|
HC IVUS EA ADDL NON CORONARY VESSEL
|
Facility
|
OP
|
$1,324.84
|
|
|
Service Code
|
CPT 37253
|
| Hospital Charge Code |
36100484
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$314.65 |
| Max. Negotiated Rate |
$1,192.36 |
| Rate for Payer: Aetna Commercial |
$1,126.11
|
| Rate for Payer: Aetna Medicare |
$344.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$414.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$414.01
|
| Rate for Payer: BCBS Complete |
$529.94
|
| Rate for Payer: BCBS MAPPO |
$331.21
|
| Rate for Payer: BCBS Trust/PPO |
$1,089.15
|
| Rate for Payer: BCN Commercial |
$1,030.06
|
| Rate for Payer: BCN Medicare Advantage |
$331.21
|
| Rate for Payer: Cash Price |
$1,059.87
|
| Rate for Payer: Cofinity Commercial |
$1,139.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,059.87
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$331.21
|
| Rate for Payer: Healthscope Commercial |
$1,192.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$993.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$347.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$380.89
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,126.11
|
| Rate for Payer: Nomi Health Commercial |
$1,086.37
|
| Rate for Payer: PACE Senior Care Partners |
$314.65
|
| Rate for Payer: PACE SWMI |
$331.21
|
| Rate for Payer: PHP Commercial |
$1,126.11
|
| Rate for Payer: PHP Medicare Advantage |
$331.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$861.15
|
| Rate for Payer: Priority Health HMO/PPO |
$1,152.61
|
| Rate for Payer: Priority Health Medicare |
$334.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$887.64
|
| Rate for Payer: Railroad Medicare Medicare |
$331.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,165.86
|
| Rate for Payer: UHC Core |
$1,106.24
|
| Rate for Payer: UHC Dual Complete DSNP |
$331.21
|
| Rate for Payer: UHC Exchange |
$331.21
|
| Rate for Payer: UHC Medicare Advantage |
$331.21
|
| Rate for Payer: VA VA |
$331.21
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$993.63
|
|
|
HC IVUS NON CORONARY INITIAL
|
Facility
|
IP
|
$7,832.55
|
|
|
Service Code
|
CPT 37252
|
| Hospital Charge Code |
36100483
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,091.16 |
| Max. Negotiated Rate |
$7,049.30 |
| Rate for Payer: Aetna Commercial |
$6,657.67
|
| Rate for Payer: BCBS Trust/PPO |
$6,393.71
|
| Rate for Payer: BCN Commercial |
$6,052.99
|
| Rate for Payer: Cash Price |
$6,266.04
|
| Rate for Payer: Cofinity Commercial |
$6,735.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,266.04
|
| Rate for Payer: Healthscope Commercial |
$7,049.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,874.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,657.67
|
| Rate for Payer: Nomi Health Commercial |
$6,422.69
|
| Rate for Payer: PHP Commercial |
$6,657.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,091.16
|
| Rate for Payer: Priority Health HMO/PPO |
$6,814.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,247.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,892.64
|
| Rate for Payer: UHC Core |
$6,540.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,874.41
|
|
|
HC IVUS NON CORONARY INITIAL
|
Facility
|
OP
|
$7,832.55
|
|
|
Service Code
|
CPT 37252
|
| Hospital Charge Code |
36100483
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,860.23 |
| Max. Negotiated Rate |
$7,049.30 |
| Rate for Payer: Aetna Commercial |
$6,657.67
|
| Rate for Payer: Aetna Medicare |
$2,036.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,447.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,447.67
|
| Rate for Payer: BCBS Complete |
$3,133.02
|
| Rate for Payer: BCBS MAPPO |
$1,958.14
|
| Rate for Payer: BCBS Trust/PPO |
$6,439.14
|
| Rate for Payer: BCN Commercial |
$6,089.81
|
| Rate for Payer: BCN Medicare Advantage |
$1,958.14
|
| Rate for Payer: Cash Price |
$6,266.04
|
| Rate for Payer: Cofinity Commercial |
$6,735.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,266.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$1,958.14
|
| Rate for Payer: Healthscope Commercial |
$7,049.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$5,874.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,056.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,251.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,657.67
|
| Rate for Payer: Nomi Health Commercial |
$6,422.69
|
| Rate for Payer: PACE Senior Care Partners |
$1,860.23
|
| Rate for Payer: PACE SWMI |
$1,958.14
|
| Rate for Payer: PHP Commercial |
$6,657.67
|
| Rate for Payer: PHP Medicare Advantage |
$1,958.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,091.16
|
| Rate for Payer: Priority Health HMO/PPO |
$6,814.32
|
| Rate for Payer: Priority Health Medicare |
$1,977.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$5,247.81
|
| Rate for Payer: Railroad Medicare Medicare |
$1,958.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$6,892.64
|
| Rate for Payer: UHC Core |
$6,540.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$1,958.14
|
| Rate for Payer: UHC Exchange |
$1,958.14
|
| Rate for Payer: UHC Medicare Advantage |
$1,958.14
|
| Rate for Payer: VA VA |
$1,958.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$5,874.41
|
|
|
HC IVUS OR OCT EACH ADDL VESSEL
|
Facility
|
OP
|
$1,532.20
|
|
|
Service Code
|
CPT 92979
|
| Hospital Charge Code |
48100107
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$363.90 |
| Max. Negotiated Rate |
$1,378.98 |
| Rate for Payer: Aetna Commercial |
$1,302.37
|
| Rate for Payer: Aetna Medicare |
$398.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$478.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$478.81
|
| Rate for Payer: BCBS Complete |
$612.88
|
| Rate for Payer: BCBS MAPPO |
$383.05
|
| Rate for Payer: BCBS Trust/PPO |
$1,259.62
|
| Rate for Payer: BCN Commercial |
$1,191.29
|
| Rate for Payer: BCN Medicare Advantage |
$383.05
|
| Rate for Payer: Cash Price |
$1,225.76
|
| Rate for Payer: Cofinity Commercial |
$1,317.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,225.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$383.05
|
| Rate for Payer: Healthscope Commercial |
$1,378.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,149.15
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$402.20
|
| Rate for Payer: MI Amish Medical Board Commercial |
$440.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,302.37
|
| Rate for Payer: Nomi Health Commercial |
$1,256.40
|
| Rate for Payer: PACE Senior Care Partners |
$363.90
|
| Rate for Payer: PACE SWMI |
$383.05
|
| Rate for Payer: PHP Commercial |
$1,302.37
|
| Rate for Payer: PHP Medicare Advantage |
$383.05
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.93
|
| Rate for Payer: Priority Health HMO/PPO |
$1,333.01
|
| Rate for Payer: Priority Health Medicare |
$386.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.57
|
| Rate for Payer: Railroad Medicare Medicare |
$383.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,348.34
|
| Rate for Payer: UHC Core |
$1,279.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$383.05
|
| Rate for Payer: UHC Exchange |
$383.05
|
| Rate for Payer: UHC Medicare Advantage |
$383.05
|
| Rate for Payer: VA VA |
$383.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,149.15
|
|
|
HC IVUS OR OCT EACH ADDL VESSEL
|
Facility
|
IP
|
$1,532.20
|
|
|
Service Code
|
CPT 92979
|
| Hospital Charge Code |
48100107
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$995.93 |
| Max. Negotiated Rate |
$1,378.98 |
| Rate for Payer: Aetna Commercial |
$1,302.37
|
| Rate for Payer: BCBS Trust/PPO |
$1,250.73
|
| Rate for Payer: BCN Commercial |
$1,184.08
|
| Rate for Payer: Cash Price |
$1,225.76
|
| Rate for Payer: Cofinity Commercial |
$1,317.69
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,225.76
|
| Rate for Payer: Healthscope Commercial |
$1,378.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,149.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,302.37
|
| Rate for Payer: Nomi Health Commercial |
$1,256.40
|
| Rate for Payer: PHP Commercial |
$1,302.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$995.93
|
| Rate for Payer: Priority Health HMO/PPO |
$1,333.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,026.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,348.34
|
| Rate for Payer: UHC Core |
$1,279.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,149.15
|
|
|
HC IVUS OR OCT INITIAL VESSEL
|
Facility
|
IP
|
$3,693.88
|
|
|
Service Code
|
CPT 92978
|
| Hospital Charge Code |
48100106
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,401.02 |
| Max. Negotiated Rate |
$3,324.49 |
| Rate for Payer: Aetna Commercial |
$3,139.80
|
| Rate for Payer: BCBS Trust/PPO |
$3,015.31
|
| Rate for Payer: BCN Commercial |
$2,854.63
|
| Rate for Payer: Cash Price |
$2,955.10
|
| Rate for Payer: Cofinity Commercial |
$3,176.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,955.10
|
| Rate for Payer: Healthscope Commercial |
$3,324.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.80
|
| Rate for Payer: Nomi Health Commercial |
$3,028.98
|
| Rate for Payer: PHP Commercial |
$3,139.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,401.02
|
| Rate for Payer: Priority Health HMO/PPO |
$3,213.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,474.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.61
|
| Rate for Payer: UHC Core |
$3,084.39
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.41
|
|
|
HC IVUS OR OCT INITIAL VESSEL
|
Facility
|
OP
|
$3,693.88
|
|
|
Service Code
|
CPT 92978
|
| Hospital Charge Code |
48100106
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$877.30 |
| Max. Negotiated Rate |
$3,324.49 |
| Rate for Payer: Aetna Commercial |
$3,139.80
|
| Rate for Payer: Aetna Medicare |
$960.41
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,154.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,154.34
|
| Rate for Payer: BCBS Complete |
$1,477.55
|
| Rate for Payer: BCBS MAPPO |
$923.47
|
| Rate for Payer: BCBS Trust/PPO |
$3,036.74
|
| Rate for Payer: BCN Commercial |
$2,871.99
|
| Rate for Payer: BCN Medicare Advantage |
$923.47
|
| Rate for Payer: Cash Price |
$2,955.10
|
| Rate for Payer: Cofinity Commercial |
$3,176.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,955.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$923.47
|
| Rate for Payer: Healthscope Commercial |
$3,324.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,770.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$969.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,061.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,139.80
|
| Rate for Payer: Nomi Health Commercial |
$3,028.98
|
| Rate for Payer: PACE Senior Care Partners |
$877.30
|
| Rate for Payer: PACE SWMI |
$923.47
|
| Rate for Payer: PHP Commercial |
$3,139.80
|
| Rate for Payer: PHP Medicare Advantage |
$923.47
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,401.02
|
| Rate for Payer: Priority Health HMO/PPO |
$3,213.68
|
| Rate for Payer: Priority Health Medicare |
$932.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,474.90
|
| Rate for Payer: Railroad Medicare Medicare |
$923.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,250.61
|
| Rate for Payer: UHC Core |
$3,084.39
|
| Rate for Payer: UHC Dual Complete DSNP |
$923.47
|
| Rate for Payer: UHC Exchange |
$923.47
|
| Rate for Payer: UHC Medicare Advantage |
$923.47
|
| Rate for Payer: VA VA |
$923.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,770.41
|
|
|
HC JAK2 EXON 12 MUTATION DETECTION
|
Facility
|
IP
|
$373.32
|
|
|
Service Code
|
CPT 0027U
|
| Hospital Charge Code |
31000148
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$242.66 |
| Max. Negotiated Rate |
$335.99 |
| Rate for Payer: Aetna Commercial |
$317.32
|
| Rate for Payer: BCBS Trust/PPO |
$304.74
|
| Rate for Payer: BCN Commercial |
$288.50
|
| Rate for Payer: Cash Price |
$298.66
|
| Rate for Payer: Cofinity Commercial |
$321.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.66
|
| Rate for Payer: Healthscope Commercial |
$335.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.32
|
| Rate for Payer: Nomi Health Commercial |
$306.12
|
| Rate for Payer: PHP Commercial |
$317.32
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.66
|
| Rate for Payer: Priority Health HMO/PPO |
$324.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$250.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.52
|
| Rate for Payer: UHC Core |
$311.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.99
|
|
|
HC JAK2 EXON 12 MUTATION DETECTION
|
Facility
|
OP
|
$373.32
|
|
|
Service Code
|
CPT 0027U
|
| Hospital Charge Code |
31000148
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$88.14 |
| Max. Negotiated Rate |
$335.99 |
| Rate for Payer: Aetna Commercial |
$317.32
|
| Rate for Payer: Aetna Medicare |
$97.06
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$116.66
|
| Rate for Payer: Amish Plain Church Group Commercial |
$116.66
|
| Rate for Payer: BCBS Complete |
$92.55
|
| Rate for Payer: BCBS MAPPO |
$93.33
|
| Rate for Payer: BCBS Trust/PPO |
$306.91
|
| Rate for Payer: BCN Commercial |
$290.26
|
| Rate for Payer: BCN Medicare Advantage |
$93.33
|
| Rate for Payer: Cash Price |
$298.66
|
| Rate for Payer: Cash Price |
$298.66
|
| Rate for Payer: Cofinity Commercial |
$321.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$298.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.33
|
| Rate for Payer: Healthscope Commercial |
$335.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$279.99
|
| Rate for Payer: Mclaren Medicaid |
$88.14
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.00
|
| Rate for Payer: Meridian Medicaid |
$92.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$107.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$317.32
|
| Rate for Payer: Nomi Health Commercial |
$306.12
|
| Rate for Payer: PACE Senior Care Partners |
$88.66
|
| Rate for Payer: PACE SWMI |
$93.33
|
| Rate for Payer: PHP Commercial |
$317.32
|
| Rate for Payer: PHP Medicare Advantage |
$93.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$88.14
|
| Rate for Payer: Priority Health Cigna Priority Health |
$242.66
|
| Rate for Payer: Priority Health HMO/PPO |
$324.79
|
| Rate for Payer: Priority Health Medicare |
$94.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$250.12
|
| Rate for Payer: Railroad Medicare Medicare |
$93.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$328.52
|
| Rate for Payer: UHC Core |
$311.72
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.33
|
| Rate for Payer: UHC Exchange |
$93.33
|
| Rate for Payer: UHC Medicare Advantage |
$93.33
|
| Rate for Payer: UHCCP Medicaid |
$88.14
|
| Rate for Payer: VA VA |
$93.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$279.99
|
|
|
HC JAK2 V617F MUTATION
|
Facility
|
OP
|
$388.07
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
31000101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$66.27 |
| Max. Negotiated Rate |
$349.26 |
| Rate for Payer: Aetna Commercial |
$329.86
|
| Rate for Payer: Aetna Medicare |
$100.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$121.27
|
| Rate for Payer: Amish Plain Church Group Commercial |
$121.27
|
| Rate for Payer: BCBS Complete |
$69.59
|
| Rate for Payer: BCBS MAPPO |
$97.02
|
| Rate for Payer: BCBS Trust/PPO |
$319.03
|
| Rate for Payer: BCN Commercial |
$301.72
|
| Rate for Payer: BCN Medicare Advantage |
$97.02
|
| Rate for Payer: Cash Price |
$310.46
|
| Rate for Payer: Cash Price |
$310.46
|
| Rate for Payer: Cofinity Commercial |
$333.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$97.02
|
| Rate for Payer: Healthscope Commercial |
$349.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.05
|
| Rate for Payer: Mclaren Medicaid |
$66.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$101.87
|
| Rate for Payer: Meridian Medicaid |
$69.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$111.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.86
|
| Rate for Payer: Nomi Health Commercial |
$318.22
|
| Rate for Payer: PACE Senior Care Partners |
$92.17
|
| Rate for Payer: PACE SWMI |
$97.02
|
| Rate for Payer: PHP Commercial |
$329.86
|
| Rate for Payer: PHP Medicare Advantage |
$97.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.25
|
| Rate for Payer: Priority Health HMO/PPO |
$337.62
|
| Rate for Payer: Priority Health Medicare |
$97.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.01
|
| Rate for Payer: Railroad Medicare Medicare |
$97.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.50
|
| Rate for Payer: UHC Core |
$324.04
|
| Rate for Payer: UHC Dual Complete DSNP |
$97.02
|
| Rate for Payer: UHC Exchange |
$97.02
|
| Rate for Payer: UHC Medicare Advantage |
$97.02
|
| Rate for Payer: UHCCP Medicaid |
$66.27
|
| Rate for Payer: VA VA |
$97.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.05
|
|
|
HC JAK2 V617F MUTATION
|
Facility
|
IP
|
$388.07
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
31000101
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$252.25 |
| Max. Negotiated Rate |
$349.26 |
| Rate for Payer: Aetna Commercial |
$329.86
|
| Rate for Payer: BCBS Trust/PPO |
$316.78
|
| Rate for Payer: BCN Commercial |
$299.90
|
| Rate for Payer: Cash Price |
$310.46
|
| Rate for Payer: Cofinity Commercial |
$333.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$310.46
|
| Rate for Payer: Healthscope Commercial |
$349.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$291.05
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$329.86
|
| Rate for Payer: Nomi Health Commercial |
$318.22
|
| Rate for Payer: PHP Commercial |
$329.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$252.25
|
| Rate for Payer: Priority Health HMO/PPO |
$337.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$260.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$341.50
|
| Rate for Payer: UHC Core |
$324.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$291.05
|
|
|
HC JC VIRUS, PCR, CSF
|
Facility
|
IP
|
$108.12
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600335
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.28 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: BCBS Trust/PPO |
$88.26
|
| Rate for Payer: BCN Commercial |
$83.56
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: Nomi Health Commercial |
$88.66
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health HMO/PPO |
$94.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$90.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC JC VIRUS, PCR, CSF
|
Facility
|
OP
|
$108.12
|
|
|
Service Code
|
CPT 87798
|
| Hospital Charge Code |
30600335
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$25.37 |
| Max. Negotiated Rate |
$97.31 |
| Rate for Payer: Aetna Commercial |
$91.90
|
| Rate for Payer: Aetna Medicare |
$28.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$33.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$33.79
|
| Rate for Payer: BCBS Complete |
$26.64
|
| Rate for Payer: BCBS MAPPO |
$27.03
|
| Rate for Payer: BCBS Trust/PPO |
$88.89
|
| Rate for Payer: BCN Commercial |
$84.06
|
| Rate for Payer: BCN Medicare Advantage |
$27.03
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cash Price |
$86.50
|
| Rate for Payer: Cofinity Commercial |
$92.98
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$86.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$27.03
|
| Rate for Payer: Healthscope Commercial |
$97.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$81.09
|
| Rate for Payer: Mclaren Medicaid |
$25.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$28.38
|
| Rate for Payer: Meridian Medicaid |
$26.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$31.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$91.90
|
| Rate for Payer: Nomi Health Commercial |
$88.66
|
| Rate for Payer: PACE Senior Care Partners |
$25.68
|
| Rate for Payer: PACE SWMI |
$27.03
|
| Rate for Payer: PHP Commercial |
$91.90
|
| Rate for Payer: PHP Medicare Advantage |
$27.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$70.28
|
| Rate for Payer: Priority Health HMO/PPO |
$94.06
|
| Rate for Payer: Priority Health Medicare |
$27.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$72.44
|
| Rate for Payer: Railroad Medicare Medicare |
$27.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$95.15
|
| Rate for Payer: UHC Core |
$90.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$27.03
|
| Rate for Payer: UHC Exchange |
$27.03
|
| Rate for Payer: UHC Medicare Advantage |
$27.03
|
| Rate for Payer: UHCCP Medicaid |
$25.37
|
| Rate for Payer: VA VA |
$27.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$81.09
|
|
|
HC JET VENT INITIAL DAY
|
Facility
|
IP
|
$2,576.21
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000057
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,674.54 |
| Max. Negotiated Rate |
$2,318.59 |
| Rate for Payer: Aetna Commercial |
$2,189.78
|
| Rate for Payer: BCBS Trust/PPO |
$2,102.96
|
| Rate for Payer: BCN Commercial |
$1,990.90
|
| Rate for Payer: Cash Price |
$2,060.97
|
| Rate for Payer: Cofinity Commercial |
$2,215.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,060.97
|
| Rate for Payer: Healthscope Commercial |
$2,318.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,932.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,189.78
|
| Rate for Payer: Nomi Health Commercial |
$2,112.49
|
| Rate for Payer: PHP Commercial |
$2,189.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,674.54
|
| Rate for Payer: Priority Health HMO/PPO |
$2,241.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,726.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,267.06
|
| Rate for Payer: UHC Core |
$2,151.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,932.16
|
|
|
HC JET VENT INITIAL DAY
|
Facility
|
OP
|
$2,576.21
|
|
|
Service Code
|
CPT 94002
|
| Hospital Charge Code |
41000057
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$468.31 |
| Max. Negotiated Rate |
$2,318.59 |
| Rate for Payer: Aetna Commercial |
$2,189.78
|
| Rate for Payer: Aetna Medicare |
$669.81
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$805.07
|
| Rate for Payer: Amish Plain Church Group Commercial |
$805.07
|
| Rate for Payer: BCBS Complete |
$491.76
|
| Rate for Payer: BCBS MAPPO |
$644.05
|
| Rate for Payer: BCBS Trust/PPO |
$2,117.90
|
| Rate for Payer: BCN Commercial |
$2,003.00
|
| Rate for Payer: BCN Medicare Advantage |
$644.05
|
| Rate for Payer: Cash Price |
$2,060.97
|
| Rate for Payer: Cash Price |
$2,060.97
|
| Rate for Payer: Cofinity Commercial |
$2,215.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,060.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$644.05
|
| Rate for Payer: Healthscope Commercial |
$2,318.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,932.16
|
| Rate for Payer: Mclaren Medicaid |
$468.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$676.26
|
| Rate for Payer: Meridian Medicaid |
$491.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$740.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,189.78
|
| Rate for Payer: Nomi Health Commercial |
$2,112.49
|
| Rate for Payer: PACE Senior Care Partners |
$611.85
|
| Rate for Payer: PACE SWMI |
$644.05
|
| Rate for Payer: PHP Commercial |
$2,189.78
|
| Rate for Payer: PHP Medicare Advantage |
$644.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,674.54
|
| Rate for Payer: Priority Health HMO/PPO |
$2,241.30
|
| Rate for Payer: Priority Health Medicare |
$650.49
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,726.06
|
| Rate for Payer: Railroad Medicare Medicare |
$644.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,267.06
|
| Rate for Payer: UHC Core |
$2,151.14
|
| Rate for Payer: UHC Dual Complete DSNP |
$644.05
|
| Rate for Payer: UHC Exchange |
$644.05
|
| Rate for Payer: UHC Medicare Advantage |
$644.05
|
| Rate for Payer: UHCCP Medicaid |
$468.31
|
| Rate for Payer: VA VA |
$644.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,932.16
|
|
|
HC JET VENT SUB DAY
|
Facility
|
IP
|
$1,897.80
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000058
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$1,233.57 |
| Max. Negotiated Rate |
$1,708.02 |
| Rate for Payer: Aetna Commercial |
$1,613.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,549.17
|
| Rate for Payer: BCN Commercial |
$1,466.62
|
| Rate for Payer: Cash Price |
$1,518.24
|
| Rate for Payer: Cofinity Commercial |
$1,632.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.24
|
| Rate for Payer: Healthscope Commercial |
$1,708.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.13
|
| Rate for Payer: Nomi Health Commercial |
$1,556.20
|
| Rate for Payer: PHP Commercial |
$1,613.13
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,233.57
|
| Rate for Payer: Priority Health HMO/PPO |
$1,651.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,271.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,670.06
|
| Rate for Payer: UHC Core |
$1,584.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.35
|
|
|
HC JET VENT SUB DAY
|
Facility
|
OP
|
$1,897.80
|
|
|
Service Code
|
CPT 94003
|
| Hospital Charge Code |
41000058
|
|
Hospital Revenue Code
|
410
|
| Min. Negotiated Rate |
$450.73 |
| Max. Negotiated Rate |
$1,708.02 |
| Rate for Payer: Aetna Commercial |
$1,613.13
|
| Rate for Payer: Aetna Medicare |
$493.43
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$593.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$593.06
|
| Rate for Payer: BCBS Complete |
$491.76
|
| Rate for Payer: BCBS MAPPO |
$474.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,560.18
|
| Rate for Payer: BCN Commercial |
$1,475.54
|
| Rate for Payer: BCN Medicare Advantage |
$474.45
|
| Rate for Payer: Cash Price |
$1,518.24
|
| Rate for Payer: Cash Price |
$1,518.24
|
| Rate for Payer: Cofinity Commercial |
$1,632.11
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,518.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$474.45
|
| Rate for Payer: Healthscope Commercial |
$1,708.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,423.35
|
| Rate for Payer: Mclaren Medicaid |
$468.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$498.17
|
| Rate for Payer: Meridian Medicaid |
$491.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$545.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,613.13
|
| Rate for Payer: Nomi Health Commercial |
$1,556.20
|
| Rate for Payer: PACE Senior Care Partners |
$450.73
|
| Rate for Payer: PACE SWMI |
$474.45
|
| Rate for Payer: PHP Commercial |
$1,613.13
|
| Rate for Payer: PHP Medicare Advantage |
$474.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$468.31
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,233.57
|
| Rate for Payer: Priority Health HMO/PPO |
$1,651.09
|
| Rate for Payer: Priority Health Medicare |
$479.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,271.53
|
| Rate for Payer: Railroad Medicare Medicare |
$474.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,670.06
|
| Rate for Payer: UHC Core |
$1,584.66
|
| Rate for Payer: UHC Dual Complete DSNP |
$474.45
|
| Rate for Payer: UHC Exchange |
$474.45
|
| Rate for Payer: UHC Medicare Advantage |
$474.45
|
| Rate for Payer: UHCCP Medicaid |
$468.31
|
| Rate for Payer: VA VA |
$474.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,423.35
|
|
|
HC JO 1 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC JO 1 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200163
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC JOBST FOAM PADDING
|
Facility
|
IP
|
$11.11
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000364
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$7.22 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Aetna Commercial |
$9.44
|
| Rate for Payer: BCBS Trust/PPO |
$9.07
|
| Rate for Payer: BCN Commercial |
$8.59
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Cofinity Commercial |
$9.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.89
|
| Rate for Payer: Healthscope Commercial |
$10.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.44
|
| Rate for Payer: Nomi Health Commercial |
$9.11
|
| Rate for Payer: PHP Commercial |
$9.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.22
|
| Rate for Payer: Priority Health HMO/PPO |
$9.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.78
|
| Rate for Payer: UHC Core |
$9.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.33
|
|
|
HC JOBST FOAM PADDING
|
Facility
|
OP
|
$11.11
|
|
|
Service Code
|
HCPCS A9270
|
| Hospital Charge Code |
27000364
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$10.00 |
| Rate for Payer: Aetna Commercial |
$9.44
|
| Rate for Payer: Aetna Medicare |
$2.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3.47
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3.47
|
| Rate for Payer: BCBS Complete |
$4.44
|
| Rate for Payer: BCBS MAPPO |
$2.78
|
| Rate for Payer: BCBS Trust/PPO |
$9.13
|
| Rate for Payer: BCN Commercial |
$8.64
|
| Rate for Payer: BCN Medicare Advantage |
$2.78
|
| Rate for Payer: Cash Price |
$8.89
|
| Rate for Payer: Cofinity Commercial |
$9.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8.89
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2.78
|
| Rate for Payer: Healthscope Commercial |
$10.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2.92
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9.44
|
| Rate for Payer: Nomi Health Commercial |
$9.11
|
| Rate for Payer: PACE Senior Care Partners |
$2.64
|
| Rate for Payer: PACE SWMI |
$2.78
|
| Rate for Payer: PHP Commercial |
$9.44
|
| Rate for Payer: PHP Medicare Advantage |
$2.78
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7.22
|
| Rate for Payer: Priority Health HMO/PPO |
$9.67
|
| Rate for Payer: Priority Health Medicare |
$2.81
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7.44
|
| Rate for Payer: Railroad Medicare Medicare |
$2.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9.78
|
| Rate for Payer: UHC Core |
$9.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$2.78
|
| Rate for Payer: UHC Exchange |
$2.78
|
| Rate for Payer: UHC Medicare Advantage |
$2.78
|
| Rate for Payer: VA VA |
$2.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8.33
|
|
|
HC JOINT W MANUAL STRESS
|
Facility
|
OP
|
$212.87
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
32000287
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$50.56 |
| Max. Negotiated Rate |
$191.58 |
| Rate for Payer: Aetna Commercial |
$180.94
|
| Rate for Payer: Aetna Medicare |
$55.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$66.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$66.52
|
| Rate for Payer: BCBS Complete |
$65.50
|
| Rate for Payer: BCBS MAPPO |
$53.22
|
| Rate for Payer: BCBS Trust/PPO |
$175.00
|
| Rate for Payer: BCN Commercial |
$165.51
|
| Rate for Payer: BCN Medicare Advantage |
$53.22
|
| Rate for Payer: Cash Price |
$170.30
|
| Rate for Payer: Cash Price |
$170.30
|
| Rate for Payer: Cofinity Commercial |
$183.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$53.22
|
| Rate for Payer: Healthscope Commercial |
$191.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.65
|
| Rate for Payer: Mclaren Medicaid |
$62.37
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$55.88
|
| Rate for Payer: Meridian Medicaid |
$65.50
|
| Rate for Payer: MI Amish Medical Board Commercial |
$61.20
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.94
|
| Rate for Payer: Nomi Health Commercial |
$174.55
|
| Rate for Payer: PACE Senior Care Partners |
$50.56
|
| Rate for Payer: PACE SWMI |
$53.22
|
| Rate for Payer: PHP Commercial |
$180.94
|
| Rate for Payer: PHP Medicare Advantage |
$53.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$62.37
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.37
|
| Rate for Payer: Priority Health HMO/PPO |
$185.20
|
| Rate for Payer: Priority Health Medicare |
$53.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.62
|
| Rate for Payer: Railroad Medicare Medicare |
$53.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.33
|
| Rate for Payer: UHC Core |
$177.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$53.22
|
| Rate for Payer: UHC Exchange |
$53.22
|
| Rate for Payer: UHC Medicare Advantage |
$53.22
|
| Rate for Payer: UHCCP Medicaid |
$62.37
|
| Rate for Payer: VA VA |
$53.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.65
|
|
|
HC JOINT W MANUAL STRESS
|
Facility
|
IP
|
$212.87
|
|
|
Service Code
|
CPT 77071
|
| Hospital Charge Code |
32000287
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$138.37 |
| Max. Negotiated Rate |
$191.58 |
| Rate for Payer: Aetna Commercial |
$180.94
|
| Rate for Payer: BCBS Trust/PPO |
$173.77
|
| Rate for Payer: BCN Commercial |
$164.51
|
| Rate for Payer: Cash Price |
$170.30
|
| Rate for Payer: Cofinity Commercial |
$183.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$170.30
|
| Rate for Payer: Healthscope Commercial |
$191.58
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$159.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$180.94
|
| Rate for Payer: Nomi Health Commercial |
$174.55
|
| Rate for Payer: PHP Commercial |
$180.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$138.37
|
| Rate for Payer: Priority Health HMO/PPO |
$185.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$142.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$187.33
|
| Rate for Payer: UHC Core |
$177.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$159.65
|
|
|
HC KAPPA FREE LIGHT CHAIN SERUM
|
Facility
|
IP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100307
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$50.32 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: BCBS Trust/PPO |
$63.20
|
| Rate for Payer: BCN Commercial |
$59.83
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO |
$67.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.13
|
| Rate for Payer: UHC Core |
$64.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
|
HC KAPPA FREE LIGHT CHAIN SERUM
|
Facility
|
OP
|
$77.42
|
|
|
Service Code
|
CPT 83521
|
| Hospital Charge Code |
30100307
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.49 |
| Max. Negotiated Rate |
$69.68 |
| Rate for Payer: Aetna Commercial |
$65.81
|
| Rate for Payer: Aetna Medicare |
$20.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.19
|
| Rate for Payer: BCBS Complete |
$13.11
|
| Rate for Payer: BCBS MAPPO |
$19.36
|
| Rate for Payer: BCBS Trust/PPO |
$63.65
|
| Rate for Payer: BCN Commercial |
$60.19
|
| Rate for Payer: BCN Medicare Advantage |
$19.36
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cash Price |
$61.94
|
| Rate for Payer: Cofinity Commercial |
$66.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$61.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.36
|
| Rate for Payer: Healthscope Commercial |
$69.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$58.06
|
| Rate for Payer: Mclaren Medicaid |
$12.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.32
|
| Rate for Payer: Meridian Medicaid |
$13.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$65.81
|
| Rate for Payer: Nomi Health Commercial |
$63.48
|
| Rate for Payer: PACE Senior Care Partners |
$18.39
|
| Rate for Payer: PACE SWMI |
$19.36
|
| Rate for Payer: PHP Commercial |
$65.81
|
| Rate for Payer: PHP Medicare Advantage |
$19.36
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$50.32
|
| Rate for Payer: Priority Health HMO/PPO |
$67.36
|
| Rate for Payer: Priority Health Medicare |
$19.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$51.87
|
| Rate for Payer: Railroad Medicare Medicare |
$19.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$68.13
|
| Rate for Payer: UHC Core |
$64.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.36
|
| Rate for Payer: UHC Exchange |
$19.36
|
| Rate for Payer: UHC Medicare Advantage |
$19.36
|
| Rate for Payer: UHCCP Medicaid |
$12.49
|
| Rate for Payer: VA VA |
$19.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$58.06
|
|
