PPO |
$3,252.34
|
| Rate for Payer: BCN Commercial |
$3,252.34
|
| Rate for Payer: BCN Medicare Advantage |
$989.03
|
| Rate for Payer: Cash Price |
$3,164.91
|
| Rate for Payer: Cofinity Commercial |
$3,402.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,164.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$989.03
|
| Rate for Payer: Healthscope Commercial |
$3,560.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,967.11
|
| Rate for Payer: Mclaren Medicaid |
$697.47
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,038.49
|
| Rate for Payer: Meridian Medicaid |
$732.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,137.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,087.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,362.72
|
| Rate for Payer: Nomi Health Commercial |
$3,244.03
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,967.11
|
| Rate for Payer: PACE Senior Care Partners |
$939.58
|
| Rate for Payer: PACE SWMI |
$989.03
|
| Rate for Payer: PHP Commercial |
$3,362.72
|
| Rate for Payer: PHP Medicare Advantage |
$989.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$697.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,441.84
|
| Rate for Payer: Priority Health Medicare |
$998.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,753.47
|
| Rate for Payer: Railroad Medicare Medicare |
$989.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,481.40
|
| Rate for Payer: UHC Core |
$3,303.38
|
| Rate for Payer: UHC Exchange |
$989.03
|
| Rate for Payer: UHC Medicaid |
$697.47
|
| Rate for Payer: UHC Medicare Advantage |
$989.03
|
| Rate for Payer: UHCCP Medicaid |
$697.47
|
| Rate for Payer: VA VA |
$989.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,967.11
|
|
|
HC FFR MEASUREMENT ADD VESS
|
Facility
|
IP
|
$857.37
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
48100028
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$596.73 |
| Max. Negotiated Rate |
$771.63 |
| Rate for Payer: Aetna Commercial |
$728.76
|
| Rate for Payer: BCBS Trust/PPO |
$708.10
|
| Rate for Payer: BCN Commercial |
$708.10
|
| Rate for Payer: Cash Price |
$685.90
|
| Rate for Payer: Cofinity Commercial |
$737.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.90
|
| Rate for Payer: Healthscope Commercial |
$771.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.76
|
| Rate for Payer: Nomi Health Commercial |
$703.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.03
|
| Rate for Payer: PHP Commercial |
$728.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$745.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$596.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.49
|
| Rate for Payer: UHC Core |
$715.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.03
|
|
|
HC FFR MEASUREMENT ADD VESS
|
Facility
|
OP
|
$857.37
|
|
|
Service Code
|
CPT 93572
|
| Hospital Charge Code |
48100028
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$151.15 |
| Max. Negotiated Rate |
$771.63 |
| Rate for Payer: Aetna Commercial |
$728.76
|
| Rate for Payer: Aetna Medicare |
$222.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$267.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$267.93
|
| Rate for Payer: BCBS Complete |
$158.70
|
| Rate for Payer: BCBS MAPPO |
$214.34
|
| Rate for Payer: BCBS Trust/PPO |
$704.84
|
| Rate for Payer: BCN Commercial |
$704.84
|
| Rate for Payer: BCN Medicare Advantage |
$214.34
|
| Rate for Payer: Cash Price |
$685.90
|
| Rate for Payer: Cofinity Commercial |
$737.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$685.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.34
|
| Rate for Payer: Healthscope Commercial |
$771.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.03
|
| Rate for Payer: Mclaren Medicaid |
$151.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.06
|
| Rate for Payer: Meridian Medicaid |
$158.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$235.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$728.76
|
| Rate for Payer: Nomi Health Commercial |
$703.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.03
|
| Rate for Payer: PACE Senior Care Partners |
$203.63
|
| Rate for Payer: PACE SWMI |
$214.34
|
| Rate for Payer: PHP Commercial |
$728.76
|
| Rate for Payer: PHP Medicare Advantage |
$214.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$745.91
|
| Rate for Payer: Priority Health Medicare |
$216.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$596.73
|
| Rate for Payer: Railroad Medicare Medicare |
$214.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$754.49
|
| Rate for Payer: UHC Core |
$715.90
|
| Rate for Payer: UHC Exchange |
$214.34
|
| Rate for Payer: UHC Medicaid |
$151.15
|
| Rate for Payer: UHC Medicare Advantage |
$214.34
|
| Rate for Payer: UHCCP Medicaid |
$151.15
|
| Rate for Payer: VA VA |
$214.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.03
|
|
|
HC FIBEROPTIC IABP KIT
|
Facility
|
OP
|
$2,729.96
|
|
| Hospital Charge Code |
27200301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$481.29 |
| Max. Negotiated Rate |
$2,456.96 |
| Rate for Payer: Aetna Commercial |
$2,320.47
|
| Rate for Payer: Aetna Medicare |
$709.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$853.11
|
| Rate for Payer: Amish Plain Church Group Commercial |
$853.11
|
| Rate for Payer: BCBS Complete |
$505.32
|
| Rate for Payer: BCBS MAPPO |
$682.49
|
| Rate for Payer: BCBS Trust/PPO |
$2,244.30
|
| Rate for Payer: BCN Commercial |
$2,244.30
|
| Rate for Payer: BCN Medicare Advantage |
$682.49
|
| Rate for Payer: Cash Price |
$2,183.97
|
| Rate for Payer: Cofinity Commercial |
$2,347.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,183.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$682.49
|
| Rate for Payer: Healthscope Commercial |
$2,456.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,047.47
|
| Rate for Payer: Mclaren Medicaid |
$481.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$716.61
|
| Rate for Payer: Meridian Medicaid |
$505.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$784.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$750.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,320.47
|
| Rate for Payer: Nomi Health Commercial |
$2,238.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,047.47
|
| Rate for Payer: PACE Senior Care Partners |
$648.37
|
| Rate for Payer: PACE SWMI |
$682.49
|
| Rate for Payer: PHP Commercial |
$2,320.47
|
| Rate for Payer: PHP Medicare Advantage |
$682.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$481.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,375.07
|
| Rate for Payer: Priority Health Medicare |
$689.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,900.05
|
| Rate for Payer: Railroad Medicare Medicare |
$682.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,402.36
|
| Rate for Payer: UHC Core |
$2,279.52
|
| Rate for Payer: UHC Exchange |
$682.49
|
| Rate for Payer: UHC Medicaid |
$481.29
|
| Rate for Payer: UHC Medicare Advantage |
$682.49
|
| Rate for Payer: UHCCP Medicaid |
$481.29
|
| Rate for Payer: VA VA |
$682.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,047.47
|
|
|
HC FIBEROPTIC IABP KIT
|
Facility
|
IP
|
$2,729.96
|
|
| Hospital Charge Code |
27200301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1,900.05 |
| Max. Negotiated Rate |
$2,456.96 |
| Rate for Payer: Aetna Commercial |
$2,320.47
|
| Rate for Payer: BCBS Trust/PPO |
$2,254.67
|
| Rate for Payer: BCN Commercial |
$2,254.67
|
| Rate for Payer: Cash Price |
$2,183.97
|
| Rate for Payer: Cofinity Commercial |
$2,347.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,183.97
|
| Rate for Payer: Healthscope Commercial |
$2,456.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,047.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,320.47
|
| Rate for Payer: Nomi Health Commercial |
$2,238.57
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,047.47
|
| Rate for Payer: PHP Commercial |
$2,320.47
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,375.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,900.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,402.36
|
| Rate for Payer: UHC Core |
$2,279.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,047.47
|
|
|
HC FIBRINOGEN
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500045
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$20.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.52
|
| Rate for Payer: BCBS Complete |
$14.52
|
| Rate for Payer: BCBS MAPPO |
$19.61
|
| Rate for Payer: BCBS Trust/PPO |
$64.49
|
| Rate for Payer: BCN Commercial |
$64.49
|
| Rate for Payer: BCN Medicare Advantage |
$19.61
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Mclaren Medicaid |
$13.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.59
|
| Rate for Payer: Meridian Medicaid |
$14.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Senior Care Partners |
$18.63
|
| Rate for Payer: PACE SWMI |
$19.61
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$19.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$19.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.60
|
| Rate for Payer: Railroad Medicare Medicare |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: UHC Exchange |
$19.61
|
| Rate for Payer: UHC Medicaid |
$13.83
|
| Rate for Payer: UHC Medicare Advantage |
$19.61
|
| Rate for Payer: UHCCP Medicaid |
$13.83
|
| Rate for Payer: VA VA |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC FIBRINOGEN
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 85384
|
| Hospital Charge Code |
30500045
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: BCBS Trust/PPO |
$64.79
|
| Rate for Payer: BCN Commercial |
$64.79
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC FIBROTEST-ACTITEST, S
|
Facility
|
IP
|
$296.51
|
|
|
Service Code
|
CPT 81596
|
| Hospital Charge Code |
30000155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$206.37 |
| Max. Negotiated Rate |
$266.86 |
| Rate for Payer: Aetna Commercial |
$252.03
|
| Rate for Payer: BCBS Trust/PPO |
$244.89
|
| Rate for Payer: BCN Commercial |
$244.89
|
| Rate for Payer: Cash Price |
$237.21
|
| Rate for Payer: Cofinity Commercial |
$255.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.21
|
| Rate for Payer: Healthscope Commercial |
$266.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.03
|
| Rate for Payer: Nomi Health Commercial |
$243.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.38
|
| Rate for Payer: PHP Commercial |
$252.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$257.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$206.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.93
|
| Rate for Payer: UHC Core |
$247.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.38
|
|
|
HC FIBROTEST-ACTITEST, S
|
Facility
|
OP
|
$296.51
|
|
|
Service Code
|
CPT 81596
|
| Hospital Charge Code |
30000155
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$52.27 |
| Max. Negotiated Rate |
$266.86 |
| Rate for Payer: Aetna Commercial |
$252.03
|
| Rate for Payer: Aetna Medicare |
$77.09
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$92.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$92.66
|
| Rate for Payer: BCBS Complete |
$54.88
|
| Rate for Payer: BCBS MAPPO |
$74.13
|
| Rate for Payer: BCBS Trust/PPO |
$243.76
|
| Rate for Payer: BCN Commercial |
$243.76
|
| Rate for Payer: BCN Medicare Advantage |
$74.13
|
| Rate for Payer: Cash Price |
$237.21
|
| Rate for Payer: Cofinity Commercial |
$255.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$237.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$74.13
|
| Rate for Payer: Healthscope Commercial |
$266.86
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$222.38
|
| Rate for Payer: Mclaren Medicaid |
$52.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$77.83
|
| Rate for Payer: Meridian Medicaid |
$54.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$85.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$81.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$252.03
|
| Rate for Payer: Nomi Health Commercial |
$243.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$222.38
|
| Rate for Payer: PACE Senior Care Partners |
$70.42
|
| Rate for Payer: PACE SWMI |
$74.13
|
| Rate for Payer: PHP Commercial |
$252.03
|
| Rate for Payer: PHP Medicare Advantage |
$74.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$257.96
|
| Rate for Payer: Priority Health Medicare |
$74.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$206.37
|
| Rate for Payer: Railroad Medicare Medicare |
$74.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$260.93
|
| Rate for Payer: UHC Core |
$247.59
|
| Rate for Payer: UHC Exchange |
$74.13
|
| Rate for Payer: UHC Medicaid |
$52.27
|
| Rate for Payer: UHC Medicare Advantage |
$74.13
|
| Rate for Payer: UHCCP Medicaid |
$52.27
|
| Rate for Payer: VA VA |
$74.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$222.38
|
|
