|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN A IGA
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100208
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
OP
|
$39.78
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: Aetna Medicare |
$10.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.43
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$9.95
|
| Rate for Payer: BCBS Trust/PPO |
$32.70
|
| Rate for Payer: BCN Commercial |
$30.93
|
| Rate for Payer: BCN Medicare Advantage |
$9.95
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.95
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.44
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.81
|
| Rate for Payer: Nomi Health Commercial |
$32.62
|
| Rate for Payer: PACE Senior Care Partners |
$9.45
|
| Rate for Payer: PACE SWMI |
$9.95
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: PHP Medicare Advantage |
$9.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.86
|
| Rate for Payer: Priority Health HMO/PPO |
$34.61
|
| Rate for Payer: Priority Health Medicare |
$10.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.65
|
| Rate for Payer: Railroad Medicare Medicare |
$9.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.01
|
| Rate for Payer: UHC Core |
$33.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.95
|
| Rate for Payer: UHC Exchange |
$9.95
|
| Rate for Payer: UHC Medicare Advantage |
$9.95
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$9.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC IMMUNOGLOBULIN A (IGA), S
|
Facility
|
IP
|
$39.78
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100756
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$25.86 |
| Max. Negotiated Rate |
$35.80 |
| Rate for Payer: Aetna Commercial |
$33.81
|
| Rate for Payer: BCBS Trust/PPO |
$32.47
|
| Rate for Payer: BCN Commercial |
$30.74
|
| Rate for Payer: Cash Price |
$31.82
|
| Rate for Payer: Cofinity Commercial |
$34.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.82
|
| Rate for Payer: Healthscope Commercial |
$35.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.81
|
| Rate for Payer: Nomi Health Commercial |
$32.62
|
| Rate for Payer: PHP Commercial |
$33.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.86
|
| Rate for Payer: Priority Health HMO/PPO |
$34.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$26.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$35.01
|
| Rate for Payer: UHC Core |
$33.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.84
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
IP
|
$63.26
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$41.12 |
| Max. Negotiated Rate |
$56.93 |
| Rate for Payer: Aetna Commercial |
$53.77
|
| Rate for Payer: BCBS Trust/PPO |
$51.64
|
| Rate for Payer: BCN Commercial |
$48.89
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.61
|
| Rate for Payer: Healthscope Commercial |
$56.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.77
|
| Rate for Payer: Nomi Health Commercial |
$51.87
|
| Rate for Payer: PHP Commercial |
$53.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.12
|
| Rate for Payer: Priority Health HMO/PPO |
$55.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.67
|
| Rate for Payer: UHC Core |
$52.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.45
|
|
|
HC IMMUNOGLOBULIN E IGE ALLERGY SPECIFIC
|
Facility
|
OP
|
$63.26
|
|
|
Service Code
|
CPT 82785
|
| Hospital Charge Code |
30100213
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.90 |
| Max. Negotiated Rate |
$56.93 |
| Rate for Payer: Aetna Commercial |
$53.77
|
| Rate for Payer: Aetna Medicare |
$16.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.77
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.77
|
| Rate for Payer: BCBS Complete |
$12.50
|
| Rate for Payer: BCBS MAPPO |
$15.81
|
| Rate for Payer: BCBS Trust/PPO |
$52.01
|
| Rate for Payer: BCN Commercial |
$49.18
|
| Rate for Payer: BCN Medicare Advantage |
$15.81
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cash Price |
$50.61
|
| Rate for Payer: Cofinity Commercial |
$54.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$50.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.81
|
| Rate for Payer: Healthscope Commercial |
$56.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$47.45
|
| Rate for Payer: Mclaren Medicaid |
$11.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.61
|
| Rate for Payer: Meridian Medicaid |
$12.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$18.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$53.77
|
| Rate for Payer: Nomi Health Commercial |
$51.87
|
| Rate for Payer: PACE Senior Care Partners |
$15.02
|
| Rate for Payer: PACE SWMI |
$15.81
|
| Rate for Payer: PHP Commercial |
$53.77
|
| Rate for Payer: PHP Medicare Advantage |
$15.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$11.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$41.12
|
| Rate for Payer: Priority Health HMO/PPO |
$55.04
|
| Rate for Payer: Priority Health Medicare |
$15.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.38
|
| Rate for Payer: Railroad Medicare Medicare |
$15.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$55.67
|
| Rate for Payer: UHC Core |
$52.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$15.81
|
| Rate for Payer: UHC Exchange |
$15.81
|
| Rate for Payer: UHC Medicare Advantage |
$15.81
|
| Rate for Payer: UHCCP Medicaid |
$11.90
|
| Rate for Payer: VA VA |
$15.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$47.45
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN G IGG
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100207
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
IP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$49.99 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: BCBS Trust/PPO |
$62.78
|
| Rate for Payer: BCN Commercial |
$59.44
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN M IGM
|
Facility
|
OP
|
$76.91
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100209
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$69.22 |
| Rate for Payer: Aetna Commercial |
$65.37
|
| Rate for Payer: Aetna Medicare |
$20.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.03
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.03
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$19.23
|
| Rate for Payer: BCBS Trust/PPO |
$63.23
|
| Rate for Payer: BCN Commercial |
$59.80
|
| Rate for Payer: BCN Medicare Advantage |
$19.23
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cash Price |
$61.53
|
| Rate for Payer: Cofinity Commercial |
$66.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.23
|
| Rate for Payer: Healthscope Commercial |
$69.22
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$57.68
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.19
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.37
|
| Rate for Payer: Nomi Health Commercial |
$63.07
|
| Rate for Payer: PACE Senior Care Partners |
$18.27
|
| Rate for Payer: PACE SWMI |
$19.23
|
| Rate for Payer: PHP Commercial |
$65.37
|
| Rate for Payer: PHP Medicare Advantage |
$19.23
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$49.99
|
| Rate for Payer: Priority Health HMO/PPO |
$66.91
|
| Rate for Payer: Priority Health Medicare |
$19.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.53
|
| Rate for Payer: Railroad Medicare Medicare |
$19.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$67.68
|
| Rate for Payer: UHC Core |
$64.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.23
|
| Rate for Payer: UHC Exchange |
$19.23
|
| Rate for Payer: UHC Medicare Advantage |
$19.23
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$19.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$57.68
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
OP
|
$22.89
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.44 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: Aetna Medicare |
$5.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.15
|
| Rate for Payer: BCBS Complete |
$7.06
|
| Rate for Payer: BCBS MAPPO |
$5.72
|
| Rate for Payer: BCBS Trust/PPO |
$18.82
|
| Rate for Payer: BCN Commercial |
$17.80
|
| Rate for Payer: BCN Medicare Advantage |
$5.72
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.72
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Mclaren Medicaid |
$6.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.01
|
| Rate for Payer: Meridian Medicaid |
$7.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$6.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PACE Senior Care Partners |
$5.44
|
| Rate for Payer: PACE SWMI |
$5.72
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: PHP Medicare Advantage |
$5.72
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Medicare |
$5.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: Railroad Medicare Medicare |
$5.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$5.72
|
| Rate for Payer: UHC Exchange |
$5.72
|
| Rate for Payer: UHC Medicare Advantage |
$5.72
|
| Rate for Payer: UHCCP Medicaid |
$6.72
|
| Rate for Payer: VA VA |
$5.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC IMMUNOGLOBULIN SUBCLASSES
|
Facility
|
IP
|
$22.89
|
|
|
Service Code
|
CPT 82784
|
| Hospital Charge Code |
30100211
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.88 |
| Max. Negotiated Rate |
$20.60 |
| Rate for Payer: Aetna Commercial |
$19.46
|
| Rate for Payer: BCBS Trust/PPO |
$18.69
|
| Rate for Payer: BCN Commercial |
$17.69
|
| Rate for Payer: Cash Price |
$18.31
|
| Rate for Payer: Cofinity Commercial |
$19.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$18.31
|
| Rate for Payer: Healthscope Commercial |
$20.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$17.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$19.46
|
| Rate for Payer: Nomi Health Commercial |
$18.77
|
| Rate for Payer: PHP Commercial |
$19.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$14.88
|
| Rate for Payer: Priority Health HMO/PPO |
$19.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$15.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$20.14
|
| Rate for Payer: UHC Core |
$19.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$17.17
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
OP
|
$168.30
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$39.97 |
| Max. Negotiated Rate |
$151.47 |
| Rate for Payer: Aetna Commercial |
$143.06
|
| Rate for Payer: Aetna Medicare |
$43.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.59
|
| Rate for Payer: BCBS Complete |
$67.32
|
| Rate for Payer: BCBS MAPPO |
$42.08
|
| Rate for Payer: BCBS Trust/PPO |
$138.36
|
| Rate for Payer: BCN Commercial |
$130.85
|
| Rate for Payer: BCN Medicare Advantage |
$42.08
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.08
|
| Rate for Payer: Healthscope Commercial |
$151.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.22
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.06
|
| Rate for Payer: Nomi Health Commercial |
$138.01
|
| Rate for Payer: PACE Senior Care Partners |
$39.97
|
| Rate for Payer: PACE SWMI |
$42.08
|
| Rate for Payer: PHP Commercial |
$143.06
|
| Rate for Payer: PHP Medicare Advantage |
$42.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.39
|
| Rate for Payer: Priority Health HMO/PPO |
$146.42
|
| Rate for Payer: Priority Health Medicare |
$42.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.76
|
| Rate for Payer: Railroad Medicare Medicare |
$42.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.10
|
| Rate for Payer: UHC Core |
$140.53
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.08
|
| Rate for Payer: UHC Exchange |
$42.08
|
| Rate for Payer: UHC Medicare Advantage |
$42.08
|
| Rate for Payer: VA VA |
$42.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.22
|
|
|
HC IMMUNOHISTOCHEMISTRY EA ADDL STAIN PER SPECIMEN
|
Facility
|
IP
|
$168.30
|
|
|
Service Code
|
CPT 88341
|
| Hospital Charge Code |
31000118
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$109.39 |
| Max. Negotiated Rate |
$151.47 |
| Rate for Payer: Aetna Commercial |
$143.06
|
| Rate for Payer: BCBS Trust/PPO |
$137.38
|
| Rate for Payer: BCN Commercial |
$130.06
|
| Rate for Payer: Cash Price |
$134.64
|
| Rate for Payer: Cofinity Commercial |
$144.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.64
|
| Rate for Payer: Healthscope Commercial |
$151.47
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$126.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$143.06
|
| Rate for Payer: Nomi Health Commercial |
$138.01
|
| Rate for Payer: PHP Commercial |
$143.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.39
|
| Rate for Payer: Priority Health HMO/PPO |
$146.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$148.10
|
| Rate for Payer: UHC Core |
$140.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$126.22
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
OP
|
$190.42
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$45.22 |
| Max. Negotiated Rate |
$171.38 |
| Rate for Payer: Aetna Commercial |
$161.86
|
| Rate for Payer: Aetna Medicare |
$49.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$59.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$59.51
|
| Rate for Payer: BCBS Complete |
$130.10
|
| Rate for Payer: BCBS MAPPO |
$47.60
|
| Rate for Payer: BCBS Trust/PPO |
$156.54
|
| Rate for Payer: BCN Commercial |
$148.05
|
| Rate for Payer: BCN Medicare Advantage |
$47.60
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$47.60
|
| Rate for Payer: Healthscope Commercial |
$171.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.81
|
| Rate for Payer: Mclaren Medicaid |
$123.89
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$49.99
|
| Rate for Payer: Meridian Medicaid |
$130.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$54.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.86
|
| Rate for Payer: Nomi Health Commercial |
$156.14
|
| Rate for Payer: PACE Senior Care Partners |
$45.22
|
| Rate for Payer: PACE SWMI |
$47.60
|
| Rate for Payer: PHP Commercial |
$161.86
|
| Rate for Payer: PHP Medicare Advantage |
$47.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.77
|
| Rate for Payer: Priority Health HMO/PPO |
$165.67
|
| Rate for Payer: Priority Health Medicare |
$48.08
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.58
|
| Rate for Payer: Railroad Medicare Medicare |
$47.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.57
|
| Rate for Payer: UHC Core |
$159.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$47.60
|
| Rate for Payer: UHC Exchange |
$47.60
|
| Rate for Payer: UHC Medicare Advantage |
$47.60
|
| Rate for Payer: UHCCP Medicaid |
$123.89
|
| Rate for Payer: VA VA |
$47.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.81
|
|
|
HC IMMUNOHISTOCHEMISTRY STAIN
|
Facility
|
IP
|
$190.42
|
|
|
Service Code
|
CPT 88342
|
| Hospital Charge Code |
31000058
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$123.77 |
| Max. Negotiated Rate |
$171.38 |
| Rate for Payer: Aetna Commercial |
$161.86
|
| Rate for Payer: BCBS Trust/PPO |
$155.44
|
| Rate for Payer: BCN Commercial |
$147.16
|
| Rate for Payer: Cash Price |
$152.34
|
| Rate for Payer: Cofinity Commercial |
$163.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$152.34
|
| Rate for Payer: Healthscope Commercial |
$171.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$142.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$161.86
|
| Rate for Payer: Nomi Health Commercial |
$156.14
|
| Rate for Payer: PHP Commercial |
$161.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$123.77
|
| Rate for Payer: Priority Health HMO/PPO |
$165.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$127.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$167.57
|
| Rate for Payer: UHC Core |
$159.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$142.81
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
IP
|
$355.46
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$231.05 |
| Max. Negotiated Rate |
$319.91 |
| Rate for Payer: Aetna Commercial |
$302.14
|
| Rate for Payer: BCBS Trust/PPO |
$290.16
|
| Rate for Payer: BCN Commercial |
$274.70
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cofinity Commercial |
$305.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.37
|
| Rate for Payer: Healthscope Commercial |
$319.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.14
|
| Rate for Payer: Nomi Health Commercial |
$291.48
|
| Rate for Payer: PHP Commercial |
$302.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.05
|
| Rate for Payer: Priority Health HMO/PPO |
$309.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.80
|
| Rate for Payer: UHC Core |
$296.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.60
|
|
|
HC IMMUNOHISTOCHEMISTY MULTIPLEX STAINS
|
Facility
|
OP
|
$355.46
|
|
|
Service Code
|
CPT 88344
|
| Hospital Charge Code |
31000117
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$84.42 |
| Max. Negotiated Rate |
$319.91 |
| Rate for Payer: Aetna Commercial |
$302.14
|
| Rate for Payer: Aetna Medicare |
$92.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$111.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$111.08
|
| Rate for Payer: BCBS Complete |
$273.10
|
| Rate for Payer: BCBS MAPPO |
$88.86
|
| Rate for Payer: BCBS Trust/PPO |
$292.22
|
| Rate for Payer: BCN Commercial |
$276.37
|
| Rate for Payer: BCN Medicare Advantage |
$88.86
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cash Price |
$284.37
|
| Rate for Payer: Cofinity Commercial |
$305.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$284.37
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$88.86
|
| Rate for Payer: Healthscope Commercial |
$319.91
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$266.60
|
| Rate for Payer: Mclaren Medicaid |
$260.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$93.31
|
| Rate for Payer: Meridian Medicaid |
$273.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$102.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$302.14
|
| Rate for Payer: Nomi Health Commercial |
$291.48
|
| Rate for Payer: PACE Senior Care Partners |
$84.42
|
| Rate for Payer: PACE SWMI |
$88.86
|
| Rate for Payer: PHP Commercial |
$302.14
|
| Rate for Payer: PHP Medicare Advantage |
$88.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$231.05
|
| Rate for Payer: Priority Health HMO/PPO |
$309.25
|
| Rate for Payer: Priority Health Medicare |
$89.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$238.16
|
| Rate for Payer: Railroad Medicare Medicare |
$88.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$312.80
|
| Rate for Payer: UHC Core |
$296.81
|
| Rate for Payer: UHC Dual Complete DSNP |
$88.86
|
| Rate for Payer: UHC Exchange |
$88.86
|
| Rate for Payer: UHC Medicare Advantage |
$88.86
|
| Rate for Payer: UHCCP Medicaid |
$260.08
|
| Rate for Payer: VA VA |
$88.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$266.60
|
|
|
HC IMPELLA LVAD
|
Facility
|
IP
|
$46,227.59
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$30,047.93 |
| Max. Negotiated Rate |
$41,604.83 |
| Rate for Payer: Aetna Commercial |
$39,293.45
|
| Rate for Payer: BCBS Trust/PPO |
$37,735.58
|
| Rate for Payer: BCN Commercial |
$35,724.68
|
| Rate for Payer: Cash Price |
$36,982.07
|
| Rate for Payer: Cofinity Commercial |
$39,755.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,982.07
|
| Rate for Payer: Healthscope Commercial |
$41,604.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34,670.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,293.45
|
| Rate for Payer: Nomi Health Commercial |
$37,906.62
|
| Rate for Payer: PHP Commercial |
$39,293.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30,047.93
|
| Rate for Payer: Priority Health HMO/PPO |
$40,218.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30,972.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,680.28
|
| Rate for Payer: UHC Core |
$38,600.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34,670.69
|
|
|
HC IMPELLA LVAD
|
Facility
|
OP
|
$46,227.59
|
|
| Hospital Charge Code |
27200132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10,979.05 |
| Max. Negotiated Rate |
$41,604.83 |
| Rate for Payer: Aetna Commercial |
$39,293.45
|
| Rate for Payer: Aetna Medicare |
$12,019.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$14,446.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$14,446.12
|
| Rate for Payer: BCBS Complete |
$18,491.04
|
| Rate for Payer: BCBS MAPPO |
$11,556.90
|
| Rate for Payer: BCBS Trust/PPO |
$38,003.70
|
| Rate for Payer: BCN Commercial |
$35,941.95
|
| Rate for Payer: BCN Medicare Advantage |
$11,556.90
|
| Rate for Payer: Cash Price |
$36,982.07
|
| Rate for Payer: Cofinity Commercial |
$39,755.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36,982.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$11,556.90
|
| Rate for Payer: Healthscope Commercial |
$41,604.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$34,670.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12,134.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$13,290.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$39,293.45
|
| Rate for Payer: Nomi Health Commercial |
$37,906.62
|
| Rate for Payer: PACE Senior Care Partners |
$10,979.05
|
| Rate for Payer: PACE SWMI |
$11,556.90
|
| Rate for Payer: PHP Commercial |
$39,293.45
|
| Rate for Payer: PHP Medicare Advantage |
$11,556.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$30,047.93
|
| Rate for Payer: Priority Health HMO/PPO |
$40,218.00
|
| Rate for Payer: Priority Health Medicare |
$11,672.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$30,972.49
|
| Rate for Payer: Railroad Medicare Medicare |
$11,556.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$40,680.28
|
| Rate for Payer: UHC Core |
$38,600.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$11,556.90
|
| Rate for Payer: UHC Exchange |
$11,556.90
|
| Rate for Payer: UHC Medicare Advantage |
$11,556.90
|
| Rate for Payer: VA VA |
$11,556.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$34,670.69
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
OP
|
$339.45
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$80.62 |
| Max. Negotiated Rate |
$305.50 |
| Rate for Payer: Aetna Commercial |
$288.53
|
| Rate for Payer: Aetna Medicare |
$88.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$106.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$106.08
|
| Rate for Payer: BCBS Complete |
$135.78
|
| Rate for Payer: BCBS MAPPO |
$84.86
|
| Rate for Payer: BCBS Trust/PPO |
$279.06
|
| Rate for Payer: BCN Commercial |
$263.92
|
| Rate for Payer: BCN Medicare Advantage |
$84.86
|
| Rate for Payer: Cash Price |
$271.56
|
| Rate for Payer: Cofinity Commercial |
$291.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.86
|
| Rate for Payer: Healthscope Commercial |
$305.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$89.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.53
|
| Rate for Payer: Nomi Health Commercial |
$278.35
|
| Rate for Payer: PACE Senior Care Partners |
$80.62
|
| Rate for Payer: PACE SWMI |
$84.86
|
| Rate for Payer: PHP Commercial |
$288.53
|
| Rate for Payer: PHP Medicare Advantage |
$84.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.64
|
| Rate for Payer: Priority Health HMO/PPO |
$295.32
|
| Rate for Payer: Priority Health Medicare |
$85.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.43
|
| Rate for Payer: Railroad Medicare Medicare |
$84.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.72
|
| Rate for Payer: UHC Core |
$283.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$84.86
|
| Rate for Payer: UHC Exchange |
$84.86
|
| Rate for Payer: UHC Medicare Advantage |
$84.86
|
| Rate for Payer: VA VA |
$84.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.59
|
|
|
HC IMPELLA MONITORING KIT
|
Facility
|
IP
|
$339.45
|
|
| Hospital Charge Code |
27200133
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$220.64 |
| Max. Negotiated Rate |
$305.50 |
| Rate for Payer: Aetna Commercial |
$288.53
|
| Rate for Payer: BCBS Trust/PPO |
$277.09
|
| Rate for Payer: BCN Commercial |
$262.33
|
| Rate for Payer: Cash Price |
$271.56
|
| Rate for Payer: Cofinity Commercial |
$291.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$271.56
|
| Rate for Payer: Healthscope Commercial |
$305.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$254.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$288.53
|
| Rate for Payer: Nomi Health Commercial |
$278.35
|
| Rate for Payer: PHP Commercial |
$288.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$220.64
|
| Rate for Payer: Priority Health HMO/PPO |
$295.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$227.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$298.72
|
| Rate for Payer: UHC Core |
$283.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$254.59
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
IP
|
$2,930.58
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$1,904.88 |
| Max. Negotiated Rate |
$2,637.52 |
| Rate for Payer: Aetna Commercial |
$2,490.99
|
| Rate for Payer: BCBS Trust/PPO |
$2,392.23
|
| Rate for Payer: BCN Commercial |
$2,264.75
|
| Rate for Payer: Cash Price |
$2,344.46
|
| Rate for Payer: Cofinity Commercial |
$2,520.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,344.46
|
| Rate for Payer: Healthscope Commercial |
$2,637.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,197.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,490.99
|
| Rate for Payer: Nomi Health Commercial |
$2,403.08
|
| Rate for Payer: PHP Commercial |
$2,490.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,904.88
|
| Rate for Payer: Priority Health HMO/PPO |
$2,549.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,963.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,578.91
|
| Rate for Payer: UHC Core |
$2,447.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,197.93
|
|
|
HC IMPELLA REMOVAL
|
Facility
|
OP
|
$2,930.58
|
|
|
Service Code
|
CPT 33992
|
| Hospital Charge Code |
48100114
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$696.01 |
| Max. Negotiated Rate |
$2,637.52 |
| Rate for Payer: Aetna Commercial |
$2,490.99
|
| Rate for Payer: Aetna Medicare |
$761.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$915.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$915.81
|
| Rate for Payer: BCBS Complete |
$1,172.23
|
| Rate for Payer: BCBS MAPPO |
$732.64
|
| Rate for Payer: BCBS Trust/PPO |
$2,409.23
|
| Rate for Payer: BCN Commercial |
$2,278.53
|
| Rate for Payer: BCN Medicare Advantage |
$732.64
|
| Rate for Payer: Cash Price |
$2,344.46
|
| Rate for Payer: Cofinity Commercial |
$2,520.30
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,344.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$732.64
|
| Rate for Payer: Healthscope Commercial |
$2,637.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,197.93
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$769.28
|
| Rate for Payer: MI Amish Medical Board Commercial |
$842.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,490.99
|
| Rate for Payer: Nomi Health Commercial |
$2,403.08
|
| Rate for Payer: PACE Senior Care Partners |
$696.01
|
| Rate for Payer: PACE SWMI |
$732.64
|
| Rate for Payer: PHP Commercial |
$2,490.99
|
| Rate for Payer: PHP Medicare Advantage |
$732.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,904.88
|
| Rate for Payer: Priority Health HMO/PPO |
$2,549.60
|
| Rate for Payer: Priority Health Medicare |
$739.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,963.49
|
| Rate for Payer: Railroad Medicare Medicare |
$732.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,578.91
|
| Rate for Payer: UHC Core |
$2,447.03
|
| Rate for Payer: UHC Dual Complete DSNP |
$732.64
|
| Rate for Payer: UHC Exchange |
$732.64
|
| Rate for Payer: UHC Medicare Advantage |
$732.64
|
| Rate for Payer: VA VA |
$732.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,197.93
|
|
|
HC IMPLANTABLE PRESSURE SENSOR W ANGIO
|
Facility
|
IP
|
$6,202.63
|
|
|
Service Code
|
CPT 33289
|
| Hospital Charge Code |
48100105
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$4,031.71 |
| Max. Negotiated Rate |
$5,582.37 |
| Rate for Payer: Aetna Commercial |
$5,272.24
|
| Rate for Payer: BCBS Trust/PPO |
$5,063.21
|
| Rate for Payer: BCN Commercial |
$4,793.39
|
| Rate for Payer: Cash Price |
$4,962.10
|
| Rate for Payer: Cofinity Commercial |
$5,334.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$4,962.10
|
| Rate for Payer: Healthscope Commercial |
$5,582.37
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,651.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,272.24
|
| Rate for Payer: Nomi Health Commercial |
$5,086.16
|
| Rate for Payer: PHP Commercial |
$5,272.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,031.71
|
| Rate for Payer: Priority Health HMO/PPO |
$5,396.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,155.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,458.31
|
| Rate for Payer: UHC Core |
$5,179.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,651.97
|
|
