|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$208.50
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$36.76 |
| Max. Negotiated Rate |
$187.65 |
| Rate for Payer: Aetna Commercial |
$177.22
|
| Rate for Payer: Aetna Medicare |
$54.21
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$65.16
|
| Rate for Payer: Amish Plain Church Group Commercial |
$65.16
|
| Rate for Payer: BCBS Complete |
$38.59
|
| Rate for Payer: BCBS MAPPO |
$52.12
|
| Rate for Payer: BCBS Trust/PPO |
$171.41
|
| Rate for Payer: BCN Commercial |
$171.41
|
| Rate for Payer: BCN Medicare Advantage |
$52.12
|
| Rate for Payer: Cash Price |
$166.80
|
| Rate for Payer: Cofinity Commercial |
$179.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.80
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$52.12
|
| Rate for Payer: Healthscope Commercial |
$187.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.38
|
| Rate for Payer: Mclaren Medicaid |
$36.76
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$54.73
|
| Rate for Payer: Meridian Medicaid |
$38.59
|
| Rate for Payer: MI Amish Medical Board Commercial |
$59.94
|
| Rate for Payer: Molina Medicare/Medicaid |
$57.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.22
|
| Rate for Payer: Nomi Health Commercial |
$170.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.38
|
| Rate for Payer: PACE Senior Care Partners |
$49.52
|
| Rate for Payer: PACE SWMI |
$52.12
|
| Rate for Payer: PHP Commercial |
$177.22
|
| Rate for Payer: PHP Medicare Advantage |
$52.12
|
| Rate for Payer: Priority Health Choice Medicaid |
$36.76
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.40
|
| Rate for Payer: Priority Health Medicare |
$52.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.12
|
| Rate for Payer: Railroad Medicare Medicare |
$52.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.48
|
| Rate for Payer: UHC Core |
$174.10
|
| Rate for Payer: UHC Exchange |
$52.12
|
| Rate for Payer: UHC Medicaid |
$36.76
|
| Rate for Payer: UHC Medicare Advantage |
$52.12
|
| Rate for Payer: UHCCP Medicaid |
$36.76
|
| Rate for Payer: VA VA |
$52.12
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.38
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$208.50
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$145.12 |
| Max. Negotiated Rate |
$187.65 |
| Rate for Payer: Aetna Commercial |
$177.22
|
| Rate for Payer: BCBS Trust/PPO |
$172.20
|
| Rate for Payer: BCN Commercial |
$172.20
|
| Rate for Payer: Cash Price |
$166.80
|
| Rate for Payer: Cofinity Commercial |
$179.31
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$166.80
|
| Rate for Payer: Healthscope Commercial |
$187.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$156.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$177.22
|
| Rate for Payer: Nomi Health Commercial |
$170.97
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$156.38
|
| Rate for Payer: PHP Commercial |
$177.22
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$181.40
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$145.12
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$183.48
|
| Rate for Payer: UHC Core |
$174.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$156.38
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
OP
|
$9,259.56
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,632.46 |
| Max. Negotiated Rate |
$8,333.60 |
| Rate for Payer: Aetna Commercial |
$7,870.63
|
| Rate for Payer: Aetna Medicare |
$2,407.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,893.61
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,893.61
|
| Rate for Payer: BCBS Complete |
$1,713.94
|
| Rate for Payer: BCBS MAPPO |
$2,314.89
|
| Rate for Payer: BCBS Trust/PPO |
$7,612.28
|
| Rate for Payer: BCN Commercial |
$7,612.28
|
| Rate for Payer: BCN Medicare Advantage |
$2,314.89
|
| Rate for Payer: Cash Price |
$7,407.65
|
| Rate for Payer: Cofinity Commercial |
$7,963.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,407.65
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,314.89
|
| Rate for Payer: Healthscope Commercial |
$8,333.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,944.67
|
| Rate for Payer: Mclaren Medicaid |
$1,632.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,430.63
|
| Rate for Payer: Meridian Medicaid |
$1,713.94
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,662.12
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,546.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,870.63
|
| Rate for Payer: Nomi Health Commercial |
$7,592.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,944.67
|
| Rate for Payer: PACE Senior Care Partners |
$2,199.15
|
| Rate for Payer: PACE SWMI |
$2,314.89
|
| Rate for Payer: PHP Commercial |
$7,870.63
|
| Rate for Payer: PHP Medicare Advantage |
$2,314.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,632.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,055.82
|
| Rate for Payer: Priority Health Medicare |
$2,338.04
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,444.65
|
| Rate for Payer: Railroad Medicare Medicare |
$2,314.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,148.41
|
| Rate for Payer: UHC Core |
$7,731.73
|
| Rate for Payer: UHC Exchange |
$2,314.89
|
| Rate for Payer: UHC Medicaid |
$1,632.46
|
| Rate for Payer: UHC Medicare Advantage |
$2,314.89
|
| Rate for Payer: UHCCP Medicaid |
$1,632.46
|
| Rate for Payer: VA VA |
$2,314.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,944.67
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
IP
|
$9,259.56
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$6,444.65 |
| Max. Negotiated Rate |
$8,333.60 |
| Rate for Payer: Aetna Commercial |
$7,870.63
|
| Rate for Payer: BCBS Trust/PPO |
$7,647.47
|
| Rate for Payer: BCN Commercial |
$7,647.47
|
| Rate for Payer: Cash Price |
$7,407.65
|
| Rate for Payer: Cofinity Commercial |
$7,963.22
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,407.65
|
| Rate for Payer: Healthscope Commercial |
$8,333.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,944.67
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,870.63
|
| Rate for Payer: Nomi Health Commercial |
$7,592.84
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$6,944.67
|
| Rate for Payer: PHP Commercial |
$7,870.63
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$8,055.82
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,444.65
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$8,148.41
|
| Rate for Payer: UHC Core |
$7,731.73
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,944.67
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
IP
|
$337.83
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$235.13 |
| Max. Negotiated Rate |
$304.05 |
| Rate for Payer: Aetna Commercial |
$287.16
|
| Rate for Payer: BCBS Trust/PPO |
$279.01
|
| Rate for Payer: BCN Commercial |
$279.01
|
| Rate for Payer: Cash Price |
$270.26
|
| Rate for Payer: Cofinity Commercial |
$290.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.26
|
| Rate for Payer: Healthscope Commercial |
$304.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.16
|
| Rate for Payer: Nomi Health Commercial |
$277.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.37
|
| Rate for Payer: PHP Commercial |
$287.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$293.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.13
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.29
|
| Rate for Payer: UHC Core |
$282.09
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.37
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
OP
|
$337.83
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$59.56 |
| Max. Negotiated Rate |
$304.05 |
| Rate for Payer: Aetna Commercial |
$287.16
|
| Rate for Payer: Aetna Medicare |
$87.84
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$105.57
|
| Rate for Payer: Amish Plain Church Group Commercial |
$105.57
|
| Rate for Payer: BCBS Complete |
$62.53
|
| Rate for Payer: BCBS MAPPO |
$84.46
|
| Rate for Payer: BCBS Trust/PPO |
$277.73
|
| Rate for Payer: BCN Commercial |
$277.73
|
| Rate for Payer: BCN Medicare Advantage |
$84.46
|
| Rate for Payer: Cash Price |
$270.26
|
| Rate for Payer: Cofinity Commercial |
$290.53
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$270.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$84.46
|
| Rate for Payer: Healthscope Commercial |
$304.05
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$253.37
|
| Rate for Payer: Mclaren Medicaid |
$59.56
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$88.68
|
| Rate for Payer: Meridian Medicaid |
$62.53
|
| Rate for Payer: MI Amish Medical Board Commercial |
$97.13
|
| Rate for Payer: Molina Medicare/Medicaid |
$92.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$287.16
|
| Rate for Payer: Nomi Health Commercial |
$277.02
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$253.37
|
| Rate for Payer: PACE Senior Care Partners |
$80.23
|
| Rate for Payer: PACE SWMI |
$84.46
|
| Rate for Payer: PHP Commercial |
$287.16
|
| Rate for Payer: PHP Medicare Advantage |
$84.46
|
| Rate for Payer: Priority Health Choice Medicaid |
$59.56
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$293.91
|
| Rate for Payer: Priority Health Medicare |
$85.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$235.13
|
| Rate for Payer: Railroad Medicare Medicare |
$84.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$297.29
|
| Rate for Payer: UHC Core |
$282.09
|
| Rate for Payer: UHC Exchange |
$84.46
|
| Rate for Payer: UHC Medicaid |
$59.56
|
| Rate for Payer: UHC Medicare Advantage |
$84.46
|
| Rate for Payer: UHCCP Medicaid |
$59.56
|
| Rate for Payer: VA VA |
$84.46
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$253.37
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,716.17
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$655.16 |
| Max. Negotiated Rate |
$3,344.55 |
| Rate for Payer: Aetna Commercial |
$3,158.74
|
| Rate for Payer: Aetna Medicare |
$966.20
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,161.30
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,161.30
|
| Rate for Payer: BCBS Complete |
$687.86
|
| Rate for Payer: BCBS MAPPO |
$929.04
|
| Rate for Payer: BCBS Trust/PPO |
$3,055.06
|
| Rate for Payer: BCN Commercial |
$3,055.06
|
| Rate for Payer: BCN Medicare Advantage |
$929.04
|
| Rate for Payer: Cash Price |
$2,972.94
|
| Rate for Payer: Cofinity Commercial |
$3,195.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,972.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$929.04
|
| Rate for Payer: Healthscope Commercial |
$3,344.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,787.13
|
| Rate for Payer: Mclaren Medicaid |
$655.16
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$975.49
|
| Rate for Payer: Meridian Medicaid |
$687.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,068.40
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,021.95
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,158.74
|
| Rate for Payer: Nomi Health Commercial |
$3,047.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,787.13
|
| Rate for Payer: PACE Senior Care Partners |
$882.59
|
| Rate for Payer: PACE SWMI |
$929.04
|
| Rate for Payer: PHP Commercial |
$3,158.74
|
| Rate for Payer: PHP Medicare Advantage |
$929.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$655.16
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,233.07
|
| Rate for Payer: Priority Health Medicare |
$938.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,586.45
|
| Rate for Payer: Railroad Medicare Medicare |
$929.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,270.23
|
| Rate for Payer: UHC Core |
$3,103.00
|
| Rate for Payer: UHC Exchange |
$929.04
|
| Rate for Payer: UHC Medicaid |
$655.16
|
| Rate for Payer: UHC Medicare Advantage |
$929.04
|
| Rate for Payer: UHCCP Medicaid |
$655.16
|
| Rate for Payer: VA VA |
$929.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,787.13
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,716.17
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,586.45 |
| Max. Negotiated Rate |
$3,344.55 |
| Rate for Payer: Aetna Commercial |
$3,158.74
|
| Rate for Payer: BCBS Trust/PPO |
$3,069.18
|
| Rate for Payer: BCN Commercial |
$3,069.18
|
| Rate for Payer: Cash Price |
$2,972.94
|
| Rate for Payer: Cofinity Commercial |
$3,195.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,972.94
|
| Rate for Payer: Healthscope Commercial |
$3,344.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,787.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,158.74
|
| Rate for Payer: Nomi Health Commercial |
$3,047.26
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,787.13
|
| Rate for Payer: PHP Commercial |
$3,158.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,233.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,586.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,270.23
|
| Rate for Payer: UHC Core |
$3,103.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,787.13
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
IP
|
$3,825.47
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,662.53 |
| Max. Negotiated Rate |
$3,442.92 |
| Rate for Payer: Aetna Commercial |
$3,251.65
|
| Rate for Payer: BCBS Trust/PPO |
$3,159.46
|
| Rate for Payer: BCN Commercial |
$3,159.46
|
| Rate for Payer: Cash Price |
$3,060.38
|
| Rate for Payer: Cofinity Commercial |
$3,289.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,060.38
|
| Rate for Payer: Healthscope Commercial |
$3,442.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,869.10
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,251.65
|
| Rate for Payer: Nomi Health Commercial |
$3,136.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,869.10
|
| Rate for Payer: PHP Commercial |
$3,251.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,328.16
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,662.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,366.41
|
| Rate for Payer: UHC Core |
$3,194.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,869.10
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
OP
|
$3,825.47
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$674.43 |
| Max. Negotiated Rate |
$3,442.92 |
| Rate for Payer: Aetna Commercial |
$3,251.65
|
| Rate for Payer: Aetna Medicare |
$994.62
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,195.46
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,195.46
|
| Rate for Payer: BCBS Complete |
$708.09
|
| Rate for Payer: BCBS MAPPO |
$956.37
|
| Rate for Payer: BCBS Trust/PPO |
$3,144.92
|
| Rate for Payer: BCN Commercial |
$3,144.92
|
| Rate for Payer: BCN Medicare Advantage |
$956.37
|
| Rate for Payer: Cash Price |
$3,060.38
|
| Rate for Payer: Cofinity Commercial |
$3,289.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,060.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$956.37
|
| Rate for Payer: Healthscope Commercial |
$3,442.92
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,869.10
|
| Rate for Payer: Mclaren Medicaid |
$674.43
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$1,004.19
|
| Rate for Payer: Meridian Medicaid |
$708.09
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,099.82
|
| Rate for Payer: Molina Medicare/Medicaid |
$1,052.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,251.65
|
| Rate for Payer: Nomi Health Commercial |
$3,136.89
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,869.10
|
| Rate for Payer: PACE Senior Care Partners |
$908.55
|
| Rate for Payer: PACE SWMI |
$956.37
|
| Rate for Payer: PHP Commercial |
$3,251.65
|
| Rate for Payer: PHP Medicare Advantage |
$956.37
|
| Rate for Payer: Priority Health Choice Medicaid |
$674.43
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$3,328.16
|
| Rate for Payer: Priority Health Medicare |
$965.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,662.53
|
| Rate for Payer: Railroad Medicare Medicare |
$956.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,366.41
|
| Rate for Payer: UHC Core |
$3,194.27
|
| Rate for Payer: UHC Exchange |
$956.37
|
| Rate for Payer: UHC Medicaid |
$674.43
|
| Rate for Payer: UHC Medicare Advantage |
$956.37
|
| Rate for Payer: UHCCP Medicaid |
$674.43
|
| Rate for Payer: VA VA |
$956.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,869.10
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
OP
|
$273.63
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$48.24 |
| Max. Negotiated Rate |
$246.27 |
| Rate for Payer: Aetna Commercial |
$232.59
|
| Rate for Payer: Aetna Medicare |
$71.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.51
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.51
|
| Rate for Payer: BCBS Complete |
$50.65
|
| Rate for Payer: BCBS MAPPO |
$68.41
|
| Rate for Payer: BCBS Trust/PPO |
$224.95
|
| Rate for Payer: BCN Commercial |
$224.95
|
| Rate for Payer: BCN Medicare Advantage |
$68.41
|
| Rate for Payer: Cash Price |
$218.90
|
| Rate for Payer: Cofinity Commercial |
$235.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.41
|
| Rate for Payer: Healthscope Commercial |
$246.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.22
|
| Rate for Payer: Mclaren Medicaid |
$48.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$71.83
|
| Rate for Payer: Meridian Medicaid |
$50.65
|
| Rate for Payer: MI Amish Medical Board Commercial |
$78.67
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.59
|
| Rate for Payer: Nomi Health Commercial |
$224.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.22
|
| Rate for Payer: PACE Senior Care Partners |
$64.99
|
| Rate for Payer: PACE SWMI |
$68.41
|
| Rate for Payer: PHP Commercial |
$232.59
|
| Rate for Payer: PHP Medicare Advantage |
$68.41
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.24
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$238.06
|
| Rate for Payer: Priority Health Medicare |
$69.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.45
|
| Rate for Payer: Railroad Medicare Medicare |
$68.41
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.79
|
| Rate for Payer: UHC Core |
$228.48
|
| Rate for Payer: UHC Exchange |
$68.41
|
| Rate for Payer: UHC Medicaid |
$48.24
|
| Rate for Payer: UHC Medicare Advantage |
$68.41
|
| Rate for Payer: UHCCP Medicaid |
$48.24
|
| Rate for Payer: VA VA |
$68.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.22
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
IP
|
$273.63
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$190.45 |
| Max. Negotiated Rate |
$246.27 |
| Rate for Payer: Aetna Commercial |
$232.59
|
| Rate for Payer: BCBS Trust/PPO |
$225.99
|
| Rate for Payer: BCN Commercial |
$225.99
|
| Rate for Payer: Cash Price |
$218.90
|
| Rate for Payer: Cofinity Commercial |
$235.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$218.90
|
| Rate for Payer: Healthscope Commercial |
$246.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$205.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$232.59
|
| Rate for Payer: Nomi Health Commercial |
$224.38
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$205.22
|
| Rate for Payer: PHP Commercial |
$232.59
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$238.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$190.45
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$240.79
|
| Rate for Payer: UHC Core |
$228.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$205.22
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
IP
|
$161.53
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$112.42 |
| Max. Negotiated Rate |
$145.38 |
| Rate for Payer: Aetna Commercial |
$137.30
|
| Rate for Payer: BCBS Trust/PPO |
$133.41
|
| Rate for Payer: BCN Commercial |
$133.41
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Healthscope Commercial |
$145.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.15
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.30
|
| Rate for Payer: Nomi Health Commercial |
$132.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.15
|
| Rate for Payer: PHP Commercial |
$137.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.53
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.42
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.15
|
| Rate for Payer: UHC Core |
$134.88
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.15
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
OP
|
$161.53
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$28.48 |
| Max. Negotiated Rate |
$145.38 |
| Rate for Payer: Aetna Commercial |
$137.30
|
| Rate for Payer: Aetna Medicare |
$42.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.48
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.48
|
| Rate for Payer: BCBS Complete |
$29.90
|
| Rate for Payer: BCBS MAPPO |
$40.38
|
| Rate for Payer: BCBS Trust/PPO |
$132.79
|
| Rate for Payer: BCN Commercial |
$132.79
|
| Rate for Payer: BCN Medicare Advantage |
$40.38
|
| Rate for Payer: Cash Price |
$129.22
|
| Rate for Payer: Cofinity Commercial |
$138.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$129.22
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.38
|
| Rate for Payer: Healthscope Commercial |
$145.38
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$121.15
|
| Rate for Payer: Mclaren Medicaid |
$28.48
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.40
|
| Rate for Payer: Meridian Medicaid |
$29.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.44
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$137.30
|
| Rate for Payer: Nomi Health Commercial |
$132.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$121.15
|
| Rate for Payer: PACE Senior Care Partners |
$38.36
|
| Rate for Payer: PACE SWMI |
$40.38
|
| Rate for Payer: PHP Commercial |
$137.30
|
| Rate for Payer: PHP Medicare Advantage |
$40.38
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.48
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$140.53
|
| Rate for Payer: Priority Health Medicare |
$40.79
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$112.42
|
| Rate for Payer: Railroad Medicare Medicare |
$40.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$142.15
|
| Rate for Payer: UHC Core |
$134.88
|
| Rate for Payer: UHC Exchange |
$40.38
|
| Rate for Payer: UHC Medicaid |
$28.48
|
| Rate for Payer: UHC Medicare Advantage |
$40.38
|
| Rate for Payer: UHCCP Medicaid |
$28.48
|
| Rate for Payer: VA VA |
$40.38
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$121.15
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.08 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: BCBS Trust/PPO |
$44.00
|
| Rate for Payer: BCN Commercial |
$44.00
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$53.28
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.39 |
| Max. Negotiated Rate |
$47.95 |
| Rate for Payer: Aetna Commercial |
$45.29
|
| Rate for Payer: Aetna Medicare |
$13.85
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.65
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.65
|
| Rate for Payer: BCBS Complete |
$9.86
|
| Rate for Payer: BCBS MAPPO |
$13.32
|
| Rate for Payer: BCBS Trust/PPO |
$43.80
|
| Rate for Payer: BCN Commercial |
$43.80
|
| Rate for Payer: BCN Medicare Advantage |
$13.32
|
| Rate for Payer: Cash Price |
$42.62
|
| Rate for Payer: Cofinity Commercial |
$45.82
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$42.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$13.32
|
| Rate for Payer: Healthscope Commercial |
$47.95
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.96
|
| Rate for Payer: Mclaren Medicaid |
$9.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.99
|
| Rate for Payer: Meridian Medicaid |
$9.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$14.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$45.29
|
| Rate for Payer: Nomi Health Commercial |
$43.69
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$39.96
|
| Rate for Payer: PACE Senior Care Partners |
$12.65
|
| Rate for Payer: PACE SWMI |
$13.32
|
| Rate for Payer: PHP Commercial |
$45.29
|
| Rate for Payer: PHP Medicare Advantage |
$13.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$46.35
|
| Rate for Payer: Priority Health Medicare |
$13.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$37.08
|
| Rate for Payer: Railroad Medicare Medicare |
$13.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$46.89
|
| Rate for Payer: UHC Core |
$44.49
|
| Rate for Payer: UHC Exchange |
$13.32
|
| Rate for Payer: UHC Medicaid |
$9.39
|
| Rate for Payer: UHC Medicare Advantage |
$13.32
|
| Rate for Payer: UHCCP Medicaid |
$9.39
|
| Rate for Payer: VA VA |
$13.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.96
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$117.88
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$20.78 |
| Max. Negotiated Rate |
$106.09 |
| Rate for Payer: Aetna Commercial |
$100.20
|
| Rate for Payer: Aetna Medicare |
$30.65
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.84
|
| Rate for Payer: BCBS Complete |
$21.82
|
| Rate for Payer: BCBS MAPPO |
$29.47
|
| Rate for Payer: BCBS Trust/PPO |
$96.91
|
| Rate for Payer: BCN Commercial |
$96.91
|
| Rate for Payer: BCN Medicare Advantage |
$29.47
|
| Rate for Payer: Cash Price |
$94.30
|
| Rate for Payer: Cofinity Commercial |
$101.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.30
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.47
|
| Rate for Payer: Healthscope Commercial |
$106.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.41
|
| Rate for Payer: Mclaren Medicaid |
$20.78
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.94
|
| Rate for Payer: Meridian Medicaid |
$21.82
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.89
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.20
|
| Rate for Payer: Nomi Health Commercial |
$96.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.41
|
| Rate for Payer: PACE Senior Care Partners |
$28.00
|
| Rate for Payer: PACE SWMI |
$29.47
|
| Rate for Payer: PHP Commercial |
$100.20
|
| Rate for Payer: PHP Medicare Advantage |
$29.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$20.78
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.56
|
| Rate for Payer: Priority Health Medicare |
$29.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.04
|
| Rate for Payer: Railroad Medicare Medicare |
$29.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.73
|
| Rate for Payer: UHC Core |
$98.43
|
| Rate for Payer: UHC Exchange |
$29.47
|
| Rate for Payer: UHC Medicaid |
$20.78
|
| Rate for Payer: UHC Medicare Advantage |
$29.47
|
| Rate for Payer: UHCCP Medicaid |
$20.78
|
| Rate for Payer: VA VA |
$29.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.41
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$117.88
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$82.04 |
| Max. Negotiated Rate |
$106.09 |
| Rate for Payer: Aetna Commercial |
$100.20
|
| Rate for Payer: BCBS Trust/PPO |
$97.36
|
| Rate for Payer: BCN Commercial |
$97.36
|
| Rate for Payer: Cash Price |
$94.30
|
| Rate for Payer: Cofinity Commercial |
$101.38
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$94.30
|
| Rate for Payer: Healthscope Commercial |
$106.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$88.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$100.20
|
| Rate for Payer: Nomi Health Commercial |
$96.66
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$88.41
|
| Rate for Payer: PHP Commercial |
$100.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$102.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$82.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$103.73
|
| Rate for Payer: UHC Core |
$98.43
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$88.41
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$163.32
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$28.79 |
| Max. Negotiated Rate |
$146.99 |
| Rate for Payer: Aetna Commercial |
$138.82
|
| Rate for Payer: Aetna Medicare |
$42.46
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$51.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$51.04
|
| Rate for Payer: BCBS Complete |
$30.23
|
| Rate for Payer: BCBS MAPPO |
$40.83
|
| Rate for Payer: BCBS Trust/PPO |
$134.27
|
| Rate for Payer: BCN Commercial |
$134.27
|
| Rate for Payer: BCN Medicare Advantage |
$40.83
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cofinity Commercial |
$140.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.66
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.83
|
| Rate for Payer: Healthscope Commercial |
$146.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.49
|
| Rate for Payer: Mclaren Medicaid |
$28.79
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.87
|
| Rate for Payer: Meridian Medicaid |
$30.23
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.95
|
| Rate for Payer: Molina Medicare/Medicaid |
$44.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.82
|
| Rate for Payer: Nomi Health Commercial |
$133.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.49
|
| Rate for Payer: PACE Senior Care Partners |
$38.79
|
| Rate for Payer: PACE SWMI |
$40.83
|
| Rate for Payer: PHP Commercial |
$138.82
|
| Rate for Payer: PHP Medicare Advantage |
$40.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$28.79
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.09
|
| Rate for Payer: Priority Health Medicare |
$41.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.67
|
| Rate for Payer: Railroad Medicare Medicare |
$40.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.72
|
| Rate for Payer: UHC Core |
$136.37
|
| Rate for Payer: UHC Exchange |
$40.83
|
| Rate for Payer: UHC Medicaid |
$28.79
|
| Rate for Payer: UHC Medicare Advantage |
$40.83
|
| Rate for Payer: UHCCP Medicaid |
$28.79
|
| Rate for Payer: VA VA |
$40.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.49
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$163.32
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$113.67 |
| Max. Negotiated Rate |
$146.99 |
| Rate for Payer: Aetna Commercial |
$138.82
|
| Rate for Payer: BCBS Trust/PPO |
$134.89
|
| Rate for Payer: BCN Commercial |
$134.89
|
| Rate for Payer: Cash Price |
$130.66
|
| Rate for Payer: Cofinity Commercial |
$140.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$130.66
|
| Rate for Payer: Healthscope Commercial |
$146.99
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$122.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$138.82
|
| Rate for Payer: Nomi Health Commercial |
$133.92
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$122.49
|
| Rate for Payer: PHP Commercial |
$138.82
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$142.09
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$113.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$143.72
|
| Rate for Payer: UHC Core |
$136.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$122.49
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$88.08
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$15.53 |
| Max. Negotiated Rate |
$79.27 |
| Rate for Payer: Aetna Commercial |
$74.87
|
| Rate for Payer: Aetna Medicare |
$22.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$27.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$27.52
|
| Rate for Payer: BCBS Complete |
$16.30
|
| Rate for Payer: BCBS MAPPO |
$22.02
|
| Rate for Payer: BCBS Trust/PPO |
$72.41
|
| Rate for Payer: BCN Commercial |
$72.41
|
| Rate for Payer: BCN Medicare Advantage |
$22.02
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$22.02
|
| Rate for Payer: Healthscope Commercial |
$79.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.06
|
| Rate for Payer: Mclaren Medicaid |
$15.53
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$23.12
|
| Rate for Payer: Meridian Medicaid |
$16.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$25.32
|
| Rate for Payer: Molina Medicare/Medicaid |
$24.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Nomi Health Commercial |
$72.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PACE Senior Care Partners |
$20.92
|
| Rate for Payer: PACE SWMI |
$22.02
|
| Rate for Payer: PHP Commercial |
$74.87
|
| Rate for Payer: PHP Medicare Advantage |
$22.02
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.63
|
| Rate for Payer: Priority Health Medicare |
$22.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.30
|
| Rate for Payer: Railroad Medicare Medicare |
$22.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.51
|
| Rate for Payer: UHC Core |
$73.55
|
| Rate for Payer: UHC Exchange |
$22.02
|
| Rate for Payer: UHC Medicaid |
$15.53
|
| Rate for Payer: UHC Medicare Advantage |
$22.02
|
| Rate for Payer: UHCCP Medicaid |
$15.53
|
| Rate for Payer: VA VA |
$22.02
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.06
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$88.08
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$61.30 |
| Max. Negotiated Rate |
$79.27 |
| Rate for Payer: Aetna Commercial |
$74.87
|
| Rate for Payer: BCBS Trust/PPO |
$72.75
|
| Rate for Payer: BCN Commercial |
$72.75
|
| Rate for Payer: Cash Price |
$70.46
|
| Rate for Payer: Cofinity Commercial |
$75.75
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$70.46
|
| Rate for Payer: Healthscope Commercial |
$79.27
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$66.06
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$74.87
|
| Rate for Payer: Nomi Health Commercial |
$72.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$66.06
|
| Rate for Payer: PHP Commercial |
$74.87
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$76.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$61.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$77.51
|
| Rate for Payer: UHC Core |
$73.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$66.06
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$69.06 |
| Max. Negotiated Rate |
$89.31 |
| Rate for Payer: Aetna Commercial |
$84.35
|
| Rate for Payer: BCBS Trust/PPO |
$81.95
|
| Rate for Payer: BCN Commercial |
$81.95
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$85.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Healthscope Commercial |
$89.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$81.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PHP Commercial |
$84.35
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.32
|
| Rate for Payer: UHC Core |
$82.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.42
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$17.49 |
| Max. Negotiated Rate |
$89.31 |
| Rate for Payer: Aetna Commercial |
$84.35
|
| Rate for Payer: Aetna Medicare |
$25.80
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.01
|
| Rate for Payer: BCBS Complete |
$18.37
|
| Rate for Payer: BCBS MAPPO |
$24.81
|
| Rate for Payer: BCBS Trust/PPO |
$81.58
|
| Rate for Payer: BCN Commercial |
$81.58
|
| Rate for Payer: BCN Medicare Advantage |
$24.81
|
| Rate for Payer: Cash Price |
$79.38
|
| Rate for Payer: Cofinity Commercial |
$85.34
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.81
|
| Rate for Payer: Healthscope Commercial |
$89.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.42
|
| Rate for Payer: Mclaren Medicaid |
$17.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.05
|
| Rate for Payer: Meridian Medicaid |
$18.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.53
|
| Rate for Payer: Molina Medicare/Medicaid |
$27.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.35
|
| Rate for Payer: Nomi Health Commercial |
$81.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$74.42
|
| Rate for Payer: PACE Senior Care Partners |
$23.57
|
| Rate for Payer: PACE SWMI |
$24.81
|
| Rate for Payer: PHP Commercial |
$84.35
|
| Rate for Payer: PHP Medicare Advantage |
$24.81
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.49
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$86.33
|
| Rate for Payer: Priority Health Medicare |
$25.06
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$69.06
|
| Rate for Payer: Railroad Medicare Medicare |
$24.81
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.32
|
| Rate for Payer: UHC Core |
$82.86
|
| Rate for Payer: UHC Exchange |
$24.81
|
| Rate for Payer: UHC Medicaid |
$17.49
|
| Rate for Payer: UHC Medicare Advantage |
$24.81
|
| Rate for Payer: UHCCP Medicaid |
$17.49
|
| Rate for Payer: VA VA |
$24.81
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.42
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$101.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$70.91 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: Aetna Commercial |
$86.60
|
| Rate for Payer: BCBS Trust/PPO |
$84.14
|
| Rate for Payer: BCN Commercial |
$84.14
|
| Rate for Payer: Cash Price |
$81.50
|
| Rate for Payer: Cofinity Commercial |
$87.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$81.50
|
| Rate for Payer: Healthscope Commercial |
$91.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$86.60
|
| Rate for Payer: Nomi Health Commercial |
$83.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$76.41
|
| Rate for Payer: PHP Commercial |
$86.60
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.65
|
| Rate for Payer: UHC Core |
$85.07
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.41
|
|
