|
HC MOUSE IGE
|
Facility
|
OP
|
$25.39
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200048
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.77 |
| Max. Negotiated Rate |
$22.85 |
| Rate for Payer: Aetna Commercial |
$21.58
|
| Rate for Payer: Aetna Medicare |
$6.60
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$7.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$7.93
|
| Rate for Payer: BCBS Complete |
$3.96
|
| Rate for Payer: BCBS MAPPO |
$6.35
|
| Rate for Payer: BCBS Trust/PPO |
$20.87
|
| Rate for Payer: BCN Commercial |
$19.74
|
| Rate for Payer: BCN Medicare Advantage |
$6.35
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cash Price |
$20.31
|
| Rate for Payer: Cofinity Commercial |
$21.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.35
|
| Rate for Payer: Healthscope Commercial |
$22.85
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.04
|
| Rate for Payer: Mclaren Medicaid |
$3.77
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.66
|
| Rate for Payer: Meridian Medicaid |
$3.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$21.58
|
| Rate for Payer: Nomi Health Commercial |
$20.82
|
| Rate for Payer: PACE Senior Care Partners |
$6.03
|
| Rate for Payer: PACE SWMI |
$6.35
|
| Rate for Payer: PHP Commercial |
$21.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.35
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.77
|
| Rate for Payer: Priority Health Cigna Priority Health |
$16.50
|
| Rate for Payer: Priority Health HMO/PPO |
$22.09
|
| Rate for Payer: Priority Health Medicare |
$6.41
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.01
|
| Rate for Payer: Railroad Medicare Medicare |
$6.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.34
|
| Rate for Payer: UHC Core |
$21.20
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.35
|
| Rate for Payer: UHC Exchange |
$6.35
|
| Rate for Payer: UHC Medicare Advantage |
$6.35
|
| Rate for Payer: UHCCP Medicaid |
$3.77
|
| Rate for Payer: VA VA |
$6.35
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.04
|
|
|
HC MPCDS CELL SORTING BM
|
Facility
|
IP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100048
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$111.01 |
| Max. Negotiated Rate |
$153.70 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: BCBS Trust/PPO |
$139.41
|
| Rate for Payer: BCN Commercial |
$131.98
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO |
$148.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.29
|
| Rate for Payer: UHC Core |
$142.60
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC MPCDS CELL SORTING BM
|
Facility
|
OP
|
$170.78
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31100048
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$40.56 |
| Max. Negotiated Rate |
$267.58 |
| Rate for Payer: Aetna Commercial |
$145.16
|
| Rate for Payer: Aetna Medicare |
$44.40
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$53.37
|
| Rate for Payer: Amish Plain Church Group Commercial |
$53.37
|
| Rate for Payer: BCBS Complete |
$267.58
|
| Rate for Payer: BCBS MAPPO |
$42.70
|
| Rate for Payer: BCBS Trust/PPO |
$140.40
|
| Rate for Payer: BCN Commercial |
$132.78
|
| Rate for Payer: BCN Medicare Advantage |
$42.70
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cash Price |
$136.62
|
| Rate for Payer: Cofinity Commercial |
$146.87
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$136.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$42.70
|
| Rate for Payer: Healthscope Commercial |
$153.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$128.08
|
| Rate for Payer: Mclaren Medicaid |
$254.82
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.83
|
| Rate for Payer: Meridian Medicaid |
$267.58
|
| Rate for Payer: MI Amish Medical Board Commercial |
$49.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$145.16
|
| Rate for Payer: Nomi Health Commercial |
$140.04
|
| Rate for Payer: PACE Senior Care Partners |
$40.56
|
| Rate for Payer: PACE SWMI |
$42.70
|
| Rate for Payer: PHP Commercial |
$145.16
|
| Rate for Payer: PHP Medicare Advantage |
$42.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$254.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$111.01
|
| Rate for Payer: Priority Health HMO/PPO |
$148.58
|
| Rate for Payer: Priority Health Medicare |
$43.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$114.42
|
| Rate for Payer: Railroad Medicare Medicare |
$42.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$150.29
|
| Rate for Payer: UHC Core |
$142.60
|
| Rate for Payer: UHC Dual Complete DSNP |
$42.70
|
| Rate for Payer: UHC Exchange |
$42.70
|
| Rate for Payer: UHC Medicare Advantage |
$42.70
|
| Rate for Payer: UHCCP Medicaid |
$254.82
|
| Rate for Payer: VA VA |
$42.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$128.08
|
|
|
HC MPCDS CELL SORTING BM CMPT
|
Facility
|
OP
|
$53.78
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100049
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$12.77 |
| Max. Negotiated Rate |
$48.40 |
| Rate for Payer: Aetna Commercial |
$45.71
|
| Rate for Payer: Aetna Medicare |
$13.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.81
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.81
|
| Rate for Payer: BCBS Complete |
$21.51
|
| Rate for Payer: BCBS MAPPO |
$13.44
|
| Rate for Payer: BCBS Trust/PPO |
$44.21
|
| Rate for Payer: BCN Commercial |
$41.81
|
| Rate for Payer: BCN Medicare Advantage |
$13.44
|
| Rate for Payer: Cash Price |
$43.02
|
| Rate for Payer: Cofinity Commercial |
$46.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.44
|
| Rate for Payer: Healthscope Commercial |
$48.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.12
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.71
|
| Rate for Payer: Nomi Health Commercial |
$44.10
|
| Rate for Payer: PACE Senior Care Partners |
$12.77
|
| Rate for Payer: PACE SWMI |
$13.44
|
| Rate for Payer: PHP Commercial |
$45.71
|
| Rate for Payer: PHP Medicare Advantage |
$13.44
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.96
|
| Rate for Payer: Priority Health HMO/PPO |
$46.79
|
| Rate for Payer: Priority Health Medicare |
$13.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.03
|
| Rate for Payer: Railroad Medicare Medicare |
$13.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.33
|
| Rate for Payer: UHC Core |
$44.91
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.44
|
| Rate for Payer: UHC Exchange |
$13.44
|
| Rate for Payer: UHC Medicare Advantage |
$13.44
|
| Rate for Payer: VA VA |
$13.44
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.34
|
|
|
HC MPCDS CELL SORTING BM CMPT
|
Facility
|
IP
|
$53.78
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100049
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$34.96 |
| Max. Negotiated Rate |
$48.40 |
| Rate for Payer: Aetna Commercial |
$45.71
|
| Rate for Payer: BCBS Trust/PPO |
$43.90
|
| Rate for Payer: BCN Commercial |
$41.56
|
| Rate for Payer: Cash Price |
$43.02
|
| Rate for Payer: Cofinity Commercial |
$46.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.02
|
| Rate for Payer: Healthscope Commercial |
$48.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.71
|
| Rate for Payer: Nomi Health Commercial |
$44.10
|
| Rate for Payer: PHP Commercial |
$45.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$34.96
|
| Rate for Payer: Priority Health HMO/PPO |
$46.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.33
|
| Rate for Payer: UHC Core |
$44.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.34
|
|
|
HC MPL EXON 10 MUTATION DETECTION
|
Facility
|
IP
|
$379.75
|
|
|
Service Code
|
CPT 81339
|
| Hospital Charge Code |
31000149
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$246.84 |
| Max. Negotiated Rate |
$341.78 |
| Rate for Payer: Aetna Commercial |
$322.79
|
| Rate for Payer: BCBS Trust/PPO |
$309.99
|
| Rate for Payer: BCN Commercial |
$293.47
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cofinity Commercial |
$326.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.80
|
| Rate for Payer: Healthscope Commercial |
$341.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.79
|
| Rate for Payer: Nomi Health Commercial |
$311.40
|
| Rate for Payer: PHP Commercial |
$322.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.84
|
| Rate for Payer: Priority Health HMO/PPO |
$330.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.18
|
| Rate for Payer: UHC Core |
$317.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.81
|
|
|
HC MPL EXON 10 MUTATION DETECTION
|
Facility
|
OP
|
$379.75
|
|
|
Service Code
|
CPT 81339
|
| Hospital Charge Code |
31000149
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$90.19 |
| Max. Negotiated Rate |
$341.78 |
| Rate for Payer: Aetna Commercial |
$322.79
|
| Rate for Payer: Aetna Medicare |
$98.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$118.67
|
| Rate for Payer: Amish Plain Church Group Commercial |
$118.67
|
| Rate for Payer: BCBS Complete |
$140.60
|
| Rate for Payer: BCBS MAPPO |
$94.94
|
| Rate for Payer: BCBS Trust/PPO |
$312.19
|
| Rate for Payer: BCN Commercial |
$295.26
|
| Rate for Payer: BCN Medicare Advantage |
$94.94
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cash Price |
$303.80
|
| Rate for Payer: Cofinity Commercial |
$326.58
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$303.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$94.94
|
| Rate for Payer: Healthscope Commercial |
$341.78
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$284.81
|
| Rate for Payer: Mclaren Medicaid |
$133.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$99.68
|
| Rate for Payer: Meridian Medicaid |
$140.60
|
| Rate for Payer: MI Amish Medical Board Commercial |
$109.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$322.79
|
| Rate for Payer: Nomi Health Commercial |
$311.40
|
| Rate for Payer: PACE Senior Care Partners |
$90.19
|
| Rate for Payer: PACE SWMI |
$94.94
|
| Rate for Payer: PHP Commercial |
$322.79
|
| Rate for Payer: PHP Medicare Advantage |
$94.94
|
| Rate for Payer: Priority Health Choice Medicaid |
$133.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$246.84
|
| Rate for Payer: Priority Health HMO/PPO |
$330.38
|
| Rate for Payer: Priority Health Medicare |
$95.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$254.43
|
| Rate for Payer: Railroad Medicare Medicare |
$94.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$334.18
|
| Rate for Payer: UHC Core |
$317.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$94.94
|
| Rate for Payer: UHC Exchange |
$94.94
|
| Rate for Payer: UHC Medicare Advantage |
$94.94
|
| Rate for Payer: UHCCP Medicaid |
$133.90
|
| Rate for Payer: VA VA |
$94.94
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$284.81
|
|
|
HC MPL EXON10 MUTATION DETECTION
|
Facility
|
IP
|
$600.31
|
|
|
Service Code
|
CPT 81170
|
| Hospital Charge Code |
30000109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$390.20 |
| Max. Negotiated Rate |
$540.28 |
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: BCBS Trust/PPO |
$490.03
|
| Rate for Payer: BCN Commercial |
$463.92
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cofinity Commercial |
$516.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.25
|
| Rate for Payer: Healthscope Commercial |
$540.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.26
|
| Rate for Payer: Nomi Health Commercial |
$492.25
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.20
|
| Rate for Payer: Priority Health HMO/PPO |
$522.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.27
|
| Rate for Payer: UHC Core |
$501.26
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.23
|
|
|
HC MPL EXON10 MUTATION DETECTION
|
Facility
|
OP
|
$600.31
|
|
|
Service Code
|
CPT 81170
|
| Hospital Charge Code |
30000109
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$142.57 |
| Max. Negotiated Rate |
$540.28 |
| Rate for Payer: Aetna Commercial |
$510.26
|
| Rate for Payer: Aetna Medicare |
$156.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$187.60
|
| Rate for Payer: Amish Plain Church Group Commercial |
$187.60
|
| Rate for Payer: BCBS Complete |
$227.76
|
| Rate for Payer: BCBS MAPPO |
$150.08
|
| Rate for Payer: BCBS Trust/PPO |
$493.51
|
| Rate for Payer: BCN Commercial |
$466.74
|
| Rate for Payer: BCN Medicare Advantage |
$150.08
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cash Price |
$480.25
|
| Rate for Payer: Cofinity Commercial |
$516.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$480.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$150.08
|
| Rate for Payer: Healthscope Commercial |
$540.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$450.23
|
| Rate for Payer: Mclaren Medicaid |
$216.90
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$157.58
|
| Rate for Payer: Meridian Medicaid |
$227.76
|
| Rate for Payer: MI Amish Medical Board Commercial |
$172.59
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$510.26
|
| Rate for Payer: Nomi Health Commercial |
$492.25
|
| Rate for Payer: PACE Senior Care Partners |
$142.57
|
| Rate for Payer: PACE SWMI |
$150.08
|
| Rate for Payer: PHP Commercial |
$510.26
|
| Rate for Payer: PHP Medicare Advantage |
$150.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$216.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$390.20
|
| Rate for Payer: Priority Health HMO/PPO |
$522.27
|
| Rate for Payer: Priority Health Medicare |
$151.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$402.21
|
| Rate for Payer: Railroad Medicare Medicare |
$150.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$528.27
|
| Rate for Payer: UHC Core |
$501.26
|
| Rate for Payer: UHC Dual Complete DSNP |
$150.08
|
| Rate for Payer: UHC Exchange |
$150.08
|
| Rate for Payer: UHC Medicare Advantage |
$150.08
|
| Rate for Payer: UHCCP Medicaid |
$216.90
|
| Rate for Payer: VA VA |
$150.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$450.23
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
IP
|
$648.17
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$421.31 |
| Max. Negotiated Rate |
$583.35 |
| Rate for Payer: Aetna Commercial |
$550.94
|
| Rate for Payer: BCBS Trust/PPO |
$529.10
|
| Rate for Payer: BCN Commercial |
$500.91
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cofinity Commercial |
$557.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.54
|
| Rate for Payer: Healthscope Commercial |
$583.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.94
|
| Rate for Payer: Nomi Health Commercial |
$531.50
|
| Rate for Payer: PHP Commercial |
$550.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.31
|
| Rate for Payer: Priority Health HMO/PPO |
$563.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.39
|
| Rate for Payer: UHC Core |
$541.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.13
|
|
|
HC MPN, CALR GENE MUTATION, EXON 9
|
Facility
|
OP
|
$648.17
|
|
|
Service Code
|
CPT 81219
|
| Hospital Charge Code |
30000110
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$87.94 |
| Max. Negotiated Rate |
$583.35 |
| Rate for Payer: Aetna Commercial |
$550.94
|
| Rate for Payer: Aetna Medicare |
$168.52
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$202.55
|
| Rate for Payer: Amish Plain Church Group Commercial |
$202.55
|
| Rate for Payer: BCBS Complete |
$92.34
|
| Rate for Payer: BCBS MAPPO |
$162.04
|
| Rate for Payer: BCBS Trust/PPO |
$532.86
|
| Rate for Payer: BCN Commercial |
$503.95
|
| Rate for Payer: BCN Medicare Advantage |
$162.04
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cash Price |
$518.54
|
| Rate for Payer: Cofinity Commercial |
$557.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$518.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$162.04
|
| Rate for Payer: Healthscope Commercial |
$583.35
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$486.13
|
| Rate for Payer: Mclaren Medicaid |
$87.94
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$170.14
|
| Rate for Payer: Meridian Medicaid |
$92.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$186.35
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$550.94
|
| Rate for Payer: Nomi Health Commercial |
$531.50
|
| Rate for Payer: PACE Senior Care Partners |
$153.94
|
| Rate for Payer: PACE SWMI |
$162.04
|
| Rate for Payer: PHP Commercial |
$550.94
|
| Rate for Payer: PHP Medicare Advantage |
$162.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$87.94
|
| Rate for Payer: Priority Health Cigna Priority Health |
$421.31
|
| Rate for Payer: Priority Health HMO/PPO |
$563.91
|
| Rate for Payer: Priority Health Medicare |
$163.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$434.27
|
| Rate for Payer: Railroad Medicare Medicare |
$162.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$570.39
|
| Rate for Payer: UHC Core |
$541.22
|
| Rate for Payer: UHC Dual Complete DSNP |
$162.04
|
| Rate for Payer: UHC Exchange |
$162.04
|
| Rate for Payer: UHC Medicare Advantage |
$162.04
|
| Rate for Payer: UHCCP Medicaid |
$87.94
|
| Rate for Payer: VA VA |
$162.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$486.13
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
IP
|
$412.00
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$267.80 |
| Max. Negotiated Rate |
$370.80 |
| Rate for Payer: Aetna Commercial |
$350.20
|
| Rate for Payer: BCBS Trust/PPO |
$336.32
|
| Rate for Payer: BCN Commercial |
$318.39
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$354.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.60
|
| Rate for Payer: Healthscope Commercial |
$370.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.20
|
| Rate for Payer: Nomi Health Commercial |
$337.84
|
| Rate for Payer: PHP Commercial |
$350.20
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO |
$358.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.56
|
| Rate for Payer: UHC Core |
$344.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.00
|
|
|
HC MPN (JAK2, V617F, CALR, MPL) REFLEX
|
Facility
|
OP
|
$412.00
|
|
|
Service Code
|
CPT 81270
|
| Hospital Charge Code |
30000107
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$66.27 |
| Max. Negotiated Rate |
$370.80 |
| Rate for Payer: Aetna Commercial |
$350.20
|
| Rate for Payer: Aetna Medicare |
$107.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.75
|
| Rate for Payer: BCBS Complete |
$69.59
|
| Rate for Payer: BCBS MAPPO |
$103.00
|
| Rate for Payer: BCBS Trust/PPO |
$338.71
|
| Rate for Payer: BCN Commercial |
$320.33
|
| Rate for Payer: BCN Medicare Advantage |
$103.00
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cash Price |
$329.60
|
| Rate for Payer: Cofinity Commercial |
$354.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$329.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$103.00
|
| Rate for Payer: Healthscope Commercial |
$370.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$309.00
|
| Rate for Payer: Mclaren Medicaid |
$66.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$108.15
|
| Rate for Payer: Meridian Medicaid |
$69.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$350.20
|
| Rate for Payer: Nomi Health Commercial |
$337.84
|
| Rate for Payer: PACE Senior Care Partners |
$97.85
|
| Rate for Payer: PACE SWMI |
$103.00
|
| Rate for Payer: PHP Commercial |
$350.20
|
| Rate for Payer: PHP Medicare Advantage |
$103.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$66.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$267.80
|
| Rate for Payer: Priority Health HMO/PPO |
$358.44
|
| Rate for Payer: Priority Health Medicare |
$104.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$276.04
|
| Rate for Payer: Railroad Medicare Medicare |
$103.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$362.56
|
| Rate for Payer: UHC Core |
$344.02
|
| Rate for Payer: UHC Dual Complete DSNP |
$103.00
|
| Rate for Payer: UHC Exchange |
$103.00
|
| Rate for Payer: UHC Medicare Advantage |
$103.00
|
| Rate for Payer: UHCCP Medicaid |
$66.27
|
| Rate for Payer: VA VA |
$103.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$309.00
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
OP
|
$2,364.72
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,128.25 |
| Rate for Payer: Aetna Commercial |
$2,010.01
|
| Rate for Payer: Aetna Medicare |
$614.83
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$738.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$738.98
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$591.18
|
| Rate for Payer: BCBS Trust/PPO |
$1,944.04
|
| Rate for Payer: BCN Commercial |
$1,838.57
|
| Rate for Payer: BCN Medicare Advantage |
$591.18
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cofinity Commercial |
$2,033.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$591.18
|
| Rate for Payer: Healthscope Commercial |
$2,128.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.54
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$620.74
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$679.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.01
|
| Rate for Payer: Nomi Health Commercial |
$1,939.07
|
| Rate for Payer: PACE Senior Care Partners |
$561.62
|
| Rate for Payer: PACE SWMI |
$591.18
|
| Rate for Payer: PHP Commercial |
$2,010.01
|
| Rate for Payer: PHP Medicare Advantage |
$591.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.07
|
| Rate for Payer: Priority Health HMO/PPO |
$2,057.31
|
| Rate for Payer: Priority Health Medicare |
$597.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,584.36
|
| Rate for Payer: Railroad Medicare Medicare |
$591.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,080.95
|
| Rate for Payer: UHC Core |
$1,974.54
|
| Rate for Payer: UHC Dual Complete DSNP |
$591.18
|
| Rate for Payer: UHC Exchange |
$591.18
|
| Rate for Payer: UHC Medicare Advantage |
$591.18
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$591.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.54
|
|
|
HC MR ABDOMEN W CON
|
Facility
|
IP
|
$2,364.72
|
|
|
Service Code
|
CPT 74182
|
| Hospital Charge Code |
61000043
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,537.07 |
| Max. Negotiated Rate |
$2,128.25 |
| Rate for Payer: Aetna Commercial |
$2,010.01
|
| Rate for Payer: BCBS Trust/PPO |
$1,930.32
|
| Rate for Payer: BCN Commercial |
$1,827.46
|
| Rate for Payer: Cash Price |
$1,891.78
|
| Rate for Payer: Cofinity Commercial |
$2,033.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,891.78
|
| Rate for Payer: Healthscope Commercial |
$2,128.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,773.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,010.01
|
| Rate for Payer: Nomi Health Commercial |
$1,939.07
|
| Rate for Payer: PHP Commercial |
$2,010.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,537.07
|
| Rate for Payer: Priority Health HMO/PPO |
$2,057.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,584.36
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,080.95
|
| Rate for Payer: UHC Core |
$1,974.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,773.54
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
OP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,899.40 |
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: Aetna Medicare |
$548.72
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$659.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$659.52
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$527.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,735.00
|
| Rate for Payer: BCN Commercial |
$1,640.87
|
| Rate for Payer: BCN Medicare Advantage |
$527.61
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$527.61
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$553.99
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$606.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: Nomi Health Commercial |
$1,730.57
|
| Rate for Payer: PACE Senior Care Partners |
$501.23
|
| Rate for Payer: PACE SWMI |
$527.61
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| Rate for Payer: PHP Medicare Advantage |
$527.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.09
|
| Rate for Payer: Priority Health Medicare |
$532.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.00
|
| Rate for Payer: Railroad Medicare Medicare |
$527.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,857.20
|
| Rate for Payer: UHC Core |
$1,762.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$527.61
|
| Rate for Payer: UHC Exchange |
$527.61
|
| Rate for Payer: UHC Medicare Advantage |
$527.61
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$527.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR ABDOMEN WO CON
|
Facility
|
IP
|
$2,110.45
|
|
|
Service Code
|
CPT 74181
|
| Hospital Charge Code |
61000082
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,371.79 |
| Max. Negotiated Rate |
$1,899.40 |
| Rate for Payer: Aetna Commercial |
$1,793.88
|
| Rate for Payer: BCBS Trust/PPO |
$1,722.76
|
| Rate for Payer: BCN Commercial |
$1,630.96
|
| Rate for Payer: Cash Price |
$1,688.36
|
| Rate for Payer: Cofinity Commercial |
$1,814.99
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,688.36
|
| Rate for Payer: Healthscope Commercial |
$1,899.40
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,582.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,793.88
|
| Rate for Payer: Nomi Health Commercial |
$1,730.57
|
| Rate for Payer: PHP Commercial |
$1,793.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,371.79
|
| Rate for Payer: Priority Health HMO/PPO |
$1,836.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,414.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,857.20
|
| Rate for Payer: UHC Core |
$1,762.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,582.84
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
OP
|
$3,090.30
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,781.27 |
| Rate for Payer: Aetna Commercial |
$2,626.76
|
| Rate for Payer: Aetna Medicare |
$803.48
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$965.72
|
| Rate for Payer: Amish Plain Church Group Commercial |
$965.72
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$772.58
|
| Rate for Payer: BCBS Trust/PPO |
$2,540.54
|
| Rate for Payer: BCN Commercial |
$2,402.71
|
| Rate for Payer: BCN Medicare Advantage |
$772.58
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cofinity Commercial |
$2,657.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,472.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$772.58
|
| Rate for Payer: Healthscope Commercial |
$2,781.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,317.72
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$811.20
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$888.46
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,626.76
|
| Rate for Payer: Nomi Health Commercial |
$2,534.05
|
| Rate for Payer: PACE Senior Care Partners |
$733.95
|
| Rate for Payer: PACE SWMI |
$772.58
|
| Rate for Payer: PHP Commercial |
$2,626.76
|
| Rate for Payer: PHP Medicare Advantage |
$772.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,008.70
|
| Rate for Payer: Priority Health HMO/PPO |
$2,688.56
|
| Rate for Payer: Priority Health Medicare |
$780.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,070.50
|
| Rate for Payer: Railroad Medicare Medicare |
$772.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,719.46
|
| Rate for Payer: UHC Core |
$2,580.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$772.58
|
| Rate for Payer: UHC Exchange |
$772.58
|
| Rate for Payer: UHC Medicare Advantage |
$772.58
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$772.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,317.72
|
|
|
HC MR ABDOMEN WO W CON
|
Facility
|
IP
|
$3,090.30
|
|
|
Service Code
|
CPT 74183
|
| Hospital Charge Code |
61000044
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$2,008.70 |
| Max. Negotiated Rate |
$2,781.27 |
| Rate for Payer: Aetna Commercial |
$2,626.76
|
| Rate for Payer: BCBS Trust/PPO |
$2,522.61
|
| Rate for Payer: BCN Commercial |
$2,388.18
|
| Rate for Payer: Cash Price |
$2,472.24
|
| Rate for Payer: Cofinity Commercial |
$2,657.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,472.24
|
| Rate for Payer: Healthscope Commercial |
$2,781.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,317.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,626.76
|
| Rate for Payer: Nomi Health Commercial |
$2,534.05
|
| Rate for Payer: PHP Commercial |
$2,626.76
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,008.70
|
| Rate for Payer: Priority Health HMO/PPO |
$2,688.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,070.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,719.46
|
| Rate for Payer: UHC Core |
$2,580.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,317.72
|
|
|
HC MRA HEAD WO CON
|
Facility
|
OP
|
$1,809.20
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,628.28 |
| Rate for Payer: Aetna Commercial |
$1,537.82
|
| Rate for Payer: Aetna Medicare |
$470.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$565.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$565.38
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$452.30
|
| Rate for Payer: BCBS Trust/PPO |
$1,487.34
|
| Rate for Payer: BCN Commercial |
$1,406.65
|
| Rate for Payer: BCN Medicare Advantage |
$452.30
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cofinity Commercial |
$1,555.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,447.36
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$452.30
|
| Rate for Payer: Healthscope Commercial |
$1,628.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,356.90
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$474.92
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$520.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,537.82
|
| Rate for Payer: Nomi Health Commercial |
$1,483.54
|
| Rate for Payer: PACE Senior Care Partners |
$429.68
|
| Rate for Payer: PACE SWMI |
$452.30
|
| Rate for Payer: PHP Commercial |
$1,537.82
|
| Rate for Payer: PHP Medicare Advantage |
$452.30
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,574.00
|
| Rate for Payer: Priority Health Medicare |
$456.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,212.16
|
| Rate for Payer: Railroad Medicare Medicare |
$452.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,592.10
|
| Rate for Payer: UHC Core |
$1,510.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$452.30
|
| Rate for Payer: UHC Exchange |
$452.30
|
| Rate for Payer: UHC Medicare Advantage |
$452.30
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$452.30
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,356.90
|
|
|
HC MRA HEAD WO CON
|
Facility
|
IP
|
$1,809.20
|
|
|
Service Code
|
CPT 70544
|
| Hospital Charge Code |
61500001
|
|
Hospital Revenue Code
|
615
|
| Min. Negotiated Rate |
$1,175.98 |
| Max. Negotiated Rate |
$1,628.28 |
| Rate for Payer: Aetna Commercial |
$1,537.82
|
| Rate for Payer: BCBS Trust/PPO |
$1,476.85
|
| Rate for Payer: BCN Commercial |
$1,398.15
|
| Rate for Payer: Cash Price |
$1,447.36
|
| Rate for Payer: Cofinity Commercial |
$1,555.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,447.36
|
| Rate for Payer: Healthscope Commercial |
$1,628.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,356.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,537.82
|
| Rate for Payer: Nomi Health Commercial |
$1,483.54
|
| Rate for Payer: PHP Commercial |
$1,537.82
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,175.98
|
| Rate for Payer: Priority Health HMO/PPO |
$1,574.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,212.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,592.10
|
| Rate for Payer: UHC Core |
$1,510.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,356.90
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
OP
|
$3,052.80
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$252.98 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: Aetna Medicare |
$793.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$954.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$954.00
|
| Rate for Payer: BCBS Complete |
$265.65
|
| Rate for Payer: BCBS MAPPO |
$763.20
|
| Rate for Payer: BCBS Trust/PPO |
$2,509.71
|
| Rate for Payer: BCN Commercial |
$2,373.55
|
| Rate for Payer: BCN Medicare Advantage |
$763.20
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$763.20
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Mclaren Medicaid |
$252.98
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$801.36
|
| Rate for Payer: Meridian Medicaid |
$265.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$877.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PACE Senior Care Partners |
$725.04
|
| Rate for Payer: PACE SWMI |
$763.20
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: PHP Medicare Advantage |
$763.20
|
| Rate for Payer: Priority Health Choice Medicaid |
$252.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.94
|
| Rate for Payer: Priority Health Medicare |
$770.83
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.38
|
| Rate for Payer: Railroad Medicare Medicare |
$763.20
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.46
|
| Rate for Payer: UHC Core |
$2,549.09
|
| Rate for Payer: UHC Dual Complete DSNP |
$763.20
|
| Rate for Payer: UHC Exchange |
$763.20
|
| Rate for Payer: UHC Medicare Advantage |
$763.20
|
| Rate for Payer: UHCCP Medicaid |
$252.98
|
| Rate for Payer: VA VA |
$763.20
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MRA HEAD WO W CON
|
Facility
|
IP
|
$3,052.80
|
|
|
Service Code
|
CPT 70546
|
| Hospital Charge Code |
61000006
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$1,984.32 |
| Max. Negotiated Rate |
$2,747.52 |
| Rate for Payer: Aetna Commercial |
$2,594.88
|
| Rate for Payer: BCBS Trust/PPO |
$2,492.00
|
| Rate for Payer: BCN Commercial |
$2,359.20
|
| Rate for Payer: Cash Price |
$2,442.24
|
| Rate for Payer: Cofinity Commercial |
$2,625.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,442.24
|
| Rate for Payer: Healthscope Commercial |
$2,747.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,289.60
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,594.88
|
| Rate for Payer: Nomi Health Commercial |
$2,503.30
|
| Rate for Payer: PHP Commercial |
$2,594.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,984.32
|
| Rate for Payer: Priority Health HMO/PPO |
$2,655.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,045.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,686.46
|
| Rate for Payer: UHC Core |
$2,549.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,289.60
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
IP
|
$1,412.55
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$918.16 |
| Max. Negotiated Rate |
$1,271.30 |
| Rate for Payer: Aetna Commercial |
$1,200.67
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.06
|
| Rate for Payer: BCN Commercial |
$1,091.62
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cofinity Commercial |
$1,214.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.04
|
| Rate for Payer: Healthscope Commercial |
$1,271.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.67
|
| Rate for Payer: Nomi Health Commercial |
$1,158.29
|
| Rate for Payer: PHP Commercial |
$1,200.67
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,228.92
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.04
|
| Rate for Payer: UHC Core |
$1,179.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.41
|
|
|
HC MR BONE MARROW BLOOD SUPPLY
|
Facility
|
OP
|
$1,412.55
|
|
|
Service Code
|
CPT 77084
|
| Hospital Charge Code |
61000051
|
|
Hospital Revenue Code
|
610
|
| Min. Negotiated Rate |
$171.23 |
| Max. Negotiated Rate |
$1,271.30 |
| Rate for Payer: Aetna Commercial |
$1,200.67
|
| Rate for Payer: Aetna Medicare |
$367.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$441.42
|
| Rate for Payer: Amish Plain Church Group Commercial |
$441.42
|
| Rate for Payer: BCBS Complete |
$179.80
|
| Rate for Payer: BCBS MAPPO |
$353.14
|
| Rate for Payer: BCBS Trust/PPO |
$1,161.26
|
| Rate for Payer: BCN Commercial |
$1,098.26
|
| Rate for Payer: BCN Medicare Advantage |
$353.14
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cash Price |
$1,130.04
|
| Rate for Payer: Cofinity Commercial |
$1,214.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,130.04
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$353.14
|
| Rate for Payer: Healthscope Commercial |
$1,271.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,059.41
|
| Rate for Payer: Mclaren Medicaid |
$171.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$370.79
|
| Rate for Payer: Meridian Medicaid |
$179.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$406.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,200.67
|
| Rate for Payer: Nomi Health Commercial |
$1,158.29
|
| Rate for Payer: PACE Senior Care Partners |
$335.48
|
| Rate for Payer: PACE SWMI |
$353.14
|
| Rate for Payer: PHP Commercial |
$1,200.67
|
| Rate for Payer: PHP Medicare Advantage |
$353.14
|
| Rate for Payer: Priority Health Choice Medicaid |
$171.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$918.16
|
| Rate for Payer: Priority Health HMO/PPO |
$1,228.92
|
| Rate for Payer: Priority Health Medicare |
$356.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$946.41
|
| Rate for Payer: Railroad Medicare Medicare |
$353.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,243.04
|
| Rate for Payer: UHC Core |
$1,179.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$353.14
|
| Rate for Payer: UHC Exchange |
$353.14
|
| Rate for Payer: UHC Medicare Advantage |
$353.14
|
| Rate for Payer: UHCCP Medicaid |
$171.23
|
| Rate for Payer: VA VA |
$353.14
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,059.41
|
|
