|
HC LUMBAR PUNCTURE DIAGNOSTIC
|
Facility
|
OP
|
$934.71
|
|
|
Service Code
|
CPT 62270
|
| Hospital Charge Code |
36100278
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$164.79 |
| Max. Negotiated Rate |
$841.24 |
| Rate for Payer: Aetna Commercial |
$794.50
|
| Rate for Payer: Aetna Medicare |
$243.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$292.10
|
| Rate for Payer: Amish Plain Church Group Commercial |
$292.10
|
| Rate for Payer: BCBS Complete |
$173.01
|
| Rate for Payer: BCBS MAPPO |
$233.68
|
| Rate for Payer: BCBS Trust/PPO |
$768.43
|
| Rate for Payer: BCN Commercial |
$768.43
|
| Rate for Payer: BCN Medicare Advantage |
$233.68
|
| Rate for Payer: Cash Price |
$747.77
|
| Rate for Payer: Cofinity Commercial |
$803.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$747.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$233.68
|
| Rate for Payer: Healthscope Commercial |
$841.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$701.03
|
| Rate for Payer: Mclaren Medicaid |
$164.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$245.36
|
| Rate for Payer: Meridian Medicaid |
$173.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$268.73
|
| Rate for Payer: Molina Medicare/Medicaid |
$257.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$794.50
|
| Rate for Payer: Nomi Health Commercial |
$766.46
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$701.03
|
| Rate for Payer: PACE Senior Care Partners |
$221.99
|
| Rate for Payer: PACE SWMI |
$233.68
|
| Rate for Payer: PHP Commercial |
$794.50
|
| Rate for Payer: PHP Medicare Advantage |
$233.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$813.20
|
| Rate for Payer: Priority Health Medicare |
$236.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$650.56
|
| Rate for Payer: Railroad Medicare Medicare |
$233.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$822.54
|
| Rate for Payer: UHC Core |
$780.48
|
| Rate for Payer: UHC Exchange |
$233.68
|
| Rate for Payer: UHC Medicaid |
$164.79
|
| Rate for Payer: UHC Medicare Advantage |
$233.68
|
| Rate for Payer: UHCCP Medicaid |
$164.79
|
| Rate for Payer: VA VA |
$233.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$701.03
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
IP
|
$786.42
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$547.35 |
| Max. Negotiated Rate |
$707.78 |
| Rate for Payer: Aetna Commercial |
$668.46
|
| Rate for Payer: BCBS Trust/PPO |
$649.50
|
| Rate for Payer: BCN Commercial |
$649.50
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cofinity Commercial |
$676.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.14
|
| Rate for Payer: Healthscope Commercial |
$707.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.46
|
| Rate for Payer: Nomi Health Commercial |
$644.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$589.82
|
| Rate for Payer: PHP Commercial |
$668.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$684.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$692.05
|
| Rate for Payer: UHC Core |
$656.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.82
|
|
|
HC LUMBAR PUNCTURE THERAPEUTIC
|
Facility
|
OP
|
$786.42
|
|
|
Service Code
|
CPT 62272
|
| Hospital Charge Code |
36100279
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$138.65 |
| Max. Negotiated Rate |
$707.78 |
| Rate for Payer: Aetna Commercial |
$668.46
|
| Rate for Payer: Aetna Medicare |
$204.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$245.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$245.76
|
| Rate for Payer: BCBS Complete |
$145.57
|
| Rate for Payer: BCBS MAPPO |
$196.60
|
| Rate for Payer: BCBS Trust/PPO |
$646.52
|
| Rate for Payer: BCN Commercial |
$646.52
|
| Rate for Payer: BCN Medicare Advantage |
$196.60
|
| Rate for Payer: Cash Price |
$629.14
|
| Rate for Payer: Cofinity Commercial |
$676.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$629.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$196.60
|
| Rate for Payer: Healthscope Commercial |
$707.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$589.82
|
| Rate for Payer: Mclaren Medicaid |
$138.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$206.44
|
| Rate for Payer: Meridian Medicaid |
$145.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$226.10
|
| Rate for Payer: Molina Medicare/Medicaid |
$216.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$668.46
|
| Rate for Payer: Nomi Health Commercial |
$644.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$589.82
|
| Rate for Payer: PACE Senior Care Partners |
$186.77
|
| Rate for Payer: PACE SWMI |
$196.60
|
| Rate for Payer: PHP Commercial |
$668.46
|
| Rate for Payer: PHP Medicare Advantage |
$196.60
|
| Rate for Payer: Priority Health Choice Medicaid |
$138.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$684.19
|
| Rate for Payer: Priority Health Medicare |
$198.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$547.35
|
| Rate for Payer: Railroad Medicare Medicare |
$196.60
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$692.05
|
| Rate for Payer: UHC Core |
$656.66
|
| Rate for Payer: UHC Exchange |
$196.60
|
| Rate for Payer: UHC Medicaid |
$138.65
|
| Rate for Payer: UHC Medicare Advantage |
$196.60
|
| Rate for Payer: UHCCP Medicaid |
$138.65
|
| Rate for Payer: VA VA |
$196.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$589.82
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
OP
|
$2,150.09
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$379.06 |
| Max. Negotiated Rate |
$1,935.08 |
| Rate for Payer: Aetna Commercial |
$1,827.58
|
| Rate for Payer: Aetna Medicare |
$559.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.90
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.90
|
| Rate for Payer: BCBS Complete |
$397.98
|
| Rate for Payer: BCBS MAPPO |
$537.52
|
| Rate for Payer: BCBS Trust/PPO |
$1,767.59
|
| Rate for Payer: BCN Commercial |
$1,767.59
|
| Rate for Payer: BCN Medicare Advantage |
$537.52
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cofinity Commercial |
$1,849.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.07
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.52
|
| Rate for Payer: Healthscope Commercial |
$1,935.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,612.57
|
| Rate for Payer: Mclaren Medicaid |
$379.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.40
|
| Rate for Payer: Meridian Medicaid |
$397.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.58
|
| Rate for Payer: Nomi Health Commercial |
$1,763.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.57
|
| Rate for Payer: PACE Senior Care Partners |
$510.65
|
| Rate for Payer: PACE SWMI |
$537.52
|
| Rate for Payer: PHP Commercial |
$1,827.58
|
| Rate for Payer: PHP Medicare Advantage |
$537.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$379.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,870.58
|
| Rate for Payer: Priority Health Medicare |
$542.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,496.46
|
| Rate for Payer: Railroad Medicare Medicare |
$537.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,892.08
|
| Rate for Payer: UHC Core |
$1,795.33
|
| Rate for Payer: UHC Exchange |
$537.52
|
| Rate for Payer: UHC Medicaid |
$379.06
|
| Rate for Payer: UHC Medicare Advantage |
$537.52
|
| Rate for Payer: UHCCP Medicaid |
$379.06
|
| Rate for Payer: VA VA |
$537.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,612.57
|
|
|
HC LUNG/MED BIOPSY
|
Facility
|
IP
|
$2,150.09
|
|
|
Service Code
|
CPT 32408
|
| Hospital Charge Code |
36100609
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,496.46 |
| Max. Negotiated Rate |
$1,935.08 |
| Rate for Payer: Aetna Commercial |
$1,827.58
|
| Rate for Payer: BCBS Trust/PPO |
$1,775.76
|
| Rate for Payer: BCN Commercial |
$1,775.76
|
| Rate for Payer: Cash Price |
$1,720.07
|
| Rate for Payer: Cofinity Commercial |
$1,849.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,720.07
|
| Rate for Payer: Healthscope Commercial |
$1,935.08
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,612.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,827.58
|
| Rate for Payer: Nomi Health Commercial |
$1,763.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,612.57
|
| Rate for Payer: PHP Commercial |
$1,827.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,870.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,496.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,892.08
|
| Rate for Payer: UHC Core |
$1,795.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,612.57
|
|
|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
IP
|
$166.46
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$115.86 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: BCBS Trust/PPO |
$137.48
|
| Rate for Payer: BCN Commercial |
$137.48
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC LUPUS ANTICOAGULANT HEX PHASE
|
Facility
|
OP
|
$166.46
|
|
|
Service Code
|
CPT 85598
|
| Hospital Charge Code |
30500057
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$29.35 |
| Max. Negotiated Rate |
$149.81 |
| Rate for Payer: Aetna Commercial |
$141.49
|
| Rate for Payer: Aetna Medicare |
$43.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.02
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.02
|
| Rate for Payer: BCBS Complete |
$30.81
|
| Rate for Payer: BCBS MAPPO |
$41.62
|
| Rate for Payer: BCBS Trust/PPO |
$136.85
|
| Rate for Payer: BCN Commercial |
$136.85
|
| Rate for Payer: BCN Medicare Advantage |
$41.62
|
| Rate for Payer: Cash Price |
$133.17
|
| Rate for Payer: Cofinity Commercial |
$143.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.17
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$149.81
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$124.84
|
| Rate for Payer: Mclaren Medicaid |
$29.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.70
|
| Rate for Payer: Meridian Medicaid |
$30.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$47.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$45.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$141.49
|
| Rate for Payer: Nomi Health Commercial |
$136.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$124.84
|
| Rate for Payer: PACE Senior Care Partners |
$39.53
|
| Rate for Payer: PACE SWMI |
$41.62
|
| Rate for Payer: PHP Commercial |
$141.49
|
| Rate for Payer: PHP Medicare Advantage |
$41.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$144.82
|
| Rate for Payer: Priority Health Medicare |
$42.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$115.86
|
| Rate for Payer: Railroad Medicare Medicare |
$41.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$146.48
|
| Rate for Payer: UHC Core |
$138.99
|
| Rate for Payer: UHC Exchange |
$41.62
|
| Rate for Payer: UHC Medicaid |
$29.35
|
| Rate for Payer: UHC Medicare Advantage |
$41.62
|
| Rate for Payer: UHCCP Medicaid |
$29.35
|
| Rate for Payer: VA VA |
$41.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$124.84
|
|
|
HC LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, 1 MILLICURIE
|
Facility
|
OP
|
$325.00
|
|
|
Service Code
|
HCPCS A9607
|
| Hospital Charge Code |
34300040
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$57.30 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$276.25
|
| Rate for Payer: Aetna Medicare |
$84.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$101.56
|
| Rate for Payer: Amish Plain Church Group Commercial |
$101.56
|
| Rate for Payer: BCBS Complete |
$60.16
|
| Rate for Payer: BCBS MAPPO |
$81.25
|
| Rate for Payer: BCBS Trust/PPO |
$267.18
|
| Rate for Payer: BCN Commercial |
$267.18
|
| Rate for Payer: BCN Medicare Advantage |
$81.25
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$279.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$81.25
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.75
|
| Rate for Payer: Mclaren Medicaid |
$57.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$85.31
|
| Rate for Payer: Meridian Medicaid |
$60.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$93.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$89.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.25
|
| Rate for Payer: Nomi Health Commercial |
$266.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PACE Senior Care Partners |
$77.19
|
| Rate for Payer: PACE SWMI |
$81.25
|
| Rate for Payer: PHP Commercial |
$276.25
|
| Rate for Payer: PHP Medicare Advantage |
$81.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$57.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$282.75
|
| Rate for Payer: Priority Health Medicare |
$82.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.20
|
| Rate for Payer: Railroad Medicare Medicare |
$81.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.00
|
| Rate for Payer: UHC Core |
$271.38
|
| Rate for Payer: UHC Exchange |
$81.25
|
| Rate for Payer: UHC Medicaid |
$57.30
|
| Rate for Payer: UHC Medicare Advantage |
$81.25
|
| Rate for Payer: UHCCP Medicaid |
$57.30
|
| Rate for Payer: VA VA |
$81.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.75
|
|
|
HC LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, 1 MILLICURIE
|
Facility
|
IP
|
$325.00
|
|
|
Service Code
|
HCPCS A9607
|
| Hospital Charge Code |
34300040
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$226.20 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Aetna Commercial |
$276.25
|
| Rate for Payer: BCBS Trust/PPO |
$268.42
|
| Rate for Payer: BCN Commercial |
$268.42
|
| Rate for Payer: Cash Price |
$260.00
|
| Rate for Payer: Cofinity Commercial |
$279.50
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$260.00
|
| Rate for Payer: Healthscope Commercial |
$292.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$243.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$276.25
|
| Rate for Payer: Nomi Health Commercial |
$266.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$243.75
|
| Rate for Payer: PHP Commercial |
$276.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$282.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$226.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$286.00
|
| Rate for Payer: UHC Core |
$271.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$243.75
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
OP
|
$317.32
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$55.94 |
| Max. Negotiated Rate |
$285.59 |
| Rate for Payer: Aetna Commercial |
$269.72
|
| Rate for Payer: Aetna Medicare |
$82.50
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$99.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$99.16
|
| Rate for Payer: BCBS Complete |
$58.74
|
| Rate for Payer: BCBS MAPPO |
$79.33
|
| Rate for Payer: BCBS Trust/PPO |
$260.87
|
| Rate for Payer: BCCCP Commercial |
$67.27
|
| Rate for Payer: BCN Commercial |
$260.87
|
| Rate for Payer: BCN Medicare Advantage |
$79.33
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cofinity Commercial |
$272.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$79.33
|
| Rate for Payer: Healthscope Commercial |
$285.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.99
|
| Rate for Payer: Mclaren Medicaid |
$55.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$83.30
|
| Rate for Payer: Meridian Medicaid |
$58.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$91.23
|
| Rate for Payer: Molina Medicare/Medicaid |
$87.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.72
|
| Rate for Payer: Nomi Health Commercial |
$260.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.99
|
| Rate for Payer: PACE Senior Care Partners |
$75.36
|
| Rate for Payer: PACE SWMI |
$79.33
|
| Rate for Payer: PHP Commercial |
$269.72
|
| Rate for Payer: PHP Medicare Advantage |
$79.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$55.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$276.07
|
| Rate for Payer: Priority Health Medicare |
$80.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.85
|
| Rate for Payer: Railroad Medicare Medicare |
$79.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.24
|
| Rate for Payer: UHC Core |
$264.96
|
| Rate for Payer: UHC Exchange |
$79.33
|
| Rate for Payer: UHC Medicaid |
$55.94
|
| Rate for Payer: UHC Medicare Advantage |
$79.33
|
| Rate for Payer: UHCCP Medicaid |
$55.94
|
| Rate for Payer: VA VA |
$79.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.99
|
|
|
HC LV4RP GROSS_MICRO (BILL ONLY)
|
Facility
|
IP
|
$317.32
|
|
|
Service Code
|
CPT 88305
|
| Hospital Charge Code |
31000087
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$220.85 |
| Max. Negotiated Rate |
$285.59 |
| Rate for Payer: Aetna Commercial |
$269.72
|
| Rate for Payer: BCBS Trust/PPO |
$262.07
|
| Rate for Payer: BCN Commercial |
$262.07
|
| Rate for Payer: Cash Price |
$253.86
|
| Rate for Payer: Cofinity Commercial |
$272.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$253.86
|
| Rate for Payer: Healthscope Commercial |
$285.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$237.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$269.72
|
| Rate for Payer: Nomi Health Commercial |
$260.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$237.99
|
| Rate for Payer: PHP Commercial |
$269.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$276.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$220.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$279.24
|
| Rate for Payer: UHC Core |
$264.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$237.99
|
|
|
HC LVAD INSERTION
|
Facility
|
OP
|
$3,288.11
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$579.69 |
| Max. Negotiated Rate |
$2,959.30 |
| Rate for Payer: Aetna Commercial |
$2,794.89
|
| Rate for Payer: Aetna Medicare |
$854.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,027.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,027.53
|
| Rate for Payer: BCBS Complete |
$608.63
|
| Rate for Payer: BCBS MAPPO |
$822.03
|
| Rate for Payer: BCBS Trust/PPO |
$2,703.16
|
| Rate for Payer: BCN Commercial |
$2,703.16
|
| Rate for Payer: BCN Medicare Advantage |
$822.03
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cofinity Commercial |
$2,827.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.49
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.03
|
| Rate for Payer: Healthscope Commercial |
$2,959.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.08
|
| Rate for Payer: Mclaren Medicaid |
$579.69
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.13
|
| Rate for Payer: Meridian Medicaid |
$608.63
|
| Rate for Payer: MI Amish Medical Board Commercial |
$945.33
|
| Rate for Payer: Molina Medicare/Medicaid |
$904.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.89
|
| Rate for Payer: Nomi Health Commercial |
$2,696.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.08
|
| Rate for Payer: PACE Senior Care Partners |
$780.93
|
| Rate for Payer: PACE SWMI |
$822.03
|
| Rate for Payer: PHP Commercial |
$2,794.89
|
| Rate for Payer: PHP Medicare Advantage |
$822.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$579.69
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,860.66
|
| Rate for Payer: Priority Health Medicare |
$830.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,288.52
|
| Rate for Payer: Railroad Medicare Medicare |
$822.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.54
|
| Rate for Payer: UHC Core |
$2,745.57
|
| Rate for Payer: UHC Exchange |
$822.03
|
| Rate for Payer: UHC Medicaid |
$579.69
|
| Rate for Payer: UHC Medicare Advantage |
$822.03
|
| Rate for Payer: UHCCP Medicaid |
$579.69
|
| Rate for Payer: VA VA |
$822.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.08
|
|
|
HC LVAD INSERTION
|
Facility
|
IP
|
$3,288.11
|
|
|
Service Code
|
CPT 33990
|
| Hospital Charge Code |
36100084
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,288.52 |
| Max. Negotiated Rate |
$2,959.30 |
| Rate for Payer: Aetna Commercial |
$2,794.89
|
| Rate for Payer: BCBS Trust/PPO |
$2,715.65
|
| Rate for Payer: BCN Commercial |
$2,715.65
|
| Rate for Payer: Cash Price |
$2,630.49
|
| Rate for Payer: Cofinity Commercial |
$2,827.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.49
|
| Rate for Payer: Healthscope Commercial |
$2,959.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.89
|
| Rate for Payer: Nomi Health Commercial |
$2,696.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,466.08
|
| Rate for Payer: PHP Commercial |
$2,794.89
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,860.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,288.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.54
|
| Rate for Payer: UHC Core |
$2,745.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.08
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
IP
|
$2,889.46
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$2,011.06 |
| Max. Negotiated Rate |
$2,600.51 |
| Rate for Payer: Aetna Commercial |
$2,456.04
|
| Rate for Payer: BCBS Trust/PPO |
$2,386.41
|
| Rate for Payer: BCN Commercial |
$2,386.41
|
| Rate for Payer: Cash Price |
$2,311.57
|
| Rate for Payer: Cofinity Commercial |
$2,484.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,311.57
|
| Rate for Payer: Healthscope Commercial |
$2,600.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,167.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,456.04
|
| Rate for Payer: Nomi Health Commercial |
$2,369.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,167.09
|
| Rate for Payer: PHP Commercial |
$2,456.04
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,513.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,011.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,542.72
|
| Rate for Payer: UHC Core |
$2,412.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,167.09
|
|
|
HC LVDS PLT PER LEUKO RED IRRAD
|
Facility
|
OP
|
$2,889.46
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000088
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$509.41 |
| Max. Negotiated Rate |
$2,600.51 |
| Rate for Payer: Aetna Commercial |
$2,456.04
|
| Rate for Payer: Aetna Medicare |
$751.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$902.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$902.96
|
| Rate for Payer: BCBS Complete |
$534.84
|
| Rate for Payer: BCBS MAPPO |
$722.37
|
| Rate for Payer: BCBS Trust/PPO |
$2,375.43
|
| Rate for Payer: BCN Commercial |
$2,375.43
|
| Rate for Payer: BCN Medicare Advantage |
$722.37
|
| Rate for Payer: Cash Price |
$2,311.57
|
| Rate for Payer: Cofinity Commercial |
$2,484.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,311.57
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$722.37
|
| Rate for Payer: Healthscope Commercial |
$2,600.51
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,167.09
|
| Rate for Payer: Mclaren Medicaid |
$509.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$758.48
|
| Rate for Payer: Meridian Medicaid |
$534.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$830.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$794.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,456.04
|
| Rate for Payer: Nomi Health Commercial |
$2,369.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,167.09
|
| Rate for Payer: PACE Senior Care Partners |
$686.25
|
| Rate for Payer: PACE SWMI |
$722.37
|
| Rate for Payer: PHP Commercial |
$2,456.04
|
| Rate for Payer: PHP Medicare Advantage |
$722.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$509.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,513.83
|
| Rate for Payer: Priority Health Medicare |
$729.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,011.06
|
| Rate for Payer: Railroad Medicare Medicare |
$722.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,542.72
|
| Rate for Payer: UHC Core |
$2,412.70
|
| Rate for Payer: UHC Exchange |
$722.37
|
| Rate for Payer: UHC Medicaid |
$509.41
|
| Rate for Payer: UHC Medicare Advantage |
$722.37
|
| Rate for Payer: UHCCP Medicaid |
$509.41
|
| Rate for Payer: VA VA |
$722.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,167.09
|
|
|
HC LVDS PLT PHER LEUKO RED
|
Facility
|
OP
|
$2,244.05
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000087
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$395.63 |
| Max. Negotiated Rate |
$2,019.64 |
| Rate for Payer: Aetna Commercial |
$1,907.44
|
| Rate for Payer: Aetna Medicare |
$583.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$701.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$701.27
|
| Rate for Payer: BCBS Complete |
$415.37
|
| Rate for Payer: BCBS MAPPO |
$561.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,844.83
|
| Rate for Payer: BCN Commercial |
$1,844.83
|
| Rate for Payer: BCN Medicare Advantage |
$561.01
|
| Rate for Payer: Cash Price |
$1,795.24
|
| Rate for Payer: Cofinity Commercial |
$1,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,795.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$561.01
|
| Rate for Payer: Healthscope Commercial |
$2,019.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,683.04
|
| Rate for Payer: Mclaren Medicaid |
$395.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$589.06
|
| Rate for Payer: Meridian Medicaid |
$415.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$645.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$617.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,907.44
|
| Rate for Payer: Nomi Health Commercial |
$1,840.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,683.04
|
| Rate for Payer: PACE Senior Care Partners |
$532.96
|
| Rate for Payer: PACE SWMI |
$561.01
|
| Rate for Payer: PHP Commercial |
$1,907.44
|
| Rate for Payer: PHP Medicare Advantage |
$561.01
|
| Rate for Payer: Priority Health Choice Medicaid |
$395.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,952.32
|
| Rate for Payer: Priority Health Medicare |
$566.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,561.86
|
| Rate for Payer: Railroad Medicare Medicare |
$561.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.76
|
| Rate for Payer: UHC Core |
$1,873.78
|
| Rate for Payer: UHC Exchange |
$561.01
|
| Rate for Payer: UHC Medicaid |
$395.63
|
| Rate for Payer: UHC Medicare Advantage |
$561.01
|
| Rate for Payer: UHCCP Medicaid |
$395.63
|
| Rate for Payer: VA VA |
$561.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,683.04
|
|
|
HC LVDS PLT PHER LEUKO RED
|
Facility
|
IP
|
$2,244.05
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000087
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,561.86 |
| Max. Negotiated Rate |
$2,019.64 |
| Rate for Payer: Aetna Commercial |
$1,907.44
|
| Rate for Payer: BCBS Trust/PPO |
$1,853.36
|
| Rate for Payer: BCN Commercial |
$1,853.36
|
| Rate for Payer: Cash Price |
$1,795.24
|
| Rate for Payer: Cofinity Commercial |
$1,929.88
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,795.24
|
| Rate for Payer: Healthscope Commercial |
$2,019.64
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,683.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,907.44
|
| Rate for Payer: Nomi Health Commercial |
$1,840.12
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,683.04
|
| Rate for Payer: PHP Commercial |
$1,907.44
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,952.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,561.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,974.76
|
| Rate for Payer: UHC Core |
$1,873.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,683.04
|
|
|
HC LV LEAD PLACEMENT
|
Facility
|
IP
|
$9,737.48
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
36100070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,777.29 |
| Max. Negotiated Rate |
$8,763.73 |
| Rate for Payer: Aetna Commercial |
$8,276.86
|
| Rate for Payer: BCBS Trust/PPO |
$8,042.18
|
| Rate for Payer: BCN Commercial |
$8,042.18
|
| Rate for Payer: Cash Price |
$7,789.98
|
| Rate for Payer: Cofinity Commercial |
$8,374.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,789.98
|
| Rate for Payer: Healthscope Commercial |
$8,763.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,303.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,276.86
|
| Rate for Payer: Nomi Health Commercial |
$7,984.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,303.11
|
| Rate for Payer: PHP Commercial |
$8,276.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,471.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,777.29
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,568.98
|
| Rate for Payer: UHC Core |
$8,130.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,303.11
|
|
|
HC LV LEAD PLACEMENT
|
Facility
|
OP
|
$9,737.48
|
|
|
Service Code
|
CPT 33225
|
| Hospital Charge Code |
36100070
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,716.72 |
| Max. Negotiated Rate |
$8,763.73 |
| Rate for Payer: Aetna Commercial |
$8,276.86
|
| Rate for Payer: Aetna Medicare |
$2,531.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,042.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,042.96
|
| Rate for Payer: BCBS Complete |
$1,802.41
|
| Rate for Payer: BCBS MAPPO |
$2,434.37
|
| Rate for Payer: BCBS Trust/PPO |
$8,005.18
|
| Rate for Payer: BCN Commercial |
$8,005.18
|
| Rate for Payer: BCN Medicare Advantage |
$2,434.37
|
| Rate for Payer: Cash Price |
$7,789.98
|
| Rate for Payer: Cofinity Commercial |
$8,374.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,789.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,434.37
|
| Rate for Payer: Healthscope Commercial |
$8,763.73
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$7,303.11
|
| Rate for Payer: Mclaren Medicaid |
$1,716.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,556.09
|
| Rate for Payer: Meridian Medicaid |
$1,802.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,799.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,677.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$8,276.86
|
| Rate for Payer: Nomi Health Commercial |
$7,984.73
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$7,303.11
|
| Rate for Payer: PACE Senior Care Partners |
$2,312.65
|
| Rate for Payer: PACE SWMI |
$2,434.37
|
| Rate for Payer: PHP Commercial |
$8,276.86
|
| Rate for Payer: PHP Medicare Advantage |
$2,434.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,716.72
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,471.61
|
| Rate for Payer: Priority Health Medicare |
$2,458.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,777.29
|
| Rate for Payer: Railroad Medicare Medicare |
$2,434.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,568.98
|
| Rate for Payer: UHC Core |
$8,130.80
|
| Rate for Payer: UHC Exchange |
$2,434.37
|
| Rate for Payer: UHC Medicaid |
$1,716.72
|
| Rate for Payer: UHC Medicare Advantage |
$2,434.37
|
| Rate for Payer: UHCCP Medicaid |
$1,716.72
|
| Rate for Payer: VA VA |
$2,434.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$7,303.11
|
|
|
HC LV LEAD REPOSITIONING
|
Facility
|
OP
|
$3,660.20
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
36100071
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$645.29 |
| Max. Negotiated Rate |
$3,294.18 |
| Rate for Payer: Aetna Commercial |
$3,111.17
|
| Rate for Payer: Aetna Medicare |
$951.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,143.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,143.81
|
| Rate for Payer: BCBS Complete |
$677.50
|
| Rate for Payer: BCBS MAPPO |
$915.05
|
| Rate for Payer: BCBS Trust/PPO |
$3,009.05
|
| Rate for Payer: BCN Commercial |
$3,009.05
|
| Rate for Payer: BCN Medicare Advantage |
$915.05
|
| Rate for Payer: Cash Price |
$2,928.16
|
| Rate for Payer: Cofinity Commercial |
$3,147.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,928.16
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$915.05
|
| Rate for Payer: Healthscope Commercial |
$3,294.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,745.15
|
| Rate for Payer: Mclaren Medicaid |
$645.29
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$960.80
|
| Rate for Payer: Meridian Medicaid |
$677.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,052.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,006.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,111.17
|
| Rate for Payer: Nomi Health Commercial |
$3,001.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,745.15
|
| Rate for Payer: PACE Senior Care Partners |
$869.30
|
| Rate for Payer: PACE SWMI |
$915.05
|
| Rate for Payer: PHP Commercial |
$3,111.17
|
| Rate for Payer: PHP Medicare Advantage |
$915.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$645.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,184.37
|
| Rate for Payer: Priority Health Medicare |
$924.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,547.50
|
| Rate for Payer: Railroad Medicare Medicare |
$915.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,220.98
|
| Rate for Payer: UHC Core |
$3,056.27
|
| Rate for Payer: UHC Exchange |
$915.05
|
| Rate for Payer: UHC Medicaid |
$645.29
|
| Rate for Payer: UHC Medicare Advantage |
$915.05
|
| Rate for Payer: UHCCP Medicaid |
$645.29
|
| Rate for Payer: VA VA |
$915.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,745.15
|
|
|
HC LV LEAD REPOSITIONING
|
Facility
|
IP
|
$3,660.20
|
|
|
Service Code
|
CPT 33226
|
| Hospital Charge Code |
36100071
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,547.50 |
| Max. Negotiated Rate |
$3,294.18 |
| Rate for Payer: Aetna Commercial |
$3,111.17
|
| Rate for Payer: BCBS Trust/PPO |
$3,022.96
|
| Rate for Payer: BCN Commercial |
$3,022.96
|
| Rate for Payer: Cash Price |
$2,928.16
|
| Rate for Payer: Cofinity Commercial |
$3,147.77
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,928.16
|
| Rate for Payer: Healthscope Commercial |
$3,294.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,745.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,111.17
|
| Rate for Payer: Nomi Health Commercial |
$3,001.36
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,745.15
|
| Rate for Payer: PHP Commercial |
$3,111.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,184.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,547.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,220.98
|
| Rate for Payer: UHC Core |
$3,056.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,745.15
|
|
|
HC LYME AB CONFIRMATION CMPT
|
Facility
|
IP
|
$35.02
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$24.37 |
| Max. Negotiated Rate |
$31.52 |
| Rate for Payer: Aetna Commercial |
$29.77
|
| Rate for Payer: BCBS Trust/PPO |
$28.92
|
| Rate for Payer: BCN Commercial |
$28.92
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cofinity Commercial |
$30.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.02
|
| Rate for Payer: Healthscope Commercial |
$31.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.27
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.77
|
| Rate for Payer: Nomi Health Commercial |
$28.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.27
|
| Rate for Payer: PHP Commercial |
$29.77
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.82
|
| Rate for Payer: UHC Core |
$29.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.27
|
|
|
HC LYME AB CONFIRMATION CMPT
|
Facility
|
OP
|
$35.02
|
|
|
Service Code
|
CPT 86617
|
| Hospital Charge Code |
30200232
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.17 |
| Max. Negotiated Rate |
$31.52 |
| Rate for Payer: Aetna Commercial |
$29.77
|
| Rate for Payer: Aetna Medicare |
$9.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.94
|
| Rate for Payer: BCBS Complete |
$6.48
|
| Rate for Payer: BCBS MAPPO |
$8.76
|
| Rate for Payer: BCBS Trust/PPO |
$28.79
|
| Rate for Payer: BCN Commercial |
$28.79
|
| Rate for Payer: BCN Medicare Advantage |
$8.76
|
| Rate for Payer: Cash Price |
$28.02
|
| Rate for Payer: Cofinity Commercial |
$30.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.76
|
| Rate for Payer: Healthscope Commercial |
$31.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.27
|
| Rate for Payer: Mclaren Medicaid |
$6.17
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.19
|
| Rate for Payer: Meridian Medicaid |
$6.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.07
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.77
|
| Rate for Payer: Nomi Health Commercial |
$28.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.27
|
| Rate for Payer: PACE Senior Care Partners |
$8.32
|
| Rate for Payer: PACE SWMI |
$8.76
|
| Rate for Payer: PHP Commercial |
$29.77
|
| Rate for Payer: PHP Medicare Advantage |
$8.76
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.47
|
| Rate for Payer: Priority Health Medicare |
$8.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.37
|
| Rate for Payer: Railroad Medicare Medicare |
$8.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.82
|
| Rate for Payer: UHC Core |
$29.24
|
| Rate for Payer: UHC Exchange |
$8.76
|
| Rate for Payer: UHC Medicaid |
$6.17
|
| Rate for Payer: UHC Medicare Advantage |
$8.76
|
| Rate for Payer: UHCCP Medicaid |
$6.17
|
| Rate for Payer: VA VA |
$8.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.27
|
|
|
HC LYME CSF COMPONENT 1
|
Facility
|
OP
|
$61.38
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100669
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.82 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: Aetna Medicare |
$15.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$19.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$19.18
|
| Rate for Payer: BCBS Complete |
$11.36
|
| Rate for Payer: BCBS MAPPO |
$15.35
|
| Rate for Payer: BCBS Trust/PPO |
$50.46
|
| Rate for Payer: BCN Commercial |
$50.46
|
| Rate for Payer: BCN Medicare Advantage |
$15.35
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$15.35
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Mclaren Medicaid |
$10.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$16.11
|
| Rate for Payer: Meridian Medicaid |
$11.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$17.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.03
|
| Rate for Payer: PACE Senior Care Partners |
$14.58
|
| Rate for Payer: PACE SWMI |
$15.35
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: PHP Medicare Advantage |
$15.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.40
|
| Rate for Payer: Priority Health Medicare |
$15.50
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.72
|
| Rate for Payer: Railroad Medicare Medicare |
$15.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.01
|
| Rate for Payer: UHC Core |
$51.25
|
| Rate for Payer: UHC Exchange |
$15.35
|
| Rate for Payer: UHC Medicaid |
$10.82
|
| Rate for Payer: UHC Medicare Advantage |
$15.35
|
| Rate for Payer: UHCCP Medicaid |
$10.82
|
| Rate for Payer: VA VA |
$15.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
|
HC LYME CSF COMPONENT 1
|
Facility
|
IP
|
$61.38
|
|
|
Service Code
|
CPT 82042
|
| Hospital Charge Code |
30100669
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$42.72 |
| Max. Negotiated Rate |
$55.24 |
| Rate for Payer: Aetna Commercial |
$52.17
|
| Rate for Payer: BCBS Trust/PPO |
$50.69
|
| Rate for Payer: BCN Commercial |
$50.69
|
| Rate for Payer: Cash Price |
$49.10
|
| Rate for Payer: Cofinity Commercial |
$52.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$49.10
|
| Rate for Payer: Healthscope Commercial |
$55.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$46.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$52.17
|
| Rate for Payer: Nomi Health Commercial |
$50.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$46.03
|
| Rate for Payer: PHP Commercial |
$52.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$53.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$42.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$54.01
|
| Rate for Payer: UHC Core |
$51.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$46.03
|
|
