|
HC PLACE STENT BILE DUCT EA STENT THRU NEW ACCESS W PLACE OF SE BILIARY CATH
|
Facility
|
IP
|
$6,624.17
|
|
|
Service Code
|
CPT 47540
|
| Hospital Charge Code |
36100497
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,305.71 |
| Max. Negotiated Rate |
$5,961.75 |
| Rate for Payer: Aetna Commercial |
$5,630.54
|
| Rate for Payer: BCBS Trust/PPO |
$5,407.31
|
| Rate for Payer: BCN Commercial |
$5,119.16
|
| Rate for Payer: Cash Price |
$5,299.34
|
| Rate for Payer: Cofinity Commercial |
$5,696.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$5,299.34
|
| Rate for Payer: Healthscope Commercial |
$5,961.75
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$4,968.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$5,630.54
|
| Rate for Payer: Nomi Health Commercial |
$5,431.82
|
| Rate for Payer: PHP Commercial |
$5,630.54
|
| Rate for Payer: Priority Health Cigna Priority Health |
$4,305.71
|
| Rate for Payer: Priority Health HMO/PPO |
$5,763.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$4,438.19
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$5,829.27
|
| Rate for Payer: UHC Core |
$5,531.18
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$4,968.13
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
OP
|
$204.41
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$48.55 |
| Max. Negotiated Rate |
$183.97 |
| Rate for Payer: Aetna Commercial |
$173.75
|
| Rate for Payer: Aetna Medicare |
$53.15
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$63.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$63.88
|
| Rate for Payer: BCBS Complete |
$81.76
|
| Rate for Payer: BCBS MAPPO |
$51.10
|
| Rate for Payer: BCBS Trust/PPO |
$168.05
|
| Rate for Payer: BCN Commercial |
$158.93
|
| Rate for Payer: BCN Medicare Advantage |
$51.10
|
| Rate for Payer: Cash Price |
$163.53
|
| Rate for Payer: Cofinity Commercial |
$175.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.53
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$51.10
|
| Rate for Payer: Healthscope Commercial |
$183.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$53.66
|
| Rate for Payer: MI Amish Medical Board Commercial |
$58.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.75
|
| Rate for Payer: Nomi Health Commercial |
$167.62
|
| Rate for Payer: PACE Senior Care Partners |
$48.55
|
| Rate for Payer: PACE SWMI |
$51.10
|
| Rate for Payer: PHP Commercial |
$173.75
|
| Rate for Payer: PHP Medicare Advantage |
$51.10
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.87
|
| Rate for Payer: Priority Health HMO/PPO |
$177.84
|
| Rate for Payer: Priority Health Medicare |
$51.61
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.95
|
| Rate for Payer: Railroad Medicare Medicare |
$51.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.88
|
| Rate for Payer: UHC Core |
$170.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$51.10
|
| Rate for Payer: UHC Exchange |
$51.10
|
| Rate for Payer: UHC Medicare Advantage |
$51.10
|
| Rate for Payer: VA VA |
$51.10
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.31
|
|
|
HC PLACE STENT CENTRAL DIALYSIS W IMAGING
|
Facility
|
IP
|
$204.41
|
|
|
Service Code
|
CPT 36908
|
| Hospital Charge Code |
36100532
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$132.87 |
| Max. Negotiated Rate |
$183.97 |
| Rate for Payer: Aetna Commercial |
$173.75
|
| Rate for Payer: BCBS Trust/PPO |
$166.86
|
| Rate for Payer: BCN Commercial |
$157.97
|
| Rate for Payer: Cash Price |
$163.53
|
| Rate for Payer: Cofinity Commercial |
$175.79
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$163.53
|
| Rate for Payer: Healthscope Commercial |
$183.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$153.31
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$173.75
|
| Rate for Payer: Nomi Health Commercial |
$167.62
|
| Rate for Payer: PHP Commercial |
$173.75
|
| Rate for Payer: Priority Health Cigna Priority Health |
$132.87
|
| Rate for Payer: Priority Health HMO/PPO |
$177.84
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$136.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$179.88
|
| Rate for Payer: UHC Core |
$170.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$153.31
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
IP
|
$9,078.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$5,900.70 |
| Max. Negotiated Rate |
$8,170.20 |
| Rate for Payer: Aetna Commercial |
$7,716.30
|
| Rate for Payer: BCBS Trust/PPO |
$7,410.37
|
| Rate for Payer: BCN Commercial |
$7,015.48
|
| Rate for Payer: Cash Price |
$7,262.40
|
| Rate for Payer: Cofinity Commercial |
$7,807.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.40
|
| Rate for Payer: Healthscope Commercial |
$8,170.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,808.50
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.30
|
| Rate for Payer: Nomi Health Commercial |
$7,443.96
|
| Rate for Payer: PHP Commercial |
$7,716.30
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,900.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,897.86
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,082.26
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,988.64
|
| Rate for Payer: UHC Core |
$7,580.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,808.50
|
|
|
HC PLACE STENT INTRATHORACIC COMMON CAROTID OR INNOMINATE ARTERY
|
Facility
|
OP
|
$9,078.00
|
|
|
Service Code
|
CPT 37218
|
| Hospital Charge Code |
36100517
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,156.03 |
| Max. Negotiated Rate |
$8,170.20 |
| Rate for Payer: Aetna Commercial |
$7,716.30
|
| Rate for Payer: Aetna Medicare |
$2,360.28
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,836.88
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,836.88
|
| Rate for Payer: BCBS Complete |
$3,631.20
|
| Rate for Payer: BCBS MAPPO |
$2,269.50
|
| Rate for Payer: BCBS Trust/PPO |
$7,463.02
|
| Rate for Payer: BCN Commercial |
$7,058.15
|
| Rate for Payer: BCN Medicare Advantage |
$2,269.50
|
| Rate for Payer: Cash Price |
$7,262.40
|
| Rate for Payer: Cofinity Commercial |
$7,807.08
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$7,262.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,269.50
|
| Rate for Payer: Healthscope Commercial |
$8,170.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$6,808.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,382.97
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,609.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$7,716.30
|
| Rate for Payer: Nomi Health Commercial |
$7,443.96
|
| Rate for Payer: PACE Senior Care Partners |
$2,156.03
|
| Rate for Payer: PACE SWMI |
$2,269.50
|
| Rate for Payer: PHP Commercial |
$7,716.30
|
| Rate for Payer: PHP Medicare Advantage |
$2,269.50
|
| Rate for Payer: Priority Health Cigna Priority Health |
$5,900.70
|
| Rate for Payer: Priority Health HMO/PPO |
$7,897.86
|
| Rate for Payer: Priority Health Medicare |
$2,292.20
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$6,082.26
|
| Rate for Payer: Railroad Medicare Medicare |
$2,269.50
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$7,988.64
|
| Rate for Payer: UHC Core |
$7,580.13
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,269.50
|
| Rate for Payer: UHC Exchange |
$2,269.50
|
| Rate for Payer: UHC Medicare Advantage |
$2,269.50
|
| Rate for Payer: VA VA |
$2,269.50
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$6,808.50
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
OP
|
$331.21
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$78.66 |
| Max. Negotiated Rate |
$2,618.46 |
| Rate for Payer: Aetna Commercial |
$281.53
|
| Rate for Payer: Aetna Medicare |
$86.11
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$103.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$103.50
|
| Rate for Payer: BCBS Complete |
$2,618.46
|
| Rate for Payer: BCBS MAPPO |
$82.80
|
| Rate for Payer: BCBS Trust/PPO |
$272.29
|
| Rate for Payer: BCN Commercial |
$257.52
|
| Rate for Payer: BCN Medicare Advantage |
$82.80
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cofinity Commercial |
$284.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.97
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$82.80
|
| Rate for Payer: Healthscope Commercial |
$298.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.41
|
| Rate for Payer: Mclaren Medicaid |
$2,493.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$86.94
|
| Rate for Payer: Meridian Medicaid |
$2,618.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$95.22
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.53
|
| Rate for Payer: Nomi Health Commercial |
$271.59
|
| Rate for Payer: PACE Senior Care Partners |
$78.66
|
| Rate for Payer: PACE SWMI |
$82.80
|
| Rate for Payer: PHP Commercial |
$281.53
|
| Rate for Payer: PHP Medicare Advantage |
$82.80
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,493.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.29
|
| Rate for Payer: Priority Health HMO/PPO |
$288.15
|
| Rate for Payer: Priority Health Medicare |
$83.63
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.91
|
| Rate for Payer: Railroad Medicare Medicare |
$82.80
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.46
|
| Rate for Payer: UHC Core |
$276.56
|
| Rate for Payer: UHC Dual Complete DSNP |
$82.80
|
| Rate for Payer: UHC Exchange |
$82.80
|
| Rate for Payer: UHC Medicare Advantage |
$82.80
|
| Rate for Payer: UHCCP Medicaid |
$2,493.61
|
| Rate for Payer: VA VA |
$82.80
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.41
|
|
|
HC PLACE URETERAL STENT NEW ACCESS WO NEPHROSTOMY CATH
|
Facility
|
IP
|
$331.21
|
|
|
Service Code
|
CPT 50694
|
| Hospital Charge Code |
36100509
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$215.29 |
| Max. Negotiated Rate |
$298.09 |
| Rate for Payer: Aetna Commercial |
$281.53
|
| Rate for Payer: BCBS Trust/PPO |
$270.37
|
| Rate for Payer: BCN Commercial |
$255.96
|
| Rate for Payer: Cash Price |
$264.97
|
| Rate for Payer: Cofinity Commercial |
$284.84
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$264.97
|
| Rate for Payer: Healthscope Commercial |
$298.09
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.41
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$281.53
|
| Rate for Payer: Nomi Health Commercial |
$271.59
|
| Rate for Payer: PHP Commercial |
$281.53
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.29
|
| Rate for Payer: Priority Health HMO/PPO |
$288.15
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$221.91
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$291.46
|
| Rate for Payer: UHC Core |
$276.56
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.41
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
IP
|
$3,643.30
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,368.14 |
| Max. Negotiated Rate |
$3,278.97 |
| Rate for Payer: Aetna Commercial |
$3,096.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,974.03
|
| Rate for Payer: BCN Commercial |
$2,815.54
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,133.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Healthscope Commercial |
$3,278.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,732.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: Nomi Health Commercial |
$2,987.51
|
| Rate for Payer: PHP Commercial |
$3,096.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health HMO/PPO |
$3,169.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,441.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,206.10
|
| Rate for Payer: UHC Core |
$3,042.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,732.47
|
|
|
HC PLACE URETERAL STENT NEW ACCESS W SEPARATE NEPHROSTOMY CATH
|
Facility
|
OP
|
$3,643.30
|
|
|
Service Code
|
CPT 50695
|
| Hospital Charge Code |
36100510
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$865.28 |
| Max. Negotiated Rate |
$3,278.97 |
| Rate for Payer: Aetna Commercial |
$3,096.80
|
| Rate for Payer: Aetna Medicare |
$947.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,138.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,138.53
|
| Rate for Payer: BCBS Complete |
$2,618.46
|
| Rate for Payer: BCBS MAPPO |
$910.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,995.16
|
| Rate for Payer: BCN Commercial |
$2,832.67
|
| Rate for Payer: BCN Medicare Advantage |
$910.83
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,133.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.83
|
| Rate for Payer: Healthscope Commercial |
$3,278.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,732.47
|
| Rate for Payer: Mclaren Medicaid |
$2,493.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$956.37
|
| Rate for Payer: Meridian Medicaid |
$2,618.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,047.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: Nomi Health Commercial |
$2,987.51
|
| Rate for Payer: PACE Senior Care Partners |
$865.28
|
| Rate for Payer: PACE SWMI |
$910.83
|
| Rate for Payer: PHP Commercial |
$3,096.80
|
| Rate for Payer: PHP Medicare Advantage |
$910.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,493.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health HMO/PPO |
$3,169.67
|
| Rate for Payer: Priority Health Medicare |
$919.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,441.01
|
| Rate for Payer: Railroad Medicare Medicare |
$910.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,206.10
|
| Rate for Payer: UHC Core |
$3,042.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$910.83
|
| Rate for Payer: UHC Exchange |
$910.83
|
| Rate for Payer: UHC Medicare Advantage |
$910.83
|
| Rate for Payer: UHCCP Medicaid |
$2,493.61
|
| Rate for Payer: VA VA |
$910.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,732.47
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
OP
|
$3,643.30
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$865.28 |
| Max. Negotiated Rate |
$3,278.97 |
| Rate for Payer: Aetna Commercial |
$3,096.80
|
| Rate for Payer: Aetna Medicare |
$947.26
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,138.53
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,138.53
|
| Rate for Payer: BCBS Complete |
$2,618.46
|
| Rate for Payer: BCBS MAPPO |
$910.83
|
| Rate for Payer: BCBS Trust/PPO |
$2,995.16
|
| Rate for Payer: BCN Commercial |
$2,832.67
|
| Rate for Payer: BCN Medicare Advantage |
$910.83
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,133.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$910.83
|
| Rate for Payer: Healthscope Commercial |
$3,278.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,732.47
|
| Rate for Payer: Mclaren Medicaid |
$2,493.61
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$956.37
|
| Rate for Payer: Meridian Medicaid |
$2,618.46
|
| Rate for Payer: MI Amish Medical Board Commercial |
$1,047.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: Nomi Health Commercial |
$2,987.51
|
| Rate for Payer: PACE Senior Care Partners |
$865.28
|
| Rate for Payer: PACE SWMI |
$910.83
|
| Rate for Payer: PHP Commercial |
$3,096.80
|
| Rate for Payer: PHP Medicare Advantage |
$910.83
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,493.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health HMO/PPO |
$3,169.67
|
| Rate for Payer: Priority Health Medicare |
$919.93
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,441.01
|
| Rate for Payer: Railroad Medicare Medicare |
$910.83
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,206.10
|
| Rate for Payer: UHC Core |
$3,042.16
|
| Rate for Payer: UHC Dual Complete DSNP |
$910.83
|
| Rate for Payer: UHC Exchange |
$910.83
|
| Rate for Payer: UHC Medicare Advantage |
$910.83
|
| Rate for Payer: UHCCP Medicaid |
$2,493.61
|
| Rate for Payer: VA VA |
$910.83
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,732.47
|
|
|
HC PLACE URETERAL STENT PRE EXISTING NEPHROSTOMY TRACT
|
Facility
|
IP
|
$3,643.30
|
|
|
Service Code
|
CPT 50693
|
| Hospital Charge Code |
36100508
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,368.14 |
| Max. Negotiated Rate |
$3,278.97 |
| Rate for Payer: Aetna Commercial |
$3,096.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,974.03
|
| Rate for Payer: BCN Commercial |
$2,815.54
|
| Rate for Payer: Cash Price |
$2,914.64
|
| Rate for Payer: Cofinity Commercial |
$3,133.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,914.64
|
| Rate for Payer: Healthscope Commercial |
$3,278.97
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,732.47
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,096.80
|
| Rate for Payer: Nomi Health Commercial |
$2,987.51
|
| Rate for Payer: PHP Commercial |
$3,096.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,368.14
|
| Rate for Payer: Priority Health HMO/PPO |
$3,169.67
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,441.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$3,206.10
|
| Rate for Payer: UHC Core |
$3,042.16
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,732.47
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
OP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.49 |
| Max. Negotiated Rate |
$241.43 |
| Rate for Payer: Aetna Commercial |
$228.02
|
| Rate for Payer: Aetna Medicare |
$69.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$83.83
|
| Rate for Payer: Amish Plain Church Group Commercial |
$83.83
|
| Rate for Payer: BCBS Complete |
$16.26
|
| Rate for Payer: BCBS MAPPO |
$67.06
|
| Rate for Payer: BCBS Trust/PPO |
$220.54
|
| Rate for Payer: BCN Commercial |
$208.57
|
| Rate for Payer: BCN Medicare Advantage |
$67.06
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$230.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$67.06
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.19
|
| Rate for Payer: Mclaren Medicaid |
$15.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$70.42
|
| Rate for Payer: Meridian Medicaid |
$16.26
|
| Rate for Payer: MI Amish Medical Board Commercial |
$77.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: Nomi Health Commercial |
$219.97
|
| Rate for Payer: PACE Senior Care Partners |
$63.71
|
| Rate for Payer: PACE SWMI |
$67.06
|
| Rate for Payer: PHP Commercial |
$228.02
|
| Rate for Payer: PHP Medicare Advantage |
$67.06
|
| Rate for Payer: Priority Health Choice Medicaid |
$15.49
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health HMO/PPO |
$233.39
|
| Rate for Payer: Priority Health Medicare |
$67.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.73
|
| Rate for Payer: Railroad Medicare Medicare |
$67.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.07
|
| Rate for Payer: UHC Core |
$224.00
|
| Rate for Payer: UHC Dual Complete DSNP |
$67.06
|
| Rate for Payer: UHC Exchange |
$67.06
|
| Rate for Payer: UHC Medicare Advantage |
$67.06
|
| Rate for Payer: UHCCP Medicaid |
$15.49
|
| Rate for Payer: VA VA |
$67.06
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.19
|
|
|
HC PLASMA CELL PCPD FISH.
|
Facility
|
IP
|
$268.26
|
|
|
Service Code
|
CPT 88271
|
| Hospital Charge Code |
31100044
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$174.37 |
| Max. Negotiated Rate |
$241.43 |
| Rate for Payer: Aetna Commercial |
$228.02
|
| Rate for Payer: BCBS Trust/PPO |
$218.98
|
| Rate for Payer: BCN Commercial |
$207.31
|
| Rate for Payer: Cash Price |
$214.61
|
| Rate for Payer: Cofinity Commercial |
$230.70
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$214.61
|
| Rate for Payer: Healthscope Commercial |
$241.43
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$201.19
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$228.02
|
| Rate for Payer: Nomi Health Commercial |
$219.97
|
| Rate for Payer: PHP Commercial |
$228.02
|
| Rate for Payer: Priority Health Cigna Priority Health |
$174.37
|
| Rate for Payer: Priority Health HMO/PPO |
$233.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$179.73
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$236.07
|
| Rate for Payer: UHC Core |
$224.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$201.19
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
OP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$37.61 |
| Max. Negotiated Rate |
$273.10 |
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: Aetna Medicare |
$41.17
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$49.49
|
| Rate for Payer: Amish Plain Church Group Commercial |
$49.49
|
| Rate for Payer: BCBS Complete |
$273.10
|
| Rate for Payer: BCBS MAPPO |
$39.59
|
| Rate for Payer: BCBS Trust/PPO |
$130.19
|
| Rate for Payer: BCN Commercial |
$123.12
|
| Rate for Payer: BCN Medicare Advantage |
$39.59
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$136.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$39.59
|
| Rate for Payer: Healthscope Commercial |
$142.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.77
|
| Rate for Payer: Mclaren Medicaid |
$260.08
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$41.57
|
| Rate for Payer: Meridian Medicaid |
$273.10
|
| Rate for Payer: MI Amish Medical Board Commercial |
$45.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: Nomi Health Commercial |
$129.86
|
| Rate for Payer: PACE Senior Care Partners |
$37.61
|
| Rate for Payer: PACE SWMI |
$39.59
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: PHP Medicare Advantage |
$39.59
|
| Rate for Payer: Priority Health Choice Medicaid |
$260.08
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: Priority Health HMO/PPO |
$137.77
|
| Rate for Payer: Priority Health Medicare |
$39.99
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.10
|
| Rate for Payer: Railroad Medicare Medicare |
$39.59
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.36
|
| Rate for Payer: UHC Core |
$132.23
|
| Rate for Payer: UHC Dual Complete DSNP |
$39.59
|
| Rate for Payer: UHC Exchange |
$39.59
|
| Rate for Payer: UHC Medicare Advantage |
$39.59
|
| Rate for Payer: UHCCP Medicaid |
$260.08
|
| Rate for Payer: VA VA |
$39.59
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.77
|
|
|
HC PLASMA CELL PROLIFERATION, MARROW CMPT 1
|
Facility
|
IP
|
$158.36
|
|
|
Service Code
|
CPT 88184
|
| Hospital Charge Code |
31000139
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$102.93 |
| Max. Negotiated Rate |
$142.52 |
| Rate for Payer: Aetna Commercial |
$134.61
|
| Rate for Payer: BCBS Trust/PPO |
$129.27
|
| Rate for Payer: BCN Commercial |
$122.38
|
| Rate for Payer: Cash Price |
$126.69
|
| Rate for Payer: Cofinity Commercial |
$136.19
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$126.69
|
| Rate for Payer: Healthscope Commercial |
$142.52
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$118.77
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$134.61
|
| Rate for Payer: Nomi Health Commercial |
$129.86
|
| Rate for Payer: PHP Commercial |
$134.61
|
| Rate for Payer: Priority Health Cigna Priority Health |
$102.93
|
| Rate for Payer: Priority Health HMO/PPO |
$137.77
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$106.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$139.36
|
| Rate for Payer: UHC Core |
$132.23
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$118.77
|
|
|
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 PROLIFERATION, MARROW CMPT 2
|
Facility
|
OP
|
$52.24
|
|
|
Service Code
|
CPT 88185
|
| Hospital Charge Code |
31000140
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$12.41 |
| Max. Negotiated Rate |
$47.02 |
| Rate for Payer: Aetna Commercial |
$44.40
|
| Rate for Payer: Aetna Medicare |
$13.58
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$16.32
|
| Rate for Payer: Amish Plain Church Group Commercial |
$16.32
|
| Rate for Payer: BCBS Complete |
$20.90
|
| Rate for Payer: BCBS MAPPO |
$13.06
|
| Rate for Payer: BCBS Trust/PPO |
$42.95
|
| Rate for Payer: BCN Commercial |
$40.62
|
| Rate for Payer: BCN Medicare Advantage |
$13.06
|
| 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: Health Alliance Plan Medicare Advantage |
$13.06
|
| Rate for Payer: Healthscope Commercial |
$47.02
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$39.18
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$13.71
|
| Rate for Payer: MI Amish Medical Board Commercial |
$15.02
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$44.40
|
| Rate for Payer: Nomi Health Commercial |
$42.84
|
| Rate for Payer: PACE Senior Care Partners |
$12.41
|
| Rate for Payer: PACE SWMI |
$13.06
|
| Rate for Payer: PHP Commercial |
$44.40
|
| Rate for Payer: PHP Medicare Advantage |
$13.06
|
| Rate for Payer: Priority Health Cigna Priority Health |
$33.96
|
| Rate for Payer: Priority Health HMO/PPO |
$45.45
|
| Rate for Payer: Priority Health Medicare |
$13.19
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$35.00
|
| Rate for Payer: Railroad Medicare Medicare |
$13.06
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$45.97
|
| Rate for Payer: UHC Core |
$43.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$13.06
|
| Rate for Payer: UHC Exchange |
$13.06
|
| Rate for Payer: UHC Medicare Advantage |
$13.06
|
| Rate for Payer: VA VA |
$13.06
|
| 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 |
$40.56
|
| 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 |
$38.63
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$30.34
|
| Rate for Payer: Meridian Medicaid |
$40.56
|
| 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 |
$38.63
|
| 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 |
$38.63
|
| Rate for Payer: VA VA |
$28.89
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$86.68
|
|
|
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 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 |
$111.83
|
| 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 |
$106.50
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$42.03
|
| Rate for Payer: Meridian Medicaid |
$111.83
|
| 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 |
$106.50
|
| 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 |
$106.50
|
| Rate for Payer: VA VA |
$40.03
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$120.09
|
|
|
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 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 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
|
|
