|
HC PACKED CELLS DIRECT
|
Facility
|
IP
|
$841.79
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000058
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$585.89 |
| Max. Negotiated Rate |
$757.61 |
| Rate for Payer: Aetna Commercial |
$715.52
|
| Rate for Payer: BCBS Trust/PPO |
$695.23
|
| Rate for Payer: BCN Commercial |
$695.23
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cofinity Commercial |
$723.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.43
|
| Rate for Payer: Healthscope Commercial |
$757.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.52
|
| Rate for Payer: Nomi Health Commercial |
$690.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.34
|
| Rate for Payer: PHP Commercial |
$715.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$732.36
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.78
|
| Rate for Payer: UHC Core |
$702.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.34
|
|
|
HC PACKED CELLS DIRECT
|
Facility
|
OP
|
$841.79
|
|
|
Service Code
|
HCPCS P9016
|
| Hospital Charge Code |
39000058
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$148.41 |
| Max. Negotiated Rate |
$757.61 |
| Rate for Payer: Aetna Commercial |
$715.52
|
| Rate for Payer: Aetna Medicare |
$218.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$263.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$263.06
|
| Rate for Payer: BCBS Complete |
$155.82
|
| Rate for Payer: BCBS MAPPO |
$210.45
|
| Rate for Payer: BCBS Trust/PPO |
$692.04
|
| Rate for Payer: BCN Commercial |
$692.04
|
| Rate for Payer: BCN Medicare Advantage |
$210.45
|
| Rate for Payer: Cash Price |
$673.43
|
| Rate for Payer: Cofinity Commercial |
$723.94
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$673.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$210.45
|
| Rate for Payer: Healthscope Commercial |
$757.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$631.34
|
| Rate for Payer: Mclaren Medicaid |
$148.41
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$220.97
|
| Rate for Payer: Meridian Medicaid |
$155.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$242.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$231.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$715.52
|
| Rate for Payer: Nomi Health Commercial |
$690.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$631.34
|
| Rate for Payer: PACE Senior Care Partners |
$199.93
|
| Rate for Payer: PACE SWMI |
$210.45
|
| Rate for Payer: PHP Commercial |
$715.52
|
| Rate for Payer: PHP Medicare Advantage |
$210.45
|
| Rate for Payer: Priority Health Choice Medicaid |
$148.41
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$732.36
|
| Rate for Payer: Priority Health Medicare |
$212.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$585.89
|
| Rate for Payer: Railroad Medicare Medicare |
$210.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$740.78
|
| Rate for Payer: UHC Core |
$702.89
|
| Rate for Payer: UHC Exchange |
$210.45
|
| Rate for Payer: UHC Medicaid |
$148.41
|
| Rate for Payer: UHC Medicare Advantage |
$210.45
|
| Rate for Payer: UHCCP Medicaid |
$148.41
|
| Rate for Payer: VA VA |
$210.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$631.34
|
|
|
HC PACKED CELLS DIRECT LRIR
|
Facility
|
OP
|
$1,282.23
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000080
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$226.06 |
| Max. Negotiated Rate |
$1,154.01 |
| Rate for Payer: Aetna Commercial |
$1,089.90
|
| Rate for Payer: Aetna Medicare |
$333.38
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$400.70
|
| Rate for Payer: Amish Plain Church Group Commercial |
$400.70
|
| Rate for Payer: BCBS Complete |
$237.34
|
| Rate for Payer: BCBS MAPPO |
$320.56
|
| Rate for Payer: BCBS Trust/PPO |
$1,054.12
|
| Rate for Payer: BCN Commercial |
$1,054.12
|
| Rate for Payer: BCN Medicare Advantage |
$320.56
|
| Rate for Payer: Cash Price |
$1,025.78
|
| Rate for Payer: Cofinity Commercial |
$1,102.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,025.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$320.56
|
| Rate for Payer: Healthscope Commercial |
$1,154.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$961.67
|
| Rate for Payer: Mclaren Medicaid |
$226.06
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$336.59
|
| Rate for Payer: Meridian Medicaid |
$237.34
|
| Rate for Payer: MI Amish Medical Board Commercial |
$368.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$352.61
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,089.90
|
| Rate for Payer: Nomi Health Commercial |
$1,051.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$961.67
|
| Rate for Payer: PACE Senior Care Partners |
$304.53
|
| Rate for Payer: PACE SWMI |
$320.56
|
| Rate for Payer: PHP Commercial |
$1,089.90
|
| Rate for Payer: PHP Medicare Advantage |
$320.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$226.06
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,115.54
|
| Rate for Payer: Priority Health Medicare |
$323.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$892.43
|
| Rate for Payer: Railroad Medicare Medicare |
$320.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,128.36
|
| Rate for Payer: UHC Core |
$1,070.66
|
| Rate for Payer: UHC Exchange |
$320.56
|
| Rate for Payer: UHC Medicaid |
$226.06
|
| Rate for Payer: UHC Medicare Advantage |
$320.56
|
| Rate for Payer: UHCCP Medicaid |
$226.06
|
| Rate for Payer: VA VA |
$320.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$961.67
|
|
|
HC PACKED CELLS DIRECT LRIR
|
Facility
|
IP
|
$1,282.23
|
|
|
Service Code
|
HCPCS P9040
|
| Hospital Charge Code |
39000080
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$892.43 |
| Max. Negotiated Rate |
$1,154.01 |
| Rate for Payer: Aetna Commercial |
$1,089.90
|
| Rate for Payer: BCBS Trust/PPO |
$1,058.99
|
| Rate for Payer: BCN Commercial |
$1,058.99
|
| Rate for Payer: Cash Price |
$1,025.78
|
| Rate for Payer: Cofinity Commercial |
$1,102.72
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,025.78
|
| Rate for Payer: Healthscope Commercial |
$1,154.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$961.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,089.90
|
| Rate for Payer: Nomi Health Commercial |
$1,051.43
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$961.67
|
| Rate for Payer: PHP Commercial |
$1,089.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,115.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$892.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,128.36
|
| Rate for Payer: UHC Core |
$1,070.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$961.67
|
|
|
HC PACK LEFT HEART BYPASS
|
Facility
|
OP
|
$99.88
|
|
| Hospital Charge Code |
27000654
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$17.61 |
| Max. Negotiated Rate |
$89.89 |
| Rate for Payer: Aetna Commercial |
$84.90
|
| Rate for Payer: Aetna Medicare |
$25.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.21
|
| Rate for Payer: BCBS Complete |
$18.49
|
| Rate for Payer: BCBS MAPPO |
$24.97
|
| Rate for Payer: BCBS Trust/PPO |
$82.11
|
| Rate for Payer: BCN Commercial |
$82.11
|
| Rate for Payer: BCN Medicare Advantage |
$24.97
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.91
|
| Rate for Payer: Mclaren Medicaid |
$17.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.22
|
| Rate for Payer: Meridian Medicaid |
$18.49
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.72
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.90
|
| Rate for Payer: Nomi Health Commercial |
$81.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.91
|
| Rate for Payer: PACE Senior Care Partners |
$23.72
|
| Rate for Payer: PACE SWMI |
$24.97
|
| Rate for Payer: PHP Commercial |
$84.90
|
| Rate for Payer: PHP Medicare Advantage |
$24.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.61
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.90
|
| Rate for Payer: Priority Health Medicare |
$25.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.52
|
| Rate for Payer: Railroad Medicare Medicare |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.89
|
| Rate for Payer: UHC Core |
$83.40
|
| Rate for Payer: UHC Exchange |
$24.97
|
| Rate for Payer: UHC Medicaid |
$17.61
|
| Rate for Payer: UHC Medicare Advantage |
$24.97
|
| Rate for Payer: UHCCP Medicaid |
$17.61
|
| Rate for Payer: VA VA |
$24.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.91
|
|
|
HC PACK LEFT HEART BYPASS
|
Facility
|
IP
|
$99.88
|
|
| Hospital Charge Code |
27000654
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$69.52 |
| Max. Negotiated Rate |
$89.89 |
| Rate for Payer: Aetna Commercial |
$84.90
|
| Rate for Payer: BCBS Trust/PPO |
$82.49
|
| Rate for Payer: BCN Commercial |
$82.49
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.90
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.90
|
| Rate for Payer: Nomi Health Commercial |
$81.90
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.91
|
| Rate for Payer: PHP Commercial |
$84.90
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.89
|
| Rate for Payer: UHC Core |
$83.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.91
|
|
|
HC PACK QUEST CARDIOPLEGIA
|
Facility
|
IP
|
$702.27
|
|
| Hospital Charge Code |
27000457
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$488.78 |
| Max. Negotiated Rate |
$632.04 |
| Rate for Payer: Aetna Commercial |
$596.93
|
| Rate for Payer: BCBS Trust/PPO |
$580.00
|
| Rate for Payer: BCN Commercial |
$580.00
|
| Rate for Payer: Cash Price |
$561.82
|
| Rate for Payer: Cofinity Commercial |
$603.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.82
|
| Rate for Payer: Healthscope Commercial |
$632.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.93
|
| Rate for Payer: Nomi Health Commercial |
$575.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.70
|
| Rate for Payer: PHP Commercial |
$596.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$610.97
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$618.00
|
| Rate for Payer: UHC Core |
$586.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.70
|
|
|
HC PACK QUEST CARDIOPLEGIA
|
Facility
|
OP
|
$702.27
|
|
| Hospital Charge Code |
27000457
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$123.81 |
| Max. Negotiated Rate |
$632.04 |
| Rate for Payer: Aetna Commercial |
$596.93
|
| Rate for Payer: Aetna Medicare |
$182.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$219.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$219.46
|
| Rate for Payer: BCBS Complete |
$129.99
|
| Rate for Payer: BCBS MAPPO |
$175.57
|
| Rate for Payer: BCBS Trust/PPO |
$577.34
|
| Rate for Payer: BCN Commercial |
$577.34
|
| Rate for Payer: BCN Medicare Advantage |
$175.57
|
| Rate for Payer: Cash Price |
$561.82
|
| Rate for Payer: Cofinity Commercial |
$603.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$561.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$175.57
|
| Rate for Payer: Healthscope Commercial |
$632.04
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$526.70
|
| Rate for Payer: Mclaren Medicaid |
$123.81
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$184.35
|
| Rate for Payer: Meridian Medicaid |
$129.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$201.90
|
| Rate for Payer: Molina Medicare/Medicaid |
$193.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$596.93
|
| Rate for Payer: Nomi Health Commercial |
$575.86
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$526.70
|
| Rate for Payer: PACE Senior Care Partners |
$166.79
|
| Rate for Payer: PACE SWMI |
$175.57
|
| Rate for Payer: PHP Commercial |
$596.93
|
| Rate for Payer: PHP Medicare Advantage |
$175.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$123.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$610.97
|
| Rate for Payer: Priority Health Medicare |
$177.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$488.78
|
| Rate for Payer: Railroad Medicare Medicare |
$175.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$618.00
|
| Rate for Payer: UHC Core |
$586.40
|
| Rate for Payer: UHC Exchange |
$175.57
|
| Rate for Payer: UHC Medicaid |
$123.81
|
| Rate for Payer: UHC Medicare Advantage |
$175.57
|
| Rate for Payer: UHCCP Medicaid |
$123.81
|
| Rate for Payer: VA VA |
$175.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$526.70
|
|
|
HC PACK TABLE LINE
|
Facility
|
OP
|
$209.12
|
|
| Hospital Charge Code |
27000676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$36.87 |
| Max. Negotiated Rate |
$188.21 |
| Rate for Payer: Aetna Commercial |
$177.75
|
| Rate for Payer: Aetna Medicare |
$54.37
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.35
|
| Rate for Payer: BCBS Complete |
$38.71
|
| Rate for Payer: BCBS MAPPO |
$52.28
|
| Rate for Payer: BCBS Trust/PPO |
$171.92
|
| Rate for Payer: BCN Commercial |
$171.92
|
| Rate for Payer: BCN Medicare Advantage |
$52.28
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.28
|
| Rate for Payer: Healthscope Commercial |
$188.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.84
|
| Rate for Payer: Mclaren Medicaid |
$36.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.89
|
| Rate for Payer: Meridian Medicaid |
$38.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$60.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.51
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.75
|
| Rate for Payer: Nomi Health Commercial |
$171.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.84
|
| Rate for Payer: PACE Senior Care Partners |
$49.67
|
| Rate for Payer: PACE SWMI |
$52.28
|
| Rate for Payer: PHP Commercial |
$177.75
|
| Rate for Payer: PHP Medicare Advantage |
$52.28
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.93
|
| Rate for Payer: Priority Health Medicare |
$52.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.55
|
| Rate for Payer: Railroad Medicare Medicare |
$52.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.03
|
| Rate for Payer: UHC Core |
$174.62
|
| Rate for Payer: UHC Exchange |
$52.28
|
| Rate for Payer: UHC Medicaid |
$36.87
|
| Rate for Payer: UHC Medicare Advantage |
$52.28
|
| Rate for Payer: UHCCP Medicaid |
$36.87
|
| Rate for Payer: VA VA |
$52.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.84
|
|
|
HC PACK TABLE LINE
|
Facility
|
IP
|
$209.12
|
|
| Hospital Charge Code |
27000676
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$145.55 |
| Max. Negotiated Rate |
$188.21 |
| Rate for Payer: Aetna Commercial |
$177.75
|
| Rate for Payer: BCBS Trust/PPO |
$172.71
|
| Rate for Payer: BCN Commercial |
$172.71
|
| Rate for Payer: Cash Price |
$167.30
|
| Rate for Payer: Cofinity Commercial |
$179.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$167.30
|
| Rate for Payer: Healthscope Commercial |
$188.21
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.75
|
| Rate for Payer: Nomi Health Commercial |
$171.48
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.84
|
| Rate for Payer: PHP Commercial |
$177.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$184.03
|
| Rate for Payer: UHC Core |
$174.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.84
|
|
|
HC PACK W/O RESERV TERUMO
|
Facility
|
OP
|
$858.33
|
|
| Hospital Charge Code |
27000648
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$151.32 |
| Max. Negotiated Rate |
$772.50 |
| Rate for Payer: Aetna Commercial |
$729.58
|
| Rate for Payer: Aetna Medicare |
$223.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$268.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$268.23
|
| Rate for Payer: BCBS Complete |
$158.88
|
| Rate for Payer: BCBS MAPPO |
$214.58
|
| Rate for Payer: BCBS Trust/PPO |
$705.63
|
| Rate for Payer: BCN Commercial |
$705.63
|
| Rate for Payer: BCN Medicare Advantage |
$214.58
|
| Rate for Payer: Cash Price |
$686.66
|
| Rate for Payer: Cofinity Commercial |
$738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$214.58
|
| Rate for Payer: Healthscope Commercial |
$772.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.75
|
| Rate for Payer: Mclaren Medicaid |
$151.32
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$225.31
|
| Rate for Payer: Meridian Medicaid |
$158.88
|
| Rate for Payer: MI Amish Medical Board Commercial |
$246.77
|
| Rate for Payer: Molina Medicare/Medicaid |
$236.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.58
|
| Rate for Payer: Nomi Health Commercial |
$703.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.75
|
| Rate for Payer: PACE Senior Care Partners |
$203.85
|
| Rate for Payer: PACE SWMI |
$214.58
|
| Rate for Payer: PHP Commercial |
$729.58
|
| Rate for Payer: PHP Medicare Advantage |
$214.58
|
| Rate for Payer: Priority Health Choice Medicaid |
$151.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$746.75
|
| Rate for Payer: Priority Health Medicare |
$216.73
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$597.40
|
| Rate for Payer: Railroad Medicare Medicare |
$214.58
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.33
|
| Rate for Payer: UHC Core |
$716.71
|
| Rate for Payer: UHC Exchange |
$214.58
|
| Rate for Payer: UHC Medicaid |
$151.32
|
| Rate for Payer: UHC Medicare Advantage |
$214.58
|
| Rate for Payer: UHCCP Medicaid |
$151.32
|
| Rate for Payer: VA VA |
$214.58
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.75
|
|
|
HC PACK W/O RESERV TERUMO
|
Facility
|
IP
|
$858.33
|
|
| Hospital Charge Code |
27000648
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$597.40 |
| Max. Negotiated Rate |
$772.50 |
| Rate for Payer: Aetna Commercial |
$729.58
|
| Rate for Payer: BCBS Trust/PPO |
$708.89
|
| Rate for Payer: BCN Commercial |
$708.89
|
| Rate for Payer: Cash Price |
$686.66
|
| Rate for Payer: Cofinity Commercial |
$738.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$686.66
|
| Rate for Payer: Healthscope Commercial |
$772.50
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$643.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$729.58
|
| Rate for Payer: Nomi Health Commercial |
$703.83
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$643.75
|
| Rate for Payer: PHP Commercial |
$729.58
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$746.75
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$597.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$755.33
|
| Rate for Payer: UHC Core |
$716.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$643.75
|
|
|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
IP
|
$167.67
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$116.70 |
| Max. Negotiated Rate |
$150.90 |
| Rate for Payer: Aetna Commercial |
$142.52
|
| Rate for Payer: BCBS Trust/PPO |
$138.48
|
| Rate for Payer: BCN Commercial |
$138.48
|
| Rate for Payer: Cash Price |
$134.14
|
| Rate for Payer: Cofinity Commercial |
$144.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.14
|
| Rate for Payer: Healthscope Commercial |
$150.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.52
|
| Rate for Payer: Nomi Health Commercial |
$137.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.75
|
| Rate for Payer: PHP Commercial |
$142.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.55
|
| Rate for Payer: UHC Core |
$140.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.75
|
|
|
HC PAIN CLINIC DRUG SCREEN, U
|
Facility
|
OP
|
$167.67
|
|
|
Service Code
|
CPT 80307
|
| Hospital Charge Code |
30100680
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$29.56 |
| Max. Negotiated Rate |
$150.90 |
| Rate for Payer: Aetna Commercial |
$142.52
|
| Rate for Payer: Aetna Medicare |
$43.59
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.40
|
| Rate for Payer: BCBS Complete |
$31.04
|
| Rate for Payer: BCBS MAPPO |
$41.92
|
| Rate for Payer: BCBS Trust/PPO |
$137.84
|
| Rate for Payer: BCN Commercial |
$137.84
|
| Rate for Payer: BCN Medicare Advantage |
$41.92
|
| Rate for Payer: Cash Price |
$134.14
|
| Rate for Payer: Cofinity Commercial |
$144.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$134.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.92
|
| Rate for Payer: Healthscope Commercial |
$150.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.75
|
| Rate for Payer: Mclaren Medicaid |
$29.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$44.01
|
| Rate for Payer: Meridian Medicaid |
$31.04
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.21
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.52
|
| Rate for Payer: Nomi Health Commercial |
$137.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.75
|
| Rate for Payer: PACE Senior Care Partners |
$39.82
|
| Rate for Payer: PACE SWMI |
$41.92
|
| Rate for Payer: PHP Commercial |
$142.52
|
| Rate for Payer: PHP Medicare Advantage |
$41.92
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.87
|
| Rate for Payer: Priority Health Medicare |
$42.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.70
|
| Rate for Payer: Railroad Medicare Medicare |
$41.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.55
|
| Rate for Payer: UHC Core |
$140.00
|
| Rate for Payer: UHC Exchange |
$41.92
|
| Rate for Payer: UHC Medicaid |
$29.56
|
| Rate for Payer: UHC Medicare Advantage |
$41.92
|
| Rate for Payer: UHCCP Medicaid |
$29.56
|
| Rate for Payer: VA VA |
$41.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.75
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
OP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$21.87 |
| Max. Negotiated Rate |
$136.61 |
| Rate for Payer: Aetna Commercial |
$129.02
|
| Rate for Payer: Aetna Medicare |
$39.47
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$47.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$47.43
|
| Rate for Payer: BCBS Complete |
$28.10
|
| Rate for Payer: BCBS MAPPO |
$37.95
|
| Rate for Payer: BCBS Trust/PPO |
$124.79
|
| Rate for Payer: BCCCP Commercial |
$21.87
|
| Rate for Payer: BCN Commercial |
$124.79
|
| Rate for Payer: BCN Medicare Advantage |
$37.95
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$130.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$37.95
|
| Rate for Payer: Healthscope Commercial |
$136.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.84
|
| Rate for Payer: Mclaren Medicaid |
$26.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$39.84
|
| Rate for Payer: Meridian Medicaid |
$28.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$43.64
|
| Rate for Payer: Molina Medicare/Medicaid |
$41.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.02
|
| Rate for Payer: Nomi Health Commercial |
$124.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.84
|
| Rate for Payer: PACE Senior Care Partners |
$36.05
|
| Rate for Payer: PACE SWMI |
$37.95
|
| Rate for Payer: PHP Commercial |
$129.02
|
| Rate for Payer: PHP Medicare Advantage |
$37.95
|
| Rate for Payer: Priority Health Choice Medicaid |
$26.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.06
|
| Rate for Payer: Priority Health Medicare |
$38.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.65
|
| Rate for Payer: Railroad Medicare Medicare |
$37.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.58
|
| Rate for Payer: UHC Core |
$126.74
|
| Rate for Payer: UHC Exchange |
$37.95
|
| Rate for Payer: UHC Medicaid |
$26.76
|
| Rate for Payer: UHC Medicare Advantage |
$37.95
|
| Rate for Payer: UHCCP Medicaid |
$26.76
|
| Rate for Payer: VA VA |
$37.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.84
|
|
|
HC PAIN PUMP ADJUSTMENT
|
Facility
|
IP
|
$151.79
|
|
|
Service Code
|
CPT 99211
|
| Hospital Charge Code |
76100028
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$105.65 |
| Max. Negotiated Rate |
$136.61 |
| Rate for Payer: Aetna Commercial |
$129.02
|
| Rate for Payer: BCBS Trust/PPO |
$125.36
|
| Rate for Payer: BCN Commercial |
$125.36
|
| Rate for Payer: Cash Price |
$121.43
|
| Rate for Payer: Cofinity Commercial |
$130.54
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$121.43
|
| Rate for Payer: Healthscope Commercial |
$136.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$113.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$129.02
|
| Rate for Payer: Nomi Health Commercial |
$124.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$113.84
|
| Rate for Payer: PHP Commercial |
$129.02
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$132.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$105.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$133.58
|
| Rate for Payer: UHC Core |
$126.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$113.84
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
IP
|
$942.09
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$655.69 |
| Max. Negotiated Rate |
$847.88 |
| Rate for Payer: Aetna Commercial |
$800.78
|
| Rate for Payer: BCBS Trust/PPO |
$778.07
|
| Rate for Payer: BCN Commercial |
$778.07
|
| Rate for Payer: Cash Price |
$753.67
|
| Rate for Payer: Cofinity Commercial |
$810.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$753.67
|
| Rate for Payer: Healthscope Commercial |
$847.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$706.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$800.78
|
| Rate for Payer: Nomi Health Commercial |
$772.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$706.57
|
| Rate for Payer: PHP Commercial |
$800.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$819.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$655.69
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.04
|
| Rate for Payer: UHC Core |
$786.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$706.57
|
|
|
HC PAIN PUMP SUPPLY
|
Facility
|
OP
|
$942.09
|
|
| Hospital Charge Code |
27000130
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$166.09 |
| Max. Negotiated Rate |
$847.88 |
| Rate for Payer: Aetna Commercial |
$800.78
|
| Rate for Payer: Aetna Medicare |
$244.94
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$294.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$294.40
|
| Rate for Payer: BCBS Complete |
$174.38
|
| Rate for Payer: BCBS MAPPO |
$235.52
|
| Rate for Payer: BCBS Trust/PPO |
$774.49
|
| Rate for Payer: BCN Commercial |
$774.49
|
| Rate for Payer: BCN Medicare Advantage |
$235.52
|
| Rate for Payer: Cash Price |
$753.67
|
| Rate for Payer: Cofinity Commercial |
$810.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$753.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$235.52
|
| Rate for Payer: Healthscope Commercial |
$847.88
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$706.57
|
| Rate for Payer: Mclaren Medicaid |
$166.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$247.30
|
| Rate for Payer: Meridian Medicaid |
$174.38
|
| Rate for Payer: MI Amish Medical Board Commercial |
$270.85
|
| Rate for Payer: Molina Medicare/Medicaid |
$259.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$800.78
|
| Rate for Payer: Nomi Health Commercial |
$772.51
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$706.57
|
| Rate for Payer: PACE Senior Care Partners |
$223.75
|
| Rate for Payer: PACE SWMI |
$235.52
|
| Rate for Payer: PHP Commercial |
$800.78
|
| Rate for Payer: PHP Medicare Advantage |
$235.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$166.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$819.62
|
| Rate for Payer: Priority Health Medicare |
$237.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$655.69
|
| Rate for Payer: Railroad Medicare Medicare |
$235.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$829.04
|
| Rate for Payer: UHC Core |
$786.65
|
| Rate for Payer: UHC Exchange |
$235.52
|
| Rate for Payer: UHC Medicaid |
$166.09
|
| Rate for Payer: UHC Medicare Advantage |
$235.52
|
| Rate for Payer: UHCCP Medicaid |
$166.09
|
| Rate for Payer: VA VA |
$235.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$706.57
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
IP
|
$68.67
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$47.79 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: BCBS Trust/PPO |
$56.71
|
| Rate for Payer: BCN Commercial |
$56.71
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.50
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC PANCREATIC AMYLASE
|
Facility
|
OP
|
$68.67
|
|
|
Service Code
|
CPT 82150
|
| Hospital Charge Code |
30100100
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.11 |
| Max. Negotiated Rate |
$61.80 |
| Rate for Payer: Aetna Commercial |
$58.37
|
| Rate for Payer: Aetna Medicare |
$17.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.46
|
| Rate for Payer: BCBS Complete |
$12.71
|
| Rate for Payer: BCBS MAPPO |
$17.17
|
| Rate for Payer: BCBS Trust/PPO |
$56.45
|
| Rate for Payer: BCN Commercial |
$56.45
|
| Rate for Payer: BCN Medicare Advantage |
$17.17
|
| Rate for Payer: Cash Price |
$54.94
|
| Rate for Payer: Cofinity Commercial |
$59.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$54.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.17
|
| Rate for Payer: Healthscope Commercial |
$61.80
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.50
|
| Rate for Payer: Mclaren Medicaid |
$12.11
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.03
|
| Rate for Payer: Meridian Medicaid |
$12.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.74
|
| Rate for Payer: Molina Medicare/Medicaid |
$18.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.37
|
| Rate for Payer: Nomi Health Commercial |
$56.31
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$51.50
|
| Rate for Payer: PACE Senior Care Partners |
$16.31
|
| Rate for Payer: PACE SWMI |
$17.17
|
| Rate for Payer: PHP Commercial |
$58.37
|
| Rate for Payer: PHP Medicare Advantage |
$17.17
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.11
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$59.74
|
| Rate for Payer: Priority Health Medicare |
$17.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.79
|
| Rate for Payer: Railroad Medicare Medicare |
$17.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.43
|
| Rate for Payer: UHC Core |
$57.34
|
| Rate for Payer: UHC Exchange |
$17.17
|
| Rate for Payer: UHC Medicaid |
$12.11
|
| Rate for Payer: UHC Medicare Advantage |
$17.17
|
| Rate for Payer: UHCCP Medicaid |
$12.11
|
| Rate for Payer: VA VA |
$17.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.50
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
OP
|
$119.65
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$21.09 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: Aetna Medicare |
$31.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.39
|
| Rate for Payer: BCBS Complete |
$22.15
|
| Rate for Payer: BCBS MAPPO |
$29.91
|
| Rate for Payer: BCBS Trust/PPO |
$98.36
|
| Rate for Payer: BCN Commercial |
$98.36
|
| Rate for Payer: BCN Medicare Advantage |
$29.91
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.91
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Mclaren Medicaid |
$21.09
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.41
|
| Rate for Payer: Meridian Medicaid |
$22.15
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PACE Senior Care Partners |
$28.42
|
| Rate for Payer: PACE SWMI |
$29.91
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: PHP Medicare Advantage |
$29.91
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Medicare |
$30.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: Railroad Medicare Medicare |
$29.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: UHC Exchange |
$29.91
|
| Rate for Payer: UHC Medicaid |
$21.09
|
| Rate for Payer: UHC Medicare Advantage |
$29.91
|
| Rate for Payer: UHCCP Medicaid |
$21.09
|
| Rate for Payer: VA VA |
$29.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC PANCREATIC ELAST IN STOOL
|
Facility
|
IP
|
$119.65
|
|
|
Service Code
|
CPT 82653
|
| Hospital Charge Code |
30100632
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$83.28 |
| Max. Negotiated Rate |
$107.69 |
| Rate for Payer: Aetna Commercial |
$101.70
|
| Rate for Payer: BCBS Trust/PPO |
$98.82
|
| Rate for Payer: BCN Commercial |
$98.82
|
| Rate for Payer: Cash Price |
$95.72
|
| Rate for Payer: Cofinity Commercial |
$102.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.72
|
| Rate for Payer: Healthscope Commercial |
$107.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.70
|
| Rate for Payer: Nomi Health Commercial |
$98.11
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.74
|
| Rate for Payer: PHP Commercial |
$101.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.29
|
| Rate for Payer: UHC Core |
$99.91
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.74
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
OP
|
$112.20
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.78 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: Aetna Medicare |
$29.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$35.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$35.06
|
| Rate for Payer: BCBS Complete |
$20.77
|
| Rate for Payer: BCBS MAPPO |
$28.05
|
| Rate for Payer: BCBS Trust/PPO |
$92.24
|
| Rate for Payer: BCN Commercial |
$92.24
|
| Rate for Payer: BCN Medicare Advantage |
$28.05
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.05
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Mclaren Medicaid |
$19.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$29.45
|
| Rate for Payer: Meridian Medicaid |
$20.77
|
| Rate for Payer: MI Amish Medical Board Commercial |
$32.26
|
| Rate for Payer: Molina Medicare/Medicaid |
$30.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.15
|
| Rate for Payer: PACE Senior Care Partners |
$26.65
|
| Rate for Payer: PACE SWMI |
$28.05
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: PHP Medicare Advantage |
$28.05
|
| Rate for Payer: Priority Health Choice Medicaid |
$19.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.61
|
| Rate for Payer: Priority Health Medicare |
$28.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.09
|
| Rate for Payer: Railroad Medicare Medicare |
$28.05
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$93.69
|
| Rate for Payer: UHC Exchange |
$28.05
|
| Rate for Payer: UHC Medicaid |
$19.78
|
| Rate for Payer: UHC Medicare Advantage |
$28.05
|
| Rate for Payer: UHCCP Medicaid |
$19.78
|
| Rate for Payer: VA VA |
$28.05
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC PANTOTHENIC ACID (B-5) BIOASSAY
|
Facility
|
IP
|
$112.20
|
|
|
Service Code
|
CPT 84591
|
| Hospital Charge Code |
30100762
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$78.09 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna Commercial |
$95.37
|
| Rate for Payer: BCBS Trust/PPO |
$92.67
|
| Rate for Payer: BCN Commercial |
$92.67
|
| Rate for Payer: Cash Price |
$89.76
|
| Rate for Payer: Cofinity Commercial |
$96.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$89.76
|
| Rate for Payer: Healthscope Commercial |
$100.98
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$84.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$95.37
|
| Rate for Payer: Nomi Health Commercial |
$92.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$84.15
|
| Rate for Payer: PHP Commercial |
$95.37
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$97.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$78.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$98.74
|
| Rate for Payer: UHC Core |
$93.69
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$84.15
|
|
|
HC PAPER WASP IGE
|
Facility
|
OP
|
$25.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
30200096
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.57 |
| Max. Negotiated Rate |
$23.31 |
| Rate for Payer: Aetna Commercial |
$22.02
|
| Rate for Payer: Aetna Medicare |
$6.73
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.09
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.09
|
| Rate for Payer: BCBS Complete |
$4.79
|
| Rate for Payer: BCBS MAPPO |
$6.47
|
| Rate for Payer: BCBS Trust/PPO |
$21.29
|
| Rate for Payer: BCN Commercial |
$21.29
|
| Rate for Payer: BCN Medicare Advantage |
$6.47
|
| Rate for Payer: Cash Price |
$20.72
|
| Rate for Payer: Cofinity Commercial |
$22.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$20.72
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.47
|
| Rate for Payer: Healthscope Commercial |
$23.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.43
|
| Rate for Payer: Mclaren Medicaid |
$4.57
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.80
|
| Rate for Payer: Meridian Medicaid |
$4.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.45
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.02
|
| Rate for Payer: Nomi Health Commercial |
$21.24
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$19.43
|
| Rate for Payer: PACE Senior Care Partners |
$6.15
|
| Rate for Payer: PACE SWMI |
$6.47
|
| Rate for Payer: PHP Commercial |
$22.02
|
| Rate for Payer: PHP Medicare Advantage |
$6.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$22.53
|
| Rate for Payer: Priority Health Medicare |
$6.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.03
|
| Rate for Payer: Railroad Medicare Medicare |
$6.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$22.79
|
| Rate for Payer: UHC Core |
$21.63
|
| Rate for Payer: UHC Exchange |
$6.47
|
| Rate for Payer: UHC Medicaid |
$4.57
|
| Rate for Payer: UHC Medicare Advantage |
$6.47
|
| Rate for Payer: UHCCP Medicaid |
$4.57
|
| Rate for Payer: VA VA |
$6.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.43
|
|
