|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 2
|
Facility
|
IP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$33.96 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: BCBS Trust/PPO |
$42.64
|
| Rate for Payer: BCN Commercial |
$40.37
|
| Rate for Payer: Cash Price |
$41.79
|
| Rate for Payer: Cofinity Commercial |
$44.93
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$41.79
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO |
$45.45
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.97
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$39.18
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
IP
|
$115.57
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$75.12 |
| Max. Negotiated Rate |
$104.01 |
| Rate for Payer: Aetna Commercial |
$98.23
|
| Rate for Payer: BCBS Trust/PPO |
$94.34
|
| Rate for Payer: BCN Commercial |
$89.31
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cofinity Commercial |
$99.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.46
|
| Rate for Payer: Healthscope Commercial |
$104.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.68
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.23
|
| Rate for Payer: Nomi Health Commercial |
$94.77
|
| Rate for Payer: PHP Commercial |
$98.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.12
|
| Rate for Payer: Priority Health HMO/PPO |
$100.55
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.70
|
| Rate for Payer: UHC Core |
$96.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.68
|
|
|
HC PLASMA CELL PROLIF MARROW
|
Facility
|
OP
|
$115.57
|
|
|
Service Code
|
CPT 88182
|
| Hospital Charge Code |
31100042
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$27.45 |
| Max. Negotiated Rate |
$104.01 |
| Rate for Payer: Aetna Commercial |
$98.23
|
| Rate for Payer: Aetna Medicare |
$30.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$36.12
|
| Rate for Payer: Amish Plain Church Group Commercial |
$36.12
|
| Rate for Payer: BCBS Complete |
$39.74
|
| Rate for Payer: BCBS MAPPO |
$28.89
|
| Rate for Payer: BCBS Trust/PPO |
$95.01
|
| Rate for Payer: BCN Commercial |
$89.86
|
| Rate for Payer: BCN Medicare Advantage |
$28.89
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cash Price |
$92.46
|
| Rate for Payer: Cofinity Commercial |
$99.39
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$92.46
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$28.89
|
| Rate for Payer: Healthscope Commercial |
$104.01
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$86.68
|
| Rate for Payer: Mclaren Medicaid |
$37.85
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.34
|
| Rate for Payer: Meridian Medicaid |
$39.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$33.23
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$98.23
|
| Rate for Payer: Nomi Health Commercial |
$94.77
|
| Rate for Payer: PACE Senior Care Partners |
$27.45
|
| Rate for Payer: PACE SWMI |
$28.89
|
| Rate for Payer: PHP Commercial |
$98.23
|
| Rate for Payer: PHP Medicare Advantage |
$28.89
|
| Rate for Payer: Priority Health Choice Medicaid |
$37.85
|
| Rate for Payer: Priority Health Cigna Priority Health |
$75.12
|
| Rate for Payer: Priority Health HMO/PPO |
$100.55
|
| Rate for Payer: Priority Health Medicare |
$29.18
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$77.43
|
| Rate for Payer: Railroad Medicare Medicare |
$28.89
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$101.70
|
| Rate for Payer: UHC Core |
$96.50
|
| Rate for Payer: UHC Dual Complete DSNP |
$28.89
|
| Rate for Payer: UHC Exchange |
$28.89
|
| Rate for Payer: UHC Medicare Advantage |
$28.89
|
| Rate for Payer: UHCCP Medicaid |
$37.85
|
| Rate for Payer: VA VA |
$28.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.68
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
OP
|
$160.12
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$38.03 |
| Max. Negotiated Rate |
$144.11 |
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: Aetna Medicare |
$41.63
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$50.04
|
| Rate for Payer: Amish Plain Church Group Commercial |
$50.04
|
| Rate for Payer: BCBS Complete |
$109.57
|
| Rate for Payer: BCBS MAPPO |
$40.03
|
| Rate for Payer: BCBS Trust/PPO |
$131.63
|
| Rate for Payer: BCN Commercial |
$124.49
|
| Rate for Payer: BCN Medicare Advantage |
$40.03
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cofinity Commercial |
$137.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.10
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$40.03
|
| Rate for Payer: Healthscope Commercial |
$144.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.09
|
| Rate for Payer: Mclaren Medicaid |
$104.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.03
|
| Rate for Payer: Meridian Medicaid |
$109.57
|
| Rate for Payer: MI Amish Medical Board Commercial |
$46.03
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.10
|
| Rate for Payer: Nomi Health Commercial |
$131.30
|
| Rate for Payer: PACE Senior Care Partners |
$38.03
|
| Rate for Payer: PACE SWMI |
$40.03
|
| Rate for Payer: PHP Commercial |
$136.10
|
| Rate for Payer: PHP Medicare Advantage |
$40.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$104.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.08
|
| Rate for Payer: Priority Health HMO/PPO |
$139.30
|
| Rate for Payer: Priority Health Medicare |
$40.43
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.28
|
| Rate for Payer: Railroad Medicare Medicare |
$40.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.91
|
| Rate for Payer: UHC Core |
$133.70
|
| Rate for Payer: UHC Dual Complete DSNP |
$40.03
|
| Rate for Payer: UHC Exchange |
$40.03
|
| Rate for Payer: UHC Medicare Advantage |
$40.03
|
| Rate for Payer: UHCCP Medicaid |
$104.34
|
| Rate for Payer: VA VA |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.09
|
|
|
HC PLASMA CRYO REDUCED
|
Facility
|
IP
|
$160.12
|
|
|
Service Code
|
HCPCS P9044
|
| Hospital Charge Code |
39000063
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$104.08 |
| Max. Negotiated Rate |
$144.11 |
| Rate for Payer: Aetna Commercial |
$136.10
|
| Rate for Payer: BCBS Trust/PPO |
$130.71
|
| Rate for Payer: BCN Commercial |
$123.74
|
| Rate for Payer: Cash Price |
$128.10
|
| Rate for Payer: Cofinity Commercial |
$137.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$128.10
|
| Rate for Payer: Healthscope Commercial |
$144.11
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$120.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$136.10
|
| Rate for Payer: Nomi Health Commercial |
$131.30
|
| Rate for Payer: PHP Commercial |
$136.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$104.08
|
| Rate for Payer: Priority Health HMO/PPO |
$139.30
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$107.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$140.91
|
| Rate for Payer: UHC Core |
$133.70
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.09
|
|
|
HC PLASMINOGEN
|
Facility
|
OP
|
$86.35
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: Aetna Medicare |
$22.45
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$26.98
|
| Rate for Payer: Amish Plain Church Group Commercial |
$26.98
|
| Rate for Payer: BCBS Complete |
$4.96
|
| Rate for Payer: BCBS MAPPO |
$21.59
|
| Rate for Payer: BCBS Trust/PPO |
$70.99
|
| Rate for Payer: BCN Commercial |
$67.14
|
| Rate for Payer: BCN Medicare Advantage |
$21.59
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$21.59
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Mclaren Medicaid |
$4.72
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$22.67
|
| Rate for Payer: Meridian Medicaid |
$4.96
|
| Rate for Payer: MI Amish Medical Board Commercial |
$24.83
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: PACE Senior Care Partners |
$20.51
|
| Rate for Payer: PACE SWMI |
$21.59
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: PHP Medicare Advantage |
$21.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$4.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.13
|
| Rate for Payer: Priority Health HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Medicare |
$21.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.85
|
| Rate for Payer: Railroad Medicare Medicare |
$21.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.99
|
| Rate for Payer: UHC Core |
$72.10
|
| Rate for Payer: UHC Dual Complete DSNP |
$21.59
|
| Rate for Payer: UHC Exchange |
$21.59
|
| Rate for Payer: UHC Medicare Advantage |
$21.59
|
| Rate for Payer: UHCCP Medicaid |
$4.72
|
| Rate for Payer: VA VA |
$21.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PLASMINOGEN
|
Facility
|
IP
|
$86.35
|
|
|
Service Code
|
CPT 85420
|
| Hospital Charge Code |
30500068
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$56.13 |
| Max. Negotiated Rate |
$77.72 |
| Rate for Payer: Aetna Commercial |
$73.40
|
| Rate for Payer: BCBS Trust/PPO |
$70.49
|
| Rate for Payer: BCN Commercial |
$66.73
|
| Rate for Payer: Cash Price |
$69.08
|
| Rate for Payer: Cofinity Commercial |
$74.26
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$69.08
|
| Rate for Payer: Healthscope Commercial |
$77.72
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$64.76
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$73.40
|
| Rate for Payer: Nomi Health Commercial |
$70.81
|
| Rate for Payer: PHP Commercial |
$73.40
|
| Rate for Payer: Priority Health Cigna Priority Health |
$56.13
|
| Rate for Payer: Priority Health HMO/PPO |
$75.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$57.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$75.99
|
| Rate for Payer: UHC Core |
$72.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$64.76
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
IP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$63.23 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: BCBS Trust/PPO |
$79.41
|
| Rate for Payer: BCN Commercial |
$75.18
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: Nomi Health Commercial |
$79.77
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health HMO/PPO |
$84.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.61
|
| Rate for Payer: UHC Core |
$81.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.96
|
|
|
HC PLATELET AGGREGATION EA AGENT
|
Facility
|
OP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500055
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.01 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna Medicare |
$25.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.40
|
| Rate for Payer: BCBS Complete |
$18.91
|
| Rate for Payer: BCBS MAPPO |
$24.32
|
| Rate for Payer: BCBS Trust/PPO |
$79.97
|
| Rate for Payer: BCN Commercial |
$75.64
|
| Rate for Payer: BCN Medicare Advantage |
$24.32
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.32
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.96
|
| Rate for Payer: Mclaren Medicaid |
$18.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.54
|
| Rate for Payer: Meridian Medicaid |
$18.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: Nomi Health Commercial |
$79.77
|
| Rate for Payer: PACE Senior Care Partners |
$23.10
|
| Rate for Payer: PACE SWMI |
$24.32
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: PHP Medicare Advantage |
$24.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health HMO/PPO |
$84.63
|
| Rate for Payer: Priority Health Medicare |
$24.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.18
|
| Rate for Payer: Railroad Medicare Medicare |
$24.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.61
|
| Rate for Payer: UHC Core |
$81.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.32
|
| Rate for Payer: UHC Exchange |
$24.32
|
| Rate for Payer: UHC Medicare Advantage |
$24.32
|
| Rate for Payer: UHCCP Medicaid |
$18.01
|
| Rate for Payer: VA VA |
$24.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.96
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
IP
|
$99.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$64.92 |
| Max. Negotiated Rate |
$89.89 |
| Rate for Payer: Aetna Commercial |
$84.90
|
| Rate for Payer: BCBS Trust/PPO |
$81.53
|
| Rate for Payer: BCN Commercial |
$77.19
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.90
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.91
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.90
|
| Rate for Payer: Nomi Health Commercial |
$81.90
|
| Rate for Payer: PHP Commercial |
$84.90
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.92
|
| Rate for Payer: Priority Health HMO/PPO |
$86.90
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.92
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.89
|
| Rate for Payer: UHC Core |
$83.40
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.91
|
|
|
HC PLATELET ANTIBODY
|
Facility
|
OP
|
$99.88
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
30200129
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$13.28 |
| Max. Negotiated Rate |
$89.89 |
| Rate for Payer: Aetna Commercial |
$84.90
|
| Rate for Payer: Aetna Medicare |
$25.97
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$31.21
|
| Rate for Payer: Amish Plain Church Group Commercial |
$31.21
|
| Rate for Payer: BCBS Complete |
$13.95
|
| Rate for Payer: BCBS MAPPO |
$24.97
|
| Rate for Payer: BCBS Trust/PPO |
$82.11
|
| Rate for Payer: BCN Commercial |
$77.66
|
| Rate for Payer: BCN Medicare Advantage |
$24.97
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cash Price |
$79.90
|
| Rate for Payer: Cofinity Commercial |
$85.90
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$79.90
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.97
|
| Rate for Payer: Healthscope Commercial |
$89.89
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$74.91
|
| Rate for Payer: Mclaren Medicaid |
$13.28
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$26.22
|
| Rate for Payer: Meridian Medicaid |
$13.95
|
| Rate for Payer: MI Amish Medical Board Commercial |
$28.72
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$84.90
|
| Rate for Payer: Nomi Health Commercial |
$81.90
|
| Rate for Payer: PACE Senior Care Partners |
$23.72
|
| Rate for Payer: PACE SWMI |
$24.97
|
| Rate for Payer: PHP Commercial |
$84.90
|
| Rate for Payer: PHP Medicare Advantage |
$24.97
|
| Rate for Payer: Priority Health Choice Medicaid |
$13.28
|
| Rate for Payer: Priority Health Cigna Priority Health |
$64.92
|
| Rate for Payer: Priority Health HMO/PPO |
$86.90
|
| Rate for Payer: Priority Health Medicare |
$25.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$66.92
|
| Rate for Payer: Railroad Medicare Medicare |
$24.97
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$87.89
|
| Rate for Payer: UHC Core |
$83.40
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.97
|
| Rate for Payer: UHC Exchange |
$24.97
|
| Rate for Payer: UHC Medicare Advantage |
$24.97
|
| Rate for Payer: UHCCP Medicaid |
$13.28
|
| Rate for Payer: VA VA |
$24.97
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$74.91
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
OP
|
$279.14
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$66.30 |
| Max. Negotiated Rate |
$251.23 |
| Rate for Payer: Aetna Commercial |
$237.27
|
| Rate for Payer: Aetna Medicare |
$72.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$87.23
|
| Rate for Payer: Amish Plain Church Group Commercial |
$87.23
|
| Rate for Payer: BCBS Complete |
$93.56
|
| Rate for Payer: BCBS MAPPO |
$69.78
|
| Rate for Payer: BCBS Trust/PPO |
$229.48
|
| Rate for Payer: BCN Commercial |
$217.03
|
| Rate for Payer: BCN Medicare Advantage |
$69.78
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cofinity Commercial |
$240.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.31
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$69.78
|
| Rate for Payer: Healthscope Commercial |
$251.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.36
|
| Rate for Payer: Mclaren Medicaid |
$89.10
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$73.27
|
| Rate for Payer: Meridian Medicaid |
$93.56
|
| Rate for Payer: MI Amish Medical Board Commercial |
$80.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.27
|
| Rate for Payer: Nomi Health Commercial |
$228.89
|
| Rate for Payer: PACE Senior Care Partners |
$66.30
|
| Rate for Payer: PACE SWMI |
$69.78
|
| Rate for Payer: PHP Commercial |
$237.27
|
| Rate for Payer: PHP Medicare Advantage |
$69.78
|
| Rate for Payer: Priority Health Choice Medicaid |
$89.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.44
|
| Rate for Payer: Priority Health HMO/PPO |
$242.85
|
| Rate for Payer: Priority Health Medicare |
$70.48
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.02
|
| Rate for Payer: Railroad Medicare Medicare |
$69.78
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.64
|
| Rate for Payer: UHC Core |
$233.08
|
| Rate for Payer: UHC Dual Complete DSNP |
$69.78
|
| Rate for Payer: UHC Exchange |
$69.78
|
| Rate for Payer: UHC Medicare Advantage |
$69.78
|
| Rate for Payer: UHCCP Medicaid |
$89.10
|
| Rate for Payer: VA VA |
$69.78
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.36
|
|
|
HC PLATELET CONCENTRATE
|
Facility
|
IP
|
$279.14
|
|
|
Service Code
|
HCPCS P9031
|
| Hospital Charge Code |
39000060
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$181.44 |
| Max. Negotiated Rate |
$251.23 |
| Rate for Payer: Aetna Commercial |
$237.27
|
| Rate for Payer: BCBS Trust/PPO |
$227.86
|
| Rate for Payer: BCN Commercial |
$215.72
|
| Rate for Payer: Cash Price |
$223.31
|
| Rate for Payer: Cofinity Commercial |
$240.06
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$223.31
|
| Rate for Payer: Healthscope Commercial |
$251.23
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$209.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$237.27
|
| Rate for Payer: Nomi Health Commercial |
$228.89
|
| Rate for Payer: PHP Commercial |
$237.27
|
| Rate for Payer: Priority Health Cigna Priority Health |
$181.44
|
| Rate for Payer: Priority Health HMO/PPO |
$242.85
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$187.02
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$245.64
|
| Rate for Payer: UHC Core |
$233.08
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$209.36
|
|
|
HC PLATELET COUNT
|
Facility
|
OP
|
$38.66
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$3.24 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: Aetna Medicare |
$10.05
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$12.08
|
| Rate for Payer: Amish Plain Church Group Commercial |
$12.08
|
| Rate for Payer: BCBS Complete |
$3.40
|
| Rate for Payer: BCBS MAPPO |
$9.66
|
| Rate for Payer: BCBS Trust/PPO |
$31.78
|
| Rate for Payer: BCN Commercial |
$30.06
|
| Rate for Payer: BCN Medicare Advantage |
$9.66
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$9.66
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Mclaren Medicaid |
$3.24
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$10.15
|
| Rate for Payer: Meridian Medicaid |
$3.40
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PACE Senior Care Partners |
$9.18
|
| Rate for Payer: PACE SWMI |
$9.66
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: PHP Medicare Advantage |
$9.66
|
| Rate for Payer: Priority Health Choice Medicaid |
$3.24
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Medicare |
$9.76
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: Railroad Medicare Medicare |
$9.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: UHC Dual Complete DSNP |
$9.66
|
| Rate for Payer: UHC Exchange |
$9.66
|
| Rate for Payer: UHC Medicare Advantage |
$9.66
|
| Rate for Payer: UHCCP Medicaid |
$3.24
|
| Rate for Payer: VA VA |
$9.66
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC PLATELET COUNT
|
Facility
|
IP
|
$38.66
|
|
|
Service Code
|
CPT 85049
|
| Hospital Charge Code |
30500012
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$25.13 |
| Max. Negotiated Rate |
$34.79 |
| Rate for Payer: Aetna Commercial |
$32.86
|
| Rate for Payer: BCBS Trust/PPO |
$31.56
|
| Rate for Payer: BCN Commercial |
$29.88
|
| Rate for Payer: Cash Price |
$30.93
|
| Rate for Payer: Cofinity Commercial |
$33.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$30.93
|
| Rate for Payer: Healthscope Commercial |
$34.79
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$29.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$32.86
|
| Rate for Payer: Nomi Health Commercial |
$31.70
|
| Rate for Payer: PHP Commercial |
$32.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$25.13
|
| Rate for Payer: Priority Health HMO/PPO |
$33.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$25.90
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$34.02
|
| Rate for Payer: UHC Core |
$32.28
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$29.00
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
IP
|
$124.01
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$80.61 |
| Max. Negotiated Rate |
$111.61 |
| Rate for Payer: Aetna Commercial |
$105.41
|
| Rate for Payer: BCBS Trust/PPO |
$101.23
|
| Rate for Payer: BCN Commercial |
$95.83
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cofinity Commercial |
$106.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.21
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.01
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.41
|
| Rate for Payer: Nomi Health Commercial |
$101.69
|
| Rate for Payer: PHP Commercial |
$105.41
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.61
|
| Rate for Payer: Priority Health HMO/PPO |
$107.89
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.09
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.13
|
| Rate for Payer: UHC Core |
$103.55
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.01
|
|
|
HC PLATELET FUNCTION ADP
|
Facility
|
OP
|
$124.01
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500054
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.01 |
| Max. Negotiated Rate |
$111.61 |
| Rate for Payer: Aetna Commercial |
$105.41
|
| Rate for Payer: Aetna Medicare |
$32.24
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$38.75
|
| Rate for Payer: Amish Plain Church Group Commercial |
$38.75
|
| Rate for Payer: BCBS Complete |
$18.91
|
| Rate for Payer: BCBS MAPPO |
$31.00
|
| Rate for Payer: BCBS Trust/PPO |
$101.95
|
| Rate for Payer: BCN Commercial |
$96.42
|
| Rate for Payer: BCN Medicare Advantage |
$31.00
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cash Price |
$99.21
|
| Rate for Payer: Cofinity Commercial |
$106.65
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$99.21
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$31.00
|
| Rate for Payer: Healthscope Commercial |
$111.61
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$93.01
|
| Rate for Payer: Mclaren Medicaid |
$18.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$32.55
|
| Rate for Payer: Meridian Medicaid |
$18.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$35.65
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$105.41
|
| Rate for Payer: Nomi Health Commercial |
$101.69
|
| Rate for Payer: PACE Senior Care Partners |
$29.45
|
| Rate for Payer: PACE SWMI |
$31.00
|
| Rate for Payer: PHP Commercial |
$105.41
|
| Rate for Payer: PHP Medicare Advantage |
$31.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$80.61
|
| Rate for Payer: Priority Health HMO/PPO |
$107.89
|
| Rate for Payer: Priority Health Medicare |
$31.31
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$83.09
|
| Rate for Payer: Railroad Medicare Medicare |
$31.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$109.13
|
| Rate for Payer: UHC Core |
$103.55
|
| Rate for Payer: UHC Dual Complete DSNP |
$31.00
|
| Rate for Payer: UHC Exchange |
$31.00
|
| Rate for Payer: UHC Medicare Advantage |
$31.00
|
| Rate for Payer: UHCCP Medicaid |
$18.01
|
| Rate for Payer: VA VA |
$31.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$93.01
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
IP
|
$402.53
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$261.64 |
| Max. Negotiated Rate |
$362.28 |
| Rate for Payer: Aetna Commercial |
$342.15
|
| Rate for Payer: BCBS Trust/PPO |
$328.59
|
| Rate for Payer: BCN Commercial |
$311.08
|
| Rate for Payer: Cash Price |
$322.02
|
| Rate for Payer: Cofinity Commercial |
$346.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.02
|
| Rate for Payer: Healthscope Commercial |
$362.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.90
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.15
|
| Rate for Payer: Nomi Health Commercial |
$330.07
|
| Rate for Payer: PHP Commercial |
$342.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.64
|
| Rate for Payer: Priority Health HMO/PPO |
$350.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.23
|
| Rate for Payer: UHC Core |
$336.11
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.90
|
|
|
HC PLATELET LEUKO REDUCED IRRAD
|
Facility
|
OP
|
$402.53
|
|
|
Service Code
|
HCPCS P9033
|
| Hospital Charge Code |
39000064
|
|
Hospital Revenue Code
|
390
|
| Min. Negotiated Rate |
$95.60 |
| Max. Negotiated Rate |
$362.28 |
| Rate for Payer: Aetna Commercial |
$342.15
|
| Rate for Payer: Aetna Medicare |
$104.66
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$125.79
|
| Rate for Payer: Amish Plain Church Group Commercial |
$125.79
|
| Rate for Payer: BCBS Complete |
$152.78
|
| Rate for Payer: BCBS MAPPO |
$100.63
|
| Rate for Payer: BCBS Trust/PPO |
$330.92
|
| Rate for Payer: BCN Commercial |
$312.97
|
| Rate for Payer: BCN Medicare Advantage |
$100.63
|
| Rate for Payer: Cash Price |
$322.02
|
| Rate for Payer: Cash Price |
$322.02
|
| Rate for Payer: Cofinity Commercial |
$346.18
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$322.02
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$100.63
|
| Rate for Payer: Healthscope Commercial |
$362.28
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$301.90
|
| Rate for Payer: Mclaren Medicaid |
$145.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$105.66
|
| Rate for Payer: Meridian Medicaid |
$152.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$115.73
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$342.15
|
| Rate for Payer: Nomi Health Commercial |
$330.07
|
| Rate for Payer: PACE Senior Care Partners |
$95.60
|
| Rate for Payer: PACE SWMI |
$100.63
|
| Rate for Payer: PHP Commercial |
$342.15
|
| Rate for Payer: PHP Medicare Advantage |
$100.63
|
| Rate for Payer: Priority Health Choice Medicaid |
$145.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$261.64
|
| Rate for Payer: Priority Health HMO/PPO |
$350.20
|
| Rate for Payer: Priority Health Medicare |
$101.64
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$269.70
|
| Rate for Payer: Railroad Medicare Medicare |
$100.63
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$354.23
|
| Rate for Payer: UHC Core |
$336.11
|
| Rate for Payer: UHC Dual Complete DSNP |
$100.63
|
| Rate for Payer: UHC Exchange |
$100.63
|
| Rate for Payer: UHC Medicare Advantage |
$100.63
|
| Rate for Payer: UHCCP Medicaid |
$145.50
|
| Rate for Payer: VA VA |
$100.63
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$301.90
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
IP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$63.23 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: BCBS Trust/PPO |
$79.41
|
| Rate for Payer: BCN Commercial |
$75.18
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.96
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: Nomi Health Commercial |
$79.77
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health HMO/PPO |
$84.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.18
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.61
|
| Rate for Payer: UHC Core |
$81.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.96
|
|
|
HC PLATELET RESISTANCE TEST CMPT
|
Facility
|
OP
|
$97.28
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500053
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.01 |
| Max. Negotiated Rate |
$87.55 |
| Rate for Payer: Aetna Commercial |
$82.69
|
| Rate for Payer: Aetna Medicare |
$25.29
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$30.40
|
| Rate for Payer: Amish Plain Church Group Commercial |
$30.40
|
| Rate for Payer: BCBS Complete |
$18.91
|
| Rate for Payer: BCBS MAPPO |
$24.32
|
| Rate for Payer: BCBS Trust/PPO |
$79.97
|
| Rate for Payer: BCN Commercial |
$75.64
|
| Rate for Payer: BCN Medicare Advantage |
$24.32
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cash Price |
$77.82
|
| Rate for Payer: Cofinity Commercial |
$83.66
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$77.82
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$24.32
|
| Rate for Payer: Healthscope Commercial |
$87.55
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$72.96
|
| Rate for Payer: Mclaren Medicaid |
$18.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$25.54
|
| Rate for Payer: Meridian Medicaid |
$18.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.97
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$82.69
|
| Rate for Payer: Nomi Health Commercial |
$79.77
|
| Rate for Payer: PACE Senior Care Partners |
$23.10
|
| Rate for Payer: PACE SWMI |
$24.32
|
| Rate for Payer: PHP Commercial |
$82.69
|
| Rate for Payer: PHP Medicare Advantage |
$24.32
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$63.23
|
| Rate for Payer: Priority Health HMO/PPO |
$84.63
|
| Rate for Payer: Priority Health Medicare |
$24.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$65.18
|
| Rate for Payer: Railroad Medicare Medicare |
$24.32
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$85.61
|
| Rate for Payer: UHC Core |
$81.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$24.32
|
| Rate for Payer: UHC Exchange |
$24.32
|
| Rate for Payer: UHC Medicare Advantage |
$24.32
|
| Rate for Payer: UHCCP Medicaid |
$18.01
|
| Rate for Payer: VA VA |
$24.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$72.96
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
OP
|
$92.60
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$18.01 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: Aetna Medicare |
$24.08
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$28.94
|
| Rate for Payer: Amish Plain Church Group Commercial |
$28.94
|
| Rate for Payer: BCBS Complete |
$18.91
|
| Rate for Payer: BCBS MAPPO |
$23.15
|
| Rate for Payer: BCBS Trust/PPO |
$76.13
|
| Rate for Payer: BCN Commercial |
$72.00
|
| Rate for Payer: BCN Medicare Advantage |
$23.15
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.15
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Mclaren Medicaid |
$18.01
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.31
|
| Rate for Payer: Meridian Medicaid |
$18.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$26.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$75.93
|
| Rate for Payer: PACE Senior Care Partners |
$21.99
|
| Rate for Payer: PACE SWMI |
$23.15
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: PHP Medicare Advantage |
$23.15
|
| Rate for Payer: Priority Health Choice Medicaid |
$18.01
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health HMO/PPO |
$80.56
|
| Rate for Payer: Priority Health Medicare |
$23.38
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.04
|
| Rate for Payer: Railroad Medicare Medicare |
$23.15
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.49
|
| Rate for Payer: UHC Core |
$77.32
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.15
|
| Rate for Payer: UHC Exchange |
$23.15
|
| Rate for Payer: UHC Medicare Advantage |
$23.15
|
| Rate for Payer: UHCCP Medicaid |
$18.01
|
| Rate for Payer: VA VA |
$23.15
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC PLAVIX RESISTANCE TEST
|
Facility
|
IP
|
$92.60
|
|
|
Service Code
|
CPT 85576
|
| Hospital Charge Code |
30500072
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$60.19 |
| Max. Negotiated Rate |
$83.34 |
| Rate for Payer: Aetna Commercial |
$78.71
|
| Rate for Payer: BCBS Trust/PPO |
$75.59
|
| Rate for Payer: BCN Commercial |
$71.56
|
| Rate for Payer: Cash Price |
$74.08
|
| Rate for Payer: Cofinity Commercial |
$79.64
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$74.08
|
| Rate for Payer: Healthscope Commercial |
$83.34
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$69.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$78.71
|
| Rate for Payer: Nomi Health Commercial |
$75.93
|
| Rate for Payer: PHP Commercial |
$78.71
|
| Rate for Payer: Priority Health Cigna Priority Health |
$60.19
|
| Rate for Payer: Priority Health HMO/PPO |
$80.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$62.04
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$81.49
|
| Rate for Payer: UHC Core |
$77.32
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$69.45
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
OP
|
$1,942.43
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$461.33 |
| Max. Negotiated Rate |
$1,748.19 |
| Rate for Payer: Aetna Commercial |
$1,651.07
|
| Rate for Payer: Aetna Medicare |
$505.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$607.01
|
| Rate for Payer: Amish Plain Church Group Commercial |
$607.01
|
| Rate for Payer: BCBS Complete |
$1,017.78
|
| Rate for Payer: BCBS MAPPO |
$485.61
|
| Rate for Payer: BCBS Trust/PPO |
$1,596.87
|
| Rate for Payer: BCN Commercial |
$1,510.24
|
| Rate for Payer: BCN Medicare Advantage |
$485.61
|
| Rate for Payer: Cash Price |
$1,553.94
|
| Rate for Payer: Cash Price |
$1,553.94
|
| Rate for Payer: Cofinity Commercial |
$1,670.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.94
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$485.61
|
| Rate for Payer: Healthscope Commercial |
$1,748.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.82
|
| Rate for Payer: Mclaren Medicaid |
$969.25
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$509.89
|
| Rate for Payer: Meridian Medicaid |
$1,017.78
|
| Rate for Payer: MI Amish Medical Board Commercial |
$558.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,651.07
|
| Rate for Payer: Nomi Health Commercial |
$1,592.79
|
| Rate for Payer: PACE Senior Care Partners |
$461.33
|
| Rate for Payer: PACE SWMI |
$485.61
|
| Rate for Payer: PHP Commercial |
$1,651.07
|
| Rate for Payer: PHP Medicare Advantage |
$485.61
|
| Rate for Payer: Priority Health Choice Medicaid |
$969.25
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.58
|
| Rate for Payer: Priority Health HMO/PPO |
$1,689.91
|
| Rate for Payer: Priority Health Medicare |
$490.46
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,301.43
|
| Rate for Payer: Railroad Medicare Medicare |
$485.61
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.34
|
| Rate for Payer: UHC Core |
$1,621.93
|
| Rate for Payer: UHC Dual Complete DSNP |
$485.61
|
| Rate for Payer: UHC Exchange |
$485.61
|
| Rate for Payer: UHC Medicare Advantage |
$485.61
|
| Rate for Payer: UHCCP Medicaid |
$969.25
|
| Rate for Payer: VA VA |
$485.61
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.82
|
|
|
HC PLMT INTERSTITIAL DEVICE RAD THER, PROST, SNGLE/MULT
|
Facility
|
IP
|
$1,942.43
|
|
|
Service Code
|
CPT 55876
|
| Hospital Charge Code |
36100577
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,262.58 |
| Max. Negotiated Rate |
$1,748.19 |
| Rate for Payer: Aetna Commercial |
$1,651.07
|
| Rate for Payer: BCBS Trust/PPO |
$1,585.61
|
| Rate for Payer: BCN Commercial |
$1,501.11
|
| Rate for Payer: Cash Price |
$1,553.94
|
| Rate for Payer: Cofinity Commercial |
$1,670.49
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,553.94
|
| Rate for Payer: Healthscope Commercial |
$1,748.19
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,456.82
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,651.07
|
| Rate for Payer: Nomi Health Commercial |
$1,592.79
|
| Rate for Payer: PHP Commercial |
$1,651.07
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,262.58
|
| Rate for Payer: Priority Health HMO/PPO |
$1,689.91
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,301.43
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$1,709.34
|
| Rate for Payer: UHC Core |
$1,621.93
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,456.82
|
|
