|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$101.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.96 |
| Max. Negotiated Rate |
$91.69 |
| Rate for Payer: Aetna Commercial |
$86.60
|
| Rate for Payer: Aetna Medicare |
$26.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.84
|
| Rate for Payer: BCBS Complete |
$18.86
|
| Rate for Payer: BCBS MAPPO |
$25.47
|
| Rate for Payer: BCBS Trust/PPO |
$83.76
|
| Rate for Payer: BCN Commercial |
$83.76
|
| Rate for Payer: BCN Medicare Advantage |
$25.47
|
| 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: Health Alliance Plan Medicare Advantage |
$25.47
|
| Rate for Payer: Healthscope Commercial |
$91.69
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$76.41
|
| Rate for Payer: Mclaren Medicaid |
$17.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.74
|
| Rate for Payer: Meridian Medicaid |
$18.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$29.29
|
| Rate for Payer: Molina Medicare/Medicaid |
$28.02
|
| 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: PACE Senior Care Partners |
$24.20
|
| Rate for Payer: PACE SWMI |
$25.47
|
| Rate for Payer: PHP Commercial |
$86.60
|
| Rate for Payer: PHP Medicare Advantage |
$25.47
|
| Rate for Payer: Priority Health Choice Medicaid |
$17.96
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$88.64
|
| Rate for Payer: Priority Health Medicare |
$25.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$70.91
|
| Rate for Payer: Railroad Medicare Medicare |
$25.47
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$89.65
|
| Rate for Payer: UHC Core |
$85.07
|
| Rate for Payer: UHC Exchange |
$25.47
|
| Rate for Payer: UHC Medicaid |
$17.96
|
| Rate for Payer: UHC Medicare Advantage |
$25.47
|
| Rate for Payer: UHCCP Medicaid |
$17.96
|
| Rate for Payer: VA VA |
$25.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$76.41
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$284.72
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$198.17 |
| Max. Negotiated Rate |
$256.25 |
| Rate for Payer: Aetna Commercial |
$242.01
|
| Rate for Payer: BCBS Trust/PPO |
$235.15
|
| Rate for Payer: BCN Commercial |
$235.15
|
| Rate for Payer: Cash Price |
$227.78
|
| Rate for Payer: Cofinity Commercial |
$244.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.78
|
| Rate for Payer: Healthscope Commercial |
$256.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.54
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.01
|
| Rate for Payer: Nomi Health Commercial |
$233.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.54
|
| Rate for Payer: PHP Commercial |
$242.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.55
|
| Rate for Payer: UHC Core |
$237.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.54
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$284.72
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$50.20 |
| Max. Negotiated Rate |
$256.25 |
| Rate for Payer: Aetna Commercial |
$242.01
|
| Rate for Payer: Aetna Medicare |
$74.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$88.97
|
| Rate for Payer: Amish Plain Church Group Commercial |
$88.97
|
| Rate for Payer: BCBS Complete |
$52.70
|
| Rate for Payer: BCBS MAPPO |
$71.18
|
| Rate for Payer: BCBS Trust/PPO |
$234.07
|
| Rate for Payer: BCN Commercial |
$234.07
|
| Rate for Payer: BCN Medicare Advantage |
$71.18
|
| Rate for Payer: Cash Price |
$227.78
|
| Rate for Payer: Cofinity Commercial |
$244.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$227.78
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$71.18
|
| Rate for Payer: Healthscope Commercial |
$256.25
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$213.54
|
| Rate for Payer: Mclaren Medicaid |
$50.20
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$74.74
|
| Rate for Payer: Meridian Medicaid |
$52.70
|
| Rate for Payer: MI Amish Medical Board Commercial |
$81.86
|
| Rate for Payer: Molina Medicare/Medicaid |
$78.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.01
|
| Rate for Payer: Nomi Health Commercial |
$233.47
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$213.54
|
| Rate for Payer: PACE Senior Care Partners |
$67.62
|
| Rate for Payer: PACE SWMI |
$71.18
|
| Rate for Payer: PHP Commercial |
$242.01
|
| Rate for Payer: PHP Medicare Advantage |
$71.18
|
| Rate for Payer: Priority Health Choice Medicaid |
$50.20
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$247.71
|
| Rate for Payer: Priority Health Medicare |
$71.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$198.17
|
| Rate for Payer: Railroad Medicare Medicare |
$71.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$250.55
|
| Rate for Payer: UHC Core |
$237.74
|
| Rate for Payer: UHC Exchange |
$71.18
|
| Rate for Payer: UHC Medicaid |
$50.20
|
| Rate for Payer: UHC Medicare Advantage |
$71.18
|
| Rate for Payer: UHCCP Medicaid |
$50.20
|
| Rate for Payer: VA VA |
$71.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$213.54
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$39.43
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$27.44 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: BCBS Trust/PPO |
$32.57
|
| Rate for Payer: BCN Commercial |
$32.57
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$39.43
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$6.95 |
| Max. Negotiated Rate |
$35.49 |
| Rate for Payer: Aetna Commercial |
$33.52
|
| Rate for Payer: Aetna Medicare |
$10.25
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.32
|
| Rate for Payer: BCBS Complete |
$7.30
|
| Rate for Payer: BCBS MAPPO |
$9.86
|
| Rate for Payer: BCBS Trust/PPO |
$32.42
|
| Rate for Payer: BCN Commercial |
$32.42
|
| Rate for Payer: BCN Medicare Advantage |
$9.86
|
| Rate for Payer: Cash Price |
$31.54
|
| Rate for Payer: Cofinity Commercial |
$33.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$31.54
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.86
|
| Rate for Payer: Healthscope Commercial |
$35.49
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.57
|
| Rate for Payer: Mclaren Medicaid |
$6.95
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.35
|
| Rate for Payer: Meridian Medicaid |
$7.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.34
|
| Rate for Payer: Molina Medicare/Medicaid |
$10.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$33.52
|
| Rate for Payer: Nomi Health Commercial |
$32.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$29.57
|
| Rate for Payer: PACE Senior Care Partners |
$9.36
|
| Rate for Payer: PACE SWMI |
$9.86
|
| Rate for Payer: PHP Commercial |
$33.52
|
| Rate for Payer: PHP Medicare Advantage |
$9.86
|
| Rate for Payer: Priority Health Choice Medicaid |
$6.95
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$34.30
|
| Rate for Payer: Priority Health Medicare |
$9.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$27.44
|
| Rate for Payer: Railroad Medicare Medicare |
$9.86
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.70
|
| Rate for Payer: UHC Core |
$32.92
|
| Rate for Payer: UHC Exchange |
$9.86
|
| Rate for Payer: UHC Medicaid |
$6.95
|
| Rate for Payer: UHC Medicare Advantage |
$9.86
|
| Rate for Payer: UHCCP Medicaid |
$6.95
|
| Rate for Payer: VA VA |
$9.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.57
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$126.49
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$88.04 |
| Max. Negotiated Rate |
$113.84 |
| Rate for Payer: Aetna Commercial |
$107.52
|
| Rate for Payer: BCBS Trust/PPO |
$104.47
|
| Rate for Payer: BCN Commercial |
$104.47
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cofinity Commercial |
$108.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.19
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.87
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.52
|
| Rate for Payer: Nomi Health Commercial |
$103.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.87
|
| Rate for Payer: PHP Commercial |
$107.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$110.05
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.31
|
| Rate for Payer: UHC Core |
$105.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.87
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$126.49
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$22.30 |
| Max. Negotiated Rate |
$113.84 |
| Rate for Payer: Aetna Commercial |
$107.52
|
| Rate for Payer: Aetna Medicare |
$32.89
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$39.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$39.53
|
| Rate for Payer: BCBS Complete |
$23.41
|
| Rate for Payer: BCBS MAPPO |
$31.62
|
| Rate for Payer: BCBS Trust/PPO |
$103.99
|
| Rate for Payer: BCN Commercial |
$103.99
|
| Rate for Payer: BCN Medicare Advantage |
$31.62
|
| Rate for Payer: Cash Price |
$101.19
|
| Rate for Payer: Cofinity Commercial |
$108.78
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$101.19
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.62
|
| Rate for Payer: Healthscope Commercial |
$113.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$94.87
|
| Rate for Payer: Mclaren Medicaid |
$22.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$33.20
|
| Rate for Payer: Meridian Medicaid |
$23.41
|
| Rate for Payer: MI Amish Medical Board Commercial |
$36.37
|
| Rate for Payer: Molina Medicare/Medicaid |
$34.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$107.52
|
| Rate for Payer: Nomi Health Commercial |
$103.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$94.87
|
| Rate for Payer: PACE Senior Care Partners |
$30.04
|
| Rate for Payer: PACE SWMI |
$31.62
|
| Rate for Payer: PHP Commercial |
$107.52
|
| Rate for Payer: PHP Medicare Advantage |
$31.62
|
| Rate for Payer: Priority Health Choice Medicaid |
$22.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$110.05
|
| Rate for Payer: Priority Health Medicare |
$31.94
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$88.04
|
| Rate for Payer: Railroad Medicare Medicare |
$31.62
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$111.31
|
| Rate for Payer: UHC Core |
$105.62
|
| Rate for Payer: UHC Exchange |
$31.62
|
| Rate for Payer: UHC Medicaid |
$22.30
|
| Rate for Payer: UHC Medicare Advantage |
$31.62
|
| Rate for Payer: UHCCP Medicaid |
$22.30
|
| Rate for Payer: VA VA |
$31.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$94.87
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$410.58
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$72.39 |
| Max. Negotiated Rate |
$369.52 |
| Rate for Payer: Aetna Commercial |
$348.99
|
| Rate for Payer: Aetna Medicare |
$106.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$128.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$128.31
|
| Rate for Payer: BCBS Complete |
$76.00
|
| Rate for Payer: BCBS MAPPO |
$102.64
|
| Rate for Payer: BCBS Trust/PPO |
$337.54
|
| Rate for Payer: BCN Commercial |
$337.54
|
| Rate for Payer: BCN Medicare Advantage |
$102.64
|
| Rate for Payer: Cash Price |
$328.46
|
| Rate for Payer: Cofinity Commercial |
$353.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$102.64
|
| Rate for Payer: Healthscope Commercial |
$369.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.94
|
| Rate for Payer: Mclaren Medicaid |
$72.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$107.78
|
| Rate for Payer: Meridian Medicaid |
$76.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$118.04
|
| Rate for Payer: Molina Medicare/Medicaid |
$112.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.99
|
| Rate for Payer: Nomi Health Commercial |
$336.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.94
|
| Rate for Payer: PACE Senior Care Partners |
$97.51
|
| Rate for Payer: PACE SWMI |
$102.64
|
| Rate for Payer: PHP Commercial |
$348.99
|
| Rate for Payer: PHP Medicare Advantage |
$102.64
|
| Rate for Payer: Priority Health Choice Medicaid |
$72.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$357.20
|
| Rate for Payer: Priority Health Medicare |
$103.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$285.76
|
| Rate for Payer: Railroad Medicare Medicare |
$102.64
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.31
|
| Rate for Payer: UHC Core |
$342.83
|
| Rate for Payer: UHC Exchange |
$102.64
|
| Rate for Payer: UHC Medicaid |
$72.39
|
| Rate for Payer: UHC Medicare Advantage |
$102.64
|
| Rate for Payer: UHCCP Medicaid |
$72.39
|
| Rate for Payer: VA VA |
$102.64
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.94
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$410.58
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$285.76 |
| Max. Negotiated Rate |
$369.52 |
| Rate for Payer: Aetna Commercial |
$348.99
|
| Rate for Payer: BCBS Trust/PPO |
$339.10
|
| Rate for Payer: BCN Commercial |
$339.10
|
| Rate for Payer: Cash Price |
$328.46
|
| Rate for Payer: Cofinity Commercial |
$353.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$328.46
|
| Rate for Payer: Healthscope Commercial |
$369.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$307.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$348.99
|
| Rate for Payer: Nomi Health Commercial |
$336.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$307.94
|
| Rate for Payer: PHP Commercial |
$348.99
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$357.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$285.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$361.31
|
| Rate for Payer: UHC Core |
$342.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$307.94
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
IP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
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 RESISTANCE TEST CMPT
|
Facility
|
OP
|
$99.23
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
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 PLAVIX RESISTANCE TEST
|
Facility
|
OP
|
$94.45
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.65 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: Aetna Medicare |
$24.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.52
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.52
|
| Rate for Payer: BCBS Complete |
$17.48
|
| Rate for Payer: BCBS MAPPO |
$23.61
|
| Rate for Payer: BCBS Trust/PPO |
$77.65
|
| Rate for Payer: BCN Commercial |
$77.65
|
| Rate for Payer: BCN Medicare Advantage |
$23.61
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.61
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Mclaren Medicaid |
$16.65
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.79
|
| Rate for Payer: Meridian Medicaid |
$17.48
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.15
|
| Rate for Payer: Molina Medicare/Medicaid |
$25.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$77.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PACE Senior Care Partners |
$22.43
|
| Rate for Payer: PACE SWMI |
$23.61
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: PHP Medicare Advantage |
$23.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.65
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$82.17
|
| Rate for Payer: Priority Health Medicare |
$23.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.74
|
| Rate for Payer: Railroad Medicare Medicare |
$23.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.12
|
| Rate for Payer: UHC Core |
$78.87
|
| Rate for Payer: UHC Exchange |
$23.61
|
| Rate for Payer: UHC Medicaid |
$16.65
|
| Rate for Payer: UHC Medicare Advantage |
$23.61
|
| Rate for Payer: UHCCP Medicaid |
$16.65
|
| Rate for Payer: VA VA |
$23.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
IP
|
$94.45
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$65.74 |
| Max. Negotiated Rate |
$85.00 |
| Rate for Payer: Aetna Commercial |
$80.28
|
| Rate for Payer: BCBS Trust/PPO |
$78.01
|
| Rate for Payer: BCN Commercial |
$78.01
|
| Rate for Payer: Cash Price |
$75.56
|
| Rate for Payer: Cofinity Commercial |
$81.23
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$75.56
|
| Rate for Payer: Healthscope Commercial |
$85.00
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$70.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.28
|
| Rate for Payer: Nomi Health Commercial |
$77.45
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$70.84
|
| Rate for Payer: PHP Commercial |
$80.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$82.17
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.74
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.12
|
| Rate for Payer: UHC Core |
$78.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$70.84
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
IP
|
$1,981.28
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,378.97 |
| Max. Negotiated Rate |
$1,783.15 |
| Rate for Payer: Aetna Commercial |
$1,684.09
|
| Rate for Payer: BCBS Trust/PPO |
$1,636.34
|
| Rate for Payer: BCN Commercial |
$1,636.34
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cofinity Commercial |
$1,703.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,585.02
|
| Rate for Payer: Healthscope Commercial |
$1,783.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.09
|
| Rate for Payer: Nomi Health Commercial |
$1,624.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.96
|
| Rate for Payer: PHP Commercial |
$1,684.09
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,723.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,378.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,743.53
|
| Rate for Payer: UHC Core |
$1,654.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.96
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
OP
|
$1,981.28
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$349.30 |
| Max. Negotiated Rate |
$1,783.15 |
| Rate for Payer: Aetna Commercial |
$1,684.09
|
| Rate for Payer: Aetna Medicare |
$515.13
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$619.15
|
| Rate for Payer: Amish Plain Church Group Commercial |
$619.15
|
| Rate for Payer: BCBS Complete |
$366.73
|
| Rate for Payer: BCBS MAPPO |
$495.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,628.81
|
| Rate for Payer: BCN Commercial |
$1,628.81
|
| Rate for Payer: BCN Medicare Advantage |
$495.32
|
| Rate for Payer: Cash Price |
$1,585.02
|
| Rate for Payer: Cofinity Commercial |
$1,703.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,585.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$495.32
|
| Rate for Payer: Healthscope Commercial |
$1,783.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,485.96
|
| Rate for Payer: Mclaren Medicaid |
$349.30
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$520.09
|
| Rate for Payer: Meridian Medicaid |
$366.73
|
| Rate for Payer: MI Amish Medical Board Commercial |
$569.62
|
| Rate for Payer: Molina Medicare/Medicaid |
$544.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,684.09
|
| Rate for Payer: Nomi Health Commercial |
$1,624.65
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,485.96
|
| Rate for Payer: PACE Senior Care Partners |
$470.55
|
| Rate for Payer: PACE SWMI |
$495.32
|
| Rate for Payer: PHP Commercial |
$1,684.09
|
| Rate for Payer: PHP Medicare Advantage |
$495.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$349.30
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,723.71
|
| Rate for Payer: Priority Health Medicare |
$500.27
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,378.97
|
| Rate for Payer: Railroad Medicare Medicare |
$495.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,743.53
|
| Rate for Payer: UHC Core |
$1,654.37
|
| Rate for Payer: UHC Exchange |
$495.32
|
| Rate for Payer: UHC Medicaid |
$349.30
|
| Rate for Payer: UHC Medicare Advantage |
$495.32
|
| Rate for Payer: UHCCP Medicaid |
$349.30
|
| Rate for Payer: VA VA |
$495.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,485.96
|
|
|
HC PLT PHER LEUKO REDUCED
|
Facility
|
IP
|
$2,248.39
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000071
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$1,564.88 |
| Max. Negotiated Rate |
$2,023.55 |
| Rate for Payer: Aetna Commercial |
$1,911.13
|
| Rate for Payer: BCBS Trust/PPO |
$1,856.95
|
| Rate for Payer: BCN Commercial |
$1,856.95
|
| Rate for Payer: Cash Price |
$1,798.71
|
| Rate for Payer: Cofinity Commercial |
$1,933.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.71
|
| Rate for Payer: Healthscope Commercial |
$2,023.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.13
|
| Rate for Payer: Nomi Health Commercial |
$1,843.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.29
|
| Rate for Payer: PHP Commercial |
$1,911.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,956.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,564.88
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.58
|
| Rate for Payer: UHC Core |
$1,877.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.29
|
|
|
HC PLT PHER LEUKO REDUCED
|
Facility
|
OP
|
$2,248.39
|
|
|
Service Code
|
HCPCS P9035
|
| Hospital Charge Code |
39000071
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$396.39 |
| Max. Negotiated Rate |
$2,023.55 |
| Rate for Payer: Aetna Commercial |
$1,911.13
|
| Rate for Payer: Aetna Medicare |
$584.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$702.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$702.62
|
| Rate for Payer: BCBS Complete |
$416.18
|
| Rate for Payer: BCBS MAPPO |
$562.10
|
| Rate for Payer: BCBS Trust/PPO |
$1,848.40
|
| Rate for Payer: BCN Commercial |
$1,848.40
|
| Rate for Payer: BCN Medicare Advantage |
$562.10
|
| Rate for Payer: Cash Price |
$1,798.71
|
| Rate for Payer: Cofinity Commercial |
$1,933.62
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,798.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$562.10
|
| Rate for Payer: Healthscope Commercial |
$2,023.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,686.29
|
| Rate for Payer: Mclaren Medicaid |
$396.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$590.20
|
| Rate for Payer: Meridian Medicaid |
$416.18
|
| Rate for Payer: MI Amish Medical Board Commercial |
$646.41
|
| Rate for Payer: Molina Medicare/Medicaid |
$618.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,911.13
|
| Rate for Payer: Nomi Health Commercial |
$1,843.68
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,686.29
|
| Rate for Payer: PACE Senior Care Partners |
$533.99
|
| Rate for Payer: PACE SWMI |
$562.10
|
| Rate for Payer: PHP Commercial |
$1,911.13
|
| Rate for Payer: PHP Medicare Advantage |
$562.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$396.39
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,956.10
|
| Rate for Payer: Priority Health Medicare |
$567.72
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,564.88
|
| Rate for Payer: Railroad Medicare Medicare |
$562.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,978.58
|
| Rate for Payer: UHC Core |
$1,877.41
|
| Rate for Payer: UHC Exchange |
$562.10
|
| Rate for Payer: UHC Medicaid |
$396.39
|
| Rate for Payer: UHC Medicare Advantage |
$562.10
|
| Rate for Payer: UHCCP Medicaid |
$396.39
|
| Rate for Payer: VA VA |
$562.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,686.29
|
|
|
HC PLT PHER LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$2,944.40
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000070
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$519.10 |
| Max. Negotiated Rate |
$2,649.96 |
| Rate for Payer: Aetna Commercial |
$2,502.74
|
| Rate for Payer: Aetna Medicare |
$765.54
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$920.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$920.12
|
| Rate for Payer: BCBS Complete |
$545.01
|
| Rate for Payer: BCBS MAPPO |
$736.10
|
| Rate for Payer: BCBS Trust/PPO |
$2,420.59
|
| Rate for Payer: BCN Commercial |
$2,420.59
|
| Rate for Payer: BCN Medicare Advantage |
$736.10
|
| Rate for Payer: Cash Price |
$2,355.52
|
| Rate for Payer: Cofinity Commercial |
$2,532.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,355.52
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$736.10
|
| Rate for Payer: Healthscope Commercial |
$2,649.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,208.30
|
| Rate for Payer: Mclaren Medicaid |
$519.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$772.90
|
| Rate for Payer: Meridian Medicaid |
$545.01
|
| Rate for Payer: MI Amish Medical Board Commercial |
$846.51
|
| Rate for Payer: Molina Medicare/Medicaid |
$809.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,502.74
|
| Rate for Payer: Nomi Health Commercial |
$2,414.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,208.30
|
| Rate for Payer: PACE Senior Care Partners |
$699.29
|
| Rate for Payer: PACE SWMI |
$736.10
|
| Rate for Payer: PHP Commercial |
$2,502.74
|
| Rate for Payer: PHP Medicare Advantage |
$736.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$519.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,561.63
|
| Rate for Payer: Priority Health Medicare |
$743.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,049.30
|
| Rate for Payer: Railroad Medicare Medicare |
$736.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,591.07
|
| Rate for Payer: UHC Core |
$2,458.57
|
| Rate for Payer: UHC Exchange |
$736.10
|
| Rate for Payer: UHC Medicaid |
$519.10
|
| Rate for Payer: UHC Medicare Advantage |
$736.10
|
| Rate for Payer: UHCCP Medicaid |
$519.10
|
| Rate for Payer: VA VA |
$736.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,208.30
|
|
|
HC PLT PHER LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$2,944.40
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000070
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$2,049.30 |
| Max. Negotiated Rate |
$2,649.96 |
| Rate for Payer: Aetna Commercial |
$2,502.74
|
| Rate for Payer: BCBS Trust/PPO |
$2,431.78
|
| Rate for Payer: BCN Commercial |
$2,431.78
|
| Rate for Payer: Cash Price |
$2,355.52
|
| Rate for Payer: Cofinity Commercial |
$2,532.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,355.52
|
| Rate for Payer: Healthscope Commercial |
$2,649.96
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,208.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,502.74
|
| Rate for Payer: Nomi Health Commercial |
$2,414.41
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,208.30
|
| Rate for Payer: PHP Commercial |
$2,502.74
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$2,561.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,049.30
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,591.07
|
| Rate for Payer: UHC Core |
$2,458.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,208.30
|
|
|
HC PLT PHER LR IRR WASH
|
Facility
|
OP
|
$1,372.14
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000081
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$241.91 |
| Max. Negotiated Rate |
$1,234.93 |
| Rate for Payer: Aetna Commercial |
$1,166.32
|
| Rate for Payer: Aetna Medicare |
$356.76
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$428.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$428.79
|
| Rate for Payer: BCBS Complete |
$253.98
|
| Rate for Payer: BCBS MAPPO |
$343.04
|
| Rate for Payer: BCBS Trust/PPO |
$1,128.04
|
| Rate for Payer: BCN Commercial |
$1,128.04
|
| Rate for Payer: BCN Medicare Advantage |
$343.04
|
| Rate for Payer: Cash Price |
$1,097.71
|
| Rate for Payer: Cofinity Commercial |
$1,180.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,097.71
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$343.04
|
| Rate for Payer: Healthscope Commercial |
$1,234.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,029.11
|
| Rate for Payer: Mclaren Medicaid |
$241.91
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$360.19
|
| Rate for Payer: Meridian Medicaid |
$253.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$394.49
|
| Rate for Payer: Molina Medicare/Medicaid |
$377.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,166.32
|
| Rate for Payer: Nomi Health Commercial |
$1,125.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.11
|
| Rate for Payer: PACE Senior Care Partners |
$325.88
|
| Rate for Payer: PACE SWMI |
$343.04
|
| Rate for Payer: PHP Commercial |
$1,166.32
|
| Rate for Payer: PHP Medicare Advantage |
$343.04
|
| Rate for Payer: Priority Health Choice Medicaid |
$241.91
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,193.76
|
| Rate for Payer: Priority Health Medicare |
$346.47
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$955.01
|
| Rate for Payer: Railroad Medicare Medicare |
$343.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,207.48
|
| Rate for Payer: UHC Core |
$1,145.74
|
| Rate for Payer: UHC Exchange |
$343.04
|
| Rate for Payer: UHC Medicaid |
$241.91
|
| Rate for Payer: UHC Medicare Advantage |
$343.04
|
| Rate for Payer: UHCCP Medicaid |
$241.91
|
| Rate for Payer: VA VA |
$343.04
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,029.11
|
|
|
HC PLT PHER LR IRR WASH
|
Facility
|
IP
|
$1,372.14
|
|
|
Service Code
|
HCPCS P9037
|
| Hospital Charge Code |
39000081
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$955.01 |
| Max. Negotiated Rate |
$1,234.93 |
| Rate for Payer: Aetna Commercial |
$1,166.32
|
| Rate for Payer: BCBS Trust/PPO |
$1,133.25
|
| Rate for Payer: BCN Commercial |
$1,133.25
|
| Rate for Payer: Cash Price |
$1,097.71
|
| Rate for Payer: Cofinity Commercial |
$1,180.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,097.71
|
| Rate for Payer: Healthscope Commercial |
$1,234.93
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,029.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,166.32
|
| Rate for Payer: Nomi Health Commercial |
$1,125.15
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,029.11
|
| Rate for Payer: PHP Commercial |
$1,166.32
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$1,193.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$955.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,207.48
|
| Rate for Payer: UHC Core |
$1,145.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,029.11
|
|
|
HC PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13) IM
|
Facility
|
OP
|
$301.38
|
|
|
Service Code
|
CPT 90670
|
| Hospital Charge Code |
63600074
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$53.13 |
| Max. Negotiated Rate |
$271.24 |
| Rate for Payer: Aetna Commercial |
$256.17
|
| Rate for Payer: Aetna Medicare |
$78.36
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$94.18
|
| Rate for Payer: Amish Plain Church Group Commercial |
$94.18
|
| Rate for Payer: BCBS Complete |
$55.79
|
| Rate for Payer: BCBS MAPPO |
$75.34
|
| Rate for Payer: BCBS Trust/PPO |
$247.76
|
| Rate for Payer: BCN Commercial |
$247.76
|
| Rate for Payer: BCN Medicare Advantage |
$75.34
|
| Rate for Payer: Cash Price |
$241.10
|
| Rate for Payer: Cofinity Commercial |
$259.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$75.34
|
| Rate for Payer: Healthscope Commercial |
$271.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.03
|
| Rate for Payer: Mclaren Medicaid |
$53.13
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$79.11
|
| Rate for Payer: Meridian Medicaid |
$55.79
|
| Rate for Payer: MI Amish Medical Board Commercial |
$86.65
|
| Rate for Payer: Molina Medicare/Medicaid |
$82.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.17
|
| Rate for Payer: Nomi Health Commercial |
$247.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.03
|
| Rate for Payer: PACE Senior Care Partners |
$71.58
|
| Rate for Payer: PACE SWMI |
$75.34
|
| Rate for Payer: PHP Commercial |
$256.17
|
| Rate for Payer: PHP Medicare Advantage |
$75.34
|
| Rate for Payer: Priority Health Choice Medicaid |
$53.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$262.20
|
| Rate for Payer: Priority Health Medicare |
$76.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$209.76
|
| Rate for Payer: Railroad Medicare Medicare |
$75.34
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.21
|
| Rate for Payer: UHC Core |
$251.65
|
| Rate for Payer: UHC Exchange |
$75.34
|
| Rate for Payer: UHC Medicaid |
$53.13
|
| Rate for Payer: UHC Medicare Advantage |
$75.34
|
| Rate for Payer: UHCCP Medicaid |
$53.13
|
| Rate for Payer: VA VA |
$75.34
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.03
|
|
|
HC PNEUMOCOCCAL CONJUGATE VACCINE, 13 VALENT (PCV13) IM
|
Facility
|
IP
|
$301.38
|
|
|
Service Code
|
CPT 90670
|
| Hospital Charge Code |
63600074
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$209.76 |
| Max. Negotiated Rate |
$271.24 |
| Rate for Payer: Aetna Commercial |
$256.17
|
| Rate for Payer: BCBS Trust/PPO |
$248.91
|
| Rate for Payer: BCN Commercial |
$248.91
|
| Rate for Payer: Cash Price |
$241.10
|
| Rate for Payer: Cofinity Commercial |
$259.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$241.10
|
| Rate for Payer: Healthscope Commercial |
$271.24
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$226.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$256.17
|
| Rate for Payer: Nomi Health Commercial |
$247.13
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$226.03
|
| Rate for Payer: PHP Commercial |
$256.17
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$262.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$209.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$265.21
|
| Rate for Payer: UHC Core |
$251.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$226.03
|
|
|
HC PNEUMOCOCCAL IGG AB CMPTS
|
Facility
|
OP
|
$26.83
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200190
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.73 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: Aetna Medicare |
$6.98
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$8.38
|
| Rate for Payer: Amish Plain Church Group Commercial |
$8.38
|
| Rate for Payer: BCBS Complete |
$4.97
|
| Rate for Payer: BCBS MAPPO |
$6.71
|
| Rate for Payer: BCBS Trust/PPO |
$22.06
|
| Rate for Payer: BCN Commercial |
$22.06
|
| Rate for Payer: BCN Medicare Advantage |
$6.71
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$6.71
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Mclaren Medicaid |
$4.73
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$7.04
|
| Rate for Payer: Meridian Medicaid |
$4.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$7.71
|
| Rate for Payer: Molina Medicare/Medicaid |
$7.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Nomi Health Commercial |
$22.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PACE Senior Care Partners |
$6.37
|
| Rate for Payer: PACE SWMI |
$6.71
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: PHP Medicare Advantage |
$6.71
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.73
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.34
|
| Rate for Payer: Priority Health Medicare |
$6.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.67
|
| Rate for Payer: Railroad Medicare Medicare |
$6.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.61
|
| Rate for Payer: UHC Core |
$22.40
|
| Rate for Payer: UHC Exchange |
$6.71
|
| Rate for Payer: UHC Medicaid |
$4.73
|
| Rate for Payer: UHC Medicare Advantage |
$6.71
|
| Rate for Payer: UHCCP Medicaid |
$4.73
|
| Rate for Payer: VA VA |
$6.71
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
|
HC PNEUMOCOCCAL IGG AB CMPTS
|
Facility
|
IP
|
$26.83
|
|
|
Service Code
|
CPT 86317
|
| Hospital Charge Code |
30200190
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$18.67 |
| Max. Negotiated Rate |
$24.15 |
| Rate for Payer: Aetna Commercial |
$22.81
|
| Rate for Payer: BCBS Trust/PPO |
$22.16
|
| Rate for Payer: BCN Commercial |
$22.16
|
| Rate for Payer: Cash Price |
$21.46
|
| Rate for Payer: Cofinity Commercial |
$23.07
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$21.46
|
| Rate for Payer: Healthscope Commercial |
$24.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$20.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$22.81
|
| Rate for Payer: Nomi Health Commercial |
$22.00
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$20.12
|
| Rate for Payer: PHP Commercial |
$22.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$23.34
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$18.67
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$23.61
|
| Rate for Payer: UHC Core |
$22.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$20.12
|
|
