|
HC IR Z ABSCESS PERIANAL
|
Facility
|
OP
|
$1,232.52
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$217.29 |
| Max. Negotiated Rate |
$1,109.27 |
| Rate for Payer: Aetna Commercial |
$1,047.64
|
| Rate for Payer: Aetna Medicare |
$320.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$385.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$385.16
|
| Rate for Payer: BCBS Complete |
$228.14
|
| Rate for Payer: BCBS MAPPO |
$308.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,013.25
|
| Rate for Payer: BCN Commercial |
$1,013.25
|
| Rate for Payer: BCN Medicare Advantage |
$308.13
|
| Rate for Payer: Cash Price |
$986.02
|
| Rate for Payer: Cofinity Commercial |
$1,059.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$308.13
|
| Rate for Payer: Healthscope Commercial |
$1,109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.39
|
| Rate for Payer: Mclaren Medicaid |
$217.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$323.54
|
| Rate for Payer: Meridian Medicaid |
$228.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$354.35
|
| Rate for Payer: Molina Medicare/Medicaid |
$338.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.64
|
| Rate for Payer: Nomi Health Commercial |
$1,010.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.39
|
| Rate for Payer: PACE Senior Care Partners |
$292.72
|
| Rate for Payer: PACE SWMI |
$308.13
|
| Rate for Payer: PHP Commercial |
$1,047.64
|
| Rate for Payer: PHP Medicare Advantage |
$308.13
|
| Rate for Payer: Priority Health Choice Medicaid |
$217.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,072.29
|
| Rate for Payer: Priority Health Medicare |
$311.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$857.83
|
| Rate for Payer: Railroad Medicare Medicare |
$308.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.62
|
| Rate for Payer: UHC Core |
$1,029.15
|
| Rate for Payer: UHC Exchange |
$308.13
|
| Rate for Payer: UHC Medicaid |
$217.29
|
| Rate for Payer: UHC Medicare Advantage |
$308.13
|
| Rate for Payer: UHCCP Medicaid |
$217.29
|
| Rate for Payer: VA VA |
$308.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.39
|
|
|
HC IR Z ABSCESS PERIANAL
|
Facility
|
IP
|
$1,232.52
|
|
|
Service Code
|
CPT 46050
|
| Hospital Charge Code |
36100369
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$857.83 |
| Max. Negotiated Rate |
$1,109.27 |
| Rate for Payer: Aetna Commercial |
$1,047.64
|
| Rate for Payer: BCBS Trust/PPO |
$1,017.94
|
| Rate for Payer: BCN Commercial |
$1,017.94
|
| Rate for Payer: Cash Price |
$986.02
|
| Rate for Payer: Cofinity Commercial |
$1,059.97
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$986.02
|
| Rate for Payer: Healthscope Commercial |
$1,109.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$924.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,047.64
|
| Rate for Payer: Nomi Health Commercial |
$1,010.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$924.39
|
| Rate for Payer: PHP Commercial |
$1,047.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,072.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$857.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,084.62
|
| Rate for Payer: UHC Core |
$1,029.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$924.39
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
OP
|
$164.59
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.02 |
| Max. Negotiated Rate |
$148.13 |
| Rate for Payer: Aetna Commercial |
$139.90
|
| Rate for Payer: Aetna Medicare |
$42.79
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.43
|
| Rate for Payer: BCBS Complete |
$30.47
|
| Rate for Payer: BCBS MAPPO |
$41.15
|
| Rate for Payer: BCBS Trust/PPO |
$135.31
|
| Rate for Payer: BCN Commercial |
$135.31
|
| Rate for Payer: BCN Medicare Advantage |
$41.15
|
| Rate for Payer: Cash Price |
$131.67
|
| Rate for Payer: Cofinity Commercial |
$141.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.15
|
| Rate for Payer: Healthscope Commercial |
$148.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.44
|
| Rate for Payer: Mclaren Medicaid |
$29.02
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.20
|
| Rate for Payer: Meridian Medicaid |
$30.47
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.90
|
| Rate for Payer: Nomi Health Commercial |
$134.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.44
|
| Rate for Payer: PACE Senior Care Partners |
$39.09
|
| Rate for Payer: PACE SWMI |
$41.15
|
| Rate for Payer: PHP Commercial |
$139.90
|
| Rate for Payer: PHP Medicare Advantage |
$41.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.19
|
| Rate for Payer: Priority Health Medicare |
$41.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.55
|
| Rate for Payer: Railroad Medicare Medicare |
$41.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.84
|
| Rate for Payer: UHC Core |
$137.43
|
| Rate for Payer: UHC Exchange |
$41.15
|
| Rate for Payer: UHC Medicaid |
$29.02
|
| Rate for Payer: UHC Medicare Advantage |
$41.15
|
| Rate for Payer: UHCCP Medicaid |
$29.02
|
| Rate for Payer: VA VA |
$41.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.44
|
|
|
HC ISCHEMIA MODIFIED ALBUMIN
|
Facility
|
IP
|
$164.59
|
|
|
Service Code
|
CPT 82045
|
| Hospital Charge Code |
30100076
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$114.55 |
| Max. Negotiated Rate |
$148.13 |
| Rate for Payer: Aetna Commercial |
$139.90
|
| Rate for Payer: BCBS Trust/PPO |
$135.93
|
| Rate for Payer: BCN Commercial |
$135.93
|
| Rate for Payer: Cash Price |
$131.67
|
| Rate for Payer: Cofinity Commercial |
$141.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$131.67
|
| Rate for Payer: Healthscope Commercial |
$148.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$123.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$139.90
|
| Rate for Payer: Nomi Health Commercial |
$134.96
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$123.44
|
| Rate for Payer: PHP Commercial |
$139.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$143.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$144.84
|
| Rate for Payer: UHC Core |
$137.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$123.44
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
IP
|
$56.24
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$39.14 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Aetna Commercial |
$47.80
|
| Rate for Payer: BCBS Trust/PPO |
$46.45
|
| Rate for Payer: BCN Commercial |
$46.45
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cofinity Commercial |
$48.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.99
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.80
|
| Rate for Payer: Nomi Health Commercial |
$46.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.18
|
| Rate for Payer: PHP Commercial |
$47.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.49
|
| Rate for Payer: UHC Core |
$46.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.18
|
|
|
HC ISLET ANTIGEN 2 ANTIBODY
|
Facility
|
OP
|
$56.24
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
30200412
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$9.92 |
| Max. Negotiated Rate |
$50.62 |
| Rate for Payer: Aetna Commercial |
$47.80
|
| Rate for Payer: Aetna Medicare |
$14.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.57
|
| Rate for Payer: BCBS Complete |
$10.41
|
| Rate for Payer: BCBS MAPPO |
$14.06
|
| Rate for Payer: BCBS Trust/PPO |
$46.23
|
| Rate for Payer: BCN Commercial |
$46.23
|
| Rate for Payer: BCN Medicare Advantage |
$14.06
|
| Rate for Payer: Cash Price |
$44.99
|
| Rate for Payer: Cofinity Commercial |
$48.37
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.99
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.06
|
| Rate for Payer: Healthscope Commercial |
$50.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.18
|
| Rate for Payer: Mclaren Medicaid |
$9.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.76
|
| Rate for Payer: Meridian Medicaid |
$10.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.80
|
| Rate for Payer: Nomi Health Commercial |
$46.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$42.18
|
| Rate for Payer: PACE Senior Care Partners |
$13.36
|
| Rate for Payer: PACE SWMI |
$14.06
|
| Rate for Payer: PHP Commercial |
$47.80
|
| Rate for Payer: PHP Medicare Advantage |
$14.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.93
|
| Rate for Payer: Priority Health Medicare |
$14.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$39.14
|
| Rate for Payer: Railroad Medicare Medicare |
$14.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.49
|
| Rate for Payer: UHC Core |
$46.96
|
| Rate for Payer: UHC Exchange |
$14.06
|
| Rate for Payer: UHC Medicaid |
$9.92
|
| Rate for Payer: UHC Medicare Advantage |
$14.06
|
| Rate for Payer: UHCCP Medicaid |
$9.92
|
| Rate for Payer: VA VA |
$14.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.18
|
|
|
HC ISOAGGLUTININ TITER ANTI A
|
Facility
|
OP
|
$111.42
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.64 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: Aetna Medicare |
$28.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.82
|
| Rate for Payer: BCBS Complete |
$20.62
|
| Rate for Payer: BCBS MAPPO |
$27.86
|
| Rate for Payer: BCBS Trust/PPO |
$91.60
|
| Rate for Payer: BCN Commercial |
$91.60
|
| Rate for Payer: BCN Medicare Advantage |
$27.86
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.86
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Mclaren Medicaid |
$19.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.25
|
| Rate for Payer: Meridian Medicaid |
$20.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PACE Senior Care Partners |
$26.46
|
| Rate for Payer: PACE SWMI |
$27.86
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: PHP Medicare Advantage |
$27.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Medicare |
$28.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: Railroad Medicare Medicare |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: UHC Exchange |
$27.86
|
| Rate for Payer: UHC Medicaid |
$19.64
|
| Rate for Payer: UHC Medicare Advantage |
$27.86
|
| Rate for Payer: UHCCP Medicaid |
$19.64
|
| Rate for Payer: VA VA |
$27.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC ISOAGGLUTININ TITER ANTI A
|
Facility
|
IP
|
$111.42
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: BCBS Trust/PPO |
$92.02
|
| Rate for Payer: BCN Commercial |
$92.02
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC ISOAGGLUTININ TITER ANTI B
|
Facility
|
IP
|
$111.42
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$77.55 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: BCBS Trust/PPO |
$92.02
|
| Rate for Payer: BCN Commercial |
$92.02
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC ISOAGGLUTININ TITER ANTI B
|
Facility
|
OP
|
$111.42
|
|
|
Service Code
|
CPT 86886
|
| Hospital Charge Code |
30200346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$19.64 |
| Max. Negotiated Rate |
$100.28 |
| Rate for Payer: Aetna Commercial |
$94.71
|
| Rate for Payer: Aetna Medicare |
$28.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.82
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.82
|
| Rate for Payer: BCBS Complete |
$20.62
|
| Rate for Payer: BCBS MAPPO |
$27.86
|
| Rate for Payer: BCBS Trust/PPO |
$91.60
|
| Rate for Payer: BCN Commercial |
$91.60
|
| Rate for Payer: BCN Medicare Advantage |
$27.86
|
| Rate for Payer: Cash Price |
$89.14
|
| Rate for Payer: Cofinity Commercial |
$95.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.86
|
| Rate for Payer: Healthscope Commercial |
$100.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$83.56
|
| Rate for Payer: Mclaren Medicaid |
$19.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.25
|
| Rate for Payer: Meridian Medicaid |
$20.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$94.71
|
| Rate for Payer: Nomi Health Commercial |
$91.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$83.56
|
| Rate for Payer: PACE Senior Care Partners |
$26.46
|
| Rate for Payer: PACE SWMI |
$27.86
|
| Rate for Payer: PHP Commercial |
$94.71
|
| Rate for Payer: PHP Medicare Advantage |
$27.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$96.94
|
| Rate for Payer: Priority Health Medicare |
$28.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.55
|
| Rate for Payer: Railroad Medicare Medicare |
$27.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.05
|
| Rate for Payer: UHC Core |
$93.04
|
| Rate for Payer: UHC Exchange |
$27.86
|
| Rate for Payer: UHC Medicaid |
$19.64
|
| Rate for Payer: UHC Medicare Advantage |
$27.86
|
| Rate for Payer: UHCCP Medicaid |
$19.64
|
| Rate for Payer: VA VA |
$27.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$83.56
|
|
|
HC ISOPROPANOL LVL
|
Facility
|
OP
|
$162.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.61 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Aetna Commercial |
$137.96
|
| Rate for Payer: Aetna Medicare |
$42.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.72
|
| Rate for Payer: BCBS Complete |
$30.04
|
| Rate for Payer: BCBS MAPPO |
$40.58
|
| Rate for Payer: BCBS Trust/PPO |
$133.43
|
| Rate for Payer: BCN Commercial |
$133.43
|
| Rate for Payer: BCN Medicare Advantage |
$40.58
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$139.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.58
|
| Rate for Payer: Healthscope Commercial |
$146.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.72
|
| Rate for Payer: Mclaren Medicaid |
$28.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.60
|
| Rate for Payer: Meridian Medicaid |
$30.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.66
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.72
|
| Rate for Payer: PACE Senior Care Partners |
$38.55
|
| Rate for Payer: PACE SWMI |
$40.58
|
| Rate for Payer: PHP Commercial |
$137.96
|
| Rate for Payer: PHP Medicare Advantage |
$40.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.20
|
| Rate for Payer: Priority Health Medicare |
$40.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.96
|
| Rate for Payer: Railroad Medicare Medicare |
$40.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.82
|
| Rate for Payer: UHC Core |
$135.52
|
| Rate for Payer: UHC Exchange |
$40.58
|
| Rate for Payer: UHC Medicaid |
$28.61
|
| Rate for Payer: UHC Medicare Advantage |
$40.58
|
| Rate for Payer: UHCCP Medicaid |
$28.61
|
| Rate for Payer: VA VA |
$40.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.72
|
|
|
HC ISOPROPANOL LVL
|
Facility
|
IP
|
$162.30
|
|
|
Service Code
|
CPT 80320
|
| Hospital Charge Code |
30100580
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$112.96 |
| Max. Negotiated Rate |
$146.07 |
| Rate for Payer: Aetna Commercial |
$137.96
|
| Rate for Payer: BCBS Trust/PPO |
$134.04
|
| Rate for Payer: BCN Commercial |
$134.04
|
| Rate for Payer: Cash Price |
$129.84
|
| Rate for Payer: Cofinity Commercial |
$139.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.84
|
| Rate for Payer: Healthscope Commercial |
$146.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.96
|
| Rate for Payer: Nomi Health Commercial |
$133.09
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.72
|
| Rate for Payer: PHP Commercial |
$137.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$141.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.82
|
| Rate for Payer: UHC Core |
$135.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.72
|
|
|
HC ISOVUE 200M PER ML
|
Facility
|
OP
|
$2.45
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600033
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Aetna Commercial |
$2.08
|
| Rate for Payer: Aetna Medicare |
$0.64
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.77
|
| Rate for Payer: BCBS Complete |
$0.45
|
| Rate for Payer: BCBS MAPPO |
$0.61
|
| Rate for Payer: BCBS Trust/PPO |
$2.01
|
| Rate for Payer: BCN Commercial |
$2.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.61
|
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Cofinity Commercial |
$2.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.96
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.61
|
| Rate for Payer: Healthscope Commercial |
$2.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.84
|
| Rate for Payer: Mclaren Medicaid |
$0.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.64
|
| Rate for Payer: Meridian Medicaid |
$0.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.08
|
| Rate for Payer: Nomi Health Commercial |
$2.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.84
|
| Rate for Payer: PACE Senior Care Partners |
$0.58
|
| Rate for Payer: PACE SWMI |
$0.61
|
| Rate for Payer: PHP Commercial |
$2.08
|
| Rate for Payer: PHP Medicare Advantage |
$0.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.13
|
| Rate for Payer: Priority Health Medicare |
$0.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.71
|
| Rate for Payer: Railroad Medicare Medicare |
$0.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.16
|
| Rate for Payer: UHC Core |
$2.05
|
| Rate for Payer: UHC Exchange |
$0.61
|
| Rate for Payer: UHC Medicaid |
$0.43
|
| Rate for Payer: UHC Medicare Advantage |
$0.61
|
| Rate for Payer: UHCCP Medicaid |
$0.43
|
| Rate for Payer: VA VA |
$0.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.84
|
|
|
HC ISOVUE 200M PER ML
|
Facility
|
IP
|
$2.45
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600033
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Aetna Commercial |
$2.08
|
| Rate for Payer: BCBS Trust/PPO |
$2.02
|
| Rate for Payer: BCN Commercial |
$2.02
|
| Rate for Payer: Cash Price |
$1.96
|
| Rate for Payer: Cofinity Commercial |
$2.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.96
|
| Rate for Payer: Healthscope Commercial |
$2.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2.08
|
| Rate for Payer: Nomi Health Commercial |
$2.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.84
|
| Rate for Payer: PHP Commercial |
$2.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2.16
|
| Rate for Payer: UHC Core |
$2.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.84
|
|
|
HC ISOVUE 200 PER ML
|
Facility
|
OP
|
$4.55
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600011
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$4.09 |
| Rate for Payer: Aetna Commercial |
$3.87
|
| Rate for Payer: Aetna Medicare |
$1.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1.42
|
| Rate for Payer: BCBS Complete |
$0.84
|
| Rate for Payer: BCBS MAPPO |
$1.14
|
| Rate for Payer: BCBS Trust/PPO |
$3.74
|
| Rate for Payer: BCN Commercial |
$3.74
|
| Rate for Payer: BCN Medicare Advantage |
$1.14
|
| Rate for Payer: Cash Price |
$3.64
|
| Rate for Payer: Cofinity Commercial |
$3.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1.14
|
| Rate for Payer: Healthscope Commercial |
$4.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.41
|
| Rate for Payer: Mclaren Medicaid |
$0.80
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1.19
|
| Rate for Payer: Meridian Medicaid |
$0.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$1.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.87
|
| Rate for Payer: Nomi Health Commercial |
$3.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.41
|
| Rate for Payer: PACE Senior Care Partners |
$1.08
|
| Rate for Payer: PACE SWMI |
$1.14
|
| Rate for Payer: PHP Commercial |
$3.87
|
| Rate for Payer: PHP Medicare Advantage |
$1.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.80
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.96
|
| Rate for Payer: Priority Health Medicare |
$1.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.17
|
| Rate for Payer: Railroad Medicare Medicare |
$1.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.00
|
| Rate for Payer: UHC Core |
$3.80
|
| Rate for Payer: UHC Exchange |
$1.14
|
| Rate for Payer: UHC Medicaid |
$0.80
|
| Rate for Payer: UHC Medicare Advantage |
$1.14
|
| Rate for Payer: UHCCP Medicaid |
$0.80
|
| Rate for Payer: VA VA |
$1.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.41
|
|
|
HC ISOVUE 200 PER ML
|
Facility
|
IP
|
$4.55
|
|
|
Service Code
|
HCPCS Q9966
|
| Hospital Charge Code |
63600011
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$4.09 |
| Rate for Payer: Aetna Commercial |
$3.87
|
| Rate for Payer: BCBS Trust/PPO |
$3.76
|
| Rate for Payer: BCN Commercial |
$3.76
|
| Rate for Payer: Cash Price |
$3.64
|
| Rate for Payer: Cofinity Commercial |
$3.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3.64
|
| Rate for Payer: Healthscope Commercial |
$4.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$3.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3.87
|
| Rate for Payer: Nomi Health Commercial |
$3.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$3.41
|
| Rate for Payer: PHP Commercial |
$3.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$3.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$4.00
|
| Rate for Payer: UHC Core |
$3.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$3.41
|
|
|
HC ISOVUE 300M PER ML
|
Facility
|
OP
|
$1.98
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600034
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$1.78 |
| Rate for Payer: Aetna Commercial |
$1.68
|
| Rate for Payer: Aetna Medicare |
$0.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.62
|
| Rate for Payer: BCBS Complete |
$0.37
|
| Rate for Payer: BCBS MAPPO |
$0.50
|
| Rate for Payer: BCBS Trust/PPO |
$1.63
|
| Rate for Payer: BCN Commercial |
$1.63
|
| Rate for Payer: BCN Medicare Advantage |
$0.50
|
| Rate for Payer: Cash Price |
$1.58
|
| Rate for Payer: Cofinity Commercial |
$1.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.50
|
| Rate for Payer: Healthscope Commercial |
$1.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.49
|
| Rate for Payer: Mclaren Medicaid |
$0.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.52
|
| Rate for Payer: Meridian Medicaid |
$0.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.57
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.68
|
| Rate for Payer: Nomi Health Commercial |
$1.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.49
|
| Rate for Payer: PACE Senior Care Partners |
$0.47
|
| Rate for Payer: PACE SWMI |
$0.50
|
| Rate for Payer: PHP Commercial |
$1.68
|
| Rate for Payer: PHP Medicare Advantage |
$0.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.72
|
| Rate for Payer: Priority Health Medicare |
$0.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.38
|
| Rate for Payer: Railroad Medicare Medicare |
$0.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.74
|
| Rate for Payer: UHC Core |
$1.65
|
| Rate for Payer: UHC Exchange |
$0.50
|
| Rate for Payer: UHC Medicaid |
$0.35
|
| Rate for Payer: UHC Medicare Advantage |
$0.50
|
| Rate for Payer: UHCCP Medicaid |
$0.35
|
| Rate for Payer: VA VA |
$0.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.49
|
|
|
HC ISOVUE 300M PER ML
|
Facility
|
IP
|
$1.98
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600034
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$1.78 |
| Rate for Payer: Aetna Commercial |
$1.68
|
| Rate for Payer: BCBS Trust/PPO |
$1.64
|
| Rate for Payer: BCN Commercial |
$1.64
|
| Rate for Payer: Cash Price |
$1.58
|
| Rate for Payer: Cofinity Commercial |
$1.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.58
|
| Rate for Payer: Healthscope Commercial |
$1.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.68
|
| Rate for Payer: Nomi Health Commercial |
$1.62
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.49
|
| Rate for Payer: PHP Commercial |
$1.68
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.74
|
| Rate for Payer: UHC Core |
$1.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.49
|
|
|
HC ISOVUE 300 PER ML
|
Facility
|
IP
|
$1.70
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600012
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.18 |
| Max. Negotiated Rate |
$1.53 |
| Rate for Payer: Aetna Commercial |
$1.45
|
| Rate for Payer: BCBS Trust/PPO |
$1.40
|
| Rate for Payer: BCN Commercial |
$1.40
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cofinity Commercial |
$1.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.36
|
| Rate for Payer: Healthscope Commercial |
$1.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.45
|
| Rate for Payer: Nomi Health Commercial |
$1.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.27
|
| Rate for Payer: PHP Commercial |
$1.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.50
|
| Rate for Payer: UHC Core |
$1.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.27
|
|
|
HC ISOVUE 300 PER ML
|
Facility
|
OP
|
$1.70
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600012
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.30 |
| Max. Negotiated Rate |
$1.53 |
| Rate for Payer: Aetna Commercial |
$1.45
|
| Rate for Payer: Aetna Medicare |
$0.44
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.53
|
| Rate for Payer: BCBS Complete |
$0.31
|
| Rate for Payer: BCBS MAPPO |
$0.43
|
| Rate for Payer: BCBS Trust/PPO |
$1.40
|
| Rate for Payer: BCN Commercial |
$1.40
|
| Rate for Payer: BCN Medicare Advantage |
$0.43
|
| Rate for Payer: Cash Price |
$1.36
|
| Rate for Payer: Cofinity Commercial |
$1.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.43
|
| Rate for Payer: Healthscope Commercial |
$1.53
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.27
|
| Rate for Payer: Mclaren Medicaid |
$0.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.45
|
| Rate for Payer: Meridian Medicaid |
$0.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.45
|
| Rate for Payer: Nomi Health Commercial |
$1.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.27
|
| Rate for Payer: PACE Senior Care Partners |
$0.40
|
| Rate for Payer: PACE SWMI |
$0.43
|
| Rate for Payer: PHP Commercial |
$1.45
|
| Rate for Payer: PHP Medicare Advantage |
$0.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.48
|
| Rate for Payer: Priority Health Medicare |
$0.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.18
|
| Rate for Payer: Railroad Medicare Medicare |
$0.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.50
|
| Rate for Payer: UHC Core |
$1.42
|
| Rate for Payer: UHC Exchange |
$0.43
|
| Rate for Payer: UHC Medicaid |
$0.30
|
| Rate for Payer: UHC Medicare Advantage |
$0.43
|
| Rate for Payer: UHCCP Medicaid |
$0.30
|
| Rate for Payer: VA VA |
$0.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.27
|
|
|
HC ISOVUE 370 PER ML
|
Facility
|
IP
|
$1.94
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600013
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$1.75 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: BCBS Trust/PPO |
$1.60
|
| Rate for Payer: BCN Commercial |
$1.60
|
| Rate for Payer: Cash Price |
$1.55
|
| Rate for Payer: Cofinity Commercial |
$1.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.55
|
| Rate for Payer: Healthscope Commercial |
$1.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.65
|
| Rate for Payer: Nomi Health Commercial |
$1.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.46
|
| Rate for Payer: PHP Commercial |
$1.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.71
|
| Rate for Payer: UHC Core |
$1.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.46
|
|
|
HC ISOVUE 370 PER ML
|
Facility
|
OP
|
$1.94
|
|
|
Service Code
|
HCPCS Q9967
|
| Hospital Charge Code |
63600013
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$1.75 |
| Rate for Payer: Aetna Commercial |
$1.65
|
| Rate for Payer: Aetna Medicare |
$0.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.61
|
| Rate for Payer: BCBS Complete |
$0.36
|
| Rate for Payer: BCBS MAPPO |
$0.49
|
| Rate for Payer: BCBS Trust/PPO |
$1.59
|
| Rate for Payer: BCN Commercial |
$1.59
|
| Rate for Payer: BCN Medicare Advantage |
$0.49
|
| Rate for Payer: Cash Price |
$1.55
|
| Rate for Payer: Cofinity Commercial |
$1.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.49
|
| Rate for Payer: Healthscope Commercial |
$1.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1.46
|
| Rate for Payer: Mclaren Medicaid |
$0.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.51
|
| Rate for Payer: Meridian Medicaid |
$0.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1.65
|
| Rate for Payer: Nomi Health Commercial |
$1.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1.46
|
| Rate for Payer: PACE Senior Care Partners |
$0.46
|
| Rate for Payer: PACE SWMI |
$0.49
|
| Rate for Payer: PHP Commercial |
$1.65
|
| Rate for Payer: PHP Medicare Advantage |
$0.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1.69
|
| Rate for Payer: Priority Health Medicare |
$0.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1.35
|
| Rate for Payer: Railroad Medicare Medicare |
$0.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1.71
|
| Rate for Payer: UHC Core |
$1.62
|
| Rate for Payer: UHC Exchange |
$0.49
|
| Rate for Payer: UHC Medicaid |
$0.34
|
| Rate for Payer: UHC Medicare Advantage |
$0.49
|
| Rate for Payer: UHCCP Medicaid |
$0.34
|
| Rate for Payer: VA VA |
$0.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1.46
|
|
|
HC IUD REMOVAL
|
Facility
|
IP
|
$328.12
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
45000086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$228.37 |
| Max. Negotiated Rate |
$295.31 |
| Rate for Payer: Aetna Commercial |
$278.90
|
| Rate for Payer: BCBS Trust/PPO |
$270.99
|
| Rate for Payer: BCN Commercial |
$270.99
|
| Rate for Payer: Cash Price |
$262.50
|
| Rate for Payer: Cofinity Commercial |
$282.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.50
|
| Rate for Payer: Healthscope Commercial |
$295.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.90
|
| Rate for Payer: Nomi Health Commercial |
$269.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.09
|
| Rate for Payer: PHP Commercial |
$278.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$285.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.75
|
| Rate for Payer: UHC Core |
$273.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.09
|
|
|
HC IUD REMOVAL
|
Facility
|
OP
|
$328.12
|
|
|
Service Code
|
HCPCS 58301
|
| Hospital Charge Code |
45000086
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$57.85 |
| Max. Negotiated Rate |
$295.31 |
| Rate for Payer: Aetna Commercial |
$278.90
|
| Rate for Payer: Aetna Medicare |
$85.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.54
|
| Rate for Payer: BCBS Complete |
$60.74
|
| Rate for Payer: BCBS MAPPO |
$82.03
|
| Rate for Payer: BCBS Trust/PPO |
$269.75
|
| Rate for Payer: BCN Commercial |
$269.75
|
| Rate for Payer: BCN Medicare Advantage |
$82.03
|
| Rate for Payer: Cash Price |
$262.50
|
| Rate for Payer: Cofinity Commercial |
$282.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.03
|
| Rate for Payer: Healthscope Commercial |
$295.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.09
|
| Rate for Payer: Mclaren Medicaid |
$57.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.13
|
| Rate for Payer: Meridian Medicaid |
$60.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$90.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.90
|
| Rate for Payer: Nomi Health Commercial |
$269.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$246.09
|
| Rate for Payer: PACE Senior Care Partners |
$77.93
|
| Rate for Payer: PACE SWMI |
$82.03
|
| Rate for Payer: PHP Commercial |
$278.90
|
| Rate for Payer: PHP Medicare Advantage |
$82.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.85
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$285.46
|
| Rate for Payer: Priority Health Medicare |
$82.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$228.37
|
| Rate for Payer: Railroad Medicare Medicare |
$82.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.75
|
| Rate for Payer: UHC Core |
$273.98
|
| Rate for Payer: UHC Exchange |
$82.03
|
| Rate for Payer: UHC Medicaid |
$57.85
|
| Rate for Payer: UHC Medicare Advantage |
$82.03
|
| Rate for Payer: UHCCP Medicaid |
$57.85
|
| Rate for Payer: VA VA |
$82.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.09
|
|
|
HC IUPC ASSIST
|
Facility
|
IP
|
$122.11
|
|
| Hospital Charge Code |
27000120
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$84.99 |
| Max. Negotiated Rate |
$109.90 |
| Rate for Payer: Aetna Commercial |
$103.79
|
| Rate for Payer: BCBS Trust/PPO |
$100.85
|
| Rate for Payer: BCN Commercial |
$100.85
|
| Rate for Payer: Cash Price |
$97.69
|
| Rate for Payer: Cofinity Commercial |
$105.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.69
|
| Rate for Payer: Healthscope Commercial |
$109.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$103.79
|
| Rate for Payer: Nomi Health Commercial |
$100.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$91.58
|
| Rate for Payer: PHP Commercial |
$103.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$106.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$107.46
|
| Rate for Payer: UHC Core |
$101.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.58
|
|
