|
HC ICP MONITOR
|
Facility
|
OP
|
$2,036.58
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$359.05 |
| Max. Negotiated Rate |
$1,832.92 |
| Rate for Payer: Aetna Commercial |
$1,731.09
|
| Rate for Payer: Aetna Medicare |
$529.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$636.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$636.43
|
| Rate for Payer: BCBS Complete |
$376.97
|
| Rate for Payer: BCBS MAPPO |
$509.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,674.27
|
| Rate for Payer: BCN Commercial |
$1,674.27
|
| Rate for Payer: BCN Medicare Advantage |
$509.14
|
| Rate for Payer: Cash Price |
$1,629.26
|
| Rate for Payer: Cofinity Commercial |
$1,751.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,629.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$509.14
|
| Rate for Payer: Healthscope Commercial |
$1,832.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,527.43
|
| Rate for Payer: Mclaren Medicaid |
$359.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$534.60
|
| Rate for Payer: Meridian Medicaid |
$376.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$585.52
|
| Rate for Payer: Molina Medicare/Medicaid |
$560.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,731.09
|
| Rate for Payer: Nomi Health Commercial |
$1,670.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.43
|
| Rate for Payer: PACE Senior Care Partners |
$483.69
|
| Rate for Payer: PACE SWMI |
$509.14
|
| Rate for Payer: PHP Commercial |
$1,731.09
|
| Rate for Payer: PHP Medicare Advantage |
$509.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$359.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,771.82
|
| Rate for Payer: Priority Health Medicare |
$514.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,417.46
|
| Rate for Payer: Railroad Medicare Medicare |
$509.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,792.19
|
| Rate for Payer: UHC Core |
$1,700.54
|
| Rate for Payer: UHC Exchange |
$509.14
|
| Rate for Payer: UHC Medicaid |
$359.05
|
| Rate for Payer: UHC Medicare Advantage |
$509.14
|
| Rate for Payer: UHCCP Medicaid |
$359.05
|
| Rate for Payer: VA VA |
$509.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,527.43
|
|
|
HC ICP MONITOR
|
Facility
|
IP
|
$2,036.58
|
|
| Hospital Charge Code |
27800143
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$1,417.46 |
| Max. Negotiated Rate |
$1,832.92 |
| Rate for Payer: Aetna Commercial |
$1,731.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,682.01
|
| Rate for Payer: BCN Commercial |
$1,682.01
|
| Rate for Payer: Cash Price |
$1,629.26
|
| Rate for Payer: Cofinity Commercial |
$1,751.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,629.26
|
| Rate for Payer: Healthscope Commercial |
$1,832.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,527.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,731.09
|
| Rate for Payer: Nomi Health Commercial |
$1,670.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,527.43
|
| Rate for Payer: PHP Commercial |
$1,731.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,771.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,417.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,792.19
|
| Rate for Payer: UHC Core |
$1,700.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,527.43
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
OP
|
$264.24
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$46.59 |
| Max. Negotiated Rate |
$237.82 |
| Rate for Payer: Aetna Commercial |
$224.60
|
| Rate for Payer: Aetna Medicare |
$68.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.58
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.58
|
| Rate for Payer: BCBS Complete |
$48.91
|
| Rate for Payer: BCBS MAPPO |
$66.06
|
| Rate for Payer: BCBS Trust/PPO |
$217.23
|
| Rate for Payer: BCN Commercial |
$217.23
|
| Rate for Payer: BCN Medicare Advantage |
$66.06
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cofinity Commercial |
$227.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.39
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.06
|
| Rate for Payer: Healthscope Commercial |
$237.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.18
|
| Rate for Payer: Mclaren Medicaid |
$46.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.36
|
| Rate for Payer: Meridian Medicaid |
$48.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.97
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.60
|
| Rate for Payer: Nomi Health Commercial |
$216.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.18
|
| Rate for Payer: PACE Senior Care Partners |
$62.76
|
| Rate for Payer: PACE SWMI |
$66.06
|
| Rate for Payer: PHP Commercial |
$224.60
|
| Rate for Payer: PHP Medicare Advantage |
$66.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$229.89
|
| Rate for Payer: Priority Health Medicare |
$66.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.91
|
| Rate for Payer: Railroad Medicare Medicare |
$66.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.53
|
| Rate for Payer: UHC Core |
$220.64
|
| Rate for Payer: UHC Exchange |
$66.06
|
| Rate for Payer: UHC Medicaid |
$46.59
|
| Rate for Payer: UHC Medicare Advantage |
$66.06
|
| Rate for Payer: UHCCP Medicaid |
$46.59
|
| Rate for Payer: VA VA |
$66.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.18
|
|
|
HC I&D BARTHOLIN GLAND ABSCESS
|
Facility
|
IP
|
$264.24
|
|
|
Service Code
|
CPT 56420
|
| Hospital Charge Code |
36100573
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$183.91 |
| Max. Negotiated Rate |
$237.82 |
| Rate for Payer: Aetna Commercial |
$224.60
|
| Rate for Payer: BCBS Trust/PPO |
$218.24
|
| Rate for Payer: BCN Commercial |
$218.24
|
| Rate for Payer: Cash Price |
$211.39
|
| Rate for Payer: Cofinity Commercial |
$227.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.39
|
| Rate for Payer: Healthscope Commercial |
$237.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$224.60
|
| Rate for Payer: Nomi Health Commercial |
$216.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.18
|
| Rate for Payer: PHP Commercial |
$224.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$229.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$183.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$232.53
|
| Rate for Payer: UHC Core |
$220.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.18
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
IP
|
$30.46
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.20 |
| Max. Negotiated Rate |
$27.41 |
| Rate for Payer: Aetna Commercial |
$25.89
|
| Rate for Payer: BCBS Trust/PPO |
$25.16
|
| Rate for Payer: BCN Commercial |
$25.16
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cofinity Commercial |
$26.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.37
|
| Rate for Payer: Healthscope Commercial |
$27.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.89
|
| Rate for Payer: Nomi Health Commercial |
$24.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.84
|
| Rate for Payer: PHP Commercial |
$25.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.80
|
| Rate for Payer: UHC Core |
$25.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.84
|
|
|
HC IDENTIFICATION BY AGGLUTINATION
|
Facility
|
OP
|
$30.46
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
30600091
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.37 |
| Max. Negotiated Rate |
$27.41 |
| Rate for Payer: Aetna Commercial |
$25.89
|
| Rate for Payer: Aetna Medicare |
$7.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.52
|
| Rate for Payer: BCBS Complete |
$5.64
|
| Rate for Payer: BCBS MAPPO |
$7.62
|
| Rate for Payer: BCBS Trust/PPO |
$25.04
|
| Rate for Payer: BCN Commercial |
$25.04
|
| Rate for Payer: BCN Medicare Advantage |
$7.62
|
| Rate for Payer: Cash Price |
$24.37
|
| Rate for Payer: Cofinity Commercial |
$26.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.62
|
| Rate for Payer: Healthscope Commercial |
$27.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.84
|
| Rate for Payer: Mclaren Medicaid |
$5.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.00
|
| Rate for Payer: Meridian Medicaid |
$5.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.76
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.89
|
| Rate for Payer: Nomi Health Commercial |
$24.98
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$22.84
|
| Rate for Payer: PACE Senior Care Partners |
$7.23
|
| Rate for Payer: PACE SWMI |
$7.62
|
| Rate for Payer: PHP Commercial |
$25.89
|
| Rate for Payer: PHP Medicare Advantage |
$7.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.50
|
| Rate for Payer: Priority Health Medicare |
$7.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.20
|
| Rate for Payer: Railroad Medicare Medicare |
$7.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.80
|
| Rate for Payer: UHC Core |
$25.43
|
| Rate for Payer: UHC Exchange |
$7.62
|
| Rate for Payer: UHC Medicaid |
$5.37
|
| Rate for Payer: UHC Medicare Advantage |
$7.62
|
| Rate for Payer: UHCCP Medicaid |
$5.37
|
| Rate for Payer: VA VA |
$7.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.84
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
OP
|
$546.22
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$96.30 |
| Max. Negotiated Rate |
$491.60 |
| Rate for Payer: Aetna Commercial |
$464.29
|
| Rate for Payer: Aetna Medicare |
$142.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$170.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$170.69
|
| Rate for Payer: BCBS Complete |
$101.11
|
| Rate for Payer: BCBS MAPPO |
$136.56
|
| Rate for Payer: BCBS Trust/PPO |
$449.05
|
| Rate for Payer: BCN Commercial |
$449.05
|
| Rate for Payer: BCN Medicare Advantage |
$136.56
|
| Rate for Payer: Cash Price |
$436.98
|
| Rate for Payer: Cofinity Commercial |
$469.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$136.56
|
| Rate for Payer: Healthscope Commercial |
$491.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.67
|
| Rate for Payer: Mclaren Medicaid |
$96.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$143.38
|
| Rate for Payer: Meridian Medicaid |
$101.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$157.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$150.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.29
|
| Rate for Payer: Nomi Health Commercial |
$447.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.67
|
| Rate for Payer: PACE Senior Care Partners |
$129.73
|
| Rate for Payer: PACE SWMI |
$136.56
|
| Rate for Payer: PHP Commercial |
$464.29
|
| Rate for Payer: PHP Medicare Advantage |
$136.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$96.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$475.21
|
| Rate for Payer: Priority Health Medicare |
$137.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$380.17
|
| Rate for Payer: Railroad Medicare Medicare |
$136.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.67
|
| Rate for Payer: UHC Core |
$456.09
|
| Rate for Payer: UHC Exchange |
$136.56
|
| Rate for Payer: UHC Medicaid |
$96.30
|
| Rate for Payer: UHC Medicare Advantage |
$136.56
|
| Rate for Payer: UHCCP Medicaid |
$96.30
|
| Rate for Payer: VA VA |
$136.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.67
|
|
|
HC I&D (OB SURGERY)
|
Facility
|
IP
|
$546.22
|
|
| Hospital Charge Code |
36000054
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$380.17 |
| Max. Negotiated Rate |
$491.60 |
| Rate for Payer: Aetna Commercial |
$464.29
|
| Rate for Payer: BCBS Trust/PPO |
$451.12
|
| Rate for Payer: BCN Commercial |
$451.12
|
| Rate for Payer: Cash Price |
$436.98
|
| Rate for Payer: Cofinity Commercial |
$469.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$436.98
|
| Rate for Payer: Healthscope Commercial |
$491.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$409.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$464.29
|
| Rate for Payer: Nomi Health Commercial |
$447.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$409.67
|
| Rate for Payer: PHP Commercial |
$464.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$475.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$380.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$480.67
|
| Rate for Payer: UHC Core |
$456.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$409.67
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
OP
|
$950.54
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$167.58 |
| Max. Negotiated Rate |
$855.49 |
| Rate for Payer: Aetna Commercial |
$807.96
|
| Rate for Payer: Aetna Medicare |
$247.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$297.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$297.04
|
| Rate for Payer: BCBS Complete |
$175.94
|
| Rate for Payer: BCBS MAPPO |
$237.63
|
| Rate for Payer: BCBS Trust/PPO |
$781.44
|
| Rate for Payer: BCN Commercial |
$781.44
|
| Rate for Payer: BCN Medicare Advantage |
$237.63
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cofinity Commercial |
$817.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$237.63
|
| Rate for Payer: Healthscope Commercial |
$855.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.90
|
| Rate for Payer: Mclaren Medicaid |
$167.58
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$249.52
|
| Rate for Payer: Meridian Medicaid |
$175.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$273.28
|
| Rate for Payer: Molina Medicare/Medicaid |
$261.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.96
|
| Rate for Payer: Nomi Health Commercial |
$779.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.90
|
| Rate for Payer: PACE Senior Care Partners |
$225.75
|
| Rate for Payer: PACE SWMI |
$237.63
|
| Rate for Payer: PHP Commercial |
$807.96
|
| Rate for Payer: PHP Medicare Advantage |
$237.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$167.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$826.97
|
| Rate for Payer: Priority Health Medicare |
$240.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.58
|
| Rate for Payer: Railroad Medicare Medicare |
$237.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.48
|
| Rate for Payer: UHC Core |
$793.70
|
| Rate for Payer: UHC Exchange |
$237.63
|
| Rate for Payer: UHC Medicaid |
$167.58
|
| Rate for Payer: UHC Medicare Advantage |
$237.63
|
| Rate for Payer: UHCCP Medicaid |
$167.58
|
| Rate for Payer: VA VA |
$237.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.90
|
|
|
HC I&D PILONIDAL CYST
|
Facility
|
IP
|
$950.54
|
|
|
Service Code
|
CPT 10080
|
| Hospital Charge Code |
45000097
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$661.58 |
| Max. Negotiated Rate |
$855.49 |
| Rate for Payer: Aetna Commercial |
$807.96
|
| Rate for Payer: BCBS Trust/PPO |
$785.05
|
| Rate for Payer: BCN Commercial |
$785.05
|
| Rate for Payer: Cash Price |
$760.43
|
| Rate for Payer: Cofinity Commercial |
$817.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$760.43
|
| Rate for Payer: Healthscope Commercial |
$855.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$712.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$807.96
|
| Rate for Payer: Nomi Health Commercial |
$779.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$712.90
|
| Rate for Payer: PHP Commercial |
$807.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$826.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$661.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$836.48
|
| Rate for Payer: UHC Core |
$793.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$712.90
|
|
|
HC I&D PROCEDURE
|
Facility
|
IP
|
$499.95
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$347.97 |
| Max. Negotiated Rate |
$449.95 |
| Rate for Payer: Aetna Commercial |
$424.96
|
| Rate for Payer: BCBS Trust/PPO |
$412.91
|
| Rate for Payer: BCN Commercial |
$412.91
|
| Rate for Payer: Cash Price |
$399.96
|
| Rate for Payer: Cofinity Commercial |
$429.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.96
|
| Rate for Payer: Healthscope Commercial |
$449.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.96
|
| Rate for Payer: Nomi Health Commercial |
$409.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.96
|
| Rate for Payer: PHP Commercial |
$424.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$434.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.96
|
| Rate for Payer: UHC Core |
$417.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.96
|
|
|
HC I&D PROCEDURE
|
Facility
|
OP
|
$499.95
|
|
| Hospital Charge Code |
45000045
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$88.14 |
| Max. Negotiated Rate |
$449.95 |
| Rate for Payer: Aetna Commercial |
$424.96
|
| Rate for Payer: Aetna Medicare |
$129.99
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$156.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$156.23
|
| Rate for Payer: BCBS Complete |
$92.54
|
| Rate for Payer: BCBS MAPPO |
$124.99
|
| Rate for Payer: BCBS Trust/PPO |
$411.01
|
| Rate for Payer: BCN Commercial |
$411.01
|
| Rate for Payer: BCN Medicare Advantage |
$124.99
|
| Rate for Payer: Cash Price |
$399.96
|
| Rate for Payer: Cash Price |
$399.96
|
| Rate for Payer: Cofinity Commercial |
$429.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$399.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$124.99
|
| Rate for Payer: Healthscope Commercial |
$449.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$374.96
|
| Rate for Payer: Mclaren Medicaid |
$88.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$131.24
|
| Rate for Payer: Meridian Medicaid |
$92.54
|
| Rate for Payer: MI Amish Medical Board Commercial |
$143.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$137.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$424.96
|
| Rate for Payer: Nomi Health Commercial |
$409.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$374.96
|
| Rate for Payer: PACE Senior Care Partners |
$118.74
|
| Rate for Payer: PACE SWMI |
$124.99
|
| Rate for Payer: PHP Commercial |
$424.96
|
| Rate for Payer: PHP Medicare Advantage |
$124.99
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$434.96
|
| Rate for Payer: Priority Health Medicare |
$126.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$347.97
|
| Rate for Payer: Railroad Medicare Medicare |
$124.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$439.96
|
| Rate for Payer: UHC Core |
$417.46
|
| Rate for Payer: UHC Exchange |
$124.99
|
| Rate for Payer: UHC Medicaid |
$88.14
|
| Rate for Payer: UHC Medicare Advantage |
$124.99
|
| Rate for Payer: UHCCP Medicaid |
$125.00
|
| Rate for Payer: VA VA |
$124.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$374.96
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
IP
|
$866.26
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$602.92 |
| Max. Negotiated Rate |
$779.63 |
| Rate for Payer: Aetna Commercial |
$736.32
|
| Rate for Payer: BCBS Trust/PPO |
$715.44
|
| Rate for Payer: BCN Commercial |
$715.44
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cofinity Commercial |
$744.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.01
|
| Rate for Payer: Healthscope Commercial |
$779.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$649.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.32
|
| Rate for Payer: Nomi Health Commercial |
$710.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$649.70
|
| Rate for Payer: PHP Commercial |
$736.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$753.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$602.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.31
|
| Rate for Payer: UHC Core |
$723.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$649.70
|
|
|
HC I&D VULVA/PERINEAL ABSCESS
|
Facility
|
OP
|
$866.26
|
|
|
Service Code
|
CPT 56405
|
| Hospital Charge Code |
76100319
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$152.72 |
| Max. Negotiated Rate |
$779.63 |
| Rate for Payer: Aetna Commercial |
$736.32
|
| Rate for Payer: Aetna Medicare |
$225.23
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$270.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$270.71
|
| Rate for Payer: BCBS Complete |
$160.34
|
| Rate for Payer: BCBS MAPPO |
$216.56
|
| Rate for Payer: BCBS Trust/PPO |
$712.15
|
| Rate for Payer: BCN Commercial |
$712.15
|
| Rate for Payer: BCN Medicare Advantage |
$216.56
|
| Rate for Payer: Cash Price |
$693.01
|
| Rate for Payer: Cofinity Commercial |
$744.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$693.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$216.56
|
| Rate for Payer: Healthscope Commercial |
$779.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$649.70
|
| Rate for Payer: Mclaren Medicaid |
$152.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$227.39
|
| Rate for Payer: Meridian Medicaid |
$160.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$249.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$238.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$736.32
|
| Rate for Payer: Nomi Health Commercial |
$710.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$649.70
|
| Rate for Payer: PACE Senior Care Partners |
$205.74
|
| Rate for Payer: PACE SWMI |
$216.56
|
| Rate for Payer: PHP Commercial |
$736.32
|
| Rate for Payer: PHP Medicare Advantage |
$216.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$152.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$753.65
|
| Rate for Payer: Priority Health Medicare |
$218.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$602.92
|
| Rate for Payer: Railroad Medicare Medicare |
$216.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$762.31
|
| Rate for Payer: UHC Core |
$723.33
|
| Rate for Payer: UHC Exchange |
$216.56
|
| Rate for Payer: UHC Medicaid |
$152.72
|
| Rate for Payer: UHC Medicare Advantage |
$216.56
|
| Rate for Payer: UHCCP Medicaid |
$152.72
|
| Rate for Payer: VA VA |
$216.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$649.70
|
|
|
HC IFR MEASUREMENT
|
Facility
|
IP
|
$3,956.14
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100132
|
|
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 IFR MEASUREMENT
|
Facility
|
OP
|
$3,956.14
|
|
|
Service Code
|
CPT 93799
|
| Hospital Charge Code |
48100132
|
|
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 IGG SUBCLASS 1-4
|
Facility
|
IP
|
$14.37
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$12.93 |
| Rate for Payer: Aetna Commercial |
$12.21
|
| Rate for Payer: BCBS Trust/PPO |
$11.87
|
| Rate for Payer: BCN Commercial |
$11.87
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cofinity Commercial |
$12.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.50
|
| Rate for Payer: Healthscope Commercial |
$12.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.21
|
| Rate for Payer: Nomi Health Commercial |
$11.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.78
|
| Rate for Payer: PHP Commercial |
$12.21
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.65
|
| Rate for Payer: UHC Core |
$12.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.78
|
|
|
HC IGG SUBCLASS 1-4
|
Facility
|
OP
|
$14.37
|
|
|
Service Code
|
CPT 82787
|
| Hospital Charge Code |
30100214
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$12.93 |
| Rate for Payer: Aetna Commercial |
$12.21
|
| Rate for Payer: Aetna Medicare |
$3.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.49
|
| Rate for Payer: BCBS Complete |
$2.66
|
| Rate for Payer: BCBS MAPPO |
$3.59
|
| Rate for Payer: BCBS Trust/PPO |
$11.81
|
| Rate for Payer: BCN Commercial |
$11.81
|
| Rate for Payer: BCN Medicare Advantage |
$3.59
|
| Rate for Payer: Cash Price |
$11.50
|
| Rate for Payer: Cofinity Commercial |
$12.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.59
|
| Rate for Payer: Healthscope Commercial |
$12.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.78
|
| Rate for Payer: Mclaren Medicaid |
$2.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.77
|
| Rate for Payer: Meridian Medicaid |
$2.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.21
|
| Rate for Payer: Nomi Health Commercial |
$11.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.78
|
| Rate for Payer: PACE Senior Care Partners |
$3.41
|
| Rate for Payer: PACE SWMI |
$3.59
|
| Rate for Payer: PHP Commercial |
$12.21
|
| Rate for Payer: PHP Medicare Advantage |
$3.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12.50
|
| Rate for Payer: Priority Health Medicare |
$3.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$10.00
|
| Rate for Payer: Railroad Medicare Medicare |
$3.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.65
|
| Rate for Payer: UHC Core |
$12.00
|
| Rate for Payer: UHC Exchange |
$3.59
|
| Rate for Payer: UHC Medicaid |
$2.53
|
| Rate for Payer: UHC Medicare Advantage |
$3.59
|
| Rate for Payer: UHCCP Medicaid |
$2.53
|
| Rate for Payer: VA VA |
$3.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.78
|
|
|
HC IGG SYNTHESIS RATE CSF
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100212
|
|
Hospital Revenue Code
|
301
|
| 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 IGG SYNTHESIS RATE CSF
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100212
|
|
Hospital Revenue Code
|
301
|
| 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 IGG SYNTHESIS RATE CSF ALBUMIN
|
Facility
|
IP
|
$16.98
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100074
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.82 |
| Max. Negotiated Rate |
$15.28 |
| Rate for Payer: Aetna Commercial |
$14.43
|
| Rate for Payer: BCBS Trust/PPO |
$14.02
|
| Rate for Payer: BCN Commercial |
$14.02
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Cofinity Commercial |
$14.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.58
|
| Rate for Payer: Healthscope Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.43
|
| Rate for Payer: Nomi Health Commercial |
$13.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.73
|
| Rate for Payer: PHP Commercial |
$14.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.94
|
| Rate for Payer: UHC Core |
$14.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.73
|
|
|
HC IGG SYNTHESIS RATE CSF ALBUMIN
|
Facility
|
OP
|
$16.98
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100074
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.99 |
| Max. Negotiated Rate |
$15.28 |
| Rate for Payer: Aetna Commercial |
$14.43
|
| Rate for Payer: Aetna Medicare |
$4.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.31
|
| Rate for Payer: BCBS Complete |
$3.14
|
| Rate for Payer: BCBS MAPPO |
$4.25
|
| Rate for Payer: BCBS Trust/PPO |
$13.96
|
| Rate for Payer: BCN Commercial |
$13.96
|
| Rate for Payer: BCN Medicare Advantage |
$4.25
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Cofinity Commercial |
$14.60
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$13.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.25
|
| Rate for Payer: Healthscope Commercial |
$15.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$12.73
|
| Rate for Payer: Mclaren Medicaid |
$2.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.46
|
| Rate for Payer: Meridian Medicaid |
$3.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.88
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$14.43
|
| Rate for Payer: Nomi Health Commercial |
$13.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$12.73
|
| Rate for Payer: PACE Senior Care Partners |
$4.03
|
| Rate for Payer: PACE SWMI |
$4.25
|
| Rate for Payer: PHP Commercial |
$14.43
|
| Rate for Payer: PHP Medicare Advantage |
$4.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$14.77
|
| Rate for Payer: Priority Health Medicare |
$4.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$11.82
|
| Rate for Payer: Railroad Medicare Medicare |
$4.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$14.94
|
| Rate for Payer: UHC Core |
$14.18
|
| Rate for Payer: UHC Exchange |
$4.25
|
| Rate for Payer: UHC Medicaid |
$2.99
|
| Rate for Payer: UHC Medicare Advantage |
$4.25
|
| Rate for Payer: UHCCP Medicaid |
$2.99
|
| Rate for Payer: VA VA |
$4.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$12.73
|
|
|
HC IGG SYNTHESIS RATE CSF-IGG
|
Facility
|
IP
|
$21.23
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100210
|
|
Hospital Revenue Code
|
301
|
| 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 IGG SYNTHESIS RATE CSF-IGG
|
Facility
|
OP
|
$21.23
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100210
|
|
Hospital Revenue Code
|
301
|
| 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 IGG SYNTHESIS RATE CSF-PROTEIN
|
Facility
|
OP
|
$10.61
|
|
|
Service Code
|
CPT 82040
|
| Hospital Charge Code |
30100073
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$9.55 |
| Rate for Payer: Aetna Commercial |
$9.02
|
| Rate for Payer: Aetna Medicare |
$2.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.32
|
| Rate for Payer: BCBS Complete |
$1.96
|
| Rate for Payer: BCBS MAPPO |
$2.65
|
| Rate for Payer: BCBS Trust/PPO |
$8.72
|
| Rate for Payer: BCN Commercial |
$8.72
|
| Rate for Payer: BCN Medicare Advantage |
$2.65
|
| Rate for Payer: Cash Price |
$8.49
|
| Rate for Payer: Cofinity Commercial |
$9.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.65
|
| Rate for Payer: Healthscope Commercial |
$9.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7.96
|
| Rate for Payer: Mclaren Medicaid |
$1.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.79
|
| Rate for Payer: Meridian Medicaid |
$1.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.05
|
| Rate for Payer: Molina Medicare/Medicaid |
$2.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.02
|
| Rate for Payer: Nomi Health Commercial |
$8.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7.96
|
| Rate for Payer: PACE Senior Care Partners |
$2.52
|
| Rate for Payer: PACE SWMI |
$2.65
|
| Rate for Payer: PHP Commercial |
$9.02
|
| Rate for Payer: PHP Medicare Advantage |
$2.65
|
| Rate for Payer: Priority Health Choice Medicaid |
$1.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.23
|
| Rate for Payer: Priority Health Medicare |
$2.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.38
|
| Rate for Payer: Railroad Medicare Medicare |
$2.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.34
|
| Rate for Payer: UHC Core |
$8.86
|
| Rate for Payer: UHC Exchange |
$2.65
|
| Rate for Payer: UHC Medicaid |
$1.87
|
| Rate for Payer: UHC Medicare Advantage |
$2.65
|
| Rate for Payer: UHCCP Medicaid |
$1.87
|
| Rate for Payer: VA VA |
$2.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7.96
|
|
