|
HC FILTER ATS LIPIGUARD
|
Facility
|
OP
|
$58.14
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.81 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: Aetna Medicare |
$15.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.17
|
| Rate for Payer: BCBS Complete |
$23.26
|
| Rate for Payer: BCBS MAPPO |
$14.54
|
| Rate for Payer: BCBS Trust/PPO |
$47.80
|
| Rate for Payer: BCN Commercial |
$45.20
|
| Rate for Payer: BCN Medicare Advantage |
$14.54
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.54
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PACE Senior Care Partners |
$13.81
|
| Rate for Payer: PACE SWMI |
$14.54
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: PHP Medicare Advantage |
$14.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Medicare |
$14.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: Railroad Medicare Medicare |
$14.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.54
|
| Rate for Payer: UHC Exchange |
$14.54
|
| Rate for Payer: UHC Medicare Advantage |
$14.54
|
| Rate for Payer: VA VA |
$14.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC FILTER ATS LIPIGUARD
|
Facility
|
IP
|
$58.14
|
|
| Hospital Charge Code |
27000121
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$37.79 |
| Max. Negotiated Rate |
$52.33 |
| Rate for Payer: Aetna Commercial |
$49.42
|
| Rate for Payer: BCBS Trust/PPO |
$47.46
|
| Rate for Payer: BCN Commercial |
$44.93
|
| Rate for Payer: Cash Price |
$46.51
|
| Rate for Payer: Cofinity Commercial |
$50.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.51
|
| Rate for Payer: Healthscope Commercial |
$52.33
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.42
|
| Rate for Payer: Nomi Health Commercial |
$47.67
|
| Rate for Payer: PHP Commercial |
$49.42
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.79
|
| Rate for Payer: Priority Health HMO/PPO |
$50.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.16
|
| Rate for Payer: UHC Core |
$48.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.60
|
|
|
HC FILTERWIRE
|
Facility
|
OP
|
$3,814.45
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$905.93 |
| Max. Negotiated Rate |
$3,433.01 |
| Rate for Payer: Aetna Commercial |
$3,242.28
|
| Rate for Payer: Aetna Medicare |
$991.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,192.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,192.02
|
| Rate for Payer: BCBS Complete |
$1,525.78
|
| Rate for Payer: BCBS MAPPO |
$953.61
|
| Rate for Payer: BCBS Trust/PPO |
$3,135.86
|
| Rate for Payer: BCN Commercial |
$2,965.73
|
| Rate for Payer: BCN Medicare Advantage |
$953.61
|
| Rate for Payer: Cash Price |
$3,051.56
|
| Rate for Payer: Cofinity Commercial |
$3,280.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,051.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$953.61
|
| Rate for Payer: Healthscope Commercial |
$3,433.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,860.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,001.29
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,096.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,242.28
|
| Rate for Payer: Nomi Health Commercial |
$3,127.85
|
| Rate for Payer: PACE Senior Care Partners |
$905.93
|
| Rate for Payer: PACE SWMI |
$953.61
|
| Rate for Payer: PHP Commercial |
$3,242.28
|
| Rate for Payer: PHP Medicare Advantage |
$953.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,479.39
|
| Rate for Payer: Priority Health HMO/PPO |
$3,318.57
|
| Rate for Payer: Priority Health Medicare |
$963.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,555.68
|
| Rate for Payer: Railroad Medicare Medicare |
$953.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,356.72
|
| Rate for Payer: UHC Core |
$3,185.07
|
| Rate for Payer: UHC Dual Complete DSNP |
$953.61
|
| Rate for Payer: UHC Exchange |
$953.61
|
| Rate for Payer: UHC Medicare Advantage |
$953.61
|
| Rate for Payer: VA VA |
$953.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,860.84
|
|
|
HC FILTERWIRE
|
Facility
|
IP
|
$3,814.45
|
|
|
Service Code
|
HCPCS C1884
|
| Hospital Charge Code |
27800011
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$2,479.39 |
| Max. Negotiated Rate |
$3,433.01 |
| Rate for Payer: Aetna Commercial |
$3,242.28
|
| Rate for Payer: BCBS Trust/PPO |
$3,113.74
|
| Rate for Payer: BCN Commercial |
$2,947.81
|
| Rate for Payer: Cash Price |
$3,051.56
|
| Rate for Payer: Cofinity Commercial |
$3,280.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,051.56
|
| Rate for Payer: Healthscope Commercial |
$3,433.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,860.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,242.28
|
| Rate for Payer: Nomi Health Commercial |
$3,127.85
|
| Rate for Payer: PHP Commercial |
$3,242.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,479.39
|
| Rate for Payer: Priority Health HMO/PPO |
$3,318.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,555.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,356.72
|
| Rate for Payer: UHC Core |
$3,185.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,860.84
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
IP
|
$20.81
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$13.53 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: BCBS Trust/PPO |
$16.99
|
| Rate for Payer: BCN Commercial |
$16.08
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC FINGER SPLINT, STATIC, SUPPLY
|
Facility
|
OP
|
$20.81
|
|
| Hospital Charge Code |
27000646
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$4.94 |
| Max. Negotiated Rate |
$18.73 |
| Rate for Payer: Aetna Commercial |
$17.69
|
| Rate for Payer: Aetna Medicare |
$5.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.50
|
| Rate for Payer: BCBS Complete |
$8.32
|
| Rate for Payer: BCBS MAPPO |
$5.20
|
| Rate for Payer: BCBS Trust/PPO |
$17.11
|
| Rate for Payer: BCN Commercial |
$16.18
|
| Rate for Payer: BCN Medicare Advantage |
$5.20
|
| Rate for Payer: Cash Price |
$16.65
|
| Rate for Payer: Cofinity Commercial |
$17.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.20
|
| Rate for Payer: Healthscope Commercial |
$18.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.69
|
| Rate for Payer: Nomi Health Commercial |
$17.06
|
| Rate for Payer: PACE Senior Care Partners |
$4.94
|
| Rate for Payer: PACE SWMI |
$5.20
|
| Rate for Payer: PHP Commercial |
$17.69
|
| Rate for Payer: PHP Medicare Advantage |
$5.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$13.53
|
| Rate for Payer: Priority Health HMO/PPO |
$18.10
|
| Rate for Payer: Priority Health Medicare |
$5.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.94
|
| Rate for Payer: Railroad Medicare Medicare |
$5.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.31
|
| Rate for Payer: UHC Core |
$17.38
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.20
|
| Rate for Payer: UHC Exchange |
$5.20
|
| Rate for Payer: UHC Medicare Advantage |
$5.20
|
| Rate for Payer: VA VA |
$5.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.61
|
|
|
HC FISH PRENATAL ANEUPLOIDY
|
Facility
|
IP
|
$168.54
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$109.55 |
| Max. Negotiated Rate |
$151.69 |
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: BCBS Trust/PPO |
$137.58
|
| Rate for Payer: BCN Commercial |
$130.25
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Nomi Health Commercial |
$138.20
|
| Rate for Payer: PHP Commercial |
$143.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.55
|
| Rate for Payer: Priority Health HMO/PPO |
$146.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.32
|
| Rate for Payer: UHC Core |
$140.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.41
|
|
|
HC FISH PRENATAL ANEUPLOIDY
|
Facility
|
OP
|
$168.54
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000034
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.01 |
| Max. Negotiated Rate |
$151.69 |
| Rate for Payer: Aetna Commercial |
$143.26
|
| Rate for Payer: Aetna Medicare |
$43.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.67
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$42.13
|
| Rate for Payer: BCBS Trust/PPO |
$138.56
|
| Rate for Payer: BCN Commercial |
$131.04
|
| Rate for Payer: BCN Medicare Advantage |
$42.13
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cash Price |
$134.83
|
| Rate for Payer: Cofinity Commercial |
$144.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.13
|
| Rate for Payer: Healthscope Commercial |
$151.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.41
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.24
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.26
|
| Rate for Payer: Nomi Health Commercial |
$138.20
|
| Rate for Payer: PACE Senior Care Partners |
$40.03
|
| Rate for Payer: PACE SWMI |
$42.13
|
| Rate for Payer: PHP Commercial |
$143.26
|
| Rate for Payer: PHP Medicare Advantage |
$42.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.55
|
| Rate for Payer: Priority Health HMO/PPO |
$146.63
|
| Rate for Payer: Priority Health Medicare |
$42.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.92
|
| Rate for Payer: Railroad Medicare Medicare |
$42.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.32
|
| Rate for Payer: UHC Core |
$140.73
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.13
|
| Rate for Payer: UHC Exchange |
$42.13
|
| Rate for Payer: UHC Medicare Advantage |
$42.13
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$42.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.41
|
|
|
HC FISH PROBES
|
Facility
|
IP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000067
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$50.62 |
| Max. Negotiated Rate |
$70.08 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: BCBS Trust/PPO |
$63.57
|
| Rate for Payer: BCN Commercial |
$60.18
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Healthscope Commercial |
$70.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: PHP Commercial |
$66.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health HMO/PPO |
$67.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.53
|
| Rate for Payer: UHC Core |
$65.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.40
|
|
|
HC FISH PROBES
|
Facility
|
OP
|
$77.87
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000067
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.49 |
| Max. Negotiated Rate |
$70.08 |
| Rate for Payer: Aetna Commercial |
$66.19
|
| Rate for Payer: Aetna Medicare |
$20.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.33
|
| Rate for Payer: BCBS Complete |
$38.86
|
| Rate for Payer: BCBS MAPPO |
$19.47
|
| Rate for Payer: BCBS Trust/PPO |
$64.02
|
| Rate for Payer: BCN Commercial |
$60.54
|
| Rate for Payer: BCN Medicare Advantage |
$19.47
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cash Price |
$62.30
|
| Rate for Payer: Cofinity Commercial |
$66.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.47
|
| Rate for Payer: Healthscope Commercial |
$70.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.40
|
| Rate for Payer: Mclaren Medicaid |
$37.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.44
|
| Rate for Payer: Meridian Medicaid |
$38.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.19
|
| Rate for Payer: Nomi Health Commercial |
$63.85
|
| Rate for Payer: PACE Senior Care Partners |
$18.49
|
| Rate for Payer: PACE SWMI |
$19.47
|
| Rate for Payer: PHP Commercial |
$66.19
|
| Rate for Payer: PHP Medicare Advantage |
$19.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.62
|
| Rate for Payer: Priority Health HMO/PPO |
$67.75
|
| Rate for Payer: Priority Health Medicare |
$19.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.17
|
| Rate for Payer: Railroad Medicare Medicare |
$19.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.53
|
| Rate for Payer: UHC Core |
$65.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.47
|
| Rate for Payer: UHC Exchange |
$19.47
|
| Rate for Payer: UHC Medicare Advantage |
$19.47
|
| Rate for Payer: UHCCP Medicaid |
$37.01
|
| Rate for Payer: VA VA |
$19.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.40
|
|
|
HC FISTULA SHUNTOGRAM
|
Facility
|
OP
|
$2,254.14
|
|
| Hospital Charge Code |
32000264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$535.36 |
| Max. Negotiated Rate |
$2,028.73 |
| Rate for Payer: Aetna Commercial |
$1,916.02
|
| Rate for Payer: Aetna Medicare |
$586.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$704.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$704.42
|
| Rate for Payer: BCBS Complete |
$901.66
|
| Rate for Payer: BCBS MAPPO |
$563.53
|
| Rate for Payer: BCBS Trust/PPO |
$1,853.13
|
| Rate for Payer: BCN Commercial |
$1,752.59
|
| Rate for Payer: BCN Medicare Advantage |
$563.53
|
| Rate for Payer: Cash Price |
$1,803.31
|
| Rate for Payer: Cofinity Commercial |
$1,938.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,803.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$563.53
|
| Rate for Payer: Healthscope Commercial |
$2,028.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,690.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$591.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$648.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,916.02
|
| Rate for Payer: Nomi Health Commercial |
$1,848.39
|
| Rate for Payer: PACE Senior Care Partners |
$535.36
|
| Rate for Payer: PACE SWMI |
$563.53
|
| Rate for Payer: PHP Commercial |
$1,916.02
|
| Rate for Payer: PHP Medicare Advantage |
$563.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,961.10
|
| Rate for Payer: Priority Health Medicare |
$569.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,510.27
|
| Rate for Payer: Railroad Medicare Medicare |
$563.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,983.64
|
| Rate for Payer: UHC Core |
$1,882.21
|
| Rate for Payer: UHC Dual Complete DSNP |
$563.53
|
| Rate for Payer: UHC Exchange |
$563.53
|
| Rate for Payer: UHC Medicare Advantage |
$563.53
|
| Rate for Payer: VA VA |
$563.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,690.61
|
|
|
HC FISTULA SHUNTOGRAM
|
Facility
|
IP
|
$2,254.14
|
|
| Hospital Charge Code |
32000264
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,465.19 |
| Max. Negotiated Rate |
$2,028.73 |
| Rate for Payer: Aetna Commercial |
$1,916.02
|
| Rate for Payer: BCBS Trust/PPO |
$1,840.05
|
| Rate for Payer: BCN Commercial |
$1,742.00
|
| Rate for Payer: Cash Price |
$1,803.31
|
| Rate for Payer: Cofinity Commercial |
$1,938.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,803.31
|
| Rate for Payer: Healthscope Commercial |
$2,028.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,690.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,916.02
|
| Rate for Payer: Nomi Health Commercial |
$1,848.39
|
| Rate for Payer: PHP Commercial |
$1,916.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,465.19
|
| Rate for Payer: Priority Health HMO/PPO |
$1,961.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,510.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,983.64
|
| Rate for Payer: UHC Core |
$1,882.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,690.61
|
|
|
HC FIT INSERT INTRAVAG SUPPORT DEVICE
|
Facility
|
IP
|
$258.96
|
|
|
Service Code
|
CPT 57150
|
| Hospital Charge Code |
76100203
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$168.32 |
| Max. Negotiated Rate |
$233.06 |
| Rate for Payer: Aetna Commercial |
$220.12
|
| Rate for Payer: BCBS Trust/PPO |
$211.39
|
| Rate for Payer: BCN Commercial |
$200.12
|
| Rate for Payer: Cash Price |
$207.17
|
| Rate for Payer: Cofinity Commercial |
$222.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.17
|
| Rate for Payer: Healthscope Commercial |
$233.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.12
|
| Rate for Payer: Nomi Health Commercial |
$212.35
|
| Rate for Payer: PHP Commercial |
$220.12
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.32
|
| Rate for Payer: Priority Health HMO/PPO |
$225.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.88
|
| Rate for Payer: UHC Core |
$216.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.22
|
|
|
HC FIT INSERT INTRAVAG SUPPORT DEVICE
|
Facility
|
OP
|
$258.96
|
|
|
Service Code
|
CPT 57150
|
| Hospital Charge Code |
76100203
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$42.95 |
| Max. Negotiated Rate |
$233.06 |
| Rate for Payer: Aetna Commercial |
$220.12
|
| Rate for Payer: Aetna Medicare |
$67.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$80.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$80.92
|
| Rate for Payer: BCBS Complete |
$45.10
|
| Rate for Payer: BCBS MAPPO |
$64.74
|
| Rate for Payer: BCBS Trust/PPO |
$212.89
|
| Rate for Payer: BCN Commercial |
$201.34
|
| Rate for Payer: BCN Medicare Advantage |
$64.74
|
| Rate for Payer: Cash Price |
$207.17
|
| Rate for Payer: Cash Price |
$207.17
|
| Rate for Payer: Cofinity Commercial |
$222.71
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$207.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$64.74
|
| Rate for Payer: Healthscope Commercial |
$233.06
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$194.22
|
| Rate for Payer: Mclaren Medicaid |
$42.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$67.98
|
| Rate for Payer: Meridian Medicaid |
$45.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$74.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$220.12
|
| Rate for Payer: Nomi Health Commercial |
$212.35
|
| Rate for Payer: PACE Senior Care Partners |
$61.50
|
| Rate for Payer: PACE SWMI |
$64.74
|
| Rate for Payer: PHP Commercial |
$220.12
|
| Rate for Payer: PHP Medicare Advantage |
$64.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$42.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$168.32
|
| Rate for Payer: Priority Health HMO/PPO |
$225.30
|
| Rate for Payer: Priority Health Medicare |
$65.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$173.50
|
| Rate for Payer: Railroad Medicare Medicare |
$64.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$227.88
|
| Rate for Payer: UHC Core |
$216.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$64.74
|
| Rate for Payer: UHC Exchange |
$64.74
|
| Rate for Payer: UHC Medicare Advantage |
$64.74
|
| Rate for Payer: UHCCP Medicaid |
$42.95
|
| Rate for Payer: VA VA |
$64.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$194.22
|
|
|
HC FIT & INSERT PESSARY/OTHER DEVICE
|
Facility
|
OP
|
$524.95
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
76100357
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$124.68 |
| Max. Negotiated Rate |
$472.45 |
| Rate for Payer: Aetna Commercial |
$446.21
|
| Rate for Payer: Aetna Medicare |
$136.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$164.05
|
| Rate for Payer: Amish Plain Church Group Commercial |
$164.05
|
| Rate for Payer: BCBS Complete |
$152.73
|
| Rate for Payer: BCBS MAPPO |
$131.24
|
| Rate for Payer: BCBS Trust/PPO |
$431.56
|
| Rate for Payer: BCN Commercial |
$408.15
|
| Rate for Payer: BCN Medicare Advantage |
$131.24
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cofinity Commercial |
$451.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$131.24
|
| Rate for Payer: Healthscope Commercial |
$472.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.71
|
| Rate for Payer: Mclaren Medicaid |
$145.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$137.80
|
| Rate for Payer: Meridian Medicaid |
$152.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$150.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.21
|
| Rate for Payer: Nomi Health Commercial |
$430.46
|
| Rate for Payer: PACE Senior Care Partners |
$124.68
|
| Rate for Payer: PACE SWMI |
$131.24
|
| Rate for Payer: PHP Commercial |
$446.21
|
| Rate for Payer: PHP Medicare Advantage |
$131.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.22
|
| Rate for Payer: Priority Health HMO/PPO |
$456.71
|
| Rate for Payer: Priority Health Medicare |
$132.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.72
|
| Rate for Payer: Railroad Medicare Medicare |
$131.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.96
|
| Rate for Payer: UHC Core |
$438.33
|
| Rate for Payer: UHC Dual Complete DSNP |
$131.24
|
| Rate for Payer: UHC Exchange |
$131.24
|
| Rate for Payer: UHC Medicare Advantage |
$131.24
|
| Rate for Payer: UHCCP Medicaid |
$145.45
|
| Rate for Payer: VA VA |
$131.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.71
|
|
|
HC FIT & INSERT PESSARY/OTHER DEVICE
|
Facility
|
IP
|
$524.95
|
|
|
Service Code
|
CPT 57160
|
| Hospital Charge Code |
76100357
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$341.22 |
| Max. Negotiated Rate |
$472.45 |
| Rate for Payer: Aetna Commercial |
$446.21
|
| Rate for Payer: BCBS Trust/PPO |
$428.52
|
| Rate for Payer: BCN Commercial |
$405.68
|
| Rate for Payer: Cash Price |
$419.96
|
| Rate for Payer: Cofinity Commercial |
$451.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$419.96
|
| Rate for Payer: Healthscope Commercial |
$472.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$393.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$446.21
|
| Rate for Payer: Nomi Health Commercial |
$430.46
|
| Rate for Payer: PHP Commercial |
$446.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$341.22
|
| Rate for Payer: Priority Health HMO/PPO |
$456.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$351.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$461.96
|
| Rate for Payer: UHC Core |
$438.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$393.71
|
|
|
HC FLEXIBLE SIGMOIDOSCOPY
|
Facility
|
OP
|
$1,777.90
|
|
| Hospital Charge Code |
36000044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$422.25 |
| Max. Negotiated Rate |
$1,600.11 |
| Rate for Payer: Aetna Commercial |
$1,511.21
|
| Rate for Payer: Aetna Medicare |
$462.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$555.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$555.59
|
| Rate for Payer: BCBS Complete |
$711.16
|
| Rate for Payer: BCBS MAPPO |
$444.48
|
| Rate for Payer: BCBS Trust/PPO |
$1,461.61
|
| Rate for Payer: BCN Commercial |
$1,382.32
|
| Rate for Payer: BCN Medicare Advantage |
$444.48
|
| Rate for Payer: Cash Price |
$1,422.32
|
| Rate for Payer: Cofinity Commercial |
$1,528.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,422.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$444.48
|
| Rate for Payer: Healthscope Commercial |
$1,600.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,333.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$466.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$511.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,511.21
|
| Rate for Payer: Nomi Health Commercial |
$1,457.88
|
| Rate for Payer: PACE Senior Care Partners |
$422.25
|
| Rate for Payer: PACE SWMI |
$444.48
|
| Rate for Payer: PHP Commercial |
$1,511.21
|
| Rate for Payer: PHP Medicare Advantage |
$444.48
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,546.77
|
| Rate for Payer: Priority Health Medicare |
$448.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,191.19
|
| Rate for Payer: Railroad Medicare Medicare |
$444.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.55
|
| Rate for Payer: UHC Core |
$1,484.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$444.48
|
| Rate for Payer: UHC Exchange |
$444.48
|
| Rate for Payer: UHC Medicare Advantage |
$444.48
|
| Rate for Payer: VA VA |
$444.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,333.42
|
|
|
HC FLEXIBLE SIGMOIDOSCOPY
|
Facility
|
IP
|
$1,777.90
|
|
| Hospital Charge Code |
36000044
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,155.63 |
| Max. Negotiated Rate |
$1,600.11 |
| Rate for Payer: Aetna Commercial |
$1,511.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,451.30
|
| Rate for Payer: BCN Commercial |
$1,373.96
|
| Rate for Payer: Cash Price |
$1,422.32
|
| Rate for Payer: Cofinity Commercial |
$1,528.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,422.32
|
| Rate for Payer: Healthscope Commercial |
$1,600.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,333.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,511.21
|
| Rate for Payer: Nomi Health Commercial |
$1,457.88
|
| Rate for Payer: PHP Commercial |
$1,511.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,155.63
|
| Rate for Payer: Priority Health HMO/PPO |
$1,546.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,191.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,564.55
|
| Rate for Payer: UHC Core |
$1,484.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,333.42
|
|
|
HC FLEX SHEATH INTRO
|
Facility
|
OP
|
$254.93
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200041
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$60.55 |
| Max. Negotiated Rate |
$229.44 |
| Rate for Payer: Aetna Commercial |
$216.69
|
| Rate for Payer: Aetna Medicare |
$66.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$79.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$79.67
|
| Rate for Payer: BCBS Complete |
$101.97
|
| Rate for Payer: BCBS MAPPO |
$63.73
|
| Rate for Payer: BCBS Trust/PPO |
$209.58
|
| Rate for Payer: BCN Commercial |
$198.21
|
| Rate for Payer: BCN Medicare Advantage |
$63.73
|
| Rate for Payer: Cash Price |
$203.94
|
| Rate for Payer: Cofinity Commercial |
$219.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$63.73
|
| Rate for Payer: Healthscope Commercial |
$229.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$66.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$73.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.69
|
| Rate for Payer: Nomi Health Commercial |
$209.04
|
| Rate for Payer: PACE Senior Care Partners |
$60.55
|
| Rate for Payer: PACE SWMI |
$63.73
|
| Rate for Payer: PHP Commercial |
$216.69
|
| Rate for Payer: PHP Medicare Advantage |
$63.73
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.70
|
| Rate for Payer: Priority Health HMO/PPO |
$221.79
|
| Rate for Payer: Priority Health Medicare |
$64.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.80
|
| Rate for Payer: Railroad Medicare Medicare |
$63.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.34
|
| Rate for Payer: UHC Core |
$212.87
|
| Rate for Payer: UHC Dual Complete DSNP |
$63.73
|
| Rate for Payer: UHC Exchange |
$63.73
|
| Rate for Payer: UHC Medicare Advantage |
$63.73
|
| Rate for Payer: VA VA |
$63.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.20
|
|
|
HC FLEX SHEATH INTRO
|
Facility
|
IP
|
$254.93
|
|
|
Service Code
|
HCPCS C1894
|
| Hospital Charge Code |
27200041
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$165.70 |
| Max. Negotiated Rate |
$229.44 |
| Rate for Payer: Aetna Commercial |
$216.69
|
| Rate for Payer: BCBS Trust/PPO |
$208.10
|
| Rate for Payer: BCN Commercial |
$197.01
|
| Rate for Payer: Cash Price |
$203.94
|
| Rate for Payer: Cofinity Commercial |
$219.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$203.94
|
| Rate for Payer: Healthscope Commercial |
$229.44
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$191.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$216.69
|
| Rate for Payer: Nomi Health Commercial |
$209.04
|
| Rate for Payer: PHP Commercial |
$216.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$165.70
|
| Rate for Payer: Priority Health HMO/PPO |
$221.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$170.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$224.34
|
| Rate for Payer: UHC Core |
$212.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$191.20
|
|
|
HC FLOSEAL HEMOSTATIC MATRIX
|
Facility
|
OP
|
$745.52
|
|
| Hospital Charge Code |
27200123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$177.06 |
| Max. Negotiated Rate |
$670.97 |
| Rate for Payer: Aetna Commercial |
$633.69
|
| Rate for Payer: Aetna Medicare |
$193.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$232.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$232.97
|
| Rate for Payer: BCBS Complete |
$298.21
|
| Rate for Payer: BCBS MAPPO |
$186.38
|
| Rate for Payer: BCBS Trust/PPO |
$612.89
|
| Rate for Payer: BCN Commercial |
$579.64
|
| Rate for Payer: BCN Medicare Advantage |
$186.38
|
| Rate for Payer: Cash Price |
$596.42
|
| Rate for Payer: Cofinity Commercial |
$641.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.42
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$186.38
|
| Rate for Payer: Healthscope Commercial |
$670.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$195.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$214.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.69
|
| Rate for Payer: Nomi Health Commercial |
$611.33
|
| Rate for Payer: PACE Senior Care Partners |
$177.06
|
| Rate for Payer: PACE SWMI |
$186.38
|
| Rate for Payer: PHP Commercial |
$633.69
|
| Rate for Payer: PHP Medicare Advantage |
$186.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.59
|
| Rate for Payer: Priority Health HMO/PPO |
$648.60
|
| Rate for Payer: Priority Health Medicare |
$188.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$499.50
|
| Rate for Payer: Railroad Medicare Medicare |
$186.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.06
|
| Rate for Payer: UHC Core |
$622.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$186.38
|
| Rate for Payer: UHC Exchange |
$186.38
|
| Rate for Payer: UHC Medicare Advantage |
$186.38
|
| Rate for Payer: VA VA |
$186.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.14
|
|
|
HC FLOSEAL HEMOSTATIC MATRIX
|
Facility
|
IP
|
$745.52
|
|
| Hospital Charge Code |
27200123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$484.59 |
| Max. Negotiated Rate |
$670.97 |
| Rate for Payer: Aetna Commercial |
$633.69
|
| Rate for Payer: BCBS Trust/PPO |
$608.57
|
| Rate for Payer: BCN Commercial |
$576.14
|
| Rate for Payer: Cash Price |
$596.42
|
| Rate for Payer: Cofinity Commercial |
$641.15
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$596.42
|
| Rate for Payer: Healthscope Commercial |
$670.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$559.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$633.69
|
| Rate for Payer: Nomi Health Commercial |
$611.33
|
| Rate for Payer: PHP Commercial |
$633.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$484.59
|
| Rate for Payer: Priority Health HMO/PPO |
$648.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$499.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$656.06
|
| Rate for Payer: UHC Core |
$622.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$559.14
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, ADDL
|
Facility
|
OP
|
$61.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100041
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: Aetna Medicare |
$16.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.33
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.33
|
| Rate for Payer: BCBS Complete |
$24.74
|
| Rate for Payer: BCBS MAPPO |
$15.46
|
| Rate for Payer: BCBS Trust/PPO |
$50.85
|
| Rate for Payer: BCN Commercial |
$48.09
|
| Rate for Payer: BCN Medicare Advantage |
$15.46
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.46
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.24
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.57
|
| Rate for Payer: Nomi Health Commercial |
$50.72
|
| Rate for Payer: PACE Senior Care Partners |
$14.69
|
| Rate for Payer: PACE SWMI |
$15.46
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: PHP Medicare Advantage |
$15.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.20
|
| Rate for Payer: Priority Health HMO/PPO |
$53.81
|
| Rate for Payer: Priority Health Medicare |
$15.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.44
|
| Rate for Payer: Railroad Medicare Medicare |
$15.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.43
|
| Rate for Payer: UHC Core |
$51.64
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.46
|
| Rate for Payer: UHC Exchange |
$15.46
|
| Rate for Payer: UHC Medicare Advantage |
$15.46
|
| Rate for Payer: VA VA |
$15.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, ADDL
|
Facility
|
IP
|
$61.85
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100041
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$40.20 |
| Max. Negotiated Rate |
$55.66 |
| Rate for Payer: Aetna Commercial |
$52.57
|
| Rate for Payer: BCBS Trust/PPO |
$50.49
|
| Rate for Payer: BCN Commercial |
$47.80
|
| Rate for Payer: Cash Price |
$49.48
|
| Rate for Payer: Cofinity Commercial |
$53.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.48
|
| Rate for Payer: Healthscope Commercial |
$55.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.57
|
| Rate for Payer: Nomi Health Commercial |
$50.72
|
| Rate for Payer: PHP Commercial |
$52.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$40.20
|
| Rate for Payer: Priority Health HMO/PPO |
$53.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$41.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.43
|
| Rate for Payer: UHC Core |
$51.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.39
|
|
|
HC FLOW CYTOMETRY, CELL SURFACE, FIRST
|
Facility
|
OP
|
$203.86
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100040
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$48.42 |
| Max. Negotiated Rate |
$273.10 |
| Rate for Payer: Aetna Commercial |
$173.28
|
| Rate for Payer: Aetna Medicare |
$53.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.71
|
| Rate for Payer: BCBS Complete |
$273.10
|
| Rate for Payer: BCBS MAPPO |
$50.97
|
| Rate for Payer: BCBS Trust/PPO |
$167.59
|
| Rate for Payer: BCN Commercial |
$158.50
|
| Rate for Payer: BCN Medicare Advantage |
$50.97
|
| Rate for Payer: Cash Price |
$163.09
|
| Rate for Payer: Cash Price |
$163.09
|
| Rate for Payer: Cofinity Commercial |
$175.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.09
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$50.97
|
| Rate for Payer: Healthscope Commercial |
$183.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$152.90
|
| Rate for Payer: Mclaren Medicaid |
$260.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.51
|
| Rate for Payer: Meridian Medicaid |
$273.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.28
|
| Rate for Payer: Nomi Health Commercial |
$167.17
|
| Rate for Payer: PACE Senior Care Partners |
$48.42
|
| Rate for Payer: PACE SWMI |
$50.97
|
| Rate for Payer: PHP Commercial |
$173.28
|
| Rate for Payer: PHP Medicare Advantage |
$50.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.51
|
| Rate for Payer: Priority Health HMO/PPO |
$177.36
|
| Rate for Payer: Priority Health Medicare |
$51.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.59
|
| Rate for Payer: Railroad Medicare Medicare |
$50.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.40
|
| Rate for Payer: UHC Core |
$170.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$50.97
|
| Rate for Payer: UHC Exchange |
$50.97
|
| Rate for Payer: UHC Medicare Advantage |
$50.97
|
| Rate for Payer: UHCCP Medicaid |
$260.08
|
| Rate for Payer: VA VA |
$50.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$152.90
|
|
