|
HC MYELOID BLAST PANEL CMPT
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31100017
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$40.37
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO |
$45.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.97
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
IP
|
$30.17
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$19.61 |
| Max. Negotiated Rate |
$27.15 |
| Rate for Payer: Aetna Commercial |
$25.64
|
| Rate for Payer: BCBS Trust/PPO |
$24.63
|
| Rate for Payer: BCN Commercial |
$23.32
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Healthscope Commercial |
$27.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.63
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PHP Commercial |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO |
$26.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.21
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.55
|
| Rate for Payer: UHC Core |
$25.19
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.63
|
|
|
HC MYELOPEROXIDASE AB (HC ANCA VACULITIS PANEL MPO PR3)
|
Facility
|
OP
|
$30.17
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100253
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.17 |
| Max. Negotiated Rate |
$27.15 |
| Rate for Payer: Aetna Commercial |
$25.64
|
| Rate for Payer: Aetna Medicare |
$7.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$9.43
|
| Rate for Payer: Amish Plain Church Group Commercial |
$9.43
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$7.54
|
| Rate for Payer: BCBS Trust/PPO |
$24.80
|
| Rate for Payer: BCN Commercial |
$23.46
|
| Rate for Payer: BCN Medicare Advantage |
$7.54
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cash Price |
$24.14
|
| Rate for Payer: Cofinity Commercial |
$25.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$24.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$7.54
|
| Rate for Payer: Healthscope Commercial |
$27.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$22.63
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.92
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$8.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$25.64
|
| Rate for Payer: Nomi Health Commercial |
$24.74
|
| Rate for Payer: PACE Senior Care Partners |
$7.17
|
| Rate for Payer: PACE SWMI |
$7.54
|
| Rate for Payer: PHP Commercial |
$25.64
|
| Rate for Payer: PHP Medicare Advantage |
$7.54
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$19.61
|
| Rate for Payer: Priority Health HMO/PPO |
$26.25
|
| Rate for Payer: Priority Health Medicare |
$7.62
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$20.21
|
| Rate for Payer: Railroad Medicare Medicare |
$7.54
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$26.55
|
| Rate for Payer: UHC Core |
$25.19
|
| Rate for Payer: UHC Dual Complete DSNP |
$7.54
|
| Rate for Payer: UHC Exchange |
$7.54
|
| Rate for Payer: UHC Medicare Advantage |
$7.54
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$7.54
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$22.63
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
OP
|
$34.70
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.24 |
| Max. Negotiated Rate |
$31.23 |
| Rate for Payer: Aetna Commercial |
$29.50
|
| Rate for Payer: Aetna Medicare |
$9.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.84
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$8.68
|
| Rate for Payer: BCBS Trust/PPO |
$28.53
|
| Rate for Payer: BCN Commercial |
$26.98
|
| Rate for Payer: BCN Medicare Advantage |
$8.68
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cofinity Commercial |
$29.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.76
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.68
|
| Rate for Payer: Healthscope Commercial |
$31.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.02
|
| Rate for Payer: Mclaren Medicaid |
$9.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.11
|
| Rate for Payer: Meridian Medicaid |
$9.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$9.98
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: Nomi Health Commercial |
$28.45
|
| Rate for Payer: PACE Senior Care Partners |
$8.24
|
| Rate for Payer: PACE SWMI |
$8.68
|
| Rate for Payer: PHP Commercial |
$29.50
|
| Rate for Payer: PHP Medicare Advantage |
$8.68
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.39
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.56
|
| Rate for Payer: Priority Health HMO/PPO |
$30.19
|
| Rate for Payer: Priority Health Medicare |
$8.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.25
|
| Rate for Payer: Railroad Medicare Medicare |
$8.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC Core |
$28.97
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.68
|
| Rate for Payer: UHC Exchange |
$8.68
|
| Rate for Payer: UHC Medicare Advantage |
$8.68
|
| Rate for Payer: UHCCP Medicaid |
$9.39
|
| Rate for Payer: VA VA |
$8.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.02
|
|
|
HC MYOBLOC PER 100U (RIMABOTULINUMTOXINB)
|
Facility
|
IP
|
$34.70
|
|
|
Service Code
|
HCPCS J0587
|
| Hospital Charge Code |
63600172
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.56 |
| Max. Negotiated Rate |
$31.23 |
| Rate for Payer: Aetna Commercial |
$29.50
|
| Rate for Payer: BCBS Trust/PPO |
$28.33
|
| Rate for Payer: BCN Commercial |
$26.82
|
| Rate for Payer: Cash Price |
$27.76
|
| Rate for Payer: Cofinity Commercial |
$29.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$27.76
|
| Rate for Payer: Healthscope Commercial |
$31.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.50
|
| Rate for Payer: Nomi Health Commercial |
$28.45
|
| Rate for Payer: PHP Commercial |
$29.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.56
|
| Rate for Payer: Priority Health HMO/PPO |
$30.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.54
|
| Rate for Payer: UHC Core |
$28.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.02
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
IP
|
$145.96
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$94.87 |
| Max. Negotiated Rate |
$131.36 |
| Rate for Payer: Aetna Commercial |
$124.07
|
| Rate for Payer: BCBS Trust/PPO |
$119.15
|
| Rate for Payer: BCN Commercial |
$112.80
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$125.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Healthscope Commercial |
$131.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: Nomi Health Commercial |
$119.69
|
| Rate for Payer: PHP Commercial |
$124.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health HMO/PPO |
$126.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.44
|
| Rate for Payer: UHC Core |
$121.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.47
|
|
|
HC MYOGLOBIN SERUM
|
Facility
|
OP
|
$145.96
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100303
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$131.36 |
| Rate for Payer: Aetna Commercial |
$124.07
|
| Rate for Payer: Aetna Medicare |
$37.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$45.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$45.61
|
| Rate for Payer: BCBS Complete |
$9.81
|
| Rate for Payer: BCBS MAPPO |
$36.49
|
| Rate for Payer: BCBS Trust/PPO |
$119.99
|
| Rate for Payer: BCN Commercial |
$113.48
|
| Rate for Payer: BCN Medicare Advantage |
$36.49
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cash Price |
$116.77
|
| Rate for Payer: Cofinity Commercial |
$125.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$116.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$36.49
|
| Rate for Payer: Healthscope Commercial |
$131.36
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$109.47
|
| Rate for Payer: Mclaren Medicaid |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$38.31
|
| Rate for Payer: Meridian Medicaid |
$9.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$41.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$124.07
|
| Rate for Payer: Nomi Health Commercial |
$119.69
|
| Rate for Payer: PACE Senior Care Partners |
$34.67
|
| Rate for Payer: PACE SWMI |
$36.49
|
| Rate for Payer: PHP Commercial |
$124.07
|
| Rate for Payer: PHP Medicare Advantage |
$36.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$94.87
|
| Rate for Payer: Priority Health HMO/PPO |
$126.99
|
| Rate for Payer: Priority Health Medicare |
$36.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$97.79
|
| Rate for Payer: Railroad Medicare Medicare |
$36.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$128.44
|
| Rate for Payer: UHC Core |
$121.88
|
| Rate for Payer: UHC Dual Complete DSNP |
$36.49
|
| Rate for Payer: UHC Exchange |
$36.49
|
| Rate for Payer: UHC Medicare Advantage |
$36.49
|
| Rate for Payer: UHCCP Medicaid |
$9.34
|
| Rate for Payer: VA VA |
$36.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$109.47
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
IP
|
$54.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.16 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: BCBS Trust/PPO |
$44.16
|
| Rate for Payer: BCN Commercial |
$41.81
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO |
$47.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC MYOGLOBIN SERUM.
|
Facility
|
OP
|
$54.10
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100664
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$48.69 |
| Rate for Payer: Aetna Commercial |
$45.98
|
| Rate for Payer: Aetna Medicare |
$14.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.91
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.91
|
| Rate for Payer: BCBS Complete |
$9.81
|
| Rate for Payer: BCBS MAPPO |
$13.52
|
| Rate for Payer: BCBS Trust/PPO |
$44.48
|
| Rate for Payer: BCN Commercial |
$42.06
|
| Rate for Payer: BCN Medicare Advantage |
$13.52
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cash Price |
$43.28
|
| Rate for Payer: Cofinity Commercial |
$46.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$43.28
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.52
|
| Rate for Payer: Healthscope Commercial |
$48.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$40.58
|
| Rate for Payer: Mclaren Medicaid |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$14.20
|
| Rate for Payer: Meridian Medicaid |
$9.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.98
|
| Rate for Payer: Nomi Health Commercial |
$44.36
|
| Rate for Payer: PACE Senior Care Partners |
$12.85
|
| Rate for Payer: PACE SWMI |
$13.52
|
| Rate for Payer: PHP Commercial |
$45.98
|
| Rate for Payer: PHP Medicare Advantage |
$13.52
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$35.16
|
| Rate for Payer: Priority Health HMO/PPO |
$47.07
|
| Rate for Payer: Priority Health Medicare |
$13.66
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$36.25
|
| Rate for Payer: Railroad Medicare Medicare |
$13.52
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$47.61
|
| Rate for Payer: UHC Core |
$45.17
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.52
|
| Rate for Payer: UHC Exchange |
$13.52
|
| Rate for Payer: UHC Medicare Advantage |
$13.52
|
| Rate for Payer: UHCCP Medicaid |
$9.34
|
| Rate for Payer: VA VA |
$13.52
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$40.58
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
OP
|
$48.90
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$9.34 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: Aetna Medicare |
$12.71
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$15.28
|
| Rate for Payer: Amish Plain Church Group Commercial |
$15.28
|
| Rate for Payer: BCBS Complete |
$9.81
|
| Rate for Payer: BCBS MAPPO |
$12.22
|
| Rate for Payer: BCBS Trust/PPO |
$40.20
|
| Rate for Payer: BCN Commercial |
$38.02
|
| Rate for Payer: BCN Medicare Advantage |
$12.22
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$12.22
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.68
|
| Rate for Payer: Mclaren Medicaid |
$9.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$12.84
|
| Rate for Payer: Meridian Medicaid |
$9.81
|
| Rate for Payer: MI Amish Medical Board Commercial |
$14.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PACE Senior Care Partners |
$11.61
|
| Rate for Payer: PACE SWMI |
$12.22
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: PHP Medicare Advantage |
$12.22
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Medicare |
$12.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: Railroad Medicare Medicare |
$12.22
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: UHC Dual Complete DSNP |
$12.22
|
| Rate for Payer: UHC Exchange |
$12.22
|
| Rate for Payer: UHC Medicare Advantage |
$12.22
|
| Rate for Payer: UHCCP Medicaid |
$9.34
|
| Rate for Payer: VA VA |
$12.22
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.68
|
|
|
HC MYOGLOBIN URINE
|
Facility
|
IP
|
$48.90
|
|
|
Service Code
|
CPT 83874
|
| Hospital Charge Code |
30100302
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$31.78 |
| Max. Negotiated Rate |
$44.01 |
| Rate for Payer: Aetna Commercial |
$41.56
|
| Rate for Payer: BCBS Trust/PPO |
$39.92
|
| Rate for Payer: BCN Commercial |
$37.79
|
| Rate for Payer: Cash Price |
$39.12
|
| Rate for Payer: Cofinity Commercial |
$42.05
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$39.12
|
| Rate for Payer: Healthscope Commercial |
$44.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$36.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$41.56
|
| Rate for Payer: Nomi Health Commercial |
$40.10
|
| Rate for Payer: PHP Commercial |
$41.56
|
| Rate for Payer: Priority Health Cigna Priority Health |
$31.78
|
| Rate for Payer: Priority Health HMO/PPO |
$42.54
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$32.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$43.03
|
| Rate for Payer: UHC Core |
$40.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$36.68
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
IP
|
$26.56
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.26 |
| Max. Negotiated Rate |
$23.90 |
| Rate for Payer: Aetna Commercial |
$22.58
|
| Rate for Payer: BCBS Trust/PPO |
$21.68
|
| Rate for Payer: BCN Commercial |
$20.53
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cofinity Commercial |
$22.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.25
|
| Rate for Payer: Healthscope Commercial |
$23.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.58
|
| Rate for Payer: Nomi Health Commercial |
$21.78
|
| Rate for Payer: PHP Commercial |
$22.58
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health HMO/PPO |
$23.11
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.37
|
| Rate for Payer: UHC Core |
$22.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.92
|
|
|
HC MYOMARKER 3 CMPT
|
Facility
|
OP
|
$26.56
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200503
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$6.31 |
| Max. Negotiated Rate |
$23.90 |
| Rate for Payer: Aetna Commercial |
$22.58
|
| Rate for Payer: Aetna Medicare |
$6.91
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.30
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$6.64
|
| Rate for Payer: BCBS Trust/PPO |
$21.83
|
| Rate for Payer: BCN Commercial |
$20.65
|
| Rate for Payer: BCN Medicare Advantage |
$6.64
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cash Price |
$21.25
|
| Rate for Payer: Cofinity Commercial |
$22.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.25
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.64
|
| Rate for Payer: Healthscope Commercial |
$23.90
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$19.92
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$6.97
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.58
|
| Rate for Payer: Nomi Health Commercial |
$21.78
|
| Rate for Payer: PACE Senior Care Partners |
$6.31
|
| Rate for Payer: PACE SWMI |
$6.64
|
| Rate for Payer: PHP Commercial |
$22.58
|
| Rate for Payer: PHP Medicare Advantage |
$6.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$17.26
|
| Rate for Payer: Priority Health HMO/PPO |
$23.11
|
| Rate for Payer: Priority Health Medicare |
$6.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$17.80
|
| Rate for Payer: Railroad Medicare Medicare |
$6.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.37
|
| Rate for Payer: UHC Core |
$22.18
|
| Rate for Payer: UHC Dual Complete DSNP |
$6.64
|
| Rate for Payer: UHC Exchange |
$6.64
|
| Rate for Payer: UHC Medicare Advantage |
$6.64
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$6.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$19.92
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
OP
|
$19.91
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$17.92 |
| Rate for Payer: Aetna Commercial |
$16.92
|
| Rate for Payer: Aetna Medicare |
$5.18
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$6.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$6.22
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$4.98
|
| Rate for Payer: BCBS Trust/PPO |
$16.37
|
| Rate for Payer: BCN Commercial |
$15.48
|
| Rate for Payer: BCN Medicare Advantage |
$4.98
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cofinity Commercial |
$17.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.98
|
| Rate for Payer: Healthscope Commercial |
$17.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.93
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$5.23
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$5.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$16.33
|
| Rate for Payer: PACE Senior Care Partners |
$4.73
|
| Rate for Payer: PACE SWMI |
$4.98
|
| Rate for Payer: PHP Commercial |
$16.92
|
| Rate for Payer: PHP Medicare Advantage |
$4.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health HMO/PPO |
$17.32
|
| Rate for Payer: Priority Health Medicare |
$5.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.34
|
| Rate for Payer: Railroad Medicare Medicare |
$4.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.52
|
| Rate for Payer: UHC Core |
$16.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$4.98
|
| Rate for Payer: UHC Exchange |
$4.98
|
| Rate for Payer: UHC Medicare Advantage |
$4.98
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$4.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.93
|
|
|
HC MYOMARKER 3 PROFILE
|
Facility
|
IP
|
$19.91
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30100746
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$12.94 |
| Max. Negotiated Rate |
$17.92 |
| Rate for Payer: Aetna Commercial |
$16.92
|
| Rate for Payer: BCBS Trust/PPO |
$16.25
|
| Rate for Payer: BCN Commercial |
$15.39
|
| Rate for Payer: Cash Price |
$15.93
|
| Rate for Payer: Cofinity Commercial |
$17.12
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$15.93
|
| Rate for Payer: Healthscope Commercial |
$17.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$14.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$16.92
|
| Rate for Payer: Nomi Health Commercial |
$16.33
|
| Rate for Payer: PHP Commercial |
$16.92
|
| Rate for Payer: Priority Health Cigna Priority Health |
$12.94
|
| Rate for Payer: Priority Health HMO/PPO |
$17.32
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$13.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$17.52
|
| Rate for Payer: UHC Core |
$16.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$14.93
|
|
|
HC MYRINGOPLASTY
|
Facility
|
OP
|
$9,020.00
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$2,142.25 |
| Max. Negotiated Rate |
$8,118.00 |
| Rate for Payer: Aetna Commercial |
$7,667.00
|
| Rate for Payer: Aetna Medicare |
$2,345.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,818.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,818.75
|
| Rate for Payer: BCBS Complete |
$2,412.36
|
| Rate for Payer: BCBS MAPPO |
$2,255.00
|
| Rate for Payer: BCBS Trust/PPO |
$7,415.34
|
| Rate for Payer: BCN Commercial |
$7,013.05
|
| Rate for Payer: BCN Medicare Advantage |
$2,255.00
|
| Rate for Payer: Cash Price |
$7,216.00
|
| Rate for Payer: Cash Price |
$7,216.00
|
| Rate for Payer: Cofinity Commercial |
$7,757.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.00
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,255.00
|
| Rate for Payer: Healthscope Commercial |
$8,118.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,765.00
|
| Rate for Payer: Mclaren Medicaid |
$2,297.33
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,367.75
|
| Rate for Payer: Meridian Medicaid |
$2,412.36
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,593.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.00
|
| Rate for Payer: Nomi Health Commercial |
$7,396.40
|
| Rate for Payer: PACE Senior Care Partners |
$2,142.25
|
| Rate for Payer: PACE SWMI |
$2,255.00
|
| Rate for Payer: PHP Commercial |
$7,667.00
|
| Rate for Payer: PHP Medicare Advantage |
$2,255.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,297.33
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,863.00
|
| Rate for Payer: Priority Health HMO/PPO |
$7,847.40
|
| Rate for Payer: Priority Health Medicare |
$2,277.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,043.40
|
| Rate for Payer: Railroad Medicare Medicare |
$2,255.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,937.60
|
| Rate for Payer: UHC Core |
$7,531.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,255.00
|
| Rate for Payer: UHC Exchange |
$2,255.00
|
| Rate for Payer: UHC Medicare Advantage |
$2,255.00
|
| Rate for Payer: UHCCP Medicaid |
$2,297.33
|
| Rate for Payer: VA VA |
$2,255.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,765.00
|
|
|
HC MYRINGOPLASTY
|
Facility
|
IP
|
$9,020.00
|
|
|
Service Code
|
CPT 69620
|
| Hospital Charge Code |
76100435
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,863.00 |
| Max. Negotiated Rate |
$8,118.00 |
| Rate for Payer: Aetna Commercial |
$7,667.00
|
| Rate for Payer: BCBS Trust/PPO |
$7,363.03
|
| Rate for Payer: BCN Commercial |
$6,970.66
|
| Rate for Payer: Cash Price |
$7,216.00
|
| Rate for Payer: Cofinity Commercial |
$7,757.20
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,216.00
|
| Rate for Payer: Healthscope Commercial |
$8,118.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,765.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,667.00
|
| Rate for Payer: Nomi Health Commercial |
$7,396.40
|
| Rate for Payer: PHP Commercial |
$7,667.00
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,863.00
|
| Rate for Payer: Priority Health HMO/PPO |
$7,847.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,043.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,937.60
|
| Rate for Payer: UHC Core |
$7,531.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,765.00
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
OP
|
$628.32
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$149.23 |
| Max. Negotiated Rate |
$565.49 |
| Rate for Payer: Aetna Commercial |
$534.07
|
| Rate for Payer: Aetna Medicare |
$163.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$196.35
|
| Rate for Payer: Amish Plain Church Group Commercial |
$196.35
|
| Rate for Payer: BCBS Complete |
$172.73
|
| Rate for Payer: BCBS MAPPO |
$157.08
|
| Rate for Payer: BCBS Trust/PPO |
$516.54
|
| Rate for Payer: BCN Commercial |
$488.52
|
| Rate for Payer: BCN Medicare Advantage |
$157.08
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$157.08
|
| Rate for Payer: Healthscope Commercial |
$565.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.24
|
| Rate for Payer: Mclaren Medicaid |
$164.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$164.93
|
| Rate for Payer: Meridian Medicaid |
$172.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$180.64
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: Nomi Health Commercial |
$515.22
|
| Rate for Payer: PACE Senior Care Partners |
$149.23
|
| Rate for Payer: PACE SWMI |
$157.08
|
| Rate for Payer: PHP Commercial |
$534.07
|
| Rate for Payer: PHP Medicare Advantage |
$157.08
|
| Rate for Payer: Priority Health Choice Medicaid |
$164.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health HMO/PPO |
$546.64
|
| Rate for Payer: Priority Health Medicare |
$158.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.97
|
| Rate for Payer: Railroad Medicare Medicare |
$157.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.92
|
| Rate for Payer: UHC Core |
$524.65
|
| Rate for Payer: UHC Dual Complete DSNP |
$157.08
|
| Rate for Payer: UHC Exchange |
$157.08
|
| Rate for Payer: UHC Medicare Advantage |
$157.08
|
| Rate for Payer: UHCCP Medicaid |
$164.50
|
| Rate for Payer: VA VA |
$157.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.24
|
|
|
HC MYRINGOTOMY ASPIR&EUSTACHIAN TUBE NFLTJ
|
Facility
|
IP
|
$628.32
|
|
|
Service Code
|
CPT 69420
|
| Hospital Charge Code |
76100484
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$408.41 |
| Max. Negotiated Rate |
$565.49 |
| Rate for Payer: Aetna Commercial |
$534.07
|
| Rate for Payer: BCBS Trust/PPO |
$512.90
|
| Rate for Payer: BCN Commercial |
$485.57
|
| Rate for Payer: Cash Price |
$502.66
|
| Rate for Payer: Cofinity Commercial |
$540.36
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$502.66
|
| Rate for Payer: Healthscope Commercial |
$565.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$471.24
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$534.07
|
| Rate for Payer: Nomi Health Commercial |
$515.22
|
| Rate for Payer: PHP Commercial |
$534.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$408.41
|
| Rate for Payer: Priority Health HMO/PPO |
$546.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$420.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$552.92
|
| Rate for Payer: UHC Core |
$524.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$471.24
|
|
|
HC NAIL BED REPAIR
|
Facility
|
IP
|
$757.63
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$492.46 |
| Max. Negotiated Rate |
$681.87 |
| Rate for Payer: Aetna Commercial |
$643.99
|
| Rate for Payer: BCBS Trust/PPO |
$618.45
|
| Rate for Payer: BCN Commercial |
$585.50
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cofinity Commercial |
$651.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.10
|
| Rate for Payer: Healthscope Commercial |
$681.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$568.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$643.99
|
| Rate for Payer: Nomi Health Commercial |
$621.26
|
| Rate for Payer: PHP Commercial |
$643.99
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.46
|
| Rate for Payer: Priority Health HMO/PPO |
$659.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.71
|
| Rate for Payer: UHC Core |
$632.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$568.22
|
|
|
HC NAIL BED REPAIR
|
Facility
|
OP
|
$757.63
|
|
|
Service Code
|
CPT 11760
|
| Hospital Charge Code |
45000077
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$179.94 |
| Max. Negotiated Rate |
$681.87 |
| Rate for Payer: Aetna Commercial |
$643.99
|
| Rate for Payer: Aetna Medicare |
$196.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$236.76
|
| Rate for Payer: Amish Plain Church Group Commercial |
$236.76
|
| Rate for Payer: BCBS Complete |
$455.33
|
| Rate for Payer: BCBS MAPPO |
$189.41
|
| Rate for Payer: BCBS Trust/PPO |
$622.85
|
| Rate for Payer: BCN Commercial |
$589.06
|
| Rate for Payer: BCN Medicare Advantage |
$189.41
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cash Price |
$606.10
|
| Rate for Payer: Cofinity Commercial |
$651.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$606.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$189.41
|
| Rate for Payer: Healthscope Commercial |
$681.87
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$568.22
|
| Rate for Payer: Mclaren Medicaid |
$433.62
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$198.88
|
| Rate for Payer: Meridian Medicaid |
$455.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$217.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$643.99
|
| Rate for Payer: Nomi Health Commercial |
$621.26
|
| Rate for Payer: PACE Senior Care Partners |
$179.94
|
| Rate for Payer: PACE SWMI |
$189.41
|
| Rate for Payer: PHP Commercial |
$643.99
|
| Rate for Payer: PHP Medicare Advantage |
$189.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$433.62
|
| Rate for Payer: Priority Health Cigna Priority Health |
$492.46
|
| Rate for Payer: Priority Health HMO/PPO |
$659.14
|
| Rate for Payer: Priority Health Medicare |
$191.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$507.61
|
| Rate for Payer: Railroad Medicare Medicare |
$189.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$666.71
|
| Rate for Payer: UHC Core |
$632.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$189.41
|
| Rate for Payer: UHC Exchange |
$189.41
|
| Rate for Payer: UHC Medicare Advantage |
$189.41
|
| Rate for Payer: UHCCP Medicaid |
$433.62
|
| Rate for Payer: VA VA |
$189.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$568.22
|
|
|
HC NAIL PROCEDURE
|
Facility
|
OP
|
$271.81
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$64.55 |
| Max. Negotiated Rate |
$244.63 |
| Rate for Payer: Aetna Commercial |
$231.04
|
| Rate for Payer: Aetna Medicare |
$70.67
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$84.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$84.94
|
| Rate for Payer: BCBS Complete |
$108.72
|
| Rate for Payer: BCBS MAPPO |
$67.95
|
| Rate for Payer: BCBS Trust/PPO |
$223.46
|
| Rate for Payer: BCN Commercial |
$211.33
|
| Rate for Payer: BCN Medicare Advantage |
$67.95
|
| Rate for Payer: Cash Price |
$217.45
|
| Rate for Payer: Cofinity Commercial |
$233.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.45
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.95
|
| Rate for Payer: Healthscope Commercial |
$244.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.04
|
| Rate for Payer: Nomi Health Commercial |
$222.88
|
| Rate for Payer: PACE Senior Care Partners |
$64.55
|
| Rate for Payer: PACE SWMI |
$67.95
|
| Rate for Payer: PHP Commercial |
$231.04
|
| Rate for Payer: PHP Medicare Advantage |
$67.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.68
|
| Rate for Payer: Priority Health HMO/PPO |
$236.47
|
| Rate for Payer: Priority Health Medicare |
$68.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.11
|
| Rate for Payer: Railroad Medicare Medicare |
$67.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.19
|
| Rate for Payer: UHC Core |
$226.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.95
|
| Rate for Payer: UHC Exchange |
$67.95
|
| Rate for Payer: UHC Medicare Advantage |
$67.95
|
| Rate for Payer: VA VA |
$67.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.86
|
|
|
HC NAIL PROCEDURE
|
Facility
|
IP
|
$271.81
|
|
| Hospital Charge Code |
45000047
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$176.68 |
| Max. Negotiated Rate |
$244.63 |
| Rate for Payer: Aetna Commercial |
$231.04
|
| Rate for Payer: BCBS Trust/PPO |
$221.88
|
| Rate for Payer: BCN Commercial |
$210.05
|
| Rate for Payer: Cash Price |
$217.45
|
| Rate for Payer: Cofinity Commercial |
$233.76
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$217.45
|
| Rate for Payer: Healthscope Commercial |
$244.63
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$203.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$231.04
|
| Rate for Payer: Nomi Health Commercial |
$222.88
|
| Rate for Payer: PHP Commercial |
$231.04
|
| Rate for Payer: Priority Health Cigna Priority Health |
$176.68
|
| Rate for Payer: Priority Health HMO/PPO |
$236.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$182.11
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$239.19
|
| Rate for Payer: UHC Core |
$226.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$203.86
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
OP
|
$328.09
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$77.92 |
| Max. Negotiated Rate |
$295.28 |
| Rate for Payer: Aetna Commercial |
$278.88
|
| Rate for Payer: Aetna Medicare |
$85.30
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$102.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$102.53
|
| Rate for Payer: BCBS Complete |
$135.99
|
| Rate for Payer: BCBS MAPPO |
$82.02
|
| Rate for Payer: BCBS Trust/PPO |
$269.72
|
| Rate for Payer: BCN Commercial |
$255.09
|
| Rate for Payer: BCN Medicare Advantage |
$82.02
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cofinity Commercial |
$282.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.47
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.02
|
| Rate for Payer: Healthscope Commercial |
$295.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.07
|
| Rate for Payer: Mclaren Medicaid |
$129.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.12
|
| Rate for Payer: Meridian Medicaid |
$135.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$94.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.88
|
| Rate for Payer: Nomi Health Commercial |
$269.03
|
| Rate for Payer: PACE Senior Care Partners |
$77.92
|
| Rate for Payer: PACE SWMI |
$82.02
|
| Rate for Payer: PHP Commercial |
$278.88
|
| Rate for Payer: PHP Medicare Advantage |
$82.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$129.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.26
|
| Rate for Payer: Priority Health HMO/PPO |
$285.44
|
| Rate for Payer: Priority Health Medicare |
$82.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.82
|
| Rate for Payer: Railroad Medicare Medicare |
$82.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.72
|
| Rate for Payer: UHC Core |
$273.96
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.02
|
| Rate for Payer: UHC Exchange |
$82.02
|
| Rate for Payer: UHC Medicare Advantage |
$82.02
|
| Rate for Payer: UHCCP Medicaid |
$129.50
|
| Rate for Payer: VA VA |
$82.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.07
|
|
|
HC NA PHOSPHATE PER MCI
|
Facility
|
IP
|
$328.09
|
|
|
Service Code
|
HCPCS A9563
|
| Hospital Charge Code |
34400004
|
|
Hospital Revenue Code
|
344
|
| Min. Negotiated Rate |
$213.26 |
| Max. Negotiated Rate |
$295.28 |
| Rate for Payer: Aetna Commercial |
$278.88
|
| Rate for Payer: BCBS Trust/PPO |
$267.82
|
| Rate for Payer: BCN Commercial |
$253.55
|
| Rate for Payer: Cash Price |
$262.47
|
| Rate for Payer: Cofinity Commercial |
$282.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$262.47
|
| Rate for Payer: Healthscope Commercial |
$295.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$246.07
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$278.88
|
| Rate for Payer: Nomi Health Commercial |
$269.03
|
| Rate for Payer: PHP Commercial |
$278.88
|
| Rate for Payer: Priority Health Cigna Priority Health |
$213.26
|
| Rate for Payer: Priority Health HMO/PPO |
$285.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$219.82
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$288.72
|
| Rate for Payer: UHC Core |
$273.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$246.07
|
|
