|
HC IVUS OR OCT INITIAL VESSEL
|
Facility
|
OP
|
$3,767.76
|
|
|
Service Code
|
CPT 92978
|
| Hospital Charge Code |
48100106
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$664.26 |
| Max. Negotiated Rate |
$3,390.98 |
| Rate for Payer: Aetna Commercial |
$3,202.60
|
| Rate for Payer: Aetna Medicare |
$979.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,177.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,177.42
|
| Rate for Payer: BCBS Complete |
$697.41
|
| Rate for Payer: BCBS MAPPO |
$941.94
|
| Rate for Payer: BCBS Trust/PPO |
$3,097.48
|
| Rate for Payer: BCN Commercial |
$3,097.48
|
| Rate for Payer: BCN Medicare Advantage |
$941.94
|
| Rate for Payer: Cash Price |
$3,014.21
|
| Rate for Payer: Cofinity Commercial |
$3,240.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,014.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$941.94
|
| Rate for Payer: Healthscope Commercial |
$3,390.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,825.82
|
| Rate for Payer: Mclaren Medicaid |
$664.26
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$989.04
|
| Rate for Payer: Meridian Medicaid |
$697.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,083.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,036.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,202.60
|
| Rate for Payer: Nomi Health Commercial |
$3,089.56
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,825.82
|
| Rate for Payer: PACE Senior Care Partners |
$894.84
|
| Rate for Payer: PACE SWMI |
$941.94
|
| Rate for Payer: PHP Commercial |
$3,202.60
|
| Rate for Payer: PHP Medicare Advantage |
$941.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$664.26
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,277.95
|
| Rate for Payer: Priority Health Medicare |
$951.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,622.36
|
| Rate for Payer: Railroad Medicare Medicare |
$941.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,315.63
|
| Rate for Payer: UHC Core |
$3,146.08
|
| Rate for Payer: UHC Exchange |
$941.94
|
| Rate for Payer: UHC Medicaid |
$664.26
|
| Rate for Payer: UHC Medicare Advantage |
$941.94
|
| Rate for Payer: UHCCP Medicaid |
$664.26
|
| Rate for Payer: VA VA |
$941.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,825.82
|
|
|
HC JADA SYSTEM
|
Facility
|
IP
|
$3,697.50
|
|
| Hospital Charge Code |
27200395
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2,573.46 |
| Max. Negotiated Rate |
$3,327.75 |
| Rate for Payer: Aetna Commercial |
$3,142.88
|
| Rate for Payer: BCBS Trust/PPO |
$3,053.77
|
| Rate for Payer: BCN Commercial |
$3,053.77
|
| Rate for Payer: Cash Price |
$2,958.00
|
| Rate for Payer: Cofinity Commercial |
$3,179.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,958.00
|
| Rate for Payer: Healthscope Commercial |
$3,327.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,773.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,142.88
|
| Rate for Payer: Nomi Health Commercial |
$3,031.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,773.12
|
| Rate for Payer: PHP Commercial |
$3,142.88
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,216.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,573.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,253.80
|
| Rate for Payer: UHC Core |
$3,087.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,773.12
|
|
|
HC JADA SYSTEM
|
Facility
|
OP
|
$3,697.50
|
|
| Hospital Charge Code |
27200395
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$651.87 |
| Max. Negotiated Rate |
$3,327.75 |
| Rate for Payer: Aetna Commercial |
$3,142.88
|
| Rate for Payer: Aetna Medicare |
$961.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,155.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,155.47
|
| Rate for Payer: BCBS Complete |
$684.41
|
| Rate for Payer: BCBS MAPPO |
$924.38
|
| Rate for Payer: BCBS Trust/PPO |
$3,039.71
|
| Rate for Payer: BCN Commercial |
$3,039.71
|
| Rate for Payer: BCN Medicare Advantage |
$924.38
|
| Rate for Payer: Cash Price |
$2,958.00
|
| Rate for Payer: Cofinity Commercial |
$3,179.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,958.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$924.38
|
| Rate for Payer: Healthscope Commercial |
$3,327.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,773.12
|
| Rate for Payer: Mclaren Medicaid |
$651.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$970.59
|
| Rate for Payer: Meridian Medicaid |
$684.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,063.03
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,016.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,142.88
|
| Rate for Payer: Nomi Health Commercial |
$3,031.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,773.12
|
| Rate for Payer: PACE Senior Care Partners |
$878.16
|
| Rate for Payer: PACE SWMI |
$924.38
|
| Rate for Payer: PHP Commercial |
$3,142.88
|
| Rate for Payer: PHP Medicare Advantage |
$924.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$651.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,216.82
|
| Rate for Payer: Priority Health Medicare |
$933.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,573.46
|
| Rate for Payer: Railroad Medicare Medicare |
$924.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,253.80
|
| Rate for Payer: UHC Core |
$3,087.41
|
| Rate for Payer: UHC Exchange |
$924.38
|
| Rate for Payer: UHC Medicaid |
$651.87
|
| Rate for Payer: UHC Medicare Advantage |
$924.38
|
| Rate for Payer: UHCCP Medicaid |
$651.87
|
| Rate for Payer: VA VA |
$924.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,773.12
|
|
|
HC JAK2 EXON 12 MUTATION DETECTION
|
Facility
|
IP
|
$380.79
|
|
|
Service Code
|
CPT 0027U
|
| Hospital Charge Code |
31000148
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$265.03 |
| Max. Negotiated Rate |
$342.71 |
| Rate for Payer: Aetna Commercial |
$323.67
|
| Rate for Payer: BCBS Trust/PPO |
$314.49
|
| Rate for Payer: BCN Commercial |
$314.49
|
| Rate for Payer: Cash Price |
$304.63
|
| Rate for Payer: Cofinity Commercial |
$327.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.63
|
| Rate for Payer: Healthscope Commercial |
$342.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.67
|
| Rate for Payer: Nomi Health Commercial |
$312.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.59
|
| Rate for Payer: PHP Commercial |
$323.67
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$331.29
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$265.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.10
|
| Rate for Payer: UHC Core |
$317.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.59
|
|
|
HC JAK2 EXON 12 MUTATION DETECTION
|
Facility
|
OP
|
$380.79
|
|
|
Service Code
|
CPT 0027U
|
| Hospital Charge Code |
31000148
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$67.13 |
| Max. Negotiated Rate |
$342.71 |
| Rate for Payer: Aetna Commercial |
$323.67
|
| Rate for Payer: Aetna Medicare |
$99.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$119.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$119.00
|
| Rate for Payer: BCBS Complete |
$70.48
|
| Rate for Payer: BCBS MAPPO |
$95.20
|
| Rate for Payer: BCBS Trust/PPO |
$313.05
|
| Rate for Payer: BCN Commercial |
$313.05
|
| Rate for Payer: BCN Medicare Advantage |
$95.20
|
| Rate for Payer: Cash Price |
$304.63
|
| Rate for Payer: Cofinity Commercial |
$327.48
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$304.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$95.20
|
| Rate for Payer: Healthscope Commercial |
$342.71
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$285.59
|
| Rate for Payer: Mclaren Medicaid |
$67.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.96
|
| Rate for Payer: Meridian Medicaid |
$70.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.48
|
| Rate for Payer: Molina Medicare/Medicaid |
$104.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$323.67
|
| Rate for Payer: Nomi Health Commercial |
$312.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$285.59
|
| Rate for Payer: PACE Senior Care Partners |
$90.44
|
| Rate for Payer: PACE SWMI |
$95.20
|
| Rate for Payer: PHP Commercial |
$323.67
|
| Rate for Payer: PHP Medicare Advantage |
$95.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$67.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$331.29
|
| Rate for Payer: Priority Health Medicare |
$96.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$265.03
|
| Rate for Payer: Railroad Medicare Medicare |
$95.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$335.10
|
| Rate for Payer: UHC Core |
$317.96
|
| Rate for Payer: UHC Exchange |
$95.20
|
| Rate for Payer: UHC Medicaid |
$67.13
|
| Rate for Payer: UHC Medicare Advantage |
$95.20
|
| Rate for Payer: UHCCP Medicaid |
$67.13
|
| Rate for Payer: VA VA |
$95.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$285.59
|
|
|
HC JAK2 V617F MUTATION
|
Facility
|
OP
|
$395.83
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
31000101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$69.78 |
| Max. Negotiated Rate |
$356.25 |
| Rate for Payer: Aetna Commercial |
$336.46
|
| Rate for Payer: Aetna Medicare |
$102.92
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.70
|
| Rate for Payer: BCBS Complete |
$73.27
|
| Rate for Payer: BCBS MAPPO |
$98.96
|
| Rate for Payer: BCBS Trust/PPO |
$325.41
|
| Rate for Payer: BCN Commercial |
$325.41
|
| Rate for Payer: BCN Medicare Advantage |
$98.96
|
| Rate for Payer: Cash Price |
$316.66
|
| Rate for Payer: Cofinity Commercial |
$340.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.96
|
| Rate for Payer: Healthscope Commercial |
$356.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.87
|
| Rate for Payer: Mclaren Medicaid |
$69.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$103.91
|
| Rate for Payer: Meridian Medicaid |
$73.27
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$108.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.46
|
| Rate for Payer: Nomi Health Commercial |
$324.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.87
|
| Rate for Payer: PACE Senior Care Partners |
$94.01
|
| Rate for Payer: PACE SWMI |
$98.96
|
| Rate for Payer: PHP Commercial |
$336.46
|
| Rate for Payer: PHP Medicare Advantage |
$98.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$69.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.37
|
| Rate for Payer: Priority Health Medicare |
$99.95
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.50
|
| Rate for Payer: Railroad Medicare Medicare |
$98.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.33
|
| Rate for Payer: UHC Core |
$330.52
|
| Rate for Payer: UHC Exchange |
$98.96
|
| Rate for Payer: UHC Medicaid |
$69.78
|
| Rate for Payer: UHC Medicare Advantage |
$98.96
|
| Rate for Payer: UHCCP Medicaid |
$69.78
|
| Rate for Payer: VA VA |
$98.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.87
|
|
|
HC JAK2 V617F MUTATION
|
Facility
|
IP
|
$395.83
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
31000101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$275.50 |
| Max. Negotiated Rate |
$356.25 |
| Rate for Payer: Aetna Commercial |
$336.46
|
| Rate for Payer: BCBS Trust/PPO |
$326.92
|
| Rate for Payer: BCN Commercial |
$326.92
|
| Rate for Payer: Cash Price |
$316.66
|
| Rate for Payer: Cofinity Commercial |
$340.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$316.66
|
| Rate for Payer: Healthscope Commercial |
$356.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$296.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$336.46
|
| Rate for Payer: Nomi Health Commercial |
$324.58
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$296.87
|
| Rate for Payer: PHP Commercial |
$336.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$344.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$275.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$348.33
|
| Rate for Payer: UHC Core |
$330.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$296.87
|
|
|
HC JC VIRUS, PCR, CSF
|
Facility
|
OP
|
$110.28
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600335
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$19.44 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: Aetna Medicare |
$28.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$34.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$34.46
|
| Rate for Payer: BCBS Complete |
$20.41
|
| Rate for Payer: BCBS MAPPO |
$27.57
|
| Rate for Payer: BCBS Trust/PPO |
$90.66
|
| Rate for Payer: BCN Commercial |
$90.66
|
| Rate for Payer: BCN Medicare Advantage |
$27.57
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.57
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.71
|
| Rate for Payer: Mclaren Medicaid |
$19.44
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.95
|
| Rate for Payer: Meridian Medicaid |
$20.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Nomi Health Commercial |
$90.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.71
|
| Rate for Payer: PACE Senior Care Partners |
$26.19
|
| Rate for Payer: PACE SWMI |
$27.57
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: PHP Medicare Advantage |
$27.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.94
|
| Rate for Payer: Priority Health Medicare |
$27.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.75
|
| Rate for Payer: Railroad Medicare Medicare |
$27.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.05
|
| Rate for Payer: UHC Core |
$92.08
|
| Rate for Payer: UHC Exchange |
$27.57
|
| Rate for Payer: UHC Medicaid |
$19.44
|
| Rate for Payer: UHC Medicare Advantage |
$27.57
|
| Rate for Payer: UHCCP Medicaid |
$19.44
|
| Rate for Payer: VA VA |
$27.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.71
|
|
|
HC JC VIRUS, PCR, CSF
|
Facility
|
IP
|
$110.28
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600335
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$76.75 |
| Max. Negotiated Rate |
$99.25 |
| Rate for Payer: Aetna Commercial |
$93.74
|
| Rate for Payer: BCBS Trust/PPO |
$91.08
|
| Rate for Payer: BCN Commercial |
$91.08
|
| Rate for Payer: Cash Price |
$88.22
|
| Rate for Payer: Cofinity Commercial |
$94.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$88.22
|
| Rate for Payer: Healthscope Commercial |
$99.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$82.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$93.74
|
| Rate for Payer: Nomi Health Commercial |
$90.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$82.71
|
| Rate for Payer: PHP Commercial |
$93.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$95.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$76.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$97.05
|
| Rate for Payer: UHC Core |
$92.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$82.71
|
|
|
HC JET VENT INITIAL DAY
|
Facility
|
OP
|
$2,627.73
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000057
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$463.27 |
| Max. Negotiated Rate |
$2,364.96 |
| Rate for Payer: Aetna Commercial |
$2,233.57
|
| Rate for Payer: Aetna Medicare |
$683.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$821.17
|
| Rate for Payer: Amish Plain Church Group Commercial |
$821.17
|
| Rate for Payer: BCBS Complete |
$486.39
|
| Rate for Payer: BCBS MAPPO |
$656.93
|
| Rate for Payer: BCBS Trust/PPO |
$2,160.26
|
| Rate for Payer: BCN Commercial |
$2,160.26
|
| Rate for Payer: BCN Medicare Advantage |
$656.93
|
| Rate for Payer: Cash Price |
$2,102.18
|
| Rate for Payer: Cofinity Commercial |
$2,259.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,102.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$656.93
|
| Rate for Payer: Healthscope Commercial |
$2,364.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,970.80
|
| Rate for Payer: Mclaren Medicaid |
$463.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$689.78
|
| Rate for Payer: Meridian Medicaid |
$486.39
|
| Rate for Payer: MI Amish Medical Board Commercial |
$755.47
|
| Rate for Payer: Molina Medicare/Medicaid |
$722.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,233.57
|
| Rate for Payer: Nomi Health Commercial |
$2,154.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,970.80
|
| Rate for Payer: PACE Senior Care Partners |
$624.09
|
| Rate for Payer: PACE SWMI |
$656.93
|
| Rate for Payer: PHP Commercial |
$2,233.57
|
| Rate for Payer: PHP Medicare Advantage |
$656.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$463.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,286.13
|
| Rate for Payer: Priority Health Medicare |
$663.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,828.90
|
| Rate for Payer: Railroad Medicare Medicare |
$656.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,312.40
|
| Rate for Payer: UHC Core |
$2,194.15
|
| Rate for Payer: UHC Exchange |
$656.93
|
| Rate for Payer: UHC Medicaid |
$463.27
|
| Rate for Payer: UHC Medicare Advantage |
$656.93
|
| Rate for Payer: UHCCP Medicaid |
$463.27
|
| Rate for Payer: VA VA |
$656.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,970.80
|
|
|
HC JET VENT INITIAL DAY
|
Facility
|
IP
|
$2,627.73
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000057
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,828.90 |
| Max. Negotiated Rate |
$2,364.96 |
| Rate for Payer: Aetna Commercial |
$2,233.57
|
| Rate for Payer: BCBS Trust/PPO |
$2,170.24
|
| Rate for Payer: BCN Commercial |
$2,170.24
|
| Rate for Payer: Cash Price |
$2,102.18
|
| Rate for Payer: Cofinity Commercial |
$2,259.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,102.18
|
| Rate for Payer: Healthscope Commercial |
$2,364.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,970.80
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,233.57
|
| Rate for Payer: Nomi Health Commercial |
$2,154.74
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,970.80
|
| Rate for Payer: PHP Commercial |
$2,233.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,286.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,828.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,312.40
|
| Rate for Payer: UHC Core |
$2,194.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,970.80
|
|
|
HC JET VENT SUB DAY
|
Facility
|
IP
|
$1,935.76
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000058
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,347.29 |
| Max. Negotiated Rate |
$1,742.18 |
| Rate for Payer: Aetna Commercial |
$1,645.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,598.74
|
| Rate for Payer: BCN Commercial |
$1,598.74
|
| Rate for Payer: Cash Price |
$1,548.61
|
| Rate for Payer: Cofinity Commercial |
$1,664.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,548.61
|
| Rate for Payer: Healthscope Commercial |
$1,742.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,451.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.40
|
| Rate for Payer: Nomi Health Commercial |
$1,587.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,451.82
|
| Rate for Payer: PHP Commercial |
$1,645.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,684.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,347.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,703.47
|
| Rate for Payer: UHC Core |
$1,616.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,451.82
|
|
|
HC JET VENT SUB DAY
|
Facility
|
OP
|
$1,935.76
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000058
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$341.27 |
| Max. Negotiated Rate |
$1,742.18 |
| Rate for Payer: Aetna Commercial |
$1,645.40
|
| Rate for Payer: Aetna Medicare |
$503.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$604.92
|
| Rate for Payer: Amish Plain Church Group Commercial |
$604.92
|
| Rate for Payer: BCBS Complete |
$358.31
|
| Rate for Payer: BCBS MAPPO |
$483.94
|
| Rate for Payer: BCBS Trust/PPO |
$1,591.39
|
| Rate for Payer: BCN Commercial |
$1,591.39
|
| Rate for Payer: BCN Medicare Advantage |
$483.94
|
| Rate for Payer: Cash Price |
$1,548.61
|
| Rate for Payer: Cofinity Commercial |
$1,664.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,548.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$483.94
|
| Rate for Payer: Healthscope Commercial |
$1,742.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,451.82
|
| Rate for Payer: Mclaren Medicaid |
$341.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$508.14
|
| Rate for Payer: Meridian Medicaid |
$358.31
|
| Rate for Payer: MI Amish Medical Board Commercial |
$556.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$532.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,645.40
|
| Rate for Payer: Nomi Health Commercial |
$1,587.32
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,451.82
|
| Rate for Payer: PACE Senior Care Partners |
$459.74
|
| Rate for Payer: PACE SWMI |
$483.94
|
| Rate for Payer: PHP Commercial |
$1,645.40
|
| Rate for Payer: PHP Medicare Advantage |
$483.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$341.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,684.11
|
| Rate for Payer: Priority Health Medicare |
$488.78
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,347.29
|
| Rate for Payer: Railroad Medicare Medicare |
$483.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,703.47
|
| Rate for Payer: UHC Core |
$1,616.36
|
| Rate for Payer: UHC Exchange |
$483.94
|
| Rate for Payer: UHC Medicaid |
$341.27
|
| Rate for Payer: UHC Medicare Advantage |
$483.94
|
| Rate for Payer: UHCCP Medicaid |
$341.27
|
| Rate for Payer: VA VA |
$483.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,451.82
|
|
|
HC JO 1 ANTIBODY
|
Facility
|
IP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.97 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: BCBS Trust/PPO |
$29.63
|
| Rate for Payer: BCN Commercial |
$29.63
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC JO 1 ANTIBODY
|
Facility
|
OP
|
$35.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.32 |
| Max. Negotiated Rate |
$32.28 |
| Rate for Payer: Aetna Commercial |
$30.49
|
| Rate for Payer: Aetna Medicare |
$9.33
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.21
|
| Rate for Payer: BCBS Complete |
$6.64
|
| Rate for Payer: BCBS MAPPO |
$8.97
|
| Rate for Payer: BCBS Trust/PPO |
$29.49
|
| Rate for Payer: BCN Commercial |
$29.49
|
| Rate for Payer: BCN Medicare Advantage |
$8.97
|
| Rate for Payer: Cash Price |
$28.70
|
| Rate for Payer: Cofinity Commercial |
$30.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.97
|
| Rate for Payer: Healthscope Commercial |
$32.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.90
|
| Rate for Payer: Mclaren Medicaid |
$6.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.42
|
| Rate for Payer: Meridian Medicaid |
$6.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.49
|
| Rate for Payer: Nomi Health Commercial |
$29.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.90
|
| Rate for Payer: PACE Senior Care Partners |
$8.52
|
| Rate for Payer: PACE SWMI |
$8.97
|
| Rate for Payer: PHP Commercial |
$30.49
|
| Rate for Payer: PHP Medicare Advantage |
$8.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$31.21
|
| Rate for Payer: Priority Health Medicare |
$9.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.97
|
| Rate for Payer: Railroad Medicare Medicare |
$8.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.57
|
| Rate for Payer: UHC Core |
$29.95
|
| Rate for Payer: UHC Exchange |
$8.97
|
| Rate for Payer: UHC Medicaid |
$6.32
|
| Rate for Payer: UHC Medicare Advantage |
$8.97
|
| Rate for Payer: UHCCP Medicaid |
$6.32
|
| Rate for Payer: VA VA |
$8.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.90
|
|
|
HC JOBST FOAM PADDING
|
Facility
|
OP
|
$11.33
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000364
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$10.20 |
| Rate for Payer: Aetna Commercial |
$9.63
|
| Rate for Payer: Aetna Medicare |
$2.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.54
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.54
|
| Rate for Payer: BCBS Complete |
$2.10
|
| Rate for Payer: BCBS MAPPO |
$2.83
|
| Rate for Payer: BCBS Trust/PPO |
$9.31
|
| Rate for Payer: BCN Commercial |
$9.31
|
| Rate for Payer: BCN Medicare Advantage |
$2.83
|
| Rate for Payer: Cash Price |
$9.06
|
| Rate for Payer: Cofinity Commercial |
$9.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.06
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.83
|
| Rate for Payer: Healthscope Commercial |
$10.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.50
|
| Rate for Payer: Mclaren Medicaid |
$2.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.97
|
| Rate for Payer: Meridian Medicaid |
$2.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$3.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.63
|
| Rate for Payer: Nomi Health Commercial |
$9.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.50
|
| Rate for Payer: PACE Senior Care Partners |
$2.69
|
| Rate for Payer: PACE SWMI |
$2.83
|
| Rate for Payer: PHP Commercial |
$9.63
|
| Rate for Payer: PHP Medicare Advantage |
$2.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.86
|
| Rate for Payer: Priority Health Medicare |
$2.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.89
|
| Rate for Payer: Railroad Medicare Medicare |
$2.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.97
|
| Rate for Payer: UHC Core |
$9.46
|
| Rate for Payer: UHC Exchange |
$2.83
|
| Rate for Payer: UHC Medicaid |
$2.00
|
| Rate for Payer: UHC Medicare Advantage |
$2.83
|
| Rate for Payer: UHCCP Medicaid |
$2.00
|
| Rate for Payer: VA VA |
$2.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.50
|
|
|
HC JOBST FOAM PADDING
|
Facility
|
IP
|
$11.33
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000364
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.89 |
| Max. Negotiated Rate |
$10.20 |
| Rate for Payer: Aetna Commercial |
$9.63
|
| Rate for Payer: BCBS Trust/PPO |
$9.36
|
| Rate for Payer: BCN Commercial |
$9.36
|
| Rate for Payer: Cash Price |
$9.06
|
| Rate for Payer: Cofinity Commercial |
$9.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$9.06
|
| Rate for Payer: Healthscope Commercial |
$10.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.63
|
| Rate for Payer: Nomi Health Commercial |
$9.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$8.50
|
| Rate for Payer: PHP Commercial |
$9.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$9.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.97
|
| Rate for Payer: UHC Core |
$9.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.50
|
|
|
HC JOINT W MANUAL STRESS
|
Facility
|
IP
|
$217.13
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
32000287
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$151.12 |
| Max. Negotiated Rate |
$195.42 |
| Rate for Payer: Aetna Commercial |
$184.56
|
| Rate for Payer: BCBS Trust/PPO |
$179.33
|
| Rate for Payer: BCN Commercial |
$179.33
|
| Rate for Payer: Cash Price |
$173.70
|
| Rate for Payer: Cofinity Commercial |
$186.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.70
|
| Rate for Payer: Healthscope Commercial |
$195.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.56
|
| Rate for Payer: Nomi Health Commercial |
$178.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.85
|
| Rate for Payer: PHP Commercial |
$184.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.07
|
| Rate for Payer: UHC Core |
$181.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.85
|
|
|
HC JOINT W MANUAL STRESS
|
Facility
|
OP
|
$217.13
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
32000287
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$38.28 |
| Max. Negotiated Rate |
$195.42 |
| Rate for Payer: Aetna Commercial |
$184.56
|
| Rate for Payer: Aetna Medicare |
$56.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$67.85
|
| Rate for Payer: Amish Plain Church Group Commercial |
$67.85
|
| Rate for Payer: BCBS Complete |
$40.19
|
| Rate for Payer: BCBS MAPPO |
$54.28
|
| Rate for Payer: BCBS Trust/PPO |
$178.50
|
| Rate for Payer: BCN Commercial |
$178.50
|
| Rate for Payer: BCN Medicare Advantage |
$54.28
|
| Rate for Payer: Cash Price |
$173.70
|
| Rate for Payer: Cofinity Commercial |
$186.73
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$173.70
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$54.28
|
| Rate for Payer: Healthscope Commercial |
$195.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$162.85
|
| Rate for Payer: Mclaren Medicaid |
$38.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$57.00
|
| Rate for Payer: Meridian Medicaid |
$40.19
|
| Rate for Payer: MI Amish Medical Board Commercial |
$62.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$59.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$184.56
|
| Rate for Payer: Nomi Health Commercial |
$178.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$162.85
|
| Rate for Payer: PACE Senior Care Partners |
$51.57
|
| Rate for Payer: PACE SWMI |
$54.28
|
| Rate for Payer: PHP Commercial |
$184.56
|
| Rate for Payer: PHP Medicare Advantage |
$54.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$38.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$188.90
|
| Rate for Payer: Priority Health Medicare |
$54.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$151.12
|
| Rate for Payer: Railroad Medicare Medicare |
$54.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$191.07
|
| Rate for Payer: UHC Core |
$181.30
|
| Rate for Payer: UHC Exchange |
$54.28
|
| Rate for Payer: UHC Medicaid |
$38.28
|
| Rate for Payer: UHC Medicare Advantage |
$54.28
|
| Rate for Payer: UHCCP Medicaid |
$38.28
|
| Rate for Payer: VA VA |
$54.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$162.85
|
|
|
HC KAPPA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$78.97
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100307
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$54.96 |
| Max. Negotiated Rate |
$71.07 |
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: BCBS Trust/PPO |
$65.22
|
| Rate for Payer: BCN Commercial |
$65.22
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cofinity Commercial |
$67.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.18
|
| Rate for Payer: Healthscope Commercial |
$71.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.12
|
| Rate for Payer: Nomi Health Commercial |
$64.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.23
|
| Rate for Payer: PHP Commercial |
$67.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.49
|
| Rate for Payer: UHC Core |
$65.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.23
|
|
|
HC KAPPA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$78.97
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100307
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.92 |
| Max. Negotiated Rate |
$71.07 |
| Rate for Payer: Aetna Commercial |
$67.12
|
| Rate for Payer: Aetna Medicare |
$20.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.68
|
| Rate for Payer: BCBS Complete |
$14.62
|
| Rate for Payer: BCBS MAPPO |
$19.74
|
| Rate for Payer: BCBS Trust/PPO |
$64.92
|
| Rate for Payer: BCN Commercial |
$64.92
|
| Rate for Payer: BCN Medicare Advantage |
$19.74
|
| Rate for Payer: Cash Price |
$63.18
|
| Rate for Payer: Cofinity Commercial |
$67.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.18
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.74
|
| Rate for Payer: Healthscope Commercial |
$71.07
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.23
|
| Rate for Payer: Mclaren Medicaid |
$13.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.73
|
| Rate for Payer: Meridian Medicaid |
$14.62
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.70
|
| Rate for Payer: Molina Medicare/Medicaid |
$21.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.12
|
| Rate for Payer: Nomi Health Commercial |
$64.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$59.23
|
| Rate for Payer: PACE Senior Care Partners |
$18.76
|
| Rate for Payer: PACE SWMI |
$19.74
|
| Rate for Payer: PHP Commercial |
$67.12
|
| Rate for Payer: PHP Medicare Advantage |
$19.74
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$68.70
|
| Rate for Payer: Priority Health Medicare |
$19.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$54.96
|
| Rate for Payer: Railroad Medicare Medicare |
$19.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.49
|
| Rate for Payer: UHC Core |
$65.94
|
| Rate for Payer: UHC Exchange |
$19.74
|
| Rate for Payer: UHC Medicaid |
$13.92
|
| Rate for Payer: UHC Medicare Advantage |
$19.74
|
| Rate for Payer: UHCCP Medicaid |
$13.92
|
| Rate for Payer: VA VA |
$19.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.23
|
|
|
HC KARIUS SPECTRUM, PLASMA
|
Facility
|
IP
|
$2,225.00
|
|
|
Service Code
|
CPT 0152U
|
| Hospital Charge Code |
30000177
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$1,548.60 |
| Max. Negotiated Rate |
$2,002.50 |
| Rate for Payer: Aetna Commercial |
$1,891.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,837.63
|
| Rate for Payer: BCN Commercial |
$1,837.63
|
| Rate for Payer: Cash Price |
$1,780.00
|
| Rate for Payer: Cofinity Commercial |
$1,913.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,780.00
|
| Rate for Payer: Healthscope Commercial |
$2,002.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,668.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,891.25
|
| Rate for Payer: Nomi Health Commercial |
$1,824.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,668.75
|
| Rate for Payer: PHP Commercial |
$1,891.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,935.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,548.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,958.00
|
| Rate for Payer: UHC Core |
$1,857.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,668.75
|
|
|
HC KARIUS SPECTRUM, PLASMA
|
Facility
|
OP
|
$2,225.00
|
|
|
Service Code
|
CPT 0152U
|
| Hospital Charge Code |
30000177
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$392.27 |
| Max. Negotiated Rate |
$2,002.50 |
| Rate for Payer: Aetna Commercial |
$1,891.25
|
| Rate for Payer: Aetna Medicare |
$578.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$695.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$695.31
|
| Rate for Payer: BCBS Complete |
$411.85
|
| Rate for Payer: BCBS MAPPO |
$556.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,829.17
|
| Rate for Payer: BCN Commercial |
$1,829.17
|
| Rate for Payer: BCN Medicare Advantage |
$556.25
|
| Rate for Payer: Cash Price |
$1,780.00
|
| Rate for Payer: Cofinity Commercial |
$1,913.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,780.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$556.25
|
| Rate for Payer: Healthscope Commercial |
$2,002.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,668.75
|
| Rate for Payer: Mclaren Medicaid |
$392.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$584.06
|
| Rate for Payer: Meridian Medicaid |
$411.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$639.69
|
| Rate for Payer: Molina Medicare/Medicaid |
$611.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,891.25
|
| Rate for Payer: Nomi Health Commercial |
$1,824.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,668.75
|
| Rate for Payer: PACE Senior Care Partners |
$528.44
|
| Rate for Payer: PACE SWMI |
$556.25
|
| Rate for Payer: PHP Commercial |
$1,891.25
|
| Rate for Payer: PHP Medicare Advantage |
$556.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$392.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,935.75
|
| Rate for Payer: Priority Health Medicare |
$561.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,548.60
|
| Rate for Payer: Railroad Medicare Medicare |
$556.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,958.00
|
| Rate for Payer: UHC Core |
$1,857.88
|
| Rate for Payer: UHC Exchange |
$556.25
|
| Rate for Payer: UHC Medicaid |
$392.27
|
| Rate for Payer: UHC Medicare Advantage |
$556.25
|
| Rate for Payer: UHCCP Medicaid |
$392.27
|
| Rate for Payer: VA VA |
$556.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,668.75
|
|
|
HC KENTUCKY BLUE IGE
|
Facility
|
IP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200090
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.03 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$21.39
|
| Rate for Payer: BCN Commercial |
$21.39
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
|
HC KENTUCKY BLUE IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200090
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
