|
HC LEGIONELLA PNEUMOPHILA AB
|
Facility
|
IP
|
$49.94
|
|
|
Service Code
|
CPT 86713
|
| Hospital Charge Code |
30200301
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$34.76 |
| Max. Negotiated Rate |
$44.95 |
| Rate for Payer: Aetna Commercial |
$42.45
|
| Rate for Payer: BCBS Trust/PPO |
$41.25
|
| Rate for Payer: BCN Commercial |
$41.25
|
| Rate for Payer: Cash Price |
$39.95
|
| Rate for Payer: Cofinity Commercial |
$42.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.95
|
| Rate for Payer: Healthscope Commercial |
$44.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.45
|
| Rate for Payer: Nomi Health Commercial |
$40.95
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.45
|
| Rate for Payer: PHP Commercial |
$42.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.95
|
| Rate for Payer: UHC Core |
$41.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.45
|
|
|
HC LEPTOSPIRA ANTIBODY
|
Facility
|
OP
|
$69.71
|
|
|
Service Code
|
CPT 86720
|
| Hospital Charge Code |
30200303
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.29 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: Aetna Medicare |
$18.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.78
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.78
|
| Rate for Payer: BCBS Complete |
$12.90
|
| Rate for Payer: BCBS MAPPO |
$17.43
|
| Rate for Payer: BCBS Trust/PPO |
$57.31
|
| Rate for Payer: BCN Commercial |
$57.31
|
| Rate for Payer: BCN Medicare Advantage |
$17.43
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.43
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Mclaren Medicaid |
$12.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.30
|
| Rate for Payer: Meridian Medicaid |
$12.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$19.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PACE Senior Care Partners |
$16.56
|
| Rate for Payer: PACE SWMI |
$17.43
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: PHP Medicare Advantage |
$17.43
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.65
|
| Rate for Payer: Priority Health Medicare |
$17.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.52
|
| Rate for Payer: Railroad Medicare Medicare |
$17.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.34
|
| Rate for Payer: UHC Core |
$58.21
|
| Rate for Payer: UHC Exchange |
$17.43
|
| Rate for Payer: UHC Medicaid |
$12.29
|
| Rate for Payer: UHC Medicare Advantage |
$17.43
|
| Rate for Payer: UHCCP Medicaid |
$12.29
|
| Rate for Payer: VA VA |
$17.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC LEPTOSPIRA ANTIBODY
|
Facility
|
IP
|
$69.71
|
|
|
Service Code
|
CPT 86720
|
| Hospital Charge Code |
30200303
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$48.52 |
| Max. Negotiated Rate |
$62.74 |
| Rate for Payer: Aetna Commercial |
$59.25
|
| Rate for Payer: BCBS Trust/PPO |
$57.57
|
| Rate for Payer: BCN Commercial |
$57.57
|
| Rate for Payer: Cash Price |
$55.77
|
| Rate for Payer: Cofinity Commercial |
$59.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.77
|
| Rate for Payer: Healthscope Commercial |
$62.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$52.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$59.25
|
| Rate for Payer: Nomi Health Commercial |
$57.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$52.28
|
| Rate for Payer: PHP Commercial |
$59.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$60.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$48.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$61.34
|
| Rate for Payer: UHC Core |
$58.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$52.28
|
|
|
HC LEUKEMIA LYMPHOMA IMM T PANEL
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100014
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.00
|
| Rate for Payer: BCN Commercial |
$44.00
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUKEMIA LYMPHOMA IMM T PANEL
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100014
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.65
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCN Commercial |
$43.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.32
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Mclaren Medicaid |
$9.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$9.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PACE Senior Care Partners |
$12.65
|
| Rate for Payer: PACE SWMI |
$13.32
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: PHP Medicare Advantage |
$13.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Medicare |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: Railroad Medicare Medicare |
$13.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: UHC Exchange |
$13.32
|
| Rate for Payer: UHC Medicaid |
$9.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$9.39
|
| Rate for Payer: VA VA |
$13.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUKEMIA LYMPHOMA IMMUNOPH GLL
|
Facility
|
IP
|
$55.93
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100010
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$38.93 |
| Max. Negotiated Rate |
$50.34 |
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: BCBS Trust/PPO |
$46.19
|
| Rate for Payer: BCN Commercial |
$46.19
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.22
|
| Rate for Payer: UHC Core |
$46.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
|
HC LEUKEMIA LYMPHOMA IMMUNOPH GLL
|
Facility
|
OP
|
$55.93
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100010
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$50.34 |
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.48
|
| Rate for Payer: BCBS Complete |
$10.35
|
| Rate for Payer: BCBS MAPPO |
$13.98
|
| Rate for Payer: BCBS Trust/PPO |
$45.98
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: BCN Medicare Advantage |
$13.98
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.98
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.68
|
| Rate for Payer: Meridian Medicaid |
$10.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PACE Senior Care Partners |
$13.28
|
| Rate for Payer: PACE SWMI |
$13.98
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Medicare Advantage |
$13.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.66
|
| Rate for Payer: Priority Health Medicare |
$14.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.22
|
| Rate for Payer: UHC Core |
$46.70
|
| Rate for Payer: UHC Exchange |
$13.98
|
| Rate for Payer: UHC Medicaid |
$9.86
|
| Rate for Payer: UHC Medicare Advantage |
$13.98
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$13.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
|
HC LEUKEMIA LYMPHOMA IMMUNOPH TCR
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100009
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.65
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCN Commercial |
$43.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.32
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Mclaren Medicaid |
$9.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$9.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PACE Senior Care Partners |
$12.65
|
| Rate for Payer: PACE SWMI |
$13.32
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: PHP Medicare Advantage |
$13.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Medicare |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: Railroad Medicare Medicare |
$13.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: UHC Exchange |
$13.32
|
| Rate for Payer: UHC Medicaid |
$9.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$9.39
|
| Rate for Payer: VA VA |
$13.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUKEMIA LYMPHOMA IMMUNOPH TCR
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100009
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.00
|
| Rate for Payer: BCN Commercial |
$44.00
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUKEMIA LYMPHOMA PLASMA CELL
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100013
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.00
|
| Rate for Payer: BCN Commercial |
$44.00
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUKEMIA LYMPHOMA PLASMA CELL
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100013
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.65
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCN Commercial |
$43.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.32
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Mclaren Medicaid |
$9.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$9.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PACE Senior Care Partners |
$12.65
|
| Rate for Payer: PACE SWMI |
$13.32
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: PHP Medicare Advantage |
$13.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Medicare |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: Railroad Medicare Medicare |
$13.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: UHC Exchange |
$13.32
|
| Rate for Payer: UHC Medicaid |
$9.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$9.39
|
| Rate for Payer: VA VA |
$13.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT B
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.65
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCN Commercial |
$43.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.32
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Mclaren Medicaid |
$9.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$9.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PACE Senior Care Partners |
$12.65
|
| Rate for Payer: PACE SWMI |
$13.32
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: PHP Medicare Advantage |
$13.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Medicare |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: Railroad Medicare Medicare |
$13.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: UHC Exchange |
$13.32
|
| Rate for Payer: UHC Medicaid |
$9.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$9.39
|
| Rate for Payer: VA VA |
$13.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT B
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000008
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.00
|
| Rate for Payer: BCN Commercial |
$44.00
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT C
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.65
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCN Commercial |
$43.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.32
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Mclaren Medicaid |
$9.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$9.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PACE Senior Care Partners |
$12.65
|
| Rate for Payer: PACE SWMI |
$13.32
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: PHP Medicare Advantage |
$13.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Medicare |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: Railroad Medicare Medicare |
$13.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: UHC Exchange |
$13.32
|
| Rate for Payer: UHC Medicaid |
$9.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$9.39
|
| Rate for Payer: VA VA |
$13.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT C
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000009
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.00
|
| Rate for Payer: BCN Commercial |
$44.00
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT D
|
Facility
|
OP
|
$55.93
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.86 |
| Max. Negotiated Rate |
$50.34 |
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: Aetna Medicare |
$14.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.48
|
| Rate for Payer: BCBS Complete |
$10.35
|
| Rate for Payer: BCBS MAPPO |
$13.98
|
| Rate for Payer: BCBS Trust/PPO |
$45.98
|
| Rate for Payer: BCN Commercial |
$45.98
|
| Rate for Payer: BCN Medicare Advantage |
$13.98
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.98
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Mclaren Medicaid |
$9.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.68
|
| Rate for Payer: Meridian Medicaid |
$10.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.08
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PACE Senior Care Partners |
$13.28
|
| Rate for Payer: PACE SWMI |
$13.98
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: PHP Medicare Advantage |
$13.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.66
|
| Rate for Payer: Priority Health Medicare |
$14.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: Railroad Medicare Medicare |
$13.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.22
|
| Rate for Payer: UHC Core |
$46.70
|
| Rate for Payer: UHC Exchange |
$13.98
|
| Rate for Payer: UHC Medicaid |
$9.86
|
| Rate for Payer: UHC Medicare Advantage |
$13.98
|
| Rate for Payer: UHCCP Medicaid |
$9.86
|
| Rate for Payer: VA VA |
$13.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
|
HC LEUK/LYMPH IMMUNOPHENO CMPT D
|
Facility
|
IP
|
$55.93
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000010
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$38.93 |
| Max. Negotiated Rate |
$50.34 |
| Rate for Payer: Aetna Commercial |
$47.54
|
| Rate for Payer: BCBS Trust/PPO |
$46.19
|
| Rate for Payer: BCN Commercial |
$46.19
|
| Rate for Payer: Cash Price |
$44.74
|
| Rate for Payer: Cofinity Commercial |
$48.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.74
|
| Rate for Payer: Healthscope Commercial |
$50.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$47.54
|
| Rate for Payer: Nomi Health Commercial |
$45.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.95
|
| Rate for Payer: PHP Commercial |
$47.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$49.22
|
| Rate for Payer: UHC Core |
$46.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.95
|
|
|
HC LEUK LYMPHOMA IMMUNOPHEN TISSUE
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100015
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.65
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCN Commercial |
$43.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.32
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Mclaren Medicaid |
$9.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$9.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PACE Senior Care Partners |
$12.65
|
| Rate for Payer: PACE SWMI |
$13.32
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: PHP Medicare Advantage |
$13.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Medicare |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: Railroad Medicare Medicare |
$13.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: UHC Exchange |
$13.32
|
| Rate for Payer: UHC Medicaid |
$9.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$9.39
|
| Rate for Payer: VA VA |
$13.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUK LYMPHOMA IMMUNOPHEN TISSUE
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100015
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.00
|
| Rate for Payer: BCN Commercial |
$44.00
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC LEUKOTRIENE E4, U
|
Facility
|
IP
|
$265.30
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100715
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$184.65 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: BCBS Trust/PPO |
$219.11
|
| Rate for Payer: BCN Commercial |
$219.11
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.46
|
| Rate for Payer: UHC Core |
$221.53
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC LEUKOTRIENE E4, U
|
Facility
|
OP
|
$265.30
|
|
|
Service Code
|
CPT 82542
|
| Hospital Charge Code |
30100715
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$46.77 |
| Max. Negotiated Rate |
$238.77 |
| Rate for Payer: Aetna Commercial |
$225.50
|
| Rate for Payer: Aetna Medicare |
$68.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$82.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$82.91
|
| Rate for Payer: BCBS Complete |
$49.11
|
| Rate for Payer: BCBS MAPPO |
$66.33
|
| Rate for Payer: BCBS Trust/PPO |
$218.10
|
| Rate for Payer: BCN Commercial |
$218.10
|
| Rate for Payer: BCN Medicare Advantage |
$66.33
|
| Rate for Payer: Cash Price |
$212.24
|
| Rate for Payer: Cofinity Commercial |
$228.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$212.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$66.33
|
| Rate for Payer: Healthscope Commercial |
$238.77
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$198.97
|
| Rate for Payer: Mclaren Medicaid |
$46.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$69.64
|
| Rate for Payer: Meridian Medicaid |
$49.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$76.27
|
| Rate for Payer: Molina Medicare/Medicaid |
$72.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.50
|
| Rate for Payer: Nomi Health Commercial |
$217.55
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.97
|
| Rate for Payer: PACE Senior Care Partners |
$63.01
|
| Rate for Payer: PACE SWMI |
$66.33
|
| Rate for Payer: PHP Commercial |
$225.50
|
| Rate for Payer: PHP Medicare Advantage |
$66.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$46.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$230.81
|
| Rate for Payer: Priority Health Medicare |
$66.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$184.65
|
| Rate for Payer: Railroad Medicare Medicare |
$66.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$233.46
|
| Rate for Payer: UHC Core |
$221.53
|
| Rate for Payer: UHC Exchange |
$66.33
|
| Rate for Payer: UHC Medicaid |
$46.77
|
| Rate for Payer: UHC Medicare Advantage |
$66.33
|
| Rate for Payer: UHCCP Medicaid |
$46.77
|
| Rate for Payer: VA VA |
$66.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$198.97
|
|
|
HC LEUPROLIDE ACETATE 3.75MG
|
Facility
|
OP
|
$1,051.76
|
|
|
Service Code
|
HCPCS J1950
|
| Hospital Charge Code |
63600142
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$185.43 |
| Max. Negotiated Rate |
$946.58 |
| Rate for Payer: Aetna Commercial |
$894.00
|
| Rate for Payer: Aetna Medicare |
$273.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$328.68
|
| Rate for Payer: Amish Plain Church Group Commercial |
$328.68
|
| Rate for Payer: BCBS Complete |
$194.68
|
| Rate for Payer: BCBS MAPPO |
$262.94
|
| Rate for Payer: BCBS Trust/PPO |
$864.65
|
| Rate for Payer: BCN Commercial |
$864.65
|
| Rate for Payer: BCN Medicare Advantage |
$262.94
|
| Rate for Payer: Cash Price |
$841.41
|
| Rate for Payer: Cofinity Commercial |
$904.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.41
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$262.94
|
| Rate for Payer: Healthscope Commercial |
$946.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$788.82
|
| Rate for Payer: Mclaren Medicaid |
$185.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$276.09
|
| Rate for Payer: Meridian Medicaid |
$194.68
|
| Rate for Payer: MI Amish Medical Board Commercial |
$302.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$289.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.00
|
| Rate for Payer: Nomi Health Commercial |
$862.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$788.82
|
| Rate for Payer: PACE Senior Care Partners |
$249.79
|
| Rate for Payer: PACE SWMI |
$262.94
|
| Rate for Payer: PHP Commercial |
$894.00
|
| Rate for Payer: PHP Medicare Advantage |
$262.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$185.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$915.03
|
| Rate for Payer: Priority Health Medicare |
$265.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.02
|
| Rate for Payer: Railroad Medicare Medicare |
$262.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.55
|
| Rate for Payer: UHC Core |
$878.22
|
| Rate for Payer: UHC Exchange |
$262.94
|
| Rate for Payer: UHC Medicaid |
$185.43
|
| Rate for Payer: UHC Medicare Advantage |
$262.94
|
| Rate for Payer: UHCCP Medicaid |
$185.43
|
| Rate for Payer: VA VA |
$262.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$788.82
|
|
|
HC LEUPROLIDE ACETATE 3.75MG
|
Facility
|
IP
|
$1,051.76
|
|
|
Service Code
|
HCPCS J1950
|
| Hospital Charge Code |
63600142
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$732.02 |
| Max. Negotiated Rate |
$946.58 |
| Rate for Payer: Aetna Commercial |
$894.00
|
| Rate for Payer: BCBS Trust/PPO |
$868.65
|
| Rate for Payer: BCN Commercial |
$868.65
|
| Rate for Payer: Cash Price |
$841.41
|
| Rate for Payer: Cofinity Commercial |
$904.51
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$841.41
|
| Rate for Payer: Healthscope Commercial |
$946.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$788.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$894.00
|
| Rate for Payer: Nomi Health Commercial |
$862.44
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$788.82
|
| Rate for Payer: PHP Commercial |
$894.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$915.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$732.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$925.55
|
| Rate for Payer: UHC Core |
$878.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$788.82
|
|
|
HC LEUPROLIDE ACETATE SUSPNSION/ 7.5MG
|
Facility
|
IP
|
$470.26
|
|
|
Service Code
|
HCPCS J9217
|
| Hospital Charge Code |
63600147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$327.30 |
| Max. Negotiated Rate |
$423.23 |
| Rate for Payer: Aetna Commercial |
$399.72
|
| Rate for Payer: BCBS Trust/PPO |
$388.39
|
| Rate for Payer: BCN Commercial |
$388.39
|
| Rate for Payer: Cash Price |
$376.21
|
| Rate for Payer: Cofinity Commercial |
$404.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.21
|
| Rate for Payer: Healthscope Commercial |
$423.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.69
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.72
|
| Rate for Payer: Nomi Health Commercial |
$385.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.69
|
| Rate for Payer: PHP Commercial |
$399.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$409.13
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$327.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.83
|
| Rate for Payer: UHC Core |
$392.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.69
|
|
|
HC LEUPROLIDE ACETATE SUSPNSION/ 7.5MG
|
Facility
|
OP
|
$470.26
|
|
|
Service Code
|
HCPCS J9217
|
| Hospital Charge Code |
63600147
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$82.91 |
| Max. Negotiated Rate |
$423.23 |
| Rate for Payer: Aetna Commercial |
$399.72
|
| Rate for Payer: Aetna Medicare |
$122.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$146.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$146.96
|
| Rate for Payer: BCBS Complete |
$87.05
|
| Rate for Payer: BCBS MAPPO |
$117.56
|
| Rate for Payer: BCBS Trust/PPO |
$386.60
|
| Rate for Payer: BCN Commercial |
$386.60
|
| Rate for Payer: BCN Medicare Advantage |
$117.56
|
| Rate for Payer: Cash Price |
$376.21
|
| Rate for Payer: Cofinity Commercial |
$404.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$376.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$117.56
|
| Rate for Payer: Healthscope Commercial |
$423.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$352.69
|
| Rate for Payer: Mclaren Medicaid |
$82.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$123.44
|
| Rate for Payer: Meridian Medicaid |
$87.05
|
| Rate for Payer: MI Amish Medical Board Commercial |
$135.20
|
| Rate for Payer: Molina Medicare/Medicaid |
$129.32
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$399.72
|
| Rate for Payer: Nomi Health Commercial |
$385.61
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$352.69
|
| Rate for Payer: PACE Senior Care Partners |
$111.69
|
| Rate for Payer: PACE SWMI |
$117.56
|
| Rate for Payer: PHP Commercial |
$399.72
|
| Rate for Payer: PHP Medicare Advantage |
$117.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$82.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$409.13
|
| Rate for Payer: Priority Health Medicare |
$118.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$327.30
|
| Rate for Payer: Railroad Medicare Medicare |
$117.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$413.83
|
| Rate for Payer: UHC Core |
$392.67
|
| Rate for Payer: UHC Exchange |
$117.56
|
| Rate for Payer: UHC Medicaid |
$82.91
|
| Rate for Payer: UHC Medicare Advantage |
$117.56
|
| Rate for Payer: UHCCP Medicaid |
$82.91
|
| Rate for Payer: VA VA |
$117.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$352.69
|
|
