|
HC RISTOCETIN COFACTOR
|
Facility
|
IP
|
$69.08
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$44.90 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Aetna Commercial |
$58.72
|
| Rate for Payer: BCBS Trust/PPO |
$56.39
|
| Rate for Payer: BCN Commercial |
$53.39
|
| Rate for Payer: Cash Price |
$55.26
|
| Rate for Payer: Cofinity Commercial |
$59.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.26
|
| Rate for Payer: Healthscope Commercial |
$62.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.81
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.72
|
| Rate for Payer: Nomi Health Commercial |
$56.65
|
| Rate for Payer: PHP Commercial |
$58.72
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.90
|
| Rate for Payer: Priority Health HMO/PPO |
$60.10
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.28
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.79
|
| Rate for Payer: UHC Core |
$57.68
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.81
|
|
|
HC RISTOCETIN COFACTOR
|
Facility
|
OP
|
$69.08
|
|
|
Service Code
|
CPT 85245
|
| Hospital Charge Code |
30500023
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$16.41 |
| Max. Negotiated Rate |
$62.17 |
| Rate for Payer: Aetna Commercial |
$58.72
|
| Rate for Payer: Aetna Medicare |
$17.96
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$21.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$21.59
|
| Rate for Payer: BCBS Complete |
$17.42
|
| Rate for Payer: BCBS MAPPO |
$17.27
|
| Rate for Payer: BCBS Trust/PPO |
$56.79
|
| Rate for Payer: BCN Commercial |
$53.71
|
| Rate for Payer: BCN Medicare Advantage |
$17.27
|
| Rate for Payer: Cash Price |
$55.26
|
| Rate for Payer: Cash Price |
$55.26
|
| Rate for Payer: Cofinity Commercial |
$59.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$55.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.27
|
| Rate for Payer: Healthscope Commercial |
$62.17
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$51.81
|
| Rate for Payer: Mclaren Medicaid |
$16.59
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.13
|
| Rate for Payer: Meridian Medicaid |
$17.42
|
| Rate for Payer: MI Amish Medical Board Commercial |
$19.86
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$58.72
|
| Rate for Payer: Nomi Health Commercial |
$56.65
|
| Rate for Payer: PACE Senior Care Partners |
$16.41
|
| Rate for Payer: PACE SWMI |
$17.27
|
| Rate for Payer: PHP Commercial |
$58.72
|
| Rate for Payer: PHP Medicare Advantage |
$17.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$16.59
|
| Rate for Payer: Priority Health Cigna Priority Health |
$44.90
|
| Rate for Payer: Priority Health HMO/PPO |
$60.10
|
| Rate for Payer: Priority Health Medicare |
$17.44
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$46.28
|
| Rate for Payer: Railroad Medicare Medicare |
$17.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$60.79
|
| Rate for Payer: UHC Core |
$57.68
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.27
|
| Rate for Payer: UHC Exchange |
$17.27
|
| Rate for Payer: UHC Medicare Advantage |
$17.27
|
| Rate for Payer: UHCCP Medicaid |
$16.59
|
| Rate for Payer: VA VA |
$17.27
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$51.81
|
|
|
HC RIV 4 VACC RECOMBINANT DNA PRSRV ABX FREE
|
Facility
|
OP
|
$95.17
|
|
|
Service Code
|
CPT 90682
|
| Hospital Charge Code |
63600171
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.60 |
| Max. Negotiated Rate |
$85.65 |
| Rate for Payer: Aetna Commercial |
$80.89
|
| Rate for Payer: Aetna Medicare |
$24.74
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$29.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$29.74
|
| Rate for Payer: BCBS Complete |
$38.07
|
| Rate for Payer: BCBS MAPPO |
$23.79
|
| Rate for Payer: BCBS Trust/PPO |
$78.24
|
| Rate for Payer: BCN Commercial |
$73.99
|
| Rate for Payer: BCN Medicare Advantage |
$23.79
|
| Rate for Payer: Cash Price |
$76.14
|
| Rate for Payer: Cofinity Commercial |
$81.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$23.79
|
| Rate for Payer: Healthscope Commercial |
$85.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.38
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$24.98
|
| Rate for Payer: MI Amish Medical Board Commercial |
$27.36
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.89
|
| Rate for Payer: Nomi Health Commercial |
$78.04
|
| Rate for Payer: PACE Senior Care Partners |
$22.60
|
| Rate for Payer: PACE SWMI |
$23.79
|
| Rate for Payer: PHP Commercial |
$80.89
|
| Rate for Payer: PHP Medicare Advantage |
$23.79
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.86
|
| Rate for Payer: Priority Health HMO/PPO |
$82.80
|
| Rate for Payer: Priority Health Medicare |
$24.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.76
|
| Rate for Payer: Railroad Medicare Medicare |
$23.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.75
|
| Rate for Payer: UHC Core |
$79.47
|
| Rate for Payer: UHC Dual Complete DSNP |
$23.79
|
| Rate for Payer: UHC Exchange |
$23.79
|
| Rate for Payer: UHC Medicare Advantage |
$23.79
|
| Rate for Payer: VA VA |
$23.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.38
|
|
|
HC RIV 4 VACC RECOMBINANT DNA PRSRV ABX FREE
|
Facility
|
IP
|
$95.17
|
|
|
Service Code
|
CPT 90682
|
| Hospital Charge Code |
63600171
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.86 |
| Max. Negotiated Rate |
$85.65 |
| Rate for Payer: Aetna Commercial |
$80.89
|
| Rate for Payer: BCBS Trust/PPO |
$77.69
|
| Rate for Payer: BCN Commercial |
$73.55
|
| Rate for Payer: Cash Price |
$76.14
|
| Rate for Payer: Cofinity Commercial |
$81.85
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$76.14
|
| Rate for Payer: Healthscope Commercial |
$85.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$71.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$80.89
|
| Rate for Payer: Nomi Health Commercial |
$78.04
|
| Rate for Payer: PHP Commercial |
$80.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$61.86
|
| Rate for Payer: Priority Health HMO/PPO |
$82.80
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$63.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$83.75
|
| Rate for Payer: UHC Core |
$79.47
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$71.38
|
|
|
HC RLC W INTERVENTION
|
Facility
|
OP
|
$11,199.49
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100020
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$2,325.46 |
| Max. Negotiated Rate |
$10,079.54 |
| Rate for Payer: Aetna Commercial |
$9,519.57
|
| Rate for Payer: Aetna Medicare |
$2,911.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$3,499.84
|
| Rate for Payer: Amish Plain Church Group Commercial |
$3,499.84
|
| Rate for Payer: BCBS Complete |
$2,441.90
|
| Rate for Payer: BCBS MAPPO |
$2,799.87
|
| Rate for Payer: BCBS Trust/PPO |
$9,207.10
|
| Rate for Payer: BCN Commercial |
$8,707.60
|
| Rate for Payer: BCN Medicare Advantage |
$2,799.87
|
| Rate for Payer: Cash Price |
$8,959.59
|
| Rate for Payer: Cash Price |
$8,959.59
|
| Rate for Payer: Cofinity Commercial |
$9,631.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,959.59
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,799.87
|
| Rate for Payer: Healthscope Commercial |
$10,079.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,399.62
|
| Rate for Payer: Mclaren Medicaid |
$2,325.46
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,939.87
|
| Rate for Payer: Meridian Medicaid |
$2,441.90
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,219.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,519.57
|
| Rate for Payer: Nomi Health Commercial |
$9,183.58
|
| Rate for Payer: PACE Senior Care Partners |
$2,659.88
|
| Rate for Payer: PACE SWMI |
$2,799.87
|
| Rate for Payer: PHP Commercial |
$9,519.57
|
| Rate for Payer: PHP Medicare Advantage |
$2,799.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$2,325.46
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,279.67
|
| Rate for Payer: Priority Health HMO/PPO |
$9,743.56
|
| Rate for Payer: Priority Health Medicare |
$2,827.87
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,503.66
|
| Rate for Payer: Railroad Medicare Medicare |
$2,799.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,855.55
|
| Rate for Payer: UHC Core |
$9,351.57
|
| Rate for Payer: UHC Dual Complete DSNP |
$2,799.87
|
| Rate for Payer: UHC Exchange |
$2,799.87
|
| Rate for Payer: UHC Medicare Advantage |
$2,799.87
|
| Rate for Payer: UHCCP Medicaid |
$2,325.46
|
| Rate for Payer: VA VA |
$2,799.87
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,399.62
|
|
|
HC RLC W INTERVENTION
|
Facility
|
IP
|
$11,199.49
|
|
|
Service Code
|
CPT 93460
|
| Hospital Charge Code |
48100020
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$7,279.67 |
| Max. Negotiated Rate |
$10,079.54 |
| Rate for Payer: Aetna Commercial |
$9,519.57
|
| Rate for Payer: BCBS Trust/PPO |
$9,142.14
|
| Rate for Payer: BCN Commercial |
$8,654.97
|
| Rate for Payer: Cash Price |
$8,959.59
|
| Rate for Payer: Cofinity Commercial |
$9,631.56
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$8,959.59
|
| Rate for Payer: Healthscope Commercial |
$10,079.54
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$8,399.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$9,519.57
|
| Rate for Payer: Nomi Health Commercial |
$9,183.58
|
| Rate for Payer: PHP Commercial |
$9,519.57
|
| Rate for Payer: Priority Health Cigna Priority Health |
$7,279.67
|
| Rate for Payer: Priority Health HMO/PPO |
$9,743.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$7,503.66
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$9,855.55
|
| Rate for Payer: UHC Core |
$9,351.57
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$8,399.62
|
|
|
HC RMVL EMBEDDED FB VESTIBULE MOUTH SMPL
|
Facility
|
OP
|
$2,397.00
|
|
|
Service Code
|
CPT 40804
|
| Hospital Charge Code |
76100458
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$569.29 |
| Max. Negotiated Rate |
$2,157.30 |
| Rate for Payer: Aetna Commercial |
$2,037.45
|
| Rate for Payer: Aetna Medicare |
$623.22
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$749.06
|
| Rate for Payer: Amish Plain Church Group Commercial |
$749.06
|
| Rate for Payer: BCBS Complete |
$711.80
|
| Rate for Payer: BCBS MAPPO |
$599.25
|
| Rate for Payer: BCBS Trust/PPO |
$1,970.57
|
| Rate for Payer: BCN Commercial |
$1,863.67
|
| Rate for Payer: BCN Medicare Advantage |
$599.25
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cofinity Commercial |
$2,061.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,917.60
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$599.25
|
| Rate for Payer: Healthscope Commercial |
$2,157.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,797.75
|
| Rate for Payer: Mclaren Medicaid |
$677.86
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$629.21
|
| Rate for Payer: Meridian Medicaid |
$711.80
|
| Rate for Payer: MI Amish Medical Board Commercial |
$689.14
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,037.45
|
| Rate for Payer: Nomi Health Commercial |
$1,965.54
|
| Rate for Payer: PACE Senior Care Partners |
$569.29
|
| Rate for Payer: PACE SWMI |
$599.25
|
| Rate for Payer: PHP Commercial |
$2,037.45
|
| Rate for Payer: PHP Medicare Advantage |
$599.25
|
| Rate for Payer: Priority Health Choice Medicaid |
$677.86
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,085.39
|
| Rate for Payer: Priority Health Medicare |
$605.24
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,605.99
|
| Rate for Payer: Railroad Medicare Medicare |
$599.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,109.36
|
| Rate for Payer: UHC Core |
$2,001.49
|
| Rate for Payer: UHC Dual Complete DSNP |
$599.25
|
| Rate for Payer: UHC Exchange |
$599.25
|
| Rate for Payer: UHC Medicare Advantage |
$599.25
|
| Rate for Payer: UHCCP Medicaid |
$677.86
|
| Rate for Payer: VA VA |
$599.25
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,797.75
|
|
|
HC RMVL EMBEDDED FB VESTIBULE MOUTH SMPL
|
Facility
|
IP
|
$2,397.00
|
|
|
Service Code
|
CPT 40804
|
| Hospital Charge Code |
76100458
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,558.05 |
| Max. Negotiated Rate |
$2,157.30 |
| Rate for Payer: Aetna Commercial |
$2,037.45
|
| Rate for Payer: BCBS Trust/PPO |
$1,956.67
|
| Rate for Payer: BCN Commercial |
$1,852.40
|
| Rate for Payer: Cash Price |
$1,917.60
|
| Rate for Payer: Cofinity Commercial |
$2,061.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,917.60
|
| Rate for Payer: Healthscope Commercial |
$2,157.30
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$1,797.75
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,037.45
|
| Rate for Payer: Nomi Health Commercial |
$1,965.54
|
| Rate for Payer: PHP Commercial |
$2,037.45
|
| Rate for Payer: Priority Health Cigna Priority Health |
$1,558.05
|
| Rate for Payer: Priority Health HMO/PPO |
$2,085.39
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$1,605.99
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,109.36
|
| Rate for Payer: UHC Core |
$2,001.49
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$1,797.75
|
|
|
HC RMVL FB XTRNL EYE CORNEAL W SLIT LAMP
|
Facility
|
OP
|
$359.00
|
|
|
Service Code
|
CPT 65222
|
| Hospital Charge Code |
76200521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$85.26 |
| Max. Negotiated Rate |
$323.10 |
| Rate for Payer: Aetna Commercial |
$305.15
|
| Rate for Payer: Aetna Medicare |
$93.34
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$112.19
|
| Rate for Payer: Amish Plain Church Group Commercial |
$112.19
|
| Rate for Payer: BCBS Complete |
$97.86
|
| Rate for Payer: BCBS MAPPO |
$89.75
|
| Rate for Payer: BCBS Trust/PPO |
$295.13
|
| Rate for Payer: BCN Commercial |
$279.12
|
| Rate for Payer: BCN Medicare Advantage |
$89.75
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$308.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$89.75
|
| Rate for Payer: Healthscope Commercial |
$323.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.25
|
| Rate for Payer: Mclaren Medicaid |
$93.19
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$94.24
|
| Rate for Payer: Meridian Medicaid |
$97.86
|
| Rate for Payer: MI Amish Medical Board Commercial |
$103.21
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: Nomi Health Commercial |
$294.38
|
| Rate for Payer: PACE Senior Care Partners |
$85.26
|
| Rate for Payer: PACE SWMI |
$89.75
|
| Rate for Payer: PHP Commercial |
$305.15
|
| Rate for Payer: PHP Medicare Advantage |
$89.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$93.19
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO |
$312.33
|
| Rate for Payer: Priority Health Medicare |
$90.65
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.53
|
| Rate for Payer: Railroad Medicare Medicare |
$89.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.92
|
| Rate for Payer: UHC Core |
$299.76
|
| Rate for Payer: UHC Dual Complete DSNP |
$89.75
|
| Rate for Payer: UHC Exchange |
$89.75
|
| Rate for Payer: UHC Medicare Advantage |
$89.75
|
| Rate for Payer: UHCCP Medicaid |
$93.19
|
| Rate for Payer: VA VA |
$89.75
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.25
|
|
|
HC RMVL FB XTRNL EYE CORNEAL W SLIT LAMP
|
Facility
|
IP
|
$359.00
|
|
|
Service Code
|
CPT 65222
|
| Hospital Charge Code |
76200521
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$233.35 |
| Max. Negotiated Rate |
$323.10 |
| Rate for Payer: Aetna Commercial |
$305.15
|
| Rate for Payer: BCBS Trust/PPO |
$293.05
|
| Rate for Payer: BCN Commercial |
$277.44
|
| Rate for Payer: Cash Price |
$287.20
|
| Rate for Payer: Cofinity Commercial |
$308.74
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$287.20
|
| Rate for Payer: Healthscope Commercial |
$323.10
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$269.25
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$305.15
|
| Rate for Payer: Nomi Health Commercial |
$294.38
|
| Rate for Payer: PHP Commercial |
$305.15
|
| Rate for Payer: Priority Health Cigna Priority Health |
$233.35
|
| Rate for Payer: Priority Health HMO/PPO |
$312.33
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$240.53
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$315.92
|
| Rate for Payer: UHC Core |
$299.76
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$269.25
|
|
|
HC RNA POLYMERASE III AB IGG
|
Facility
|
IP
|
$71.40
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200413
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$46.41 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: BCBS Trust/PPO |
$58.28
|
| Rate for Payer: BCN Commercial |
$55.18
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO |
$62.12
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.84
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.83
|
| Rate for Payer: UHC Core |
$59.62
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC RNA POLYMERASE III AB IGG
|
Facility
|
OP
|
$71.40
|
|
|
Service Code
|
CPT 83516
|
| Hospital Charge Code |
30200413
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.34 |
| Max. Negotiated Rate |
$64.26 |
| Rate for Payer: Aetna Commercial |
$60.69
|
| Rate for Payer: Aetna Medicare |
$18.56
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$22.31
|
| Rate for Payer: Amish Plain Church Group Commercial |
$22.31
|
| Rate for Payer: BCBS Complete |
$8.75
|
| Rate for Payer: BCBS MAPPO |
$17.85
|
| Rate for Payer: BCBS Trust/PPO |
$58.70
|
| Rate for Payer: BCN Commercial |
$55.51
|
| Rate for Payer: BCN Medicare Advantage |
$17.85
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cash Price |
$57.12
|
| Rate for Payer: Cofinity Commercial |
$61.40
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$57.12
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$17.85
|
| Rate for Payer: Healthscope Commercial |
$64.26
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$53.55
|
| Rate for Payer: Mclaren Medicaid |
$8.34
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$18.74
|
| Rate for Payer: Meridian Medicaid |
$8.75
|
| Rate for Payer: MI Amish Medical Board Commercial |
$20.53
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$60.69
|
| Rate for Payer: Nomi Health Commercial |
$58.55
|
| Rate for Payer: PACE Senior Care Partners |
$16.96
|
| Rate for Payer: PACE SWMI |
$17.85
|
| Rate for Payer: PHP Commercial |
$60.69
|
| Rate for Payer: PHP Medicare Advantage |
$17.85
|
| Rate for Payer: Priority Health Choice Medicaid |
$8.34
|
| Rate for Payer: Priority Health Cigna Priority Health |
$46.41
|
| Rate for Payer: Priority Health HMO/PPO |
$62.12
|
| Rate for Payer: Priority Health Medicare |
$18.03
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$47.84
|
| Rate for Payer: Railroad Medicare Medicare |
$17.85
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$62.83
|
| Rate for Payer: UHC Core |
$59.62
|
| Rate for Payer: UHC Dual Complete DSNP |
$17.85
|
| Rate for Payer: UHC Exchange |
$17.85
|
| Rate for Payer: UHC Medicare Advantage |
$17.85
|
| Rate for Payer: UHCCP Medicaid |
$8.34
|
| Rate for Payer: VA VA |
$17.85
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$53.55
|
|
|
HC RNP 70 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200164
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP 70 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200164
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP ANTIBODIES, IGG
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200434
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP ANTIBODIES, IGG
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200434
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP U1 ANTIBODY
|
Facility
|
OP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$8.35 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: Aetna Medicare |
$9.14
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$10.99
|
| Rate for Payer: Amish Plain Church Group Commercial |
$10.99
|
| Rate for Payer: BCBS Complete |
$13.61
|
| Rate for Payer: BCBS MAPPO |
$8.79
|
| Rate for Payer: BCBS Trust/PPO |
$28.91
|
| Rate for Payer: BCN Commercial |
$27.34
|
| Rate for Payer: BCN Medicare Advantage |
$8.79
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$8.79
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Mclaren Medicaid |
$12.96
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$9.23
|
| Rate for Payer: Meridian Medicaid |
$13.61
|
| Rate for Payer: MI Amish Medical Board Commercial |
$10.11
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PACE Senior Care Partners |
$8.35
|
| Rate for Payer: PACE SWMI |
$8.79
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: PHP Medicare Advantage |
$8.79
|
| Rate for Payer: Priority Health Choice Medicaid |
$12.96
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Medicare |
$8.88
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: Railroad Medicare Medicare |
$8.79
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: UHC Dual Complete DSNP |
$8.79
|
| Rate for Payer: UHC Exchange |
$8.79
|
| Rate for Payer: UHC Medicare Advantage |
$8.79
|
| Rate for Payer: UHCCP Medicaid |
$12.96
|
| Rate for Payer: VA VA |
$8.79
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RNP U1 ANTIBODY
|
Facility
|
IP
|
$35.17
|
|
|
Service Code
|
CPT 86235
|
| Hospital Charge Code |
30200166
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$22.86 |
| Max. Negotiated Rate |
$31.65 |
| Rate for Payer: Aetna Commercial |
$29.89
|
| Rate for Payer: BCBS Trust/PPO |
$28.71
|
| Rate for Payer: BCN Commercial |
$27.18
|
| Rate for Payer: Cash Price |
$28.14
|
| Rate for Payer: Cofinity Commercial |
$30.25
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$28.14
|
| Rate for Payer: Healthscope Commercial |
$31.65
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$26.38
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$29.89
|
| Rate for Payer: Nomi Health Commercial |
$28.84
|
| Rate for Payer: PHP Commercial |
$29.89
|
| Rate for Payer: Priority Health Cigna Priority Health |
$22.86
|
| Rate for Payer: Priority Health HMO/PPO |
$30.60
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$23.56
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$30.95
|
| Rate for Payer: UHC Core |
$29.37
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$26.38
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
OP
|
$223.79
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$53.15 |
| Max. Negotiated Rate |
$201.41 |
| Rate for Payer: Aetna Commercial |
$190.22
|
| Rate for Payer: Aetna Medicare |
$58.19
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$69.93
|
| Rate for Payer: Amish Plain Church Group Commercial |
$69.93
|
| Rate for Payer: BCBS Complete |
$89.52
|
| Rate for Payer: BCBS MAPPO |
$55.95
|
| Rate for Payer: BCBS Trust/PPO |
$183.98
|
| Rate for Payer: BCN Commercial |
$174.00
|
| Rate for Payer: BCN Medicare Advantage |
$55.95
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cofinity Commercial |
$192.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.03
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$55.95
|
| Rate for Payer: Healthscope Commercial |
$201.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.84
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$58.74
|
| Rate for Payer: MI Amish Medical Board Commercial |
$64.34
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.22
|
| Rate for Payer: Nomi Health Commercial |
$183.51
|
| Rate for Payer: PACE Senior Care Partners |
$53.15
|
| Rate for Payer: PACE SWMI |
$55.95
|
| Rate for Payer: PHP Commercial |
$190.22
|
| Rate for Payer: PHP Medicare Advantage |
$55.95
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.46
|
| Rate for Payer: Priority Health HMO/PPO |
$194.70
|
| Rate for Payer: Priority Health Medicare |
$56.51
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.94
|
| Rate for Payer: Railroad Medicare Medicare |
$55.95
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.94
|
| Rate for Payer: UHC Core |
$186.86
|
| Rate for Payer: UHC Dual Complete DSNP |
$55.95
|
| Rate for Payer: UHC Exchange |
$55.95
|
| Rate for Payer: UHC Medicare Advantage |
$55.95
|
| Rate for Payer: VA VA |
$55.95
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.84
|
|
|
HC RO GUIDE LOC TARGET VOL TX DEL
|
Facility
|
IP
|
$223.79
|
|
|
Service Code
|
CPT 77387
|
| Hospital Charge Code |
33300061
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$145.46 |
| Max. Negotiated Rate |
$201.41 |
| Rate for Payer: Aetna Commercial |
$190.22
|
| Rate for Payer: BCBS Trust/PPO |
$182.68
|
| Rate for Payer: BCN Commercial |
$172.94
|
| Rate for Payer: Cash Price |
$179.03
|
| Rate for Payer: Cofinity Commercial |
$192.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$179.03
|
| Rate for Payer: Healthscope Commercial |
$201.41
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$167.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$190.22
|
| Rate for Payer: Nomi Health Commercial |
$183.51
|
| Rate for Payer: PHP Commercial |
$190.22
|
| Rate for Payer: Priority Health Cigna Priority Health |
$145.46
|
| Rate for Payer: Priority Health HMO/PPO |
$194.70
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$149.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$196.94
|
| Rate for Payer: UHC Core |
$186.86
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$167.84
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$418.23 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: Aetna Medicare |
$854.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,027.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,027.50
|
| Rate for Payer: BCBS Complete |
$439.17
|
| Rate for Payer: BCBS MAPPO |
$822.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,703.06
|
| Rate for Payer: BCN Commercial |
$2,556.42
|
| Rate for Payer: BCN Medicare Advantage |
$822.00
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.00
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Mclaren Medicaid |
$418.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.10
|
| Rate for Payer: Meridian Medicaid |
$439.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$945.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PACE Senior Care Partners |
$780.90
|
| Rate for Payer: PACE SWMI |
$822.00
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: PHP Medicare Advantage |
$822.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,860.56
|
| Rate for Payer: Priority Health Medicare |
$830.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.96
|
| Rate for Payer: Railroad Medicare Medicare |
$822.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.44
|
| Rate for Payer: UHC Core |
$2,745.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$822.00
|
| Rate for Payer: UHC Exchange |
$822.00
|
| Rate for Payer: UHC Medicare Advantage |
$822.00
|
| Rate for Payer: UHCCP Medicaid |
$418.23
|
| Rate for Payer: VA VA |
$822.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL COMPLEX
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 77386
|
| Hospital Charge Code |
33300051
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,137.20 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,683.99
|
| Rate for Payer: BCN Commercial |
$2,540.97
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,860.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.44
|
| Rate for Payer: UHC Core |
$2,745.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
IP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$2,137.20 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: BCBS Trust/PPO |
$2,683.99
|
| Rate for Payer: BCN Commercial |
$2,540.97
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,860.56
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.96
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.44
|
| Rate for Payer: UHC Core |
$2,745.48
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO IMRT DEL SIMPLE
|
Facility
|
OP
|
$3,288.00
|
|
|
Service Code
|
CPT 77385
|
| Hospital Charge Code |
33300050
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$418.23 |
| Max. Negotiated Rate |
$2,959.20 |
| Rate for Payer: Aetna Commercial |
$2,794.80
|
| Rate for Payer: Aetna Medicare |
$854.88
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$1,027.50
|
| Rate for Payer: Amish Plain Church Group Commercial |
$1,027.50
|
| Rate for Payer: BCBS Complete |
$439.17
|
| Rate for Payer: BCBS MAPPO |
$822.00
|
| Rate for Payer: BCBS Trust/PPO |
$2,703.06
|
| Rate for Payer: BCN Commercial |
$2,556.42
|
| Rate for Payer: BCN Medicare Advantage |
$822.00
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cash Price |
$2,630.40
|
| Rate for Payer: Cofinity Commercial |
$2,827.68
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$2,630.40
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$822.00
|
| Rate for Payer: Healthscope Commercial |
$2,959.20
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$2,466.00
|
| Rate for Payer: Mclaren Medicaid |
$418.23
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$863.10
|
| Rate for Payer: Meridian Medicaid |
$439.17
|
| Rate for Payer: MI Amish Medical Board Commercial |
$945.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$2,794.80
|
| Rate for Payer: Nomi Health Commercial |
$2,696.16
|
| Rate for Payer: PACE Senior Care Partners |
$780.90
|
| Rate for Payer: PACE SWMI |
$822.00
|
| Rate for Payer: PHP Commercial |
$2,794.80
|
| Rate for Payer: PHP Medicare Advantage |
$822.00
|
| Rate for Payer: Priority Health Choice Medicaid |
$418.23
|
| Rate for Payer: Priority Health Cigna Priority Health |
$2,137.20
|
| Rate for Payer: Priority Health HMO/PPO |
$2,860.56
|
| Rate for Payer: Priority Health Medicare |
$830.22
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$2,202.96
|
| Rate for Payer: Railroad Medicare Medicare |
$822.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$2,893.44
|
| Rate for Payer: UHC Core |
$2,745.48
|
| Rate for Payer: UHC Dual Complete DSNP |
$822.00
|
| Rate for Payer: UHC Exchange |
$822.00
|
| Rate for Payer: UHC Medicare Advantage |
$822.00
|
| Rate for Payer: UHCCP Medicaid |
$418.23
|
| Rate for Payer: VA VA |
$822.00
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$2,466.00
|
|
|
HC RO INFUS RADIOACTIVE MATERIAL
|
Facility
|
IP
|
$331.89
|
|
|
Service Code
|
CPT 77750
|
| Hospital Charge Code |
33300042
|
|
Hospital Revenue Code
|
333
|
| Min. Negotiated Rate |
$215.73 |
| Max. Negotiated Rate |
$298.70 |
| Rate for Payer: Aetna Commercial |
$282.11
|
| Rate for Payer: BCBS Trust/PPO |
$270.92
|
| Rate for Payer: BCN Commercial |
$256.48
|
| Rate for Payer: Cash Price |
$265.51
|
| Rate for Payer: Cofinity Commercial |
$285.43
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$265.51
|
| Rate for Payer: Healthscope Commercial |
$298.70
|
| Rate for Payer: Lakeland Regional Health Systems Commercial |
$248.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$282.11
|
| Rate for Payer: Nomi Health Commercial |
$272.15
|
| Rate for Payer: PHP Commercial |
$282.11
|
| Rate for Payer: Priority Health Cigna Priority Health |
$215.73
|
| Rate for Payer: Priority Health HMO/PPO |
$288.74
|
| Rate for Payer: Priority Health Narrow/Tiered Network |
$222.37
|
| Rate for Payer: UHC All Payor (Choice/PPO) |
$292.06
|
| Rate for Payer: UHC Core |
$277.13
|
| Rate for Payer: Van Buren County Sheriff Dept. Commercial |
$248.92
|
|
