|
HC LH PEDS, S
|
Facility
|
OP
|
$183.60
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100738
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$165.24 |
| Rate for Payer: Aetna Commercial |
$156.06
|
| Rate for Payer: Aetna Medicare |
$47.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$57.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$57.38
|
| Rate for Payer: BCBS Complete |
$14.06
|
| Rate for Payer: BCBS MAPPO |
$45.90
|
| Rate for Payer: BCBS Trust/PPO |
$150.94
|
| Rate for Payer: BCN Commercial |
$142.75
|
| Rate for Payer: BCN Medicare Advantage |
$45.90
|
| Rate for Payer: Cash Price |
$146.88
|
| Rate for Payer: Cash Price |
$146.88
|
| Rate for Payer: Cofinity Commercial |
$157.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$146.88
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$45.90
|
| Rate for Payer: Healthscope Commercial |
$165.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$137.70
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$48.20
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$52.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$156.06
|
| Rate for Payer: Nomi Health Commercial |
$150.55
|
| Rate for Payer: PACE Senior Care Partners |
$43.60
|
| Rate for Payer: PACE SWMI |
$45.90
|
| Rate for Payer: PHP Commercial |
$156.06
|
| Rate for Payer: PHP Medicare Advantage |
$45.90
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$119.34
|
| Rate for Payer: Priority Health HMO/PPO |
$159.73
|
| Rate for Payer: Priority Health Medicare |
$46.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$123.01
|
| Rate for Payer: Railroad Medicare Medicare |
$45.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$161.57
|
| Rate for Payer: UHC Core |
$153.31
|
| Rate for Payer: UHC Dual Complete DSNP |
$45.90
|
| Rate for Payer: UHC Exchange |
$45.90
|
| Rate for Payer: UHC Medicare Advantage |
$45.90
|
| Rate for Payer: UHCCP Medicaid |
$13.39
|
| Rate for Payer: VA VA |
$45.90
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$137.70
|
|
|
HC LH ULTRASENSITIVE
|
Facility
|
OP
|
$79.07
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$13.39 |
| Max. Negotiated Rate |
$71.16 |
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: Aetna Medicare |
$20.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$24.71
|
| Rate for Payer: Amish Plain Church Group Commercial |
$24.71
|
| Rate for Payer: BCBS Complete |
$14.06
|
| Rate for Payer: BCBS MAPPO |
$19.77
|
| Rate for Payer: BCBS Trust/PPO |
$65.00
|
| Rate for Payer: BCN Commercial |
$61.48
|
| Rate for Payer: BCN Medicare Advantage |
$19.77
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$68.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$19.77
|
| Rate for Payer: Healthscope Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.30
|
| Rate for Payer: Mclaren Medicaid |
$13.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$20.76
|
| Rate for Payer: Meridian Medicaid |
$14.06
|
| Rate for Payer: MI Amish Medical Board Commercial |
$22.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: PACE Senior Care Partners |
$18.78
|
| Rate for Payer: PACE SWMI |
$19.77
|
| Rate for Payer: PHP Commercial |
$67.21
|
| Rate for Payer: PHP Medicare Advantage |
$19.77
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.40
|
| Rate for Payer: Priority Health HMO/PPO |
$68.79
|
| Rate for Payer: Priority Health Medicare |
$19.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.98
|
| Rate for Payer: Railroad Medicare Medicare |
$19.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.58
|
| Rate for Payer: UHC Core |
$66.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$19.77
|
| Rate for Payer: UHC Exchange |
$19.77
|
| Rate for Payer: UHC Medicare Advantage |
$19.77
|
| Rate for Payer: UHCCP Medicaid |
$13.39
|
| Rate for Payer: VA VA |
$19.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.30
|
|
|
HC LH ULTRASENSITIVE
|
Facility
|
IP
|
$79.07
|
|
|
Service Code
|
CPT 83002
|
| Hospital Charge Code |
30100232
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$51.40 |
| Max. Negotiated Rate |
$71.16 |
| Rate for Payer: Aetna Commercial |
$67.21
|
| Rate for Payer: BCBS Trust/PPO |
$64.54
|
| Rate for Payer: BCN Commercial |
$61.11
|
| Rate for Payer: Cash Price |
$63.26
|
| Rate for Payer: Cofinity Commercial |
$68.00
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$63.26
|
| Rate for Payer: Healthscope Commercial |
$71.16
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$59.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$67.21
|
| Rate for Payer: Nomi Health Commercial |
$64.84
|
| Rate for Payer: PHP Commercial |
$67.21
|
| Rate for Payer: Priority Health Cigna Priority Health |
$51.40
|
| Rate for Payer: Priority Health HMO/PPO |
$68.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$52.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$69.58
|
| Rate for Payer: UHC Core |
$66.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$59.30
|
|
|
HC LIDOCAINE XYLOCAINE LEVEL
|
Facility
|
OP
|
$66.30
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
30100033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.62 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: Aetna Medicare |
$17.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$20.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$20.72
|
| Rate for Payer: BCBS Complete |
$11.15
|
| Rate for Payer: BCBS MAPPO |
$16.58
|
| Rate for Payer: BCBS Trust/PPO |
$54.51
|
| Rate for Payer: BCN Commercial |
$51.55
|
| Rate for Payer: BCN Medicare Advantage |
$16.58
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$16.58
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Mclaren Medicaid |
$10.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$17.40
|
| Rate for Payer: Meridian Medicaid |
$11.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PACE Senior Care Partners |
$15.75
|
| Rate for Payer: PACE SWMI |
$16.58
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: PHP Medicare Advantage |
$16.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Medicare |
$16.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: Railroad Medicare Medicare |
$16.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: UHC Dual Complete DSNP |
$16.58
|
| Rate for Payer: UHC Exchange |
$16.58
|
| Rate for Payer: UHC Medicare Advantage |
$16.58
|
| Rate for Payer: UHCCP Medicaid |
$10.62
|
| Rate for Payer: VA VA |
$16.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC LIDOCAINE XYLOCAINE LEVEL
|
Facility
|
IP
|
$66.30
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
30100033
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$43.10 |
| Max. Negotiated Rate |
$59.67 |
| Rate for Payer: Aetna Commercial |
$56.36
|
| Rate for Payer: BCBS Trust/PPO |
$54.12
|
| Rate for Payer: BCN Commercial |
$51.24
|
| Rate for Payer: Cash Price |
$53.04
|
| Rate for Payer: Cofinity Commercial |
$57.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.04
|
| Rate for Payer: Healthscope Commercial |
$59.67
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$49.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.36
|
| Rate for Payer: Nomi Health Commercial |
$54.37
|
| Rate for Payer: PHP Commercial |
$56.36
|
| Rate for Payer: Priority Health Cigna Priority Health |
$43.10
|
| Rate for Payer: Priority Health HMO/PPO |
$57.68
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$44.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$58.34
|
| Rate for Payer: UHC Core |
$55.36
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$49.72
|
|
|
HC LIMITED SPECTRAL DOPPLER
|
Facility
|
OP
|
$375.77
|
|
|
Service Code
|
HCPCS 93321
|
| Hospital Charge Code |
48000025
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$89.25 |
| Max. Negotiated Rate |
$338.19 |
| Rate for Payer: Aetna Commercial |
$319.40
|
| Rate for Payer: Aetna Medicare |
$97.70
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$117.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$117.43
|
| Rate for Payer: BCBS Complete |
$150.31
|
| Rate for Payer: BCBS MAPPO |
$93.94
|
| Rate for Payer: BCBS Trust/PPO |
$308.92
|
| Rate for Payer: BCN Commercial |
$292.16
|
| Rate for Payer: BCN Medicare Advantage |
$93.94
|
| Rate for Payer: Cash Price |
$300.62
|
| Rate for Payer: Cofinity Commercial |
$323.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$93.94
|
| Rate for Payer: Healthscope Commercial |
$338.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.83
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$98.64
|
| Rate for Payer: MI Amish Medical Board Commercial |
$108.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.40
|
| Rate for Payer: Nomi Health Commercial |
$308.13
|
| Rate for Payer: PACE Senior Care Partners |
$89.25
|
| Rate for Payer: PACE SWMI |
$93.94
|
| Rate for Payer: PHP Commercial |
$319.40
|
| Rate for Payer: PHP Medicare Advantage |
$93.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.25
|
| Rate for Payer: Priority Health HMO/PPO |
$326.92
|
| Rate for Payer: Priority Health Medicare |
$94.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.77
|
| Rate for Payer: Railroad Medicare Medicare |
$93.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.68
|
| Rate for Payer: UHC Core |
$313.77
|
| Rate for Payer: UHC Dual Complete DSNP |
$93.94
|
| Rate for Payer: UHC Exchange |
$93.94
|
| Rate for Payer: UHC Medicare Advantage |
$93.94
|
| Rate for Payer: VA VA |
$93.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.83
|
|
|
HC LIMITED SPECTRAL DOPPLER
|
Facility
|
IP
|
$375.77
|
|
|
Service Code
|
HCPCS 93321
|
| Hospital Charge Code |
48000025
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$244.25 |
| Max. Negotiated Rate |
$338.19 |
| Rate for Payer: Aetna Commercial |
$319.40
|
| Rate for Payer: BCBS Trust/PPO |
$306.74
|
| Rate for Payer: BCN Commercial |
$290.40
|
| Rate for Payer: Cash Price |
$300.62
|
| Rate for Payer: Cofinity Commercial |
$323.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$300.62
|
| Rate for Payer: Healthscope Commercial |
$338.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$281.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$319.40
|
| Rate for Payer: Nomi Health Commercial |
$308.13
|
| Rate for Payer: PHP Commercial |
$319.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$244.25
|
| Rate for Payer: Priority Health HMO/PPO |
$326.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$251.77
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$330.68
|
| Rate for Payer: UHC Core |
$313.77
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$281.83
|
|
|
HC LINE DELIVERY EXTRA
|
Facility
|
OP
|
$126.23
|
|
| Hospital Charge Code |
27000660
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$29.98 |
| Max. Negotiated Rate |
$113.61 |
| Rate for Payer: Aetna Commercial |
$107.30
|
| Rate for Payer: Aetna Medicare |
$32.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.45
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.45
|
| Rate for Payer: BCBS Complete |
$50.49
|
| Rate for Payer: BCBS MAPPO |
$31.56
|
| Rate for Payer: BCBS Trust/PPO |
$103.77
|
| Rate for Payer: BCN Commercial |
$98.14
|
| Rate for Payer: BCN Medicare Advantage |
$31.56
|
| Rate for Payer: Cash Price |
$100.98
|
| Rate for Payer: Cofinity Commercial |
$108.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.98
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.56
|
| Rate for Payer: Healthscope Commercial |
$113.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.67
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.14
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.30
|
| Rate for Payer: Nomi Health Commercial |
$103.51
|
| Rate for Payer: PACE Senior Care Partners |
$29.98
|
| Rate for Payer: PACE SWMI |
$31.56
|
| Rate for Payer: PHP Commercial |
$107.30
|
| Rate for Payer: PHP Medicare Advantage |
$31.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.05
|
| Rate for Payer: Priority Health HMO/PPO |
$109.82
|
| Rate for Payer: Priority Health Medicare |
$31.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.57
|
| Rate for Payer: Railroad Medicare Medicare |
$31.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.08
|
| Rate for Payer: UHC Core |
$105.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.56
|
| Rate for Payer: UHC Exchange |
$31.56
|
| Rate for Payer: UHC Medicare Advantage |
$31.56
|
| Rate for Payer: VA VA |
$31.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.67
|
|
|
HC LINE DELIVERY EXTRA
|
Facility
|
IP
|
$126.23
|
|
| Hospital Charge Code |
27000660
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$82.05 |
| Max. Negotiated Rate |
$113.61 |
| Rate for Payer: Aetna Commercial |
$107.30
|
| Rate for Payer: BCBS Trust/PPO |
$103.04
|
| Rate for Payer: BCN Commercial |
$97.55
|
| Rate for Payer: Cash Price |
$100.98
|
| Rate for Payer: Cofinity Commercial |
$108.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$100.98
|
| Rate for Payer: Healthscope Commercial |
$113.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.30
|
| Rate for Payer: Nomi Health Commercial |
$103.51
|
| Rate for Payer: PHP Commercial |
$107.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$82.05
|
| Rate for Payer: Priority Health HMO/PPO |
$109.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$84.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.08
|
| Rate for Payer: UHC Core |
$105.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.67
|
|
|
HC LINE ISOLATOR (PRESSURE TRANSDUC)
|
Facility
|
IP
|
$91.80
|
|
| Hospital Charge Code |
27000673
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$59.67 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: BCBS Trust/PPO |
$74.94
|
| Rate for Payer: BCN Commercial |
$70.94
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC LINE ISOLATOR (PRESSURE TRANSDUC)
|
Facility
|
OP
|
$91.80
|
|
| Hospital Charge Code |
27000673
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$82.62 |
| Rate for Payer: Aetna Commercial |
$78.03
|
| Rate for Payer: Aetna Medicare |
$23.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.69
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.69
|
| Rate for Payer: BCBS Complete |
$36.72
|
| Rate for Payer: BCBS MAPPO |
$22.95
|
| Rate for Payer: BCBS Trust/PPO |
$75.47
|
| Rate for Payer: BCN Commercial |
$71.37
|
| Rate for Payer: BCN Medicare Advantage |
$22.95
|
| Rate for Payer: Cash Price |
$73.44
|
| Rate for Payer: Cofinity Commercial |
$78.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$73.44
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.95
|
| Rate for Payer: Healthscope Commercial |
$82.62
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$68.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.39
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.03
|
| Rate for Payer: Nomi Health Commercial |
$75.28
|
| Rate for Payer: PACE Senior Care Partners |
$21.80
|
| Rate for Payer: PACE SWMI |
$22.95
|
| Rate for Payer: PHP Commercial |
$78.03
|
| Rate for Payer: PHP Medicare Advantage |
$22.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$59.67
|
| Rate for Payer: Priority Health HMO/PPO |
$79.87
|
| Rate for Payer: Priority Health Medicare |
$23.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.51
|
| Rate for Payer: Railroad Medicare Medicare |
$22.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$80.78
|
| Rate for Payer: UHC Core |
$76.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$22.95
|
| Rate for Payer: UHC Exchange |
$22.95
|
| Rate for Payer: UHC Medicare Advantage |
$22.95
|
| Rate for Payer: VA VA |
$22.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$68.85
|
|
|
HC LINE VACUUM
|
Facility
|
IP
|
$13.77
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$8.95 |
| Max. Negotiated Rate |
$12.39 |
| Rate for Payer: Aetna Commercial |
$11.70
|
| Rate for Payer: BCBS Trust/PPO |
$11.24
|
| Rate for Payer: BCN Commercial |
$10.64
|
| Rate for Payer: Cash Price |
$11.02
|
| Rate for Payer: Cofinity Commercial |
$11.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.02
|
| Rate for Payer: Healthscope Commercial |
$12.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.70
|
| Rate for Payer: Nomi Health Commercial |
$11.29
|
| Rate for Payer: PHP Commercial |
$11.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.95
|
| Rate for Payer: Priority Health HMO/PPO |
$11.98
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.23
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.12
|
| Rate for Payer: UHC Core |
$11.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.33
|
|
|
HC LINE VACUUM
|
Facility
|
OP
|
$13.77
|
|
| Hospital Charge Code |
27000665
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$12.39 |
| Rate for Payer: Aetna Commercial |
$11.70
|
| Rate for Payer: Aetna Medicare |
$3.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4.30
|
| Rate for Payer: BCBS Complete |
$5.51
|
| Rate for Payer: BCBS MAPPO |
$3.44
|
| Rate for Payer: BCBS Trust/PPO |
$11.32
|
| Rate for Payer: BCN Commercial |
$10.71
|
| Rate for Payer: BCN Medicare Advantage |
$3.44
|
| Rate for Payer: Cash Price |
$11.02
|
| Rate for Payer: Cofinity Commercial |
$11.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3.44
|
| Rate for Payer: Healthscope Commercial |
$12.39
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$10.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$11.70
|
| Rate for Payer: Nomi Health Commercial |
$11.29
|
| Rate for Payer: PACE Senior Care Partners |
$3.27
|
| Rate for Payer: PACE SWMI |
$3.44
|
| Rate for Payer: PHP Commercial |
$11.70
|
| Rate for Payer: PHP Medicare Advantage |
$3.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$8.95
|
| Rate for Payer: Priority Health HMO/PPO |
$11.98
|
| Rate for Payer: Priority Health Medicare |
$3.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$9.23
|
| Rate for Payer: Railroad Medicare Medicare |
$3.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$12.12
|
| Rate for Payer: UHC Core |
$11.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$3.44
|
| Rate for Payer: UHC Exchange |
$3.44
|
| Rate for Payer: UHC Medicare Advantage |
$3.44
|
| Rate for Payer: VA VA |
$3.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$10.33
|
|
|
HC LIPASE
|
Facility
|
OP
|
$31.21
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: Aetna Medicare |
$8.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.75
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$7.80
|
| Rate for Payer: BCBS Trust/PPO |
$25.66
|
| Rate for Payer: BCN Commercial |
$24.27
|
| Rate for Payer: BCN Medicare Advantage |
$7.80
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.80
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$8.19
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PACE Senior Care Partners |
$7.41
|
| Rate for Payer: PACE SWMI |
$7.80
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: PHP Medicare Advantage |
$7.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Medicare |
$7.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: Railroad Medicare Medicare |
$7.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.80
|
| Rate for Payer: UHC Exchange |
$7.80
|
| Rate for Payer: UHC Medicare Advantage |
$7.80
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: VA VA |
$7.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC LIPASE
|
Facility
|
IP
|
$31.21
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100279
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$20.29 |
| Max. Negotiated Rate |
$28.09 |
| Rate for Payer: Aetna Commercial |
$26.53
|
| Rate for Payer: BCBS Trust/PPO |
$25.48
|
| Rate for Payer: BCN Commercial |
$24.12
|
| Rate for Payer: Cash Price |
$24.97
|
| Rate for Payer: Cofinity Commercial |
$26.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$28.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$23.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$26.53
|
| Rate for Payer: Nomi Health Commercial |
$25.59
|
| Rate for Payer: PHP Commercial |
$26.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$20.29
|
| Rate for Payer: Priority Health HMO/PPO |
$27.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$27.46
|
| Rate for Payer: UHC Core |
$26.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$23.41
|
|
|
HC LIPASE BF
|
Facility
|
OP
|
$57.30
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.98 |
| Max. Negotiated Rate |
$51.57 |
| Rate for Payer: Aetna Commercial |
$48.70
|
| Rate for Payer: Aetna Medicare |
$14.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$17.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$17.91
|
| Rate for Payer: BCBS Complete |
$5.23
|
| Rate for Payer: BCBS MAPPO |
$14.32
|
| Rate for Payer: BCBS Trust/PPO |
$47.11
|
| Rate for Payer: BCN Commercial |
$44.55
|
| Rate for Payer: BCN Medicare Advantage |
$14.32
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$49.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.32
|
| Rate for Payer: Healthscope Commercial |
$51.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.98
|
| Rate for Payer: Mclaren Medicaid |
$4.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.04
|
| Rate for Payer: Meridian Medicaid |
$5.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Nomi Health Commercial |
$46.99
|
| Rate for Payer: PACE Senior Care Partners |
$13.61
|
| Rate for Payer: PACE SWMI |
$14.32
|
| Rate for Payer: PHP Commercial |
$48.70
|
| Rate for Payer: PHP Medicare Advantage |
$14.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.24
|
| Rate for Payer: Priority Health HMO/PPO |
$49.85
|
| Rate for Payer: Priority Health Medicare |
$14.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.39
|
| Rate for Payer: Railroad Medicare Medicare |
$14.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.42
|
| Rate for Payer: UHC Core |
$47.85
|
| Rate for Payer: UHC Dual Complete DSNP |
$14.32
|
| Rate for Payer: UHC Exchange |
$14.32
|
| Rate for Payer: UHC Medicare Advantage |
$14.32
|
| Rate for Payer: UHCCP Medicaid |
$4.98
|
| Rate for Payer: VA VA |
$14.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.98
|
|
|
HC LIPASE BF
|
Facility
|
IP
|
$57.30
|
|
|
Service Code
|
CPT 83690
|
| Hospital Charge Code |
30100713
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$37.24 |
| Max. Negotiated Rate |
$51.57 |
| Rate for Payer: Aetna Commercial |
$48.70
|
| Rate for Payer: BCBS Trust/PPO |
$46.77
|
| Rate for Payer: BCN Commercial |
$44.28
|
| Rate for Payer: Cash Price |
$45.84
|
| Rate for Payer: Cofinity Commercial |
$49.28
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$45.84
|
| Rate for Payer: Healthscope Commercial |
$51.57
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$42.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$48.70
|
| Rate for Payer: Nomi Health Commercial |
$46.99
|
| Rate for Payer: PHP Commercial |
$48.70
|
| Rate for Payer: Priority Health Cigna Priority Health |
$37.24
|
| Rate for Payer: Priority Health HMO/PPO |
$49.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$38.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$50.42
|
| Rate for Payer: UHC Core |
$47.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$42.98
|
|
|
HC LIPID PANEL
|
Facility
|
IP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.81 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: BCBS Trust/PPO |
$42.46
|
| Rate for Payer: BCN Commercial |
$40.20
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC LIPID PANEL
|
Facility
|
OP
|
$52.02
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100015
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$46.82 |
| Rate for Payer: Aetna Commercial |
$44.22
|
| Rate for Payer: Aetna Medicare |
$13.53
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.26
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.26
|
| Rate for Payer: BCBS Complete |
$10.17
|
| Rate for Payer: BCBS MAPPO |
$13.00
|
| Rate for Payer: BCBS Trust/PPO |
$42.77
|
| Rate for Payer: BCN Commercial |
$40.45
|
| Rate for Payer: BCN Medicare Advantage |
$13.00
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cash Price |
$41.62
|
| Rate for Payer: Cofinity Commercial |
$44.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.00
|
| Rate for Payer: Healthscope Commercial |
$46.82
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.02
|
| Rate for Payer: Mclaren Medicaid |
$9.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.66
|
| Rate for Payer: Meridian Medicaid |
$10.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.22
|
| Rate for Payer: Nomi Health Commercial |
$42.66
|
| Rate for Payer: PACE Senior Care Partners |
$12.35
|
| Rate for Payer: PACE SWMI |
$13.00
|
| Rate for Payer: PHP Commercial |
$44.22
|
| Rate for Payer: PHP Medicare Advantage |
$13.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.81
|
| Rate for Payer: Priority Health HMO/PPO |
$45.26
|
| Rate for Payer: Priority Health Medicare |
$13.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.85
|
| Rate for Payer: Railroad Medicare Medicare |
$13.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.78
|
| Rate for Payer: UHC Core |
$43.44
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.00
|
| Rate for Payer: UHC Exchange |
$13.00
|
| Rate for Payer: UHC Medicare Advantage |
$13.00
|
| Rate for Payer: UHCCP Medicaid |
$9.68
|
| Rate for Payer: VA VA |
$13.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.02
|
|
|
HC LIPID PANEL LMPP
|
Facility
|
IP
|
$51.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100767
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$33.15 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: BCBS Trust/PPO |
$41.63
|
| Rate for Payer: BCN Commercial |
$39.41
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC LIPID PANEL LMPP
|
Facility
|
OP
|
$51.00
|
|
|
Service Code
|
CPT 80061
|
| Hospital Charge Code |
30100767
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.68 |
| Max. Negotiated Rate |
$45.90 |
| Rate for Payer: Aetna Commercial |
$43.35
|
| Rate for Payer: Aetna Medicare |
$13.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.94
|
| Rate for Payer: BCBS Complete |
$10.17
|
| Rate for Payer: BCBS MAPPO |
$12.75
|
| Rate for Payer: BCBS Trust/PPO |
$41.93
|
| Rate for Payer: BCN Commercial |
$39.65
|
| Rate for Payer: BCN Medicare Advantage |
$12.75
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cash Price |
$40.80
|
| Rate for Payer: Cofinity Commercial |
$43.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$40.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.75
|
| Rate for Payer: Healthscope Commercial |
$45.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$38.25
|
| Rate for Payer: Mclaren Medicaid |
$9.68
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.39
|
| Rate for Payer: Meridian Medicaid |
$10.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.66
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$43.35
|
| Rate for Payer: Nomi Health Commercial |
$41.82
|
| Rate for Payer: PACE Senior Care Partners |
$12.11
|
| Rate for Payer: PACE SWMI |
$12.75
|
| Rate for Payer: PHP Commercial |
$43.35
|
| Rate for Payer: PHP Medicare Advantage |
$12.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.68
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.15
|
| Rate for Payer: Priority Health HMO/PPO |
$44.37
|
| Rate for Payer: Priority Health Medicare |
$12.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$34.17
|
| Rate for Payer: Railroad Medicare Medicare |
$12.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$44.88
|
| Rate for Payer: UHC Core |
$42.58
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.75
|
| Rate for Payer: UHC Exchange |
$12.75
|
| Rate for Payer: UHC Medicare Advantage |
$12.75
|
| Rate for Payer: UHCCP Medicaid |
$9.68
|
| Rate for Payer: VA VA |
$12.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$38.25
|
|
|
HC LIPOPROTEIN A
|
Facility
|
OP
|
$41.62
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
30100280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.88 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: Aetna Medicare |
$10.82
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$13.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$13.01
|
| Rate for Payer: BCBS Complete |
$10.87
|
| Rate for Payer: BCBS MAPPO |
$10.40
|
| Rate for Payer: BCBS Trust/PPO |
$34.22
|
| Rate for Payer: BCN Commercial |
$32.36
|
| Rate for Payer: BCN Medicare Advantage |
$10.40
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$10.40
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Mclaren Medicaid |
$10.35
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.93
|
| Rate for Payer: Meridian Medicaid |
$10.87
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PACE Senior Care Partners |
$9.88
|
| Rate for Payer: PACE SWMI |
$10.40
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: PHP Medicare Advantage |
$10.40
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.35
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Medicare |
$10.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: Railroad Medicare Medicare |
$10.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: UHC Dual Complete DSNP |
$10.40
|
| Rate for Payer: UHC Exchange |
$10.40
|
| Rate for Payer: UHC Medicare Advantage |
$10.40
|
| Rate for Payer: UHCCP Medicaid |
$10.35
|
| Rate for Payer: VA VA |
$10.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC LIPOPROTEIN A
|
Facility
|
IP
|
$41.62
|
|
|
Service Code
|
CPT 83695
|
| Hospital Charge Code |
30100280
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$27.05 |
| Max. Negotiated Rate |
$37.46 |
| Rate for Payer: Aetna Commercial |
$35.38
|
| Rate for Payer: BCBS Trust/PPO |
$33.97
|
| Rate for Payer: BCN Commercial |
$32.16
|
| Rate for Payer: Cash Price |
$33.30
|
| Rate for Payer: Cofinity Commercial |
$35.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$33.30
|
| Rate for Payer: Healthscope Commercial |
$37.46
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$31.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$35.38
|
| Rate for Payer: Nomi Health Commercial |
$34.13
|
| Rate for Payer: PHP Commercial |
$35.38
|
| Rate for Payer: Priority Health Cigna Priority Health |
$27.05
|
| Rate for Payer: Priority Health HMO/PPO |
$36.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$36.63
|
| Rate for Payer: UHC Core |
$34.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$31.22
|
|
|
HC LIQUID PLASMA IRRADIATED
|
Facility
|
IP
|
$365.05
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000096
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$237.28 |
| Max. Negotiated Rate |
$328.54 |
| Rate for Payer: Aetna Commercial |
$310.29
|
| Rate for Payer: BCBS Trust/PPO |
$297.99
|
| Rate for Payer: BCN Commercial |
$282.11
|
| Rate for Payer: Cash Price |
$292.04
|
| Rate for Payer: Cofinity Commercial |
$313.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.04
|
| Rate for Payer: Healthscope Commercial |
$328.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.79
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.29
|
| Rate for Payer: Nomi Health Commercial |
$299.34
|
| Rate for Payer: PHP Commercial |
$310.29
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.28
|
| Rate for Payer: Priority Health HMO/PPO |
$317.59
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.24
|
| Rate for Payer: UHC Core |
$304.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.79
|
|
|
HC LIQUID PLASMA IRRADIATED
|
Facility
|
OP
|
$365.05
|
|
|
Service Code
|
HCPCS P9017
|
| Hospital Charge Code |
39000096
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$59.71 |
| Max. Negotiated Rate |
$328.54 |
| Rate for Payer: Aetna Commercial |
$310.29
|
| Rate for Payer: Aetna Medicare |
$94.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$114.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$114.08
|
| Rate for Payer: BCBS Complete |
$62.70
|
| Rate for Payer: BCBS MAPPO |
$91.26
|
| Rate for Payer: BCBS Trust/PPO |
$300.11
|
| Rate for Payer: BCN Commercial |
$283.83
|
| Rate for Payer: BCN Medicare Advantage |
$91.26
|
| Rate for Payer: Cash Price |
$292.04
|
| Rate for Payer: Cash Price |
$292.04
|
| Rate for Payer: Cofinity Commercial |
$313.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$292.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$91.26
|
| Rate for Payer: Healthscope Commercial |
$328.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$273.79
|
| Rate for Payer: Mclaren Medicaid |
$59.71
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$95.83
|
| Rate for Payer: Meridian Medicaid |
$62.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$104.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$310.29
|
| Rate for Payer: Nomi Health Commercial |
$299.34
|
| Rate for Payer: PACE Senior Care Partners |
$86.70
|
| Rate for Payer: PACE SWMI |
$91.26
|
| Rate for Payer: PHP Commercial |
$310.29
|
| Rate for Payer: PHP Medicare Advantage |
$91.26
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$237.28
|
| Rate for Payer: Priority Health HMO/PPO |
$317.59
|
| Rate for Payer: Priority Health Medicare |
$92.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$244.58
|
| Rate for Payer: Railroad Medicare Medicare |
$91.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$321.24
|
| Rate for Payer: UHC Core |
$304.82
|
| Rate for Payer: UHC Dual Complete DSNP |
$91.26
|
| Rate for Payer: UHC Exchange |
$91.26
|
| Rate for Payer: UHC Medicare Advantage |
$91.26
|
| Rate for Payer: UHCCP Medicaid |
$59.71
|
| Rate for Payer: VA VA |
$91.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$273.79
|
|
