|
HC QUAD 20CM CATHETER
|
Facility
|
IP
|
$354.27
|
|
|
Service Code
|
HCPCS C1751
|
| Hospital Charge Code |
27200068
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$246.57 |
| Max. Negotiated Rate |
$318.84 |
| Rate for Payer: Aetna Commercial |
$301.13
|
| Rate for Payer: BCBS Trust/PPO |
$292.59
|
| Rate for Payer: BCN Commercial |
$292.59
|
| Rate for Payer: Cash Price |
$283.42
|
| Rate for Payer: Cofinity Commercial |
$304.67
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$283.42
|
| Rate for Payer: Healthscope Commercial |
$318.84
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$265.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$301.13
|
| Rate for Payer: Nomi Health Commercial |
$290.50
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$265.70
|
| Rate for Payer: PHP Commercial |
$301.13
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$308.21
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$246.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$311.76
|
| Rate for Payer: UHC Core |
$295.82
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$265.70
|
|
|
HC QUAD SCREEN MATERNAL
|
Facility
|
IP
|
$274.79
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
31000104
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$191.25 |
| Max. Negotiated Rate |
$247.31 |
| Rate for Payer: Aetna Commercial |
$233.57
|
| Rate for Payer: BCBS Trust/PPO |
$226.95
|
| Rate for Payer: BCN Commercial |
$226.95
|
| Rate for Payer: Cash Price |
$219.83
|
| Rate for Payer: Cofinity Commercial |
$236.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.83
|
| Rate for Payer: Healthscope Commercial |
$247.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.57
|
| Rate for Payer: Nomi Health Commercial |
$225.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.09
|
| Rate for Payer: PHP Commercial |
$233.57
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.07
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.82
|
| Rate for Payer: UHC Core |
$229.45
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.09
|
|
|
HC QUAD SCREEN MATERNAL
|
Facility
|
OP
|
$274.79
|
|
|
Service Code
|
CPT 81511
|
| Hospital Charge Code |
31000104
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.45 |
| Max. Negotiated Rate |
$247.31 |
| Rate for Payer: Aetna Commercial |
$233.57
|
| Rate for Payer: Aetna Medicare |
$71.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$85.87
|
| Rate for Payer: Amish Plain Church Group Commercial |
$85.87
|
| Rate for Payer: BCBS Complete |
$50.86
|
| Rate for Payer: BCBS MAPPO |
$68.70
|
| Rate for Payer: BCBS Trust/PPO |
$225.90
|
| Rate for Payer: BCN Commercial |
$225.90
|
| Rate for Payer: BCN Medicare Advantage |
$68.70
|
| Rate for Payer: Cash Price |
$219.83
|
| Rate for Payer: Cofinity Commercial |
$236.32
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$219.83
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$68.70
|
| Rate for Payer: Healthscope Commercial |
$247.31
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$206.09
|
| Rate for Payer: Mclaren Medicaid |
$48.45
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$72.13
|
| Rate for Payer: Meridian Medicaid |
$50.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$79.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$75.57
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$233.57
|
| Rate for Payer: Nomi Health Commercial |
$225.33
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$206.09
|
| Rate for Payer: PACE Senior Care Partners |
$65.26
|
| Rate for Payer: PACE SWMI |
$68.70
|
| Rate for Payer: PHP Commercial |
$233.57
|
| Rate for Payer: PHP Medicare Advantage |
$68.70
|
| Rate for Payer: Priority Health Choice Medicaid |
$48.45
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$239.07
|
| Rate for Payer: Priority Health Medicare |
$69.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$191.25
|
| Rate for Payer: Railroad Medicare Medicare |
$68.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$241.82
|
| Rate for Payer: UHC Core |
$229.45
|
| Rate for Payer: UHC Exchange |
$68.70
|
| Rate for Payer: UHC Medicaid |
$48.45
|
| Rate for Payer: UHC Medicare Advantage |
$68.70
|
| Rate for Payer: UHCCP Medicaid |
$48.45
|
| Rate for Payer: VA VA |
$68.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$206.09
|
|
|
HC QUANTIFERON_TB GOLD
|
Facility
|
OP
|
$167.33
|
|
|
Service Code
|
CPT 86481
|
| Hospital Charge Code |
30200456
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$150.60 |
| Rate for Payer: Aetna Commercial |
$142.23
|
| Rate for Payer: Aetna Medicare |
$43.51
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$52.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$52.29
|
| Rate for Payer: BCBS Complete |
$30.97
|
| Rate for Payer: BCBS MAPPO |
$41.83
|
| Rate for Payer: BCBS Trust/PPO |
$137.56
|
| Rate for Payer: BCN Commercial |
$137.56
|
| Rate for Payer: BCN Medicare Advantage |
$41.83
|
| Rate for Payer: Cash Price |
$133.86
|
| Rate for Payer: Cofinity Commercial |
$143.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.86
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$41.83
|
| Rate for Payer: Healthscope Commercial |
$150.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.50
|
| Rate for Payer: Mclaren Medicaid |
$29.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$43.92
|
| Rate for Payer: Meridian Medicaid |
$30.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$48.11
|
| Rate for Payer: Molina Medicare/Medicaid |
$46.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.23
|
| Rate for Payer: Nomi Health Commercial |
$137.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.50
|
| Rate for Payer: PACE Senior Care Partners |
$39.74
|
| Rate for Payer: PACE SWMI |
$41.83
|
| Rate for Payer: PHP Commercial |
$142.23
|
| Rate for Payer: PHP Medicare Advantage |
$41.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$29.50
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.58
|
| Rate for Payer: Priority Health Medicare |
$42.25
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.46
|
| Rate for Payer: Railroad Medicare Medicare |
$41.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.25
|
| Rate for Payer: UHC Core |
$139.72
|
| Rate for Payer: UHC Exchange |
$41.83
|
| Rate for Payer: UHC Medicaid |
$29.50
|
| Rate for Payer: UHC Medicare Advantage |
$41.83
|
| Rate for Payer: UHCCP Medicaid |
$29.50
|
| Rate for Payer: VA VA |
$41.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.50
|
|
|
HC QUANTIFERON_TB GOLD
|
Facility
|
IP
|
$167.33
|
|
|
Service Code
|
CPT 86481
|
| Hospital Charge Code |
30200456
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$116.46 |
| Max. Negotiated Rate |
$150.60 |
| Rate for Payer: Aetna Commercial |
$142.23
|
| Rate for Payer: BCBS Trust/PPO |
$138.20
|
| Rate for Payer: BCN Commercial |
$138.20
|
| Rate for Payer: Cash Price |
$133.86
|
| Rate for Payer: Cofinity Commercial |
$143.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$133.86
|
| Rate for Payer: Healthscope Commercial |
$150.60
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$125.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$142.23
|
| Rate for Payer: Nomi Health Commercial |
$137.21
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$125.50
|
| Rate for Payer: PHP Commercial |
$142.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$145.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$116.46
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$147.25
|
| Rate for Payer: UHC Core |
$139.72
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$125.50
|
|
|
HC QUANTIFERON - TB GOLD PLUS
|
Facility
|
OP
|
$119.71
|
|
|
Service Code
|
CPT 86480
|
| Hospital Charge Code |
30200414
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$21.10 |
| Max. Negotiated Rate |
$107.74 |
| Rate for Payer: Aetna Commercial |
$101.75
|
| Rate for Payer: Aetna Medicare |
$31.12
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$37.41
|
| Rate for Payer: Amish Plain Church Group Commercial |
$37.41
|
| Rate for Payer: BCBS Complete |
$22.16
|
| Rate for Payer: BCBS MAPPO |
$29.93
|
| Rate for Payer: BCBS Trust/PPO |
$98.41
|
| Rate for Payer: BCN Commercial |
$98.41
|
| Rate for Payer: BCN Medicare Advantage |
$29.93
|
| Rate for Payer: Cash Price |
$95.77
|
| Rate for Payer: Cofinity Commercial |
$102.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.77
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$29.93
|
| Rate for Payer: Healthscope Commercial |
$107.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.78
|
| Rate for Payer: Mclaren Medicaid |
$21.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$31.42
|
| Rate for Payer: Meridian Medicaid |
$22.16
|
| Rate for Payer: MI Amish Medical Board Commercial |
$34.42
|
| Rate for Payer: Molina Medicare/Medicaid |
$32.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.75
|
| Rate for Payer: Nomi Health Commercial |
$98.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.78
|
| Rate for Payer: PACE Senior Care Partners |
$28.43
|
| Rate for Payer: PACE SWMI |
$29.93
|
| Rate for Payer: PHP Commercial |
$101.75
|
| Rate for Payer: PHP Medicare Advantage |
$29.93
|
| Rate for Payer: Priority Health Choice Medicaid |
$21.10
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.15
|
| Rate for Payer: Priority Health Medicare |
$30.23
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.32
|
| Rate for Payer: Railroad Medicare Medicare |
$29.93
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.34
|
| Rate for Payer: UHC Core |
$99.96
|
| Rate for Payer: UHC Exchange |
$29.93
|
| Rate for Payer: UHC Medicaid |
$21.10
|
| Rate for Payer: UHC Medicare Advantage |
$29.93
|
| Rate for Payer: UHCCP Medicaid |
$21.10
|
| Rate for Payer: VA VA |
$29.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.78
|
|
|
HC QUANTIFERON - TB GOLD PLUS
|
Facility
|
IP
|
$119.71
|
|
|
Service Code
|
CPT 86480
|
| Hospital Charge Code |
30200414
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$83.32 |
| Max. Negotiated Rate |
$107.74 |
| Rate for Payer: Aetna Commercial |
$101.75
|
| Rate for Payer: BCBS Trust/PPO |
$98.87
|
| Rate for Payer: BCN Commercial |
$98.87
|
| Rate for Payer: Cash Price |
$95.77
|
| Rate for Payer: Cofinity Commercial |
$102.95
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$95.77
|
| Rate for Payer: Healthscope Commercial |
$107.74
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$89.78
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$101.75
|
| Rate for Payer: Nomi Health Commercial |
$98.16
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$89.78
|
| Rate for Payer: PHP Commercial |
$101.75
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$104.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$105.34
|
| Rate for Payer: UHC Core |
$99.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$89.78
|
|
|
HC QUINIDINE LEVEL
|
Facility
|
IP
|
$58.26
|
|
|
Service Code
|
CPT 80194
|
| Hospital Charge Code |
30100044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.55 |
| Max. Negotiated Rate |
$52.43 |
| Rate for Payer: Aetna Commercial |
$49.52
|
| Rate for Payer: BCBS Trust/PPO |
$48.12
|
| Rate for Payer: BCN Commercial |
$48.12
|
| Rate for Payer: Cash Price |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.61
|
| Rate for Payer: Healthscope Commercial |
$52.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.52
|
| Rate for Payer: Nomi Health Commercial |
$47.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.70
|
| Rate for Payer: PHP Commercial |
$49.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.69
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.55
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.27
|
| Rate for Payer: UHC Core |
$48.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.70
|
|
|
HC QUINIDINE LEVEL
|
Facility
|
OP
|
$58.26
|
|
|
Service Code
|
CPT 80194
|
| Hospital Charge Code |
30100044
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.27 |
| Max. Negotiated Rate |
$52.43 |
| Rate for Payer: Aetna Commercial |
$49.52
|
| Rate for Payer: Aetna Medicare |
$15.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$18.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$18.21
|
| Rate for Payer: BCBS Complete |
$10.78
|
| Rate for Payer: BCBS MAPPO |
$14.56
|
| Rate for Payer: BCBS Trust/PPO |
$47.90
|
| Rate for Payer: BCN Commercial |
$47.90
|
| Rate for Payer: BCN Medicare Advantage |
$14.56
|
| Rate for Payer: Cash Price |
$46.61
|
| Rate for Payer: Cofinity Commercial |
$50.10
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$46.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$14.56
|
| Rate for Payer: Healthscope Commercial |
$52.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$43.70
|
| Rate for Payer: Mclaren Medicaid |
$10.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$15.29
|
| Rate for Payer: Meridian Medicaid |
$10.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$16.75
|
| Rate for Payer: Molina Medicare/Medicaid |
$16.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$49.52
|
| Rate for Payer: Nomi Health Commercial |
$47.77
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$43.70
|
| Rate for Payer: PACE Senior Care Partners |
$13.84
|
| Rate for Payer: PACE SWMI |
$14.56
|
| Rate for Payer: PHP Commercial |
$49.52
|
| Rate for Payer: PHP Medicare Advantage |
$14.56
|
| Rate for Payer: Priority Health Choice Medicaid |
$10.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$50.69
|
| Rate for Payer: Priority Health Medicare |
$14.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$40.55
|
| Rate for Payer: Railroad Medicare Medicare |
$14.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$51.27
|
| Rate for Payer: UHC Core |
$48.65
|
| Rate for Payer: UHC Exchange |
$14.56
|
| Rate for Payer: UHC Medicaid |
$10.27
|
| Rate for Payer: UHC Medicare Advantage |
$14.56
|
| Rate for Payer: UHCCP Medicaid |
$10.27
|
| Rate for Payer: VA VA |
$14.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$43.70
|
|
|
HC RABIES VACCINE IM
|
Facility
|
OP
|
$1,057.98
|
|
|
Service Code
|
CPT 90675
|
| Hospital Charge Code |
63600234
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$186.52 |
| Max. Negotiated Rate |
$952.18 |
| Rate for Payer: Aetna Commercial |
$899.28
|
| Rate for Payer: Aetna Medicare |
$275.07
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$330.62
|
| Rate for Payer: Amish Plain Church Group Commercial |
$330.62
|
| Rate for Payer: BCBS Complete |
$195.83
|
| Rate for Payer: BCBS MAPPO |
$264.50
|
| Rate for Payer: BCBS Trust/PPO |
$869.77
|
| Rate for Payer: BCN Commercial |
$869.77
|
| Rate for Payer: BCN Medicare Advantage |
$264.50
|
| Rate for Payer: Cash Price |
$846.38
|
| Rate for Payer: Cofinity Commercial |
$909.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$846.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$264.50
|
| Rate for Payer: Healthscope Commercial |
$952.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$793.49
|
| Rate for Payer: Mclaren Medicaid |
$186.52
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$277.72
|
| Rate for Payer: Meridian Medicaid |
$195.83
|
| Rate for Payer: MI Amish Medical Board Commercial |
$304.17
|
| Rate for Payer: Molina Medicare/Medicaid |
$290.94
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$899.28
|
| Rate for Payer: Nomi Health Commercial |
$867.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$793.49
|
| Rate for Payer: PACE Senior Care Partners |
$251.27
|
| Rate for Payer: PACE SWMI |
$264.50
|
| Rate for Payer: PHP Commercial |
$899.28
|
| Rate for Payer: PHP Medicare Advantage |
$264.50
|
| Rate for Payer: Priority Health Choice Medicaid |
$186.52
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$920.44
|
| Rate for Payer: Priority Health Medicare |
$267.14
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$736.35
|
| Rate for Payer: Railroad Medicare Medicare |
$264.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$931.02
|
| Rate for Payer: UHC Core |
$883.41
|
| Rate for Payer: UHC Exchange |
$264.50
|
| Rate for Payer: UHC Medicaid |
$186.52
|
| Rate for Payer: UHC Medicare Advantage |
$264.50
|
| Rate for Payer: UHCCP Medicaid |
$186.52
|
| Rate for Payer: VA VA |
$264.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$793.49
|
|
|
HC RABIES VACCINE IM
|
Facility
|
IP
|
$1,057.98
|
|
|
Service Code
|
CPT 90675
|
| Hospital Charge Code |
63600234
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$736.35 |
| Max. Negotiated Rate |
$952.18 |
| Rate for Payer: Aetna Commercial |
$899.28
|
| Rate for Payer: BCBS Trust/PPO |
$873.79
|
| Rate for Payer: BCN Commercial |
$873.79
|
| Rate for Payer: Cash Price |
$846.38
|
| Rate for Payer: Cofinity Commercial |
$909.86
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$846.38
|
| Rate for Payer: Healthscope Commercial |
$952.18
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$793.49
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$899.28
|
| Rate for Payer: Nomi Health Commercial |
$867.54
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$793.49
|
| Rate for Payer: PHP Commercial |
$899.28
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$920.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$736.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$931.02
|
| Rate for Payer: UHC Core |
$883.41
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$793.49
|
|
|
HC RADIAL COMPRESSION DEVICE
|
Facility
|
OP
|
$192.39
|
|
| Hospital Charge Code |
27000157
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$33.92 |
| Max. Negotiated Rate |
$173.15 |
| Rate for Payer: Aetna Commercial |
$163.53
|
| Rate for Payer: Aetna Medicare |
$50.02
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$60.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$60.12
|
| Rate for Payer: BCBS Complete |
$35.61
|
| Rate for Payer: BCBS MAPPO |
$48.10
|
| Rate for Payer: BCBS Trust/PPO |
$158.16
|
| Rate for Payer: BCN Commercial |
$158.16
|
| Rate for Payer: BCN Medicare Advantage |
$48.10
|
| Rate for Payer: Cash Price |
$153.91
|
| Rate for Payer: Cofinity Commercial |
$165.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.91
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$48.10
|
| Rate for Payer: Healthscope Commercial |
$173.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.29
|
| Rate for Payer: Mclaren Medicaid |
$33.92
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$50.50
|
| Rate for Payer: Meridian Medicaid |
$35.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$55.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$52.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.53
|
| Rate for Payer: Nomi Health Commercial |
$157.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.29
|
| Rate for Payer: PACE Senior Care Partners |
$45.69
|
| Rate for Payer: PACE SWMI |
$48.10
|
| Rate for Payer: PHP Commercial |
$163.53
|
| Rate for Payer: PHP Medicare Advantage |
$48.10
|
| Rate for Payer: Priority Health Choice Medicaid |
$33.92
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$167.38
|
| Rate for Payer: Priority Health Medicare |
$48.58
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.90
|
| Rate for Payer: Railroad Medicare Medicare |
$48.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.30
|
| Rate for Payer: UHC Core |
$160.65
|
| Rate for Payer: UHC Exchange |
$48.10
|
| Rate for Payer: UHC Medicaid |
$33.92
|
| Rate for Payer: UHC Medicare Advantage |
$48.10
|
| Rate for Payer: UHCCP Medicaid |
$33.92
|
| Rate for Payer: VA VA |
$48.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.29
|
|
|
HC RADIAL COMPRESSION DEVICE
|
Facility
|
IP
|
$192.39
|
|
| Hospital Charge Code |
27000157
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$133.90 |
| Max. Negotiated Rate |
$173.15 |
| Rate for Payer: Aetna Commercial |
$163.53
|
| Rate for Payer: BCBS Trust/PPO |
$158.89
|
| Rate for Payer: BCN Commercial |
$158.89
|
| Rate for Payer: Cash Price |
$153.91
|
| Rate for Payer: Cofinity Commercial |
$165.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$153.91
|
| Rate for Payer: Healthscope Commercial |
$173.15
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$144.29
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$163.53
|
| Rate for Payer: Nomi Health Commercial |
$157.76
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$144.29
|
| Rate for Payer: PHP Commercial |
$163.53
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$167.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$133.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$169.30
|
| Rate for Payer: UHC Core |
$160.65
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$144.29
|
|
|
HC RADIATION PROCEDURE
|
Facility
|
OP
|
$438.28
|
|
|
Service Code
|
CPT 77399
|
| Hospital Charge Code |
33300034
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$77.27 |
| Max. Negotiated Rate |
$394.45 |
| Rate for Payer: Aetna Commercial |
$372.54
|
| Rate for Payer: Aetna Medicare |
$113.95
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$136.96
|
| Rate for Payer: Amish Plain Church Group Commercial |
$136.96
|
| Rate for Payer: BCBS Complete |
$81.13
|
| Rate for Payer: BCBS MAPPO |
$109.57
|
| Rate for Payer: BCBS Trust/PPO |
$360.31
|
| Rate for Payer: BCN Commercial |
$360.31
|
| Rate for Payer: BCN Medicare Advantage |
$109.57
|
| Rate for Payer: Cash Price |
$350.62
|
| Rate for Payer: Cofinity Commercial |
$376.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.62
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$109.57
|
| Rate for Payer: Healthscope Commercial |
$394.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.71
|
| Rate for Payer: Mclaren Medicaid |
$77.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$115.05
|
| Rate for Payer: Meridian Medicaid |
$81.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$126.01
|
| Rate for Payer: Molina Medicare/Medicaid |
$120.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.54
|
| Rate for Payer: Nomi Health Commercial |
$359.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.71
|
| Rate for Payer: PACE Senior Care Partners |
$104.09
|
| Rate for Payer: PACE SWMI |
$109.57
|
| Rate for Payer: PHP Commercial |
$372.54
|
| Rate for Payer: PHP Medicare Advantage |
$109.57
|
| Rate for Payer: Priority Health Choice Medicaid |
$77.27
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$381.30
|
| Rate for Payer: Priority Health Medicare |
$110.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.04
|
| Rate for Payer: Railroad Medicare Medicare |
$109.57
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.69
|
| Rate for Payer: UHC Core |
$365.96
|
| Rate for Payer: UHC Exchange |
$109.57
|
| Rate for Payer: UHC Medicaid |
$77.27
|
| Rate for Payer: UHC Medicare Advantage |
$109.57
|
| Rate for Payer: UHCCP Medicaid |
$77.27
|
| Rate for Payer: VA VA |
$109.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.71
|
|
|
HC RADIATION PROCEDURE
|
Facility
|
IP
|
$438.28
|
|
|
Service Code
|
CPT 77399
|
| Hospital Charge Code |
33300034
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$305.04 |
| Max. Negotiated Rate |
$394.45 |
| Rate for Payer: Aetna Commercial |
$372.54
|
| Rate for Payer: BCBS Trust/PPO |
$361.98
|
| Rate for Payer: BCN Commercial |
$361.98
|
| Rate for Payer: Cash Price |
$350.62
|
| Rate for Payer: Cofinity Commercial |
$376.92
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$350.62
|
| Rate for Payer: Healthscope Commercial |
$394.45
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$328.71
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$372.54
|
| Rate for Payer: Nomi Health Commercial |
$359.39
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$328.71
|
| Rate for Payer: PHP Commercial |
$372.54
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$381.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$305.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$385.69
|
| Rate for Payer: UHC Core |
$365.96
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$328.71
|
|
|
HC RADIUM RA223 DICHLORIDE XOFIGO PER MICROCURIE
|
Facility
|
OP
|
$291.91
|
|
|
Service Code
|
HCPCS A9606
|
| Hospital Charge Code |
63600051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.46 |
| Max. Negotiated Rate |
$262.72 |
| Rate for Payer: Aetna Commercial |
$248.12
|
| Rate for Payer: Aetna Medicare |
$75.90
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$91.22
|
| Rate for Payer: Amish Plain Church Group Commercial |
$91.22
|
| Rate for Payer: BCBS Complete |
$54.03
|
| Rate for Payer: BCBS MAPPO |
$72.98
|
| Rate for Payer: BCBS Trust/PPO |
$239.98
|
| Rate for Payer: BCN Commercial |
$239.98
|
| Rate for Payer: BCN Medicare Advantage |
$72.98
|
| Rate for Payer: Cash Price |
$233.53
|
| Rate for Payer: Cofinity Commercial |
$251.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$72.98
|
| Rate for Payer: Healthscope Commercial |
$262.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.93
|
| Rate for Payer: Mclaren Medicaid |
$51.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$76.63
|
| Rate for Payer: Meridian Medicaid |
$54.03
|
| Rate for Payer: MI Amish Medical Board Commercial |
$83.92
|
| Rate for Payer: Molina Medicare/Medicaid |
$80.28
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.12
|
| Rate for Payer: Nomi Health Commercial |
$239.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.93
|
| Rate for Payer: PACE Senior Care Partners |
$69.33
|
| Rate for Payer: PACE SWMI |
$72.98
|
| Rate for Payer: PHP Commercial |
$248.12
|
| Rate for Payer: PHP Medicare Advantage |
$72.98
|
| Rate for Payer: Priority Health Choice Medicaid |
$51.46
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$253.96
|
| Rate for Payer: Priority Health Medicare |
$73.71
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.17
|
| Rate for Payer: Railroad Medicare Medicare |
$72.98
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.88
|
| Rate for Payer: UHC Core |
$243.74
|
| Rate for Payer: UHC Exchange |
$72.98
|
| Rate for Payer: UHC Medicaid |
$51.46
|
| Rate for Payer: UHC Medicare Advantage |
$72.98
|
| Rate for Payer: UHCCP Medicaid |
$51.46
|
| Rate for Payer: VA VA |
$72.98
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.93
|
|
|
HC RADIUM RA223 DICHLORIDE XOFIGO PER MICROCURIE
|
Facility
|
IP
|
$291.91
|
|
|
Service Code
|
HCPCS A9606
|
| Hospital Charge Code |
63600051
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$203.17 |
| Max. Negotiated Rate |
$262.72 |
| Rate for Payer: Aetna Commercial |
$248.12
|
| Rate for Payer: BCBS Trust/PPO |
$241.09
|
| Rate for Payer: BCN Commercial |
$241.09
|
| Rate for Payer: Cash Price |
$233.53
|
| Rate for Payer: Cofinity Commercial |
$251.04
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$233.53
|
| Rate for Payer: Healthscope Commercial |
$262.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$218.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$248.12
|
| Rate for Payer: Nomi Health Commercial |
$239.37
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$218.93
|
| Rate for Payer: PHP Commercial |
$248.12
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$253.96
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$203.17
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$256.88
|
| Rate for Payer: UHC Core |
$243.74
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$218.93
|
|
|
HC RAD TX BREAST CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1081
|
| Hospital Charge Code |
33300067
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX BREAST CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1081
|
| Hospital Charge Code |
33300067
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX CERVIAL CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1085
|
| Hospital Charge Code |
33300069
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX CERVIAL CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1085
|
| Hospital Charge Code |
33300069
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX CNS TUMOR ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1083
|
| Hospital Charge Code |
33300068
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX CNS TUMOR ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1083
|
| Hospital Charge Code |
33300068
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX COLORECTAL CA ROM 90 DAY EP
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
HCPCS M1087
|
| Hospital Charge Code |
33300070
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
|
HC RAD TX COLORECTAL CA ROM 90 DAY EP
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
HCPCS M1087
|
| Hospital Charge Code |
33300070
|
|
Hospital Revenue Code
|
333
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Aetna Commercial |
$0.01
|
| Rate for Payer: Aetna Medicare |
$0.00
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$0.00
|
| Rate for Payer: Amish Plain Church Group Commercial |
$0.00
|
| Rate for Payer: BCBS Complete |
$0.00
|
| Rate for Payer: BCBS MAPPO |
$0.00
|
| Rate for Payer: BCBS Trust/PPO |
$0.01
|
| Rate for Payer: BCN Commercial |
$0.01
|
| Rate for Payer: BCN Medicare Advantage |
$0.00
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cofinity Commercial |
$0.01
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$0.01
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$0.00
|
| Rate for Payer: Healthscope Commercial |
$0.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$0.01
|
| Rate for Payer: Mclaren Medicaid |
$0.00
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$0.00
|
| Rate for Payer: Meridian Medicaid |
$0.00
|
| Rate for Payer: MI Amish Medical Board Commercial |
$0.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$0.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$0.01
|
| Rate for Payer: Nomi Health Commercial |
$0.01
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$0.01
|
| Rate for Payer: PACE Senior Care Partners |
$0.00
|
| Rate for Payer: PACE SWMI |
$0.00
|
| Rate for Payer: PHP Commercial |
$0.01
|
| Rate for Payer: PHP Medicare Advantage |
$0.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$0.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO |
$0.01
|
| Rate for Payer: Priority Health Medicare |
$0.00
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$0.01
|
| Rate for Payer: Railroad Medicare Medicare |
$0.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$0.01
|
| Rate for Payer: UHC Core |
$0.01
|
| Rate for Payer: UHC Exchange |
$0.00
|
| Rate for Payer: UHC Medicaid |
$0.00
|
| Rate for Payer: UHC Medicare Advantage |
$0.00
|
| Rate for Payer: UHCCP Medicaid |
$0.00
|
| Rate for Payer: VA VA |
$0.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$0.01
|
|
