|
HC HEMO CMS INITIAL COMP
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500001
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$313.20 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Aetna Commercial |
$382.50
|
| Rate for Payer: BCBS Trust/PPO |
$371.65
|
| Rate for Payer: BCN Commercial |
$371.65
|
| Rate for Payer: Cash Price |
$360.00
|
| Rate for Payer: Cofinity Commercial |
$387.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$360.00
|
| Rate for Payer: Healthscope Commercial |
$405.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$337.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$382.50
|
| Rate for Payer: Nomi Health Commercial |
$369.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$337.50
|
| Rate for Payer: PHP Commercial |
$382.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$391.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$313.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$396.00
|
| Rate for Payer: UHC Core |
$375.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$337.50
|
|
|
HC HEMO CMS SUPP/SERV
|
Facility
|
OP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500004
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: Aetna Medicare |
$19.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: BCBS Complete |
$13.88
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.66
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$61.66
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Mclaren Medicaid |
$13.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: Meridian Medicaid |
$13.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.75
|
| Rate for Payer: Nomi Health Commercial |
$61.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: PACE Senior Care Partners |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.25
|
| Rate for Payer: Priority Health Medicare |
$18.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.20
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: UHC Exchange |
$18.75
|
| Rate for Payer: UHC Medicaid |
$13.22
|
| Rate for Payer: UHC Medicare Advantage |
$18.75
|
| Rate for Payer: UHCCP Medicaid |
$13.22
|
| Rate for Payer: VA VA |
$18.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HEMO CMS SUPP/SERV
|
Facility
|
IP
|
$75.00
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
51500004
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$52.20 |
| Max. Negotiated Rate |
$67.50 |
| Rate for Payer: Aetna Commercial |
$63.75
|
| Rate for Payer: BCBS Trust/PPO |
$61.94
|
| Rate for Payer: BCN Commercial |
$61.94
|
| Rate for Payer: Cash Price |
$60.00
|
| Rate for Payer: Cofinity Commercial |
$64.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$60.00
|
| Rate for Payer: Healthscope Commercial |
$67.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$56.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$63.75
|
| Rate for Payer: Nomi Health Commercial |
$61.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$56.25
|
| Rate for Payer: PHP Commercial |
$63.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$65.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$66.00
|
| Rate for Payer: UHC Core |
$62.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$56.25
|
|
|
HC HEMOCONCENTRATOR
|
Facility
|
IP
|
$237.89
|
|
| Hospital Charge Code |
27006703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$165.57 |
| Max. Negotiated Rate |
$214.10 |
| Rate for Payer: Aetna Commercial |
$202.21
|
| Rate for Payer: BCBS Trust/PPO |
$196.47
|
| Rate for Payer: BCN Commercial |
$196.47
|
| Rate for Payer: Cash Price |
$190.31
|
| Rate for Payer: Cofinity Commercial |
$204.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.31
|
| Rate for Payer: Healthscope Commercial |
$214.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.21
|
| Rate for Payer: Nomi Health Commercial |
$195.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.42
|
| Rate for Payer: PHP Commercial |
$202.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$206.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.34
|
| Rate for Payer: UHC Core |
$198.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.42
|
|
|
HC HEMOCONCENTRATOR
|
Facility
|
OP
|
$237.89
|
|
| Hospital Charge Code |
27006703
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$41.94 |
| Max. Negotiated Rate |
$214.10 |
| Rate for Payer: Aetna Commercial |
$202.21
|
| Rate for Payer: Aetna Medicare |
$61.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$74.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$74.34
|
| Rate for Payer: BCBS Complete |
$44.03
|
| Rate for Payer: BCBS MAPPO |
$59.47
|
| Rate for Payer: BCBS Trust/PPO |
$195.57
|
| Rate for Payer: BCN Commercial |
$195.57
|
| Rate for Payer: BCN Medicare Advantage |
$59.47
|
| Rate for Payer: Cash Price |
$190.31
|
| Rate for Payer: Cofinity Commercial |
$204.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$190.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$59.47
|
| Rate for Payer: Healthscope Commercial |
$214.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$178.42
|
| Rate for Payer: Mclaren Medicaid |
$41.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$62.45
|
| Rate for Payer: Meridian Medicaid |
$44.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$68.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$65.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$202.21
|
| Rate for Payer: Nomi Health Commercial |
$195.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$178.42
|
| Rate for Payer: PACE Senior Care Partners |
$56.50
|
| Rate for Payer: PACE SWMI |
$59.47
|
| Rate for Payer: PHP Commercial |
$202.21
|
| Rate for Payer: PHP Medicare Advantage |
$59.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$41.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$206.96
|
| Rate for Payer: Priority Health Medicare |
$60.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$165.57
|
| Rate for Payer: Railroad Medicare Medicare |
$59.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$209.34
|
| Rate for Payer: UHC Core |
$198.64
|
| Rate for Payer: UHC Exchange |
$59.47
|
| Rate for Payer: UHC Medicaid |
$41.94
|
| Rate for Payer: UHC Medicare Advantage |
$59.47
|
| Rate for Payer: UHCCP Medicaid |
$41.94
|
| Rate for Payer: VA VA |
$59.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$178.42
|
|
|
HC HEMOCONCENTRATOR DHF
|
Facility
|
IP
|
$262.18
|
|
| Hospital Charge Code |
27000658
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$182.48 |
| Max. Negotiated Rate |
$235.96 |
| Rate for Payer: Aetna Commercial |
$222.85
|
| Rate for Payer: BCBS Trust/PPO |
$216.53
|
| Rate for Payer: BCN Commercial |
$216.53
|
| Rate for Payer: Cash Price |
$209.74
|
| Rate for Payer: Cofinity Commercial |
$225.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.74
|
| Rate for Payer: Healthscope Commercial |
$235.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.85
|
| Rate for Payer: Nomi Health Commercial |
$214.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.63
|
| Rate for Payer: PHP Commercial |
$222.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.72
|
| Rate for Payer: UHC Core |
$218.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.63
|
|
|
HC HEMOCONCENTRATOR DHF
|
Facility
|
OP
|
$262.18
|
|
| Hospital Charge Code |
27000658
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$46.22 |
| Max. Negotiated Rate |
$235.96 |
| Rate for Payer: Aetna Commercial |
$222.85
|
| Rate for Payer: Aetna Medicare |
$68.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$81.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$81.93
|
| Rate for Payer: BCBS Complete |
$48.53
|
| Rate for Payer: BCBS MAPPO |
$65.55
|
| Rate for Payer: BCBS Trust/PPO |
$215.54
|
| Rate for Payer: BCN Commercial |
$215.54
|
| Rate for Payer: BCN Medicare Advantage |
$65.55
|
| Rate for Payer: Cash Price |
$209.74
|
| Rate for Payer: Cofinity Commercial |
$225.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$209.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.55
|
| Rate for Payer: Healthscope Commercial |
$235.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$196.63
|
| Rate for Payer: Mclaren Medicaid |
$46.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$68.82
|
| Rate for Payer: Meridian Medicaid |
$48.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$222.85
|
| Rate for Payer: Nomi Health Commercial |
$214.99
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$196.63
|
| Rate for Payer: PACE Senior Care Partners |
$62.27
|
| Rate for Payer: PACE SWMI |
$65.55
|
| Rate for Payer: PHP Commercial |
$222.85
|
| Rate for Payer: PHP Medicare Advantage |
$65.55
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$228.10
|
| Rate for Payer: Priority Health Medicare |
$66.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.48
|
| Rate for Payer: Railroad Medicare Medicare |
$65.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$230.72
|
| Rate for Payer: UHC Core |
$218.92
|
| Rate for Payer: UHC Exchange |
$65.55
|
| Rate for Payer: UHC Medicaid |
$46.22
|
| Rate for Payer: UHC Medicare Advantage |
$65.55
|
| Rate for Payer: UHCCP Medicaid |
$46.22
|
| Rate for Payer: VA VA |
$65.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$196.63
|
|
|
HC HEMOCONCENTRATOR LONG
|
Facility
|
IP
|
$218.48
|
|
| Hospital Charge Code |
27000103
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$152.06 |
| Max. Negotiated Rate |
$196.63 |
| Rate for Payer: Aetna Commercial |
$185.71
|
| Rate for Payer: BCBS Trust/PPO |
$180.44
|
| Rate for Payer: BCN Commercial |
$180.44
|
| Rate for Payer: Cash Price |
$174.78
|
| Rate for Payer: Cofinity Commercial |
$187.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.78
|
| Rate for Payer: Healthscope Commercial |
$196.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.71
|
| Rate for Payer: Nomi Health Commercial |
$179.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.86
|
| Rate for Payer: PHP Commercial |
$185.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.26
|
| Rate for Payer: UHC Core |
$182.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.86
|
|
|
HC HEMOCONCENTRATOR LONG
|
Facility
|
OP
|
$218.48
|
|
| Hospital Charge Code |
27000103
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$38.52 |
| Max. Negotiated Rate |
$196.63 |
| Rate for Payer: Aetna Commercial |
$185.71
|
| Rate for Payer: Aetna Medicare |
$56.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$68.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$68.28
|
| Rate for Payer: BCBS Complete |
$40.44
|
| Rate for Payer: BCBS MAPPO |
$54.62
|
| Rate for Payer: BCBS Trust/PPO |
$179.61
|
| Rate for Payer: BCN Commercial |
$179.61
|
| Rate for Payer: BCN Medicare Advantage |
$54.62
|
| Rate for Payer: Cash Price |
$174.78
|
| Rate for Payer: Cofinity Commercial |
$187.89
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$174.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.62
|
| Rate for Payer: Healthscope Commercial |
$196.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$163.86
|
| Rate for Payer: Mclaren Medicaid |
$38.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.35
|
| Rate for Payer: Meridian Medicaid |
$40.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.81
|
| Rate for Payer: Molina Medicare/Medicaid |
$60.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$185.71
|
| Rate for Payer: Nomi Health Commercial |
$179.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$163.86
|
| Rate for Payer: PACE Senior Care Partners |
$51.89
|
| Rate for Payer: PACE SWMI |
$54.62
|
| Rate for Payer: PHP Commercial |
$185.71
|
| Rate for Payer: PHP Medicare Advantage |
$54.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$190.08
|
| Rate for Payer: Priority Health Medicare |
$55.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$152.06
|
| Rate for Payer: Railroad Medicare Medicare |
$54.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$192.26
|
| Rate for Payer: UHC Core |
$182.43
|
| Rate for Payer: UHC Exchange |
$54.62
|
| Rate for Payer: UHC Medicaid |
$38.52
|
| Rate for Payer: UHC Medicare Advantage |
$54.62
|
| Rate for Payer: UHCCP Medicaid |
$38.52
|
| Rate for Payer: VA VA |
$54.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$163.86
|
|
|
HC HEMODIALYSIS NON-URGENT
|
Facility
|
IP
|
$988.38
|
|
| Hospital Charge Code |
88100003
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$687.91 |
| Max. Negotiated Rate |
$889.54 |
| Rate for Payer: Aetna Commercial |
$840.12
|
| Rate for Payer: BCBS Trust/PPO |
$816.30
|
| Rate for Payer: BCN Commercial |
$816.30
|
| Rate for Payer: Cash Price |
$790.70
|
| Rate for Payer: Cofinity Commercial |
$850.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$790.70
|
| Rate for Payer: Healthscope Commercial |
$889.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.12
|
| Rate for Payer: Nomi Health Commercial |
$810.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.28
|
| Rate for Payer: PHP Commercial |
$840.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$859.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$687.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.77
|
| Rate for Payer: UHC Core |
$825.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.28
|
|
|
HC HEMODIALYSIS NON-URGENT
|
Facility
|
OP
|
$988.38
|
|
| Hospital Charge Code |
88100003
|
|
Hospital Revenue Code
|
881
|
| Min. Negotiated Rate |
$174.25 |
| Max. Negotiated Rate |
$889.54 |
| Rate for Payer: Aetna Commercial |
$840.12
|
| Rate for Payer: Aetna Medicare |
$256.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$308.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$308.87
|
| Rate for Payer: BCBS Complete |
$182.95
|
| Rate for Payer: BCBS MAPPO |
$247.09
|
| Rate for Payer: BCBS Trust/PPO |
$812.55
|
| Rate for Payer: BCN Commercial |
$812.55
|
| Rate for Payer: BCN Medicare Advantage |
$247.09
|
| Rate for Payer: Cash Price |
$790.70
|
| Rate for Payer: Cofinity Commercial |
$850.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$790.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$247.09
|
| Rate for Payer: Healthscope Commercial |
$889.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$741.28
|
| Rate for Payer: Mclaren Medicaid |
$174.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$259.45
|
| Rate for Payer: Meridian Medicaid |
$182.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$284.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$271.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$840.12
|
| Rate for Payer: Nomi Health Commercial |
$810.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$741.28
|
| Rate for Payer: PACE Senior Care Partners |
$234.74
|
| Rate for Payer: PACE SWMI |
$247.09
|
| Rate for Payer: PHP Commercial |
$840.12
|
| Rate for Payer: PHP Medicare Advantage |
$247.09
|
| Rate for Payer: Priority Health Choice Medicaid |
$174.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$859.89
|
| Rate for Payer: Priority Health Medicare |
$249.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$687.91
|
| Rate for Payer: Railroad Medicare Medicare |
$247.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$869.77
|
| Rate for Payer: UHC Core |
$825.30
|
| Rate for Payer: UHC Exchange |
$247.09
|
| Rate for Payer: UHC Medicaid |
$174.25
|
| Rate for Payer: UHC Medicare Advantage |
$247.09
|
| Rate for Payer: UHCCP Medicaid |
$174.25
|
| Rate for Payer: VA VA |
$247.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$741.28
|
|
|
HC HEMOFILTRATION MONITORING HOUR
|
Facility
|
IP
|
$416.84
|
|
| Hospital Charge Code |
27000114
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$290.12 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: BCBS Trust/PPO |
$344.27
|
| Rate for Payer: BCN Commercial |
$344.27
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: Nomi Health Commercial |
$341.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.63
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.82
|
| Rate for Payer: UHC Core |
$348.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC HEMOFILTRATION MONITORING HOUR
|
Facility
|
OP
|
$416.84
|
|
| Hospital Charge Code |
27000114
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$73.49 |
| Max. Negotiated Rate |
$375.16 |
| Rate for Payer: Aetna Commercial |
$354.31
|
| Rate for Payer: Aetna Medicare |
$108.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$130.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$130.26
|
| Rate for Payer: BCBS Complete |
$77.16
|
| Rate for Payer: BCBS MAPPO |
$104.21
|
| Rate for Payer: BCBS Trust/PPO |
$342.68
|
| Rate for Payer: BCN Commercial |
$342.68
|
| Rate for Payer: BCN Medicare Advantage |
$104.21
|
| Rate for Payer: Cash Price |
$333.47
|
| Rate for Payer: Cofinity Commercial |
$358.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$333.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$104.21
|
| Rate for Payer: Healthscope Commercial |
$375.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$312.63
|
| Rate for Payer: Mclaren Medicaid |
$73.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$109.42
|
| Rate for Payer: Meridian Medicaid |
$77.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$119.84
|
| Rate for Payer: Molina Medicare/Medicaid |
$114.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$354.31
|
| Rate for Payer: Nomi Health Commercial |
$341.81
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$312.63
|
| Rate for Payer: PACE Senior Care Partners |
$99.00
|
| Rate for Payer: PACE SWMI |
$104.21
|
| Rate for Payer: PHP Commercial |
$354.31
|
| Rate for Payer: PHP Medicare Advantage |
$104.21
|
| Rate for Payer: Priority Health Choice Medicaid |
$73.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$362.65
|
| Rate for Payer: Priority Health Medicare |
$105.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$290.12
|
| Rate for Payer: Railroad Medicare Medicare |
$104.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$366.82
|
| Rate for Payer: UHC Core |
$348.06
|
| Rate for Payer: UHC Exchange |
$104.21
|
| Rate for Payer: UHC Medicaid |
$73.49
|
| Rate for Payer: UHC Medicare Advantage |
$104.21
|
| Rate for Payer: UHCCP Medicaid |
$73.49
|
| Rate for Payer: VA VA |
$104.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$312.63
|
|
|
HC HEMOGLOBIN
|
Facility
|
OP
|
$32.25
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
30500006
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.69 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: Aetna Medicare |
$8.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.08
|
| Rate for Payer: BCBS Complete |
$5.97
|
| Rate for Payer: BCBS MAPPO |
$8.06
|
| Rate for Payer: BCBS Trust/PPO |
$26.51
|
| Rate for Payer: BCN Commercial |
$26.51
|
| Rate for Payer: BCN Medicare Advantage |
$8.06
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.06
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Mclaren Medicaid |
$5.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.47
|
| Rate for Payer: Meridian Medicaid |
$5.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PACE Senior Care Partners |
$7.66
|
| Rate for Payer: PACE SWMI |
$8.06
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: PHP Medicare Advantage |
$8.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Medicare |
$8.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.45
|
| Rate for Payer: Railroad Medicare Medicare |
$8.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.38
|
| Rate for Payer: UHC Core |
$26.93
|
| Rate for Payer: UHC Exchange |
$8.06
|
| Rate for Payer: UHC Medicaid |
$5.69
|
| Rate for Payer: UHC Medicare Advantage |
$8.06
|
| Rate for Payer: UHCCP Medicaid |
$5.69
|
| Rate for Payer: VA VA |
$8.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC HEMOGLOBIN
|
Facility
|
IP
|
$32.25
|
|
|
Service Code
|
CPT 85018
|
| Hospital Charge Code |
30500006
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.45 |
| Max. Negotiated Rate |
$29.02 |
| Rate for Payer: Aetna Commercial |
$27.41
|
| Rate for Payer: BCBS Trust/PPO |
$26.64
|
| Rate for Payer: BCN Commercial |
$26.64
|
| Rate for Payer: Cash Price |
$25.80
|
| Rate for Payer: Cofinity Commercial |
$27.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.80
|
| Rate for Payer: Healthscope Commercial |
$29.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$24.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.41
|
| Rate for Payer: Nomi Health Commercial |
$26.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$24.19
|
| Rate for Payer: PHP Commercial |
$27.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$28.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.38
|
| Rate for Payer: UHC Core |
$26.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$24.19
|
|
|
HC HEMOGLOBIN A2 AND F
|
Facility
|
OP
|
$28.03
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
30100624
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$25.23 |
| Rate for Payer: Aetna Commercial |
$23.83
|
| Rate for Payer: Aetna Medicare |
$7.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.76
|
| Rate for Payer: BCBS Complete |
$5.19
|
| Rate for Payer: BCBS MAPPO |
$7.01
|
| Rate for Payer: BCBS Trust/PPO |
$23.04
|
| Rate for Payer: BCN Commercial |
$23.04
|
| Rate for Payer: BCN Medicare Advantage |
$7.01
|
| Rate for Payer: Cash Price |
$22.42
|
| Rate for Payer: Cofinity Commercial |
$24.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.01
|
| Rate for Payer: Healthscope Commercial |
$25.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.02
|
| Rate for Payer: Mclaren Medicaid |
$4.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.36
|
| Rate for Payer: Meridian Medicaid |
$5.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.06
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.83
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.02
|
| Rate for Payer: PACE Senior Care Partners |
$6.66
|
| Rate for Payer: PACE SWMI |
$7.01
|
| Rate for Payer: PHP Commercial |
$23.83
|
| Rate for Payer: PHP Medicare Advantage |
$7.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.39
|
| Rate for Payer: Priority Health Medicare |
$7.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.51
|
| Rate for Payer: Railroad Medicare Medicare |
$7.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.67
|
| Rate for Payer: UHC Core |
$23.41
|
| Rate for Payer: UHC Exchange |
$7.01
|
| Rate for Payer: UHC Medicaid |
$4.94
|
| Rate for Payer: UHC Medicare Advantage |
$7.01
|
| Rate for Payer: UHCCP Medicaid |
$4.94
|
| Rate for Payer: VA VA |
$7.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.02
|
|
|
HC HEMOGLOBIN A2 AND F
|
Facility
|
IP
|
$28.03
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
30100624
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.51 |
| Max. Negotiated Rate |
$25.23 |
| Rate for Payer: Aetna Commercial |
$23.83
|
| Rate for Payer: BCBS Trust/PPO |
$23.15
|
| Rate for Payer: BCN Commercial |
$23.15
|
| Rate for Payer: Cash Price |
$22.42
|
| Rate for Payer: Cofinity Commercial |
$24.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$22.42
|
| Rate for Payer: Healthscope Commercial |
$25.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$21.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$23.83
|
| Rate for Payer: Nomi Health Commercial |
$22.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$21.02
|
| Rate for Payer: PHP Commercial |
$23.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$24.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$19.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$24.67
|
| Rate for Payer: UHC Core |
$23.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$21.02
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
IP
|
$99.04
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100235
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.93 |
| Max. Negotiated Rate |
$89.14 |
| Rate for Payer: Aetna Commercial |
$84.18
|
| Rate for Payer: BCBS Trust/PPO |
$81.80
|
| Rate for Payer: BCN Commercial |
$81.80
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cofinity Commercial |
$85.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.18
|
| Rate for Payer: Nomi Health Commercial |
$81.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.28
|
| Rate for Payer: PHP Commercial |
$84.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.16
|
| Rate for Payer: UHC Core |
$82.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.28
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS
|
Facility
|
OP
|
$99.04
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100235
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.46 |
| Max. Negotiated Rate |
$89.14 |
| Rate for Payer: Aetna Commercial |
$84.18
|
| Rate for Payer: Aetna Medicare |
$25.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.95
|
| Rate for Payer: BCBS Complete |
$18.33
|
| Rate for Payer: BCBS MAPPO |
$24.76
|
| Rate for Payer: BCBS Trust/PPO |
$81.42
|
| Rate for Payer: BCN Commercial |
$81.42
|
| Rate for Payer: BCN Medicare Advantage |
$24.76
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cofinity Commercial |
$85.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.76
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.28
|
| Rate for Payer: Mclaren Medicaid |
$17.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.00
|
| Rate for Payer: Meridian Medicaid |
$18.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.18
|
| Rate for Payer: Nomi Health Commercial |
$81.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.28
|
| Rate for Payer: PACE Senior Care Partners |
$23.52
|
| Rate for Payer: PACE SWMI |
$24.76
|
| Rate for Payer: PHP Commercial |
$84.18
|
| Rate for Payer: PHP Medicare Advantage |
$24.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.16
|
| Rate for Payer: Priority Health Medicare |
$25.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.16
|
| Rate for Payer: UHC Core |
$82.70
|
| Rate for Payer: UHC Exchange |
$24.76
|
| Rate for Payer: UHC Medicaid |
$17.46
|
| Rate for Payer: UHC Medicare Advantage |
$24.76
|
| Rate for Payer: UHCCP Medicaid |
$17.46
|
| Rate for Payer: VA VA |
$24.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.28
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS, B
|
Facility
|
OP
|
$39.26
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100623
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.92 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: Aetna Medicare |
$10.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.27
|
| Rate for Payer: BCBS Complete |
$7.27
|
| Rate for Payer: BCBS MAPPO |
$9.81
|
| Rate for Payer: BCBS Trust/PPO |
$32.28
|
| Rate for Payer: BCN Commercial |
$32.28
|
| Rate for Payer: BCN Medicare Advantage |
$9.81
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.81
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Mclaren Medicaid |
$6.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.31
|
| Rate for Payer: Meridian Medicaid |
$7.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PACE Senior Care Partners |
$9.32
|
| Rate for Payer: PACE SWMI |
$9.81
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: PHP Medicare Advantage |
$9.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Medicare |
$9.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: Railroad Medicare Medicare |
$9.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: UHC Exchange |
$9.81
|
| Rate for Payer: UHC Medicaid |
$6.92
|
| Rate for Payer: UHC Medicare Advantage |
$9.81
|
| Rate for Payer: UHCCP Medicaid |
$6.92
|
| Rate for Payer: VA VA |
$9.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS, B
|
Facility
|
IP
|
$39.26
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100623
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.32 |
| Max. Negotiated Rate |
$35.33 |
| Rate for Payer: Aetna Commercial |
$33.37
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: Cash Price |
$31.41
|
| Rate for Payer: Cofinity Commercial |
$33.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.41
|
| Rate for Payer: Healthscope Commercial |
$35.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.37
|
| Rate for Payer: Nomi Health Commercial |
$32.19
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.45
|
| Rate for Payer: PHP Commercial |
$33.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.55
|
| Rate for Payer: UHC Core |
$32.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.45
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS CMP
|
Facility
|
OP
|
$99.04
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.46 |
| Max. Negotiated Rate |
$89.14 |
| Rate for Payer: Aetna Commercial |
$84.18
|
| Rate for Payer: Aetna Medicare |
$25.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.95
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.95
|
| Rate for Payer: BCBS Complete |
$18.33
|
| Rate for Payer: BCBS MAPPO |
$24.76
|
| Rate for Payer: BCBS Trust/PPO |
$81.42
|
| Rate for Payer: BCN Commercial |
$81.42
|
| Rate for Payer: BCN Medicare Advantage |
$24.76
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cofinity Commercial |
$85.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.23
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.76
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.28
|
| Rate for Payer: Mclaren Medicaid |
$17.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.00
|
| Rate for Payer: Meridian Medicaid |
$18.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.18
|
| Rate for Payer: Nomi Health Commercial |
$81.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.28
|
| Rate for Payer: PACE Senior Care Partners |
$23.52
|
| Rate for Payer: PACE SWMI |
$24.76
|
| Rate for Payer: PHP Commercial |
$84.18
|
| Rate for Payer: PHP Medicare Advantage |
$24.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.16
|
| Rate for Payer: Priority Health Medicare |
$25.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.93
|
| Rate for Payer: Railroad Medicare Medicare |
$24.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.16
|
| Rate for Payer: UHC Core |
$82.70
|
| Rate for Payer: UHC Exchange |
$24.76
|
| Rate for Payer: UHC Medicaid |
$17.46
|
| Rate for Payer: UHC Medicare Advantage |
$24.76
|
| Rate for Payer: UHCCP Medicaid |
$17.46
|
| Rate for Payer: VA VA |
$24.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.28
|
|
|
HC HEMOGLOBIN ELECTROPHORESIS CMP
|
Facility
|
IP
|
$99.04
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
30100236
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$68.93 |
| Max. Negotiated Rate |
$89.14 |
| Rate for Payer: Aetna Commercial |
$84.18
|
| Rate for Payer: BCBS Trust/PPO |
$81.80
|
| Rate for Payer: BCN Commercial |
$81.80
|
| Rate for Payer: Cash Price |
$79.23
|
| Rate for Payer: Cofinity Commercial |
$85.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.23
|
| Rate for Payer: Healthscope Commercial |
$89.14
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.18
|
| Rate for Payer: Nomi Health Commercial |
$81.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.28
|
| Rate for Payer: PHP Commercial |
$84.18
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$68.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.16
|
| Rate for Payer: UHC Core |
$82.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.28
|
|
|
HC HEM/ONC CMS COMP
|
Facility
|
OP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500006
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$52.89 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: Aetna Medicare |
$78.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$93.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$93.75
|
| Rate for Payer: BCBS Complete |
$55.53
|
| Rate for Payer: BCBS MAPPO |
$75.00
|
| Rate for Payer: BCBS Trust/PPO |
$246.63
|
| Rate for Payer: BCN Commercial |
$246.63
|
| Rate for Payer: BCN Medicare Advantage |
$75.00
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Mclaren Medicaid |
$52.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$78.75
|
| Rate for Payer: Meridian Medicaid |
$55.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.25
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Nomi Health Commercial |
$246.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PACE Senior Care Partners |
$71.25
|
| Rate for Payer: PACE SWMI |
$75.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: PHP Medicare Advantage |
$75.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$52.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$261.00
|
| Rate for Payer: Priority Health Medicare |
$75.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.80
|
| Rate for Payer: Railroad Medicare Medicare |
$75.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: UHC Exchange |
$75.00
|
| Rate for Payer: UHC Medicaid |
$52.89
|
| Rate for Payer: UHC Medicare Advantage |
$75.00
|
| Rate for Payer: UHCCP Medicaid |
$52.89
|
| Rate for Payer: VA VA |
$75.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
|
HC HEM/ONC CMS COMP
|
Facility
|
IP
|
$300.00
|
|
|
Service Code
|
CPT 99215
|
| Hospital Charge Code |
51500006
|
|
Hospital Revenue Code
|
515
|
| Min. Negotiated Rate |
$208.80 |
| Max. Negotiated Rate |
$270.00 |
| Rate for Payer: Aetna Commercial |
$255.00
|
| Rate for Payer: BCBS Trust/PPO |
$247.77
|
| Rate for Payer: BCN Commercial |
$247.77
|
| Rate for Payer: Cash Price |
$240.00
|
| Rate for Payer: Cofinity Commercial |
$258.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$240.00
|
| Rate for Payer: Healthscope Commercial |
$270.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$225.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$255.00
|
| Rate for Payer: Nomi Health Commercial |
$246.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$225.00
|
| Rate for Payer: PHP Commercial |
$255.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$261.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$208.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$264.00
|
| Rate for Payer: UHC Core |
$250.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$225.00
|
|
