|
HC FILSHIE CLIP
|
Facility
|
IP
|
$342.54
|
|
| Hospital Charge Code |
27000076
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$238.41 |
| Max. Negotiated Rate |
$308.29 |
| Rate for Payer: Aetna Commercial |
$291.16
|
| Rate for Payer: BCBS Trust/PPO |
$282.90
|
| Rate for Payer: BCN Commercial |
$282.90
|
| Rate for Payer: Cash Price |
$274.03
|
| Rate for Payer: Cofinity Commercial |
$294.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.03
|
| Rate for Payer: Healthscope Commercial |
$308.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$256.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.16
|
| Rate for Payer: Nomi Health Commercial |
$280.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.90
|
| Rate for Payer: PHP Commercial |
$291.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.44
|
| Rate for Payer: UHC Core |
$286.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$256.90
|
|
|
HC FILSHIE CLIP
|
Facility
|
OP
|
$342.54
|
|
| Hospital Charge Code |
27000076
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$60.39 |
| Max. Negotiated Rate |
$308.29 |
| Rate for Payer: Aetna Commercial |
$291.16
|
| Rate for Payer: Aetna Medicare |
$89.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$107.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$107.04
|
| Rate for Payer: BCBS Complete |
$63.40
|
| Rate for Payer: BCBS MAPPO |
$85.64
|
| Rate for Payer: BCBS Trust/PPO |
$281.60
|
| Rate for Payer: BCN Commercial |
$281.60
|
| Rate for Payer: BCN Medicare Advantage |
$85.64
|
| Rate for Payer: Cash Price |
$274.03
|
| Rate for Payer: Cofinity Commercial |
$294.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$274.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$85.64
|
| Rate for Payer: Healthscope Commercial |
$308.29
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$256.90
|
| Rate for Payer: Mclaren Medicaid |
$60.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.92
|
| Rate for Payer: Meridian Medicaid |
$63.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$98.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$94.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$291.16
|
| Rate for Payer: Nomi Health Commercial |
$280.88
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$256.90
|
| Rate for Payer: PACE Senior Care Partners |
$81.35
|
| Rate for Payer: PACE SWMI |
$85.64
|
| Rate for Payer: PHP Commercial |
$291.16
|
| Rate for Payer: PHP Medicare Advantage |
$85.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$60.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$298.01
|
| Rate for Payer: Priority Health Medicare |
$86.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.41
|
| Rate for Payer: Railroad Medicare Medicare |
$85.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$301.44
|
| Rate for Payer: UHC Core |
$286.02
|
| Rate for Payer: UHC Exchange |
$85.64
|
| Rate for Payer: UHC Medicaid |
$60.39
|
| Rate for Payer: UHC Medicare Advantage |
$85.64
|
| Rate for Payer: UHCCP Medicaid |
$60.39
|
| Rate for Payer: VA VA |
$85.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$256.90
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
OP
|
$59.30
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$10.45 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: Aetna Medicare |
$15.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.53
|
| Rate for Payer: BCBS Complete |
$10.98
|
| Rate for Payer: BCBS MAPPO |
$14.82
|
| Rate for Payer: BCBS Trust/PPO |
$48.75
|
| Rate for Payer: BCN Commercial |
$48.75
|
| Rate for Payer: BCN Medicare Advantage |
$14.82
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.82
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Mclaren Medicaid |
$10.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.57
|
| Rate for Payer: Meridian Medicaid |
$10.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PACE Senior Care Partners |
$14.08
|
| Rate for Payer: PACE SWMI |
$14.82
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: PHP Medicare Advantage |
$14.82
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.59
|
| Rate for Payer: Priority Health Medicare |
$14.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.27
|
| Rate for Payer: Railroad Medicare Medicare |
$14.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.18
|
| Rate for Payer: UHC Core |
$49.52
|
| Rate for Payer: UHC Exchange |
$14.82
|
| Rate for Payer: UHC Medicaid |
$10.45
|
| Rate for Payer: UHC Medicare Advantage |
$14.82
|
| Rate for Payer: UHCCP Medicaid |
$10.45
|
| Rate for Payer: VA VA |
$14.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
IP
|
$59.30
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.27 |
| Max. Negotiated Rate |
$53.37 |
| Rate for Payer: Aetna Commercial |
$50.41
|
| Rate for Payer: BCBS Trust/PPO |
$48.98
|
| Rate for Payer: BCN Commercial |
$48.98
|
| Rate for Payer: Cash Price |
$47.44
|
| Rate for Payer: Cofinity Commercial |
$51.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$47.44
|
| Rate for Payer: Healthscope Commercial |
$53.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$44.48
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$50.41
|
| Rate for Payer: Nomi Health Commercial |
$48.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$44.48
|
| Rate for Payer: PHP Commercial |
$50.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$51.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$52.18
|
| Rate for Payer: UHC Core |
$49.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$44.48
|
|
|
HC FILTERWIRE
|
Facility
|
OP
|
$3,890.74
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$685.94 |
| Max. Negotiated Rate |
$3,501.67 |
| Rate for Payer: Aetna Commercial |
$3,307.13
|
| Rate for Payer: Aetna Medicare |
$1,011.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,215.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,215.86
|
| Rate for Payer: BCBS Complete |
$720.18
|
| Rate for Payer: BCBS MAPPO |
$972.68
|
| Rate for Payer: BCBS Trust/PPO |
$3,198.58
|
| Rate for Payer: BCN Commercial |
$3,198.58
|
| Rate for Payer: BCN Medicare Advantage |
$972.68
|
| Rate for Payer: Cash Price |
$3,112.59
|
| Rate for Payer: Cofinity Commercial |
$3,346.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$972.68
|
| Rate for Payer: Healthscope Commercial |
$3,501.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,918.05
|
| Rate for Payer: Mclaren Medicaid |
$685.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,021.32
|
| Rate for Payer: Meridian Medicaid |
$720.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,118.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,069.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.13
|
| Rate for Payer: Nomi Health Commercial |
$3,190.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,918.05
|
| Rate for Payer: PACE Senior Care Partners |
$924.05
|
| Rate for Payer: PACE SWMI |
$972.68
|
| Rate for Payer: PHP Commercial |
$3,307.13
|
| Rate for Payer: PHP Medicare Advantage |
$972.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$685.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,384.94
|
| Rate for Payer: Priority Health Medicare |
$982.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,707.96
|
| Rate for Payer: Railroad Medicare Medicare |
$972.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,423.85
|
| Rate for Payer: UHC Core |
$3,248.77
|
| Rate for Payer: UHC Exchange |
$972.68
|
| Rate for Payer: UHC Medicaid |
$685.94
|
| Rate for Payer: UHC Medicare Advantage |
$972.68
|
| Rate for Payer: UHCCP Medicaid |
$685.94
|
| Rate for Payer: VA VA |
$972.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.05
|
|
|
HC FILTERWIRE
|
Facility
|
IP
|
$3,890.74
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,707.96 |
| Max. Negotiated Rate |
$3,501.67 |
| Rate for Payer: Aetna Commercial |
$3,307.13
|
| Rate for Payer: BCBS Trust/PPO |
$3,213.36
|
| Rate for Payer: BCN Commercial |
$3,213.36
|
| Rate for Payer: Cash Price |
$3,112.59
|
| Rate for Payer: Cofinity Commercial |
$3,346.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,112.59
|
| Rate for Payer: Healthscope Commercial |
$3,501.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,918.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,307.13
|
| Rate for Payer: Nomi Health Commercial |
$3,190.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,918.05
|
| Rate for Payer: PHP Commercial |
$3,307.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,384.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,707.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,423.85
|
| Rate for Payer: UHC Core |
$3,248.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,918.05
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
OP
|
$21.23
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: Aetna Medicare |
$5.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.63
|
| Rate for Payer: BCBS Complete |
$3.93
|
| Rate for Payer: BCBS MAPPO |
$5.31
|
| Rate for Payer: BCBS Trust/PPO |
$17.45
|
| Rate for Payer: BCN Commercial |
$17.45
|
| Rate for Payer: BCN Medicare Advantage |
$5.31
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.31
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Mclaren Medicaid |
$3.74
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.57
|
| Rate for Payer: Meridian Medicaid |
$3.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PACE Senior Care Partners |
$5.04
|
| Rate for Payer: PACE SWMI |
$5.31
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: PHP Medicare Advantage |
$5.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Medicare |
$5.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: Railroad Medicare Medicare |
$5.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: UHC Exchange |
$5.31
|
| Rate for Payer: UHC Medicaid |
$3.74
|
| Rate for Payer: UHC Medicare Advantage |
$5.31
|
| Rate for Payer: UHCCP Medicaid |
$3.74
|
| Rate for Payer: VA VA |
$5.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
IP
|
$21.23
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$14.78 |
| Max. Negotiated Rate |
$19.11 |
| Rate for Payer: Aetna Commercial |
$18.05
|
| Rate for Payer: BCBS Trust/PPO |
$17.53
|
| Rate for Payer: BCN Commercial |
$17.53
|
| Rate for Payer: Cash Price |
$16.98
|
| Rate for Payer: Cofinity Commercial |
$18.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.98
|
| Rate for Payer: Healthscope Commercial |
$19.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$18.05
|
| Rate for Payer: Nomi Health Commercial |
$17.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.92
|
| Rate for Payer: PHP Commercial |
$18.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$18.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.68
|
| Rate for Payer: UHC Core |
$17.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.92
|
|
|
HC FISH PRENATAL ANEUPLOIDY
|
Facility
|
IP
|
$171.91
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$119.65 |
| Max. Negotiated Rate |
$154.72 |
| Rate for Payer: Aetna Commercial |
$146.12
|
| Rate for Payer: BCBS Trust/PPO |
$141.98
|
| Rate for Payer: BCN Commercial |
$141.98
|
| Rate for Payer: Cash Price |
$137.53
|
| Rate for Payer: Cofinity Commercial |
$147.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.53
|
| Rate for Payer: Healthscope Commercial |
$154.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.12
|
| Rate for Payer: Nomi Health Commercial |
$140.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.93
|
| Rate for Payer: PHP Commercial |
$146.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$149.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.28
|
| Rate for Payer: UHC Core |
$143.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.93
|
|
|
HC FISH PRENATAL ANEUPLOIDY
|
Facility
|
OP
|
$171.91
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$30.31 |
| Max. Negotiated Rate |
$154.72 |
| Rate for Payer: Aetna Commercial |
$146.12
|
| Rate for Payer: Aetna Medicare |
$44.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.72
|
| Rate for Payer: BCBS Complete |
$31.82
|
| Rate for Payer: BCBS MAPPO |
$42.98
|
| Rate for Payer: BCBS Trust/PPO |
$141.33
|
| Rate for Payer: BCN Commercial |
$141.33
|
| Rate for Payer: BCN Medicare Advantage |
$42.98
|
| Rate for Payer: Cash Price |
$137.53
|
| Rate for Payer: Cofinity Commercial |
$147.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$137.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.98
|
| Rate for Payer: Healthscope Commercial |
$154.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.93
|
| Rate for Payer: Mclaren Medicaid |
$30.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.13
|
| Rate for Payer: Meridian Medicaid |
$31.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.12
|
| Rate for Payer: Nomi Health Commercial |
$140.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$128.93
|
| Rate for Payer: PACE Senior Care Partners |
$40.83
|
| Rate for Payer: PACE SWMI |
$42.98
|
| Rate for Payer: PHP Commercial |
$146.12
|
| Rate for Payer: PHP Medicare Advantage |
$42.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$149.56
|
| Rate for Payer: Priority Health Medicare |
$43.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$119.65
|
| Rate for Payer: Railroad Medicare Medicare |
$42.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.28
|
| Rate for Payer: UHC Core |
$143.54
|
| Rate for Payer: UHC Exchange |
$42.98
|
| Rate for Payer: UHC Medicaid |
$30.31
|
| Rate for Payer: UHC Medicare Advantage |
$42.98
|
| Rate for Payer: UHCCP Medicaid |
$30.31
|
| Rate for Payer: VA VA |
$42.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.93
|
|
|
HC FISH PROBES
|
Facility
|
IP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000067
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$55.28 |
| Max. Negotiated Rate |
$71.49 |
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: BCBS Trust/PPO |
$65.60
|
| Rate for Payer: BCN Commercial |
$65.60
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$65.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.90
|
| Rate for Payer: UHC Core |
$66.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.57
|
|
|
HC FISH PROBES
|
Facility
|
OP
|
$79.43
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000067
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$14.00 |
| Max. Negotiated Rate |
$71.49 |
| Rate for Payer: Aetna Commercial |
$67.52
|
| Rate for Payer: Aetna Medicare |
$20.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.82
|
| Rate for Payer: BCBS Complete |
$14.70
|
| Rate for Payer: BCBS MAPPO |
$19.86
|
| Rate for Payer: BCBS Trust/PPO |
$65.30
|
| Rate for Payer: BCN Commercial |
$65.30
|
| Rate for Payer: BCN Medicare Advantage |
$19.86
|
| Rate for Payer: Cash Price |
$63.54
|
| Rate for Payer: Cofinity Commercial |
$68.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.86
|
| Rate for Payer: Healthscope Commercial |
$71.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.57
|
| Rate for Payer: Mclaren Medicaid |
$14.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.85
|
| Rate for Payer: Meridian Medicaid |
$14.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.52
|
| Rate for Payer: Nomi Health Commercial |
$65.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.57
|
| Rate for Payer: PACE Senior Care Partners |
$18.86
|
| Rate for Payer: PACE SWMI |
$19.86
|
| Rate for Payer: PHP Commercial |
$67.52
|
| Rate for Payer: PHP Medicare Advantage |
$19.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$14.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$69.10
|
| Rate for Payer: Priority Health Medicare |
$20.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$55.28
|
| Rate for Payer: Railroad Medicare Medicare |
$19.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.90
|
| Rate for Payer: UHC Core |
$66.32
|
| Rate for Payer: UHC Exchange |
$19.86
|
| Rate for Payer: UHC Medicaid |
$14.00
|
| Rate for Payer: UHC Medicare Advantage |
$19.86
|
| Rate for Payer: UHCCP Medicaid |
$14.00
|
| Rate for Payer: VA VA |
$19.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.57
|
|
|
HC FISTULA SHUNTOGRAM
|
Facility
|
OP
|
$2,299.22
|
|
| Hospital Charge Code |
32000264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$405.35 |
| Max. Negotiated Rate |
$2,069.30 |
| Rate for Payer: Aetna Commercial |
$1,954.34
|
| Rate for Payer: Aetna Medicare |
$597.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$718.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$718.51
|
| Rate for Payer: BCBS Complete |
$425.59
|
| Rate for Payer: BCBS MAPPO |
$574.80
|
| Rate for Payer: BCBS Trust/PPO |
$1,890.19
|
| Rate for Payer: BCN Commercial |
$1,890.19
|
| Rate for Payer: BCN Medicare Advantage |
$574.80
|
| Rate for Payer: Cash Price |
$1,839.38
|
| Rate for Payer: Cofinity Commercial |
$1,977.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,839.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$574.80
|
| Rate for Payer: Healthscope Commercial |
$2,069.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,724.41
|
| Rate for Payer: Mclaren Medicaid |
$405.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$603.55
|
| Rate for Payer: Meridian Medicaid |
$425.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$661.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$632.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,954.34
|
| Rate for Payer: Nomi Health Commercial |
$1,885.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.41
|
| Rate for Payer: PACE Senior Care Partners |
$546.06
|
| Rate for Payer: PACE SWMI |
$574.80
|
| Rate for Payer: PHP Commercial |
$1,954.34
|
| Rate for Payer: PHP Medicare Advantage |
$574.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$405.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,000.32
|
| Rate for Payer: Priority Health Medicare |
$580.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,600.26
|
| Rate for Payer: Railroad Medicare Medicare |
$574.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,023.31
|
| Rate for Payer: UHC Core |
$1,919.85
|
| Rate for Payer: UHC Exchange |
$574.80
|
| Rate for Payer: UHC Medicaid |
$405.35
|
| Rate for Payer: UHC Medicare Advantage |
$574.80
|
| Rate for Payer: UHCCP Medicaid |
$405.35
|
| Rate for Payer: VA VA |
$574.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,724.41
|
|
|
HC FISTULA SHUNTOGRAM
|
Facility
|
IP
|
$2,299.22
|
|
| Hospital Charge Code |
32000264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,600.26 |
| Max. Negotiated Rate |
$2,069.30 |
| Rate for Payer: Aetna Commercial |
$1,954.34
|
| Rate for Payer: BCBS Trust/PPO |
$1,898.93
|
| Rate for Payer: BCN Commercial |
$1,898.93
|
| Rate for Payer: Cash Price |
$1,839.38
|
| Rate for Payer: Cofinity Commercial |
$1,977.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,839.38
|
| Rate for Payer: Healthscope Commercial |
$2,069.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,724.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,954.34
|
| Rate for Payer: Nomi Health Commercial |
$1,885.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,724.41
|
| Rate for Payer: PHP Commercial |
$1,954.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,000.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,600.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,023.31
|
| Rate for Payer: UHC Core |
$1,919.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,724.41
|
|
|
HC FIT INSERT INTRAVAG SUPPORT DEVICE
|
Facility
|
IP
|
$264.14
|
|
|
Service Code
|
CPT 57150
|
| Hospital Charge Code |
76100203
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.84 |
| Max. Negotiated Rate |
$237.73 |
| Rate for Payer: Aetna Commercial |
$224.52
|
| Rate for Payer: BCBS Trust/PPO |
$218.15
|
| Rate for Payer: BCN Commercial |
$218.15
|
| Rate for Payer: Cash Price |
$211.31
|
| Rate for Payer: Cofinity Commercial |
$227.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.31
|
| Rate for Payer: Healthscope Commercial |
$237.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.52
|
| Rate for Payer: Nomi Health Commercial |
$216.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.10
|
| Rate for Payer: PHP Commercial |
$224.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$229.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.44
|
| Rate for Payer: UHC Core |
$220.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.10
|
|
|
HC FIT INSERT INTRAVAG SUPPORT DEVICE
|
Facility
|
OP
|
$264.14
|
|
|
Service Code
|
CPT 57150
|
| Hospital Charge Code |
76100203
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.57 |
| Max. Negotiated Rate |
$237.73 |
| Rate for Payer: Aetna Commercial |
$224.52
|
| Rate for Payer: Aetna Medicare |
$68.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.54
|
| Rate for Payer: BCBS Complete |
$48.89
|
| Rate for Payer: BCBS MAPPO |
$66.03
|
| Rate for Payer: BCBS Trust/PPO |
$217.15
|
| Rate for Payer: BCN Commercial |
$217.15
|
| Rate for Payer: BCN Medicare Advantage |
$66.03
|
| Rate for Payer: Cash Price |
$211.31
|
| Rate for Payer: Cofinity Commercial |
$227.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.03
|
| Rate for Payer: Healthscope Commercial |
$237.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.10
|
| Rate for Payer: Mclaren Medicaid |
$46.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.34
|
| Rate for Payer: Meridian Medicaid |
$48.89
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.52
|
| Rate for Payer: Nomi Health Commercial |
$216.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.10
|
| Rate for Payer: PACE Senior Care Partners |
$62.73
|
| Rate for Payer: PACE SWMI |
$66.03
|
| Rate for Payer: PHP Commercial |
$224.52
|
| Rate for Payer: PHP Medicare Advantage |
$66.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$229.80
|
| Rate for Payer: Priority Health Medicare |
$66.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.84
|
| Rate for Payer: Railroad Medicare Medicare |
$66.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.44
|
| Rate for Payer: UHC Core |
$220.56
|
| Rate for Payer: UHC Exchange |
$66.03
|
| Rate for Payer: UHC Medicaid |
$46.57
|
| Rate for Payer: UHC Medicare Advantage |
$66.03
|
| Rate for Payer: UHCCP Medicaid |
$46.57
|
| Rate for Payer: VA VA |
$66.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.10
|
|
|
HC FIT & INSERT PESSARY/OTHER DEVICE
|
Facility
|
OP
|
$535.45
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
76100357
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$94.40 |
| Max. Negotiated Rate |
$481.90 |
| Rate for Payer: Aetna Commercial |
$455.13
|
| Rate for Payer: Aetna Medicare |
$139.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$167.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$167.33
|
| Rate for Payer: BCBS Complete |
$99.11
|
| Rate for Payer: BCBS MAPPO |
$133.86
|
| Rate for Payer: BCBS Trust/PPO |
$440.19
|
| Rate for Payer: BCN Commercial |
$440.19
|
| Rate for Payer: BCN Medicare Advantage |
$133.86
|
| Rate for Payer: Cash Price |
$428.36
|
| Rate for Payer: Cofinity Commercial |
$460.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$133.86
|
| Rate for Payer: Healthscope Commercial |
$481.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.59
|
| Rate for Payer: Mclaren Medicaid |
$94.40
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$140.56
|
| Rate for Payer: Meridian Medicaid |
$99.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$153.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$147.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.13
|
| Rate for Payer: Nomi Health Commercial |
$439.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$401.59
|
| Rate for Payer: PACE Senior Care Partners |
$127.17
|
| Rate for Payer: PACE SWMI |
$133.86
|
| Rate for Payer: PHP Commercial |
$455.13
|
| Rate for Payer: PHP Medicare Advantage |
$133.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$94.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$465.84
|
| Rate for Payer: Priority Health Medicare |
$135.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.67
|
| Rate for Payer: Railroad Medicare Medicare |
$133.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.20
|
| Rate for Payer: UHC Core |
$447.10
|
| Rate for Payer: UHC Exchange |
$133.86
|
| Rate for Payer: UHC Medicaid |
$94.40
|
| Rate for Payer: UHC Medicare Advantage |
$133.86
|
| Rate for Payer: UHCCP Medicaid |
$94.40
|
| Rate for Payer: VA VA |
$133.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.59
|
|
|
HC FIT & INSERT PESSARY/OTHER DEVICE
|
Facility
|
IP
|
$535.45
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
76100357
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$372.67 |
| Max. Negotiated Rate |
$481.90 |
| Rate for Payer: Aetna Commercial |
$455.13
|
| Rate for Payer: BCBS Trust/PPO |
$442.23
|
| Rate for Payer: BCN Commercial |
$442.23
|
| Rate for Payer: Cash Price |
$428.36
|
| Rate for Payer: Cofinity Commercial |
$460.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$428.36
|
| Rate for Payer: Healthscope Commercial |
$481.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$401.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$455.13
|
| Rate for Payer: Nomi Health Commercial |
$439.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$401.59
|
| Rate for Payer: PHP Commercial |
$455.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$465.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$372.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$471.20
|
| Rate for Payer: UHC Core |
$447.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$401.59
|
|
|
HC FLEXIBLE SIGMOIDOSCOPY
|
Facility
|
IP
|
$1,813.46
|
|
| Hospital Charge Code |
36000044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,262.17 |
| Max. Negotiated Rate |
$1,632.11 |
| Rate for Payer: Aetna Commercial |
$1,541.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,497.74
|
| Rate for Payer: BCN Commercial |
$1,497.74
|
| Rate for Payer: Cash Price |
$1,450.77
|
| Rate for Payer: Cofinity Commercial |
$1,559.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,450.77
|
| Rate for Payer: Healthscope Commercial |
$1,632.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,360.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,541.44
|
| Rate for Payer: Nomi Health Commercial |
$1,487.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,360.10
|
| Rate for Payer: PHP Commercial |
$1,541.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,577.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,262.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,595.84
|
| Rate for Payer: UHC Core |
$1,514.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,360.10
|
|
|
HC FLEXIBLE SIGMOIDOSCOPY
|
Facility
|
OP
|
$1,813.46
|
|
| Hospital Charge Code |
36000044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$319.71 |
| Max. Negotiated Rate |
$1,632.11 |
| Rate for Payer: Aetna Commercial |
$1,541.44
|
| Rate for Payer: Aetna Medicare |
$471.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$566.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$566.71
|
| Rate for Payer: BCBS Complete |
$335.67
|
| Rate for Payer: BCBS MAPPO |
$453.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,490.85
|
| Rate for Payer: BCN Commercial |
$1,490.85
|
| Rate for Payer: BCN Medicare Advantage |
$453.37
|
| Rate for Payer: Cash Price |
$1,450.77
|
| Rate for Payer: Cofinity Commercial |
$1,559.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,450.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$453.37
|
| Rate for Payer: Healthscope Commercial |
$1,632.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,360.10
|
| Rate for Payer: Mclaren Medicaid |
$319.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$476.03
|
| Rate for Payer: Meridian Medicaid |
$335.67
|
| Rate for Payer: MI Amish Medical Board Commercial |
$521.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$498.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,541.44
|
| Rate for Payer: Nomi Health Commercial |
$1,487.04
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,360.10
|
| Rate for Payer: PACE Senior Care Partners |
$430.70
|
| Rate for Payer: PACE SWMI |
$453.37
|
| Rate for Payer: PHP Commercial |
$1,541.44
|
| Rate for Payer: PHP Medicare Advantage |
$453.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$319.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,577.71
|
| Rate for Payer: Priority Health Medicare |
$457.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,262.17
|
| Rate for Payer: Railroad Medicare Medicare |
$453.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,595.84
|
| Rate for Payer: UHC Core |
$1,514.24
|
| Rate for Payer: UHC Exchange |
$453.37
|
| Rate for Payer: UHC Medicaid |
$319.71
|
| Rate for Payer: UHC Medicare Advantage |
$453.37
|
| Rate for Payer: UHCCP Medicaid |
$319.71
|
| Rate for Payer: VA VA |
$453.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,360.10
|
|
|
HC FLEX SHEATH INTRO
|
Facility
|
OP
|
$260.03
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200041
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$45.84 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: Aetna Medicare |
$67.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.26
|
| Rate for Payer: BCBS Complete |
$48.13
|
| Rate for Payer: BCBS MAPPO |
$65.01
|
| Rate for Payer: BCBS Trust/PPO |
$213.77
|
| Rate for Payer: BCN Commercial |
$213.77
|
| Rate for Payer: BCN Medicare Advantage |
$65.01
|
| Rate for Payer: Cash Price |
$208.02
|
| Rate for Payer: Cofinity Commercial |
$223.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.01
|
| Rate for Payer: Healthscope Commercial |
$234.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.02
|
| Rate for Payer: Mclaren Medicaid |
$45.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.26
|
| Rate for Payer: Meridian Medicaid |
$48.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$71.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.03
|
| Rate for Payer: Nomi Health Commercial |
$213.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.02
|
| Rate for Payer: PACE Senior Care Partners |
$61.76
|
| Rate for Payer: PACE SWMI |
$65.01
|
| Rate for Payer: PHP Commercial |
$221.03
|
| Rate for Payer: PHP Medicare Advantage |
$65.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$45.84
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.23
|
| Rate for Payer: Priority Health Medicare |
$65.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.98
|
| Rate for Payer: Railroad Medicare Medicare |
$65.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.83
|
| Rate for Payer: UHC Core |
$217.13
|
| Rate for Payer: UHC Exchange |
$65.01
|
| Rate for Payer: UHC Medicaid |
$45.84
|
| Rate for Payer: UHC Medicare Advantage |
$65.01
|
| Rate for Payer: UHCCP Medicaid |
$45.84
|
| Rate for Payer: VA VA |
$65.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.02
|
|
|
HC FLEX SHEATH INTRO
|
Facility
|
IP
|
$260.03
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200041
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$180.98 |
| Max. Negotiated Rate |
$234.03 |
| Rate for Payer: Aetna Commercial |
$221.03
|
| Rate for Payer: BCBS Trust/PPO |
$214.76
|
| Rate for Payer: BCN Commercial |
$214.76
|
| Rate for Payer: Cash Price |
$208.02
|
| Rate for Payer: Cofinity Commercial |
$223.63
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$208.02
|
| Rate for Payer: Healthscope Commercial |
$234.03
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$195.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$221.03
|
| Rate for Payer: Nomi Health Commercial |
$213.22
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$195.02
|
| Rate for Payer: PHP Commercial |
$221.03
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$226.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$180.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$228.83
|
| Rate for Payer: UHC Core |
$217.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$195.02
|
|
|
HC FLOSEAL HEMOSTATIC MATRIX
|
Facility
|
IP
|
$760.43
|
|
| Hospital Charge Code |
27200123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$529.26 |
| Max. Negotiated Rate |
$684.39 |
| Rate for Payer: Aetna Commercial |
$646.37
|
| Rate for Payer: BCBS Trust/PPO |
$628.04
|
| Rate for Payer: BCN Commercial |
$628.04
|
| Rate for Payer: Cash Price |
$608.34
|
| Rate for Payer: Cofinity Commercial |
$653.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.34
|
| Rate for Payer: Healthscope Commercial |
$684.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$570.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.37
|
| Rate for Payer: Nomi Health Commercial |
$623.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$570.32
|
| Rate for Payer: PHP Commercial |
$646.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$661.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.18
|
| Rate for Payer: UHC Core |
$634.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$570.32
|
|
|
HC FLOSEAL HEMOSTATIC MATRIX
|
Facility
|
OP
|
$760.43
|
|
| Hospital Charge Code |
27200123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$134.06 |
| Max. Negotiated Rate |
$684.39 |
| Rate for Payer: Aetna Commercial |
$646.37
|
| Rate for Payer: Aetna Medicare |
$197.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$237.63
|
| Rate for Payer: Amish Plain Church Group Commercial |
$237.63
|
| Rate for Payer: BCBS Complete |
$140.76
|
| Rate for Payer: BCBS MAPPO |
$190.11
|
| Rate for Payer: BCBS Trust/PPO |
$625.15
|
| Rate for Payer: BCN Commercial |
$625.15
|
| Rate for Payer: BCN Medicare Advantage |
$190.11
|
| Rate for Payer: Cash Price |
$608.34
|
| Rate for Payer: Cofinity Commercial |
$653.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$608.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$190.11
|
| Rate for Payer: Healthscope Commercial |
$684.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$570.32
|
| Rate for Payer: Mclaren Medicaid |
$134.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$199.61
|
| Rate for Payer: Meridian Medicaid |
$140.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$218.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$209.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$646.37
|
| Rate for Payer: Nomi Health Commercial |
$623.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$570.32
|
| Rate for Payer: PACE Senior Care Partners |
$180.60
|
| Rate for Payer: PACE SWMI |
$190.11
|
| Rate for Payer: PHP Commercial |
$646.37
|
| Rate for Payer: PHP Medicare Advantage |
$190.11
|
| Rate for Payer: Priority Health Choice Medicaid |
$134.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$661.57
|
| Rate for Payer: Priority Health Medicare |
$192.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$529.26
|
| Rate for Payer: Railroad Medicare Medicare |
$190.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$669.18
|
| Rate for Payer: UHC Core |
$634.96
|
| Rate for Payer: UHC Exchange |
$190.11
|
| Rate for Payer: UHC Medicaid |
$134.06
|
| Rate for Payer: UHC Medicare Advantage |
$190.11
|
| Rate for Payer: UHCCP Medicaid |
$134.06
|
| Rate for Payer: VA VA |
$190.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$570.32
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, ADDL
|
Facility
|
OP
|
$64.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100041
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$11.43 |
| Max. Negotiated Rate |
$58.37 |
| Rate for Payer: Aetna Commercial |
$55.12
|
| Rate for Payer: Aetna Medicare |
$16.86
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.27
|
| Rate for Payer: BCBS Complete |
$12.00
|
| Rate for Payer: BCBS MAPPO |
$16.21
|
| Rate for Payer: BCBS Trust/PPO |
$53.31
|
| Rate for Payer: BCN Commercial |
$53.31
|
| Rate for Payer: BCN Medicare Advantage |
$16.21
|
| Rate for Payer: Cash Price |
$51.88
|
| Rate for Payer: Cofinity Commercial |
$55.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.21
|
| Rate for Payer: Healthscope Commercial |
$58.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.64
|
| Rate for Payer: Mclaren Medicaid |
$11.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.02
|
| Rate for Payer: Meridian Medicaid |
$12.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$55.12
|
| Rate for Payer: Nomi Health Commercial |
$53.18
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.64
|
| Rate for Payer: PACE Senior Care Partners |
$15.40
|
| Rate for Payer: PACE SWMI |
$16.21
|
| Rate for Payer: PHP Commercial |
$55.12
|
| Rate for Payer: PHP Medicare Advantage |
$16.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.42
|
| Rate for Payer: Priority Health Medicare |
$16.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$45.14
|
| Rate for Payer: Railroad Medicare Medicare |
$16.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$57.07
|
| Rate for Payer: UHC Core |
$54.15
|
| Rate for Payer: UHC Exchange |
$16.21
|
| Rate for Payer: UHC Medicaid |
$11.43
|
| Rate for Payer: UHC Medicare Advantage |
$16.21
|
| Rate for Payer: UHCCP Medicaid |
$11.43
|
| Rate for Payer: VA VA |
$16.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.64
|
|
