|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
OP
|
$3,571.86
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$848.32 |
| Max. Negotiated Rate |
$3,214.67 |
| Rate for Payer: Aetna Commercial |
$3,036.08
|
| Rate for Payer: Aetna Medicare |
$928.68
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,116.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,116.21
|
| Rate for Payer: BCBS Complete |
$2,401.24
|
| Rate for Payer: BCBS MAPPO |
$892.96
|
| Rate for Payer: BCBS Trust/PPO |
$2,777.12
|
| Rate for Payer: BCN Commercial |
$2,777.12
|
| Rate for Payer: BCN Medicare Advantage |
$892.96
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$3,071.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$892.96
|
| Rate for Payer: Healthscope Commercial |
$3,214.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,678.90
|
| Rate for Payer: Mclaren Medicaid |
$2,286.89
|
| Rate for Payer: Meridian Medicaid |
$2,401.24
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$937.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,026.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PACE Senior Care Partners |
$848.32
|
| Rate for Payer: PACE SWMI |
$892.96
|
| Rate for Payer: PHP Commercial |
$3,036.08
|
| Rate for Payer: PHP Medicare Advantage |
$892.96
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,286.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,107.52
|
| Rate for Payer: Priority Health Medicare |
$892.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,178.48
|
| Rate for Payer: Railroad Medicare Medicare |
$892.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,143.24
|
| Rate for Payer: UHC Core |
$2,982.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$892.96
|
| Rate for Payer: UHC Medicare Advantage |
$919.75
|
| Rate for Payer: VA VA |
$892.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,678.90
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
IP
|
$3,571.86
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,178.48 |
| Max. Negotiated Rate |
$3,214.67 |
| Rate for Payer: Aetna Commercial |
$3,036.08
|
| Rate for Payer: BCBS Trust/PPO |
$2,760.33
|
| Rate for Payer: BCN Commercial |
$2,760.33
|
| Rate for Payer: Cash Price |
$2,857.49
|
| Rate for Payer: Cofinity Commercial |
$3,071.80
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,857.49
|
| Rate for Payer: Healthscope Commercial |
$3,214.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,678.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$3,036.08
|
| Rate for Payer: PHP Commercial |
$3,036.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,500.30
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$3,107.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,178.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,143.24
|
| Rate for Payer: UHC Core |
$2,982.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,678.90
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
OP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.81 |
| Max. Negotiated Rate |
$236.70 |
| Rate for Payer: Aetna Commercial |
$223.55
|
| Rate for Payer: Aetna Medicare |
$68.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.19
|
| Rate for Payer: BCBS Complete |
$16.60
|
| Rate for Payer: BCBS MAPPO |
$65.75
|
| Rate for Payer: BCBS Trust/PPO |
$204.48
|
| Rate for Payer: BCN Commercial |
$204.48
|
| Rate for Payer: BCN Medicare Advantage |
$65.75
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$226.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$65.75
|
| Rate for Payer: Healthscope Commercial |
$236.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.25
|
| Rate for Payer: Mclaren Medicaid |
$15.81
|
| Rate for Payer: Meridian Medicaid |
$16.60
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$69.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$75.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PACE Senior Care Partners |
$62.46
|
| Rate for Payer: PACE SWMI |
$65.75
|
| Rate for Payer: PHP Commercial |
$223.55
|
| Rate for Payer: PHP Medicare Advantage |
$65.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.81
|
| Rate for Payer: Priority Health Medicare |
$65.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.40
|
| Rate for Payer: Railroad Medicare Medicare |
$65.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.44
|
| Rate for Payer: UHC Core |
$219.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$65.75
|
| Rate for Payer: UHC Medicare Advantage |
$67.72
|
| Rate for Payer: VA VA |
$65.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.25
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
IP
|
$263.00
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$160.40 |
| Max. Negotiated Rate |
$236.70 |
| Rate for Payer: Aetna Commercial |
$223.55
|
| Rate for Payer: BCBS Trust/PPO |
$203.25
|
| Rate for Payer: BCN Commercial |
$203.25
|
| Rate for Payer: Cash Price |
$210.40
|
| Rate for Payer: Cofinity Commercial |
$226.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$210.40
|
| Rate for Payer: Healthscope Commercial |
$236.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$197.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$223.55
|
| Rate for Payer: PHP Commercial |
$223.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$184.10
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$228.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$160.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$231.44
|
| Rate for Payer: UHC Core |
$219.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$197.25
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
IP
|
$155.25
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$94.69 |
| Max. Negotiated Rate |
$139.72 |
| Rate for Payer: Aetna Commercial |
$131.96
|
| Rate for Payer: BCBS Trust/PPO |
$119.98
|
| Rate for Payer: BCN Commercial |
$119.98
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cofinity Commercial |
$133.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.20
|
| Rate for Payer: Healthscope Commercial |
$139.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.96
|
| Rate for Payer: PHP Commercial |
$131.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.62
|
| Rate for Payer: UHC Core |
$129.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.44
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
OP
|
$155.25
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$36.87 |
| Max. Negotiated Rate |
$247.59 |
| Rate for Payer: Aetna Commercial |
$131.96
|
| Rate for Payer: Aetna Medicare |
$40.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$48.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$48.52
|
| Rate for Payer: BCBS Complete |
$247.59
|
| Rate for Payer: BCBS MAPPO |
$38.81
|
| Rate for Payer: BCBS Trust/PPO |
$120.71
|
| Rate for Payer: BCN Commercial |
$120.71
|
| Rate for Payer: BCN Medicare Advantage |
$38.81
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cash Price |
$124.20
|
| Rate for Payer: Cofinity Commercial |
$133.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$124.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$38.81
|
| Rate for Payer: Healthscope Commercial |
$139.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$116.44
|
| Rate for Payer: Mclaren Medicaid |
$235.80
|
| Rate for Payer: Meridian Medicaid |
$247.59
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$40.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$44.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$131.96
|
| Rate for Payer: PACE Senior Care Partners |
$36.87
|
| Rate for Payer: PACE SWMI |
$38.81
|
| Rate for Payer: PHP Commercial |
$131.96
|
| Rate for Payer: PHP Medicare Advantage |
$38.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$235.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$108.68
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$135.07
|
| Rate for Payer: Priority Health Medicare |
$38.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$94.69
|
| Rate for Payer: Railroad Medicare Medicare |
$38.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$136.62
|
| Rate for Payer: UHC Core |
$129.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$38.81
|
| Rate for Payer: UHC Medicare Advantage |
$39.98
|
| Rate for Payer: VA VA |
$38.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$116.44
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.16 |
| Max. Negotiated Rate |
$46.10 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: Aetna Medicare |
$13.32
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.01
|
| Rate for Payer: BCBS Complete |
$20.49
|
| Rate for Payer: BCBS MAPPO |
$12.80
|
| Rate for Payer: BCBS Trust/PPO |
$39.82
|
| Rate for Payer: BCN Commercial |
$39.82
|
| Rate for Payer: BCN Medicare Advantage |
$12.80
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.80
|
| Rate for Payer: Healthscope Commercial |
$46.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.42
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$13.45
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: PACE Senior Care Partners |
$12.16
|
| Rate for Payer: PACE SWMI |
$12.80
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: PHP Medicare Advantage |
$12.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.56
|
| Rate for Payer: Priority Health Medicare |
$12.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.24
|
| Rate for Payer: Railroad Medicare Medicare |
$12.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.07
|
| Rate for Payer: UHC Core |
$42.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.80
|
| Rate for Payer: UHC Medicare Advantage |
$13.19
|
| Rate for Payer: VA VA |
$12.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.42
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$51.22
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.24 |
| Max. Negotiated Rate |
$46.10 |
| Rate for Payer: Aetna Commercial |
$43.54
|
| Rate for Payer: BCBS Trust/PPO |
$39.58
|
| Rate for Payer: BCN Commercial |
$39.58
|
| Rate for Payer: Cash Price |
$40.98
|
| Rate for Payer: Cofinity Commercial |
$44.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.98
|
| Rate for Payer: Healthscope Commercial |
$46.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$43.54
|
| Rate for Payer: PHP Commercial |
$43.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.85
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$44.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$31.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.07
|
| Rate for Payer: UHC Core |
$42.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.42
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$113.30
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$69.10 |
| Max. Negotiated Rate |
$101.97 |
| Rate for Payer: Aetna Commercial |
$96.30
|
| Rate for Payer: BCBS Trust/PPO |
$87.56
|
| Rate for Payer: BCN Commercial |
$87.56
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cofinity Commercial |
$97.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.64
|
| Rate for Payer: Healthscope Commercial |
$101.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.30
|
| Rate for Payer: PHP Commercial |
$96.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.70
|
| Rate for Payer: UHC Core |
$94.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.98
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$113.30
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$26.91 |
| Max. Negotiated Rate |
$101.97 |
| Rate for Payer: Aetna Commercial |
$96.30
|
| Rate for Payer: Aetna Medicare |
$29.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.41
|
| Rate for Payer: BCBS Complete |
$37.33
|
| Rate for Payer: BCBS MAPPO |
$28.32
|
| Rate for Payer: BCBS Trust/PPO |
$88.09
|
| Rate for Payer: BCN Commercial |
$88.09
|
| Rate for Payer: BCN Medicare Advantage |
$28.32
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cash Price |
$90.64
|
| Rate for Payer: Cofinity Commercial |
$97.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$90.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.32
|
| Rate for Payer: Healthscope Commercial |
$101.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.98
|
| Rate for Payer: Mclaren Medicaid |
$35.55
|
| Rate for Payer: Meridian Medicaid |
$37.33
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$29.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$96.30
|
| Rate for Payer: PACE Senior Care Partners |
$26.91
|
| Rate for Payer: PACE SWMI |
$28.32
|
| Rate for Payer: PHP Commercial |
$96.30
|
| Rate for Payer: PHP Medicare Advantage |
$28.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$35.55
|
| Rate for Payer: Priority Health Cigna Priority Health |
$79.31
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$98.57
|
| Rate for Payer: Priority Health Medicare |
$28.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.10
|
| Rate for Payer: Railroad Medicare Medicare |
$28.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$99.70
|
| Rate for Payer: UHC Core |
$94.61
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.32
|
| Rate for Payer: UHC Medicare Advantage |
$29.17
|
| Rate for Payer: VA VA |
$28.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.98
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$156.98
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$37.28 |
| Max. Negotiated Rate |
$141.28 |
| Rate for Payer: Aetna Commercial |
$133.43
|
| Rate for Payer: Aetna Medicare |
$40.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.06
|
| Rate for Payer: BCBS Complete |
$49.99
|
| Rate for Payer: BCBS MAPPO |
$39.24
|
| Rate for Payer: BCBS Trust/PPO |
$122.05
|
| Rate for Payer: BCN Commercial |
$122.05
|
| Rate for Payer: BCN Medicare Advantage |
$39.24
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cofinity Commercial |
$135.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.58
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.24
|
| Rate for Payer: Healthscope Commercial |
$141.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.74
|
| Rate for Payer: Mclaren Medicaid |
$47.61
|
| Rate for Payer: Meridian Medicaid |
$49.99
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$41.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.43
|
| Rate for Payer: PACE Senior Care Partners |
$37.28
|
| Rate for Payer: PACE SWMI |
$39.24
|
| Rate for Payer: PHP Commercial |
$133.43
|
| Rate for Payer: PHP Medicare Advantage |
$39.24
|
| Rate for Payer: Priority Health Choice Medicaid |
$47.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.57
|
| Rate for Payer: Priority Health Medicare |
$39.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.74
|
| Rate for Payer: Railroad Medicare Medicare |
$39.24
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.14
|
| Rate for Payer: UHC Core |
$131.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.24
|
| Rate for Payer: UHC Medicare Advantage |
$40.42
|
| Rate for Payer: VA VA |
$39.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.74
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$156.98
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$95.74 |
| Max. Negotiated Rate |
$141.28 |
| Rate for Payer: Aetna Commercial |
$133.43
|
| Rate for Payer: BCBS Trust/PPO |
$121.31
|
| Rate for Payer: BCN Commercial |
$121.31
|
| Rate for Payer: Cash Price |
$125.58
|
| Rate for Payer: Cofinity Commercial |
$135.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$125.58
|
| Rate for Payer: Healthscope Commercial |
$141.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$117.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$133.43
|
| Rate for Payer: PHP Commercial |
$133.43
|
| Rate for Payer: Priority Health Cigna Priority Health |
$109.89
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$136.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$95.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$138.14
|
| Rate for Payer: UHC Core |
$131.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$117.74
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$84.66
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.82 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: Aetna Medicare |
$22.01
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.46
|
| Rate for Payer: BCBS Complete |
$5.06
|
| Rate for Payer: BCBS MAPPO |
$21.16
|
| Rate for Payer: BCBS Trust/PPO |
$65.82
|
| Rate for Payer: BCN Commercial |
$65.82
|
| Rate for Payer: BCN Medicare Advantage |
$21.16
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.16
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Mclaren Medicaid |
$4.82
|
| Rate for Payer: Meridian Medicaid |
$5.06
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$22.22
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PACE Senior Care Partners |
$20.11
|
| Rate for Payer: PACE SWMI |
$21.16
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: PHP Medicare Advantage |
$21.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.65
|
| Rate for Payer: Priority Health Medicare |
$21.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.63
|
| Rate for Payer: Railroad Medicare Medicare |
$21.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Core |
$70.69
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.16
|
| Rate for Payer: UHC Medicare Advantage |
$21.80
|
| Rate for Payer: VA VA |
$21.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$84.66
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$51.63 |
| Max. Negotiated Rate |
$76.19 |
| Rate for Payer: Aetna Commercial |
$71.96
|
| Rate for Payer: BCBS Trust/PPO |
$65.43
|
| Rate for Payer: BCN Commercial |
$65.43
|
| Rate for Payer: Cash Price |
$67.73
|
| Rate for Payer: Cofinity Commercial |
$72.81
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$67.73
|
| Rate for Payer: Healthscope Commercial |
$76.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$63.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$71.96
|
| Rate for Payer: PHP Commercial |
$71.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.26
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$73.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$74.50
|
| Rate for Payer: UHC Core |
$70.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$63.50
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$95.37
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$58.17 |
| Max. Negotiated Rate |
$85.83 |
| Rate for Payer: Aetna Commercial |
$81.06
|
| Rate for Payer: BCBS Trust/PPO |
$73.70
|
| Rate for Payer: BCN Commercial |
$73.70
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$82.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.30
|
| Rate for Payer: Healthscope Commercial |
$85.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.06
|
| Rate for Payer: PHP Commercial |
$81.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.93
|
| Rate for Payer: UHC Core |
$79.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.53
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$95.37
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.38 |
| Max. Negotiated Rate |
$85.83 |
| Rate for Payer: Aetna Commercial |
$81.06
|
| Rate for Payer: Aetna Medicare |
$24.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.80
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.80
|
| Rate for Payer: BCBS Complete |
$19.30
|
| Rate for Payer: BCBS MAPPO |
$23.84
|
| Rate for Payer: BCBS Trust/PPO |
$74.15
|
| Rate for Payer: BCN Commercial |
$74.15
|
| Rate for Payer: BCN Medicare Advantage |
$23.84
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cash Price |
$76.30
|
| Rate for Payer: Cofinity Commercial |
$82.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.84
|
| Rate for Payer: Healthscope Commercial |
$85.83
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.53
|
| Rate for Payer: Mclaren Medicaid |
$18.38
|
| Rate for Payer: Meridian Medicaid |
$19.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$81.06
|
| Rate for Payer: PACE Senior Care Partners |
$22.65
|
| Rate for Payer: PACE SWMI |
$23.84
|
| Rate for Payer: PHP Commercial |
$81.06
|
| Rate for Payer: PHP Medicare Advantage |
$23.84
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$66.76
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$82.97
|
| Rate for Payer: Priority Health Medicare |
$23.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$58.17
|
| Rate for Payer: Railroad Medicare Medicare |
$23.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.93
|
| Rate for Payer: UHC Core |
$79.63
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.84
|
| Rate for Payer: UHC Medicare Advantage |
$24.56
|
| Rate for Payer: VA VA |
$23.84
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.53
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$97.92
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$59.72 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: BCBS Trust/PPO |
$75.67
|
| Rate for Payer: BCN Commercial |
$75.67
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.23
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.17
|
| Rate for Payer: UHC Core |
$81.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$97.92
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.56 |
| Max. Negotiated Rate |
$88.13 |
| Rate for Payer: Aetna Commercial |
$83.23
|
| Rate for Payer: Aetna Medicare |
$25.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.60
|
| Rate for Payer: BCBS Complete |
$14.23
|
| Rate for Payer: BCBS MAPPO |
$24.48
|
| Rate for Payer: BCBS Trust/PPO |
$76.13
|
| Rate for Payer: BCN Commercial |
$76.13
|
| Rate for Payer: BCN Medicare Advantage |
$24.48
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cash Price |
$78.34
|
| Rate for Payer: Cofinity Commercial |
$84.21
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$78.34
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.48
|
| Rate for Payer: Healthscope Commercial |
$88.13
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$73.44
|
| Rate for Payer: Mclaren Medicaid |
$13.56
|
| Rate for Payer: Meridian Medicaid |
$14.23
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$25.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$83.23
|
| Rate for Payer: PACE Senior Care Partners |
$23.26
|
| Rate for Payer: PACE SWMI |
$24.48
|
| Rate for Payer: PHP Commercial |
$83.23
|
| Rate for Payer: PHP Medicare Advantage |
$24.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$68.54
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$85.19
|
| Rate for Payer: Priority Health Medicare |
$24.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$59.72
|
| Rate for Payer: Railroad Medicare Medicare |
$24.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$86.17
|
| Rate for Payer: UHC Core |
$81.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.48
|
| Rate for Payer: UHC Medicare Advantage |
$25.21
|
| Rate for Payer: VA VA |
$24.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$73.44
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$273.67
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$166.91 |
| Max. Negotiated Rate |
$246.30 |
| Rate for Payer: Aetna Commercial |
$232.62
|
| Rate for Payer: BCBS Trust/PPO |
$211.49
|
| Rate for Payer: BCN Commercial |
$211.49
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cofinity Commercial |
$235.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.94
|
| Rate for Payer: Healthscope Commercial |
$246.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.62
|
| Rate for Payer: PHP Commercial |
$232.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.83
|
| Rate for Payer: UHC Core |
$228.51
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.25
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$273.67
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$65.00 |
| Max. Negotiated Rate |
$246.30 |
| Rate for Payer: Aetna Commercial |
$232.62
|
| Rate for Payer: Aetna Medicare |
$71.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.52
|
| Rate for Payer: BCBS Complete |
$94.62
|
| Rate for Payer: BCBS MAPPO |
$68.42
|
| Rate for Payer: BCBS Trust/PPO |
$212.78
|
| Rate for Payer: BCN Commercial |
$212.78
|
| Rate for Payer: BCN Medicare Advantage |
$68.42
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cash Price |
$218.94
|
| Rate for Payer: Cofinity Commercial |
$235.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.42
|
| Rate for Payer: Healthscope Commercial |
$246.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.25
|
| Rate for Payer: Mclaren Medicaid |
$90.11
|
| Rate for Payer: Meridian Medicaid |
$94.62
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$71.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$232.62
|
| Rate for Payer: PACE Senior Care Partners |
$65.00
|
| Rate for Payer: PACE SWMI |
$68.42
|
| Rate for Payer: PHP Commercial |
$232.62
|
| Rate for Payer: PHP Medicare Advantage |
$68.42
|
| Rate for Payer: Priority Health Choice Medicaid |
$90.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$191.57
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$238.09
|
| Rate for Payer: Priority Health Medicare |
$68.42
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$166.91
|
| Rate for Payer: Railroad Medicare Medicare |
$68.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.83
|
| Rate for Payer: UHC Core |
$228.51
|
| Rate for Payer: UHC Dual Complete DSNP |
$68.42
|
| Rate for Payer: UHC Medicare Advantage |
$70.47
|
| Rate for Payer: VA VA |
$68.42
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.25
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$37.90
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$23.12 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: BCBS Trust/PPO |
$29.29
|
| Rate for Payer: BCN Commercial |
$29.29
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$37.90
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$34.11 |
| Rate for Payer: Aetna Commercial |
$32.22
|
| Rate for Payer: Aetna Medicare |
$9.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.84
|
| Rate for Payer: BCBS Complete |
$3.47
|
| Rate for Payer: BCBS MAPPO |
$9.48
|
| Rate for Payer: BCBS Trust/PPO |
$29.47
|
| Rate for Payer: BCN Commercial |
$29.47
|
| Rate for Payer: BCN Medicare Advantage |
$9.48
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cash Price |
$30.32
|
| Rate for Payer: Cofinity Commercial |
$32.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.32
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.48
|
| Rate for Payer: Healthscope Commercial |
$34.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$28.42
|
| Rate for Payer: Mclaren Medicaid |
$3.31
|
| Rate for Payer: Meridian Medicaid |
$3.47
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$9.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$32.22
|
| Rate for Payer: PACE Senior Care Partners |
$9.00
|
| Rate for Payer: PACE SWMI |
$9.48
|
| Rate for Payer: PHP Commercial |
$32.22
|
| Rate for Payer: PHP Medicare Advantage |
$9.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$26.53
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$32.97
|
| Rate for Payer: Priority Health Medicare |
$9.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.12
|
| Rate for Payer: Railroad Medicare Medicare |
$9.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$33.35
|
| Rate for Payer: UHC Core |
$31.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.48
|
| Rate for Payer: UHC Medicare Advantage |
$9.76
|
| Rate for Payer: VA VA |
$9.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$28.42
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$121.58
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.38 |
| Max. Negotiated Rate |
$109.42 |
| Rate for Payer: Aetna Commercial |
$103.34
|
| Rate for Payer: Aetna Medicare |
$31.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.99
|
| Rate for Payer: BCBS Complete |
$19.30
|
| Rate for Payer: BCBS MAPPO |
$30.40
|
| Rate for Payer: BCBS Trust/PPO |
$94.53
|
| Rate for Payer: BCN Commercial |
$94.53
|
| Rate for Payer: BCN Medicare Advantage |
$30.40
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cofinity Commercial |
$104.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$30.40
|
| Rate for Payer: Healthscope Commercial |
$109.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.18
|
| Rate for Payer: Mclaren Medicaid |
$18.38
|
| Rate for Payer: Meridian Medicaid |
$19.30
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$31.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.34
|
| Rate for Payer: PACE Senior Care Partners |
$28.88
|
| Rate for Payer: PACE SWMI |
$30.40
|
| Rate for Payer: PHP Commercial |
$103.34
|
| Rate for Payer: PHP Medicare Advantage |
$30.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.77
|
| Rate for Payer: Priority Health Medicare |
$30.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.15
|
| Rate for Payer: Railroad Medicare Medicare |
$30.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.99
|
| Rate for Payer: UHC Core |
$101.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$30.40
|
| Rate for Payer: UHC Medicare Advantage |
$31.31
|
| Rate for Payer: VA VA |
$30.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.18
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$121.58
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$74.15 |
| Max. Negotiated Rate |
$109.42 |
| Rate for Payer: Aetna Commercial |
$103.34
|
| Rate for Payer: BCBS Trust/PPO |
$93.96
|
| Rate for Payer: BCN Commercial |
$93.96
|
| Rate for Payer: Cash Price |
$97.26
|
| Rate for Payer: Cofinity Commercial |
$104.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$97.26
|
| Rate for Payer: Healthscope Commercial |
$109.42
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$91.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$103.34
|
| Rate for Payer: PHP Commercial |
$103.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$85.11
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$105.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$74.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$106.99
|
| Rate for Payer: UHC Core |
$101.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$91.18
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$394.64
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$93.73 |
| Max. Negotiated Rate |
$355.18 |
| Rate for Payer: Aetna Commercial |
$335.44
|
| Rate for Payer: Aetna Medicare |
$102.61
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$123.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$123.32
|
| Rate for Payer: BCBS Complete |
$166.73
|
| Rate for Payer: BCBS MAPPO |
$98.66
|
| Rate for Payer: BCBS Trust/PPO |
$306.83
|
| Rate for Payer: BCN Commercial |
$306.83
|
| Rate for Payer: BCN Medicare Advantage |
$98.66
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cash Price |
$315.71
|
| Rate for Payer: Cofinity Commercial |
$339.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$315.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$98.66
|
| Rate for Payer: Healthscope Commercial |
$355.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$295.98
|
| Rate for Payer: Mclaren Medicaid |
$158.79
|
| Rate for Payer: Meridian Medicaid |
$166.73
|
| Rate for Payer: Meridian Wellcare - Medicare Advantage |
$103.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$113.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Multiplan/Beech St/PHCS |
$335.44
|
| Rate for Payer: PACE Senior Care Partners |
$93.73
|
| Rate for Payer: PACE SWMI |
$98.66
|
| Rate for Payer: PHP Commercial |
$335.44
|
| Rate for Payer: PHP Medicare Advantage |
$98.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$158.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$276.25
|
| Rate for Payer: Priority Health HMO/PPO/Tiered Network |
$343.34
|
| Rate for Payer: Priority Health Medicare |
$98.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.69
|
| Rate for Payer: Railroad Medicare Medicare |
$98.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$347.28
|
| Rate for Payer: UHC Core |
$329.52
|
| Rate for Payer: UHC Dual Complete DSNP |
$98.66
|
| Rate for Payer: UHC Medicare Advantage |
$101.62
|
| Rate for Payer: VA VA |
$98.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$295.98
|
|
