|
HC IMMUNOFIXATION ELEC URINE/CSF
|
Facility
|
OP
|
$172.50
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
30200196
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$30.41 |
| Max. Negotiated Rate |
$155.25 |
| Rate for Payer: Aetna Commercial |
$146.62
|
| Rate for Payer: Aetna Medicare |
$44.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.91
|
| Rate for Payer: BCBS Complete |
$31.93
|
| Rate for Payer: BCBS MAPPO |
$43.12
|
| Rate for Payer: BCBS Trust/PPO |
$141.81
|
| Rate for Payer: BCN Commercial |
$141.81
|
| Rate for Payer: BCN Medicare Advantage |
$43.12
|
| Rate for Payer: Cash Price |
$138.00
|
| Rate for Payer: Cofinity Commercial |
$148.35
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$138.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$43.12
|
| Rate for Payer: Healthscope Commercial |
$155.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$129.38
|
| Rate for Payer: Mclaren Medicaid |
$30.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$45.28
|
| Rate for Payer: Meridian Medicaid |
$31.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.59
|
| Rate for Payer: Molina Medicare/Medicaid |
$47.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$146.62
|
| Rate for Payer: Nomi Health Commercial |
$141.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$129.38
|
| Rate for Payer: PACE Senior Care Partners |
$40.97
|
| Rate for Payer: PACE SWMI |
$43.12
|
| Rate for Payer: PHP Commercial |
$146.62
|
| Rate for Payer: PHP Medicare Advantage |
$43.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$30.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$150.07
|
| Rate for Payer: Priority Health Medicare |
$43.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$120.06
|
| Rate for Payer: Railroad Medicare Medicare |
$43.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$151.80
|
| Rate for Payer: UHC Core |
$144.04
|
| Rate for Payer: UHC Exchange |
$43.12
|
| Rate for Payer: UHC Medicaid |
$30.41
|
| Rate for Payer: UHC Medicare Advantage |
$43.12
|
| Rate for Payer: UHCCP Medicaid |
$30.41
|
| Rate for Payer: VA VA |
$43.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$129.38
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: BCBS Trust/PPO |
$64.79
|
| Rate for Payer: BCN Commercial |
$64.79
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$20.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.52
|
| Rate for Payer: BCBS Complete |
$14.52
|
| Rate for Payer: BCBS MAPPO |
$19.61
|
| Rate for Payer: BCBS Trust/PPO |
$64.49
|
| Rate for Payer: BCN Commercial |
$64.49
|
| Rate for Payer: BCN Medicare Advantage |
$19.61
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Mclaren Medicaid |
$13.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.59
|
| Rate for Payer: Meridian Medicaid |
$14.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Senior Care Partners |
$18.63
|
| Rate for Payer: PACE SWMI |
$19.61
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$19.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$19.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.60
|
| Rate for Payer: Railroad Medicare Medicare |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: UHC Exchange |
$19.61
|
| Rate for Payer: UHC Medicaid |
$13.83
|
| Rate for Payer: UHC Medicare Advantage |
$19.61
|
| Rate for Payer: UHCCP Medicaid |
$13.83
|
| Rate for Payer: VA VA |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
IP
|
$40.58
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.24 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: BCBS Trust/PPO |
$33.52
|
| Rate for Payer: BCN Commercial |
$33.52
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.43
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.71
|
| Rate for Payer: UHC Core |
$33.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.43
|
|
|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
OP
|
$40.58
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.15 |
| Max. Negotiated Rate |
$36.52 |
| Rate for Payer: Aetna Commercial |
$34.49
|
| Rate for Payer: Aetna Medicare |
$10.55
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.68
|
| Rate for Payer: BCBS Complete |
$7.51
|
| Rate for Payer: BCBS MAPPO |
$10.14
|
| Rate for Payer: BCBS Trust/PPO |
$33.36
|
| Rate for Payer: BCN Commercial |
$33.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.14
|
| Rate for Payer: Cash Price |
$32.46
|
| Rate for Payer: Cofinity Commercial |
$34.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$32.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.14
|
| Rate for Payer: Healthscope Commercial |
$36.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$30.43
|
| Rate for Payer: Mclaren Medicaid |
$7.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.65
|
| Rate for Payer: Meridian Medicaid |
$7.51
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$11.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$34.49
|
| Rate for Payer: Nomi Health Commercial |
$33.28
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$30.43
|
| Rate for Payer: PACE Senior Care Partners |
$9.64
|
| Rate for Payer: PACE SWMI |
$10.14
|
| Rate for Payer: PHP Commercial |
$34.49
|
| Rate for Payer: PHP Medicare Advantage |
$10.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$7.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$35.30
|
| Rate for Payer: Priority Health Medicare |
$10.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$28.24
|
| Rate for Payer: Railroad Medicare Medicare |
$10.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.71
|
| Rate for Payer: UHC Core |
$33.88
|
| Rate for Payer: UHC Exchange |
$10.14
|
| Rate for Payer: UHC Medicaid |
$7.15
|
| Rate for Payer: UHC Medicare Advantage |
$10.14
|
| Rate for Payer: UHCCP Medicaid |
$7.15
|
| Rate for Payer: VA VA |
$10.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$30.43
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
OP
|
$64.53
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.38 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Aetna Commercial |
$54.85
|
| Rate for Payer: Aetna Medicare |
$16.78
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.17
|
| Rate for Payer: BCBS Complete |
$11.94
|
| Rate for Payer: BCBS MAPPO |
$16.13
|
| Rate for Payer: BCBS Trust/PPO |
$53.05
|
| Rate for Payer: BCN Commercial |
$53.05
|
| Rate for Payer: BCN Medicare Advantage |
$16.13
|
| Rate for Payer: Cash Price |
$51.62
|
| Rate for Payer: Cofinity Commercial |
$55.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.13
|
| Rate for Payer: Healthscope Commercial |
$58.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.40
|
| Rate for Payer: Mclaren Medicaid |
$11.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.94
|
| Rate for Payer: Meridian Medicaid |
$11.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$17.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.85
|
| Rate for Payer: Nomi Health Commercial |
$52.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.40
|
| Rate for Payer: PACE Senior Care Partners |
$15.33
|
| Rate for Payer: PACE SWMI |
$16.13
|
| Rate for Payer: PHP Commercial |
$54.85
|
| Rate for Payer: PHP Medicare Advantage |
$16.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.38
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.14
|
| Rate for Payer: Priority Health Medicare |
$16.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.91
|
| Rate for Payer: Railroad Medicare Medicare |
$16.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.79
|
| Rate for Payer: UHC Core |
$53.88
|
| Rate for Payer: UHC Exchange |
$16.13
|
| Rate for Payer: UHC Medicaid |
$11.38
|
| Rate for Payer: UHC Medicare Advantage |
$16.13
|
| Rate for Payer: UHCCP Medicaid |
$11.38
|
| Rate for Payer: VA VA |
$16.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.40
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
IP
|
$64.53
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$44.91 |
| Max. Negotiated Rate |
$58.08 |
| Rate for Payer: Aetna Commercial |
$54.85
|
| Rate for Payer: BCBS Trust/PPO |
$53.30
|
| Rate for Payer: BCN Commercial |
$53.30
|
| Rate for Payer: Cash Price |
$51.62
|
| Rate for Payer: Cofinity Commercial |
$55.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$51.62
|
| Rate for Payer: Healthscope Commercial |
$58.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$48.40
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$54.85
|
| Rate for Payer: Nomi Health Commercial |
$52.91
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$48.40
|
| Rate for Payer: PHP Commercial |
$54.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$56.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$56.79
|
| Rate for Payer: UHC Core |
$53.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$48.40
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: BCBS Trust/PPO |
$64.79
|
| Rate for Payer: BCN Commercial |
$64.79
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$20.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.52
|
| Rate for Payer: BCBS Complete |
$14.52
|
| Rate for Payer: BCBS MAPPO |
$19.61
|
| Rate for Payer: BCBS Trust/PPO |
$64.49
|
| Rate for Payer: BCN Commercial |
$64.49
|
| Rate for Payer: BCN Medicare Advantage |
$19.61
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Mclaren Medicaid |
$13.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.59
|
| Rate for Payer: Meridian Medicaid |
$14.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Senior Care Partners |
$18.63
|
| Rate for Payer: PACE SWMI |
$19.61
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$19.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$19.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.60
|
| Rate for Payer: Railroad Medicare Medicare |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: UHC Exchange |
$19.61
|
| Rate for Payer: UHC Medicaid |
$13.83
|
| Rate for Payer: UHC Medicare Advantage |
$19.61
|
| Rate for Payer: UHCCP Medicaid |
$13.83
|
| Rate for Payer: VA VA |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
OP
|
$78.45
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.83 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: Aetna Medicare |
$20.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.52
|
| Rate for Payer: BCBS Complete |
$14.52
|
| Rate for Payer: BCBS MAPPO |
$19.61
|
| Rate for Payer: BCBS Trust/PPO |
$64.49
|
| Rate for Payer: BCN Commercial |
$64.49
|
| Rate for Payer: BCN Medicare Advantage |
$19.61
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.61
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Mclaren Medicaid |
$13.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.59
|
| Rate for Payer: Meridian Medicaid |
$14.52
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.55
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PACE Senior Care Partners |
$18.63
|
| Rate for Payer: PACE SWMI |
$19.61
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: PHP Medicare Advantage |
$19.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.83
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Medicare |
$19.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.60
|
| Rate for Payer: Railroad Medicare Medicare |
$19.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: UHC Exchange |
$19.61
|
| Rate for Payer: UHC Medicaid |
$13.83
|
| Rate for Payer: UHC Medicare Advantage |
$19.61
|
| Rate for Payer: UHCCP Medicaid |
$13.83
|
| Rate for Payer: VA VA |
$19.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
IP
|
$78.45
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.60 |
| Max. Negotiated Rate |
$70.61 |
| Rate for Payer: Aetna Commercial |
$66.68
|
| Rate for Payer: BCBS Trust/PPO |
$64.79
|
| Rate for Payer: BCN Commercial |
$64.79
|
| Rate for Payer: Cash Price |
$62.76
|
| Rate for Payer: Cofinity Commercial |
$67.47
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$62.76
|
| Rate for Payer: Healthscope Commercial |
$70.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$66.68
|
| Rate for Payer: Nomi Health Commercial |
$64.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$58.84
|
| Rate for Payer: PHP Commercial |
$66.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.04
|
| Rate for Payer: UHC Core |
$65.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.84
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
OP
|
$23.35
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Aetna Commercial |
$19.85
|
| Rate for Payer: Aetna Medicare |
$6.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.30
|
| Rate for Payer: BCBS Complete |
$4.32
|
| Rate for Payer: BCBS MAPPO |
$5.84
|
| Rate for Payer: BCBS Trust/PPO |
$19.20
|
| Rate for Payer: BCN Commercial |
$19.20
|
| Rate for Payer: BCN Medicare Advantage |
$5.84
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$20.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.84
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.51
|
| Rate for Payer: Mclaren Medicaid |
$4.12
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.13
|
| Rate for Payer: Meridian Medicaid |
$4.32
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$6.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PACE Senior Care Partners |
$5.55
|
| Rate for Payer: PACE SWMI |
$5.84
|
| Rate for Payer: PHP Commercial |
$19.85
|
| Rate for Payer: PHP Medicare Advantage |
$5.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.31
|
| Rate for Payer: Priority Health Medicare |
$5.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.25
|
| Rate for Payer: Railroad Medicare Medicare |
$5.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Core |
$19.50
|
| Rate for Payer: UHC Exchange |
$5.84
|
| Rate for Payer: UHC Medicaid |
$4.12
|
| Rate for Payer: UHC Medicare Advantage |
$5.84
|
| Rate for Payer: UHCCP Medicaid |
$4.12
|
| Rate for Payer: VA VA |
$5.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.51
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
IP
|
$23.35
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$16.25 |
| Max. Negotiated Rate |
$21.02 |
| Rate for Payer: Aetna Commercial |
$19.85
|
| Rate for Payer: BCBS Trust/PPO |
$19.28
|
| Rate for Payer: BCN Commercial |
$19.28
|
| Rate for Payer: Cash Price |
$18.68
|
| Rate for Payer: Cofinity Commercial |
$20.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.68
|
| Rate for Payer: Healthscope Commercial |
$21.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.85
|
| Rate for Payer: Nomi Health Commercial |
$19.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$17.51
|
| Rate for Payer: PHP Commercial |
$19.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$20.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$16.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.55
|
| Rate for Payer: UHC Core |
$19.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.51
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
OP
|
$197.36
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.79 |
| Max. Negotiated Rate |
$177.62 |
| Rate for Payer: Aetna Commercial |
$167.76
|
| Rate for Payer: Aetna Medicare |
$51.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.67
|
| Rate for Payer: BCBS Complete |
$36.53
|
| Rate for Payer: BCBS MAPPO |
$49.34
|
| Rate for Payer: BCBS Trust/PPO |
$162.25
|
| Rate for Payer: BCCCP Commercial |
$89.57
|
| Rate for Payer: BCN Commercial |
$162.25
|
| Rate for Payer: BCN Medicare Advantage |
$49.34
|
| Rate for Payer: Cash Price |
$157.89
|
| Rate for Payer: Cash Price |
$157.89
|
| Rate for Payer: Cofinity Commercial |
$169.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.34
|
| Rate for Payer: Healthscope Commercial |
$177.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.02
|
| Rate for Payer: Mclaren Medicaid |
$34.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.81
|
| Rate for Payer: Meridian Medicaid |
$36.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$54.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.76
|
| Rate for Payer: Nomi Health Commercial |
$161.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.02
|
| Rate for Payer: PACE Senior Care Partners |
$46.87
|
| Rate for Payer: PACE SWMI |
$49.34
|
| Rate for Payer: PHP Commercial |
$167.76
|
| Rate for Payer: PHP Medicare Advantage |
$49.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$34.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.70
|
| Rate for Payer: Priority Health Medicare |
$49.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.36
|
| Rate for Payer: Railroad Medicare Medicare |
$49.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.68
|
| Rate for Payer: UHC Core |
$164.80
|
| Rate for Payer: UHC Exchange |
$49.34
|
| Rate for Payer: UHC Medicaid |
$34.79
|
| Rate for Payer: UHC Medicare Advantage |
$49.34
|
| Rate for Payer: UHCCP Medicaid |
$34.79
|
| Rate for Payer: VA VA |
$49.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.02
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
IP
|
$197.36
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$137.36 |
| Max. Negotiated Rate |
$177.62 |
| Rate for Payer: Aetna Commercial |
$167.76
|
| Rate for Payer: BCBS Trust/PPO |
$163.00
|
| Rate for Payer: BCN Commercial |
$163.00
|
| Rate for Payer: Cash Price |
$157.89
|
| Rate for Payer: Cofinity Commercial |
$169.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$157.89
|
| Rate for Payer: Healthscope Commercial |
$177.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$148.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$167.76
|
| Rate for Payer: Nomi Health Commercial |
$161.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$148.02
|
| Rate for Payer: PHP Commercial |
$167.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$171.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$137.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$173.68
|
| Rate for Payer: UHC Core |
$164.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$148.02
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
OP
|
$225.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.67 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna Commercial |
$191.25
|
| Rate for Payer: Aetna Medicare |
$58.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$70.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$70.31
|
| Rate for Payer: BCBS Complete |
$41.65
|
| Rate for Payer: BCBS MAPPO |
$56.25
|
| Rate for Payer: BCBS Trust/PPO |
$184.97
|
| Rate for Payer: BCN Commercial |
$184.97
|
| Rate for Payer: BCN Medicare Advantage |
$56.25
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$193.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$56.25
|
| Rate for Payer: Healthscope Commercial |
$202.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.75
|
| Rate for Payer: Mclaren Medicaid |
$39.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$59.06
|
| Rate for Payer: Meridian Medicaid |
$41.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$61.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.25
|
| Rate for Payer: Nomi Health Commercial |
$184.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: PACE Senior Care Partners |
$53.44
|
| Rate for Payer: PACE SWMI |
$56.25
|
| Rate for Payer: PHP Commercial |
$191.25
|
| Rate for Payer: PHP Medicare Advantage |
$56.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$39.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$195.75
|
| Rate for Payer: Priority Health Medicare |
$56.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.60
|
| Rate for Payer: Railroad Medicare Medicare |
$56.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.00
|
| Rate for Payer: UHC Core |
$187.88
|
| Rate for Payer: UHC Exchange |
$56.25
|
| Rate for Payer: UHC Medicaid |
$39.67
|
| Rate for Payer: UHC Medicare Advantage |
$56.25
|
| Rate for Payer: UHCCP Medicaid |
$39.67
|
| Rate for Payer: VA VA |
$56.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.75
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
IP
|
$225.00
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$156.60 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Aetna Commercial |
$191.25
|
| Rate for Payer: BCBS Trust/PPO |
$185.83
|
| Rate for Payer: BCN Commercial |
$185.83
|
| Rate for Payer: Cash Price |
$180.00
|
| Rate for Payer: Cofinity Commercial |
$193.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$180.00
|
| Rate for Payer: Healthscope Commercial |
$202.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$168.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$191.25
|
| Rate for Payer: Nomi Health Commercial |
$184.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$168.75
|
| Rate for Payer: PHP Commercial |
$191.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$195.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$156.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$198.00
|
| Rate for Payer: UHC Core |
$187.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$168.75
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
OP
|
$386.14
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$68.08 |
| Max. Negotiated Rate |
$347.53 |
| Rate for Payer: Aetna Commercial |
$328.22
|
| Rate for Payer: Aetna Medicare |
$100.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$120.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$120.67
|
| Rate for Payer: BCBS Complete |
$71.47
|
| Rate for Payer: BCBS MAPPO |
$96.53
|
| Rate for Payer: BCBS Trust/PPO |
$317.45
|
| Rate for Payer: BCN Commercial |
$317.45
|
| Rate for Payer: BCN Medicare Advantage |
$96.53
|
| Rate for Payer: Cash Price |
$308.91
|
| Rate for Payer: Cofinity Commercial |
$332.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$96.53
|
| Rate for Payer: Healthscope Commercial |
$347.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.61
|
| Rate for Payer: Mclaren Medicaid |
$68.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.36
|
| Rate for Payer: Meridian Medicaid |
$71.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.02
|
| Rate for Payer: Molina Medicare/Medicaid |
$106.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.22
|
| Rate for Payer: Nomi Health Commercial |
$316.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.61
|
| Rate for Payer: PACE Senior Care Partners |
$91.71
|
| Rate for Payer: PACE SWMI |
$96.53
|
| Rate for Payer: PHP Commercial |
$328.22
|
| Rate for Payer: PHP Medicare Advantage |
$96.53
|
| Rate for Payer: Priority Health Choice Medicaid |
$68.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.94
|
| Rate for Payer: Priority Health Medicare |
$97.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.75
|
| Rate for Payer: Railroad Medicare Medicare |
$96.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.80
|
| Rate for Payer: UHC Core |
$322.43
|
| Rate for Payer: UHC Exchange |
$96.53
|
| Rate for Payer: UHC Medicaid |
$68.08
|
| Rate for Payer: UHC Medicare Advantage |
$96.53
|
| Rate for Payer: UHCCP Medicaid |
$68.08
|
| Rate for Payer: VA VA |
$96.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.61
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
IP
|
$386.14
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$268.75 |
| Max. Negotiated Rate |
$347.53 |
| Rate for Payer: Aetna Commercial |
$328.22
|
| Rate for Payer: BCBS Trust/PPO |
$318.91
|
| Rate for Payer: BCN Commercial |
$318.91
|
| Rate for Payer: Cash Price |
$308.91
|
| Rate for Payer: Cofinity Commercial |
$332.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$308.91
|
| Rate for Payer: Healthscope Commercial |
$347.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$289.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$328.22
|
| Rate for Payer: Nomi Health Commercial |
$316.63
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$289.61
|
| Rate for Payer: PHP Commercial |
$328.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$335.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$268.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$339.80
|
| Rate for Payer: UHC Core |
$322.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$289.61
|
|
|
HC IMPELLA LVAD
|
Facility
|
IP
|
$47,152.14
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$32,817.89 |
| Max. Negotiated Rate |
$42,436.93 |
| Rate for Payer: Aetna Commercial |
$40,079.32
|
| Rate for Payer: BCBS Trust/PPO |
$38,942.95
|
| Rate for Payer: BCN Commercial |
$38,942.95
|
| Rate for Payer: Cash Price |
$37,721.71
|
| Rate for Payer: Cofinity Commercial |
$40,550.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37,721.71
|
| Rate for Payer: Healthscope Commercial |
$42,436.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35,364.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,079.32
|
| Rate for Payer: Nomi Health Commercial |
$38,664.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,364.11
|
| Rate for Payer: PHP Commercial |
$40,079.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41,022.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32,817.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41,493.88
|
| Rate for Payer: UHC Core |
$39,372.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35,364.11
|
|
|
HC IMPELLA LVAD
|
Facility
|
OP
|
$47,152.14
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8,312.92 |
| Max. Negotiated Rate |
$42,436.93 |
| Rate for Payer: Aetna Commercial |
$40,079.32
|
| Rate for Payer: Aetna Medicare |
$12,259.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,735.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,735.04
|
| Rate for Payer: BCBS Complete |
$8,727.86
|
| Rate for Payer: BCBS MAPPO |
$11,788.03
|
| Rate for Payer: BCBS Trust/PPO |
$38,763.77
|
| Rate for Payer: BCN Commercial |
$38,763.77
|
| Rate for Payer: BCN Medicare Advantage |
$11,788.03
|
| Rate for Payer: Cash Price |
$37,721.71
|
| Rate for Payer: Cofinity Commercial |
$40,550.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$37,721.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,788.03
|
| Rate for Payer: Healthscope Commercial |
$42,436.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$35,364.11
|
| Rate for Payer: Mclaren Medicaid |
$8,312.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,377.44
|
| Rate for Payer: Meridian Medicaid |
$8,727.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,556.24
|
| Rate for Payer: Molina Medicare/Medicaid |
$12,966.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$40,079.32
|
| Rate for Payer: Nomi Health Commercial |
$38,664.75
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$35,364.11
|
| Rate for Payer: PACE Senior Care Partners |
$11,198.63
|
| Rate for Payer: PACE SWMI |
$11,788.03
|
| Rate for Payer: PHP Commercial |
$40,079.32
|
| Rate for Payer: PHP Medicare Advantage |
$11,788.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$8,312.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$41,022.36
|
| Rate for Payer: Priority Health Medicare |
$11,905.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32,817.89
|
| Rate for Payer: Railroad Medicare Medicare |
$11,788.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$41,493.88
|
| Rate for Payer: UHC Core |
$39,372.04
|
| Rate for Payer: UHC Exchange |
$11,788.03
|
| Rate for Payer: UHC Medicaid |
$8,312.92
|
| Rate for Payer: UHC Medicare Advantage |
$11,788.03
|
| Rate for Payer: UHCCP Medicaid |
$8,312.92
|
| Rate for Payer: VA VA |
$11,788.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$35,364.11
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
IP
|
$346.24
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$240.98 |
| Max. Negotiated Rate |
$311.62 |
| Rate for Payer: Aetna Commercial |
$294.30
|
| Rate for Payer: BCBS Trust/PPO |
$285.96
|
| Rate for Payer: BCN Commercial |
$285.96
|
| Rate for Payer: Cash Price |
$276.99
|
| Rate for Payer: Cofinity Commercial |
$297.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.99
|
| Rate for Payer: Healthscope Commercial |
$311.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.30
|
| Rate for Payer: Nomi Health Commercial |
$283.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.68
|
| Rate for Payer: PHP Commercial |
$294.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$301.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.69
|
| Rate for Payer: UHC Core |
$289.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.68
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
OP
|
$346.24
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$61.04 |
| Max. Negotiated Rate |
$311.62 |
| Rate for Payer: Aetna Commercial |
$294.30
|
| Rate for Payer: Aetna Medicare |
$90.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$108.20
|
| Rate for Payer: Amish Plain Church Group Commercial |
$108.20
|
| Rate for Payer: BCBS Complete |
$64.09
|
| Rate for Payer: BCBS MAPPO |
$86.56
|
| Rate for Payer: BCBS Trust/PPO |
$284.64
|
| Rate for Payer: BCN Commercial |
$284.64
|
| Rate for Payer: BCN Medicare Advantage |
$86.56
|
| Rate for Payer: Cash Price |
$276.99
|
| Rate for Payer: Cofinity Commercial |
$297.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$276.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$86.56
|
| Rate for Payer: Healthscope Commercial |
$311.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$259.68
|
| Rate for Payer: Mclaren Medicaid |
$61.04
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$90.89
|
| Rate for Payer: Meridian Medicaid |
$64.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$99.54
|
| Rate for Payer: Molina Medicare/Medicaid |
$95.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$294.30
|
| Rate for Payer: Nomi Health Commercial |
$283.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$259.68
|
| Rate for Payer: PACE Senior Care Partners |
$82.23
|
| Rate for Payer: PACE SWMI |
$86.56
|
| Rate for Payer: PHP Commercial |
$294.30
|
| Rate for Payer: PHP Medicare Advantage |
$86.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$61.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$301.23
|
| Rate for Payer: Priority Health Medicare |
$87.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.98
|
| Rate for Payer: Railroad Medicare Medicare |
$86.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$304.69
|
| Rate for Payer: UHC Core |
$289.11
|
| Rate for Payer: UHC Exchange |
$86.56
|
| Rate for Payer: UHC Medicaid |
$61.04
|
| Rate for Payer: UHC Medicare Advantage |
$86.56
|
| Rate for Payer: UHCCP Medicaid |
$61.04
|
| Rate for Payer: VA VA |
$86.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$259.68
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
IP
|
$2,989.19
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,080.48 |
| Max. Negotiated Rate |
$2,690.27 |
| Rate for Payer: Aetna Commercial |
$2,540.81
|
| Rate for Payer: BCBS Trust/PPO |
$2,468.77
|
| Rate for Payer: BCN Commercial |
$2,468.77
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cofinity Commercial |
$2,570.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.35
|
| Rate for Payer: Healthscope Commercial |
$2,690.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,241.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,540.81
|
| Rate for Payer: Nomi Health Commercial |
$2,451.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,241.89
|
| Rate for Payer: PHP Commercial |
$2,540.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,600.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,080.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,630.49
|
| Rate for Payer: UHC Core |
$2,495.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,241.89
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
OP
|
$2,989.19
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$526.99 |
| Max. Negotiated Rate |
$2,690.27 |
| Rate for Payer: Aetna Commercial |
$2,540.81
|
| Rate for Payer: Aetna Medicare |
$777.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$934.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$934.12
|
| Rate for Payer: BCBS Complete |
$553.30
|
| Rate for Payer: BCBS MAPPO |
$747.30
|
| Rate for Payer: BCBS Trust/PPO |
$2,457.41
|
| Rate for Payer: BCN Commercial |
$2,457.41
|
| Rate for Payer: BCN Medicare Advantage |
$747.30
|
| Rate for Payer: Cash Price |
$2,391.35
|
| Rate for Payer: Cofinity Commercial |
$2,570.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,391.35
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$747.30
|
| Rate for Payer: Healthscope Commercial |
$2,690.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,241.89
|
| Rate for Payer: Mclaren Medicaid |
$526.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$784.66
|
| Rate for Payer: Meridian Medicaid |
$553.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$859.39
|
| Rate for Payer: Molina Medicare/Medicaid |
$822.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,540.81
|
| Rate for Payer: Nomi Health Commercial |
$2,451.14
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,241.89
|
| Rate for Payer: PACE Senior Care Partners |
$709.93
|
| Rate for Payer: PACE SWMI |
$747.30
|
| Rate for Payer: PHP Commercial |
$2,540.81
|
| Rate for Payer: PHP Medicare Advantage |
$747.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$526.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,600.60
|
| Rate for Payer: Priority Health Medicare |
$754.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,080.48
|
| Rate for Payer: Railroad Medicare Medicare |
$747.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,630.49
|
| Rate for Payer: UHC Core |
$2,495.97
|
| Rate for Payer: UHC Exchange |
$747.30
|
| Rate for Payer: UHC Medicaid |
$526.99
|
| Rate for Payer: UHC Medicare Advantage |
$747.30
|
| Rate for Payer: UHCCP Medicaid |
$526.99
|
| Rate for Payer: VA VA |
$747.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,241.89
|
|
