|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
IP
|
$178.29
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$124.09 |
| Max. Negotiated Rate |
$160.46 |
| Rate for Payer: Aetna Commercial |
$151.55
|
| Rate for Payer: BCBS Trust/PPO |
$147.25
|
| Rate for Payer: BCN Commercial |
$147.25
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cofinity Commercial |
$153.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.63
|
| Rate for Payer: Healthscope Commercial |
$160.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.55
|
| Rate for Payer: Nomi Health Commercial |
$146.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.72
|
| Rate for Payer: PHP Commercial |
$151.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$155.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.90
|
| Rate for Payer: UHC Core |
$148.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.72
|
|
|
HC MYELODYSPLASTIC SYNDROME FISH
|
Facility
|
OP
|
$178.29
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
31000036
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$31.43 |
| Max. Negotiated Rate |
$160.46 |
| Rate for Payer: Aetna Commercial |
$151.55
|
| Rate for Payer: Aetna Medicare |
$46.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$55.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$55.72
|
| Rate for Payer: BCBS Complete |
$33.00
|
| Rate for Payer: BCBS MAPPO |
$44.57
|
| Rate for Payer: BCBS Trust/PPO |
$146.57
|
| Rate for Payer: BCN Commercial |
$146.57
|
| Rate for Payer: BCN Medicare Advantage |
$44.57
|
| Rate for Payer: Cash Price |
$142.63
|
| Rate for Payer: Cofinity Commercial |
$153.33
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$142.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$44.57
|
| Rate for Payer: Healthscope Commercial |
$160.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$133.72
|
| Rate for Payer: Mclaren Medicaid |
$31.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$46.80
|
| Rate for Payer: Meridian Medicaid |
$33.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$51.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$49.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$151.55
|
| Rate for Payer: Nomi Health Commercial |
$146.20
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$133.72
|
| Rate for Payer: PACE Senior Care Partners |
$42.34
|
| Rate for Payer: PACE SWMI |
$44.57
|
| Rate for Payer: PHP Commercial |
$151.55
|
| Rate for Payer: PHP Medicare Advantage |
$44.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$31.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$155.11
|
| Rate for Payer: Priority Health Medicare |
$45.02
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$124.09
|
| Rate for Payer: Railroad Medicare Medicare |
$44.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$156.90
|
| Rate for Payer: UHC Core |
$148.87
|
| Rate for Payer: UHC Exchange |
$44.57
|
| Rate for Payer: UHC Medicaid |
$31.43
|
| Rate for Payer: UHC Medicare Advantage |
$44.57
|
| Rate for Payer: UHCCP Medicaid |
$31.43
|
| Rate for Payer: VA VA |
$44.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$133.72
|
|
|
HC MYELOID BLAST PANEL
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
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 MYELOID BLAST PANEL
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100016
|
|
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 MYELOID BLAST PANEL CMPT
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
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 MYELOID BLAST PANEL CMPT
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
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 MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
OP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.42 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: Aetna Medicare |
$8.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.62
|
| Rate for Payer: BCBS Complete |
$5.70
|
| Rate for Payer: BCBS MAPPO |
$7.69
|
| Rate for Payer: BCBS Trust/PPO |
$25.30
|
| Rate for Payer: BCN Commercial |
$25.30
|
| Rate for Payer: BCN Medicare Advantage |
$7.69
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.69
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Mclaren Medicaid |
$5.42
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.08
|
| Rate for Payer: Meridian Medicaid |
$5.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$25.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PACE Senior Care Partners |
$7.31
|
| Rate for Payer: PACE SWMI |
$7.69
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: PHP Medicare Advantage |
$7.69
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.42
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.77
|
| Rate for Payer: Priority Health Medicare |
$7.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.42
|
| Rate for Payer: Railroad Medicare Medicare |
$7.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.08
|
| Rate for Payer: UHC Core |
$25.69
|
| Rate for Payer: UHC Exchange |
$7.69
|
| Rate for Payer: UHC Medicaid |
$5.42
|
| Rate for Payer: UHC Medicare Advantage |
$7.69
|
| Rate for Payer: UHCCP Medicaid |
$5.42
|
| Rate for Payer: VA VA |
$7.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
IP
|
$30.77
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.42 |
| Max. Negotiated Rate |
$27.69 |
| Rate for Payer: Aetna Commercial |
$26.15
|
| Rate for Payer: BCBS Trust/PPO |
$25.41
|
| Rate for Payer: BCN Commercial |
$25.41
|
| Rate for Payer: Cash Price |
$24.62
|
| Rate for Payer: Cofinity Commercial |
$26.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.62
|
| Rate for Payer: Healthscope Commercial |
$27.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.15
|
| Rate for Payer: Nomi Health Commercial |
$25.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.08
|
| Rate for Payer: PHP Commercial |
$26.15
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$26.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$21.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.08
|
| Rate for Payer: UHC Core |
$25.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.08
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
OP
|
$35.39
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.24 |
| Max. Negotiated Rate |
$31.85 |
| Rate for Payer: Aetna Commercial |
$30.08
|
| Rate for Payer: Aetna Medicare |
$9.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$11.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$11.06
|
| Rate for Payer: BCBS Complete |
$6.55
|
| Rate for Payer: BCBS MAPPO |
$8.85
|
| Rate for Payer: BCBS Trust/PPO |
$29.09
|
| Rate for Payer: BCN Commercial |
$29.09
|
| Rate for Payer: BCN Medicare Advantage |
$8.85
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.85
|
| Rate for Payer: Healthscope Commercial |
$31.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.54
|
| Rate for Payer: Mclaren Medicaid |
$6.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.29
|
| Rate for Payer: Meridian Medicaid |
$6.55
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$9.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.08
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.54
|
| Rate for Payer: PACE Senior Care Partners |
$8.41
|
| Rate for Payer: PACE SWMI |
$8.85
|
| Rate for Payer: PHP Commercial |
$30.08
|
| Rate for Payer: PHP Medicare Advantage |
$8.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.79
|
| Rate for Payer: Priority Health Medicare |
$8.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.63
|
| Rate for Payer: Railroad Medicare Medicare |
$8.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.14
|
| Rate for Payer: UHC Core |
$29.55
|
| Rate for Payer: UHC Exchange |
$8.85
|
| Rate for Payer: UHC Medicaid |
$6.24
|
| Rate for Payer: UHC Medicare Advantage |
$8.85
|
| Rate for Payer: UHCCP Medicaid |
$6.24
|
| Rate for Payer: VA VA |
$8.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.54
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
IP
|
$35.39
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$24.63 |
| Max. Negotiated Rate |
$31.85 |
| Rate for Payer: Aetna Commercial |
$30.08
|
| Rate for Payer: BCBS Trust/PPO |
$29.23
|
| Rate for Payer: BCN Commercial |
$29.23
|
| Rate for Payer: Cash Price |
$28.31
|
| Rate for Payer: Cofinity Commercial |
$30.44
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.31
|
| Rate for Payer: Healthscope Commercial |
$31.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$30.08
|
| Rate for Payer: Nomi Health Commercial |
$29.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$26.54
|
| Rate for Payer: PHP Commercial |
$30.08
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$30.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$24.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$31.14
|
| Rate for Payer: UHC Core |
$29.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.54
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
OP
|
$148.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$26.25 |
| Max. Negotiated Rate |
$133.99 |
| Rate for Payer: Aetna Commercial |
$126.55
|
| Rate for Payer: Aetna Medicare |
$38.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$46.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$46.52
|
| Rate for Payer: BCBS Complete |
$27.56
|
| Rate for Payer: BCBS MAPPO |
$37.22
|
| Rate for Payer: BCBS Trust/PPO |
$122.39
|
| Rate for Payer: BCN Commercial |
$122.39
|
| Rate for Payer: BCN Medicare Advantage |
$37.22
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cofinity Commercial |
$128.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.22
|
| Rate for Payer: Healthscope Commercial |
$133.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.66
|
| Rate for Payer: Mclaren Medicaid |
$26.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.08
|
| Rate for Payer: Meridian Medicaid |
$27.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$42.80
|
| Rate for Payer: Molina Medicare/Medicaid |
$40.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.55
|
| Rate for Payer: Nomi Health Commercial |
$122.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.66
|
| Rate for Payer: PACE Senior Care Partners |
$35.36
|
| Rate for Payer: PACE SWMI |
$37.22
|
| Rate for Payer: PHP Commercial |
$126.55
|
| Rate for Payer: PHP Medicare Advantage |
$37.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.53
|
| Rate for Payer: Priority Health Medicare |
$37.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.62
|
| Rate for Payer: Railroad Medicare Medicare |
$37.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.01
|
| Rate for Payer: UHC Core |
$124.31
|
| Rate for Payer: UHC Exchange |
$37.22
|
| Rate for Payer: UHC Medicaid |
$26.25
|
| Rate for Payer: UHC Medicare Advantage |
$37.22
|
| Rate for Payer: UHCCP Medicaid |
$26.25
|
| Rate for Payer: VA VA |
$37.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.66
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
IP
|
$148.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$103.62 |
| Max. Negotiated Rate |
$133.99 |
| Rate for Payer: Aetna Commercial |
$126.55
|
| Rate for Payer: BCBS Trust/PPO |
$122.96
|
| Rate for Payer: BCN Commercial |
$122.96
|
| Rate for Payer: Cash Price |
$119.10
|
| Rate for Payer: Cofinity Commercial |
$128.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$119.10
|
| Rate for Payer: Healthscope Commercial |
$133.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$111.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$126.55
|
| Rate for Payer: Nomi Health Commercial |
$122.08
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$111.66
|
| Rate for Payer: PHP Commercial |
$126.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$129.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$103.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$131.01
|
| Rate for Payer: UHC Core |
$124.31
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$111.66
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
IP
|
$55.18
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$38.41 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: BCBS Trust/PPO |
$45.57
|
| Rate for Payer: BCN Commercial |
$45.57
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.56
|
| Rate for Payer: UHC Core |
$46.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
OP
|
$55.18
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.73 |
| Max. Negotiated Rate |
$49.66 |
| Rate for Payer: Aetna Commercial |
$46.90
|
| Rate for Payer: Aetna Medicare |
$14.35
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.24
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.24
|
| Rate for Payer: BCBS Complete |
$10.21
|
| Rate for Payer: BCBS MAPPO |
$13.79
|
| Rate for Payer: BCBS Trust/PPO |
$45.36
|
| Rate for Payer: BCN Commercial |
$45.36
|
| Rate for Payer: BCN Medicare Advantage |
$13.79
|
| Rate for Payer: Cash Price |
$44.14
|
| Rate for Payer: Cofinity Commercial |
$47.45
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$44.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.79
|
| Rate for Payer: Healthscope Commercial |
$49.66
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$41.38
|
| Rate for Payer: Mclaren Medicaid |
$9.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.48
|
| Rate for Payer: Meridian Medicaid |
$10.21
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$15.17
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$46.90
|
| Rate for Payer: Nomi Health Commercial |
$45.25
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$41.38
|
| Rate for Payer: PACE Senior Care Partners |
$13.11
|
| Rate for Payer: PACE SWMI |
$13.79
|
| Rate for Payer: PHP Commercial |
$46.90
|
| Rate for Payer: PHP Medicare Advantage |
$13.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$48.01
|
| Rate for Payer: Priority Health Medicare |
$13.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.41
|
| Rate for Payer: Railroad Medicare Medicare |
$13.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$48.56
|
| Rate for Payer: UHC Core |
$46.08
|
| Rate for Payer: UHC Exchange |
$13.79
|
| Rate for Payer: UHC Medicaid |
$9.73
|
| Rate for Payer: UHC Medicare Advantage |
$13.79
|
| Rate for Payer: UHCCP Medicaid |
$9.73
|
| Rate for Payer: VA VA |
$13.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$41.38
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
OP
|
$49.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.79 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: Aetna Medicare |
$12.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.59
|
| Rate for Payer: BCBS Complete |
$9.23
|
| Rate for Payer: BCBS MAPPO |
$12.47
|
| Rate for Payer: BCBS Trust/PPO |
$41.01
|
| Rate for Payer: BCN Commercial |
$41.01
|
| Rate for Payer: BCN Medicare Advantage |
$12.47
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.47
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Mclaren Medicaid |
$8.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.09
|
| Rate for Payer: Meridian Medicaid |
$9.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$13.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PACE Senior Care Partners |
$11.85
|
| Rate for Payer: PACE SWMI |
$12.47
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: PHP Medicare Advantage |
$12.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Medicare |
$12.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: Railroad Medicare Medicare |
$12.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: UHC Exchange |
$12.47
|
| Rate for Payer: UHC Medicaid |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$12.47
|
| Rate for Payer: UHCCP Medicaid |
$8.79
|
| Rate for Payer: VA VA |
$12.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
IP
|
$49.88
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$34.72 |
| Max. Negotiated Rate |
$44.89 |
| Rate for Payer: Aetna Commercial |
$42.40
|
| Rate for Payer: BCBS Trust/PPO |
$41.20
|
| Rate for Payer: BCN Commercial |
$41.20
|
| Rate for Payer: Cash Price |
$39.90
|
| Rate for Payer: Cofinity Commercial |
$42.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.90
|
| Rate for Payer: Healthscope Commercial |
$44.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$37.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$42.40
|
| Rate for Payer: Nomi Health Commercial |
$40.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$37.41
|
| Rate for Payer: PHP Commercial |
$42.40
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$43.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.72
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.89
|
| Rate for Payer: UHC Core |
$41.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$37.41
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$31.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.62 |
| Max. Negotiated Rate |
$28.68 |
| Rate for Payer: Aetna Commercial |
$27.09
|
| Rate for Payer: Aetna Medicare |
$8.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.96
|
| Rate for Payer: BCBS Complete |
$5.90
|
| Rate for Payer: BCBS MAPPO |
$7.97
|
| Rate for Payer: BCBS Trust/PPO |
$26.20
|
| Rate for Payer: BCN Commercial |
$26.20
|
| Rate for Payer: BCN Medicare Advantage |
$7.97
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.97
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.90
|
| Rate for Payer: Mclaren Medicaid |
$5.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.37
|
| Rate for Payer: Meridian Medicaid |
$5.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.16
|
| Rate for Payer: Molina Medicare/Medicaid |
$8.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: Nomi Health Commercial |
$26.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.90
|
| Rate for Payer: PACE Senior Care Partners |
$7.57
|
| Rate for Payer: PACE SWMI |
$7.97
|
| Rate for Payer: PHP Commercial |
$27.09
|
| Rate for Payer: PHP Medicare Advantage |
$7.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$5.62
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.73
|
| Rate for Payer: Priority Health Medicare |
$8.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: Railroad Medicare Medicare |
$7.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.05
|
| Rate for Payer: UHC Core |
$26.61
|
| Rate for Payer: UHC Exchange |
$7.97
|
| Rate for Payer: UHC Medicaid |
$5.62
|
| Rate for Payer: UHC Medicare Advantage |
$7.97
|
| Rate for Payer: UHCCP Medicaid |
$5.62
|
| Rate for Payer: VA VA |
$7.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.90
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
IP
|
$31.87
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.18 |
| Max. Negotiated Rate |
$28.68 |
| Rate for Payer: Aetna Commercial |
$27.09
|
| Rate for Payer: BCBS Trust/PPO |
$26.32
|
| Rate for Payer: BCN Commercial |
$26.32
|
| Rate for Payer: Cash Price |
$25.50
|
| Rate for Payer: Cofinity Commercial |
$27.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$25.50
|
| Rate for Payer: Healthscope Commercial |
$28.68
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$27.09
|
| Rate for Payer: Nomi Health Commercial |
$26.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$23.90
|
| Rate for Payer: PHP Commercial |
$27.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$27.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$22.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$28.05
|
| Rate for Payer: UHC Core |
$26.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.90
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
IP
|
$20.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$14.37 |
| Max. Negotiated Rate |
$18.59 |
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: BCBS Trust/PPO |
$17.05
|
| Rate for Payer: BCN Commercial |
$17.05
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Healthscope Commercial |
$18.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Nomi Health Commercial |
$16.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.49
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.17
|
| Rate for Payer: UHC Core |
$17.24
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.49
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
OP
|
$20.65
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.64 |
| Max. Negotiated Rate |
$18.59 |
| Rate for Payer: Aetna Commercial |
$17.55
|
| Rate for Payer: Aetna Medicare |
$5.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.45
|
| Rate for Payer: BCBS Complete |
$3.82
|
| Rate for Payer: BCBS MAPPO |
$5.16
|
| Rate for Payer: BCBS Trust/PPO |
$16.98
|
| Rate for Payer: BCN Commercial |
$16.98
|
| Rate for Payer: BCN Medicare Advantage |
$5.16
|
| Rate for Payer: Cash Price |
$16.52
|
| Rate for Payer: Cofinity Commercial |
$17.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$16.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$5.16
|
| Rate for Payer: Healthscope Commercial |
$18.59
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$15.49
|
| Rate for Payer: Mclaren Medicaid |
$3.64
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.42
|
| Rate for Payer: Meridian Medicaid |
$3.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$5.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$17.55
|
| Rate for Payer: Nomi Health Commercial |
$16.93
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$15.49
|
| Rate for Payer: PACE Senior Care Partners |
$4.90
|
| Rate for Payer: PACE SWMI |
$5.16
|
| Rate for Payer: PHP Commercial |
$17.55
|
| Rate for Payer: PHP Medicare Advantage |
$5.16
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$17.97
|
| Rate for Payer: Priority Health Medicare |
$5.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$14.37
|
| Rate for Payer: Railroad Medicare Medicare |
$5.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$18.17
|
| Rate for Payer: UHC Core |
$17.24
|
| Rate for Payer: UHC Exchange |
$5.16
|
| Rate for Payer: UHC Medicaid |
$3.64
|
| Rate for Payer: UHC Medicare Advantage |
$5.16
|
| Rate for Payer: UHCCP Medicaid |
$3.64
|
| Rate for Payer: VA VA |
$5.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$15.49
|
|
|
HC MYRINGOPLASTY
|
Facility
|
OP
|
$13,800.60
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,433.05 |
| Max. Negotiated Rate |
$12,420.54 |
| Rate for Payer: Aetna Commercial |
$11,730.51
|
| Rate for Payer: Aetna Commercial |
$7,820.34
|
| Rate for Payer: Aetna Medicare |
$2,392.10
|
| Rate for Payer: Aetna Medicare |
$3,588.16
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,875.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,312.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,312.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,875.12
|
| Rate for Payer: BCBS Complete |
$2,554.49
|
| Rate for Payer: BCBS Complete |
$1,702.99
|
| Rate for Payer: BCBS MAPPO |
$3,450.15
|
| Rate for Payer: BCBS MAPPO |
$2,300.10
|
| Rate for Payer: BCBS Trust/PPO |
$11,345.47
|
| Rate for Payer: BCBS Trust/PPO |
$7,563.65
|
| Rate for Payer: BCN Commercial |
$7,563.65
|
| Rate for Payer: BCN Commercial |
$11,345.47
|
| Rate for Payer: BCN Medicare Advantage |
$2,300.10
|
| Rate for Payer: BCN Medicare Advantage |
$3,450.15
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cofinity Commercial |
$11,868.52
|
| Rate for Payer: Cofinity Commercial |
$7,912.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,360.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,040.48
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,300.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,450.15
|
| Rate for Payer: Healthscope Commercial |
$12,420.54
|
| Rate for Payer: Healthscope Commercial |
$8,280.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,350.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,900.30
|
| Rate for Payer: Mclaren Medicaid |
$1,622.03
|
| Rate for Payer: Mclaren Medicaid |
$2,433.05
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,415.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,622.66
|
| Rate for Payer: Meridian Medicaid |
$2,554.49
|
| Rate for Payer: Meridian Medicaid |
$1,702.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,645.11
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,967.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,530.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,795.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,820.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,730.51
|
| Rate for Payer: Nomi Health Commercial |
$7,544.33
|
| Rate for Payer: Nomi Health Commercial |
$11,316.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,350.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,900.30
|
| Rate for Payer: PACE Senior Care Partners |
$2,185.09
|
| Rate for Payer: PACE Senior Care Partners |
$3,277.64
|
| Rate for Payer: PACE SWMI |
$2,300.10
|
| Rate for Payer: PACE SWMI |
$3,450.15
|
| Rate for Payer: PHP Commercial |
$11,730.51
|
| Rate for Payer: PHP Commercial |
$7,820.34
|
| Rate for Payer: PHP Medicare Advantage |
$3,450.15
|
| Rate for Payer: PHP Medicare Advantage |
$2,300.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,622.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,433.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,004.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,006.52
|
| Rate for Payer: Priority Health Medicare |
$2,323.10
|
| Rate for Payer: Priority Health Medicare |
$3,484.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,605.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,403.48
|
| Rate for Payer: Railroad Medicare Medicare |
$3,450.15
|
| Rate for Payer: Railroad Medicare Medicare |
$2,300.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,144.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,096.35
|
| Rate for Payer: UHC Core |
$7,682.33
|
| Rate for Payer: UHC Core |
$11,523.50
|
| Rate for Payer: UHC Exchange |
$2,300.10
|
| Rate for Payer: UHC Exchange |
$3,450.15
|
| Rate for Payer: UHC Medicaid |
$1,622.03
|
| Rate for Payer: UHC Medicaid |
$2,433.05
|
| Rate for Payer: UHC Medicare Advantage |
$3,450.15
|
| Rate for Payer: UHC Medicare Advantage |
$2,300.10
|
| Rate for Payer: UHCCP Medicaid |
$2,433.05
|
| Rate for Payer: UHCCP Medicaid |
$1,622.03
|
| Rate for Payer: VA VA |
$3,450.15
|
| Rate for Payer: VA VA |
$2,300.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,900.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,350.45
|
|
|
HC MYRINGOPLASTY
|
Facility
|
IP
|
$13,800.60
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$9,605.22 |
| Max. Negotiated Rate |
$12,420.54 |
| Rate for Payer: Aetna Commercial |
$11,730.51
|
| Rate for Payer: Aetna Commercial |
$7,820.34
|
| Rate for Payer: BCBS Trust/PPO |
$11,397.92
|
| Rate for Payer: BCBS Trust/PPO |
$7,598.61
|
| Rate for Payer: BCN Commercial |
$11,397.92
|
| Rate for Payer: BCN Commercial |
$7,598.61
|
| Rate for Payer: Cash Price |
$11,040.48
|
| Rate for Payer: Cash Price |
$7,360.32
|
| Rate for Payer: Cofinity Commercial |
$7,912.34
|
| Rate for Payer: Cofinity Commercial |
$11,868.52
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,360.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11,040.48
|
| Rate for Payer: Healthscope Commercial |
$12,420.54
|
| Rate for Payer: Healthscope Commercial |
$8,280.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10,350.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,900.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11,730.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,820.34
|
| Rate for Payer: Nomi Health Commercial |
$11,316.49
|
| Rate for Payer: Nomi Health Commercial |
$7,544.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10,350.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,900.30
|
| Rate for Payer: PHP Commercial |
$7,820.34
|
| Rate for Payer: PHP Commercial |
$11,730.51
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,004.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$12,006.52
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9,605.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,403.48
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12,144.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,096.35
|
| Rate for Payer: UHC Core |
$11,523.50
|
| Rate for Payer: UHC Core |
$7,682.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10,350.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,900.30
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
IP
|
$640.89
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$446.06 |
| Max. Negotiated Rate |
$576.80 |
| Rate for Payer: Aetna Commercial |
$544.76
|
| Rate for Payer: Aetna Commercial |
$817.13
|
| Rate for Payer: BCBS Trust/PPO |
$529.31
|
| Rate for Payer: BCBS Trust/PPO |
$793.96
|
| Rate for Payer: BCN Commercial |
$529.31
|
| Rate for Payer: BCN Commercial |
$793.96
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cofinity Commercial |
$826.74
|
| Rate for Payer: Cofinity Commercial |
$551.17
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Healthscope Commercial |
$576.80
|
| Rate for Payer: Healthscope Commercial |
$865.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$480.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$721.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.13
|
| Rate for Payer: Nomi Health Commercial |
$525.53
|
| Rate for Payer: Nomi Health Commercial |
$788.29
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.00
|
| Rate for Payer: PHP Commercial |
$817.13
|
| Rate for Payer: PHP Commercial |
$544.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$836.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$557.57
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$669.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$845.97
|
| Rate for Payer: UHC Core |
$535.14
|
| Rate for Payer: UHC Core |
$802.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$480.67
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$721.00
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
OP
|
$640.89
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$112.99 |
| Max. Negotiated Rate |
$576.80 |
| Rate for Payer: Aetna Commercial |
$544.76
|
| Rate for Payer: Aetna Commercial |
$817.13
|
| Rate for Payer: Aetna Medicare |
$249.95
|
| Rate for Payer: Aetna Medicare |
$166.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$300.42
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$200.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$200.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$300.42
|
| Rate for Payer: BCBS Complete |
$118.63
|
| Rate for Payer: BCBS Complete |
$177.94
|
| Rate for Payer: BCBS MAPPO |
$160.22
|
| Rate for Payer: BCBS MAPPO |
$240.33
|
| Rate for Payer: BCBS Trust/PPO |
$526.88
|
| Rate for Payer: BCBS Trust/PPO |
$790.31
|
| Rate for Payer: BCN Commercial |
$790.31
|
| Rate for Payer: BCN Commercial |
$526.88
|
| Rate for Payer: BCN Medicare Advantage |
$240.33
|
| Rate for Payer: BCN Medicare Advantage |
$160.22
|
| Rate for Payer: Cash Price |
$512.71
|
| Rate for Payer: Cash Price |
$769.06
|
| Rate for Payer: Cofinity Commercial |
$551.17
|
| Rate for Payer: Cofinity Commercial |
$826.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$769.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$512.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$240.33
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$160.22
|
| Rate for Payer: Healthscope Commercial |
$576.80
|
| Rate for Payer: Healthscope Commercial |
$865.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$480.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$721.00
|
| Rate for Payer: Mclaren Medicaid |
$169.48
|
| Rate for Payer: Mclaren Medicaid |
$112.99
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$252.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$168.23
|
| Rate for Payer: Meridian Medicaid |
$118.63
|
| Rate for Payer: Meridian Medicaid |
$177.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$276.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$184.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$264.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$176.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$817.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$544.76
|
| Rate for Payer: Nomi Health Commercial |
$788.29
|
| Rate for Payer: Nomi Health Commercial |
$525.53
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$480.67
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$721.00
|
| Rate for Payer: PACE Senior Care Partners |
$228.32
|
| Rate for Payer: PACE Senior Care Partners |
$152.21
|
| Rate for Payer: PACE SWMI |
$240.33
|
| Rate for Payer: PACE SWMI |
$160.22
|
| Rate for Payer: PHP Commercial |
$544.76
|
| Rate for Payer: PHP Commercial |
$817.13
|
| Rate for Payer: PHP Medicare Advantage |
$160.22
|
| Rate for Payer: PHP Medicare Advantage |
$240.33
|
| Rate for Payer: Priority Health Choice Medicaid |
$169.48
|
| Rate for Payer: Priority Health Choice Medicaid |
$112.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$836.36
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$557.57
|
| Rate for Payer: Priority Health Medicare |
$242.74
|
| Rate for Payer: Priority Health Medicare |
$161.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$446.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$669.09
|
| Rate for Payer: Railroad Medicare Medicare |
$160.22
|
| Rate for Payer: Railroad Medicare Medicare |
$240.33
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$563.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$845.97
|
| Rate for Payer: UHC Core |
$802.71
|
| Rate for Payer: UHC Core |
$535.14
|
| Rate for Payer: UHC Exchange |
$240.33
|
| Rate for Payer: UHC Exchange |
$160.22
|
| Rate for Payer: UHC Medicaid |
$169.48
|
| Rate for Payer: UHC Medicaid |
$112.99
|
| Rate for Payer: UHC Medicare Advantage |
$160.22
|
| Rate for Payer: UHC Medicare Advantage |
$240.33
|
| Rate for Payer: UHCCP Medicaid |
$112.99
|
| Rate for Payer: UHCCP Medicaid |
$169.48
|
| Rate for Payer: VA VA |
$160.22
|
| Rate for Payer: VA VA |
$240.33
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$721.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$480.67
|
|
|
HC NAIL BED REPAIR
|
Facility
|
IP
|
$772.78
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$537.85 |
| Max. Negotiated Rate |
$695.50 |
| Rate for Payer: Aetna Commercial |
$656.86
|
| Rate for Payer: BCBS Trust/PPO |
$638.24
|
| Rate for Payer: BCN Commercial |
$638.24
|
| Rate for Payer: Cash Price |
$618.22
|
| Rate for Payer: Cofinity Commercial |
$664.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$618.22
|
| Rate for Payer: Healthscope Commercial |
$695.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$579.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$656.86
|
| Rate for Payer: Nomi Health Commercial |
$633.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$579.59
|
| Rate for Payer: PHP Commercial |
$656.86
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$672.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$537.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$680.05
|
| Rate for Payer: UHC Core |
$645.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$579.59
|
|
